Quick Finds: HIT/Data

Remote Scribes, Transcription, Talk-to-Type, and Virtual Assistants: Tools for Decreasing Documentation Burden in the EHR; Developed October 2019 (2020). Resource Type: Publication. Description: Electronic Health Records (EHRs) have replaced obsolete paper medical charts and records, and their ability to exchange health information electronically have helped organizations provide higher quality and safer care for patients. However, despite their numerous advantages, EHRs can create an overload of documentation and clerical responsibilities for physicians, placing an increased demand on physicians’ time and compromise efficiency. Medical dictation, transcription, and scribing services have become an increasingly popular solution to address this hindrance. This resource introduces different transcription, scribing, and dictation services, and reasons why health centers should consider using them to reduce the burden of EHR documentation. More Details...

HITEQ Highlights: Using Health IT to Facilitate the Development and Administration of a PrEP Program (2020). Resource Type: Archived Webinar. Description: The HITEQ Center is launching a new webinar series for health centers to learn how their health center peers are using health IT to improve HIV prevention and care. For the first webinar, Using Health IT to Facilitate the Development and Administration of a PrEP Program, Robert Harris from the Community Health Center of Buffalo, Inc. described their whole system approach to develop an IT-supported PrEP program. Robert presented how they developed a viable and sustainable PrEP program maximizing the use of IT resources while minimizing the amount of staff resources needed to administer the program effectively. More Details...

HITEQ Highlights: Updates to the HITEQ UDS Clinical Analysis Dashboards (2020). Resource Type: Archived Webinar. Description: During this HITEQ Highlights webinar, learn about the updated HITEQ Center’s UDS dashboards, available on the HITEQ site for HCCNs, PCAs, and health centers, as well as a nationwide version available to all website visitors. These dashboards show UDS clinical quality measure reporting from calendar year 2018, historical data, and benchmark data from Healthy People 2020 goals. These updated dashboards include a number of new features, to allow users to compare outcomes across various groups to improve the understanding of how certain characteristics correlate with clinical quality outcomes. More Details...

HITEQ Highlights: Documentation Tips when using the Collaborative Care Model for the Treatment of Depression and Anxiety in Primary Care (2020). Resource Type: Archived Webinar. Description: Join the HITEQ Center, in collaboration with the National Council for Behavioral Health, for a webinar on Documentation Tips when using the Collaborative Care Model for the Treatment of Depression and Anxiety in Primary Care. The webinar provided a brief overview and benefits of the collaborative care model as well as information specific to each of the main staff roles. The role-specific nuances of documentation were highlighted, including considerations for tracking data such as clinical activities accomplished with each patient during the month. More Details...

Health Center Health IT/ EHR Assessment Tool: For PCAs and HCCNs to Assess Health IT across Multiple Health Centers; Updated in 2019 (2020). Resource Type: Publication. Description: HITEQ created this template to assist HCCNs, PCAs, or other organizations in conducting health IT assessments of multiple health centers. The questions within this instrument were adopted from proposed UDS health IT capabilities questions and the HITEQ Center's Meaningful Use readiness assessment survey. This instrument may include some questions that are more comprehensive than some organizations need, but a secondary goal is to ease future responses to UDS and other health IT-related surveys. More Details...

Assessing Provider Satisfaction: And how to design health IT interventions to improve satisfaction and reduce burden, January 2020 (2020). Resource Type: Publication. Description: This resource puts forth several options for assessing provider satisfaction or burden, with a focus on health IT. Each provider assessment also includes information about cost and access. In addition to surveying providers, there is other information that can be assessed for baseline when planning an intervention to decrease burden. These can be used for pre– and post-intervention monitoring and evaluation. Finally, related research findings, including the overall relationship between EHR and provider satisfaction, regulatory and documentation requirements, the impact of training, provider autonomy and role in EHR design, and in-basket management, are described. More Details...

HITEQ Highlights: Getting Started with a Social Media Strategy for HIV Prevention and Care (2020). Resource Type: Archived Webinar . Description: Join the HITEQ Center for a webinar on how to develop a social media strategy to improve your health center’s HIV prevention and care outreach. Using the POST (People, Objectives, Strategy, Technology) method, attendees learned how to use social media more efficiently to reach your target audiences. We also reviewed social media platforms including Facebook, Instagram, and Twitter, their uses and differences. Attendees received recommendations for social media management and graphic design tools at the end of the discussion. More Details...

Collecting Sexual Orientation and Gender Identity (SO/GI) Data In Electronic Health Records (2020). Resource Type: Archived Webinar. Description: Alex S. Keuroghlian, MD, MPH and Chris Grasso, MPH present the most up-to-date information and strategies for collecting sexual orientation and gender identity information. More Details...

EHR-Related Resources for 330 and RWHAP Dually Funded Health Centers: Resources curated from TargetHIV.org and other sites in October 2019 (2019). Resource Type: Publication. Description: Health centers funded by the Ryan White HIV/AIDS Program (RWHAP) must submit the Ryan White Services Report (RSR) annually and often maintain separate databases from their EHR to do so, which is less than ideal in many situations. This document summarizes resources related to integrating RWHAP data reporting requirements into EHRs, including specific vendors, as well as those related to improving HIV service delivery using technology. More Details...

