Governor Signs Variety of Bills Affecting Californians’ Healthcare

HIV Prevention

California will be the first state to allow people to access HIV prevention drugs from pharmacies without a doctor’s prescription. Pre-exposure prophylaxis (PrEP) is a once-a-day pill for HIV-negative people that may keep them from becoming infected, and post-exposure prophylaxis (PEP) is a medication that can help prevent the virus from taking hold if they have been exposed to it. SB-159 by state Sen. Scott Wiener (D-San Francisco) will allow pharmacists to dispense a 60-day supply of PrEP or a 28-day course of PEP. Patients will need to see a physician to obtain more medication. The bill prohibits insurance companies from requiring patients to obtain prior authorization before obtaining the medication.

Abortion Pill




Students at California’s 34 California State University and University of California campuses will have access to medication-induced abortion — commonly known as the abortion pill — at on-campus student health centers by Jan. 1, 2023. Under SB-24 by state Sen. Connie Leyva (D-Chino), students who are up to 10 weeks pregnant will be eligible. Initial costs, such as the purchase of medical equipment, will be paid for with private, not state, dollars.

Maternal Health




Black women are three to four times more likely to die during childbirth and from other pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention. SB-464 by state Sen. Holly Mitchell (D-Los Angeles) will require perinatal healthcare providers to undergo bias training with the goal of reducing preventable maternal deaths among black women. “The disproportionate effect of the maternal mortality rate on this community is a public health crisis and a major health equity issue,” Newsom said upon signing the bill.

Some new moms returning to their jobs who want to pump milk at work will face fewer barriers. SB-142 by Wiener will require employers to provide new mothers with a private space that includes a table, chair, electric outlet and nearby access to running water and refrigeration. Businesses with fewer than 50 employees may be eligible for an exemption. “Too many new mothers are unable to express milk at work or are forced to do so in a restroom or other unsuitable space,” Wiener said.                                                 

 


 Financial Abuse of Older Adults





Investment advisers and broker-dealers will be required to report suspected financial abuse of an elder or dependent adults. SB-496 by state Sen. John Moorlach (R-Costa Mesa) allows these financial experts to temporarily delay requested transactions, such as stock trades and disbursement of funds, when they suspect potential abuse. “With growing Alzheimer’s and dementia concerns, it is critical that we provide safeguards to prevent financial abuse for those in the beginning stages of a difficult life journey,” Moorlach said in a statement.

               

 Ban Smoking in State Parks






Californians will be prohibited from smoking or vaping at state beaches and parks, except for paved roads and parking areas. Violations of SB-8 by state Sen. Steve Glazer (D-Orinda) will carry a fine of up to $25. Similar efforts were vetoed by former Gov. Jerry Brown.

     

                                                                           


Nurse Staffing





State health officials who make unannounced inspections of hospitals will start reviewing nurse staffing levels. Some California hospitals disregard the state’s current nurse-to-patient ratio requirements, Leyva, the bill’s author, argued. SB-227 establishes penalties for violations: $15,000 for the first offense and $30,000 for each subsequent violation.

Medical Marijuana on School Grounds





Even though medicinal cannabis has been legal for years in California, it has not been allowed on school grounds. SB-223 by state Sen. Jerry Hill (D-San Mateo), will allow school boards to adopt policies that authorize parents or guardians of students with severe medical and developmental disabilities to administer medicinal cannabis on campus, as long as it is not via smoking or vaping. This allows students to “take their dose at school and then get on with their studies,” Hill said.

Dialysis Industry Profits





One new law could disrupt the dialysis industry’s business model. Dialysis companies often get higher reimbursements from private insurers than they do from public coverage. One way low-income patients remain on private insurance is by getting financial assistance from the American Kidney Fund, a nonprofit that receives most of its donations from the two largest dialysis companies, Fresenius Medical Care and DaVita Inc. AB-290, by Assemblyman Jim Wood (D-Santa Rosa), will limit the private-insurance reimbursement rate that dialysis companies receive for patients who get assistance from groups such as the American Kidney Fund.

Healthcare in Jails and Prisons

County jails and state prisons will be prohibited from charging inmates copays — usually $3 to $5 — for medical and dental services with the passage of AB-45, by state Assemblyman Mark Stone (D-Scotts Valley). Some states already prohibit copays in prison, but California is the first to eliminate copays in county jails.

Cancer Patients

Some Californians undergoing cancer treatment such as radiation or chemotherapy will have insurance coverage for fertility preservation treatments. Under SB-600 by state Sen. Anthony Portantino (D-La Cañada Flintridge), private health plans regulated by the state must cover procedures such as the freezing of eggs, sperm or embryos for patients who want to try to have children in the future.

Big Pharma,

The Democratic governor also signed what health advocacy groups deem this year’s biggest effort to lower prescription drug costs. AB-824 will give the state attorney general more power to go after pharmaceutical companies that engage in “pay for delay,” a practice in which makers of brand-name drugs pay off generic manufacturers to keep the lower-cost generic versions of their medications off the market.

