Written on February 23rd, 2010 by tasha
Search engines love blogs. Having a blog means that your website gets updated on a regular basis. It also adds content on topics of interest to your customers. The more useful the content, the more likely it is that others will link to you. With one tool, therefore, you are able to hit three of the top five factors that will boost your ranking in a search engine result.
Blogs are fun and easy. Of all the social media (Facebook, Twitter, YouTube, etc.) a blog is quick and casual, requiring very little computer knowledge. If you know Word, you will be able to find your way through a blog application, and can even post pictures and videos if you have them available in your archives.
A blog is not a small project, however. Where your business website is like a fish (set up the aquarium and then it needs relatively minimal maintenance), a blog is like a puppy. It needs to be monitored daily and you need to post on it regularly. (I would say once a week.) Your articles do not have to be long. And they can be more commentary and opinion, rather than a fact-based research article. Still, you do need to have a writer who can take a factoid or two and produce 200-300 words of fairly interesting content on a regular basis. Many hospices have closet writers on their staff. Ask around. You may be surprised.
Because a blog invites comments from readers, you need to be ready with policies in place to address negative comments, and assure that protected health information is not revealed by staff, or by the commenters themselves. (Think HIPAA.) Safeguards can easily be put in place to handle both, but it takes some preparation and forethought before you jump in and start blogging.
If you would like to learn more about blogging (and Facebook, Twitter and YouTube for that matter), please come to the Pre-Conference workshop Social Media and Hospice (PC-05) that I will be co-presenting at the NHPCO Management and Leadership Conference with 3 other in-the-trenches hospice social media folk: David Cherry (of NHPCO); Susan Wallace (of the Ohio Hospice and Palliative Care Organization); and Liza Paul of The Mount Carmel Hospice.
Tags: classic, Management and Leadership Conference, NHPCO, Social Media and Hospice
Posted in Blogging, Hospice Marketing, Internet Marketing, Social Networking
Written on February 17th, 2010 by tasha
The new HITECH regs went into effect today. Most particularly, these include:
- increased rights for patients to have access to their records.
- increased responsibilities of covered entities to make sure any allied businesses working with patient data also have HIPAA protections in place.
- specific clarification of notification procedures if the security of sensitive and potentially harmful information has been compromised.
- increased civil, and now criminal penalties for individuals, in the event of HIPAA violations.
I’d love to hear what folks are doing to accommodate the new regs. Please comment!
In preparation for this day, I have recently been researching HIPAA and thought I might share some insights. Understand, I am not a lawyer. And my System Administrator will tell you, with the kindest, gentlest smile on his face, that I know enough to be dangerous. With those disclaimers in mind, therefore, here is my lay person’s take on performing a HIPAA tune-up.
HIPAA was originally written to protect the kind of information that would be in an electronic health record. However as a “covered entity” (and now your business associates also), privacy protections extend to anything that is considered “Protected Health Information” (PHI). While you might think that PHI includes things like diagnoses and treatment information, the definition is much broader. There is a very long list, but some examples of PHI include the obvious and not so obvious:
- Name
- Phone number
- Address
- Email Addresses
- IP Address (the address of someone’s personal computer)
- Photographs
- Medical Record numbers…
If I’m understanding correctly, any quasi-unique piece of data that might be used to trace back to the actual identity of the individual, even if it is NOT linked to medical treatment or diagnostic information, is considered PHI. Some compliance experts I have spoken with say that even the name of a relative is considered PHI. Working with family caregivers as I do, this is important to know.
Providing HIPAA protection involves 3 components:
- Policies regarding the behavior of employees (and now your business associates and their employees and subcontractors). These include restricting access to PHI to a need-to-know basis; training and updating employees on what kinds of information they can/can’t give and to whom; appointing someone in charge of monitoring security; having enforcement procedures with consequences for those who violate the protective policies…
- Physical protections include measures such as keeping paper records under lock and key; keeping electronic data on servers that are physically located in an environment where only authorized personnel can enter; keeping computer monitors out of hallways or other publicly visible venues.
