How Good Is the Patient Data Security in Your Multi-Disciplinary Clinic Applications?

Written by: Sue-Ellen McKelvey DC PhD MBA

We are all constantly seeing in the media security breaches and the “value” seen in personal health information (PHI) by cyber criminals. These activities remind all in the healthcare industry to stay aware of this very real potential threat. The front desk/reception is to have a daily vigilance from email phishing and scams to maintaining software password protocols. The organization must have an absolute commitment to maintain the security of patient data; the concept is huge. 
A series of measures are now part of good management; all must be actively checked and all in agreement that only by working at all levels against cyberattacks can any clinic/health organization or software platform protect this critical information.
Personal health information (PHI) is priceless and increasingly this realm of ‘identity’ is the target of thieves and hijackers.  Your clinic server can be hacked, or vital health information accessed; often data is at its most vulnerable when being up and downloaded; check all is encrypted when being transferred. We have grave concerns about the security of data in any transfer across the internet; check if you are using an unsecured patient portal for your clinic or how PHI is shared in electronic exchange such as email.
Of course, you already have policies in place securing patient clinical data from ‘internal clinic staff or inappropriate eyes’- but in 2021 the management needs to be more proactive — putting more dynamic measures in place across their organization to check what is the set-up around all data that is PHI?
Check the secured access to PHI: What can and can’t be seen by the different members of your clinical, front desk and administration staff? Some clinical notes that must be kept 100% closed to prying eyes should be able to be secured 100% to a specific user log in; sensitive information around a patient’s mental health is an absolute requirement in 2021?  The increased use of Telehealth for remote healthcare exchange and management plans from a distance must only be delivered in a secured platform. Can you audit all who access this sensitive data? Could a hacker gain access via the online booking site or telehealth program with which you have done a recent integration? Ask the right questions of all the software you use for your healthcare business. Ask if you can quantify in a report what PHI (data) is accessed by whom; across all the staff working in your clinic and those accessing via online means such as telehealth, patient portals and online booking sites?
Unfortunately, often the most common response is, “I’m not really sure...”. 

Post Covid –19 is going to be a more complex healthcare environment; your clinic has any points of vulnerability get some answers and set up proactive measures to show there is no breach point in the security approach your clinic maintains for securing personal health information that is “in your hands”.

Any clinic software solution for the coming decade must offer a clear cybersecurity risk management. You and your clinic staff as a healthcare /medical organization must have a team approach to vigilance from email phishing awareness to not sending PHI as email attachments. In 2021 get some demo’s that show you a clear security approach in their software cybersecurity approach; in partnership with great software you will then be able to confidently optimize your practice approach (medicolegal consents and operational security as much as transferring clinical notes and protecting PHI). Assess the software’s capacity to set-up ‘secured roles’ to ensure an audit trail of user access to sensitive personal health information. 
You may need to set up a team of disciplines working together as a team but can you still protect confidential or sensitive health information concerns. Can you enable a patient to choose a preferred provider or restrict another provider’s access to their records? Clinician teams may want to nominate a management team by name and tailor who can access to clinical notes; in a client centric approach the client/patient themselves may want to see an audit of where their PHI has been shared. 

This is the future.
As Primary Health providers accelerate provision of multi-disciplinary health services, the capacity to selectively secure patient data as to which provider and which approved staff member can access to view becomes critical.
In a patient’s healing program, clinical data is shared by many - nursing and support staff as well as several disciplines. The patient is in the middle of this ‘information sharing’; active and online. Can they just use an e-consent to share and have this automatically in their file?    
Check the cybersecurity risk management of the patient portal you use. Any online access to your clinic may have a point of breach if attacked by criminal experts. Secure the ‘up and download’ of data; this is an overt security weakness recognized as a potential ‘hole’ for hackers.
Visual Outcomes USA adheres to the highest of  standards in always modeling all parts of its complete healthcare software platform to protect personal health information (HIPAA 2020 sees this post Covid world as having more and more  Multi-Disciplinary  teams) 
Primary health is now a team approach of many providers with more patients interacting online via their portal or with Telehealth. From now on, increasingly it is a fact that online care is seen by all our clients or patients as the new normal.
So, all of us must be proactive and have dynamic measures to avoid cyber vulnerabilities and checks for local user vigilance using the internet.

