This summary provides an overview of a systematic review examining research on telehealth privacy and security practices used by healthcare providers:
1) The review analyzed 21 research papers published between 2004-2016 that studied privacy and security practices when US healthcare providers used telehealth technologies.
2) Most papers were policy studies (67%) or survey/interview research (14%). No randomized controlled trials were identified.
3) The review found it is necessary to have more research providing specific details on privacy and security practices used during telehealth and examining patient and provider preferences for keeping data private and secure.
International Journal of Telerehabilitation • telere.docxtarifarmarie
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2 Fall 2017 • (10.5195/ijt.2017.6231) 39
A SYSTEMATIC REVIEW OF RESEARCH STUDIES
EXAMINING TELEHEALTH PRIVACY AND SECURITY
PRACTICES USED BY HEALTHCARE PROVIDERS
VALERIE J. M. WATZLAF, PHD, MPH, RHIA, FAHIMA, LEMING ZHOU, PHD, DSC,
DILHARI R. DEALMEIDA, PHD, RHIA, LINDA M. HARTMAN, MLS, AHIP
DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION
SCIENCES, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PA, USA
BACKGROUND AND
SIGNIFICANCE
When in-person meetings and paper-based health
records are used, healthcare providers have a clear idea
about how to protect the privacy and security of healthcare
information. Providers see each patient in a private room
and the patient records are locked in a secure office setting
which is only accessible to authorized personnel. When the
healthcare practice is moved to the Internet, as in the case
with telehealth, and all information is electronic, the situation
becomes more complex. Most healthcare providers are not
trained in protecting security and patient privacy in
cyberspace. In cyberspace, there are many methods that
can be used to break into the electronic system and gain
unauthorized access to a large amount of protected health
information (PHI). Therefore, the information security and
patient privacy in telehealth is at a higher risk for breaches
of PHI. For instance, from 2010 to 2015 it was found that
laptops (20.2%), network servers (12.1%), desktop
computers (13%), and other portable electronic devices
(5.6%) made up 51 percent of data sources of all healthcare
data breaches that affected more than 500 individuals
(Office of the National Coordinator for Health Information
Technology, 2016).
PHI is highly regulated in the United States. The most
familiar regulation impacting healthcare facilities and
providers is the Health Insurance Portability and
Accountability Act (HIPAA) of 1996 (US Department of
Health and Human Services, 2013). HIPAA is a federal law
that provides privacy and security rules and regulations to
protect PHI. The HIPAA Privacy Rule is an administrative
regulation created by the Department of Health and Human
Services (DHHS). It was developed after the US Congress
passed HIPAA, and went into effect in 2003.
The HIPAA Privacy Rule only applies to healthcare
providers that conduct electronic billing transactions but is
effective for both paper and electronic health information. It
is a set of national standards that addresses the use and
disclosure of PHI by a covered entity such as a healthcare
organization as well as establishing privacy rights for
individuals on how their PHI is used and shared. Its major
objective is to protect the flow of health information while at
the same time providing high quality healthcare.
ABST.
This document provides an overview of the Health Insurance Portability and Accountability Act (HIPAA). It discusses the background and objectives of HIPAA in ensuring privacy of health information. It describes the key aspects of HIPAA including the Privacy Rule, Security Rule, and definitions of protected health information. It also outlines enforcement measures for non-compliance and additional regulations like HITECH that have expanded HIPAA's requirements. Challenges of ensuring HIPAA compliance are discussed as well.
Standards and Best Practices for Confidentiality of Electronic Health RecordsMEASURE Evaluation
This document summarizes standards and best practices for ensuring confidentiality of electronic health records. It discusses key concepts like privacy, security and confidentiality in the context of electronic health records. It outlines the situation in lower and middle income countries, where expertise and legal frameworks around eHealth privacy and security is often lacking. The document reviews global standards set by organizations like ISO, and emphasizes that while standards are important, non-technical factors like policy, processes and compliance are also critical to protecting health information privacy and security.
This document provides an overview of confidentiality and security training requirements under HIPAA. It defines protected health information as any patient information regarding their health status, care, or payments. The HIPAA Privacy Rule aims to protect the privacy of individually identifiable health information and requires covered entities to obtain patient consent before disclosing health information. The HIPAA Security Rule establishes standards for safeguarding electronic protected health information and defines different penalty levels for violations. All employees must complete training at hire and annually through an online computerized system.
This document provides an overview of confidentiality and security training requirements under HIPAA. It defines protected health information as any patient information regarding their health status, care, or payments. The HIPAA Privacy Rule aims to protect the privacy of individually identifiable health information and requires covered entities to obtain patient consent before disclosing health information. The HIPAA Security Rule establishes standards for safeguarding electronic protected health information and defines different penalty levels for violations. All employees must complete training at hire and annually through an online computerized system.
