Thursday, May 13, 2004

An Assessment of HIPAA Security Preparedness: Most Health Care Organizations Remain Noncompliant
A report (in Adobe Acrobat format) by URAC available at the Open Minds web site - " Until recently, patients and their physicians stored paper medical records under lock and key in their medical offices. In today’s innovative health care environment, ensuring the security of personal health information (PHI) is much more challenging. For example, PHI is regularly inserted into claims and supporting reports that are sent electronically across state lines and/or international boundaries to various stakeholders to coordinate treatment plans and pay for coverage. Although the move to more electronic data interchange (EDI) holds great promise for increasing the efficiency, efficacy, and safety of health care, the electronic transfer of PHI raises security and privacy concerns for individual patients and their treating providers. As a result, the passage of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the promulgation of implementing privacy and security regulations from the Department of Health and Human Services (HHS) signify the federal government’s intent to ensure PHI confidentiality in today’s complex business environment..."  
  

District of Columbia: Status of Reforms to the District’s Mental Health System
A GAO report (in Adobe Acrobat format) available at the Open Minds web site - "Since 1975, the District of Columbia has operated its mental health system under a series of court orders aimed at developing a community-based system of care for District residents with mental illnesses. Placed in receivership from 1997 to 2002, the District regained full control of its mental health system in 2002 but has been ordered to implement a courtapproved plan for developing and implementing a community-based mental health system. Additionally, the District must comply with exit criteria, which must be met in order to end the lawsuit. The court expects that it will take the District 3 to 5 years to implement the courtordered plan and begin measuring performance against the exit criteria, with year 1 beginning in July 2001. GAO was asked to report on the current status of the District’s efforts to develop and implement (1) a mental health department with the authority to oversee and deliver services, (2) a comprehensive enrollment and billing system that accesses available funds for federal programs such as Medicaid, (3) a consumer-centered approach to services, and (4) methods to measure the District’s performance as required by the court’s exit criteria."  
  

Some Depressing News
"Pediatrics Perspective" column in Medscape Pediatrics - " A few weeks ago, the US Food and Drug Administration (FDA) issued a "surprise" warning that patients who have just begun taking antidepressant medications can become suicidal and need to be closely monitored by their physicians. Sadly, many of the front-page news reports heralding the dangers of these drugs were perfect examples of faulty medical reporting. To be sure, depression is a deadly serious problem and the powerful medications we use to treat it need to be handled with great care. Far worse than making a person merely feel 'blue,' clinical depression interferes with just about every aspect of a victim's life..." [Viewing Medscape resources requires registration, which is free]. See also the recent PULSE Issue Brief, Renewed government scrutiny of antidepressants.  
  

All the Things They Taught Us That Were Wrong
"Medscape Psychopharmacology Today" column in Medscape General Medicine by Thomas A. M. Kramer - " One of the many wonderful things I learned in medical school is that my parents were probably wrong about not letting me go swimming after I ate. Actually, making me wait an hour probably made it more likely that I would have a cramp in the water. When it comes to debunking myths, I believe there are two kinds of people : those who think it is wonderful and those who think it is horrible My response is firmly in the former category. I see the dispelling of supposed truths as progress -- as evidence that we are moving forward, constantly questioning and continuously learning. I very much enjoyed the recent programs by the television journalist John Stossel in which he demonstrated that many accepted truisms are false. With this column, I would like to indulge in some myth-busting for psychopharmacology, and hopefully my colleagues who also enjoy questioning authority will enjoy and perhaps even contribute to this discussion..." [Viewing Medscape resources requires registration, which is free].  
  

Cover the Uninsured Week
The web site of a project sponsored by the Robert Wood Johnson Foundation - " There are nearly 44 million Americans living without health coverage – including 8.5 million children. In 2002, the number of people without health coverage increased by more than 2 million, the largest one-year increase in a decade. Unfortunately, the problem won’t get better soon. Rising health care costs continue to undermine the ability of individuals, businesses and state governments to purchase health care coverage. Reversing this disturbing trend, elevating this issue on the national and local agendas, educating Americans about the problem and providing immediate assistance to the uninsured and small business owners are the goals of Cover the Uninsured Week 2004..." See also Health Care Proposals Vary Widely in the Hartford Courant and Healthcare Issues Attract Plenty of Talk but Little Action in the Los Angeles Times.  
  

Lawmakers Assail NIH Conflict Rules
Los Angeles Times story - "Members of Congress from both parties on Wednesday criticized conflict-of-interest policies at the National Institutes of Health and told the agency's director that the recent recommendations of his blue-ribbon advisory panel fell short of what was needed. After listening to the criticisms at a hearing on Capitol Hill, NIH Director Elias A. Zerhouni conceded for the first time that the agency's policies had 'failed.' Zerhouni said that, as of this week, he was seeking to force an additional 500 senior employees to begin publicly disclosing any fees paid to them by drug companies or other parties. Two months ago, Zerhouni compelled public disclosure from 93 other NIH leaders." [Viewing Los Angeles Times stories requires registration, which is free].  
  

Lack of mental health services alarming (New Zealand)
Brief New Zealand National Party press release at Scoop - " It is an indictment on the Labour Government that a key finding of this week's Mental Health Commission Report shows 'inpatient beds for children and young people is only at 60% of recommended levels, says National's Associate Health spokesman Dr Paul Hutchison..." See also the ACT New Zealand press release at the same site of an address by Heather Roy - " It is the Labour Government's failure to provide anything that even approaches a reasonable mental health system, which has prompted me to speak out about this today. The size of the mental health sector is often overlooked, but it is a major area of public spending. . This financial year, the Government will spend around $800 million on mental health. This amount has been rising steadily since 1993 and, at the current rate of increase, we can expect it to pass $1 billion by the end of the next Parliamentary term. So how do we compare internationally? Well, we currently spend more per capita on mental health than Australia or the US. And this excludes spending by the Corrections Department to create 'special units' - which are, in reality, psychiatric wards within the prison system. But we are not getting value for money..."  
  

APA Poll: Most Americans Have Sought Mental Health Treatment But Cost, Insurance Still Barriers
APA press release at Yahoo - "Nearly half of Americans have had someone in their household seek mental health treatment, but most still perceive cost and lack of insurance coverage as barriers according to national poll results released today by the American Psychological Association (APA). The poll also shows that stigma about seeking mental health treatment is increasingly less of a barrier to getting treatment. Nearly half (48%) of American households have had someone see a mental health professional and nine out of 10 Americans say they are likely to consult or recommend a mental health professional if they or a family member are experiencing a problem..."