Time to gear up!
– sleep well with daily reports of ‘reproducible’ audits and PHI control.
Older software is still active – its modeling from the 80s and 90’s is covered with other security software Integrations. But often built to serve a single modality, a part-record or a ‘selected’ clinical note could not be securely isolated when patient requires confidentiality between practitioners in a multi-disciplinary team clinic environment. 

As we move into different forms of team-based care, methods for ‘secured’ notes are to be versatile and reproducible; reportable and auditable. And have a security matrix around PHI; vital in a client-centric Multi-Disciplinary Enterprise Clinic. 

Visual Outcomes is a purpose-built enterprise solution of a one database software platform offering PMS CRM Accounts and Billing, inbuilt Reporting Engine and multi-disciplinary clinical note recordings; offering a secured online portal with inbuilt Telehealth; designed for a multi-disciplinary clinic and/or many locations with differing set ups. 
In one platform it includes

• Team shared care health plans: all secured online.
• A flexible appointment scheduler/book for multi-disciplinary processes
• PHI security in all data uploads and downloads; fully audited.
• Online tracking of outcomes / e-consents as a part of online care/telehealth

Visual Outcomes is an integrated secure solution hosted in AWS Cloud hosting services; world standards of transfer encryption with only secured storage facilities.
This gives assurances to all stakeholders within your enterprise management as well as government regulators and professional reporting requirements. 

You can have all expected standards in your clinic/s with a purpose-built enterprise software solution. Do it under your watch and do it now!

Patient Portals: Improved Communication Means Improved Client Satisfaction

Patient-centered care is now prevalent as a 'discussed' model of delivery; the many stakeholders across the healthcare industry talk to its value. It has become clear that the average healthcare consumers are more satisfied with their care when they feel valued as an important member of their own healthcare team; considered and asked to be involved in critical decisions. Communication is key to building the solid, collaborative healthcare relationships that lead to those feelings of empowerment and engagement. Patient portal software gives providers the means to open the lines of communication, sometimes slowly at first and then increasing the frequency and quality of interactions between themselves and their clients. 

Patient portal software can streamline communications; bringing tasks online that are generally handled much less efficiently face to face or via the telephone. Areas of clinical need such as prescription renewal and referral requests, appointment booking and management, and viewing /explanations of test results. Clients can receive alerts from their healthcare providers via patient portals, reminding them of appointments, preventive care needs and/or prescription renewals, or set up alerts on their own to ensure that they remember to take medications or perform self-monitoring tasks. Providers can also deliver patient-specific health education and information to clients via the portal, supporting their efforts to become a well-informed and active participant in their care. 

Perhaps the most important of patient portal software features to engender trust in this new online Dr/patient relationship is how the provider/client communicate online. It must be respectful and effective. This involves secure messaging features, online video interactions, forums where personal health information PHI is secure, personal viewing of own health information and ongoing results and there must be online patient feedback measures that are monitored by the clinic admin team. 

Online viewing of sections of their personal health files, clients not only have access to their own health information but can be set up to be able to contribute – uploading their own photos of self- improvements, outputs from personal devices, current meals and new diets, home care observations, clinical concerns, medication compliance and other measures of self-monitoring. When the clinician team is ready, they can review these details and set up calls, online sessions and/or secure messages. Future 'patient centered healthcare' is about this type of online file - acted upon by their own healthcare team with them in the cycle of exchange. Online the clients can provide feedback quickly and efficiently, place info directly into their file; the client involved in their own outcomes - making a client more likely to make the effort. We must remember, after everything - it is all about fostering good relationships where both the provider and the client trust each other more and each feel 'heard' in their combined efforts to achieve better health. 

Not only does providing these tools facilitate more frequent and more efficient communication and information-sharing between provider and client, putting patient portal software to use in these ways adds efficiency and convenience to routine healthcare interactions. This benefits clients by reducing the time and effort involved in self-management. It also lightens the administrative load on providers and their staff, which benefits all by freeing more time for meaningful client-provider interactions and improved customer service. Better customer service, like better communication, helps ensure that clients feel valued, respected, and empowered in the healthcare relationship, leading to improved client satisfaction.   

by Dr Sue-Ellen McKelvey PhD MBA DC DO  

Patient or Client in 2021?

What we call the person is not as important as the relationship we have with them and most importantly, the outcome of that relationship.

Since the earliest days of medical care, a person was seen as in a doctor patient relationship. The person was called patient as the Latin origins of the word implied; one who endures or is suffering. Indeed, the trust was in the doctor and the knowledge and skills they had to change the suffering of that person.