21st Century Act and its Impact on Healthcare ITCitiusTech
This document gives an overview, core objectives of the act and enumerates purpose of each part / division of the 21st Century Act. It lists down the sections of the act which have a direct impact on Healthcare IT and gives a brief overview of each section.This document also explains the impact of 21st Century Cures Act on regulatory bodies: FDA / NIH / HSS.
What explains why certain services were covered and others were not .docxajoy21
This document contains questions about various healthcare topics and a passage about the HIPAA Privacy Rule, which established the first national standards for protecting private health information. It discusses what protected health information is and the deadline for covered entities to comply with the Privacy Rule. It also contains passages about public health practices using protected health information and ERISA rules that medical providers can use to challenge health insurance claim denials.
HC4110_FinalPaper_NewModelEHR_SmithKR_05062016Kathlene Smith
This document summarizes a paper on fixing the electronic health record (EHR) marketplace in the United States. It discusses how the HITECH Act incentivized EHR adoption but led to over-complication through "Meaningful Use" criteria. Fewer than 10% of providers claimed incentives due to difficulties installing and using EHR software. The paper reviews literature finding frustration with EHR costs and usability. It argues the US could learn from other countries that implemented standardized data languages and open-source software with less financial impact.
International Journal of Telerehabilitation • telere.docxtarifarmarie
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2 Fall 2017 • (10.5195/ijt.2017.6231) 39
A SYSTEMATIC REVIEW OF RESEARCH STUDIES
EXAMINING TELEHEALTH PRIVACY AND SECURITY
PRACTICES USED BY HEALTHCARE PROVIDERS
VALERIE J. M. WATZLAF, PHD, MPH, RHIA, FAHIMA, LEMING ZHOU, PHD, DSC,
DILHARI R. DEALMEIDA, PHD, RHIA, LINDA M. HARTMAN, MLS, AHIP
DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION
SCIENCES, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PA, USA
BACKGROUND AND
SIGNIFICANCE
When in-person meetings and paper-based health
records are used, healthcare providers have a clear idea
about how to protect the privacy and security of healthcare
information. Providers see each patient in a private room
and the patient records are locked in a secure office setting
which is only accessible to authorized personnel. When the
healthcare practice is moved to the Internet, as in the case
with telehealth, and all information is electronic, the situation
becomes more complex. Most healthcare providers are not
trained in protecting security and patient privacy in
cyberspace. In cyberspace, there are many methods that
can be used to break into the electronic system and gain
unauthorized access to a large amount of protected health
information (PHI). Therefore, the information security and
patient privacy in telehealth is at a higher risk for breaches
of PHI. For instance, from 2010 to 2015 it was found that
laptops (20.2%), network servers (12.1%), desktop
computers (13%), and other portable electronic devices
(5.6%) made up 51 percent of data sources of all healthcare
data breaches that affected more than 500 individuals
(Office of the National Coordinator for Health Information
Technology, 2016).
PHI is highly regulated in the United States. The most
familiar regulation impacting healthcare facilities and
providers is the Health Insurance Portability and
Accountability Act (HIPAA) of 1996 (US Department of
Health and Human Services, 2013). HIPAA is a federal law
that provides privacy and security rules and regulations to
protect PHI. The HIPAA Privacy Rule is an administrative
regulation created by the Department of Health and Human
Services (DHHS). It was developed after the US Congress
passed HIPAA, and went into effect in 2003.
The HIPAA Privacy Rule only applies to healthcare
providers that conduct electronic billing transactions but is
effective for both paper and electronic health information. It
is a set of national standards that addresses the use and
disclosure of PHI by a covered entity such as a healthcare
organization as well as establishing privacy rights for
individuals on how their PHI is used and shared. Its major
objective is to protect the flow of health information while at
the same time providing high quality healthcare.
ABST.
This document provides an overview of the Health Insurance Portability and Accountability Act (HIPAA). It discusses the background and objectives of HIPAA in ensuring privacy of health information. It describes the key aspects of HIPAA including the Privacy Rule, Security Rule, and definitions of protected health information. It also outlines enforcement measures for non-compliance and additional regulations like HITECH that have expanded HIPAA's requirements. Challenges of ensuring HIPAA compliance are discussed as well.
