Privacy and Security Risk Factors Related to Telehealth Services - A Systematic Review.

The objective of the study is to identify challenges and associated factors for privacy and security related to telehealth visits during the COVID-19 pandemic. The systematic search strategy used the databases of PubMed, ScienceDirect, ProQuest, Embase, CINAHL, and COCHRANE, with the search terms of telehealth/telemedicine, privacy, security, and confidentiality. Reviews included peer-reviewed empirical studies conducted from January 2020 to February 2022. Studies conducted outside of the US, non-empirical, and non-telehealth related were excluded. Eighteen studies were included in the final analysis. Three risk factors associated with privacy and security in telehealth practice included: environmental factors (lack of private space for vulnerable populations, difficulty sharing sensitive health information remotely), technology factors (data security issues, limited access to the internet, and technology), and operational factors (reimbursement, payer denials, technology accessibility, training, and education). Findings from this study can assist governments, policymakers, and healthcare organizations in developing best practices in telehealth privacy and security strategies.

Building Best Practices for Telehealth Record Documentation in the COVID-19 Pandemic.

Telehealth services for patient visits have substantially surged during the COVID-19 pandemic. Thus, there is increased importance and demand for high-quality telehealth clinical documentation. However, little is known about how clinical data documentation is collected and the quality of data items included. This study aimed to identify the current state of and gaps in documentation and develop a best practice strategy for telehealth record documentation. Data were collected from January to February 2021 via a self-designed questionnaire for administrators and managers from physicians' offices and mental health facilities, resulting in 76 valid responses. Survey items included health organization demographic information, use of telehealth policies and procedures, and clinical documentation for telehealth patient visits. Findings from this study can be used to assist government, policymakers, and healthcare organizations in developing best practices in telehealth usage and clinical documentation improvement strategies.

Patient clinical documentation in telehealth environment: are we collecting appropriate and sufficient information for best practice?

BACKGROUND: During the COVID-19 pandemic, the use of telehealth for patient visits grew rapidly and served an important role as a valuable and necessary resource. Although clinical documentation is critical for telehealth patient visits, there is limited information about how healthcare facilities manage telehealth patient visit documentation, technology used for telehealth visits, and challenges encountered with telehealth patient visit documentation. This study aimed to assess the use of telehealth during the pandemic, the quality of clinical documentation in telehealth practice and to identify challenges and issues encountered with telehealth patient visits in order to develop a strategy for best practices for telehealth documentation and data management. METHODS: Data were collected for this cross-sectional study in January-February 2021 via a self-designed survey of administrators/managers from physicians' offices and mental health facilities. Survey questions included four categories: health organization demographic information; telehealth visits; clinical documentation for telehealth visit; and challenges and barriers related to telehealth documentation technology use. RESULTS: Of 76 respondents, more than half (62%) of the healthcare facilities started using telehealth for patient visits within one year of the onset of the COVID-19 pandemic, with 94% of respondents indicating an increased use of telehealth for patient visits since the pandemic. The most common types of telehealth patient care provided during the pandemic included pediatrics, primary care, cardiology, and women's health. The most consistent data documentation of telehealth visits included: date of service, patient identification number, communication methods, patient informed consent, diagnosis and impression, evaluation results, and recommendations. The telehealth visit data was most commonly used for patient care and clinical practice, billing and reimbursement, quality improvement and patient satisfaction, and administrative planning. The top barriers to telehealth use by the healthcare professionals included patient challenges with telehealth services, such as inequities in quality of technology, lack of patient understanding, and lack of patient satisfaction; this was followed by frustration with constant updates of telehealth guidelines and procedures, understanding required telehealth documentation for reimbursement purposes, payer denial for telehealth visits, and legal and risk issues. CONCLUSIONS: Findings from this study can assist government entities, policymakers, and healthcare organizations in developing and advocating best practices in telehealth usage and clinical documentation improvement strategies.

Exploring Cancer Registrars' Perceptions of the Quality and Use of Cancer Registry Data for Care Coordination and Other Purposes.

BACKGROUND: Hospital cancer registry data are used for a variety of aspects of patient care, yet one of the lesser used purposes of cancer registry data is to improve care coordination. OBJECTIVES: The purposes of this study were to assess hospital cancer registrars' perceptions of (1) the use of and quality of hospital cancer registry data for care coordination and other purposes; (2) the availability of all needed data for complete hospital cancer registry data collection; and (3) the data collection of COVID-19 effects on cancer patients. METHODS: A survey was sent to hospital-based members of Cancer Registrars of Illinois between April and June 2020. Survey questions focused on current use and quality of hospital cancer registry data for care coordination as well as items related to COVID-19's effect on cancer patients. The focus of this study was hospital-based registrars, as they are the individuals collecting data directly from primary patient records. RESULTS: While hospital cancer registry data are being used for many purposes including continuity of care, this study found that providers are not using hospital cancer registry data to its fullest extent. It was also found that hospital cancer registrars have collected valuable data on the impact that COVID-19 has had on cancer patients. CONCLUSION: Care coordination between providers is especially important for cancer patients who may see multiple providers and visit several facilities. This study found that the hospital cancer registry database contains extremely useful data for cancer patients and practitioners. Further, it was found that the hospital cancer registry is a source of valuable information regarding the impact that COVID-19 has had on cancer patients.

Population Health: Identifying Skill Sets and Education Alignment for HIM Professionals.

The COVID-19 pandemic has increased the emphasis on population health, therefore potentially amplifying demand for healthcare workforce professionals in this area. There is an urgent need to explore and define the roles of health information management (HIM) professionals in the population health workforce. This study sought to identify the skill sets and qualifications needed, and HIM education alignment with skills necessary for HIM professionals entering the population health workforce. An intentionally broad internet search of job postings was conducted to determine skills in population health. Population health-related job descriptions and qualification requirements were abstracted and analyzed using ATLAS.ti. Three common job categories were identified: management, analytics, and coding. Skill set requirements included soft skills, problem solving, project management, research, and data analysis. The study results identified HIM educational alignment and found that HIM professionals are generally a good fit to meet the increased need in the population health workforce.

Code of ethics: principles for ethical leadership.

The code of ethics for a professional association incorporates values, principles, and professional standards. A review and comparative analysis of a 1934 pledge and codes of ethics from 1957, 1977, 1988, 1998, 2004, and 2011 for a health information management association was conducted. Highlights of some changes in the healthcare delivery system are identified as a general context for the codes of ethics. The codes of ethics are examined in terms of professional values and changes in the language used to express the principles of the various codes.