Category Archives: General

The Latest HIPAA Updates in Response to COVID-19

In light of the novel coronavirus (COVID-19) pandemic, government officials, medical professionals, and public health authorities have been forced to navigate an increasingly difficult situation. With a focus on affording the population widespread access to care, many regulations have recently been amended in order to assist the health care system in combating the spread of COVID-19. During an infectious disease outbreak or other emergency situation, It is important for clinicians to continue adhering to official mandates despite the national emergency.

As such, the Office for Civil Rights at the U.S. Department of Health and Human Services has recently shared an updated bulletin reminding health care providers of the ways in which patient information can be shared under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. As per the HIPAA rule, the notice recognizes the need for public health officials to have access to protected medical information as a method of protecting the health and safety of both individual patients and the public at large. As such, it permits covered entities to disclose protected health information without authorization when mandated necessary.

Guidelines for Sharing Patient Information

The HIPAA Privacy Rule is intended to protect the privacy of patients’ health information, with exceptions made for appropriate disclosures of information when necessary to treat a patient, protect the nation’s public health, and for other critical purposes. In the case of a global pandemic, such disclosures may be warranted more frequently as public health organizations and government officials rely on patient health information to inform their directives.

Serving as a reminder of the protections of the Privacy Rule which are not set aside during an emergency, the latest bulletin provides essential guidance for health care providers. The latest HIPAA regulations are outlined below and can be found on the U.S. Department of Health and Human Services’ website as well.

Treatment Information

Under the Privacy Rule, HIPAA-covered entities may disclose protected health information about a patient as necessary to treat both the patient and other patients without authorization. This includes the coordination and management of care as well as all other related services by one or more health care providers and others, consultation between providers, and the referral of patients for treatment.

Public Health Activities 

The act recognizes the legitimate need for public health officials and others responsible for ensuring public health and safety have to access protected health information that is necessary to carry out their mission. Under the Privacy Rule, covered entities can disclose the needed health information without patient authorization to public health authorities, at the direction of a public health authority to foreign government agencies, and to persons deemed at risk.

Health care providers are permitted to disclose such information to a public health authority – an agency or authority of the United States government, a State or a territory responsible for public health – as well as an individual acting under a grant of authority from such an agency. This includes the CDC or a state or local health department authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury, or disability. Examples include the reporting of disease of injury and vital events (such as births or deaths) or conducting public health surveillance, investigations, or interventions.

Under these regulations, a covered entity may disclose to the CDC protected health information as needed to report all prior and prospective cases of patients exposed to or suspected or confirmed to have COVID-19. Furthermore, protected information may be disclosed to individuals deemed at risk of contracting or spreading the virus – if allowed for by state law – to notify persons as necessary and prevent the spread of disease.

Disclosures to Family Members and Others 

According to the HIPAA Privacy Rule, a covered entity may share protected health information with a patient’s family members, relatives, friends, or other involved individuals. Information may also be shared to identify, locate, and notify anyone responsible for the patient’s care, as well as to convey the patient’s location, general condition, or death. Recipients of this information can include family members and other persons involved in the patient’s life, the police, the press, or the general public. Furthermore, a covered entity may share protected medical information with disaster relief organizations, such as the American Red Cross. However, the covered entity should receive verbal permission from patients when possible before disclosing such information.

Disclosures to Prevent Serious and Imminent Threat 

Clinicians are permitted to share protected patient information with anyone to prevent or lessen a serious and imminent threat to the health and safety of a person or the public under applicable law and standards of ethical conduct. Providers may disclose information to anyone who is in a position to prevent or lessen imminent threat without prior permission. Although, in such cases, health care professionals are urged to use professional judgement and care in making determinations about the severity of imminent threat.

Disclosures to Media or Others Not Involved

Unless otherwise noted in the bulletin, clinicians cannot disclose information about an identifiable patient to the media or public at large without written authorization from the patient or their personal representative. However, covered entities may disclose limited medical information in cases of incapacitated patients. Additionally, information can be shared about patients who have not restricted the release of protected health information if this is done in the best interest of the patient or in response to a request to disclose information about a particular patient asked for by name.

Share “Minimum Necessary”

In the majority of cases, information disclosed should be kept at a “minimum necessary” although, this does not apply to disclosures to health care providers for treatment purposes. Under the Privacy Rule, covered entities may rely on representations from public health officials to ensure the requested information is the minimum necessary. For example, covered entities may rely on CDC representations that protected health information requested by the CDC about all patients exposed to, suspected or confirmed to have COVID-19 is the minimum necessary for the public health purpose.

