The HITECH Act Defined
Does the thought of technology make you want to throw your computer out the window? Many people find technology frustrating, but the HITECH Act, which is part of HIPAA training, has made healthcare easier in several ways.
But what exactly is the HITECH Act? It's a component of HIPAA that focuses on using technology and providing care through secure electronic health records. In this blog, we’ll explain the meaning of HITECH and its relevance to your work in healthcare.
HITECH Act Overview
The Health Information Technology for Economic and Clinical Health Act (HITECH) is relatively recent. Signed into law by President Barack Obama in early 2009, HITECH has become a significant piece of healthcare legislation. It was part of an economic stimulus package known as the American Recovery and Reinvestment Act (ARRA).
This law facilitated the transition of healthcare organizations from paper records to electronic health records (EHRs). Since its enactment, more healthcare providers have adopted EHRs, enabling them to deliver high-quality care with less reliance on paper.
Additionally, patients now have greater access to their records and can view them outside of doctor's appointments.
Enforceable
Although the HITECH Act was signed into law in early 2009, healthcare providers were given some time to implement its requirements. The act's provisions became enforceable at the end of November 2009, allowing providers ample time to prepare.
At that point, compliance with the law became mandatory, with penalties for non-compliance. However, the enforcement of HITECH has evolved since then. Despite being a relatively new law, HITECH has changed, particularly in its connection to HIPAA, which has influenced its trajectory.
Today, healthcare providers must comply with HITECH and HIPAA as integrated legislation.
HITECH Act Compliance
In January 2013, the government released the HIPAA Final Omnibus Rule, which merged HIPAA and HITECH. Healthcare providers were given until September of that year to comply.
This combination strengthened the existing privacy and security rules of HIPAA. While compliance has become more challenging, it has also enhanced the protection of patient information and increased accountability for healthcare providers.
Today, compliance is mandatory for all healthcare providers. Moreover, the act applies to everyone working in healthcare settings, even if they do not work directly with patients.
HITECH Act Explained
The HITECH Act was established with multiple goals in mind. Although its structure has evolved since the HIPAA Final Omnibus Rule, it continues to address security and privacy concerns related to the use of electronic health records (EHRs) and access to protected health information (PHI).
EHRs enable providers to access patient data in real-time, allowing for the efficient updating of records as changes occur, which is much more convenient than managing bulky paper files. However, the use of EHRs is not the only focus of HITECH.
As you study HIPAA, consider how the objectives of HITECH integrate with the law and ensure compliance with all its regulations. Here are some of the purposes the HITECH Act serves:
Expand EHR Use
Before the HITECH Act, many healthcare facilities couldn't afford to transition to electronic systems due to the high costs and time involved. The act aimed to ease this burden by providing financial incentives to providers who made the switch.
This made adopting electronic health records (EHRs) much easier. As a result, more providers could afford the transition, simplifying the management of health records for everyone involved. While EHRs are not without their flaws, they enable access to a patient's medical history and streamline workflow.
Additionally, using EHRs saves physical space by digitizing records and allows patients easier access to their information.
Provide Access to Patients
Previously, providing patients with their medical records was possible but cumbersome. Healthcare providers had to make physical copies of the requested records and securely deliver them to the patient.
Now, EHRs simplify the process by enabling the transfer of electronic copies. Patients can use these electronic copies when reporting their health to schools or workplaces.
However, it can still be costly for providers to send electronic records, so HITECH permits charging a fee for this service. It's essential to ensure that PHI is shared with the correct individual to avoid violating HIPAA regulations and facing penalties.
Remove HIPAA Loopholes
While HIPAA has always been a strong act, it previously contained a loophole that allowed business associates to avoid compliance. It also permitted healthcare offices to claim ignorance of their associates' obligation to comply with the law.
However, HITECH clarified HIPAA's provisions, making it mandatory for business associates of healthcare offices to adhere to HIPAA. This applies even if an associate's role is primarily administrative; they must still secure PHI and ensure that only authorized users can access it.
By closing this loophole, the Department of Health and Human Services (HHS) can now hold medical providers accountable for the actions of all their staff. Consequently, everyone from doctors to accountants must understand and comply with HIPAA regulations.
