Is Facebook Messenger™ a HIPAA Compliant Telemedicine Platform?
About John Deutsch
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
Messenger™, also known as Facebook Messenger™, is a free instant messaging app developed in 2011 and available on desktop or mobile devices. Facebook Messenger™ allows users to send and exchange messages, photos, stickers, videos, audio, and files, in addition to supporting voice and video calls. In April of 2020 Messenger Rooms™ was launched, allowing users to video chat with up to 50 people without a time limit.
With an increased demand for telemedicine during the coronavirus pandemic, healthcare providers are seeking patient messaging solutions that are easy to integrate with their practice. Since Messenger™ has widespread adoption in the US, as one of that nation’s leading messaging platforms, many healthcare organizations are wondering if the platform can be used for telemedicine. Providers might see Messenger as an easy and familiar solution to reach patients, rather than introducing an entirely new platform. Providers can offer Messenger™ as a solution, which patients already use and are familiar with, instead of having them use a new platform.
While healthcare organizations are looking for quick and convenient turnkey solutions at this time, they should be cautious to avoid penalties and legal ramifications. Implementing a video chat solution that isn’t HIPAA compliant can have serious ramifications for your practice and the security of patient data.
For Facebook Messenger™ to be considered a HIPAA compliant telemedicine platform, it must fulfill all of the following requirements:
Employ end-to-end encryption
Implement access control
Enable audit controls
Sign a business associate agreement (BAA)
Is Facebook Messenger™ a HIPAA compliant video chat solution?
Below we assess whether Facebook Messenger™ meets the security and regulatory requirements to be considered HIPAA compliant.
End-to-end encryption
Any solution that claims to be HIPAA compliant must encrypt data at all times (at rest and in transit) so PHI is not vulnerable to interception by third parties. Facebook Messenger™ does include an option to encrypt data, but users must opt-in to this feature.
Access control
Facebook Messenger™ users aren’t required to provide login details each time they view messages in the app; therefore, the platform does not implement the proper access and authentication controls. If a device is stolen that contains the Messenger™ app, an unauthorized person will be able to access the PHI shared in the app without having to log in. Due to a lack of access controls, Facebook Messenger™ is not a HIPAA compliant telemedicine platform.
Audit controls
HIPAA-covered entities must ensure there is an audit trail. All information sent within Facebook Messenger™ would need to be stored with the ability to examine user activity within the app. It’s easy for users to delete messages, therefore, it would be difficult to maintain an audit trail on Facebook Messenger™. Due to a lack of audit controls, Facebook Messenger™ is not a HIPAA compliant video chat solution.
Business associate agreement
Business associates are companies or persons that create, transmit, receive, or maintain PHI on behalf of any covered entity. A business associate agreement is a contract between a healthcare organization and a business associate that requires both parties to protect PHI under HIPAA’s rules and regulations. Facebook will not sign a BAA so is not a HIPAA compliant telemedicine platform.
What’s the verdict?
Facebook Messenger™ fails to meet all four HIPAA requirements and is not considered a HIPAA compliant telemedicine platform.
Discover whether the following popular video conferencing tools are HIPAA compliant.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
The Americans with Disabilities Act (ADA) was passed by Congress in 1990 to prevent discrimination against people with disabilities. ADA is stringent and has a very comprehensive scope. The reality is that the vast majority of websites, patient portals, and mobile apps in healthcare are often not accessible to people with disabilities. We suggest speaking to a lawyer who specializes in ADA to find the right level of compliance for your healthcare business. Bridge recommends that all healthcare businesses have an ADA policy and remediation plan in place. One should make an effort to create an ADA patient portal that includes features that are most likely to benefit one’s patient population. An increasing proportion of patients are seniors who often have age-related disabilities, which may make it difficult for them to navigate digital media. As with most things within healthcare, punishment is delegated to those that are negligent, not those that make a documented effort towards compliance.
Title III of the ADA prohibits private entities of all sizes which provide services to the public, like healthcare providers, from discriminating against individuals with disabilities. ADA used to focus on physical measures, like wheelchair accessibility and signs with braille lettering, but recent lawsuits have pointed to discrimination in the digital environment. Consumers are suing businesses and healthcare practices because their websites, patient portals, and mobile apps are not ADA compliant.
