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New App Allows For HIPAA-Compliant Group Texting by Clinicians

Posted on June 11, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

John wrote previously on EMR and HIPAA about the need for HIPAA Secure Texting and a company he’s advising that does secure text messaging called docBeat.

Well, another new app called Medigram is being tested which will allow clinicians to send HIPAA-compliant text messages within a defined group. The app is currently in closed beta with docs at Stanford Hospital, Lucille Packard Children’s Hospital and the Palo Alto VA Hospital, according to

According to the company, Medigram meets not only HIPAA requirements but also privacy/security provisions in Subtitle D of HITECH.  It does so, in part, by using SSL connections between mobile apps and its servers, as well as NIST-approved 256-bit AES encryption to secure chat data.

Secure texting certainly seems like a good idea, given how mobile-friendly this generation of clinicians has turned out to be.  And it’s hard to argue Medigram’s core pitch, which is that texting is far more interactive than a pager. Given that a surprisingly large number of doctors still use pagers, improving on the model seems like a good thing.

My theory is that the app, if otherwise usable and bug-free, will be a big hit during its beta. If so, I expect to see HIPAA-compliant instant messaging turn up next. Smaller, presumably agile companies specializing in B2B messaging — such as HipChat, Trumpia and 24im — are logical candidates to develop such a utility. (This article outlines several other enterprise IM firms, just in case you want to dig deeper.)

Of course, there’s also Google and Microsoft, both of which have large IM bases. Perhaps creating a secure version of an existing product (such as Messenger) will be less of a marketing challenge than say, HealthVault.

Regardless, I’ll be quite interested to find out how the beta turns out — I’ll keep you posted. Meanwhile, here’s a video in which Medigram describes its product.

Healthcare Data Security, Healthcare Breaches, and EMRs

Posted on October 10, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

We’ve posted about it earlier on this blog as well, and it’s a point worth reiterating – most data breaches are not the result of hordes of internet hackers out to get your computer system, they’re due to human errors or negligence.

Here are some recent cases of patient data that has emerged from EMRs in unexpected places:
Lost in Break-In: By now, we’ve all probably already shaken our collective heads over the Tricare data breach involving data for 4.9 million military patients. Scientific Applications International Corp. (SAIC), one of Pentagon’s principal contractors, was the outfit that was responsible for the data loss, which was stolen from a break-in into a SAIC employee’s car. The data was contained in backup tapes, and contained information such as SSN, addresses and phone numbers of patients, and personal health data.

There are several perplexing things about this story – a) the statement on Tricare’s website claiming nothing important was really lost: “The risk of harm to patients is judged to be low despite the data elements involved since retrieving the data on the tapes would require knowledge of and access to specific hardware and software and knowledge of the system and data structure” per this story.
b) SAIC’s success with HHS contracts – SAIC was awarded a lucrative $15 million contract by HHS, despite the breach.

Posted on a Homework Help forum: According to this NYT story and its follow-up, patient records (names, diagnosis codes, account numbers, admission codes) from emergency visits for a six month period at Stanford Hospital, CA, were posted online. Supposedly, a Stanford vendor sent the data to a prospective contractor as part of a testing exercise. The contractor posted it all online, on a website offering tutoring help no less, without realizing it was actual patient data. The story says Stanford had the data removed from the website, and reported the breach to federal and state authorities, as well as the patients. Stanford is arguing that none of its staff has done anything wrong, and that it severed its relationship with the contractor. To me, this is the proverbial buck being passed.

Lost in the Subway: The first NYT story mentions how the paper records of 192 patients left on a subway by an employee of Massachusetts General Hospital in Boston. The hospital has agreed to pay a $1 million federal fine for HIPAA violations.

So to summarize some lessons learned from these data breaches:
Loss of paper records is worse than the loss of electronic records: This should be obvious to anyone who’s not a schoolgirl with a fancy diary guarded by a lock.

Your data is only as safe as your weakest link: If you’re farming out your data to vendors, then you have to know what policies your vendor has in place. If your vendor subcontracts further, then you have to keep going down the line till you are reasonably assured of data safety. When the hammer falls, it is *you* who will be coughing up the fines.

Prep with Data-handling Policies and Procedures that you and your staff religiously follow: The data was lost in very human ways – data left inside a car, posted by an untrained contractor. This just means you need to have robust, and enforced, policies in place for how patient data is handled by your employees. Maybe in your company this means that your employees can’t take work home, or that they must clear their workspaces of any patient data before they leave. Decide what makes sense in the context of your business, and maybe hire someone to enforce these rules.

Give kickbacks to HHS: If you’re in the business of contracting with the government, seriously figure out how SAIC has managed to stay in HHS’ good books. I wish I were kidding with this one.