The Coming HIPAAcalypse?

November 14th, 2008 by Webmaster Leave a reply »

Mayan CalendarThere was a television show on at about 3:00 AM the other morning that, once again, predicted the end of the world. This time, it was the manifestation of predictions from two ends of the earth: both the ancient Chinese and the Mayan Indians concluded 5,000 years ago that the world would end on December 21, 2012. (I think that Merlin the Magician was involved too, but he would have been just a kid 5,000 years ago!) Both predictions were written at nearly the same time, and both predicted the same date, but I believe that I have discovered what may contribute to this major catastrophe:

It is my prediction that the collapse of the planet as we know it will come from HIPAA.

According to Wikipedia,

“The Health Insurance Portability and Accountability Act was enacted by the U.S. Congress in 1996. The Centers for Medicare and Medicaid Services explain that Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers.”

Sounds pretty reasonable, doesn’t it? Just hire a full time security person for your electronic medical records, oh and don’t forget to spend millions to create the medical records in the first place. After that, life will be just fine? Right? Wrong.

If you have had little training in what the term oxymoron means, this would be a classic example; “The Administrative Simplification provision.” This provision was intended to deal with the privacy and security of health data. That is also a very noble idea. If two patients are in the same room, and someone is discussing the status of either patient, there should be a sound proof curtain between them. Soundproof curtains would also qualify as an oxymoron. For those of us who have lived this nightmare called HIPAA, Senator Kennedy has often been quoted regarding the fact that his intentions when designing this act have become grossly bureaucratic in their implementation.

Here’s the totally mystifying, Merlin-type description; the standards are meant to improve the effectiveness of our health care system by encouraging the extensive use of electronic data interchange in the U.S. health care system. Seriously, all of this sounds good. The problem comes when hundreds or thousands of government bureaucratic health care wonks and healthcare attorneys are introduced into the equation.

Well, a few weeks ago, according to Managed Healthcare Executive Magazine, the department of Health and Human Services, Office of Civil Rights (OCR) and the Centers for Medicare and Medicaid (CMS) and Providence Health Services, Providence Health System, and Providence Hospice and Home Care entered into the first case where a monetary settlement was paid to resolve a potential violation of the HIPAA privacy and security standards.

Providence agreed, without admission of liability, to pay $100,000 to the government over a data breach. This case did not involve a single egregious violation. So, it appears that, HHS may believe that enforcement time has come as they become more aggressive in their investigations and enforcement of these laws. Hence, the end of the world may be approaching. If all of the hospitals are fined into closure, and then the avian flu hits, the most often heard phrase will be “Hasta la vista, Baby.”

I don’t mean to make light of such an important topic as patient confidentiality or the potential portability of health insurance, but, if any of us mere mortals could objectively step back and witness the chaos, expense, and outright insanity created by the current implementation of these statutes, the only objective phrase that could eventually emit from that experience would be, “Holy, $%#@&!”



  1. Matthew Hahn says:

    Nick –
    I wrote a similar blog today ( regarding the administrative nightmare that is medical billing.
    Health care administration must be simplified. As you say, billing standards, CPT codes, ICD-9 codes were probably (?) established with good intentions, but the reality is that they complicate care, hugely increase costs, and probably ruin any interesting attempts to collect realistic clinical data.
    I have been hearing about you for quite some time. My mother-in-law is Winnie Bernat (my late father-in-law was Bob Bernat)…I’m married to their oldest daughter, Brenda.
    I’m a family physician, working my entire career within community health centers. I’m becoming more and more radicalized as I see patient care and patients suffer at the hands of our unworkable health care finance system, and motivated, good-hearted clinical staff becoming demoralized by a soulless (sp?) system that only sees dollars.
    Health care reform may be the battleground for America’s soul…I’m witness to a humanitarian crisis every day, happening right in front of our faces. It’s hard being a physician in a system that does all it can to disrupt good care…I’m getting involved in health care reform, in a sense, to try to save our profession.
    Would like to meet you…Brenda gave me a copy of your book.
    Matt Hahn

  2. John Franks says:

    I like to pass along things that work, in hopes that good ideas make their way back to me. Data breaches and thefts are due to a lagging business culture – and people aren’t getting the training they need. As CIO, I look for ways to help my business and IT teams further their education. Check your local library: A book that is required reading is “I.T. WARS: Managing the Business-Technology Weave in the New Millennium.” It also helps outside agencies understand your values and practices.
    The author, David Scott, has an interview that is a great exposure:
    The book came to us as a tip from an intern who attended a course at University of Wisconsin, where the book is an MBA text. It has helped us to understand that, while various systems of security are important, no system can overcome laxity, ignorance, or deliberate intent to harm. Necessary is a sustained culture and awareness; an efficient prism through which every activity is viewed from a security perspective prior to action.
    In the realm of risk, unmanaged possibilities become probabilities – read the book BEFORE you suffer a breach.

  3. Nick Jacobs says:

    John, Thanks for your advice. I’m sure that you would be absolutely amazed at the quality of our little health system when it comes to security, HIPAA, overcoming laxity, etc. It is our absolute obbession. Having said that, the entire context of my post was intended to express our complete frustration with a government imposed system that, once again, beats the mule that works the hardest. Fines, penalties, and public beatings until morale improves is NOT the best route to growth. Thanks for the tip, and I will read the book.


  4. Nick Jacobs says:

    Dear Matt,

    Bob was not only a mentor he was also a friend in the last decade of his life. We were both builders, optimists, and, I believe, men with a vision of what could be . . . not what was. He was much more intelligent and complex than mine, but his nature and soul were always good and he was an amazing teacher and profound thinker.

    Having said that, don’t get discouraged. I’m retiring in about six weeks from the day to day operations of the hospital and research institute, and my total and complete dedication in my own personal new world order (beside getting back to music) is to change the system from the ground up. I’m just waiting for a call from Barack . . . (-:

  5. Mike says:

    If you get the call from Barack ask him if he has room for one more. I’d love to get in on the ground level and rebuild this thing we call healthcare.

  6. As you said in the original post, nothing really matters now as in 2012 the Earth will be history anyways. The more I read about 2012 the more I believe it. But no, it won’t happen. Predictions about world failures never really come true, such as the Y2K bug. But still. I’ll be interested to see what outcomes Obama has for this health care system he wants to put in place.

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