How to create an ADA patient portal, mobile app, and/or website
All non-text content is to have a text alternative that serves an equivalent purpose
Provide alternatives for time-based media
Create content that can be presented in different ways without losing information or structure
Make it easier for users to see and hear content, including separating the foreground from the background
Make all functionality available from a keyboard
Provide users enough time to read and use the content
Do not design content in a way that is known to cause seizures or physical reactions
Provide ways to help users navigate, find content, and determine where they are within the chosen software
Make it easier for users to operate functionality through various inputs beyond the keyboard
Information and the operation of the user interface must be understandable
Ensure the software appears and behaves in predictable ways
Help users avoid mistakes and provide means to correct mistakes
Content must be robust enough that it can be interpreted by a wide variety of user agents, including assistive technologies
Bridge Patient Portal offers healthcare companies a feature-rich, secure, and vendor-neutral ADA patient portal.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
If you’re considering building a CCPA patient portalyou must ask yourself: Is my patient engagement company CCPA compliant? If not, your business may be at risk. Discover exactly what CCPA is and if it applies to your healthcare business.
What is CCPA compliance?
The California Consumer Privacy Act (CCPA) is a state statute intended to enhance privacy rights and consumer protection for residents of California. The bill was passed into law on June 28, 2018, and went into effect on January 1, 2020.
The Act provides California residents with the right to:
Request a business disclose the categories and specific pieces of personal information that it collects about the consumer, and the categories from which that information is collected
Know the business purposes for collecting or selling the consumer’s personal information
Know the categories of 3rd parties with which the information is shared
Request the deletion of personal information
Opt-out of the sale of personal information by a business and not be discriminated against for exercising this right (i.e. by charging different prices or providing different quality of goods or services)
Protect the sale of minor’s personal information and opt-in to having that information sold
What is considered personal information?
CCPA defines personal information as information that identifies, relates to, describes, is reasonably capable of being associated with, or could reasonably be linked, directly or indirectly, with a particular consumer or household such as:
Name or alias
Postal address or physical address
Unique personal identifier
Online identifier
Internet protocol address
Email address
Account name
Social security number
Driver’s license number
Passport number
Physical characteristics or description
Telephone number
State identification card number
Insurance policy number
Education and employment history
Financial information including bank account number, credit card number or debit card number
Medical information
Health insurance information
What data types could be subject to CCPA?
Personal information not regulated by HIPAA
Personal information which is processed by a non-healthcare division of a HIPAA-hybrid entity, or connected non-profit
Certain employee data
Personal information collected through conferences, fundraisers, marketing events, or similar activities
The CCPA applies to any business, including any for-profit entity that collects consumers’ data, which does business in California, and satisfies at least one of the following thresholds:
Has annual gross revenue exceeding $25 million
Buys or sells the personal information of 50,000 or more consumers or households
Earns more than half of its annual revenue from selling consumers’ personal information
Organizations are required to “implement and maintain reasonable security procedures and practices” in protecting consumer data.
Even if your organization doesn’t have locations in California, if you conduct business or market your offerings in California and meet the criteria above, CCPA applies to you.
Discover how to become CCPA compliant and learn about the consequences for failure to adhere. Let us help you create your next CCPA patient portal.Contact us here.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
Bridge Patient Portal v3.0 gives patients a seamless web-to-mobile experience for scheduling, messaging, bill pay, intake, medical records and more
DALLAS, Texas, March 5, 2020—Consumers expect the same level of digital capability and self enablement from their healthcare providers that they have become accustomed to in other industries; and, at the core of that expectation is the healthcare consumer’s desire for the convenience of anytime, anywhere mobile access to their personal health information and providers. In an effort to meet patient demand for self-service tools such as self-scheduling, bill payment, patient-provider messaging, electronic prescription refills, and access to medical records, many healthcare organizations accumulated siloed solutions, creating complexity and confusion for patients while increasing costs and headaches for the healthcare organization. Now, with the introduction of Bridge Patient Portal® v3.0, small-to-large healthcare organizations can offer their patients an enterprise-class set of integrated tools and information patients need and expect to successfully manage their health from both a web application and mobile app.
