Types of Healthcare Communication Systems and How HIPAA Applies to Them

There are many kinds of communications systems in healthcare but we can generalize them into three distinct categories such as provider to provider communication, internal communication, and provider to patient communication. Internal communications refer to different forms of staff messaging such asrequests to cover vacant shifts, policies and procedures and emergency messages.
Dr. Enrico Coiera published an article in the Clinical Biochemist Review in 2006 named “Communication Systems in Healthcare”. In this article, he very aptly wrote that if the information is the lifeblood of healthcare then communication systems are the heart that pumps it. The article was visionary and ahead of its time and correctly assumed that communication systems in the hospitals would evolve quickly.
It was just three years after this article that Congress passed the HITECH Act which “incentivized the use of EHRs (electronic health records). As a result of the “meaningful use” incentive, the use of EHRs increased 14.2% per year. Later in 2013, HIPAA Omnibus Rule made sure that communications systems were implemented with security and integrity of ePHI.
Patient satisfaction and patient-centered care are two goals of any healthcare provider and system. To achieve those, communication systems in healthcare are continuing to evolve to improve healthcare delivery and productivity.
Let’s look more closely at the three categories of communications in healthcare.

Provider-to-Provider Communication System

Provider to Provider communication systems is used for external clinical procedures, patient transfers, and insurance transactions, in healthcare that falls under the administrative and physical guidelines of the HIPAA Security Rule. This means that entities are responsible for protecting data integrity and for securing ePHI when it is received or sent in an electronic format. The entities have to ensure that ePHI is not disclosed, deleted, changed, or destroyed without authorization or consent. The rules regarding this category of communication systems are very strict and come with the necessity to implement ID authentication, mechanisms, data encryption, and audit trails. The department of health and human Services can issue huge fines if the HIPAA guidelines are not followed even if no data breach happens from the HIPAA violation.

Provider-to-Patient Communication Systems

The most common provider-to-patient communication is usually telemedicine consultations, reminders of appointments, etc. These systems don’t require the same type of security measures that are needed of provider to provider communication systems, but their use does fall under the HIPAA Privacy Rule. Therefore, a patient’s agreement is needed before any of these systems are used to communicate PHI. Once the consent is secured from the patient, then these communications are subject to Minimum Necessary Standard which states that PHI should be minimally exposed only to those with a need to access it.. On the flip side, there are also patient-to-provider communication systems. These can range from remote clinical consultation services (videoconferencing, consultation by email), to nurse call systems that can notify healthcare professionals about updates of a patient’s condition. Patient to provider systems can be integrated into EHRs so that they can automatically update patient records and in such a case, they are subject to the technical safeguards of the HIPAA Security Rule.

Internal Communication Systems

Internal communication systems may be subject to HIPAA Security Rule depending on how they are configured in the healthcare organization. For example, internal communication systems which are protected by a firewall may be used to communicate unencrypted ePHI only if Minimum Necessary Standard is complied with. Internal communications are always subject to HIPAA Privacy Rule and that can create huge challenges in emergency cases.
In emergency cases or when patients have to be evacuated or when there is a disaster and a surge of patients, healthcare organizations are required to activate CMS mandated Emergency Preparedness Plans. That dictates how communications during an emergency can be carried on.

Compliant Use is As Vital as Compliant Systems

Regardless of which category communications systems in healthcare are generalized into, their compliant use is important. If healthcare organizations engage in effective training and safeguards, risk of HIPAA breaches is reduced. Another way to avoid breaches is to have very effective HIPAA compliant communications tools adopted such as Hucu.ai.
Hucu.ai is a free HIPAA compliant instant messaging application that is built specifically for the healthcare industry.
The biggest advantage of having Hucu.ai in a healthcare organization is that it combines all three forms of communication. Hucu.ai brings together providers, patients, and families all in one place. It enables internal teams to coordinate care faster so that timely patient care can result in better outcomes. Here are some core benefits of Hucu.ai and how it improves patient care. Hucu.ai allows you to:
  • Make timely care decisions by quickly identifying and messaging all other stakeholders (facility, home health, therapy, specialists, etc.) unique to each specific patient
  • Spend more time providing care instead of trying to find who’s who in the care team and their contact information, for each specific patient
  • Organize & find all information for each specific patient (documents, DC summaries, med lists, wound photos, and more) shared by different staff from different organizations
  • Simplify admissions/discharge process from/to hospitals/snfs/home health and keep track of patients’ wellbeing in real-time – all remotely via Hucu.ai app irrespective of patients’ location – reduce hospitalizations
  • Take timely actions for higher acuity patients by empowering other collaborators to quickly flag (urgent, acute change in condition, PUI, COVID19 +VE. COVID19 -VE, and more) such patients.
If you want to ease communication in your healthcare facility, you can request a free demo from us. Contact us for more details.
Sources of information: hipaajournal
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What Is An Effective Nurse-Patient Communication?