Standards and Best Practices for Confidentiality of Electronic Health RecordsMEASURE Evaluation
This document summarizes standards and best practices for ensuring confidentiality of electronic health records. It discusses key concepts like privacy, security and confidentiality in the context of electronic health records. It outlines the situation in lower and middle income countries, where expertise and legal frameworks around eHealth privacy and security is often lacking. The document reviews global standards set by organizations like ISO, and emphasizes that while standards are important, non-technical factors like policy, processes and compliance are also critical to protecting health information privacy and security.
This document provides an overview of confidentiality and security training requirements under HIPAA. It defines protected health information as any patient information regarding their health status, care, or payments. The HIPAA Privacy Rule aims to protect the privacy of individually identifiable health information and requires covered entities to obtain patient consent before disclosing health information. The HIPAA Security Rule establishes standards for safeguarding electronic protected health information and defines different penalty levels for violations. All employees must complete training at hire and annually through an online computerized system.
This document provides an overview of confidentiality and security training requirements under HIPAA. It defines protected health information as any patient information regarding their health status, care, or payments. The HIPAA Privacy Rule aims to protect the privacy of individually identifiable health information and requires covered entities to obtain patient consent before disclosing health information. The HIPAA Security Rule establishes standards for safeguarding electronic protected health information and defines different penalty levels for violations. All employees must complete training at hire and annually through an online computerized system.
21st Century Act and its Impact on Healthcare ITCitiusTech
This document gives an overview, core objectives of the act and enumerates purpose of each part / division of the 21st Century Act. It lists down the sections of the act which have a direct impact on Healthcare IT and gives a brief overview of each section.This document also explains the impact of 21st Century Cures Act on regulatory bodies: FDA / NIH / HSS.
What explains why certain services were covered and others were not .docxajoy21
This document contains questions about various healthcare topics and a passage about the HIPAA Privacy Rule, which established the first national standards for protecting private health information. It discusses what protected health information is and the deadline for covered entities to comply with the Privacy Rule. It also contains passages about public health practices using protected health information and ERISA rules that medical providers can use to challenge health insurance claim denials.
HC4110_FinalPaper_NewModelEHR_SmithKR_05062016Kathlene Smith
This document summarizes a paper on fixing the electronic health record (EHR) marketplace in the United States. It discusses how the HITECH Act incentivized EHR adoption but led to over-complication through "Meaningful Use" criteria. Fewer than 10% of providers claimed incentives due to difficulties installing and using EHR software. The paper reviews literature finding frustration with EHR costs and usability. It argues the US could learn from other countries that implemented standardized data languages and open-source software with less financial impact.
This study aimed at identifying the issue, challenges and opportunities from the health consumers in
Tanzania towards interoperability of electronic health records. Reaching that level of seamless data
sharing among Hospitals needs the cooperation of all stakeholders especially the health consumer whose
data are the ones to be shared. Without their acceptance that means there is nothing to share. Recognizing
that we conducted a study in Tanzania to identify the challenges, issues and opportunities towards health
information exchange through interoperable EHRs. The study was conducted in three major cities of
Tanzania to identify the security, privacy and confidentiality issues of information sharing together with
related challenges to data sharing. This was in order to come up with a clear picture of how to implement
some EHRs that will be trusted by health consumers. The participants (n=240) were surveyed on computer
usage, EHRs knowledge, demographics, security and privacy issues. A total of 200 surveys were completed
and returned (83.3% response rate). Among them 67.5% were women, 62.6% had not heard of EHRs, 73%
were highly concerned about the privacy and security of their information. 75% believed that introduction
of various security mechanisms will make EHRs more secure and thus better. We conducted a number of
chi-square tests (p<0.05) and we realized that there was a strong relationship among the variable of age,
computer use, EHRs knowledge and the concerns for privacy and security.The study also showed that there
was just a small difference of 8.5% between those people who think EHRs are safer than paper records and
those who think otherwise. The general observation of the study was that in order to make EHRs successful
in our Hospitals then the issue of security, and health consumer involvement were they two key towards the
road of successful EHRs in our hospitals practices and that will make consumers more willing to allow
their records to be shared among different health organizations. So besides the issues identified, this study
helped us to identify the key requirements which will be implemented in our proposed framework.
Implementing The Affordable Care Act EssayMichelle Love
The document discusses the benefits of implementing electronic health record (EHR) systems. It provides perspectives from a physician who was an early adopter of EHR technology. The physician found that the EHR system improved clinical quality measures through automated feedback on adherence to evidence-based standards of care. It also reduced administrative burdens on physicians and staff, improving productivity and income. Additional benefits discussed include increased patient engagement through access to health records online and fewer calls and visits to medical records offices. Keeping EHRs error-free is also important to maintain integrity of patient information.