“For positive patient experience, the mobile app should be branded to the healthcare organization, should provide rich functionality, and that functionality should be natively built into the app, not linked out to another app or web page,” said Bridge Patient Portal CEO John Deutsch. “Bridge Patient Portal v3.0 has much of the same comprehensive functionality as our previous version, but has been completely optimized and streamlined to work seamlessly from the desktop or mobile app. We spent the last year plus rewriting the code so our customers could publish their own branded mobile app at a fraction of the cost of other options, and patients would get what they want in a mobile app—a seamless web-to-mobile experience.”
Typically, healthcare organizations have had to choose between purchasing an elementary, unbranded mobile app, or building a custom, client-branded mobile app. Building a feature-rich, a custom mobile app has historically been cost-prohibitive for most healthcare organizations. In addition, if multiple patient engagement solutions are in use, connecting all of those solutions into a mobile app is both technically challenging and time-consuming.
According to Deutsch, client-branded mobile apps typically cost hundreds of thousands of dollars to build and implement, pricing out healthcare organizations even as large as 1,000 providers. Because Bridge Patient Portal v3.0 has been rebuilt from the ground up, it now uses one source code for its mobile app and its web application. As a result, healthcare organizations with 25 providers or more can now afford to publish a client-branded mobile app, available in both iOS and Android. The mobile app patient portal also improves the patient experience by providing them with an identical interface and capabilities as the web application.
The new development technology used for Bridge v3.0 results in a sophisticated patient engagement solution with the convenience of a single login for web and mobile. Many studies have found that increased patient portal use leads to improved patient outcomes. With comprehensive functionality for patient engagement available in a web application, mobile app, and through email/SMS/IVR messaging, healthcare consumers are empowered to help manage their own care through an integrated set of tools all under one roof.
Bridge v3.0 can reduce the costs of a full patient engagement solution which includes a branded mobile app by up to five times while reducing the complexities associated with piecemealed solutions such as managing multiple patient engagement software vendors and addressing technical problems. For healthcare organizations, the new development technology makes v3.0 easy to customize, four times faster to implement, and easier to maintain. Bridge is also vendor-neutral, can interface with multiple EHR and RCM systems simultaneously, is HIPAA-compliant, and is a 2015 ONC-Certified Patient Portal.
With input from user interface experts and existing clients, design changes were also made to Bridge v3.0 to create an optimal patient-centric experience. The new design elements make Bridge more intuitive and easier to use for patients. In addition, the new version includes a patient intake solution that allows patients to check into appointments on their phone before their appointment or at their provider’s office.
For a demonstration of Bridge Version 3.0, please visit www.bridgepatientportal.com or visit Bridge at HIMSS 2020 at booth 526.
About Bridge Patient Portal
Bridge Patient Portal is an enterprise patient portal and engagement solution that empowers patients with self-service tools to better manage their care. The Bridge Patient Portal platform is ideal for health organizations seeking to replace their existing EHR portals or connect to disparate EHR environments with a single, EHR-agnostic patient portal platform. Founded in 2012 and headquartered in Dallas, Texas, Bridge Patient Portal has installations in more than 60 physician practices, hospitals and health systems nationwide. For more information, visit https://www.bridgepatientportal.com or call 800-467-2321.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
Bridge’s new version 3 is faster to implement and costs up to five times less than alternative mobile-ready patient engagement suites
Healthcare organizations have been challenged to develop a high-quality mobile apppatient portal. But, what is considered a high-quality app in the eyes of the patient? A study by Medical Web Experts researched the top published mobile apps in the market and found the following criteria should be met to provide healthcare consumers with the best experience. The patient mobile app portal should:
Be branded to the healthcare organization
Provide rich and relevant features
Have robust functionality natively built-in, which doesn’t require the user to leave the platform
In today’s market, amongst enterprise patient portal vendors we rarely see an app that meets the above criteria and is affordable for healthcare organizations. There are feature-rich apps, but they are not branded to the healthcare organization. There are apps that are branded and appear to have rich functionality, but patients quickly discover they are being sent to a variety of websites or even other apps to find such functionality. The barriers to achieving a “high-quality” app primarily come down to technical limitations and cost, which include the expense of the app, as well as the increased costs associated with staff time and efforts to manage the app.