Safeguarding Patient Information

Medical professionals must prioritize safeguarding patient information; clinicians are responsible for protecting patient health information against intentional or unintentional impermissible uses and disclosures. Covered entities must apply the administrative, physical, and technical safeguards outlined under the HIPAA Security Rule to ensure the confidentiality of electronic medical data.

HIPAA-Covered Entities and Business Associates

Lastly, the HHS’ bulletin reminds clinicians of who the HIPAA Privacy Rule applies to. Currently, the Privacy Rule applies to disclosures made by employees, volunteers, and other members of a covered entity’s or its business associate’s workforce. This includes health plans, health care clearinghouses, as well as health care providers that conduct one or more covered health care transactions electronically. Under the rule, business associates are defined as individuals or entities that perform functions or activities on behalf of or provide services to a covered entity that involve the use of protected health information. These also include subcontractors working on behalf of other business associates.

As such, the Privacy Rule does not apply to disclosures made by entities or other persons who are not covered entities or business associates, such as third-party administrators.

Understanding and following HIPAA rules is crucial to navigating the increasingly complex clinical setting during the global COVID-19 pandemic. Health care professionals are urged to treat all medical information as confidential, affording it HIPAA protections to operate out of an abundance of caution. Disclosures of protected health information should be made only to authorized personnel and care should be taken to ensure patient data is not shared unintentionally. During these tumultuous times, public health organizations and experts will continue to release the latest guidance as it becomes available to help health care providers tackle the disease while protecting themselves.

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The Biggest Wellness Trends of 2020

Last year, the rise of cannabidiol (CBD), intermittent fasting, meditation, and many other health and wellness trends dominated the $4 trillion global wellness industry. As this segment of the market continues to grow rapidly, technologic advances, emerging clinical findings, and shifting priorities are likely to influence burgeoning wellness trends for the coming year. Recently, experts from across the world gathered to forecast the biggest health trends that will take over the global wellness industry in 2020 as part of the Global Wellness Summit (GWS).

Alongside a focus on fixing disrupted circadian rhythms and mental health-promoting devices, the most significant projected trends for the forthcoming year are outlined below:

Circadian Health Optimization

According to one of the world’s leading experts on circadian health and associate professor of medicine at Harvard University Dr. Steven Lockley: “The absolute key to healthy sleep and circadian rhythms is stable, regularly-timed daily light and dark exposure—our natural daily time cues.”

Today, humans have incredibly disrupted circadian rhythms as a result of increased screen time and travel, rising stress levels, and a 24/7 culture. Current research suggests that circadian rhythms influence a variety of bodily functions ranging from hormonal fluctuations to body temperature regulation. Most importantly, they can significantly influence sleep patterns, impacting productivity and health.

As part of the solution, the concept of circadian rhythm optimization centers around adjusting the daily schedule, dietary patterns, and environmental cues to sync up with the body’s internal clock. Experts at the Global Wellness Summit predict an increased amount of people shifting their work schedules in accordance with their chronotypes, which The Sleep Foundation describes as the natural pattern by which people sleep and wake best, in an effort to optimize performance and productivity.

“Given that most of our body systems express circadian rhythms, ensuring proper alignment of our internal circadian clocks,” Dr. Lockley further explains, “starting with the management of lighting, will have major impacts on human health.”

Mental Health Technology 

The National Institute of Mental Health estimates that over 42% of 46.6 million adults with mental illness in the United States received mental health treatment in 2017. In addition, the growing patient base of Millennials is more likely to address mental health concerns than previous generations, with about 70% saying they feel comfortable seeking help. Wellness technology companies have begun to capitalize on this increased acceptance and technological advancements by developing digital therapeutic products and services.

Tech-savvy individuals are increasingly using virtual therapy apps – such as TalkSpace and BetterHelp – and digital support groups to combat modern-day issues including burnout, loneliness, depression, and anxiety. The behavioral health software market is now projected to reach $2.31 billion by 2022 and as we shift toward a more holistic approach to wellbeing, will likely continue growing.

As part of this rising trend, mental wellness wearables are growing in popularity with the introduction of meditation headsets that measure heart and breathing rates and wearable biosensors that monitor physiological signals throughout the day. These devices aim to improve stress levels, sleep patterns, and daily habits based on biologic metrics directly obtained throughout the day. For example, Sentio Solutions recently announced a new product, Feel, which is an emotion-sensing wristband with integrated biosensors which measure users’ physiological signals. Paired with an accompanying cognitive-behavioral therapy (CBT) app, it aims to help those suffering from anxiety and depression by offering on-demand support.

However, many of these technologies are still in the early stages of clinical trials and require further investigation before they can be released.

