March 5th, 2011 by GruntDoc in Health Policy, Opinion
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Via the Threatpost article “HIPAA Bares Its Teeth: $4.3m Fine For Privacy Violation“:
The health care industry’s toothless tiger finally bared its teeth, as the U.S. Department of Health and Human Services (HHS) issued a $4.3 m fine to a Maryland health care provider for violations of the HIPAA Privacy Rule. The action is the first monetary fine issued since the Act was passed in 1996.
…
A copy of a penalty notice against Cignet depicts a two-year effort in which HHS struggled with what appears to be a dysfunctional Maryland provider unaware of the potential impact of HIPAA non-compliance, and unwilling or unable to cooperate with HHS in any way.
When first reading the title I was willing to rail against HIPAA, as I’m tired of it. Then I read the post. Wow. It’s like a test case designed to see just how far you could push HHS, and frankly how incompetent you can be while pushing. Seems HHS was having trouble getting Cignet’s attention. I bet they have it now.
*This blog post was originally published at GruntDoc*
February 26th, 2011 by Steven Roy Daviss, M.D. in Health Policy, Opinion
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I read today that Eastern Ontario has started a bed registry to keep track of where open psychiatric beds are available. This is something I’ve long advocated. The United States now has less than 10 percent of the beds it used to have 50 years ago. Granted, treatment has improved and community resources are enhanced. But there are still areas that often do not have a sufficient number of hospital beds for folks needing acute inpatient psychiatric care.
The Ontario story described in the Ottawa Citizen states that six of the area hospitals have been connected to a computerized “bed board” that provides real-time information on who has an appropriate bed available. This saves time in the ER and gets patients to needed treatment more quickly. Otherwise calls need to be made to each individual hospital, which is very time-consuming.
And it’s not uncommon for all the beds to be full. Last July there was an EMTALA complaint against a hospital in Maryland because a patient sat in the ER all weekend, and this hospital said they had no beds to admit the patient to. The Department of Health and Mental Hygiene (DHMH) investigated the complaint and found that indeed the hospital was full that weekend. The ER’s record indicated that all the hospitals (except the state hospitals) were called that weekend and all indicated their beds were full. So DHMH visited every hospital (about 28, I think) thinking that surely one of them had an empty bed they were hiding. What they discovered was that every single psychiatric bed in the state was full.
Unfortunately, we have no way of determining how often this happens, but we know if happens often enough. A “bed board” like this would be very helpful in quickly finding beds when needed and keeping track of the extent of this problem. Having patients wait in ER for days is unsafe and is even discriminatory. How many people with stroke or uncontrolled diabetes sit in ER for days waiting to find a bed for treatment? I’d like to hear others’ thoughts on how this problem can be addressed.
*This blog post was originally published at Shrink Rap*
November 3rd, 2010 by Steven Roy Daviss, M.D. in Better Health Network, Health Policy, Opinion
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Back in the 1970s, Kansas passed a law that could prevent people with mental illness from voting. The law was never used, but advocates were successful in getting an amendment passed that revoked that law.
This law was passed at a time when stigma against mental illness was much higher than now. I’m guessing it was presumed that folks with a mental illness could not reason enough to exercise an informed vote, which is not true, of course. If 1outta5 have a psychiatric illness, including anxiety, depression, and substance abuse, then there could have been a huge swath of disenfranchised voters.
And there already exists, to a degree, a basic cognitive test for voting: Navigating the whole ballot process. In Maryland, ours was electronic and no harder to use than an iPad, but I could still imaging some with severe dementia unable to navigate the system. But there should never be a cognitive bar one must pass to vote. The challenge would be where to draw the line.
*This blog post was originally published at Shrink Rap*
January 30th, 2010 by Dr. Val Jones in True Stories
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Since I finished my residency training, I’ve applied for medical licenses in several states. It has been interesting to see how long it takes different states to process the same credentials. I wanted to give a quick hat tip to Maryland, for being the fastest, lowest hassle state so far. They processed my application in under 4 weeks, accepting my FCVS packet as verification for my medical school, residency training, and USMLE scores. Although the website suggests that the process may take up to 120 days, mine was fewer than 30. Thank you, Maryland Board of Physicians! Job well done.
In my personal hall of shame, however, is the Medical Board of California. I have been waiting since June, 2008 for my license. Yes, it’s been 567+ days. Read more »