Cost
Cost is the biggest obstacle facing most healthcare organizations, especially those with fewer than 500 physicians. The high cost is generally a result of the significant number of hours associated with the development of a custom mobile app and the interface into the EHR/PM, or the cost associated with buying an existing patient mobile app portal and then integrating it into the EHR/PM. Per the Medical Web Experts study, a custom, high-quality mobile app that integrates into an EHR/PM source system can cost between $150,000 and $250,000. This is, of course, considerably lower than custom app development costs were even just three years ago when some of the modern coding technologies did not exist.
Technical Limitations
Depending on the healthcare organization’s IT environment, the creation of a high-quality app can be extremely challenging. The greatest hurdle that inhibits an organization from publishing a mobile app is that all of their patient information is not available in a single system. Often, larger healthcare organizations acquire smaller clinics or merge with other health systems. This often results in that organization having multiple EHR and RCM/PM systems in use. If the data is not all in one place, the mobile app must then support multiple interfaces to access each of these systems. This adds a significant layer of complexity to the project. How and which login a patient will use to access PHI-sensitive information in the app poses another challenge. The app could be configured to provide the patient with the same login that they use for their patient portal, but if multiple patient portals exist, how would this work? If a new login has to be created for just the app, the patient might need to now remember a unique login for the patient portal (web application) and another for the mobile app.
Lastly, many healthcare organizations have acquired multiple “piecemealed” patient engagement solutions to fill the functionality gaps in their EMR, PM, Patient Portal, etc. The most common siloed solutions are for appointment reminders, self-scheduling, patient intake, account management, telemedicine, and patient surveys. Today’s healthcare consumers expect that these patient-facing features should be accessible in the mobile app. However, this has created additional problems for healthcare organizations attempting to meet their patient’s expectations because with all these one-off solutions, the number of interfaces that need to be built into the mobile app multiplies.
In summary, the technical challenges and limitations faced in creating a streamlined mobile app are a direct result of how many systems need to be interfaced with and the interface capabilities of these systems.
New Technology is Changing the Market
Bridge Patient Portal is an all-in-one web-based patient engagement solution. With its most recent version, v3.0, Bridge incorporated the latest application development technology. This allows Bridge to offer a client-branded mobile app that replicates the functionality of the web application. Having a single code base that can be used for both web and mobile reduces the time and cost it takes to publish an app, in addition to reducing the entire effort to manage the mobile and web application.
Bridge has learned that cost is the greatest barrier to healthcare organizations implementing a high-quality mobile app. The time it takes to implement a solution of this scale and the effort required by a healthcare organization to support such an implementation are major decision-making factors. The chart below analyzes the cost difference between a patient portal web-only application, a patient mobile app portal and a client-branded mobile app. A third party “piecemealed” solution with both web and mobile functionality costs between $870/mo and $1270/mo per provider.
Cost comparison between Bridge Patient Portal’s all-in-one mobile/web application and existing 3rd party options
Based on the above calculations of what is typically found in the market, Bridge’s solution is easier to implement, more feature-rich, provides a better patient experience, and costs between one-third and one-fifth of alternative solutions.
Methodology
The costs for the 3rd party patient engagement solutions and customization costs were collected by Bridge Patient Portal on its competition over the course of multiple years. As there is a significant disparity between each solution and how it is priced, Bridge has amortized all the costs (including setup and customization fees) over a three year period. The 3rd party vendors used in this price comparison are considered to be “best in class” for each of their categories, and are vendors that Bridge regularly competes against or displaces.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
DALLAS, Jan. 28, 2020 /PRNewswire/ — Bridge Patient Portal® today announced record growth for 2019 with a 68% increase in its client base–predominantly in organizations with 50 or more providers–and an 85% increase in the number of individual patients hosted in Bridge Patient Portal across the existing and new client base. Bridge Patient Portal is an enterprise patient engagement software for healthcare organizations seeking to offer enhanced patient portal functionality and to consolidate “one-off” patient engagement solutions with a single PC and mobile-ready solution.