This document discusses patient privacy and security concerns in healthcare. The Health Insurance Portability and Accountability Act (HIPAA) was designed to protect patient privacy and the confidentiality of medical records. However, maintaining confidentiality is difficult due to increased risks from advancing health information technology. The document also describes a case where staff at UCLA hospital breached security policies and did not follow HIPAA guidelines, damaging the credibility of the organization. It provides recommendations for healthcare organizations to ensure compliance with privacy and security protocols such as educating staff, implementing audits, and enforcing disciplinary actions for violations.
The HIPAA Privacy and Security Rules establish national standards for protecting individuals' personal health information. The Security Rule focuses on safeguarding electronic protected health information by requiring "covered entities" like healthcare providers and health plans to implement technical and non-technical security measures. The goals of the Security Rule are to protect privacy while allowing new technologies, and it is designed to be flexible enough to address the needs of different types and sizes of organizations. This document summarizes but does not replace reviewing the complete Security Rule requirements.
76 CHAPTER 4 Assessing Health and Health Behaviors Objecti.docxpriestmanmable
76
CHAPTER 4
Assessing Health and Health Behaviors
Objectives
this chapter will enable the reader to:
1. Describe the expected outcomes of a nursing health assessment.
2. Identify the components of a nursing health assessment conducted for an individual client.
3. Examine life span, language, and culturally appropriate nursing health assessment tools for children, adults, and older adults.
4. Compare the similarities and differences among the various approaches to assessing the family, mindful of cultural influences.
5. Evaluate the criteria for conducting a screening in the community.
6. Compare the similarities and differences among the various approaches to assessing
the community.
Athorough assessment of health and health behaviors is the foundation for tailoring a health promotion-prevention plan. Assessment provides the database for making clinical judgments about the client’s health strengths, health problems, nursing diagnoses, desired health or behavioral outcomes, as well as the interventions likely to be effective. This information also forms the nature of the client–nurse partnership such as the frequency of con- tact and the need for coordination with other health professionals. The portfolio of assessment measures depends on the characteristics of the client, including developmental stage and cul- tural orientation. The nurse assesses age, language, and cultural appropriateness of the various measures selected.
Cultural competence is the ability to communicate effectively with people of different cultures. Providing culturally competent care is the cornerstone of the nursing assessment. The nurse’s aware- ness of her own attitude toward cultural differences and her cultural worldview and characteristics
Chapter4 • AssessingHealthandHealthBehaviors 77
are critical to her understanding and knowledge of various cultures. Recognizing that diversity exists in all cultures based on educational level, socioeconomic status, religion, rural/urban residence, and individual and family characteristics will ensure a more successful encounter (The Office of Minority Health, 2013). An online cultural educational program, designed specifically for nurses and featur- ing videotaped case studies and interactive tools, is available.
The Enhanced National Standards for Culturally and Linguistically Appropriate Services, based on a definition of culture expanded to include geography, spirituality, language, race and ethnicity, and biology, provides a practical guide to culturally and linguistically sensitive care (The Office of Minority Health, 2013).
Technology is having a significant impact on health care. The Electronic Health Record (EHR) promotes involvement of the client in developing a dynamic, tailored database. The EHR offers great promise to improve health and increase the client’s satisfaction with his care. Data aggregation, cross-continuum coordination, and clinical care plan management are critical com- ponents of the.
This document discusses health information security and privacy challenges. It covers the passage of HIPAA in 1996 to protect patient privacy and the challenges of managing health information systems, such as security, data access, and lack of interoperability. Recommendations include establishing security policies, training employees on HIPAA compliance, and using technical solutions like role-based access control and encryption. The conclusion emphasizes that while new technologies benefit healthcare, privacy and security must be ensured.
This document outlines the key components of training for healthcare managers on confidentiality and privacy. It discusses HIPAA regulations regarding protected health information and patient privacy rights. Technological advances have increased privacy issues, so employers must balance monitoring employees with individual privacy rights. Managers should communicate privacy and confidentiality policies clearly to employees to avoid misunderstandings and ensure standards of conduct are followed. Adhering to relevant laws and communicating expectations are essential for protecting patient and employee privacy.
This document outlines the key components of a training for healthcare managers on confidentiality and privacy. It discusses HIPAA regulations regarding protected health information, privacy issues exacerbated by technology, and the importance of monitoring employees and clearly communicating expectations. Managers must incorporate privacy and confidentiality standards into organizational policies to comply with laws like HIPAA and balance business and employee interests. Communicating these policies is essential.
