Emerging HealthCare Technology

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This is an article written for Sally McKenzie’s newsletter. The Dentist’s Network – By Wesley Robinson, President of Integrated Axis Group, LLC and DIA Member.

If you could put part of your practice on autopilot, would you?

Every twelve to eighteen months, computers double their capabilities, and so does the information technologies that use them. Currently, there is regenerative medicine in clinical trials using consumer wireless computer-brain interfaces for $300. If we can do this today, what will it be like in twenty years, when technology is a million times better? Three-dimensional processors and memory drives along with biological, photon, and quantum computing will keep the rate of information improvement at an exponential pace.

So, without getting too technical, here are a few of my observations based on current emerging technology and solutions.

Softbank Robotics launched its first 58 cm in height NAO Robot in 2006. In 2009, a 140 cm tall humanoid ROMEO Robot project with the goal of assisting people facing a loss of autonomy. Then in 2014, the first personal emotional 120 cm in height Pepper Robot was launched. Pepper can identify the main emotions: joy, sadness, anger or surprise. He is also capable of interpreting a smile, a frown, your tone of voice, as well as the lexical field you use and non-verbal language such as the angle of your head, for example. The combination of all this information enables the robot to determine whether his human interlocutor is in a good or a bad mood. These are just a few of his capabilities.

We recently integrated Pepper a human-shaped robot in one of our Orthodontics offices. Currently, Pepper is just interacting with the patients and families as they enter the office. Both Pepper and NAO are entirely programmable and offer infinite possibilities to enrich the customers’ experience and office assistance. For example, patient education, registration, scheduling, electronic collections, patient photo and questionnaire to name a few. Plans are to also include staff training, inventory assistance, and order supplies.

It still takes time to integrate Pepper into a practice; however, as robotic technology is adopted and can be shipped pre-configured based on application, they will be easier to implement. It’s exciting to see the interaction of employees and patients of all ages with Robotics.

If you never had to ask a patient to fill out a registration, history or consent form, would you?

As the Hospitals, Dentists, Doctors, Labs, Pharmacies, Insurers, Researchers, and Patients continue to require improved collaboration, MediChain is solving the problem. For my entire Healthcare Information Systems career, this has been frustrating and inefficient due to proprietary solutions and government regulations.

MediChain is a Healthcare Big-Data platform that provides a safe way to store sensitive information without the need for trust. By using a combination of blockchain and off-chain storage of EMR, MediChain is creating a simple way to transfer information between entities. With this app, a patient can share data from their dentists, doctors, pharmacies including non-prescription medication and devices like smart watches, smartphones. Their complete records are accessible with anyone or any entity they see fit by granting access by exchanging their decryption key. As the records update so are yours, without having to enter or request updated information once the patient grants access.

Emergency access is in an extended version of MediChain even it the patient cannot give consent. This advancement will ultimately save lives by allowing easy access to accurate patient information.

As with any new technology, the current concerns with blockchain are HIPAA, PHI, FDA 510(k), IEC 60601-1 and ISO 12485 compliance. Health Information Exchange security is crucial in healthcare, especially as data sharing becomes more popular. It will need to take into consideration national and international regulations as data travels.

MediChain is currently in trial with a minimum viable product (MVP) at pain clinics in the UK. The trial has already attracted positive feedback from major pharmaceutical companies, medical technology solution suppliers, and an internationally recognized independent research institution.

Other businesses are working on bringing the EMR to the blockchain; however, MediChain has stood out to me based on these scalable and sustainable solution.

Wesley Robinson Owner / President & CEO of Integrated Axis Group, LLC  a National Managed Services Provider (MSP) based in Texas. He has been in Healthcare Information Systems for more than 30 years and is a founding board member of the Dental Integrators Association.  Married to Kelly Robinson, DDS a third-generation dentist, they have three sons and a daughter-in-law. He has personally helped countless Healthcare Providers create efficient technology strategies and service solutions that fit their unique needs.

Wesley can be reached at WRobinson@IAG-USA.com

The Real Cost of Innovation Debt

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This is an article written for Sally McKenzie’s newsletter. The Dentist’s Network – By Clay Archer, CEO and Founder of DentalPC and DIA Member.

