Friday, September 28, 2012

HIPAA and Social Media

We all love them…those gruesome injury photos from football practice or the soccer game yesterday.  And with today’s social media, our cool injury pictures can spread around the world in a matter of minutes.  I mean, there is even a twitter account made solely to disperse pictures of this sort (@injurypics).  Unfortunately, with all of this technology we could be incorrectly distributing the private health information of our athletes.
Yesterday, we had a local lawyer come speak to our staff and students about the Health Insurance Portability and Accountability Act (HIPAA) and social media.  One of our GA’s assignments for the year is to redo our website and she has gone above and beyond, creating about every account imaginable for us.  While the website is still in the works, we now have a Facebook page, a Twitter account, an Instagram, and a blog.  All of these things are great, but we thought it would be good to have someone go over the stipulations of HIPAA so we would know if we were violating any of its regulations. Our guest gave some great information to all of us and answered many of our questions.  While some of you may be experts in this area, I thought I would just pass along a little bit of the information that he gave to us as a reminder to think twice before we immediately post a picture to one of our accounts.
First of all, the section of HIPAA that we deal with is mainly the privacy rule which says that individually identifiable health information needs to be guarded.  This is not only to protect the rights of the individual, but also to promote quality health care.  HIPAA only applies to covered entities, but seeing as how athletic trainers are considered health care providers, we fall under this jurisdiction.  This means that if a passerby takes a picture of an injury, they can post it online and they would not be held accountable.  On the other hand, if any one of us did the same thing, we could get into some serious trouble.  We have the responsibility to disperse only health information that is needed to determine the course of treatment for our athletes.
Another point to consider is that most of us know not to plaster our players’ names and faces across the internet.  Therefore, we may spend time editing our pictures but even things that you may think are unidentifiable can still cause a problem.  For example, if there is something in the background of that picture that can cause identification of the individual, then you could still be in violation of HIPAA.
So what can you do?  Well, you can make sure that you always get permission from your athlete or patient before using or showing their picture.  Luckily, it does not matter whether the permission is verbal or written, but you might want to stick with the written form in order to protect yourself.  Also, you can talk to your school lawyer about the policies at your institution.  While you may get permission from the athlete, which will excuse you from any civil or criminal charges, you can still get into trouble with your employer if you are not following their rules.  Often times they will not want you disseminating information or photos because it is unprofessional and could look bad on the organization.
Obviously, having access to a variety of injury pictures through social media can be very educational.  For many of us, it may be the only time we get to see an injury of that sort.  We just need to be sure that we are taking the right steps and precautions.  Hopefully next time you go to post that awesome picture, you will think twice because protecting our athletes should always be our primary concern.

Tuesday, September 18, 2012

There's An App For That: Phone Apps for AT's

Have you ever come accross something while working in the training room or on the field and thought to yourself, "I wonder if there is an app for this?"  Well in many cases there is.  In today's world practically everyone has a cell phone on them, most of which are "Smart" phones such as an Iphone or a phone running on the Google Android operating system.  More and more companies have come to realize this and they are creating apps that work with their products.  Other companies are creating apps that fulfill some need that practically everyone has.  There are several apps out their that an Athletic Trainer would find to be helpful.