An important aspect of being a nurse is to have effective communication skills. It is also one of the foundations of nursing care that has a huge impact on patients. Some have the mistaken impression that “communication skills” are just “what we say. Excellent communication is so much more.. In fact, good communication skills are based on the fundamentals of establishing excellent rapport, building two-way channels and using various modes of communication effectively.

Establishing Rapport
  • Cultural Awareness for your patients’ context
  • Compassion and Empathy for patient feelings
  • Building trust by making personal connections at a human level
Building two-way channels
  • Active Listening
  • Offering Patient Education, particularly in response to questions
  • Asking probing questions
  • Giving plenty of time for questions
Fully utilizing modes of communication
  • Verbal communication: what is being said
  • Non-verbal communication: this includes facial expressions, body language, hand gestures, eye contact, and physical distance between a nurse and the patient.
  • Written communication via text, email, or better secure HIPAA compliant app
  • Presentation skills for communicating concepts to groups
Effective nurse-patient communication is shown to improve quality of care, patient outcomes, and most importantly, a nurse-patient relationship which can directly impact patient satisfaction in a person-centered care approach. According to the book, Interpersonal Relationships: Professional Communication for Nurses by Arnold and Boggs, having a communication competency is a primary way to established, trust and a collaborative relationship with patients and families. Effective nurse-patient communication is not as easy as it sounds; in fact, it is very challenging for nurses and calls for more than skills and experience.

Break all communication barriers in healthcare with Hucu.ai

Principles of Improving Nurse-Patient Communication

Prioritize Patients

It is necessary to give priority to your patients. Putting a patient first can shift the mindset with which care is being provided. Effective communication with patients begins with taking the time out to introduce yourself and telling them exactly how you will take care of them. Using non-verbal cues such as a smile, calm voice and a warm, welcoming tone will provide comfort to the patient. Showing respect to patients and looking at them from a person-centered care lens will help you build a connection with the patient and help him feel more comfortable under your care. This approach is successful in making patients feel cared for.

Active Listening

A nurse has to be an active listener when communicating with the patient. It requires the nurse to listen with full attention to the speaker to get the intent and feeling. A part of active listening is to pay full attention to the speaker and to let them finish without interrupting them or judging them for what they are saying. Taking time out to understand the concerns of patients can help a nurse be more prepared to address problems and issues as they arise and achieve better patient outcomes. The second aspect of active listening is to paraphrase what has been said and repeat it while maintaining eye contact so that the patient knows you’ve been listening carefully. The third aspect of active listening is to grasp non-verbal cues like eye contact, gestures, body language, and expressions. These help a nurse connect with the patient and build trust as well as elevate the level of comfort over time. Additionally, patients who have established an understanding with the nurse will be more willing to disclose the true extent of their symptoms. Balancing time “telling” with time “asking/listening” is critical.

Speak from the Heart

A nurse should talk with his/her heart. Patient communication requires a lot of time and therefore, frankness and honesty play a role in effective communication in this duration. To increase the effectiveness of communication, nurses have to have a sincere intention to truly understand a patient’s concerns and reply with kindness. One way to do this is to ask patients open-ended questions so that they can express themselves fully. Speaking slowly and using layman language for medical terms can also help in relaxing the patient and creating a better understanding of the situation. If the patient is having a hard time understanding information or instructions, a nurse has to modify or clarify the information until the patient understands. For this reason, using presentation materials like pictures or handouts can complement verbal communication.
Otherwise, poor communication or lack of it can lead to patients misunderstanding directions and failing to follow the treatment steps. This can result in workflow breakdown for the medical team and increase the chances of medical errors. Did you know that a report by Joint Commission* found out that poor communication during patient transfers led to 80% of serious medical errors? With the available technology (phone), effective communication skills, and a healthcare text messaging application like Hucu.ai, that can be avoided.

Hucu.ai Facilitates Communication During Patient Transfers.

When patients are being transferred from post-acute care to a nursing facility, current care teams have to hand over the patient’s profile, medical condition report and relay important information related to the patient’s new care team. If any information is missed or communicated wrongly, it can have serious consequences for the patient. This is where Hucu.ai can help.
Hucu.ai is a HIPAA compliant, text messaging application built for the healthcare industry. It facilitates communication between care teams, nurses, patients, families, and all healthcare members involved with just a tap on the phone. Bringing all members of the care team in one digital ‘channel’ and sharing important documents, facts, and information regarding the patient transfer reduces the chances of error. Real-time notifications and the capability to reach out to any team member from anywhere anytime can drastically reduce delays in patient care leading to better patient outcomes.