A colleague of mine from Ottawa introduced me to the concept of Innovation Debt, and it struck a chord with me. His basic premise is that we all have a certain level of innovation and technical progress in our businesses/practices. Top performing practices manage their growth in a steady, consistent pace, using budgeting and planning to make investments. Others who don’t make regular, planned progress fall behind, and once they fall too far behind the cost and disruption of making up the deficit become exponentially higher. This gap is called Innovation Debt.

When I first read about this concept, it made me think of some of the first dental practices I worked in back in the 90’s. The practice would have a wonderful older dentist whose office was past its prime. It had aged wooden paneling and the old pastel GE x-ray heads, pink, baby blue and yellow. As you walked down the hall, you would see worn carpet in the operatories. It needed a good paint job inside and out. At some point, it had been a beautiful new facility, but it went downhill from there. In year five the doctor didn’t repaint, in year ten they didn’t change out the wood paneling and carpet, in year 15-20 they didn’t upgrade any equipment. Slowly but surely the practice got to a point where getting back to a nice facility became a six-figure gut and redo that would never get done. In the same building the doctors’ peer, who maintained and planned for upgrades, had an attractive, contemporary facility and a thriving practice. Innovation debt is the same thing when it comes to technology.

Now that we have a basic idea about what innovation debt is let’s talk about three things that you can do from the beginning to ensure you don’t fall behind.

  1. Setting an annual budget like clockwork. The most important thing you can do is define what the target is. To be clear, this is not about buying every shiny object you see at a trade show. This is about systematic progress that improves patient experience, clinical care and efficiency of the office. The best way to find the “Goldilocks” amount to spend is to set and drive to a budget. Each year you can evaluate where you stand, what your profit level will be and what you choose to reinvest. If you fell short or spent too much in the previous year, you adjust your goals for the next.

 

  1. Meet with your leadership team and a Dental Integrator and discuss your innovation path. Make sure you have the buy-in from the staff, and they see the value of CAD/CAM, 3D, Recall Systems, etc.   There is nothing more detrimental to your progress than buying expensive equipment that isn’t used because it isn’t properly adopted. This is an area where your Dental Integrator can help you choose the right technology that is the best fit for your office.

 

  1. Be an active member of your dental community. Go to the dental conventions, support your component and state dental association, and meet with your peers. The best way to find out what “best in class” looks like is to talk to and visit your peers. See what is working and what isn’t and form your own prescription for your practice. I can’t emphasize enough the importance of visiting other offices, talking to your supply reps and networking. I know everyone is afraid that their reps will “sell” them more than they need, but they are a wealth of knowledge, and the right one will be consultative and help you grow.

 

Remember, small regular additions are more comfortable for your team to adopt, learn and perfect. Regular expenditures are easier to budget for and afford. If things go well and you exceed budgets, slightly bigger, similar investments can be made. It’s like working out or eating right, you build on success and add layers.

Dentists often put off updating their technology until it’s too late. The longer you put off making technology changes in your practice, the more expensive those changes become. Smaller changes become harder to implement, and the need for much more substantial changes grows. Don’t wait until you are faced with a costly and time-consuming task to update your technology. Be proactive rather than reactive and make sure you avoid falling into Innovation Debt.

 

Clay Archer is the CEO and Founder of DentalPC, a dental specific IT solutions provider serving the southeastern United States since 1995. He is also a member of the Dental Integrators Association www.dentalintegrators.org. Clay can be reached at clay@dentalpc.com

Cybersecurity Training 101- Building the Human Firewall

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Mike Whaley, Director of IT Security for CRC TechnologiesThis is an article written for Sally McKenzie’s newsletter. The Dentist’s Network – By Mike Whaley, Director of IT Security for CRC Technologies and DIA Member.

It has been estimated that it can cost the victim of a healthcare data breach (the patient) $13,500 to recover after their medical data has been stolen. A Ponemon Institute Study on Medical Identity Theft (publication date 2015) compiled these costs based on credit restoration, reimbursement to healthcare providers for fraudulent claims, and correcting inaccuracies in health care records. Due to HIPAA privacy regulations, victims of medical identity theft must be involved in the resolution of the crime. Those who have resolved their crime spent, on average, more than 200 hours working with their insurer or healthcare provider to make sure their personal medical credentials are secured and can no longer be used by an imposter, and verifying their personal health information, medical invoices, claims and electronic health records are accurate.