The word patient is still relevant today. Arguably, a person who arrives unconscious following an automobile accident to the local emergency department is closest to the origins of the word patient. They may have a next of kin ready to decide for them or another person with them, but the presumption is that they are needing care and that is decided by the person with the knowledge and skills entrusted with their needs. This person is very ill, or so sick or injured that they are deemed a more passive recipient of care.

If the person arrives and sees themselves as not “sick”, are they a patient?

As an example, if informed by their healthcare professional they have a chronic health condition with test results indicating added health risks they are an active participant when informed this way.  This become more of a ‘client’ relationship with the healthcare system; their healthcare professional has made them ‘armed and active’ with this information.[i]. But they must act for their health status to change; they have an active participant role. Their own decisions and behaviors are determinants in their healthcare outcomes, nothing will change if it is a passive relationship with their healthcare professional.

There is an argument that the term ‘patient’ is a more respectful one, whereas the term ‘client’ is one of that is fiduciary in nature; logic being that the healthcare exchange is not a financial one[ii]. However, the modern healthcare system and its relationships or encounters do serve the economics of its financial management.

It can be said that the current healthcare experience of the more developed societies is more complex. There are new levels of healthcare relationships with more “forks in the road” to be navigated; no longer only a trust relationship of doctor-patient exchange.

There is a possibility that this increasing complexity may require some new measures of trust for the person as they build a relationship with the healthcare system. A transparency of information and a measure of accountability may engender a new trust for the person in their journey through the healthcare system.

Finally, there is no consensus as to an alternative word for patient. What do you think?

We will continue to explore these relationships for a person in their total experience of healthcare in 2021 in this weekly blog.

[i] Shades of grey: patient versus client. Ratnapalan, S. CMAJ.2009 Feb 17;180(4):472 doi:10.1503/cmaj.081694
[ii] Patient, client or customer: what should we call the people we work with? Brinkman, J.T April 2018 retrieved from www.opedge.com
[iii] For whom do you care – patients or clients? Bonsall, L. April 13 2016 blog retrieved from www.nursingcenter.com/april2016

All in one platform  

Visual Outcomes is modeled on the client in their own journey ©2021 

Visual Outcomes is a 10-year established healthcare platform with full inventory management and a global reach of practice management features and practitioner-specific operational functionalities.  

Visual Outcomes is dedicated to achieving successful outcomes for all, measured by client-centric outcomes tracking alongside clinical outcomes and pathology tracking with client feedback online. 

Visual Outcomes is about the Quadruple Aim: business owners and clinician satisfaction alongside client /patient satisfaction, with great treatment outcomes and efficiencies of healthcare costs. 

Many advantages of Visual Outcomes as a unified healthcare data management platform  

1. Full inventory management in the same platform 
2. Clinical flows and online bookings for locations and a virtual clinic  
3. Remote health care management including telehealth  
4. Online clinic access/ portal for clients of the clinic  
5. Engaged and active clients are decision makers in their own journey 
6. Medical and non-medical processes accommodated as a team approach  
7. Team care plans shared online: the client as part of the team  
8. Individual health journeys online exchange; client-centric outcomes tracking 
9. Enterprise business development management services; dashboard reporting  
10. Data integrity in Visual Outcomes delivers to IPO level of financial requirements  

Clinics 

Online bookings for telehealth and in clinic appointments 

Clients can upload information to their own clinical file online 

Practitioners see what clients uploaded, pre consult and during consultation 

Use Telehealth and virtual consultations as a booking option online 

Remote online questionnaires and management of client programs   

Online ordering of supplements 

• Individual programs managed 
• Order online repeats 
• Self-record journey > testimonials  
• Bookings online 
• Virtual appointments 
• Client-centric models of interoperability  
• Record securely and with client consented management planning of crossovers 

Full Dispensary 

On the shelf products 

• Quality control of batches delivered and re traceable  

Ranges of prescribed formulae  

e-prescribing  

Ordering online  

Full inventory management  

All automated as stock ordering /receiving/ barcodes/ min and max stock levels 

All stock take management and profit/sales analysis and reporting 

Enterprise Business Services of Visual Outcomes 

Set goals for specific clinics and identified ‘teams’ in Visual Outcomes  

Create Value: analyze the utilization profile of bookings and clinical throughput 