This document discusses stakeholders in healthcare and their perspectives, as well as key developments in health information technology (IT) policy and adoption in the United States. It outlines major public health IT initiatives and frameworks, such as meaningful use stages and health information exchange. The document also examines issues in consumer health informatics, including roles of information and communication technologies and examples like personal health records and social media.
Implementation of Data Privacy and Security in an Online Student Health Recor...Kato Mivule
Kato Mivule, Stephen Otunba, Tattwamasi Tripathy, Sharad and Sharma, "Implementation of Data Privacy and Security in an Online Student Health Records System", Proceedings at the ISCA 21th Int Conf on Software Engineering and Data Engineering (SEDE-2012), Pages 143-148, Los Angeles, CA, USA
The document summarizes the agenda and discussion topics for a listening session on developing a Health IT Strategic Framework. The session aimed to get input on key topics like creating a learning health system using health IT, defining meaningful use of EHRs, necessary policies and infrastructure, and ensuring patient privacy and security. The document outlines goals, principles and objectives for each topic to guide the discussion.
This document summarizes privacy, security, and professionalism considerations for digital communications among health care professionals and between professionals and patients. It discusses how HIPAA and state laws apply to electronic communications. Encryption is recommended but not required under HIPAA. Professionals must take care to send information to the right recipient and patient. Communications should maintain professional standards regardless of format. Guidance from medical societies can help set policies for using digital tools. The document also briefly discusses FDA regulation of mobile medical apps and acceptance of data from patients.
1)Health data is sensitive and confidential; hence, it should .docxteresehearn
1)
Health data is sensitive and confidential; hence, it should be kept safe. Data security is one of the critical activities which has become challenging for many organizations (Frith, 2019). Due to technology advancements, people can save their health data online. Similarly, people are also able to share data with close friends or any other person of interest. Using online platforms to store the data has brought a lot of benefits. The primary benefit is the fact that individuals can share data with medical experts easily. By, this the medical experts will be able to assist the sick people if possible. The data is always accessible as long as one is authorized.
I read different articles that shared information concerning health data breaches. Various health organizations have been affected by data breaches (Garner, 2017). A good example is the University of Washington Medicine. This organization reported that 974,000 patients' data was affected. The attack was noticed by a patient who found some files containing personal information on public sites. The patient then notified the organization, which claimed that some employees made some errors, which led to the leakage. The files were accessible through Google, so the organization had to ask Google to remove the data. Fortunately, the files were removed from the search list, and this occurred in January 2019.
It was risky to let the files containing personal information available on the website (Ronquillo, Erik Winterholler, Cwikla, Szymanski & Levy, 2018). The organization was lucky that the data breach was not significant, and hence, the patients were not significantly affected. It is good to ensure that files containing health data are handled carefully to avoid some problems. In keeping the health data secure, it is good to ensure that the systems are well-protected. The systems can be protected by making use of firewalls which prevent unauthorized people from accessing them. During the data sharing process, a health organization should ensure that the information is encrypted. Encryption prevents unauthorized people from understanding the message that is being shared using different channels. Users should make sure that they use strong passwords.
2)
Protection of patient’s information is the top most priority of health care providers and professionals. Patient’s health information contains personal data and their health conditions hence the federal laws requires to maintain security and privacy to safeguards health information. Privacy, as distinct from confidentiality, is viewed as the right of the individual client or patient to be let alone and to make decisions about how personal information is shared (Brodnik, 2012). Health data is usually stored on paper or electronically, in both these ways it is important to respect the privacy of the patients and hence follow policies to maintain security and privacy rules.
The Health Insurance Portability and Accountabili.
Public Health Informatics, Consumer Health Informatics, mHealth & Personal He...Nawanan Theera-Ampornpunt
Presented at the Health Informatics and Health Information Technology Course, Doctor of Philosophy and Master of Science Programs in Data Science for Health Care (International Program), Faculty of Medicine Ramathibodi Hospital, Mahidol University on October 24, 2017
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...Nawanan Theera-Ampornpunt
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 10, 2021
6/29/2016 library.ahima.org/PB/DataStandards#appxA
http://library.ahima.org/PB/DataStandards#appxA 1/20
Data Standards, Data Quality, and Interoperability (2013
update)
Remove from myBoK
Editor's note: This update replaces the 2007 practice brief "Data Standards, Data Quality, and Interoperability."
Data quality and consistency are critical to ensuring patient safety, communicating delivery of health services, coordinating
care, and healthcare reporting. Assessing the quality and consistency of data requires data standards. This practice brief
provides health information management (HIM) professionals with a clear understanding of data standards as a tool to
enable interoperability and promote data quality.
