Wikipedia defines podcast as “a type of digital media consisting of an episodic series of files (either audio or video) subscribed to and downloaded through web syndication.”

Those of you are under 30 are asking why I am defining the word podcast. Certainly, everyone knows what a podcast is. I am doing so because there are many of us in the 40+ age group who have never listened to or viewed a podcast, even if we know what it is. We are still getting up to speed!

I wanted to let you know that American Psychological Association (APA) mentioned the growing availability of psychology podcasts in the January edition of the Monitor on Psychology. There are shows that focus on the brain and behavior, others on the mind, others are interviews with psychologists and neuroscience researchers. It is an extensive list!

Obviously, there are lots of ways to find podcasts that might interest you. A quick Google search for ‘Podcast Directories’ turned up 63,600,000 results. You are bound to find some interesting ones in these listings.

I have not yet downloaded podcasts. I do, however, have benefit of listening to some of those Seth has downloaded. One of my favorites is Science Friday, an NPR radio program that also uses the podcast format. They frequently have psychology and mental health-related shows.

I hope you will try out some of these resources to determine if they are a good way for you to access information in your field of expertise. If you are already hooked on podcasts, please share the names of some of those you like, whether related to behavioral health or to other areas.

Privacy and Security Mobile Device Good Practices Project Launched

ONC’s Office of the Chief Privacy Officer (OCPO), in working with the HHS Office for Civil Rights (OCR), recently launched a Privacy & Security Mobile Device project.

The project goal is to develop an effective and practical way to bring awareness and understanding to those in the clinical sector to help them better secure and protect health information while using mobile devices (e.g., laptops, tablets, and smartphones). Building on the existing HHS HIPAA Security Rule – Remote Use Guidance, the project is designed to identify privacy and security good practices for mobile devices. Identified good practices and use cases will be communicated in plain, practical, and easy to understand language for health care providers, professionals, and other entities.

HHS will be looking for your input. Stay tuned for a public roundtable this Spring.

The proliferation of laptops, smartphones, and tablets and their use to access Protected Health Information (PHI) of patients has lots of people worried. Some of the largest breaches of data reported have been through the loss of laptop computers. In November 2010, ONC developed a document on Cybersecurity: 10 Best Practices for the Small Healthcare Environment relating to offices and networks. The problem is that during the last 18 months, smartphones and tablet computers like iPads and Kindles that can access the Internet have become ubiquitous.

The biggest problem with using these devices to remotely access PHI is that there are not yet security protocols and procedures in most organizations aimed at guaranteeing the privacy of the PHI accessed remotely.

Imagine for a moment: your physician is sitting in a coffee bar with a public wi-fi when s/he gets a call that you need an emergency refill of your blood pressure medication. The doctor uses a smartphone to login to the ePrescribing software used by the practice and sends the prescription to your pharmacy. Doctor finishes the cup of coffee, slips the phone into a jacket pocket and gets up to leave the shop. Unfortunately, the phone does not make it into the pocket and winds up on the chair as the doctor leaves.

You know the rest of the story. Someone finds the phone and messes around with it while deciding whether to try to find the owner. Since Finder can start everything on the phone (you see, there is no password), they can go right back to the last app used to see what the owner was doing. Since Doctor had the browser set to save passwords, Finder can log right into the ePrescribing software. . . .

Unfortunately, additional scenarios are also possible. That public wi-fi is known to everyone in the neighborhood and there are a couple of folks who sit around drinking their coffee capturing usernames and passwords from insecure sites. Who knows what they are capturing and accessing . . . maybe your username and password for your organization’s network!

The biggest concern with mobile devices is that they have proliferated so rapidly that organizations have not had the opportunity to develop protocols and adequately train staff members to have some semblance of a guarantee that PHI is secure. So ONC is doing what it can to shed some light on the subject and increase awareness.

In the meantime, this article has 5 security tips for your smartphone or tablet.

What is your organization’s policy about accessing protected health information remotely? Do you have policies?

Please share your comments below.

As you know, there are massive changes happening in the healthcare world. Many of those changes pertain to electronic medical records (EMRs), but there are also important occurrences related to the billing/practice management side of the behavioral health organization.