Strategic Cybersecurity Breach Protection and Incident Response: Guidance and Resources for Health Centers (2019). Resource Type: Other. Description: This is Part 2 of HITEQ's Health Center Defense Against the Dark Web presentation series. This presentation provides general knowledge about breach mitigation and planning strategies for incident response. More Details...

Health Center Defense Against the Dark Web Presentation: Strategies for Building Security Awareness, Education and Compliance (2019). Resource Type: Other. Description: This cybersecurity presentation explores key concepts and best practices that should be followed by Health Centers seeking to develop Defense in Depth and effectively implement hardened security programs at their sites. Part 1 of this series will seek to motivate and educate the health center workforce on critical privacy and security concepts and methods for defense. Aspects of Security Risk Assessment, security awareness training, and breach protection will be covered with an emphasis on health center-wide information protection. More Details...

Improving Diabetes Outcomes: Curated Expert Guidance, Tools, and Resources, Updated September 2019 (2019). Resource Type: Toolkit. Description: As of CDC's 2017 National Diabetes Statistics Report, 30.3 million people, or 9.4% of the total U.S. population, have diabetes. Of these 30.3 million, only 23.1 million are diagnosed—while the other estimated 7.2 million are undiagnosed. This illustrates the need for targeted quality improvement and implementation of promising practices to address diabetes and needs of diabetic patients. This toolkit includes curated expert guidance, tools, and resources for enhancing care processes and outcomes for diabetes control, preventive care, and others targets for improvement. More Details...

Increasing Access to Healthy Food and Exercise in Public Housing Communities: Examples From Public Housing Primary Care Grantees (2019). Resource Type: Publication. Description: Public housing residents face the challenge of living in communities with poor access to healthy foods and safe places to exercise. Addressing access to healthy food and improving diet and exercise are critical components in improving the health of public housing residents. This report provides examples of Public Housing Primary Care Grantee strategies and programs that have increased access to healthy food, exercise and weight control models for public housing residents. More Details...

Ransomware Guidance Presentation for Health Centers: Updated with Ransomware Strategies from CISA (2019). Resource Type: Publication. Description: This ransomware guidance presentation for health centers, updated with ransomware strategies from CISA, provides information about ransomware, HIPPA implications, recent examples from the news, and suggested resources. More Details...

Center of Excellence for Protected Health Information: FOCUS: PHI is a SAMHSA-funded source for clear and accurate information about patient privacy and confidentiality (2019). Resource Type: Other. Description: Clear and accurate information about confidentiality is important to ensure that patient privacy is protected and that privacy laws are not erroneously interpreted to prevent disclosure of patient information. Individuals living with mental illness or substance use disorders may not seek care without guarantees of confidentiality and privacy protections. Clarifying privacy protections and promoting communication of patient records is critical for improving patients’ access to care and quality of treatment once in care. The Center for Excellence for Protected Health information is supported by SAMHSA and includes key resources around privacy and confidentiality. More Details...

Building and Sustaining a Data Driven Culture: HITEQ Webinar (2019). Resource Type: Archived Webinar. Description: The HITEQ Center conducted a webinar on building and sustaining a data driven culture for Community Health Care Association of New York State. This webinar introduced concepts, tools and examples to help manage data as a strategic asset, align data strategy with organizational strategy, and explored ways to implement a data services function. More Details...

Panel Management in the Age of Value-Based Care: Health Center Case Studies Developed with Chiron Strategy Group, June 2019 (2019). Resource Type: Publication. Description: This downloadable HITEQ resource offers guidance on improving panel management activities, including real-life examples from two health centers of the challenges and successes in managing panels. More Details...

HITEQ Highlights: Developing Community Health Centers Along the Continuum of Pay for Performance (2019). Resource Type: Archived Webinar. Description: This HITEQ Highlights webinar described the continuum of value-based contracting, and suggested steps for health centers to move up the continuum. It also outlined basic elements of infrastructure to perform well in a value-based environment. Presenters from Yakima Valley Farm Workers Clinic presented their experience. More Details...

Nurse Closer Process: Using Nonclinician Staff to Make Patient Visits More Efficient (2019). Resource Type: Other. Description: The Nurse Closer process was designed and implemented to use non clinician staff to make patient visits more efficient. The model drives quality by combining team-based care with technology and allows all team members to work at the maximum capacity of their license. The goal of the process is to achieve higher value care with out increasing clinical expenses or provider burn out. More Details...

Health Center EHR Transition: Tips for everything from selection to contract negotiation to implementation (2019). Resource Type: Publication. Description: The HITEQ Center has a number of EHR transition tools that may be helpful for health centers that are considering a transition from one EHR to another. This resource brings together all these tools for easy access. More Details...

