Making Telemedicine Easier for Physicians

In response to the growing novel coronavirus (COVID-19) pandemic, the Trump Administration announced that the federal government is immediately suspending HIPAA enforcement and penalties to facilitate use of telehealth for health care services in both the Medicare and Medicaid programs. The California Medical Association (CMA) is continuing to urge Governor Gavin Newsom to follow suit and issue an executive order that would facilitate greater adoption of telehealth services. We hope the Governor issues an order today, but California data and security laws remain in effect presently. ACCMA will send out a member alert when this changes.
 
In the meantime, the ACCMA has reached out to our friends at PrivaPlan and Associates to develop simple guidance to help ACCMA members get telemedicine services up and running quickly.  
Guidance for Adopting Telemedicine Quickly
by David Ginsberg, PrivaPlan

During the novel coronavirus (COVID-19) emergency, physicians and healthcare providers may want to adopt telemedicine as a way to provide patient care. The following outlines some easy, acceptable practices for adopting telemedicine quickly that comply with HIPAA and California data and privacy laws, but some precautions should be followed. These include:

  • Ideally use a professional telemedicine platform. One such platform that is widely available is Zoom for Healthcare. If you will be recording and saving the telemedicine visits, be sure to have a HIPAA business associate agreement in place with the vendor.
  • If you don’t need to record the visit, you can use Facetime or WhatsApp, both of which encrypt the meeting; you can also use Skype or other video meeting technology.
  • Be sure that you follow all good HIPAA security practices, especially if you will provide this from your home computer or personal smartphone: 
  • Ensure Wi-Fi is secured with WPA2 encryption (fairly easy to do if not already – see article)
  • If working from home, work from as private an area as possible, and don’t allow family members or others to shoulder surf or see your workstation screens
  • Always log off when you get up and leave your workstation at home unattended – and this is not a screen saver, but a complete log-off
  • Don’t use sticky notes or otherwise leave your passwords visible near the workstation

While the President has waived HIPAA “enforcement” during this emergency, California data and security laws currently remain in effect; also, patients can still bring an action if their PHI or personal information is breached.

Today’s announcement also means that certain HIPAA Privacy requirements are not being enforced:

  • the requirements to obtain a patient's agreement to speak with family members or friends involved in the patient’s care. See 45 CFR 164.510(b)
  • the requirement to honor a request to opt out of the facility directory. See 45 CFR 164.510(a)
  • the requirement to distribute a notice of privacy practices. See 45 CFR 164.520
  • the patient's right to request privacy restrictions. See 45 CFR 164.522(a)
  • the patient's right to request confidential communications. See 45 CFR 164.522(b)

NOTE: The ACCMA does not endorse or have any relationship with any companies or products mentioned in this article. 
Telemedicine Information and Resources

The ACCMA has compiled the following telemedicine resources for physicians needing guidance about telemedicine implementation:
 
 
CMA is working to obtain information on payor reimbursement policies related to COVID-19 and telemedicine/telephone appointments. As of now, the ACCMA is aware of the following policy announcements:

Questions/Concerns?

Please contact ACCMA and 510-654-5383 or  accma@accma.org  with any questions or concerns you have. Although we may not currently have an immediate answer to all questions, we want to know the information and resources that you need to continue to provide care for our community during this difficult time.

This information will also be posted online at   www.accma.org/COVID-19  and will be updated frequently. Please check the ACCMA website regularly for updates.