New HIPAA Rule
HITECH also introduced a new HIPAA regulation known as the Breach Notification Rule. When a covered entity, such as a healthcare office, experiences a data breach, it must notify those affected within 60 days of discovering the breach of PHI.
Covered entities are required to send breach notification letters to patients via first-class mail. The letter should detail the nature of the breach, the PHI that was exposed, the steps being taken to address the breach, and what patients can do to protect themselves.
If the breach affects more than 500 individuals, it must be reported to the HHS within 60 days, and a notice must be provided to a prominent local media outlet. For breaches affecting fewer than 500 individuals, the report can be submitted by the end of the calendar year.
When a business associate discovers a breach, they must notify their covered entity, which will then report the issue to the HHS and inform the affected individuals.
Publication of Breaches
In addition to requiring large breaches to be reported in a local publication, the Office for Civil Rights (OCR) publishes breaches of any size on its website. This list includes the name of the covered entity or business associate, the category of the breach, the location of the affected PHI, and the number of individuals impacted.
While being on this list may feel embarrassing, it includes every breach, even those beyond your control. Sometimes, security breaches can occur despite full compliance with the HIPAA Security Rule. The best course of action is to refresh your knowledge of HIPAA to help mitigate the risk of future breaches.
Stricter HIPAA Penalties
HITECH has introduced tougher penalties for HIPAA violations, making it more compelling for providers and associates to adhere to HIPAA rules and regulations. HITECH increased both the maximum fines for individual HIPAA violations and the annual maximum penalty.
Individual penalties can now reach up to $250,000, compared to the previous range starting at $100, depending on the violation category. Over a year, repeated and uncorrected violations can incur fines of up to $1.5 million, whereas the previous annual maximum was $25,000.
The HHS aims to ensure compliance with HIPAA, and higher fines are an effective means to achieve this.
HITECH Act Enforcement
The higher penalties enable the HHS to address violations more seriously. While they may waive fines for breaches beyond the control of the covered entity, they can impose substantial penalties for more severe issues.
If someone accesses PHI for personal gain or with malicious intent, they could face higher fines and even jail time. A jail sentence could be up to 10 years if the intent behind accessing PHI was to cause harm.
Consequently, healthcare offices should take extra precautions. Training healthcare and medical office staff can help prevent certain violations and reduce the risk of incurring additional fees.
Meaningful Use Requirements
As part of the HITECH Act, the HHS received a $25 billion budget to achieve specific goals, including funding the Meaningful Use Program. This program provided monetary rewards to healthcare providers that switched to certified EHRs, which meet security and usability standards.
The funding helped many providers transition to these systems despite the high costs. The program encouraged the use of EHRs for tasks like issuing prescriptions and exchanging health information.
Now called Promoting Interoperability and part of the Medicare Merit-Based Incentive Payment System (MIPS), it measures healthcare quality, cost, and improvement efforts. Although it no longer offers financial rewards, it still promotes the adoption of user-friendly EHRs for managing patient records.
Meaningful Use Program Benefits
Here are a few things the program helps with:
Improves Efficiency
EHRs provide a more efficient way to track and access patient information. Instead of sifting through physical files, healthcare providers can use electronic searches to find a patient's medical history quickly.
This is especially useful for patients with extensive records, allowing providers to find diagnosis and treatment dates easily. This efficiency saves time, enabling providers to focus more on patient care and improve the quality of care provided.
Better Coordination of Care
In most cases, multiple providers work with the same patients. During an annual visit, a nurse first notes any issues or complaints in the patient's records. The doctor can then easily review this information before seeing the patient, allowing them to address concerns immediately.
If the patient needs to see a different provider, that provider can quickly access the patient's records without searching for a physical file. This streamlines the process and ensures continuity of care.
Ensures Security and Privacy
HIPAA has already stressed the importance of security and privacy, but HITECH's Meaningful Use Program has encouraged providers to adopt more secure digital options. While no method is completely immune to breaches, encryption and other techniques make it easier to protect digital files.
These methods ensure that only authorized users can access certain patient files and allow you to track file access, identifying potential HIPAA violations. The Security Rule provides guidelines for controlling access and securely transmitting information, helping to keep PHI secure and confidential.
Engages Patients and Caregivers
Technology has made it easier for healthcare providers to communicate with patients and caregivers.