Compliance with 42 CFR Part 2: A Case Study with Community Medical Centers, Inc. (2019). Resource Type: Publication. Description: Health centers are actively expanding the substance use treatment services they offer in the community to address access to care for opioid use disorders, and more broadly to address better screening, referral and timely access to all substance use disorder (SUD) treatment. This case study is an example of how a health center is assessing operations to comply with 42 CFR Part 2, with a particular focus on changes to their health information technology (IT) systems. It includes a 42 CFR Part 2 Regulatory Checklist that health centers may find particularly helpful to review. More Details...

HITEQ Highlights: Addressing Childhood Obesity in Health Centers (2019). Resource Type: Archived Webinar. Description: This webinar focused on how to improve child weight screening, nutrition and physical activity counselling, and design appropriate and meaningful interventions according to health center peers. A number of tools that support this quality improvement around addressing child weight and potential for obesity were discussed, including Bright Futures guidance and data validation tools from HITEQ. More Details...

Telehealth Office Hours:: ADA issues in Telehealth (2019). Resource Type: Archived Webinar. Description: This presentation provides a high-level overview of accessibility considerations in telemedicine under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act. We will discuss various types of services and modifications to help ensure that people with disabilities have equal access to telemedicine services. More Details...

HITEQ Highlights: Growing and Sustaining a Data Driven Culture (2019). Resource Type: Archived Webinar. Description: Building on the HITEQ Center’s previous webinars that introduced an Analytic Capability Assessment, building a roadmap for action and using data governance to maximize the value of data, the third webinar in this series explored how to grow and sustain these efforts. More Details...

HITEQ Highlights: Using Health Information Technology to Enhance Opioid Use Disorder Treatment (2019). Resource Type: Archived Webinar. Description: The Health Information Technology, Evaluation, and Quality Center (HITEQ) hosted this webinar on promising and innovative practices for the use of health information technologies (IT) to enhance opioid use disorder (OUD) treatment. The webinar also featured the experiences and practices of health centers which are currently using health IT to enhance OUD services. More Details...

EHR Vendors Most Frequently Used by Health Centers: 2014 through 2017, according to information reported in the UDS. (2019). Resource Type: Publication. Description: These graphs and tables use health center reported UDS data from 2014 through 2017 to identify the 10 EHRs most frequently used among health center programs, and shows the change between years. Updated in late 2018 with 2017 data, these graphs and tables use health center reported UDS data from 2014 through 2017 to identify the 10 EHRs most frequently used among health center programs, and shows the change between years. Download the PDFs below for all the information. 2014 and 2015 information was taken from the EHR Form in the UDS, and 2016 and 2017 information was retrieved from the Health IT Form in the UDS. 2018 information will be added when available. Each of these forms can be seen in the UDS manual for the given year here.  Efforts have been taken to normalize data for aggregation purposes such as to combine those that reported "Next Gen" and those that reported "NextGen"; otherwise, all information is used as reported by health centers without further verification.   More Details...

HITEQ Highlights: Managing Data as a Strategic Asset: Data Governance Fundamentals (2019). Resource Type: Archived Webinar. Description: In this webinar, the HITEQ Center presented the essentials of good data management processes and introduce the Center for Care Innovation’s Data Governance Handbook, offering ideas for action and tools to improve data quality, increase data literacy, and maximize access to data. More Details...

Health Center Data Validation Tool: Tool to Validate Adult BMI UDS Clinical Measure Reporting from EHR (2019). Resource Type: Publication. Description: This Excel-based tool is designed to support validation of EHR reporting for the Adult BMI clinical measure by comparing results from EHR to results from chart reviews or examination of underlying data. This assists in identifying specific data elements that are not being captured appropriately, either as a result of workflow or EHR report logic, and thereby effecting compliance rates. More Details...

Hepatitis B and the Opioid Epidemic: Opportunities to Increase Adult Vaccination: Webinar Resources (2019). Resource Type: Archived Webinar. Description: This webinar focuses on strategies to prevent and eliminate hepatitis B as a U.S. public health threat, particularly among special and vulnerable populations impacted by the opioid epidemic. To access the slides and recording, follow the link provided More Details...

Annual UDS Clinical Measure Data Dashboard: Excel Tool for Data Monitoring (2019). Resource Type: Publication. Description: This Excel file dashboard was shared by an existing health center and is used to depict performance on UDS measures over time. It was recently updated 2018 reporting requirements and clinical measures. More Details...

A Roadmap for Building a Data Driven Culture: HITEQ Highlights Webinar (2019). Resource Type: Archived Webinar. Description: In this webinar the HITEQ Center will introduce the Analytics Capability Assessment (ACA), a tool developed by the Center for Care Innovations that allows users to look critically at an organization’s analytics capability across three key domains: people, process, and technology. By determining their level of capability in each of these factors, organizations can develop an individualized roadmap to focus and prioritize capability-building efforts. The tool also helps to demystify some of the jargon that can often alienate non-technical staff. Methods, examples, and tips for deploying the ACA in health center organizations will also be shared. More Details...

