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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

Conducting an SRA in accordance with HIPAA policy is a complex task, especially for small to medium providers such as community health centers. The HIPAA Security Rule mandates security standards to safeguard electronic Protected Health Information (ePHI) maintained by electronic health record (EHR) technology, with detailed attention to how ePHI is stored, accessed, transmitted, and audited. This rule is different from the HIPAA Privacy Rule, which requires safeguards to protect the privacy of PHI and sets limits and conditions on it use and disclosure. Meaningful Use supports the HIPAA Security Rule. In order to successfully attest to Meaningful Use, providers must conduct a security risk assessment (SRA), implement updates as needed, and correctly identify security deficiencies. By conducting an SRA regularly, providers can identify and document potential threats and vulnerabilities related to data security, and develop a plan of action to mitigate them.

Security vulnerabilities must be addressed before the SRA can be considered complete. Providers must document the process and steps taken to mitigate risks in three main areas: administration, physical environment, and technical hardware and software. The following set of resources provide education, strategies and tools for conducting SRA.

Security Risk Analysis Resources

Health Center Emergency Response Resources

Health Center Emergency Response Resources

October 2024

Ready to take the next step towards enhanced IT preparedness? The resources linked below, organized by topic, share actionable strategies that health centers can implement to move towards greater resilience.

Preserving access to Electronic Health Record (EHR) data

The Office of the National Coordinator for Health Information Technology’s Safety Assurance Factors for EHR Resilience (SAFER) self-assessment for contingency planning identifies recommended practices for managing EHR downtime, including use of redundant hardware, regular backup of data, use of uninterruptible power supplies, and protocols for use of paper forms.

The American Medical Association’s Guidelines for Developing EHR Downtime Procedures includes a list of considerations that planners can use when developing or improving information technology EHR downtime procedures. 

Preventing cyber-attacks

The HITEQ Center’s Guide to Essential Cybersecurity Tasks For Health Centers with Limited Resources provides a baseline of day-to-day tasks that health center IT and compliance staff should consider to protect their systems and comply with regulatory requirements. These include strategies to prevent successful phishing attacks, limit unnecessary physical and virtual access to systems, and keep security patches up to date. 

Responding to cyber-attacks

The U.S. Department of Commerce National Institute of Standards and Technology’s Guide for Cybersecurity Event Recovery describes the contents of a typical cyber-attack recovery plan and includes a checklist of items (a “playbook”) that should be implemented as part of the recovery process. 

Leveraging EHR data for patient outreach

The HITEQ Center’s “Accessing Your Data: Questions to consider with your Electronic Health Record Vendor,” is a checklist that can be used to talk with vendors about how health centers use EHR system capabilities for activities such as report generation. Relevant questions include 1) whether data, including reports, can be accessed from any location at any time; 2) whether and how your practice can generate ad hoc reports; and 3) whether it is possible to query the EHR to identify certain patients, for example, those with particular conditions, using particular medications, or in a particular geography.

Some EHR enhancers, such as Relevant’s Data Explorer, enable health centers to use the EHR to build reports without writing code and automate text messaging to subsets of patients.

Sharing data to prevent or lessen a serious or imminent threat

The U.S. Department of Health and Human Services Office for Civil Rights’ Hurricane Katrina Bulletin: HIPAA Privacy and Disclosures in Emergency Situations and Summary of the HIPAA Privacy Rule address the use and disclosure of protected health information by covered entities when that disclosure is believed to be necessary to prevent or lessen a serious and imminent threat to a person or the public.

Sharing data to support care continuity

In addition to the strategies for preserving access to EHR data, participation in local or state health information exchanges (HIE) or in vendor-supported EHR based data-sharing initiatives (e.g., Epic's Care Everywhere or eClinicalWorks PRISMA) facilitates data sharing.  Learn more about HIE capabilities in HITEQ Highlights: Advancing Interoperability & Health Information Exchange for Health Centers.

 

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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.

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