Tech Policy Flashcards
HIPAA breach reporting
if NOT encrypted, must report to individuals within 60 days. Public media and HHS if more than 500 records. Annual report to HHS.
CFR45
Requires security risk analysis and updates
Human Factors, what suggests poor usability
Redundancies, workarounds, low completion rate
Fitt’s Law
Usability concept. Index of difficulty is a function of mousing distance and width of target
Usability Testing
Testing - Coached, or talked through, or observation of system usage
Inspection - Mock-up, wireframe
Inquiry - Examine with an eye towards heuristic principles (Nielsen’s)
CLIA
As pertains to EHR, report must contain performing lab, reference intervals, and units of measurement (this is in addition to obvious identifier requirements)
Patient Access Rule
Pts can get lab results DIRECT from lab, but lab has no obligation to interpret. Can defer to medical records if they have ALL labs and are HIPAA-compliant.
CLSI
Clinical Lab Standards Institute. VOLUNTARY standards developed by the industry, higher bar than most regulations.
Barcodes
1D has 1/88k error rate, 2D is far superior but harder to install, and needs more software to read. Code 128 is the most common 1D.
Meds must include NDC in the barcode
No established standard on pt armband!!
HL7
Health Level 7 International, both a standard and the group that develops the standard. Named after the OSI internat layer system, level 7 due to application layer. Version 2 aimed for syntactic interoperability, and Version 3 (still being implemented) aims for semantic interoperability.
HL7, Version 3
Aims for semantic interoperability based on Reference Information Model, and object model (like OOP) of messages. Object classes are Entity, Role, Participation, Act, Action Relationship.
Uses XML as language framework for this.
CDA
Clinical Document Architecture. Multi-level approach to document interoperability. Starts with just categories of notes, goes deeper into standardized structure, and then finally into coded discrete data elements. So, structure may be “HPI” but discrete data is “cough, duration 3 days”, etc.
DICOM
Digital Imaging COMmunication. Standard for transporting images. Common to most PACS systems. Extensive use of headers to specify manufacturer, modality, and other important technical details.
ELINCS
EHR Laboratory Interoperability and Connectivity standards. Aims to create standards around how EHRs send and receive lab data, in part by constraining HL7 coding options in lab fields
Blue Button initiative
Aimed at creating a simple way (“Easy button?”) for consumers to access the full suite of their health information. Ideally this would cover all systems and providers, but of course is a major technical challenge.