Health Center Security & Compliance System Implementation Guide: 1/1/2019 (2019). Resource Type: Publication. Description: This toolkit provides a framework for Health Centers to evaluate compliance and security concerns as they purchase, adopt, and implement technology solutions. There are ever-increasing cybersecurity guidelines and protection measures that Health Centers must navigate and digest. Newer and rurally located Health Centers can especially benefit from guidance and decision support that assists them in determining how to implement systems in a manner that meets compliance requirements and doesn't expose information to undue security risk. Identifying and managing these types of risk can be especially important when procuring new Health IT e.g. EHRs, Medical Devices, Data Warehouses for the Health Center. This toolkit provides a framework for Health Centers to evaluate compliance and security concerns as they purchase, adopt, and implement technology solutions. Every time a Health Center adopts and implements newly procured technology, they could be exposing themselves to compliance gaps and security risks. Often these topics are addressed after the solution is implemented and are an after-thought. Unfortunately, the later in the adoption process that security is considered, the costlier it becomes to address as it may require redesign or reconfiguration of software, systems, and processes. Especially important for covered entities, like Health Centers, is for this process to meet the regulations outlined within HIPAA. Throughout this document, the related HIPAA requirements are highlighted within each section so as to better understand where this process sits within broader security risk assessment SRA practices. In the Appendix of this guide is an EHR/Health IT Systems checklist that can be used as an implementation interview guide when procuring new resources. This guide can help organizations identify security concerns and design the appropriate solution starting at the design and vendor-selection phase, thereby increasing the likelihood that security will be considered fully throughout the implementation process. Download the full toolkit below, which includes the following sections: System overview Information classification and inventory Business Associate Agreements and Contracts Risk Analysis Identity management Encryption Auditing and logging Contingency planning Workstation requirements Patching Security testing Vendor and developer access Physical security Network segmentation More Details...

Addressing Childhood Obesity in Health Centers: Promising Practices and Lessons Learned: January 2019 (2019). Resource Type: Publication. Description: The HITEQ Center interviewed ten health centers and health center partners to identify solutions and promising practices for addressing childhood obesity across the health center program. The focus included how health centers are meeting the Uniform Data System UDS measure and how they are taking further steps to identify and intervene with those at risk of obesity leveraging health information technology, electronic health records, and the data they have. Seven key areas are identified in the resulting issue brief. In the Fall of 2018, the HITEQ Center interviewed ten health centers and health center partners to identify solutions and promising practices for addressing childhood obesity across the health center program. The focus included how health centers are meeting the Uniform Data System UDS measure, Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents CMS155v6, and how they are taking further steps to identify and intervene with those at risk of obesity by leveraging health information technology, electronic health records, and resulting data. Seven key areas of improvement from interviews are identified in the resulting issue brief: Key 1. Embed Needed Data Capture in Workflow Key 2. Implement Successful Monitoring to Support Decision Making Key 3. Understand the Evidence Base Key 4. Identify Key Data and Metrics Key 5. Target Interventions Appropriately Key 6. Consider Alternative Appointment Types and Locations Key 7. Create Comprehensive, Accessible Interventions Download the issue brief below to see health center examples, related research, and health IT tools for each of these keys. More Details...

Using Health Information Technology to Facilitate SBIRT Service Delivery in Health Centers: HITEQ Highlights Webinar (2019). Resource Type: Archived Webinar. Description: The webinar discussed the use of health information technologies (IT) to facilitate the workflow of providing SBIRT services. Focus areas included: coding and billing for SBIRT services, using health IT to enhance SBIRT screening, communication, data capture and documentation, clinical decision support, and information sharing and reporting. The webinar presented examples and experiences of health centers currently using health IT to facilitate effective SBIRT service delivery. More Details...

HUD Policy Brief for Health Centers - Data Matching with Housing Community: Understanding the Role and Impact of Housing Policy for Health Centers (Data Matching) (2019). Resource Type: Publication. Description: Health centers and housing providers are serving the same clients, and HUD policies foster opportunities for partners to effectively share data target and improve Health Outcomes. This series translates federal housing policies to help health centers understand the impact and how to coordinate and adapt programming to create the most beneficial outcomes for clients. More Details...

Health Industry Cybersecurity Practices: Managing Threats and Protecting Patients (2019). Resource Type: Publication. Description: Cyber threats to healthcare entities put patient health, business continuity, and IT systems at risk. Under the auspices of the Cybersecurity Act of 2015 (CSA), Section 405(d), HHS convened the CSA 405(d) Task Group to enhance cybersecurity and align industry approaches by developing a common set of voluntary, consensus-based, and industry-led guidelines, practices, methodologies, procedures, and processes that healthcare organizations can use to enhance cybersecurity. More Details...