According to Adam Cherrington, Research Director over Patient Engagement for KLAS Research, “We recently interviewed providers and asked about their top priorities for future initiatives and investment within patient engagement. Patient experience surfaced as one of the top areas of engagement that providers are considering for the future. Because experience can potentially hit core goals of the quadruple aim of improving healthcare, we expect this to be a key area in healthcare for 2020 and beyond.”
Bridge’s growth in 2019 has been driven by this increasing demand among medium- to large-sized healthcare organizations seeking to improve the patient experience. Bridge improves the patient experience by providing patients with a “single pane of glass” to access a comprehensive set of fully-integrated self-service features. Healthcare organizations are also attracted to Bridge because it can significantly reduce the costs associated with managing multiple “one-off” or “piecemealed” patient engagement solutions.
Bridge Patient Portal CEO John Deutsch attributes the company’s dramatic growth to a favorable marketplace and the successful implementation of a few key initiatives.
Bridge spent the last two years heavily focused on R&D, and the software now includes all the main features that healthcare organizations have historically had to piecemeal together.
Bridge completed an interface into Centricity™ Practice Solution. Now, healthcare organizations using Centricity Practice Solution can easily interface with Bridge’s software. Bridge also supports some of healthcare’s most popular EHRs, including Greenway, NextGen and athenahealth.
Bridge focused on meeting the modern patients’ needs and user experience expectations in developing new functionality for its upcoming version 3.0. This included the development of a patient intake/check-in solution, IVR-based (Interactive Voice Recognition) notifications and a new mobile-ready user interface.
“Most of 2019 was focused on development, not growth, so these numbers are very encouraging, and we are expecting even greater growth in 2020 since all of our main development objectives are now completed,” said Deutsch. “Bridge is at a point where we can scale quickly. We are very well positioned as we embark on this upcoming major growth phase.”
In 2020, Bridge Patient Portal’s main focus will be on continued growth. Bridge will be upgrading existing clients to version 3.0, which is expected to launch in Q1. In addition, Bridge will be attracting new clients interested in leveraging the complete functionality offered by Bridge, especially Bridge’s new iOS and Android-based mobile app, and its new patient intake solution for patient web check-in.
About Bridge Patient Portal Bridge Patient Portal is an enterprise patient portal and engagement solution that empowers patients with self-service tools to better manage their care. The Bridge Patient Portal platform is ideal for health organizations seeking to replace their existing EHR portals or connect to disparate EHR environments with a single, EHR-agnostic patient portal platform. Founded in 2012 and headquartered in Dallas, Texas, Bridge Patient Portal has installations in more than 60 physician practices, hospitals and health systems nationwide. For more information, visit https://www.bridgepatientportal.com/ or call 866-838-9455.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
In the healthcare industry, successful organizations need to always be mindful of their consumer. Effective communication is one major factor that attributes to consistent patient retention and heightened patient engagement among healthcare companies. Healthcare organizations need to operate with simple, transparent, and important messaging in order to attain effective communication with their patients. This can easily be achieved by switching to a single patient engagement solution.
In the current market, many healthcare organizations are still operating using a multiple patient engagement solution. They will often purchase various patient engagement software systems (e.g. patient bill pay software, patient scheduling software, appointment reminders, patient portal, etc.) as opposed to buying one single solution. These multiple engagement solutions can severely impact the communication between a healthcare organization and their patients negatively.
Respecting Patient Communication Preferences
When an organization uses multiple patient engagement systems at the same time, it is nearly impossible to respect a patient’s communication preferences. There is no synchronization of preferences between an organization’s multiple patient engagement solutions and source systems (ie. practice management software, revenue cycle management software, electronic medical record software). A patient will opt-in or opt-out of receiving messages from one system, and another system will not be able to respect that patient’s request. Not only can this be an annoyance and violation of trust for the consumer, but it also poses the risk of serious legal ramifications for an organization. With a single, all-in-one solution, an organization possesses the ability to honor a patient’s preference when opting in or out of receiving specific messaging.
Better Patient Communication
Disparate systems from different vendors generally don’t have the ability to communicate with each other so a patient’s communication preferences can’t be respected. For example, a patient might prefer email notifications over SMS, or if they change their email, the account would have to be updated in all systems manually (assuming the systems are not interfaced). With a piecemealed patient engagement solution, patients can end up receiving messages at inopportune times, or they receive too many unimportant or duplicate messages. This can irritate patients, causing them to opt-out of receiving any messaging at all. Practices will attempt to correct their patients’ frustrations by limiting their messaging, thus self-regulating themselves and not utilizing patient messaging to its full potential. A single solution solves this problem by ensuring coordinated, direct, and effective messaging to patients.