The online version of this practice brief [...] is accompanied by an appendix that provides HIM professionals with a list of
standards to reference in data dictionary development, electronic health records, the exchange of health information, and
general data management processes to ensure information integrity and reliability. Evaluation of data validity, reliability,
completeness, and timeliness are accomplished through a combination of human and machine processes in healthcare, and
the list of data standard sources is a helpful reference guide when more detailed information is required.
Data Standards and Regulatory Framework
Data standards are "documented agreements on representations, formats, and definitions of common data. Data standards
provide a method to codify invalid, meaningful, comprehensive, and actionable ways, information captured in the course of
doing business." Rules to describe how the data is recorded to ensure consistency across multiple sources is another way to
think of data standards. Without data standards and data quality, the future of interoperability is bleak. Data fields and the
content of those fields need to be standardized.
Standards development organizations (SDOs) address a variety of aspects of health information and informatics. For
example, the American Society for Testing and Materials (ASTM) and Health Level Seven (HL7) target clinical data
standards. Insurance and remittance standards are a focus of the Accredited Standards Committee (ASC) X12. Standards to
transmit diagnostic images are developed through Digital Imaging and Communications in Medicine (DICOM). The
National Council for Prescription Drug Programs (NCPDP) represents pharmacy messages.
The Institute of Electrical and Electronics Engineers (IEEE), HL7, ASTM, and others develop data models and
frameworks. See the table on page 65 for a breakdown of regulatory agencies responsible for working with the American
National Standards Institute (ANSI) to drive data standards to achieve interoperability.
The AHIMA Leadership Model states that HIM professionals should serve as the leaders in healthcare organizations and in
their professional community for ensuring that data content standards are identified, understood, implemented, a.
6/29/2016 library.ahima.org/PB/DataStandards#appxA
http://library.ahima.org/PB/DataStandards#appxA 1/20
Data Standards, Data Quality, and Interoperability (2013
update)
Remove from myBoK
Editor's note: This update replaces the 2007 practice brief "Data Standards, Data Quality, and Interoperability."
Data quality and consistency are critical to ensuring patient safety, communicating delivery of health services, coordinating
care, and healthcare reporting. Assessing the quality and consistency of data requires data standards. This practice brief
provides health information management (HIM) professionals with a clear understanding of data standards as a tool to
enable interoperability and promote data quality.
The online version of this practice brief [...] is accompanied by an appendix that provides HIM professionals with a list of
standards to reference in data dictionary development, electronic health records, the exchange of health information, and
general data management processes to ensure information integrity and reliability. Evaluation of data validity, reliability,
completeness, and timeliness are accomplished through a combination of human and machine processes in healthcare, and
the list of data standard sources is a helpful reference guide when more detailed information is required.
Data Standards and Regulatory Framework
Data standards are "documented agreements on representations, formats, and definitions of common data. Data standards
provide a method to codify invalid, meaningful, comprehensive, and actionable ways, information captured in the course of
doing business." Rules to describe how the data is recorded to ensure consistency across multiple sources is another way to
think of data standards. Without data standards and data quality, the future of interoperability is bleak. Data fields and the
content of those fields need to be standardized.
Standards development organizations (SDOs) address a variety of aspects of health information and informatics. For
example, the American Society for Testing and Materials (ASTM) and Health Level Seven (HL7) target clinical data
standards. Insurance and remittance standards are a focus of the Accredited Standards Committee (ASC) X12. Standards to
transmit diagnostic images are developed through Digital Imaging and Communications in Medicine (DICOM). The
National Council for Prescription Drug Programs (NCPDP) represents pharmacy messages.
The Institute of Electrical and Electronics Engineers (IEEE), HL7, ASTM, and others develop data models and
frameworks. See the table on page 65 for a breakdown of regulatory agencies responsible for working with the American
National Standards Institute (ANSI) to drive data standards to achieve interoperability.
The AHIMA Leadership Model states that HIM professionals should serve as the leaders in healthcare organizations and in
their professional community for ensuring that data content standards are identified, understood, implemented, a ...
Running Head THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 1.docxtodd521
Running Head: THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 1
THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 9
The Health Information Exchange (HIE) in U.S
Yehyun Park
Purdue University
01/02/2019
The impetus of Health Information Exchange in U.S
Health Information Exchange (HIE) is an information system that promotes a secure sharing of critical information as well the inclusive access critical medical information about a patient electronically (Abdelhak et al, 2014). One merit of the use of such electronic systems in the U.S is that they occur in different verities. The HIE also offer different types of services. Evidently, a recent development has enabled the HIE systems to promote the Marketplace and regional institutional services concerning the health sector. The merit of HIE applications included the improvement of speed, Quality, safety and reduced relative prices of charge per patient for care. This is made possible by the quick sharing of critical information among the doctors, pharmacists, nurses among all the relevant health personnel. The HGIE systems are such that, they are technically enabled to provide quick response to information demand with the relevant urgency and thus aids in the making of vital patient’s data and medical progress devoid of medical errors, readmissions, and duplicate testing. The resulting system has a generally improved diagnosis.