Dental professionals are keepers of some very sensitive, embarrassing, and potentially discriminatory data. Dental professionals are also keepers of enough information for one person to easily create a false identity – therefore it is necessary to take measures to keep patient data safe.

Most of a dental practice’s technical security controls are provided by their IT vendor, such as firewalls and antivirus. Hopefully the practice is already taking their IT vendors technical security control recommendations seriously and implementing them. Controls are also driven by the practice, such as security cameras or security policies and procedures, and access controls like door locks and server room locks. Even if a practice has their security locked down, it could easily take only one of their employees to accidently download and run a malicious program delivered by email or a website and BOOM – the practice data is ransomed, or the computers are suddenly being remotely viewed and staff keystrokes logged while login credentials are stolen.

If properly trained, staff can become the biggest guard against cybersecurity threats. They will become the human firewall. Security threats can come from many different directions like email phishing, the internet, phone calls, or an in-person visitor. Training employees on a regular basis about cybersecurity threats is called Cybersecurity Awareness Training.

Ongoing cybersecurity training helps to prevent bad outcomes from threats like phishing, which is when the bad guys trick a person into following a malicious link in an email or downloading an email attachment. A study reported by the INFOSEC Institute reports that, “…26% to 45% of the employees of the chosen companies were susceptible to phishing. With the security awareness program, that percentage decreased by 75%.”

Ransomware is a big moneymaker for the bad guys. If a practice downloads malware that ends up encrypting their patient data and demands money to unencrypt the data, this can cost a practice thousands of dollars in ransom to decrypt the data. Plus, if hit by ransomware, HIPAA requires practices to prove their data wasn’t taken by the bad guys, so it could be a double whammy with fines.

Cybersecurity Awareness Training programs aren’t expensive and there are plenty of options out there. Implementing a Cybersecurity Awareness program shouldn’t be a one-time event, it needs to be ongoing and training needs to take place quarterly at a minimum to be effective. The National Institute of Standards and Technology (NIST) of the U.S. Department of Commerce recommends training modules, testing users, simulations, posters, and newsletters as part of the program.

Popular security awareness training vendors include KnowBe4 and PhishMe. KnowBe4 includes phishing, fake voice calls, and they can even send a USB drive to the practice to see if staff will plug it in. PhishMe is one of the more senior companies in the space and has perfected the phish and training that goes along with it. If an end user clicks on a link in a phishing email, it will send them to a training web site. One organization to consider is SANS for their cybersecurity training. They are an organization made up of cybersecurity professionals and have a good reputation for being on the forefront for training end users.

Practices should be on the lookout for cybersecurity training that is offered from their HIPAA consultants or their bank if enrolled in a PCI compliance program. They may have training modules included with their online solutions. The practice’s IT vendor might have some good options for cybersecurity awareness training programs and may already have a program they can refer to or administer.

Rather than a costly breach or a down server do to ransomware, Cybersecurity Awareness Training can help build the human firewall and keep out the bad guys. Loss of patient data can cost not only the practice time and money, but it can cost the patients time and money also. Training programs are easy to find and easy to administer. Stay safe out there!

 

Mike Whaley is the Director of IT Security for CRC (www.crctechs.com ), a managed service provider based in Seattle, Washington. Mike has more than 20 years of client and project management along with a formalized education in Network Administration.

CRC is a proud member of the Dental Integrators Association, a network of leading independent dental technology integration firms from across the country. It was formed to create and deliver a higher standard of quality and care for dental practice technology integration.

Mike can be reached at: mike@crctechs.com

HIPAA: As Easy as…PPT?

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This is an article written for Sally McKenzie’s newsletter. The Dentist’s Network – By Amy Wood, President of ACS Technologies, LLC.

Wouldn’t it be great if HIPAA was as easy as 123 or even ABC? Well, turns out it can be as easy as People, Process and Technology – or as I like to call it, PPT. Additionally, when you have PPT in place, it benefits many other aspects of your practice as well.

