Friday, May 28, 2010

Charles Barkley and the Nanny State

Michelle Obama is deeply involved in her recently in the fight against childhood obesity. Eating healthy and exercising more is a laudable goal. But we want the government in the role of cooperatives Biggest Loser drill sergeant? Could the government to monitor weight has become a reality? Maybe. In an interview with Marv Albert, President Barack Obama had a question for Charles Barkley: "I have know you say you're not a model, but the first lady worked on this childhood obesity thing and they want to know if you are a good example by your movement and proper nutrition. If you could an honest answer because I have the means to check up. I have a lot of intelligence operations around. We have hidden cameras everywhere. Let us know you are, in fact, stick to your diet? " Although the president's comments should be taken lightly, the government has a mystery. Efforts to reduce obesity that individuals pray to lose weight probably no teeth (pun intended). Just to say "pretty please" or trying to make people feel guilty about being fat is only a moderate effect on weight loss and may even increase the incidence of eating disorders. On the opposite side, the government might impose (such as higher premiums) for overweight individuals who receive state-directed health care (eg Medicare and Medicaid). In this Fallthe President's threats can not be laughing.

OCR Request for Information: HIPAA Privacy Rule Accounting of Disclosures under HITECH

Today, the Office for Civil Rights (OCR), Department of Health and Human Services gave a Request for Information HIPAA Privacy Rule, entitled Accounting by requirements under the Health Information Technology for Economic and Clinical Health Act (75 Fed Reg 23 214 May 3 2010). For more information on the OCR website. The request for information by OCR seeking comments from consumers and health providers / organizations. OCR seeks information on the following areas: Understanding of the interests of individuals (health of consumers) in relation to such information and learning The administrative burden for covered entities (providers / organizations) and business partners of accounting for this information. The Request for Information says that § 13 405 (c) of the Health Information Technology for Economic and Clinical Health (HITECH) Act extends the right of individuals under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule to a payroll of information obtained from health information protected by HIPAA covered entities, and made their business partners. In particular, section 13 405 (c) of the Act requires HITECH that the rule change to require HIPAA Privacy, do the institutions concerned to disclose protected health information Account Betreatment, payment and health care operations, if such information is through an electronic health record. The request for information requests specific comments on the following nine questions: 1st What are the benefits of a financial year of the individual information, primarily for treatment, payment and health care operations purposes? 2nd If individuals get on their current right to an accounting of information? On what do you base this assessment? 3rd If you have a covered place, how to make it clear to individuals who receive their right to an accounting of information? How many requests for an accounting, you have received from individuals? 4th For individuals that have received a settlement of the information, the accounts give the individual the information he or she was looking for? Are you aware of how individuals use this information once obtained? 5th With regard to treatment, payment and health care operations disclosures, 45 CFR 170.210 (e) currently provides the standard that an electronic health record system, the date, time, patient identification, user identification and description of disclosure. In response to its Interim Final Rule, received the Office of the National Coordinator for Health Information Technology Comments on this standard andthe appropriate certification criterion suggesting that the standard also made to the disclosure (ie, receiver) and the reason or purpose, including for the disclosure. If a portion of treatment, payment and health care operations include such information, or other items, and if so, why? How important is it to individuals for the specific purpose of disclosure, ie, know it would be sufficient to describe the purpose, as a rule (eg für''für treatment, payment or'''','''' for health care operations purposes''), or more precisely, be for the accounting of value? To what extent individuals familiar with the various activities that constitute kann''Gesundheitsversorgung operations?''On what basis do you do this assessment? 6th For existing electronic systems for patient records: (A) Is the system zwischen''benutzt''und''''Angaben able to distinguish how these terms under the HIPAA Privacy Rule defined? Note that the Begriff''''Offenlegung includes the exchange of information between a hospital and doctors who are on the medical staff of the hospital, but not members of the staff. (B) If the system only the inclusion of access to information, regardless limited to whether there eggne use or disclosure, such as certain audit logs is what information is collected? How long this information is retained? What would keep the load on the information for three years? (C) If the system is able to distinguish between processing and dissemination of information on what data elements are automatically collected through the system for the data (that is, without requiring additional manual entries collected by the person to disclose)? What information, if any, will manually by the person who entered the disclosure? (D) If the system is able to distinguish between uses and disclosures of information, it is a description of the record information in a standardized form (for example, offer the system or a user must choose from a limited list of information) ? If so, is such a feature will be used and what are its advantages and disadvantages? (E) Is there a single, central electronic patient record system? Or it is a decentralized system (eg different Departments maintain various electronic systems for patient records and an accounting of information for treatment, Payment and health care operations should be pursued for each system)? (F) the system is automatically an accounting of disclosures in the HIPAA Privacy Rule under the current (ie, the systemsystem account for disclosures other than to carry out treatment, payment and health care Operations)? i. If yes, what would the additional burden to bear but also information on the implementation of treatment, payment and health care operations? Would additional hardware requirements (such as accounting, to store such information)? If such a function accounting impact system performance? ii. If not, it is another automated system for accounting of disclosures, and does it with Schnittstelledie electronic health record system map? 7th HiTech-The Act provides that a covered agency, that an electronic health record is obtained after first January 2009 must first start with the new accounting requirements January 2011 (or anytime after that date, if it acquires an electronic health record) correspond, unless we extend the compliance deadline of no later than 2013th If the covered entities be able to begin reporting information on an electronic patient record for the implementation of treatment, payment and health care operations 1 January 2011? If not, how much time it would provider of electronic health record systems for designing and implementing such a feature? Once such feature is available, how much time it would for one concerningto make open facility to install an updated electronic patient records with this feature? 8th What is the feasibility of an electronic health record module, which is devoted exclusively to information for financial reporting (both figures that are pursued for the purposes of accounting under the current HIPAA Privacy Rule and information needs to carry out the treatment, payment and health care operations) ? Had such a module to work with the affected facilities that use electronic systems to maintain patient records for decentralized? 9th Are there any other information to be helpful, the department would be regarding accounting disclosures by an electronic patient record for the implementation of treatment, payment and health care operations?