So here are those three things you need to know:

1. The 5010 changes only relate to electronic claims. If you are still filing claims on paper, changes from the 4010 to the 5010 versions of the 837 claim filing format do not affect you.
2. January 1, 2012 is still the deadline for beginning to send 5010 formatted claims. CMS and the Office of Civil Rights (OCR) have indicated that they will not begin to fine organizations that are not yet sending 5010 claims or payers who are not yet receiving them, but the deadline date still stands. After March 31, 2012, OCR will begin the enforcement process
3. Our clearinghouse partner, Emdeon, made this transition easier than anyone could have imagined.
   We use only one clearinghouse, but we have customers who send claims directly to several Medicare and Medicaid payers. Those custom, direct-sends have been a royal pain. Some of the payers were not ready for us to test until the last possible moment. Some of them were ready for testing but required that our customer start sending the 5010 even before the deadline. Some changed the testing process along the way; others had a procedure but did not inform us of all the steps when we first contacted them months ago. Many have been virtually impossible to reach by telephone in order to get assistance for our customers.Emdeon has done just what a clearinghouse is supposed to do. They began a timeline for testing and implementation almost two years ago. They had a testing system in place so our development staff could get help if needed but could also do iterative testing without someone there needing to intervene at each step. And finally, they assured us that there would be the capability of sending a 5010 early or continuing to send a 4010 with them translating to 5010 if a customer needed that to occur.

   Once our customers started sending, Emdeon was ready! Our customers are able to check the status of their claims using Emdeon’s Vision. If there were problems, we have an account representative we can speak to who intervenes immediately. In the couple of cases were there was an issue with a payer, Emdeon dealt with the payer, not us.

   By our standards, all of those things make our Channel Partner relationship an extremely valuable asset for our customers.

The next big, systemic change will be the move to the ICD-10, with a current deadline date of October 1, 2013. This one will affect everyone, those who file claims electronically and those who file on paper. The American Medical Association (AMA) has decided to fight that deadline on behalf of American physicians. They believe the cost to providers is too large, especially following so quickly upon the move to EMRs. Whatever the deadline, this will be a massive change requiring everyone to use different diagnosis codes and requiring hospitals to use different procedure codes. We can only hope the chaos will not be as great as could be possible.

Please share your experiences and thoughts about these changes. Just comment below.

1. I am an advocate of Healthcare Reform. I was disappointed in the bill that finally passed because I believe it was not a strong enough protection for consumers. Given that, I am glad we have a healthcare reform law on the books.

2. I believe that most consumers would benefit in the greatest possible way from a single payer system. This could be modeled on Medicare or utilize some other possibilities, but I think a single payer system is the only way we will ever get a healthcare system that truly meets the needs of most consumers and costs the least.

Given those assumptions, you will understand my reaction when I read a new article in FierceHealthPayer, a weekly newsletter for healthcare plan executives. If you are involved in the purchase of health insurance for your organization, the title of the article, Insurers Profit from Health Reform, will come as no surprise to you. Of course insurers are the primary ones who will profit from health reform in its current incarnation.

After dropping almost $90 million to oppose the health reform law, repeatedly claiming its provisions would raise costs and disrupt coverage, health insurers actually have benefited the most from the law, according to a Bloomberg Government report released Thursday.

The article goes on to explain that most of the increases in revenue are the result of these companies expanding into government programs. You see, even though Medicaid and Medicare are government programs, they are often administered by private insurance companies. With the expected expansion of the Medicaid program mandated by the Affordable Care Act, there should be even more income growth for insurance companies.

So who’s going to lose money on healthcare reform? Guess what….it’s us again. Those of us who purchase insurance in the private marketplace were subjected to 9% increases on average in 2011…increases aimed at covering the costs of the mandates of the healthcare reform law long before required by the law. That way, we absorb the costs and the insurance companies get to go on paying their executives outrageous salaries and making their profits.

I wonder what it will take for people to finally realize that healthcare and health insurance need not cost so much. I don’t expect it to happen as long as corporations control our government and our lawmakers. I know many folks believe the problem is just the opposite. Government should get out of the middle of the relationship between the healthcare provider and the consumer. Competition and market forces would take care of costs.

What do you think? Who will pay for care for the chronically ill . . . and the chronically mentally ill if we don’t all chip in to do it? Is there enough compassion in the marketplace to assure that children, the poor, and those unable to pay for health insurance because of mental illness will also receive good quality healthcare? Please share your thoughts. I would love some help in understanding how we can assure that we will all get the healthcare we need without spending half our income on health costs.

When I was a younger person, I made resolutions every year and worked hard to keep them. In the past several years, my energy has been scattered in too many directions to even make resolutions, much less to keep them.

This year feels somewhat different. I achieved several goals I set for myself personally in the last half of 2011 and doing that has made me more open to a resolution or two in 2012. Both of those I am setting pertain to my work and are shared with me by other members of the SOS team…particularly those of us in customer service.