Establish Personal Connections

In a person-centered care approach, it is critical to know the person behind the patient. What are his likes or dislikes? What makes him comfortable? What are his pet peeves? This can help in making the patient feel safer and more comfortable. Creating such personal connections with patients can improve patient outcomes. A nurse can achieve this by spending extra minutes every day and getting to know them, trying to exchange fun facts about each other, and showing genuine interest in their life story.

Cultural Knowledge

A nurse is likely to work with patients from different social and cultural backgrounds. It is important to be aware of cultural differences and be sensitive and respectful towards them. For example, if a patient is not fluent in English, it will be a good idea to bring a translator when necessary. Similarly, with trans or gender non-binary patients, a nurse can take care in using their preferred name and pronouns.
Effective nurse-patient communication is a life-long skill and can impact the quality of care a patient receives.
*The Joint Commission, “Joint Commission Center for Transforming Healthcare Releases Targeted Solutions Tool for Hand-Off Communications,” August 2012, Volume 32, Issue 8, 2019.
Sources of Information: usa.edu, minoritynurse.com
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Starting a Successful Hospice Business – Part I

Hospice care is a process where clients can find a caring environment and quality of life at the end of their days as they prepare themselves to pass on. These terminal patients are cared for in the best way possible and kept comfortable. They receive medical care round the clock from the hospice while their family members are also given support and updates about their loved ones.
Starting a Hospice business can be a tricky one because there are regulations that need to be fulfilled. It is more than just registering your hospice business with the government. Here are the essential steps that can ensure your new hospice business is well planned, registered properly, legally sound, and becomes successful.
Step 1: Planning the business correctly
An organized, clear plan is needed for a successful hospice business. It helps to map out the specifics of the business. Here are the important questions one needs to ask before opening a hospice business.

What are the major costs?

A hospice startup cost will be different depending on the type of hospice one is opening and which state it is located in. The main cost can range from $70,000 to $120,000 if it is a non-Medicare facility. If it is a Medicare-certified hospice agency the cost can range from $160,000 to $400,000. These costs include licensing for faculty and staff, computer hardware and software, physical space for the facility, accreditation, business branding, marketing materials, inventory, and insurance.
Since the regulations are strict, many entrepreneurs may choose to invest in consultation services which increase the costs while increasing confidence in compliance.

Hucu.ai Helps Hospice Save Time and Money

What are the ongoing costs?

Apart from the standard operational expenses, there will be ongoing annual costs ranging between $400,000 to $450,000 (on the higher side). Exact numbers will differ depending on the size of the facility and the number of services being offered. Payroll will take up the greatest portion of the ongoing costs.

How will the hospice business make money?

For-profit and nonprofit hospices receive funds from different sources. Charitable donations and grants are the main sources of revenue for not for profit hospices which can also be reimbursed by private insurance, Medicaid, and Medicare for the patients being cared for. Many facilities are reimbursed on a daily basis and are offered payment for every day a patient is in the facility. Hospices can also be reimbursed on an hourly basis if the patient needs home nursing care 24/7.

How much profit can be made?

The average payment reimbursed to hospice facilities by Medicare ranges from $145/day or at an hourly rate of $40/hour if care is being given 24/7. Given this, successful hospice businesses have shown to make up to $120,000 to $200,000 in profits annually. Of course, the amount will vary depending on the number of patients, number of services offered, and ongoing expenses.

How can the business profits be optimized?

Successful hospice businesses use several strategies to ensure optimization of their profits. These include finding a gap in the market, taking up underserved segments of the market, and customizing services to their needs. Another strategy is to work with physicians, hospitals and other facilities in the community and highlight the benefits of using hospice facilities. This will develop a strong referral base.
Step 2: Forming a Legal Corporate Entity and Registering for Taxes
The three most common types of legal entities are sole proprietorship, partnership, Limited Liability Company, and C corporation. If the business owner wants to be protected from being personally liable, he can opt for an LLC or a corporation.
Once the business owner has decided on the legal entity, the business must be registered for each state in which services are provided as well as for federal taxes before officially opening the business. The business owner will need an EIN to do that. If the business structure is an LLC, it can benefit from being taxed as an S Corp. there may be specific state taxes applied to a hospice business. Here are the details on starting an LLC.