SOURCE: Story By Ana B. Ibarra | Kaiser Health News. https://tinyurl.com/y2oaqfua

People trust machines more than humans for sharing data . Does this translate to health information

People tend to trust machines more than humans when it comes to sharing private information and access to their financial data, an Indian-origin researcher has stressed.

People who trusted machines were significantly more likely to hand over their credit card numbers to a computerised travel agent than a human travel agent, said S Shyam Sundar, Co-director of the Media Effects Research Laboratory and an affiliate of Penn State's Institute for CyberScience (ICS).

"A bias that those machines are more trustworthy and secure than people -- or the machine heuristic -- may be behind the effect," Sundar added.

The faith in machines may be triggered because people believe that machines do not gossip, or have unlawful designs on their private information.

However, said Sundar, while machines might not have ulterior motives for their information, the people developing and running those computers could prey on this gullibility to extract personal information from unsuspecting users, for example, through phishing scams.

"This study should serve as a warning for people to be aware of how they interact online. People should be aware that they may have a blind belief in machine superiority. They should watch themselves when they engage online with robotic interfaces," Sundar noted.

For the study, the researchers recruited 160 participants from Amazon Mechanical Turk, an online crowdsourcing website frequently used in studies.

The participants were asked to use either a human or a machine chat agent to find and purchase a plane ticket online. After the agent returned the flight information, it prompted the participants for their level of trust for each transaction.


.The presence of a machine agent on the interface served as a cue for triggering the ingrained belief that machines are superior.

People with a high degree of trust in machines only need subtle design indications that they are interacting with a machine.

"In all of this, one thing I would like to stress is that the designers have to be ethical. They should not unethically try to extract information from unsuspecting consumers," Sundar stressed.

Amazing tech news: People trust machines more than humans for sharing data: People tend to trust machines more than humans when it comes to sharing private information and access to their financial data, an Indian-origin researcher has stressed.

A Phishing Epidemic: Constant Stream of Reports | The Pulse

Since at least the beginning of the summer, it seems as though no day can go by without another phishing incident being reported by a healthcare entity. The reports are almost always the same too. …
Not many practices are equipped to deal with breaches of patient data. In the not too distant past individual medical practices and/or hospitals owned and housed their own servers.  The task of monitoring was left to each individual practice.  Today in the world of the cloud programs and data are housed online in a cloud, perhaps mirrored in multiple locations.  The chance of a cybersecurity breach increased exponentially and will continue to do so.

. After some period of time (usually not the same day), the unauthorized activity will be found in the email account of one or more employees. A forensic analysis will be conducted that cannot conclusively determine what, if any, patient information or other data were accessed. Out of an abundance of caution though, breach notification is provided to enable potentially impacted individuals to monitor accounts in the event of suspicious activity, with the entity sometimes covering the cost of such monitoring.

When asked how they would respond to slow or ineffective communication after a data breach, 66 percent said they would stop doing business with the organization, and 45 percent said they would tell their friends and family to do the same. This figure includes other industries besides health care. Physician loyalty and due to lack of alternate sources may keep patients captured unwillingly. This places even greater responsibility on health care institutions.

This goes far beyond the time and expertise of medical practices and hospitals. Recent news events reveal that even major health systems notify their clients many weeks to months after the breach. Today's technology of email, e-messaging,   and patient portals enables hospitals to notify patients.

Three-quarters of respondents said they expected a government agency to notify them within 24 hours of a breach; 73 percent expected the same response time for healthcare organizations, and only 61 percent held retailers to that standard — all lower than the 83 percent who expected banks to respond within a day.

In the healthcare sector, millions of patient records have been exposed in 2019. One of the biggest exposures of information involved American Medical Collection Agency, a billing, and collections firm that was business associate of Quest Diagnostics and Labcorp.

The FDA issues a cyber warning for medical devices, hospital networks

As remote monitoring and medical devices proliferate there is a greater risk of unauthorized access to personal data, especially if a wireless device is used for the transfer of information.

How do organizations (medical and hospitals deal with this problem?  Training and familiarity with phishing techniques.  A large measure of cybersecurity is 'avoidance'.Most breaches are due to human errors.

Leaving aside the content of a notice, the real issue of concern is how to prevent or reduce the frequency of successful phishing attacks. Getting to the root of that problem requires turning a critical internally at an organization. The first step is education and training of the workforce. The subject of another blog on the Pulse, awareness among employees of security policies is lacking. As such, taking the time to push out information and training on what phishing is, how attacks occur, and what to do to prevent an attack is essential. Training does not need to be lengthy as key facts and tidbits can be conveyed through 5-minute videos or similar media. The step to take is to get the material into the hands of all individuals across an organization. Distributing materials can then transform individuals into active components of a comprehensive security process.