1. We have resolved to provide customer service that is strikingly above expectations to our clients. Those who trust us to provide software and support to accomplish their business needs deserve nothing less.
2. We have resolved to help all of our customers to send their claims electronically . . . especially those who have already purchased our claims module, but who have never begun filing.

Neither of these resolutions is earth-shattering. We hope that makes them reasonable to accomplish. We trust that you will let us know how we are doing.

Please share your resolutions, or let us know why you have decided not to make any.

We hope for a healthy, happy and extraordinarily successful 2012 for all of you!

When I say the U.S., I do not just mean the U.S. Government. I also mean U.S. and multinational corporations that are loyal only to their bottom line, private U.S. military contractors (otherwise known as mercenaries), the U.S. economy, U.S. buying/consuming habits, and the knowledge, involvement, and activism of the U.S. citizenry.

Daniel Suarez, the author of these books, is a systems consultant and programmer. He knows about the software and devices that run our lives. He has consulted extensively on data security to Fortune 1000 companies. The technology described in his books is all current and real . . . and very frightening. His stories successfully make the point that our identities are so tied into the computer systems that run modern life, that our civilization could not survive without them. As we move toward digitizing our medical and mental health records, we simultaneoulsy decrease errors and increase our vulnerability. Long-term loss of electrical systems in a dozen major cities globally could destroy our entire way of life, including our food distribution system. Even a short-term loss of electricity can throw us into major disarray. But not necessarily . . .

A key element of Freedom^TM, is that sustainable communities that are not totally reliant on centralization of resources can survive even major disruption. Sustainability is defined on Wikipedia as “the capacity to endure.” It is the ability to survive based on a balanced and reasonable use of resources that does not deplete those resources.

Currently, the concept of sustainability is enjoying popularity in some government circles. The EPA, HUD, and DOT have developed a program for developing sustainable communities.  These programs focus on housing and business development in urban and rural areas and how to do it in a way that contributes to the well-being of everyone involved, including wildlife and the earth.

Not-for-profit organizations and think tanks focused on a sustainable future have been appearing over the last decade. Philosophical and spiritually grounded individuals have long taught of the need for changes in how we think and live that will result in our well-being. Even some businesses profess sustainability as part of their business mission.

But without action from concerned, educated, and involved individuals, none of these movements will gain the traction they need to affect how we live.

I have long believed that an informed community is also an activist community. When I take the time to educate myself about the events and issues of the day, I am also motivated to examine those events in light of my own beliefs and values. When the values I hold dear are threatened, I take action. At least, that is what I used to believe. I know a few people who do that, but not very many. I do not share the political values of the Tea Party. I do share their belief that it is the responsibility of citizens to express their opinions and to become involved in the political process . . . after educating themselves about the issues.

I know, I know…you don’t have time to breathe. You already work in healthcare, most of you in the mental health community. You take care of other people as part of how you make your living, you certainly cannot consider taking the time to learn more about what is happening in our country and worldwide so you can become even busier. Getting involved in your community or becoming activist about issues that concern you is just out of the question.

And yet . . . unless more of us take the time to become such activists, we may not have day-to-day activities to be concerned about.

I hope you will read these books when you can. They are very good reads . . . extremely entertaining and very informative. Just view them as a treat to yourself.

Then decide what you need to do.

Our first meeting immediately after the election was highly charged. Staff had been studying President Clinton’s healthcare proposals, and the notion of controlling cost through “managed care.”

President Clinton’s healthcare proposals did not fly, but the industry picked up the notion of controlling costs by managing the care provided to consumers, and psychological practice has never been the same. For private practitioners, “managed care” continues to be a primary obstacle to the practice of psychology. Costs might have been suppressed by managing care, but some would argue that the primary effect of the managed care revolution was the creation of a new industry that made money as the middle-men at the cost of providers. Indeed, after a few years of leveling of the costs of care, the rise has been renewed and expanded.

In mid-November, the Supreme Court of the U.S. agreed to hear an appeal of the Affordable Care Act, our nation’s most recent effort to reform our healthcare system.

The Supreme Court agreed to hear appeals from the United States Court of Appeals for the 11th Circuit in Atlanta, which is the only court to have struck down the individual mandate because it overstepped Congressional authority and wasn’t justified by the constitutional power “to regulate commerce” or “to lay and collect taxes.” FierceHealthPayer, November 18, 2011

According to editor Dina Overland of FierceHealthPayer newsletter, even a complete overturn of the law would have little significant impact. She believes that consumers like the changes the law is mandating and there is no stopping this train.