Observe in daily reports attendances cancellations and ordering levels  

Marketing analysis to set email campaigns e,g, highest sales across client profiles  

Set rewards with a dashboard of KPIs  

Focus on each of the clinics /dispensary profitability and quality improvements 

Select reports to be deidentified and used for staff/practitioner motivation daily 

Set up automated stakeholder reporting on a weekly /monthly or quarterly basis 

Peer reviews across practitioner-types/ clinic standards and goal setting/ KPIs and reward in dashboards across the groups 

Financial entitlements calculated according to agreed algorithms in the platform  

Reports for individuals as to the agreed method of calculated entitlements  

All data is identified as from the transaction within the Visual Outcomes platform  

Keep entitlements calculations transparent to minimize disagreements and optimize the relationships of business owners and clinic staff/teams of workers  

Tailored reporting and data analytics with a ‘Topic- in focus’ for online business sessions 

Meeting with stakeholders regularly online as enterprise business team 

Review dashboards of ‘real time’ data from KPIs to client patterns and profitability progress 

See daily/weekly updates to see that the goals and vision of the organization is on track 

Welcome 2021

Here we go into a world of uncertainty where we are still unsure daily as to what is normal.

What is for sure, is we are increasingly aware of the importance of data security and more remote online healthcare. 2021 requires vigilance in the choices made in a world of online healthcare and related services increase. As the world of 2021 embraces the use of more and more online sessions. Visual Outcomes is supporting dynamic vigilance as to cybersecurity and user access risk management. We announce the new release this week with a booking schedule now for upgrades to this latest version over the next 6 weeks. Please read the below highlights and attached document.

Telehealth

2020 was a tumultuous year of challenge and change. Many individuals who resisted remote healthcare as too “distant” embraced the safety of home-based care and these online sessions. There is wide acceptance of remote care as now a normal type of appointment; just online. Payers accept it as a valid service. Clients themselves are particularly notable in their acceptance of these sessions as follow ups and check-ins with them as to health changes and personal health programs.  Request a demo and latch this facility on to your Visual Outcomes platform.

Online bookings –   new clients book directly in your website

In 2021, you have the option of adding ‘NEW to the Clinic’ bookings as you want them booked. The set up of services follows what times and days you want to drive those bookings. When Visual Outcomes web-based portal (VOiSite) is implemented you automatically have practitioners seeing their appts and existing clients can book online. Now, you can add NEW to the Clinic bookings online directly, not via a third-party software. This is your own secured booking system. Please review the attached new features document.

Payments online – Stripe secured credit cards managed only by your client (patients).

Stripe payment is a secured system; credit card information is not kept in Visual Outcomes. Stripe is a secured online payment method for clients to pay invoices, products, and services.

Customer data protection (User password security and TFA)

Visual Outcomes has increasing required authentication online and optimizing password changes.

Visual Outcomes supports your risk management of unauthorized access to customer data:

1. Password change standards enforcing a complexity-type of user password

(Password audit service is available for your user password change protocol management)

2. Two Factor Authentication (TFA) adds access security for existing users on web-based portal (VOiSite) as a client(patient), online practitioner or other authorized personnel.

New Visual Outcomes release coming

A Sensible and Secure Messaging System for the Australian Health Sector  

Australians who prefer a collaborative team approach to their health have faced this barrier for many years. Secure, yet efficient, electronic communication around their chosen healthcare team has not been available. Too many systems not talking to each other, resulting in frustration all round, not to mention real inefficiencies.  

Visual Outcomes has always championed the clinician and client team approach - around you and with you, the patient.  

Your Visual Outcomes online portal already channels you in, boosting your voice. And now we have been working with the Australian Digital Health Agency, the Australian Health Department’s 'make it happen’ agency.  to enable: 

• searching via a federated directory to send messages, rather than through multiple individual directories, 

• standard messages that will provide interoperability, and message exchange, with different secure messaging software systems, and  

• encryption standards ensuring that messages are exchanged securely. 

The outcome is to be smooth communication among your practitioners and related health organizations important to your personal journey.  

The government’s strategy here has been to bring as many parties together as possible to consistently embed interoperable standards for secure messaging systems. 

In our anticipated Visual Outcomes new release (Version 20.10.30) planned for October 2020 the platform is there, in place. As the digital health industry moves to align with these secure messaging standards, Visual Outcomes will have it available for all practices wishing to share secure messaging.