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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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Resource Overview

Patient portals, sometimes also referred to as personal health record systems (PHR) are web-based portals commonly attached to electronic health record systems (EHRs). These patient-centered portals provide patients with the ability to login and review health information related to their care. Common patient portal services include ways in which to schedule appointments, send messages to their care providers, review test results and refill prescriptions.

Outside of the benefits to the patient, implementation of patient portals had come to the attention of healthcare providers due to the inclusion of Meaningful Use of objectives centered on the use of patient portals and electronic engagement with patients.  Stage 3 requirements are still being explored and the impact it will have on Health Centers is unknown. Therefore, it is a challenge for small practices and Health Centers to determine how to best derive value from Patient Portals and effectively implement them into their workflow.

The tools and articles posted below are meant to provide examples, templates and strategies that can assist Health Centers in understanding how patient portals can better engage their patients in self-management of their care, and after an initial investment in time and money can decrease the burden on their clinical and administrative staff.

Patient Portal Resources

Creating and Managing Strong Passwords at Your Health Center

Creating and Managing Strong Passwords at Your Health Center

Guidance in relation to updated NIST security requirements and HIPAA

Question: Is it acceptable/recommended for health centers to adopt the new password policy guidelines under NIST Special Publication 800-63B and will that still uphold the HIPAA security rule?

This question had been posed to the HITEQ Center asking whether we had any guidance or recommendations on implementing the new NIST Guidelines regarding password security.  New Digital Identity Guidelines under NIST Special Publication 800-63-B presents new guidelines regarding password security that are much more user-friendly and consequently more likely to be observed by health center staff since constantly changing, complex password on multiple systems can be a source of frustration for the end user. 

After consulting with HITEQ cybersecurity experts and consultants who have helped publish cybersecurity guidelines, the recommendations outlined below were communicated.

Answer: The short answer is Yes. HIPAA is not prescriptive and takes the general stance that authentication mechanisms should be “reasonable and appropriate” for the risk they present. Being able to say that you are implementing NIST Standards is a good way to show that you are implementing “reasonable and appropriate” controls.

Some standards are relaxed in regards to password change and complexity, those items shouldn’t be taken in isolation. The additional controls in the 800-63 recommendations should also be put in place and can include:

  • Having users check passwords against password lists from breaches (e.g., https://haveibeenpwned.com/Passwords )
  • Increasing the length requirements
  • Getting rid of password reminder questions
  • Increasing usability

Further Guidance from NCCIC/US-CERT: NCCIC/US-CERT reminds users of the importance of creating and managing strong passwords. Passwords are often the only barrier between you and your personal information. There are several programs attackers can use to help guess or "crack" passwords. However, choosing strong passwords and keeping them confidential can make it more difficult for others to access your information.

NCCIC/US-CERT recommends users take the following actions:

  • Use multi-factor authentication when available.
  • Use different passwords on different systems and accounts.
  • Don't use passwords that are based on personal information that can be easily accessed or guessed.
  • Use the longest password or passphrase permissible by each password system.
  • Don't use words that can be found in any dictionary of any language.
  • Refer to Tips on Choosing and Protecting Passwords and Supplementing Passwords for best practices and additional information.
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Intended AudienceCIO's, Privacy & Security Staff, health center staff

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Acknowledgements

This resource collection was cultivated and developed by the HITEQ team with valuable suggestions and contributions from HITEQ Project collaborators.