Hospice Facilities are Optimizing their Communication system with Hucu.ai

Step 3: Getting a Bank Account, Credit Card, and Setting Up Business Accounting
If the business owner wants personal asset protection, then dedicated business banking and credit accounts are needed. It is important to keep personal accounts separate from business accounts. It makes taxing and filing easier too.
Once that is done, the hospice business owner needs to set up business accounting to record various expenses and sources of income in order to understand the financial performance of the hospice facility.
Step 4: Getting Permits and Licenses
If a hospice business does not have the essential permits and licenses, it can result in heavy fines and shutting down the business altogether. The federal business licensing requirements call for a hospice to complete and submit an enrollment application. Once done, the hospice will be checked out to see if it meets the federal requirements.
State and local business licensing requirements are different as each state has its regulations regarding hospice care licensing. This guide will help in determining if the hospice is operating according to the correct state law.
Hospice facilities that are working out of a physical location also need a certificate of occupancy (CO). The CO confirms that all working areas, building codes, zoning laws, and government regulations are being met.
Check out the remaining steps in part II of this guide.
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Starting a Successful Hospice Business – Part II

In part I of this guide, we discussed the initial steps of starting a hospice business. While all major steps of starting a hospice business for every owner are the are the same, it is the last step discussed in this guide that will set up a hospice for a major success as compared to others.
Step 5: Getting Business Insurance
Insurance is as important as getting licenses and permits for a hospice business. It protects the company’s financial wellbeing in the event of a loss. There is a huge range of insurance policies created for different types of businesses with different kinds of risks. A hospice business can start with General Liability Insurance – which is the most common coverage.
Step 6: Creating a Hospice Brand
A strong business brand will help the hospice facility and services to stand out from from the competition. Defining the vision of the business, branding it in a consistent and specific way can make a hospice business successful in achieving the right perception and becoming the choice for clients.
There are many marketing strategies like advertising in magazines or or newspapers to promote the business. In this digital era, keeping an online presence is fundamental. Additionally, creating relationships with surgeons, hospitals, doctors and post-operative clinics can prove a huge source of referrals. The easiest way to maintain successful communication with these partners is through hucu.ai. Hucu.ai is a FREE, HIPAA compliant communication application wired for Healthcare.
Hucu.ai can solidify existing referral relationships and help build new ones. With hucu.ai, hospice owners can build bridges across providers, patients, and families, improve accessibility and responsiveness of partners, establish tighter connections with skilled nursing and home health providers, and provide visibility to collaboration performance. Find out more here about how Hucu.ai can specifically help Hospice businesses become more successful.

Hospice Using Hucu.ai Have Increased Patient and Family Satisfaction

Step 7: Create a Business Website
After defining the specifics of your hospice brand, it is essential to create a website for the business. It is important because all legitimate businesses have websites that clients check out before choosing achoosing a business. Social media accounts like LinkedIn and and Facebook are important but cannot replace a business website.
Step 8: Setting Up a Successful Communication System
The Healthcare industry incurs huge losses both financial and human because of communication gaps. A successful communication system will set up a hospice facility for success. A smooth flow of information throughout the different hierarchies in a hospice setting will free up time wasted in repeating the same information multiple times to multiple staff members. The time saved can be invested in caring better for the clients.
Thanks to modern technology like Hucu.ai, communication in a hospice facility can become a breeze. Staff can save their time by just opening their cell phones and getting real-time updates about their clients regardless of their location. The staff on the next shift do do not have to go through huge piles of documents to get status updates on their client, they just have to check the individual patient channel in the Hucu.ai app.

Hucu.ai Allows Hospice Staff to Share Videos, Pictures and Documents in a HIPAA Compliant Way

Staff can share documents, pictures, and videos in the Hucu.ai app with team members to tackle emergencies where decision-making needs to be quick. This helps them feel more supported and empowered and in turn, increases team morale. Hucu.ai helps in engaging and retaining distributed team members while building the desired work culture. Hospices that have Hucu.ai have proven better focus at work by reducing noise and distractions since the staff members don’t have to dig through personal messages to get to work messages.
Hucu.ai helps hospices improve their operations and also increases family satisfaction. Hucu.ai empowers primary care physicians by offering easy communication to provide context, oversee the care, and facilitate improvements in patient status. It enables easy information sharing to communicate med lists, patient history, advanced directives, and other important information. Hucu.ai can improve the patient/family experience by providing seamless communication across all providers.
Hospices have proven to perform at their best with Hucu.ai. If you want to increase the success rate of your hospice business, you may want to consider implementing Hucu.ai as the primary source of communication within your facility. Contact us for a free demo.
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