As confusing as HIPAA may be, especially for smaller practices to decipher, it can be broken up into three simple things: People, Process and Technology. If you look at all aspects of HIPAA with these three things in mind, it becomes easy to decode and then implement in your practice.

Let’s start with People. As an employer, if you properly train your staff and then provide tools to enforce that training, your people will become one of your strongest defenses. When training your team, you have many options to choose from. There are pre-recorded videos, webinars, and consultants that offer live trainings to review the basics of HIPAA – where you and your staff can ask pertinent questions and receive personalized answers. In addition, it is imperative that you review the Process and Technology parts of your Compliance Program with your staff, meaning your HIPAA Policies and Procedures as well as the technology vulnerabilities and security. When it comes to training, the best offense is a good defense.

Next comes the Process. The Policies and Procedures that you are supposed to be training your staff on must be created. You could purchase a manual with stock templates or try to find them on the internet, but I’ve found the most comprehensive policies are a joint effort between the practice staff, the doctor, a HIPAA consultant and the IT Provider. This way, what is written on paper is actually what is being done.

For example, if your policy says you will have Business Grade Anti-Virus on all computers that is updated at least daily and documented as such (as is recommended), but you buy an anti-virus license once per year and set it to ‘auto update’, your policy really isn’t being followed.

Last, and often most confusing, is the Technology. While this part of HIPAA is only about 20% of the puzzle, it tends to be the most talked about because it’s constantly changing. Think about it – ten years ago you were just implementing computers to schedule appointments, and now you are doing appointment reminders, patient health histories, and 2D/3D images of the teeth and head. You can access it from home and send it to colleagues to collaborate. The changes over the years have been incredible.

Unfortunately, the same goes for cyber threats. As information becomes easier to create and move, the more vulnerable that information becomes and the more frequently you have to adapt to new threats.

What exactly is the best way to secure your technology?

It used to be that locking the door and buying an anti-virus program was enough to keep the bad guys out. That’s not the case anymore. Now there’s encryption, cages and cables, firewalls, patching and updates, ‘smart’ equipment and lots of backups. Unless you are fluent in Geek, this can be daunting. Many of the programs and tools that automate this are only accessible to larger businesses.

Fortunately, many IT Providers are adopting a Managed Services Provider Model, where they provide a set of these programs and tools within your price range because they can be aggregated across many clients. This type of IT Provider essentially acts as your Systems Administrator, meaning they are an outsourced IT Department for your practice.

This is a different type of engagement than most dentists are used to and is still relatively new in this space. Most dental practices are used to calling the tech guy when something is broken. Personally, I miss those days. We were the smart guys who were like knights in shining armor. Things have certainly changed in the last few years. With all the malware, ransomware and hacking that has been happening, now if something happens we are the guys who ‘let you get hacked’. It’s no longer about fixing broken things; it’s about preventing things from being broken into. 

There is baseline security that can not only thwart most attempts to get into your business, but can also have all the tools in place proactively if something does get past all your defenses. I call this the ‘Magic Bullet Theory’. If you remember the initial reports of the JFK assassination, they talked about this ‘Magic Bullet’ that had an abnormal and impossible trajectory. Using that same theory, if you think about a threat to your Protected Health Information, in a secured and managed system, that threat would have to get past multiple layers of defense that have different points where they overlap. With all of these defenses in place, the likelihood of something getting through is extremely low.

If your IT Provider isn’t doing these things, someone needs to – whether it be you, your team or another vendor. You stay up on current standards of care for patient treatment. It’s worth it to have a conversation regarding the current standards of care about your digital security.

 

Amy Wood is President of ACS Technologies, LLC. She utilizes her experience as a Data Breach Consultant and a Healthcare IT Provider to provide comprehensive education with real and relatable examples, ensuring that practices are addressing HIPAA proactively, rather than reactively, in a reasonable and appropriate manner.

Amy educates to private practices and clinics, dental associations, study clubs and disability groups as well as to vendors and Business Associate practices. She runs ACS with her husband, Scott, and lives in Santa Rosa, CA with their three daughters. 

Amy can be reached at hipaa@acsdt.com