Mercom Capital Group, in their HIT Report of November 21, 2011, says the same thing about the massive changes in the healthcare arena at large. Basing their conclusions on a report by PwC (PricewaterhouseCoopers, LLC), Mercom reports that health organizations will continue to move forward with changes to their health technology and other innovations because the multiple drivers in the marketplace have finally come to a head. No matter the political or the financial uncertainties, PwC believes this movement will continue. These are changes consumers like, and the movement will continue no matter which market forces might change.

In their HIT Report of November 28, 2011, Mercom reports that Harvard and Aetna will ally to work to improve healthcare costs and quality. The two have formed a research collaborative focused on improving the quality and cost of healthcare. They will use bioinformatics, the interface of computer science and information technology with the fields of biology and medicine, to analyze healthcare data in innovative ways. They will focus on outcomes of various treatments considering quality and cost, factors that predict adherence to medical and drug treatments for chronic diseases, examining how claims and clinical data can be best used to predict disease and follow outcomes, as well as other treatments of data that will emerge over time.

Where is your organization in the midst of this dramatic change in how we manage healthcare? How do you see yourself participating in the sea change that is under way? Where does behavioral healthcare fit into this picture?

Just type in your thoughts below. Thanks for commenting.

We spent the past weekend working hard for our bicycling club’s annual fundraiser, the Horrible Hundred. I have written about our work on this ride in the past, but this year I have been feeling especially grateful for our wonderful team. Without them . . . their willingness to work very hard for a long day for no apparent reason other than a job well done, and their ability to overlook and laugh at the foibles of their co-leaders . . . we would never have been able to organize a successful ride rest stop for eight years.

I am also grateful that this is our last year organizing that project.

Focusing on gratitude got me started in a direction I should go more often. With the annual Thanksgiving holiday just ahead, I was encouraged to look further. I took a quit trip to the web site for The Happiness Project, Gretchen Rubin’s bestseller, and sure enough . . . she is exploring the notion of gratitude this week . . . with a focus on thankfulness for things that do not happen. A quick search of her site revealed about 40 entries in which gratitude is explored in some fashion. After all, having an attitude of gratitude is considered by many to be a key ingredient of happiness.

In fact, a quick Google search of the word gratitude comes up with over 56,600,000 results. That number amazed me! It is not quite so many hits as a Google search for the word ‘greed’ produces (it comes in at 58,200,000 quick results), but it is still a well-mentioned concept in our culture.

The number of hits on ‘greed’ suggests that we might need to improve our focus on gratitude to become better human beings. I get irritated with those greedy folks and their sense of entitlement. I am very grateful for those in my life who have an ongoing sense of awe at the beauty of the world and the goodness of others. They remind me that not everyone . . . maybe not even most people . . . believe that the world owes them anything.

• I am thankful for my family and friends who are always there when I need them….and even when I don’t.
• I am grateful for my co-workers who have been with us for so long and keep on producing so our customers have outstanding software and great support.
• I really appreciate those of you who are our customers, who use our products and recommend us to your friends and colleagues.
• I am thankful that there are a few people in addition to our customers who like to read what I have to say.
• I am profoundly grateful that we live in a beautiful place where we feel connected to nature daily.
• I am thankful that I have found yoga practice, and that I have so far to go to get anywhere near maximum benefit from it. There is only upside!
• I so much appreciate that I will see well-loved family members in just a couple of days.

What role does gratitude play in your life? Is it important in your day-to-day view of the world? For what are you most grateful? What do you do to practice gratitude?

Please share your thoughts and experiences with the rest of us. We will be most grateful. And do have a wonderful Thanksgiving holiday.

I recently finished reading Daemon by Daniel Suarez. I was so fascinated by the ideas in the book that I just downloaded the free chapters of the sequel, FreedomTM and have requested the book from my local library. While I am waiting, I have been thinking and doing some research.

The premise of the book is that a dying computer game writer creates a program (called a daemon) that initiates upon news of his death. The extent of the infiltration of that program into the worlds of the rest of us is amazing. The book explores the worlds of computer and credit card hackers, drug cartels and crime syndicates, and all the government and quasi-government but private organizations potentially involved in these events.

This book is written by a computer systems person who consults to Fortune 1000 companies. His presentation of the events and concepts makes for a very exciting though violent story. It is called a techno-thriller. I call it science fiction….but all the technologies are current, so the events could occur.

I work in a high tech industry. We write software, so I thought I was at least somewhat informed about the technological world. This book revealed to me that I am totally ignorant of this whole realm. That is part of what is interesting to me about it. How can I live and work in the sphere I do and still have no idea about this arena?

