Health Information System Security

Health Information System Security

Introduction

Healthcare information systems are mainly seen as the single most significant aspect in picking up the quality of healthcare in United States and dropping down the related expenses. Not unexpectedly, latest government projects have pushed for extensive level implementation of universal electronic health records by the year 2014 (Glaser & Aske, 2010). The security or safety of information systems comprises of the information protection and the access control to that information by means of administrative processes, physical security, and technical protection measures (Glaser & Aske, 2010). Administrative processes concentrate on the measures to choose and manage security procedures and the management of the ways of personnel concerned with the health information. These processes comprises of contingency scheduling, access controls, safety management processes, and working out. Physical protections attempt to guard the surrounding environment and the physical computer from intrusion or damage (Glaser & Aske, 2010). Protection or safety of information systems also comprises of technological safeguards to guard access, validate users and data, and protect against intrusion or damage into the networks of communication that carry health information. Thus, health care fraud is a major issue that has attracted the attention of physicians, hospitals, patients, insurers, policy makers, government agencies, and academics (Glaser & Aske, 2010). While fraud occurs throughout the health care system, fraud involving publicly funded federal health care programs has attracted the most attention because of its enormous cost. Expenditures for Medicare, the federal health care program for the aged, reached $431.5 billion in 2007; total outlays for Medicaid, the joint federal and state health care program for the poor, were $335.8 billion (Hill, 2009). The financial aspect of fraud in health care makes civil sanctions an attractive option. The most powerful civil weapon is the FCA, under which a violator can be required to pay a civil fine of $6,500 to $12,000 for every fake claim, together with three times the damages of the government. For providers such as physicians, who tend to submit thousands of relatively small claims per year, the result can be devastating. In one distinguished case, a psychiatrist was charged of submitting 7,000 fake claims, each exaggerated by just about $40, for a sum of $255,000 in damages; when the per-claim penalties were calculated, however, the total amounted to $81 million. The FCA also contains a unique qui tam provision that permits a private person who is aware of fraudulent conduct to file suit, on the government's behalf, in return for a percentage of the proceeds if the suit is successful (Hill, 2009). As the 1986 amendments rationalized the FCA and transformed it into more profitable to follow such private suits, the quantity of health-associated FCA suits has rise; by the end of 1990s, almost two-thirds of qui-tam suits concerned accusations of fraud in health care. Not surprisingly, most providers who are threatened with such litigation seek to negotiate. Consequently, majority of fraud investigations in health care are resolved through settlements in which the defendant, while not ...