Using Social Determinants of Health Data & New Technology Tools to Connect with Appropriate Community Resources: We asked the questions, now what? Updated in December 2018 (2018). Resource Type: Publication. Description: The collection of data related to patients' non-medical needs through use of Social Determinant of Health SDoH assessment tools, can accelerate systemic population health improvement, as well as engage patients in addressing their social non-medical needs such as transportation, shelter, or intimate partner violence services through coordinated access to appropriate services. This case study discusses the process a health center may use to identify and stratify need, and profiles a number of new technologies, including Aunt Bertha, Now Pow, and 211 Community Information Exchange, for connecting patients to appropriate community resources.   Download full case study at the bottom of the page. The collection of data related to patients' non-medical needs such as transportation, housing, food security, safety, etc. through use of Social Determinant of Health SDoH assessment tools e.g., NACHC’s PRAPARE, AAFP’s The EveryONE Project, can accelerate systemic population health improvement, as well as engage individual patients in addressing those needs through coordinated access to appropriate services.  According to a 2017 American Academy of Family Physicians AAFP survey, 83% of respondents agreed that family physicians should identify and help with social determinants of health. Research from Kaiser Permanente suggests that, of those patients screened for social determinants of health, approximately two-thirds needed some services. PRAPARE pilot data from participating health centers identified housing, utilities, and food as the most frequently identified needs. Unfortunately, 80% of the family physicians surveyed by AAFP responded that they don’t have time to discuss social determinants of health with patients and more than half feel unable to provide their patients with solutions.  So, tools are needed to help providers meet these newly identified needs, with existing resources. A number of these tools are profiled in the resource available for free download below. Much like other screenings that are embedded in the regular workflow and used to assess the risk or severity of the patient’s condition, such as the PHQ-9, Social Determinants of Health assessment tools like PRAPARE are designed to operate similarly.  Identifying level of risk or need among patients screened for social determinants of health in order to strategize responses is generally done with ‘risk scoring’. Here are two examples: SDoH only: A health center could assign 1 point per social determinant of health identified. Multiple sources: A health center could assign points based on number of chronic conditions, medications, ED visits in the last 12 months, and SDoH, as discussed in this HITEQ population health presentation. Whatever approach is taken, it is important to look at the distribution of risk scores or need levels across the patient population to ensure reasonable proportions identified as high, moderate, and low. Note that Care Management, Competency A in the PCMH 2017 standards is concerned with this. In this resource download below!, we focus on what technology tools exist to address social non-medical needs identified through screening. For those patients with high need, the standard response is likely to be health center-based and intensive. For example, patients with high need may be provided with 1 intensive case management, social workers, and referral coordinators; 2 direct assistance with connecting to resources; 3 follow up with external providers; and 4 regular in-person follow-up visits. This is likely to take up the majority of available staff capacity. However, gathering social determinants of health information may also point to other needs among patients with more moderate needs or in a broader array of areas such as paying utilities or legal services. Given staff capacity and resource limitations, as well as patient preferences, those patients may require another way to be connected with appropriate community resources. It is important that any approaches used allow for tracking and follow-up, as well as provide information about community service capacity. The tools in the case study below including Aunt Bertha, Now Pow, and 211 Community Information Exchange support this process by facilitating connection with community resources and needed follow-up, partially answering the question We collected social determinant of health data, now what do we do? Download the resource below for full case studies and lessons learned from using Aunt Bertha, 211 Community Information Exchange, and other new tools for connecting patients with community resources! More Details...

Update on the HRSA UDS Sealant Measure - December 2018 (2018). Resource Type: Archived Webinar. Description: In 2015, HRSA introduced the first oral health clinical quality measure to the UDS, with the UDS Sealants Measure. This session will highlight the 2017 UDS data results for the dental sealants measure. Topics to be included: common challenges health centers have experienced in developing, modifying, and/or implementing clinical workflows and procedures to report on the measure. Best practices and work-arounds to address data collection and reporting challenges will be shared for those health centers that are not yet using the EDR vendor-developed solutions for reporting on the measure. More Details...

Data Driven Programming to Maximize Care for Residents of Public Housing: Presented for National Nurse Care Consortium (NNCC) for health centers serving public housing patients (2018). Resource Type: Publication. Description: This presentation walks public housing-focused health centers, such as those with public housing primary care grants, through available UDS reports and tools that can be used for informing services and planning. A number of specific examples are shown of how information from the UDS can be used for improvement. Other information provided serves as a reference for reporting of public housing on Table 4 of the UDS.  More Details...

Building Data Teams and Skills: Maximizing Data Literacy and Data Governance for a Data Driven Culture: A compendium of references and tools, created in October 2018 (2018). Resource Type: Publication. Description: This compendium of references and tools is intended to support Quality Improvement efforts and to build skills across health center staff, in particular those who may be tasked with leading data literacy and data governance activities or are new to the health center world.  More Details...