Japanese Wellness 

In 2017, Japan had the largest per capita ratio of centenarians in the world with 67,824 people aged 100 and above. The country is known for the longevity of its population, with up to 50% of Japanese citizens born in 2007 expected to reach the age of 107. Japanese culture promotes ways to ensure long, fulfilled lives with a growing emphasis on a sense of community and work-life balance. As a result, the world is turning to Japan for longevity tips leading to the popularization of “J-wellness”, or Japanese-inspired wellness.

The practice prioritizes connecting to nature, including forest bathing which can have a beneficial effect on both mental and physical health by reducing blood pressure, stress hormones, anxiety, and depression levels. In addition, Japanese government officials emphasize social community wellness through policy measures and innovations tailored to aging societies. This includes neighborhood facilities designed for generational mingling and stress assessment programs conducted to improve work-life balance and emotional wellbeing.

Fertility Healthcare

The growing de-stigmatization of infertility and reproductive health has opened the dialogue and increased awareness of these prevalent issues, encouraging more companies to offer fertility treatments – such as in-vitro fertilization and egg freezing- as benefits to their employees. Fertility healthcare is projected to rise to the top of wellness trends to support the 12 out of 100 couples in the United State struggling to become pregnant, per data from the U.S. Department of Health and Human Services.

Current fertility benefits do not cover all procedures and reproductive assistance technologies tend to be expensive with a single round of IVF averaging above $20,000. According to the GWS report, fertility clinics are forecasted to democratize and simplify access to care, alongside innovative fertility-focused wearable technology and smartphone apps that help educate individuals and monitor important fertility metrics. Furthermore, a growing number of fertility start-ups such as KindBody, which received $10 million in investor funding last year, are beginning to infiltrate the space. Current data indicate that the femtech sector could reach a market size of $50 billion within the next five years.

Continuous research initiatives and emerging technological advancements are spurring the global wellness industry at a 12.8% compound annual growth rate. In 2020, the wellness economy will be more accessible to the average consumer than ever before, making the above trends increasingly relevant in the practice setting. Physicians should be equipped with the latest clinical knowledge to better educate patients on the potential risks and benefits of these emerging solutions and ensure their health and safety.

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How to Boost the Immune System in Times of Global Epidemic

There have now been over 290 cases of confirmed novel coronavirus in the United States and a total of 14 deaths related to the disease. The number of infected individuals outside of mainland China – the epicenter of the virus – is quickly rising and increasingly becoming a cause of global public health concern. As the epidemic continues to spread worldwide with no current solution, worries of a pandemic are profound; hand sanitizer and facial mask supplies are being depleted by anxious individuals hoping to protect themselves from exposure in this still uncontrolled situation.

External protection including virus protection masks may have the opposite of their intended effect, increasing the risk of infection instead. Frequent and proper hand-washing is consistently proving to be the most effective method of preventing the disease, while reducing exposure to COVID-19 is imperative – as is fortifying the body’s natural defense system.

Protecting the Immune System

With the number of confirmed novel coronavirus cases escalating, now is the time to focus on boosting the immune system to naturally protect the body from the evolving epidemic and effectively fight off the infection.

Maintaining a healthy lifestyle – by following good-health guidelines – is vital to naturally keep the immune system strong and functioning at its optimal capacity. Individuals hoping to protect their immune system or boost its strength should employ healthy living strategies such as: regular exercise, weight management, conscious nutritional choices, limited alcohol consumption, and adequate sleep patterns. Further, it is important to minimize stress levels as cortisol overproduction can impair immune functioning; ensuring a healthy work-life balance, taking breaks when necessary, and incorporating meditation along with other stress-reduction techniques can help support both physical and emotional wellbeing.

Boosting Immunity

While there are no quick tips to immediately boost the health of the immune system, there are several practices that can help promote optimal immune functioning over time. For example, eating foods rich in antioxidants – such as berries, garlic, and onions – can reduce the risk of virus infection as well as consuming anti-inflammatory foods on a daily basis – such as fresh vegetables and fruits – which lower body-wide inflammation, supporting systemic functions, and combating age-related chronic diseases.

Ensuring quality sleeping patterns is essential to rebuilding a struggling immune system as is the avoidance of toxins. Minimizing exposure to chlorinated drinking water, pesticides, aromatic hydrocarbons, heavy metals, pollution, and food additives can help protect against the negative effects of common toxins on the body’s immunity.

Due to its systemic nature, the immune system is challenging to boost with a singular solution. Therefore, following a holistic, healthy lifestyle, avoiding noxious elements, and reducing stress levels can have a profound impact on immune functioning. Although none of these solutions are “quick-fixes” to staying healthy in the face of a global epidemic, improving current lifestyle habits can greatly boost both physical and mental long-term health, making the body less susceptible to viruses and diseases while minimizing their severity if they do occur.

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