Techies find this book and its sequel pretty fascinating. An article written by Josh McHugh in 2008 in Wired magazine talks about how the author got serious credibility in the geek world after self-publishing the book.

An organization called The Long Now Foundation . . . that is focused on encouraging and supporting long-term thinking about and responsible action in our world . . . had Suarez present a seminar about bot-mediated reality to members. As with most things I find interesting, the links I find in the cyber-world about my starting point are equally fascinating!

I have tried not to be a spoiler about Suarez’ books. That may have made this article a bit too vague. I hope you are interested enough to take a look at the links. Maybe it is time for us to balance our focus on the present and too many things to do with thought about the future and where we are taking ourselves.

Please share your comments below. Since I have no history with computer games, please share your experience and insights in that world.

Today I received a new sort of notice from the listserv…one aimed at informing as many individuals as possible about an upcoming test of the federal Emergency Alert System.

Date:    Thu, 3 Nov 2011 12:11:48 -0400
From:    “OS OCR PrivacyList, OCR (HHS/OS)” <OCRPrivacyList@HHS.GOV>
Subject: First Nationwide Test of the Emergency Alert System; November 9 at 2pm EDT

FIRST NATIONWIDE TEST OF THE EMERGENCY ALERT SYSTEM
Test to Take Place November 9 at 2 p.m. EDT

Dear Colleagues;

We need your assistance in notifying everyone about the November 9th nationwide test of the Emergency Alert System.  Please help distribute this to all your stakeholders, as far and wide as possible, to ensure the entire community is aware that

As part of our larger efforts to strengthen our nation’s preparedness and resiliency, the Federal Communications Commission (FCC) and the U.S. Department of Homeland Security’s Federal Emergency Management Agency (FEMA) will conduct the first nation-wide test of the Emergency Alert System on November 9th at 2pm Eastern Standard Time.

The national Emergency Alert System is an alert and warning system established to enable the President of the United States, if needed, to address the American public during emergencies.  It is another critical communications tool that can protect the public and strengthen our nation’s resiliency.  The National Weather Service, governors, and state and local authorities also use parts of the system to issue more localized emergency alerts.  The test is an important exercise in ensuring that the system is effective in communicating critical information to the public in the event of a real national emergency.

This national test will help federal partners and EAS participants determine the reliability of the system, as well as its effectiveness in notifying the public of emergencies and potential disasters both nationally and regionally.  The test will also provide the FCC and FEMA a chance to identify improvements that are needed to build a new, modernized, and fully accessible Emergency Alert System.

To support the disability community, FEMA has developed a toolkit that will allow you to reach out to your constituents and local partners.  The toolkits, attached here in multiple formats, allow you and your organization to quickly disseminate information about this test.

In addition, we’re also releasing two new videos created to support the outreach efforts of our disability community partners.   FEMA Administrator Craig Fugate has long been a champion of the whole community and ensuring that FEMA represents the diversity of the people we serve.  In one video, Neil Mc Devitt, from FEMA’s Office of Disability Integration and Coordination joins Administrator Fugate in outlining the need for the upcoming Emergency Alert System test and the accessibility challenges posed by the test.   The video has American Sign Language, open-captions, and is voiced throughout.   We’re also happy to provide a Spanish version of the message with open-captions.

If you have additional questions for FEMA-Office of Disability Integration and Coordination questions, please contact our office at

Marci Roth
Director
Office of Disability Integration and Coordination

 

*        FEMA Administrator’s Message – http://www.fema.gov/medialibrary/media_records/6407

*        ASL Video: http://www.fema.gov/medialibrary/media_records/6407

*        Spanish Video: http://www.fema.gov/medialibrary/media_records/6408

Please share this information with your constituencies, colleagues, friends, and families.   Remember, on November 9th at 2pm ET, “Don’t stress; it’s only a test.”

I was fascinated at using the HIPAA listserv for this purpose. As I read through the notice, it became clear that FEMA is quite concerned about insuring that disabled individuals of all sorts receive notice of this test so they are not alarmed when the test occurs. Using a listserv that reaches healthcare providers is actually an excellent use of this list. After all, most disabled individuals are in touch with healthcare providers.

Please feel free to pass this information…or even this blog…on to your clients. It is important that consumers of behavioral health and other health services realize that the event scheduled for Wednesday, November 9, 2011 at 2pm is a TEST of the Emergency Alert System.

Good for you to know it too!

Thanks for reading and sharing the information in our blog.