Creating and Managing Strong Passwords at Your Health Center: Guidance in relation to updated NIST security requirements and HIPAA (2018). Resource Type: Publication. Description: Is it acceptable/recommended for health centers to adopt the new password policy guidelines under NIST Special Publication 800-63B and will that still uphold the HIPAA security rule? This question had been posed to the HITEQ Center asking whether we had any guidance or recommendations on implementing the new NIST Guidelines regarding password security.  New Digital Identity Guidelines under NIST Special Publication 800-63-B presents new guidelines regarding password security that are much more user-friendly and consequently more likely to be observed by health center staff since constantly changing, complex password on multiple systems can be a source of frustration for the end user.  Question: Is it acceptable/recommended for health centers to adopt the new password policy guidelines under NIST Special Publication 800-63B and will that still uphold the HIPAA security rule? This question had been posed to the HITEQ Center asking whether we had any guidance or recommendations on implementing the new NIST Guidelines regarding password security.  New Digital Identity Guidelines under NIST Special Publication 800-63-B presents new guidelines regarding password security that are much more user-friendly and consequently more likely to be observed by health center staff since constantly changing, complex password on multiple systems can be a source of frustration for the end user.  After consulting with HITEQ cybersecurity experts and consultants who have helped publish cybersecurity guidelines, the recommendations outlined below were communicated. Answer: The short answer is Yes. HIPAA is not prescriptive and takes the general stance that authentication mechanisms should be “reasonable and appropriate” for the risk they present. Being able to say that you are implementing NIST Standards is a good way to show that you are implementing “reasonable and appropriate” controls. Some standards are relaxed in regards to password change and complexity, those items shouldn’t be taken in isolation. The additional controls in the 800-63 recommendations should also be put in place and can include: Having users check passwords against password lists from breaches e.g., https://haveibeenpwned.com/Passwords  Increasing the length requirements Getting rid of password reminder questions Increasing usability Further Guidance from NCCIC/US-CERT: NCCIC/US-CERT reminds users of the importance of creating and managing strong passwords. Passwords are often the only barrier between you and your personal information. There are several programs attackers can use to help guess or "crack" passwords. However, choosing strong passwords and keeping them confidential can make it more difficult for others to access your information. NCCIC/US-CERT recommends users take the following actions: Use multi-factor authentication when available. Use different passwords on different systems and accounts. Don't use passwords that are based on personal information that can be easily accessed or guessed. Use the longest password or passphrase permissible by each password system. Don't use words that can be found in any dictionary of any language. Refer to Tips on Choosing and Protecting Passwords and Supplementing Passwords for best practices and additional information. More Details...

Increasing Access To Care thorugh Tele-Dentistry: Promising Practice (2018). Resource Type: Publication. Description: Teledentistry is an emerging trend among health centers to expand access to dental care. This promising practice will discuss the story of Ravenswood Family Health Center in California and their use of the virtual dental home model. More Details...

Behavioral Health Integration Compendium: Curated Guidance and Resources from Experienced Organizations, developed with Chiron Strategy Group (2018). Resource Type: Publication. Description: Many health centers collaborate with external behavioral health providers or provide co-located or integrated behavioral health services within their health center. Some of the most significant challenges are determining which data to share, how to store it within the Electronic Health Record, and how to use it within primary care. This compendium of literature and resources offers some guidance related to behavioral health data integration, complete with key health center considerations for each. Many health centers collaborate with external behavioral health providers or provide co-located or integrated behavioral health services within their health center. Some of the most significant challenges are determining which data to share, how to store it within the Electronic Health Record, and how to use it within primary care. This compendium of literature and resources offers some guidance related to behavioral health data integration, complete with key health center considerations for each. Click on each heading below to access the original pieces being profiled. Integrating Behavioral and Primary Care — Technology and Collaboration This article focuses on the challenges of integrating data between primary care and behavioral health. It discusses a number of concerns, and approaches that have been taken, including the benefits of developing structured data within the EHR. Health Center Takeaway: Patient consent for sharing sensitive health information can be integrated into the EHR, which will allow for greater information sharing while complying with Federal privacy expectations. Can technology shape the future of behavioral health? This article includes a number of different ways that technology plays a part in integrated behavioral health, highlighting: Adoption of telehealth as a means to augment care; Inclusion of behavioral health data in Health Information Exchanges, citing the experience of Arizona; and An example of an application being developed with NIH support that hopes to provide collaborative care tools to patients. Health Center Takeaway: Health centers are encouraged to investigate whether insurers will reimburse for telehealth and what is required to do so, to see if developing a telehealth program might augment the availability of behavioral health services for your patients. HITEQ has a number of resources related to telehealth. Integrated Behavioral Health Partners Three Case Studies on Behavioral Health Data Sharing Three California case studies where organizations shared behavioral health data.  The website includes details regarding mental health data, substance use data, consent, methods of sharing, and challenges. Health Center Takeaway: Use these examples of different approaches to consent and level of information sharing to foster conversation among your leadership on how to create greater data integration. Center for Health Care Strategies Integrating Physical and Behavioral Health Care in Medicaid Toolkit Section IV: Information Exchange CHCS has developed a rich resource for behavioral health integration.  This section focuses on information exchange, and has a number of helpful resources identified. Health Center Takeaway: The last two resources are integrated care plan templates; if you have an external behavioral health partner, consider how you might share data between the two organizations in a standardized format. Patient-Centered Primary Care Institute Behavioral Health Integration: Obstacles & Successes Lessons learned from this interview: Change the mindset from the bringing together of two services to truly integrating whole health Shift from historic care delivery methods to a focus on achieving better health outcomes Building trust with primary care providers is essential Health Center Takeaway: Determining what patients need will help guide the type of integration services your health center develops, which can include different approaches for different sites. SAMHSA’s Quick Start Guide to Behavioral Health Integration for Safety-Net Primary Care Providers This guide helps any health center think about where it is in the process of integrating behavioral health, with a number of embedded links for additional information. Key areas of Administration, Workforce, and Clinical Practice. Health Center Takeaway: Use this guide to identify barriers to a fully-developed program, and find resources to help overcome them. Zufall Health Center Integrated Behavioral Health and Primary Care Change Package Zufall Health Center partnered with a local behavioral health system to create an Integrated Behavioral Health system, using grant funding to help support the pilot. This collection of lessons learned focuses on: Leadership Commitment Clinical Information Systems and Measurable Improvement Integrated Care Delivery Clinical Decision Support Patient/Family Engagement Health Center Takeaway: Leadership must assess organizational capacity to collaborate, and then collect baseline data on health outcomes, including preventative screenings, ED visits, hospitalizations as some of the early steps. Implementing measurement and management of key clinical outcomes are critical next steps. NCQA Mainstreaming Behavioral Health Care NCQA has developed a Distinction in Behavioral Health Integration, which allows recognition of Patient Centered Medical Homes who have integrated care teams in place using evidence-based protocols and ongoing quality measurement and improvement. Health Center Takeaway: Many health centers have achieved recognition as a Patient Centered Medical Home PCMH or are along the way.  Aligning behavioral health integration work to earn this Distinction can help provide a roadmap for implementation of integration activities, and externally create validation for potential funders. How Intermountain Healthcare's Mental Health Integration is Improving Care Intermountain Healthcare is a large health system, with 22 hospitals and 180 clinics. It has been developing Mental Health Integration services for a number of years, with three key components: Their mental health assessment tool activates a team consultation workflow to determine which patients are referred. They designed an operational system in which mental health specialists and nurse care managers are included in the primary care staff, through full-time co-location or frequent rotation.They evaluate the program regularly to monitor patient outcomes, team effectiveness and the culture of healthcare delivery from the perspective of the patient and the care provider. Health Center Takeaway: Integrating behavioral health takes time. Intermountain Healthcare has created an efficient process to develop programs and they plan for two years to implement and become revenue-neutral. Health centers would benefit from a long-term approach with a commitment of upfront internal or external funding.   Deeper Reading If you are looking for more in-depth reading on the topic, visit the following links for longer articles. Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care This Journal of the American Board of Family Medicine article describes the electronic health record EHR-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology HIT solutions that emerged during implementation. Behavioral Health Information Network of Arizona: 2014 HIMSS HIE Community Roundtable This HIMSS presentation describes the design and implementation of a Health Information Exchange in Arizona that integrates behavioral health data and is 42 CFR Part 2 compliant.  Useful for any health center leadership involved in such a project with their affiliated Health Information Exchange. More Details...