HIE enables three line of services in general: directed exchange, Query-based Exchange a consumer-mediated exchange services. Direct Exchange is the sending or receiving data electronically in the aid of coordination by caregivers. Whenever heath care provider wants to consult with other providers about a planned care, they employ the Query-based exchange while consumer-mediated Exchange enables patients to manage through control of the use of their personal information (Abdelhak et al, 2014). The availability of the three forms of health information Exchange makes the strong point of HIE since their integration in use is guided by some predetermined policies, technology, principles, and policies provision which have already been piloted before. The three forms are completely available throughout. With the Consumer-mediated Exchange system, the patient can be able to monitor the use of his personal medical information by their care provider. The patients can make a participation in their care enhancing through providing alternative providers with their heath condition, describe their heath information give the health missing or incorrect information, track and manage their own health.
Describe basic HIE organizational structures, architectures, and services
The commonly known architecture types of HIE includes the centralized hybrid and the federated models of HIE. The centralized HIE model is enabled with one Clinical Data Repository (CDR). The CDR is managed by HIE authority that is under the governance of the representatives from the relevant hospitals (Abdelhak .
Health information technology (Health IT) is an area of information technology that includes the design, development, creation, use and maintenance of information systems for the healthcare industry. Automated and compatible healthcare information systems will continue to improve healthcare and healthcare, reduce costs, increase efficiency, reduce errors and increase patient satisfaction, and optimize cost recovery for outpatient and inpatient health care providers.
Ehr by jessica austin, shaun baker, victoria blankenship and kayla borokayla_ann_30
This document provides an overview of electronic health records (EHR) including what they are, key components, considerations for implementation, and security and costs. It discusses that EHRs provide a centralized digital patient record accessible by healthcare providers. The eight essential components that must be included are things like health information, order entry, decision support, and administrative functions. Proper implementation requires input from various stakeholders like medical staff, IT, and leadership. Security and privacy are also important considerations, as are the financial costs of purchasing and maintaining an EHR system.
Your employer is pleased with your desire to further your educatio.docxwoodruffeloisa
Your employer is pleased with your desire to further your education and would like you to inform other employees about the process of online education; however, she still has questions about applying. Using proper memo format, and Figure 6-1 of the textbook, explain the process of applying for a degree at CSU. Use word processing software, such as Microsoft Word, to create your memo.
Your response should be at least 200 words in length. You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.
Pfeiffer, W., & Adkins, K. (2012, 109-110).
Technical communication fundamentals
. Upper Saddle River, NJ: Prentice Hall.
.
Your finished project, including both elements of the paper, should .docxwoodruffeloisa
Your finished project, including both elements of the paper, should be approximately 12 to 14 double-spaced pages, not including the cover or reference pages but including the abstract, submitted as one document. Make sure you present an introduction and a conclusion tying together both aspects of the paper. Follow the guidelines in either Course Content or in the conference. You must post your selection in this conference. The paper is due at the end of week 8 and must be submitted in your Assignments folder. Review the late policy above. The paper will not be accepted late.
.
More Related Content
Similar to PSYC 3500 Strategies for Enhancing Learning and MemorySelf-Evalu.docx
This study aimed at identifying the issue, challenges and opportunities from the health consumers in
Tanzania towards interoperability of electronic health records. Reaching that level of seamless data
sharing among Hospitals needs the cooperation of all stakeholders especially the health consumer whose
data are the ones to be shared. Without their acceptance that means there is nothing to share. Recognizing
that we conducted a study in Tanzania to identify the challenges, issues and opportunities towards health
information exchange through interoperable EHRs. The study was conducted in three major cities of
Tanzania to identify the security, privacy and confidentiality issues of information sharing together with
related challenges to data sharing. This was in order to come up with a clear picture of how to implement
some EHRs that will be trusted by health consumers. The participants (n=240) were surveyed on computer
usage, EHRs knowledge, demographics, security and privacy issues. A total of 200 surveys were completed
and returned (83.3% response rate). Among them 67.5% were women, 62.6% had not heard of EHRs, 73%
were highly concerned about the privacy and security of their information. 75% believed that introduction
of various security mechanisms will make EHRs more secure and thus better. We conducted a number of
chi-square tests (p<0.05) and we realized that there was a strong relationship among the variable of age,
computer use, EHRs knowledge and the concerns for privacy and security.The study also showed that there
was just a small difference of 8.5% between those people who think EHRs are safer than paper records and
those who think otherwise. The general observation of the study was that in order to make EHRs successful
in our Hospitals then the issue of security, and health consumer involvement were they two key towards the
road of successful EHRs in our hospitals practices and that will make consumers more willing to allow
their records to be shared among different health organizations. So besides the issues identified, this study
helped us to identify the key requirements which will be implemented in our proposed framework.