Go to Bridge to learn more about the ease and advantages of implementing a single patient engagement solution today.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
Why early adopting healthcare organizations are replacing their disparate and piecemealed patient engagement solutions for a second-generation single solution.
In the ongoing efforts to increase quality patient engagement, many healthcare organizations have come to acquire multiple patient engagement solutions. In an attempt to satisfy patient needs without overly disrupting their IT “status quo”, healthcare organizations will often buy multiple software solutions (e.g. patient scheduling, event management, patient education, medical records access, patient portal, appointment reminders, etc.) as opposed to purchasing a single patient engagement solution. This inevitably turns into a piecemealed patient engagement solution that creates a mine of issues to be uncovered in the future, both for the organization and the consumer alike.
Not only does this have a negative impact on the customer in terms of patient communication and messaging, but it also brings forth many problems for the healthcare organization itself. These multiple patient engagement solutions can cause issues internally with an organization’s source system as it attempts to interface with this multitude of software systems. Furthermore, from a financial standpoint, these piecemealed patient engagement solutions can be very costly for organizations as well.
An Easily Interfaced System
With a piecemealed patient engagement solution, you are granting more access than is needed for each individual system. Each system (patient bill pay software, appointment reminders, patient education, etc.) needs to be interfaced with the EMR, PM, or other source systems. There is a greater potential for error, simply because of the larger number of interfaces, an organization must manage. A single solution allows for one simple interface to an organization’s source systems.
Cutting Costs
Healthcare organizations see significant financial benefit from switching to a single patient engagement solution. A piecemealed patient engagement solution has much greater costs associated with it, than with its singular counterpart. A single solution is of course more expensive, but the cost of maintaining multiple systems from multiple vendors and the unrealized ROI resulting from having solutions that are not fully utilized, makes a clear argument for a single solution.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
Most HIPAA compliant cloud hosting services don’t do a very good job of making considerations for the application or website they’re hosting. This creates a disconnect between developers and systems administrators, putting more pressure on the system administrators to customize the environment to support the software, which they likely don’t understand perfectly. This also creates barriers for the software developers to overcome for each release they make. With limited communication between system administrators and developers, vulnerabilities are easily overlooked. The net result is unexpected costs, slower deployment of new versions, and unnecessary vulnerabilities.
Medical Web Experts, a partner company of Bridge Patient Portal, recently launched the MWE Cloud, a HIPAA-compliant cloud hosting service created with website and application development in mind. This turn-key cloud hosting service is used by Bridge Patient Portal as their patient portal hosting solution. The MWE Cloud features a suite of features for compliance, security, and development, including:
Backups: Encrypted off-site backups are performed daily and are retained for 6 years.
WAF and DDoS protection: Optional packages with Web Application Firewalls (WAF) and Distributed Denial of Service (DDoS) protection.
SSL: SSL certificates that support TLS v1, v1.1, and v1.2.
Continuous monitoring: Maintain ongoing awareness of security controls, vulnerabilities, and threats to support risk management decisions.
Virtual network protection: Software-based switches and network configurations as part of the virtual environment to allow virtual machines on the same host to communicate more directly and efficiently.
Access Control: Strict access requirements, such as VPNs, bastion hosts, two-factor authentication, login audits and secure channel communication with public-key cryptography.
Encryption at-rest: Data is encrypted with 256-bit Advanced Encryption Standard (AES-256), one of the strongest block ciphers available.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
A recent study conducted by researchers at Yale University found significant deficiencies among 83 of the nation’s largest hospitals and health systems in how they provide medical record access to their patient population. One might expect that this deficiency was limited to limitations with the online medical record, patient portal or medical records portal access, but the study found that the problem runs much deeper. The Health Insurance Portability and Accountability Act (HIPAA), is a federal law that includes provisions to ensure that patients can access their medical records in a timely manner, at a reasonably low cost and in a format of their choosing.