The Health Center CIO’s Guide to HIPAA Compliant Text Messaging: 2018 Updates on Methods for Successful Electronic Patient Engagement (2018). Resource Type: Publication. Description: This slide deck provides health centers with information and a presentation template overview of the HIPAA and electronic PHI risks related to texting and messaging that are important for health center leadership and IT managers to understand in making organizational decisions for these types of tools.   Key considerations covered within this slide deck: Important to understand new changes to enforcement of HIPAA as it relates to portable devices, texting, and emailing of PHI. HIPAA privacy and security rules need not act as an obstacle to texting, but compliance requires planning and diligence. All forms of communication involve some level of risk. Text messaging merely represents a different set of risks that, like other communication technologies, needs to be managed appropriately to ensure both privacy and security of the information exchanged. More Details...

Effective Social Media Management for Health Centers: Infographic Poster (2018). Resource Type: Publication. Description: Maintaining a good name in the digital era is becoming increasingly important as social media tools and platforms continue to expand the services they offer. As a health center, having a professional social media presence is becoming an influential channel in which to engage patient populations. Maintaining a good name in the digital era is becoming increasingly important as social media tools and platforms continue to expand the services they offer. As a health center, having a professional social media presence is becoming an influential channel in which to engage patient populations. These channels enable physicians and health groups to communicate and share information quickly while reaching millions of people. However, these same channels and other social media activities also create new challenges for the patient-physician relationship. In the current health care environment, health centers often don’t have the time or resources to effectively manage their own social media presence.  The HITEQ Center has gathered this brief list of tips and resources to help health centers get started with managing and maintaining a professional and engaging social media presence for their health center. Think Before You Post Above all else, make sure that you are complying with all privacy and security requirements before you post to social media. It is better to be slow in responding, rather than unknowingly violating HIPAA regulations. Have 2-3 people review a post before submitting. When dealing with patient information, be cognizant of the standards of patient privacy and confidentiality just as you would in any other context. There are boundaries to the patient-physician relationship that must be maintained—online and off. Never post identifiable patient information online and monitor your own internet presence to ensure that personal and professional information are kept separate. Also, be wary of inadvertently committing an act that constitutes medical malpractice. The National Association of Community Health Center’s NACHC guide to social media and medical malpractice relates two main areas of concern when it comes to social media, technology, and medical malpractice: 1 Committing an act that constitutes potential malpractice; and 2 the impact of social media use on a potential or pending malpractice proceeding. Know Your Audience Understanding your audience is key if you want to ensure patient and stakeholder engagement. The message you want to disseminate should resonate with your target audience. NACHC’s guide to Social Media for Health Centers relates that it is important to not stray too far from the types of topics that brought people to your site in the first place.  Try to understand how a user might receive your message if you want it to stick. Doing so can help you engage with past, current, and potential patients through meaningful and relevant content. This can encourage discussions and build credibility. Understanding your audience is also a great way to get to know your patients and stakeholders; it can help you learn about their experiences with the health center, identify their pain points, and uncover new ways to improve care. Engage Your Population Respond to all messages, including both praise and criticism. As Dr. John Halamka writes, “We don’t make excuses. We try to take it offline as soon as we can. We send a direct message to the reviewer.” Customer service shouldn’t stop when you go online. Developing an online relationship with patients and stakeholders is critical in upholding your health center’s values in customer service and relations. Enhancing online communication between the physician and patient is one way to maintain that relationship. This means responding to their comments and questions, especially if it’s a complaint, is a professional and timely manner. Immediately connect with the user to resolve the issue. Practice Quality Having a social media presence comes with the responsibility to report violating content. The AMA writes that if you “see content posted by colleagues that appears unprofessional… bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions.” Also, recognize that your own actions online and the content you post may negatively affect you or your health center’s reputation. Be aware of the consequences and how they can undermine your reputation and public trust. More Details...