- Technology protections including password protection on sensitive files; encrypted storage of data (so even if a hacker did get access, they couldn’t easily read the files); periodic auditing of security to uncover and repair vulnerabilities; a log to be able to trace who and when access to information was provided; an incident reporting system that monitors and conveys information if there has been an unauthorized breach; a system for recovering data if it has been scrambled or otherwise destroyed; a system for destroying data once an account is closed.
With the new HITECH rules, these protections become like a string of mirrors, as the covered entity needs to be sure the business associate has protections in these three domains, and business associates need to be sure their business associates have protections who in turn…you get the picture.
The policies and physical protections are elements you will need to construct internally. In shopping for assistance for my own business, I was impressed with the consultative offerings of Trustwave. They are not set up for smaller operations (sadly, no templates for standard policies are available). But for larger enterprises, they seemed to provide a comprehensive service to assist with HIPAA compliance. Like much of the tech security industry, they are oriented around securing sensitive financial information, such as online credit card transactions. Their particular acronym for that is PCI (Payment Card Information). But many of the PCI protections actually apply to medical information and PHI, so companies such as Trustwave have expanded to include HIPAA services as well.
The technology component, especially if you do not have a large operation, will require that you contract with a specialized Internet Service Provider that is versed in the necessary protections and can provide you with logs, incident reporting, periodic security audits, etc. A simple, common sense precaution is to keep your sensitive data separated from other online data, such as your company website. The good news with this separation is that you don’t need to contract for space and traffic large enough to encompass all your Internet activities, just those that involve PHI.
Just to give you sampling of what’s out there, in my own shopping for the technology side I ran across 3 services that caught my eye:
- INet U and Firehost approach HIPAA protection in slightly different ways, but offer basically comparable services. They give you a protected server to store your sensitive information, and the technological infrastructure you need to assure encrypted storage of information, a log of who accessed which data when, monitoring to alert you if there’s been an unauthorized intrusion, etc. They keep on top of the rules and have the techies make sure that their computer systems pass muster. This liberates you to focus on the policies and physical protections back at your home base.
- For smaller operations that really just have a few forms they want to have available online, I confess I was intrigued by the ingenuity of LuxSci. What caught my eye about them was what appeared to be a relatively simple method of creating forms and storing/transmitting the data securely. You could even work with existing pdfs. They also have a system for secure (encrypted) email communication. LuxSci seems to be designed for smaller operations, with a sliding fee scale based on how much room and how many actual forms you host on their server.
This is by no means an exhaustive list. And I’m sure there are many other services out there. It just seemed appropriate to share some of the findings I came across in my own HIPAA tune-up in case they might prove useful for you.
Happy HITECH DAY!
Tasha
P.S. For more information on the new regulations, I would suggest the National Hospice and Palliative Care Organization’s HIPAA-HITECH tip sheet and a superb HIPAA-HITECH presentation prepared by the law office of Hogan & Hartsen.
Tags: classic, HIPAA, HITECH, NHPCO
Posted in Technology
Written on February 11th, 2010 by tasha
Useful insights from the new report by AARP and the National Alliance for Caregiving.
Caregiving research has long pointed out that subjective perception of stress has the strongest impact for family caregivers. Certainly, physical strain is consequential. But two caregivers can engage in the same level of care, same tasks, and spend the same amount of time, yet one can perceive it as fine while another finds it overwhelming.
Even when the baseline health of the caregiver is taken into account, it is those family members who feel stressed and overwhelmed who also incur greater health problems (including higher mortality rates) than those who do not consider themselves stressed. Caregiver strain is VERY important.
The National Alliance for Caregiving 2009 study of family caregivers found that:
- 46% report little to no stress from caregiving
- 22% report moderate stress
- 32% report high levels of stress
On the good news side, nearly half report a level of stress that is manageable. But it is those in the high stress category that need attention and may well be looking for help.
Specific groups are more likely to report high levels of stress. Below I include those subpopulations mentioned by the report, along with my own commentary based on the caregiving literature:
- Female caregivers (36% as opposed to 23% of males). This is consistent with the caregiving research. Scientists posit that females tend to be more in touch with their emotions and do not have the same societal pressures to downplay emotional response. It could be that men are equally stressed but less likely to recognize or acknowledge it. At the same time, researchers also observe that men tend to view caregiving from a task-based perspective. They theorize that male caregivers may be able to compartmentalize the pressures of elder care into a context that is more like a job and therefore less emotionally charged.
