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HIPAAPrivacy andSocialMedia:Or how to create and maintain aCulture of ConfidentialityMelissaMitchell, JD,CHC, CPC-ACarlosCruz, JD,MHA
Melissa Mitchell, JD, CHC, CPC-ADirector, Audit and ComplianceSinai Health SystemChicago, ILFive W’s ofmelissa.mitchell@sinai.orgthe“Speak Up” Culture@melissajmitchCarlos Cruz, JD, MHAChief Compliance OfficerTri-City Medical CenterOceanside, CACruzC@TCMC.com
AgendaCulture of Confidentiality: HIPAA plusTwo CaseStudies:Tri-City: A new day a new waySinai: Building the first skyscraperLessons LearnedQuestions
What were you doing in1996?HealthInsurancePortability andAccountabilityAct of 1996What were you doing in 1996?
The Basics: Privacy Rule Security Rule Breach Notification Patients’ Rights
Social Media: An ExplosionThe New Norm Used by 74% of internetusersPowerful MarketingTool 80% using platforms toresearch physicians,hospitals, and medicalnews and information General Information tothe public Sharing of experiencesMeaning . HIPAAbreaches INVOLVINGsocial media are on therise!
Office of Civil Rights (OCR): responsiblefor enforcement of HIPAAPenalties can be significant: Civil Money Penalties: fines ranging from 100 – 1,500,000 Criminal Penalties: fines up to 250,000 and up to 10years in prison Other consequences of violating HIPAA includelawsuits, the loss of a medical license, or employeetermination. And don’t forget . reputational harm! (Don’t be onthe wall of shame).
How do we usually approachHIPAA v. How we should Burdensome Protection Over-inclusiveBut really why? Under-inclusive A pain in the neck A tool Hindering care Promoting better care Old school Constantly evolving
The Case of the Nurse on Instagram
We want to go above and beyond therequirements of HIPAA.But really why?We want to evolve.We want to maintain a confidential andempathetic environment for our patients.We want to create a CULTURE OFCONFIDENTIALITY.
Sinai Health System: 2016Creating andMaintaining a Cultureof Confidentiality onthe South and Westsides of ChicagoImpact on privacy but also: How Caregivers representthemselves How Caregivers represent SinaiHealth System How Caregivers interact witheach other
Case Study #2Tri-City: A New Day A New Way
Tri-city: A public hospital district Opened in 1961; located in Oceanside, CA Community owned and operated Serves the communities of Vista, Carlsbad and Publicagency of the State of California Affiliated with UC San Diego Safety net Hospital (388 Beds); Two advanced clinical institutes forcardiovascular and orthopedic care; 700 physicians practicingin 60 specialties Challenges Reduction in patient volumes Tightening of margins Loss of DSH
Build upon the foundation:Culture of ConfidentialityProject TimelineTown Hallsand MonthlyCompliancenewsletterRevise Privacy TrainingInitiate Staff RoundingEducateoperationalleadership:help spreadthe word
Build upon the foundationEducation,education,education Revise Current Training Increase focus on“Culture ofConfidentiality”conceptRelationshipbuilding andcommunication Initiated Staff Rounding Compliance Newsletter “Town Halls”
Tri-City’s Culture of ConfidentialityJourney:“A journey of a thousand milesbegins with a single step.”Lao Tzu
“I am not sure what a “Culture ofConfidentiality means ”Education,education,education The 5 W’s of Compliance What does the concept mean? How have other organizations dealt withthis issue?
Culture is changing . slowlyIncrease inPrivacy issuesbeing raisedIncrease inPrivacy-relatedquestions Hotline, in person, viaemail Consult requestshave increased sinceonset of programA significant issueis discussed (andused as alearningopportunity)
The Case of the CT Scan Selfie Privacy issue: Investigation and corrective action Radiology Team Inappropriate selfie California Department of Public Health report andfines Media coverage Employee Corrective Action Plan Education Provided
Case Study #1Sinai HealthBut really why? System:Building theFirstSkyscraper
BeStrongerCareHarderLoveDeeper Serving Chicago’s south and southwest side Safety Net 3 hospitals, 695 beds, 300 physicians, 1 Level Itrauma center, 1 community institute, 1 urbanhealth institute, 4,000 Caregivers
Almost 100 years and yet wehaven’t aged a daySinai (Almost 100years and yet wehaven’t aged aday) History of compliance Culture of TRYING to create cultures (ofcompliance, of confidentiality, ofexcellence, of speaking up, etc.). Old system, new structure: or how youbuild a skyscraper around the peoplealready sitting in it?
Blueprints Infrastructure Relationships (withEVERYONE)Skyscraperblueprints Communication andmarketing Program effectiveness
Culture ofConfidentiality:From infancy to teenager
When I First Told People About theCulture of Confidentiality:When I first asked people to speak up, thishappened:[insert cricketnoise here]
Then I became the social mediapolice.Someone saidsomething badabout Sinai onFacebook“I am not sureI post a picture ofthis is a Canmy Sinai badge?compliance issuebut ”Someone is sayingsomething mean onTwitterWhat if I post onFacebook that Ihate all my coworkers?Can my department createtheir own Twitter page?
Now the focus is collaboration. Partnership with marketing and HR department Education on separation of issues Encouraging auditing and monitoring across theboard
Education, education,educationMake it good, tell a story.NY MedTop DownApproachTell a GOOD story.Tell them WHY.Personal, reputational, and government repercussions.
No man is an island Collaboration is keyTop Down This is not just a compliance issue!Approach HR Marketing Operational
BE the social mediapoliceTop Down Auditing and monitoring (you WILLfind things)Approach Recruit others to do the same Talk about your finds .a lot
Respond quickly andeffectively Step one is always: “take itdown” Nurse on SnapchatTop DownApproach You can ask questions duringsteps two through 100. If you educate, repeattraining steps: Tell a story Tell them why (personal,reputation, andgovernmentreprecussions)
Tell us aboutyour socialmediavictories.Tell us aboutyour socialmediachallenges.Tell us how youhave changedyour culture(confidentialitywise orotherwise).
Thank you!Melissa Mitchellmelissa.mitchell@sinai.orgQuestions?Carlos CruzCruzC@TCMC.com
Five W’s of the “Speak Up” Culture Melissa Mitchell, JD, CHC, CPC-A Director, Audit and Compliance S