Collecting Data On Asian Americans, Native Hawaiians, And Pacific Islanders For Community Health Center Needs Assessments: A Learning Series - Part 2: Data Resource Training: Using Community Commons to Map & Visualize the Needs of AA&NHPIs For Community Needs Assessments (2018). Resource Type: Archived Webinar. Description: This webinar introduces the Community Commons resource and how it can serve as a great tool to help health centers collect disaggregated data on Asian Americans, Native Hawaiians, and Pacific Islanders (AA&NHPIs). It provides a live demonstration of Community Commons’ mapping technology features and their Needs Assessment Toolkit. Speakers demonstrate how these tools can be used to inform a health center’s community health needs assessment and increase knowledge of available data resources. This will help to improve health center capacity to monitor and track the needs of medically underserved areas and populations. More Details...

Relevance of the Medicare Access and Chip Reauthorization Act (MACRA) to Health Information Exchange (HIE): An Issue Brief (2018). Resource Type: Publication. Description: This document provides an overview of Medicare Access and CHIP Reauthorization Act (MACRA), how HIE links to MACRA, and how health centers might be impacted. In this brief, we describe the relationship between new federal legislation regarding physician payment and the exchange of health information among organizations. For many years, Medicare has paid physicians on the basis of a resource-based relative value scale. This approach has led to increases in resource utilization and inappropriate care rather than rewarding physicians on the basis of quality of care and patient outcomes. It has resulted in steadily increasing physician fees, which the government attempted to control by implementing the Medicare sustainable growth rate (SGR). SGR slowed the increase and could even result in decreases in physician reimbursement. There has been a need to address these issues and to provide incentives which might lead to greater value to patients and fairer physician Medicare reimbursement. Download the brief below. More Details...

Enabling Services Data Collection Implementation Packet: Enabling Services Accountability Project (2017). Resource Type: Toolkit. Description: This toolkit includes tools and recommendations for how health centers can better capture data on enabling services (ES). This will help health centers provide a better understanding of the role of ES in health care access, utilization and outcomes for Asian Americans, Native Hawaiians, and Pacific Islanders (AA&NHPIs), and useful information to appropriately address these needs. More Details...

EHR Implementation Timeline for Health Centers: A Planning Tool for Health Centers Implementing New EHRs (2017). Resource Type: Publication. Description: To ensure successful and smooth implementation or migration of electronic health record (EHR) systems, it is critical for health center staff to carefully plan the process. This timeline document highlights key events and milestones that should take place in the months before, and immediately following, the EHR go-live date. To ensure successful and smooth implementation or migration of electronic health record (EHR) systems, it is critical for health center staff to carefully plan the process. This timeline document highlights key events and milestones that should take place in the months before, and immediately following, the EHR go-live date.   This provides a simplified timeline to aid health centers in planning EHR implementation or migration. Download the tool below.  More Details...

Collecting Data On Asian Americans, Native Hawaiians, And Pacific Islanders For Community Health Center Needs Assessments: A Learning Series - Part 1: Social Determinants of Health of Emerging Asian Americans, Native Hawaiians, and Pacific Islander (AA&NHPI) Populations by States (2017). Resource Type: Archived Webinar. Description: This webinar provides a data portrait of the fastest growing AA&NHPI populations by state with profiles of their social determinants of health characteristics. The five states are Arizona, Arkansas, Nevada, North Carolina, and North Dakota. The seven SDOH characteristics mentioned are educational attainment, foreign born, language spoken at home and ability to speak English, employment status, health insurance coverage, poverty level, and household characteristics. Collecting and having disaggregated data is important to better understand the unique barriers faced by AA&NHPIs since they represent more than 50 ethnic groups and over 100 languages. Health centers can use this data to develop more culturally and linguistically appropriate programs to better serve these communities. More Details...