When we think of the term “medical records” access for patients, in most cases, a complete Continuity of Care Document (CCD) will do. However, a CCD may or may not include lab results, so a typical “electronic” version of the “medical record” might include a CCD plus the patient’s lab results, imaging reports, discharge summaries, and other files as PDFs – which, by Bridge’s standards, is the standard “medical record” offering in their healthcare provider provided patient portal.
What were the results of the study?
Among the 83 hospitals, 44 (53%) provided patients the option on the medical record request forms to acquire their entire medical record. This doesn’t mean that a request for the complete record couldn’t be made with some effort, but the organization wasn’t making it easy for the patient to do so.
The study found similar results when it came to the medical record formats available. Hospitals were more likely to offer a greater number of options for how to release medical records when asked over the phone compared with on a form. The hospitals in the study offered the following options:
Pick up in person (69 [83%] over the phone vs 40 [48%] via the medical record request form)
Fax (20 [24%] vs 14 [17%])
Email (39 [47%] vs 27 [33%])
CD (55 [66%] vs 35 [42%])
* It is implied that a patient proficient with the internet would likely not be directed to complete a medical record request form if the “complete” medical records were available in some type of medical records portal (patient portal).
On the authorization forms, 29 hospitals (35%) disclosed exact costs either on the form or on the web page from which the form was downloaded. One hospital stated on its form that it releases records free of charge, 18 (22%) disclosed that they would charge patients but did not specify a cost, and 36 (43%) did not specify any fees. For a 200-page record, the cost of release ranged from $0.00 to $281.54, based on the 29 hospitals that disclosed costs.
In terms of processing times, 71 hospitals provided mean times of release for paper copies of records. A maximum time of release was provided by 10 hospitals, and 2 hospitals were unable to specify a mean or maximum time of release. Of the hospitals that provided mean times of release, 17 (21%) reported mean times of less than 7 days, 21 (25%) in 7 to 10 days, 26 (31%) in 11 to 20 days, 4 (5%) in 21 to 30 days, and 3 (4%) in more than 30 days.
Medical records online: Bridge’s analysis of the root cause
It goes without saying that a patient portal or mobile app which offers medical records online would solve the majority of these problems, but even with such systems, there are likely to be many instances where either a) the medical records are not a part of the standard medical record offering in the portal/app, in which case a request needs to be made; or b) medical records from the clinics associated with the health system, which often use different EHR systems, aren’t connected to the main system. This lack of integration across multiple internal EHR systems forces medical record staff to prepare medical record requests for patients manually.
Bridge uses its own proprietary interface engine to collect health summaries from multiple EHRs simultaneously. Even if existing interfaces to the EHRs don’t exist, Bridge provides patients with access to their medical records through both a client-branded web application and mobile app. Once in the application, most health summaries should be available as a result of the expanded interface. In the event that a request needs to be made for a medical record, the current methods imposed by healthcare organizations are cumbersome, requiring paper-based forms to be completed. With Bridge, when medical records are not available in the patient portal, an electronic request can be submitted in the portal, where it will then be sent to a tasking center for medical record staff to manage. Medical record attachments can be made directly in the task queue, simplifying the entire process.
Another aspect is the cost issue. Since patient portals are a free service, hospitals and health systems could fear a loss in revenue associated with patients’ medical record requests. HIPAA law does allow for a “reasonable” fee to charged to the patient for this access, so the incentive to offer such access is limited.
Our analysis of the situation is that few health organizations are truly motivated to make a change to the status quo. The entire market needs to shift toward becoming more consumer-driven and, as it stands, the patient will likely encounter much of the same if they go from hospital A to hospital B. Only the most innovative health organizations are putting a priority on the “patient experience”, and seeing how they can attract and retain patients through free and easily-accessible online medical record access.
Founder and CEO of Bridge Patient Portal, and a health IT entrepreneur and business owner of 19 years with extensive experience in Healthcare IT. Specializing in Business Development, Software Development, Patient Portals, mHealth, Patient Engagement, HIPAA, Electronic Medical Records, Web Development, and Internet Marketing. John is a Judge for the 2020 eHealthcare Leadership Awards and has appeared on multiple podcasts, including the Outcomes Rocket Podcast and the Hospital Finance Podcast.
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