Lets start with weather apps; there are several out there and you pretty much can't go wrong with any you choose.  With this said, let me tell you of some of my favorites.  You can't go wrong with The Weather Channel App.  The Weather Channel has a free app that will get you pretty much everything you need for basic weather services, including a radar map.  The free app has banner ads, but they are really not noticable at all.  If you don't want those ads, you can buy the app for $3.99, plus you get some other features.  This app only really gets you the most basic of features, as an Athletic Trainer what are we really looking for? We need an app that not only gives us radar maps, but can also tell us about lightning.  The best app in this regard is probably the Telvent WX App.  Telvent has the reputation for reliability and accuracy.  The app itself is free, however, there is a catch and it's a big one.  You need to have a subscription to their weather service for the app to work.  The Telvent weather service, subscription is expensive, so most of us won't be using it. If your school district can afford it though, it is worth it.  There used to be an app on the market called Pinpoint Lightning.  This app cost $4.99 for a 1 year subscription.  This app would send you an Alert on your phone when lightning struck within a distance that you set.  It also had radar and weather forcasts.  Apps like this are a little controversial as some professionals say there is no research proving the reliability of this app.  I used it in combination with my ThunderBolt Lightning Device (also a little controversial for the same reason) and the combination of the two seemed to work well together.  Unfortunately, the company that made this app took it of the market last April, but they plan on re-releasing it as an "In-App" purchase for one of their other apps called the MyWeather App. So be on the lookout for when they re-release this app.  When the Pinpoint App went of the market I started using another called Lightning Finder.  This app will send you text messages when lightning hits within a preset distance also, but you have to turn it on and tell it to send those messages for a certain amount of time.  It also has no research proving its relaiblity, but outside of Telvent, this is probably the best you can get.

There are several healthcare apps out there that may be useful.  The first to talk about is one called Instant Heart Rate by Azumio.  This app can actually detect your (or one of your athlete's) heart rate.  The app works very much like a pulse oximeter, in that it detects your pulse by tracking the color change in the surface of your finger tips that occurs with each beat of the heart bringing in a rush of fresh new blood to the capillaries in the skin.  All you have to do is put your finger tip over the phone's camera and start the app.  Azumio has a disclaimer that this app is meant for "fun" and shouldn't soley be relied on.  I tested this app out with the phone on one hand and a pulse oximeter on the other and I received the same result, so that was good enough for me.  Another good healthcare app includes one simply called "Eyechart" or "Eyechart HD"  this app has a Snellen chart that you hold 4 feet away from the athlete and they read it to get their vision tested.  The chart can also be randomized so the athlete can't memorize any of the lines.  Other apps out there that may be useful include apps that track your workouts, such as the Nike running app or the miCoach App from Adidas.  Each of these apps track how far and how long you ran for.  The Adidas one even has a voice coach to choose from that include Derrick Rose or Reggie Bush.

Do you use the Impact concussion software at your facility?  Did you know that Impact has a couple apps out there to help you?  The first app they came out with is called the ImCAT or the Impact Concussion Awareness Tool.  This tool has a concussion education section that has a quiz about concussions, has information about what a concussion is, what mild traumatic brain injury means, and what can you do to help prevent a concussion.  The best part of this app however, is the common signs/symptoms section.  Here you can go through and fill out a form with an athletes information and fill out a checklist of certain signs and symptoms they may have.  Once the form is filled out it can be emailed to your email to check later or to another athletic trainer's email so they know what you saw when you evaluated their athlete.  Impact also just released another app called the Impact Mobile Costomer Center.  With this new app you can access your impact account from your phone and look up clinical reports, sideline reports, organization reports, injury reports, test statistics, etc.  The app also has a sideline evaluation tool.  You can access any athlete that has taken the impact test before and fill out information about a concussion while evaluating them on the sideline.  First, you can record what symptoms they may have. Next, it gives you memory tests to perform such as a reverse numbers test (where you give them a set of numbers then they repeat them in reverse order) or the 5 words test (where you give them 5 words to repeat back to you and remember to repeat them later).  Lastly, when you perform a Rhombergs test, Stork Stand test, tandem gait, and visual tracking tests you can record the results.  All of this information is then saved in your account as a sideline report that you can access later.  If you do not have an Impact account you can use the SCAT2 app as a sideline evaluation tool.  This app has you record symptoms and perform certain tests and record the results.  The results can then be emailed to your email or another athletic trainer's email.

These are the apps I have for now, if I come accross any other useful apps I will blog about them later.  If you have any apps that you would recommend please feel free to coment about them in this blog.