Sharing patient documents is now more efficient, as you can send records instantly using a certified EHR or secure system, eliminating the need for photocopies and physical delivery. This allows you to quickly send test results and inform patients if they are normal.
Additionally, you can spend more time with patients during appointments, as administrative tasks are reduced. While technology can be frustrating, using an EHR simplifies and automates parts of your workflow.
Helps Population and Public Health
While HIPAA protects PHI, public health authorities are an exception. These agencies can collect and receive information to monitor public health, with states mandating metrics like cancer or pandemic disease numbers.
Public health agencies can share non-identifying information, such as case counts, to inform the community. EHRs make it easier to collect this data from your organization, allowing you to filter for specific metrics and save time compared to searching through paper records.
Reduces Costs
The Meaningful Use Program helped organizations save money, allowing more healthcare providers to adopt electronic systems without a large budget. EHRs also reduce long-term costs by cutting expenses for paper, ink, and printer maintenance.
Although the initial technology investment can be high, costs decrease over time. While the program no longer offers financial incentives, it demonstrates patient and provider benefits. If you haven't already, you should switch to an EHR as soon as possible.
Is HITECH Different From HIPAA?
When learning about HITECH, you might wonder how it differs from HIPAA. HIPAA covers the privacy and security of all health records, whether electronic or not. HITECH, now part of HIPAA, specifically focuses on electronic records, their security, and data breaches.
As a healthcare provider, it's crucial to understand both laws and how they work together. Whether you're a provider, associate, or office staff, you must comply with HIPAA, which includes HITECH.
Despite being a newer addition, HITECH is as important as the HIPAA Privacy and Security Rules. Non-compliance with any part of HIPAA can result in severe penalties. Understanding HITECH's impact on HIPAA is essential for full compliance.
How Has HITECH Changed HIPAA?
HITECH has modified HIPAA in several ways. Initially separate, the two acts have now merged, with HITECH becoming a crucial part of HIPAA, especially as technology becomes more integral to healthcare.
Whether you're a seasoned professional or new to the field, it's important to understand how HITECH has influenced HIPAA over the years. While future changes to the laws are likely, knowing their history is essential.
Here’s how the evolution and current state of HITECH and HIPAA impact your role in healthcare:
Reverse the Burden of Proof
Before HITECH, the HHS and OCR had to prove that a data breach exposed PHI, placing the burden of proof on the department. This made it easier for healthcare organizations to evade non-compliance, especially if they claimed ignorance of the breach.
Now, the burden is on healthcare providers to prove that a breach didn't expose PHI. This shift has allowed OCR and HHS to impose more penalties for HIPAA violations and has incentivized covered entities to strengthen their security measures.
By doing so, entities can reduce the risk of future breaches and save on penalties. This change has also freed up OCR and HHS to focus on other important health-related tasks, benefiting the entire country.
Fewer Investigations that Result in Enforcement
Since HITECH's implementation, OCR has started intervening earlier when breaches or HIPAA violations occur. This gives healthcare organizations more notice and time to resolve the issue. A covered entity can bring in a security team to conduct a risk assessment and fix any vulnerabilities, then update their security procedures to protect PHI better.
OCR also offers technical assistance to entities that need it, helping them improve policies and procedures for the future. Although changing procedures can be challenging, it leads to fewer cases escalating to serious violations, resulting in fewer penalties from OCR.
Better Data Collection and Submission
The switch from the Meaningful Use Program to the Promoting Interoperability Program removed financial incentives for using EHRs but brought other benefits. The new program emphasizes the interoperability of EHRs, helping providers collect and submit data efficiently.
This is useful for tracking diseases and public health issues. Using electronic systems also eliminates the need to copy and scan documents and reduces the time providers spend collecting data by enabling easy electronic searches.
More Patient Access
Even if patients must pay for electronic records, it's much easier than requesting a paper copy. This increased access to health records offers several benefits.
Patients can easily transfer their records to a new provider or obtain proof of immunizations for jobs or college. More access empowers patients, giving them a sense of freedom while still relying on you for care.
Understanding HITECH With 360training
The HITECH Act has encouraged providers to use electronic health records and implement stronger security measures, helping to improve patient care and data security. Regardless of your role, understanding HITECH and its integration with HIPAA is essential to ensure compliance with both regulations.
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