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American Association of Oral and Maxillofacial Surgeons

Practice Management & Allied Staff News & Materials

Practice Management Matters - Jul/Aug 2009

July 13th, 2009

Question: Is it a HIPAA violation to use text messaging to transmit patient protected health information (PHI) if it is unclear whether or not the message is actually encrypted?

Answer: Even though the HIPAA security rule identifies encryption as an addressable implementation specification, a covered entity would be hard-pressed to justify transmitting PHI unencrypted, given the improvements in encryption technology and the significant reduction in cost since the rule's finalization five years ago. Even if the mobile carrier offers secure text messaging within its network, if the text message is sent through another carrier, sent unencrypted to pagers, or is sent using the mobile carrier's roaming services (in essence, cell towers that are owned by another carrier), there is a risk that the text message be intercepted.

There are several solutions on the market that support secure communication to and between mobile devices, but the solutions require the installation of the encryption on all mobile devices that will send and receive PHI. These solutions will not provide protections for PHI transmitted to pagers-only mobile phones.

This answer was adapted with permission from the HCPro, Inc. 2009 complimentary issue of Briefings on HIPAA. For more information on this and other resources, visit www.hcpro.com.

Question: Where can I find the WHO Surgical Safety Checklist?

Answer: The checklist, developed by the World Health Organization (WHO) in 2008, includes steps such as having nursing staff confirm all equipment is sterilized and requiring that team members confirm that the patient has received antibiotics ahead of the surgery, if called for, to reduce the risks of infection. This 19-item safety checklist used by surgical teams does what it is intended, reduces complications and deaths, according to a new study. Researchers reported in the January 14 online edition of The New England Journal of Medicine that the safety checklist, designed to improve surgical team communication and consistency of care, was effective. A year after eight hospitals in various countries adopted the checklist as part of the WHO's Safe Surgery Saves Lives program, the average patient death rate fell more than 40 percent and the rate of complications fell by about a third, researchers found.

To read more about the study, please visit http://content.nejm.org/cgi/content/full/NEJMsa0810119. To see a copy of the checklist, please visit http://www.who.int/patientsafety/safesurgery/tools_resources/SSSL_Checklist_finalJun08.pdf.

This answer was reprinted with permission from the HCPro, Inc. January 21, 2009 issue of Patient Safety Monitor. For more information on this and other resources, visit www.hcpro.com.

Question: Do you have any suggestions for implementing an effective cleaning system in the OMS office?

Answer: Along with proper and frequent hand washing, the most effective way to minimize the spread of contagions is through effective cleaning. This involves not only the right products, but also the most efficient cleaning techniques and procedures. The following are suggested steps for implementing an effective system for your cleaning staff to further prevent the spread of infection in the office:

  • Put the system in writing. All professional cleaning programs should be in writing, especially those for the health care industry to formalize the program and allow for better instruction and supervision.
  • Have a "plan of attack." Cleaning is best performed in an orderly fashion. Clean from the top down, from left to right. Floors should always be cleaned last so that contaminants are not spread to other areas of the office.
  • Establish a checklist. Checklists should be placed throughout the office. These lists are commonly found behind public restroom doors. With a checklist, every cleaning duty necessary for that particular room is listed, and cleaning professionals check off tasks as they are completed. This clarifies duties and promotes responsibility.
  • Wear gloves. In addition to frequently washing hands, wearing clean disposable gloves is critical to infection control. Gloves should be changed after cleaning each room and removed so that hands and fingers never touch soiled glove areas.
  • Clean "hot spots." Many areas of an OMS office that are most likely to harbor and spread infection and that should be cleaned and disinfected daily are hot-spot areas such as door handles, light switches, railings, faucet handles, partitions, and dispenser knobs.
  • Use microfiber cloths. Studies have shown that microfiber is more effective at reducing bacteria buildup than conventional cleaning cloths and mop heads. They also require less water and cleaning chemicals, which makes them environmentally responsible, too.
  • Use color-coded microfiber. Cleaning professionals know exactly which cloth to use for each fixture or cleaning procedure when they use color-coded microfiber cleaning cloths to help stop the spread of infection or contaminants, ie, red microfiber cloths may be used only for cleaning toilets while white may be for counters and sinks.
  • Clean and store. All cleaning equipment should be properly cleaned, rinsed, and allowed to air-dry at the end of each workday.
  • Select "green" cleaning products. Wherever possible, use certified environmentally preferable cleaning products, tools, and equipment. These products are designed to effectively stop the spread of infection, and have a reduced impact on the health of the user, building users, and the environment.
  • Education and application. The best way to prevent the spread of infection is through enhanced education and application. This involves an understanding of how infection and disease are transmitted from one person to another and taking steps to prevent this from happening. Office managers should work closely with their reputable janitorial distributors to select products and develop effective cleaning programs.