It’s Not About The Box Improving Care at Group Health with People, Process and Technology

June 4, 2009

New Security “Thing” Coming at end of year

Filed under: Remote Access,Technical Issues — Gwen O'Keefe MD @ 3:20 pm

Because we are an organization that takes credit cards for our services, Group Health needs to follow the security standards for industries that have access to consumers’ financial data (in addition to the standards for personal health information!) So, IT is in the process of evaluating systems for “two factor identitication” when we access our systems remotely, such as using Citrix from home. This requires that there be another unique item such as a randomly generated password from a token – a small device you carry on your key chain, or more high tech such as a biometric signature like your fingerprint etc. The short version is that there is an evaluation going on now to select 3 possibilities with piloting to occur in the fall. The default selection will be to use a system already in place – RSA – which is a token based system. This generates a random password every minute or so, and you are required to enter this password when you log on in addition to your regular username and password. The idea is if you don’t have both the device and your knowledge of your username/password you can’t get in.

I have used these in the past – there is debate in how much additional security they really provide (you will see people have them taped to their laptops for instance). Turns out our radiologists are already using these in order to access their remote desktops to read images at night.

This will be a change for folks who work remotely in that we will have to have this additional feature with us at all times. Some of the dropdead criteria for doing this are that they have to be small, and an easy process to allow access if it’s stolen or lost.

June 3, 2009

Open Encounters

Filed under: Uncategorized — John Kaschko @ 11:50 am

We have an issue with lots of open encounters out there,  some of which date back to 2003.  At last count there were over 4,000.  Since we will be going away from Lastword in October and moving to Epic’s billing system, there are some good reasons to get these closed. There are a variety of encounters on this list,  for some of thesethere is no “reminder” in Epic that they are open.  Examples of these are “Very Brief Encounters” and “Immunotherapy Encounters.”  If staff inadvertently leave these open, there isn’t any InBasket reminder to alert them.  This should be changing the week of June 8th when the InBasket reminder for these will be turned on.  There will be some “clean up” needed to close old encounters  though most staff won’t have any.  For staff with open encounters, the average is more like 2 or 3 though there are 2 staff members with 12 each.

Unfortunately,  the above encounters only add up to about 600 of the 4,200 total. The rest are clinic visits and these also need to get closed.  For some of these, they are so old the cannot be billed.  Any visit before 11/1/2007 cannot be billed and many visits before 8/1/2008 cannot be billed (depends on insurance).  Current plan is to have an “administrative closure” of all these using a LOS code of ADMCL (Administrative Closure) if someone other than the provider closes it and  OVDEL (“no billable service provided”)  if a provider closes a visit beyond the billing window.  An issue we are still exploring is why are these open office visit encounters not displaying  InBasket?  Epic Corporation is helping us with this,  at this point it appears to be some kind of interface issue….

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