In considering training, what should be included? Real-world examples are frequently helpful because understanding how exactly an attack might come about is invaluable. Examples of training can be taking actual phishing emails and pointing out some of the key clues as to why an individual should identify the email as phishing. Elements can include (i) unsolicited messages about an account being compromised; (ii) bad grammar or phrasing that seems slightly off; (iii) spoofing letters by combining others letters to look the same (consider “m” and “rn” which in the right font can look nearly identical); (iv) pushing for action by preying upon an innate desire to helpful; or (v) email addresses or links that claim to be from or to a known place, but actually divert elsewhere if the highlighted link is reviewed.

 While these elements require an individual to stop and think about what is happening, the step of stopping to think about what to do is important and can be drilled home through education and training.

In addition to education and training, organizations should increase efforts to audit and monitor systems. Auditing and monitoring is admittedly a daunting task though. Enormous amounts of data go through systems all of the time and the pace of data will not slacken anytime soon. However, volume cannot be an excuse for throwing one’s proverbial hands in the air. Instead, it can be viewed as an opportunity to acquire and/or develop new tools to help. Additionally, some level of manual effort can also be utilized to comb through systems and look for suspicious activity. At the end of the day, a sign of victory is finding an issue in as short a period of time as possible and not letting n intruder roam unfettered through systems.


Stopping all phishing attacks is likely impossible







A Phishing Epidemic: Constant Stream of Reports | The Pulse:

More Logins, More Problems, Lack of Integration Biggest Frustration for Providers

Out-of-hospital healthcare providers are feeling the pain from a lack of integrated technology between systems in their offices. In fact, according to the 2019 Healthcare Technology Report: More Logins, More Problems just released by Updox, an all-in-one healthcare collaboration platform, survey respondents ranked lack of integration as their most frustrating health IT challenges – as well as the technology pain-point most impacting their businesses.

More Logins, More Problems

Of the more than 600 out-of-hospital healthcare providers surveyed, nearly 60% of healthcare providers rely on 4 or more different technology solutions to manage daily functions. The lack of integration between these different systems results in increased costs and enhanced physician burnout. It’s no surprise, then, that nearly 20% of respondents said they planned to reduce the number of technology solutions in 2019.

Top Technology Frustration in Healthcare

Lack of integration between these different systems topped the list as the biggest technology challenge most negatively impacting their businesses followed by:

– Service downtime/interruptions
– Poor design of systems
– Lack of features
- Poor adoption of portals by providers and patients.  Portals require a login and learning to navigate the portal.  Different providers and hospitals often have a unique or proprietary portal requiring multiple logins.

Text messaging represents a profound change in how healthcare practices work. Learn how texting will change the way you communicate and coordinate care for your patients. This is a complete explanation and demonstration of the chat feature (in the video)

Patients almost always are carrying their smartphone with them or less than five feet from themselves.  Texting is second nature to most people.  Contrary to the opinions of GenZ (who rarely seek medical attention, baby-boomers and their ancestors are frequent users of texting.

On the other end of the spectrum, respondents ranked security, outdated hardware, and outdated software, respectively, as the technology pain points that impacted their businesses the least – reflecting these organizations’ priorities. (This is especially true since the advent of SAAS using the cloud for hosting programs and data) The software can be updated on one server (or more if mirrored).

Providers Want One Solution to Manage The Business of Healthcare

From patient reminders to faxes to payments. In addition, there is an exponential number of logins to manage across platforms when multiplied by each user, depending on the size of the business and its unique needs. 43% of the out-of-hospital healthcare providers surveyed by Updox said they might reduce their number of technology vendors if they could find ones that offered multiple solutions within one platform.

In addition, more than 50% of respondents named cost as a reason to reduce technology vendors, and 44% said that staff complaints or frustration would be a reason to make a change. It’s clear that healthcare providers want highly capable, all-in-one solutions that do more at a lower cost while integrating tightly with their existing systems.

Why It Matters

“The business of healthcare runs on and through Updox. We’re living in a post-EHR world. Now that every provider has one, attention turns to managing their businesses better. Before Updox, there wasn’t a common platform for healthcare that offered the same benefits as what the EHR did for clinical care. That’s the opportunity Updox offers,” said Michael Morgan, CEO, Updox. “Through more efficient workflows, staff are happier and patients can be more engaged in their care. This also gives the supply chain a more efficient access point to providers to facilitate faster, better-coordinated care.”

The Updox application can be run on many electronic health record systems already in use.

Text messaging represents a profound change in how healthcare practices work. Learn how texting will change the way you communicate and coordinate care for your patients.
Survey Background/Methodology

Updox surveyed more than 600 physicians, pharmacists, technicians, nurses and staff about the technology challenges of their workplaces. A majority of respondents are staff at primary care practices or pharmacies with a number of additional specialty providers using at least one element of the Updox platform.











More Logins, More Problems, Lack of Integration Biggest Frustration for Providers: Providers ranked lack of integration as their most frustrating health IT challenges – as well as the technology pain point most impacting their businesses.