- Those who say their own health is fair or poor (47% as opposed to 22% of those who rate their own health as excellent). Coping with personal health challenges on top of the health challenges of a loved one can make for a very stressful lifestyle. In fact, family caregivers are known to ignore their own health needs, postpone doctor appointments, and often require major emergency interventions because they did not attend to problems when the symptoms were minor. The needs of the care receiver are often given precedence over those of the caregiver. Take-home message: encourage caregivers to see their doctors and follow recommendations, if for no other reason than they will be better able to continue giving care for the long haul. Draw upon their selflessness. “What would your loved one do if something happened to you?”
- Those who report a high level of time and care receiver dependency (51% as opposed to 19% for those spending less time caring for elders who are more independent). Watching a loved one decline can be very stressful. Watching a loved one suffer, even more so. And that doesn’t take into account other stressors, such as juggling home and work and caregiving when a loved one requires 30, 40, and more hours of attention per week. Respite and other support services are an excellent remedy for these high-stress/high-risk caregivers. Here is where information about available services, such as an online directory of local programs, can come in handy and also put you top-of-mind in terms of positive associations for helpfulness.
- Those who live with the care receiver (46% as opposed to 28% who do not “co-reside”). According to this study, approximately 20% of care receivers live with their family caregiver, making them at higher risk for caregiver strain. Most of these caregivers likely are spouses, but they are also adult children, siblings, and others. Caregivers who co-reside with their care receiver typically report a greater amount of time spent and higher level of dependency, and also report that they are in only fair or poor health themselves. Other conditions associated with co-residing are low income ($50,000 or less) and being unemployed (although 17% of employed caregivers also report that their care receiver lives in the same household).
- Those who care for persons with Alzheimer’s (40% as opposed to 28% of those caring for persons with conditions other than dementia). All the literature supports the sad fact that Alzheimer’s and other memory loss conditions are undeniably the most stressful for caregiving families. Personality changes, embarrassing behaviors, and emotional outbursts are just some of the challenges presented by conditions that impact the brain and cognitive functioning. Respite, adult day centers, education concerning behavioral strategies, and access to support groups (in person or online) can do much to relieve the extra strain experienced by these families.
What programs do you have that might be especially supportive and help you reach these high-stress/high-risk caregivers?
Tags: AARP, classic, National Alliance for Caregiving
Posted in Family Caregivers, Research Results
Written on February 8th, 2010 by tasha
Find out at the NHPCO PreConference April 21.
While there has been a lot of publicity about the swelling ranks of Boomers on Facebook, the demographics deserve a closer look. I will be co-presenting at this 3 hour workshop on Social Media and Hospice (PC05), offered in conjunction with the NHPCO Management and Leadership Conference in Washington, DC this April. Joining me will be in-the-trenches social marketing hospice folks David Cherry (NHPCO), Susan Wallace (Ohio Hospice and Palliative Care Organization) and Liza Paul (Mount Carmel Hospice).
This very practical course is designed to help you make wise strategy decisions. The focus will be on setting realistic objectives for several different departments that might benefit from the unique strengths of social media:
- Marketing/Sales
- PR/Outreach
- Fund-raising
- HR
- Volunteers
- Advocacy
This overview workshop includes topics designed help you chart a course in the dynamic, but sometimes intimidating world of Web 2.0:
- Facebook
- Twitter
- YouTube
- Blogging
- Demographics
- HIPAA and other important policy issues
- Measuring success
No programming experience is needed! (In fact, we we’ll be talking strategy the whole time. No HTML allowed!)
There are many advantages to participating in social media, not the least of which is increased exposure and search engine optimization for your company website.
If you have any questions about the session, by all means, contact me. I’d be happy to answer them: tasha@elderpagesonline.com
Or post them as comments here.
Tags: Management and Leadership Conference, NHPCO, Social Media and Hospice
Posted in Blogging, Facebook, Hospice Marketing, Internet Marketing, Social Networking, Twitter, YouTube