Public health nurses help make prevention actually happen

run in this year's big health care reform, I find it encouraging that the debate has widened rather than narrowed. Are important to discuss not only politicians, such as the reform of our health care system, they also discussed how actions can affect the lives of people within and outside the care system to help us healthier. Therefore, the terms "prevention" and "public health" is finally more and more familiar, even to the public, as a recent poll showed that voters rank as a top priority of preventing health care reform. But if you really health care reform legislation ending shift of the paradigm of how we think about health and health care to start when we see that policy to emphasize prevention as much as the disease, then we will also need to find out who was to be under the this new paradigm. In all the discussions on the proposed ideas for the payment and delivery of health care, there is very little discussed, such as health and the health care workforce need to be adjusted with these changes. When we arise from the health reform debate with more emphasis on prevention and public health, I think we are an undeniable need for a strong and well-vorbereiteten public health workers to help prevent diseases face, react and manage pandemics and natural disasters. And as public health nurses make up a quarter of employees in public health, they are of crucial importance for the implementation of health reform initiative that prevention priority and aims to improve the health of the population. Public health nurses focus on the health of the population, working with communities and the people who live in them. They promote the health of mother and child, prevent and combat the spread of tuberculosis and sexually transmitted diseases, and investigate food-borne diseases and other diseases. Open shelters and provide for the physical and mental health of the residents' basic needs. You implement mass vaccination clinics and will be asked to provide community based care and services during an emergency. They provide education for patients, such as chronic diseases, how to prevent diabetes and obesity. School-based nurses enable children with chronic diseases to success in the mainstream school to achieve. They are experts working both teachers and family members. The actions of the New York City nurse to the detection of the firstten confirmed cases of swine flu resulted in the city. But after the merger of State and Territorial Directors of Nursing (ASTDN), there is a severe shortage of health care. The number of public health nurses, based on the population has fallen dramatically in recent decades. The current shortage is complex. Bureaucratic recruitment procedures, inadequate wages, inadequate number of graduates of Baccalaureate Nursing and the aging population of nurses are einll contributing factors. State budget cuts also contribute to this deficiency. For example, in Georgia, the cuts are so serious that public health nurses will be on leave in order to reduce costs. Consequently, they have fought in order to provide essential public health, especially for the poor and underserved. These budget cuts also have an impact on staff in state and local health boards. The swine flu incident spurred revealed in the media reporting that budget cuts have many local health departments have exhausted the resources. Public health nurses to be dismissed, and departments are not to fill vacant positions. Public health nurses will be needed to help in areas that provide recurrent natural disasters and for the patients in case of pandemics orTerror attacks will deal. Failure to remedy the deficiencies in health care reform initiatives are truly a missed opportunity would be. We can not ignore the important contributions of public health nurses already in our country, the public health. And develop, as policy makers health reform legislation with the aim of improving quality, access, cost control and the promotion of prevention, we should examine what additional contributions of public health workers - specifically, public health nurses - offers to improve our population's health