Implementing The Affordable Care Act EssayMichelle Love
The document discusses the benefits of implementing electronic health record (EHR) systems. It provides perspectives from a physician who was an early adopter of EHR technology. The physician found that the EHR system improved clinical quality measures through automated feedback on adherence to evidence-based standards of care. It also reduced administrative burdens on physicians and staff, improving productivity and income. Additional benefits discussed include increased patient engagement through access to health records online and fewer calls and visits to medical records offices. Keeping EHRs error-free is also important to maintain integrity of patient information.
This document discusses patient privacy and security concerns in healthcare. The Health Insurance Portability and Accountability Act (HIPAA) was designed to protect patient privacy and the confidentiality of medical records. However, maintaining confidentiality is difficult due to increased risks from advancing health information technology. The document also describes a case where staff at UCLA hospital breached security policies and did not follow HIPAA guidelines, damaging the credibility of the organization. It provides recommendations for healthcare organizations to ensure compliance with privacy and security protocols such as educating staff, implementing audits, and enforcing disciplinary actions for violations.
The HIPAA Privacy and Security Rules establish national standards for protecting individuals' personal health information. The Security Rule focuses on safeguarding electronic protected health information by requiring "covered entities" like healthcare providers and health plans to implement technical and non-technical security measures. The goals of the Security Rule are to protect privacy while allowing new technologies, and it is designed to be flexible enough to address the needs of different types and sizes of organizations. This document summarizes but does not replace reviewing the complete Security Rule requirements.
76 CHAPTER 4 Assessing Health and Health Behaviors Objecti.docxpriestmanmable
76
CHAPTER 4
Assessing Health and Health Behaviors
Objectives
this chapter will enable the reader to:
1. Describe the expected outcomes of a nursing health assessment.
2. Identify the components of a nursing health assessment conducted for an individual client.
3. Examine life span, language, and culturally appropriate nursing health assessment tools for children, adults, and older adults.
4. Compare the similarities and differences among the various approaches to assessing the family, mindful of cultural influences.
5. Evaluate the criteria for conducting a screening in the community.
6. Compare the similarities and differences among the various approaches to assessing
the community.
Athorough assessment of health and health behaviors is the foundation for tailoring a health promotion-prevention plan. Assessment provides the database for making clinical judgments about the client’s health strengths, health problems, nursing diagnoses, desired health or behavioral outcomes, as well as the interventions likely to be effective. This information also forms the nature of the client–nurse partnership such as the frequency of con- tact and the need for coordination with other health professionals. The portfolio of assessment measures depends on the characteristics of the client, including developmental stage and cul- tural orientation. The nurse assesses age, language, and cultural appropriateness of the various measures selected.
Cultural competence is the ability to communicate effectively with people of different cultures. Providing culturally competent care is the cornerstone of the nursing assessment. The nurse’s aware- ness of her own attitude toward cultural differences and her cultural worldview and characteristics
Chapter4 • AssessingHealthandHealthBehaviors 77
are critical to her understanding and knowledge of various cultures. Recognizing that diversity exists in all cultures based on educational level, socioeconomic status, religion, rural/urban residence, and individual and family characteristics will ensure a more successful encounter (The Office of Minority Health, 2013). An online cultural educational program, designed specifically for nurses and featur- ing videotaped case studies and interactive tools, is available.
The Enhanced National Standards for Culturally and Linguistically Appropriate Services, based on a definition of culture expanded to include geography, spirituality, language, race and ethnicity, and biology, provides a practical guide to culturally and linguistically sensitive care (The Office of Minority Health, 2013).
Technology is having a significant impact on health care. The Electronic Health Record (EHR) promotes involvement of the client in developing a dynamic, tailored database. The EHR offers great promise to improve health and increase the client’s satisfaction with his care. Data aggregation, cross-continuum coordination, and clinical care plan management are critical com- ponents of the.
This document discusses health information security and privacy challenges. It covers the passage of HIPAA in 1996 to protect patient privacy and the challenges of managing health information systems, such as security, data access, and lack of interoperability. Recommendations include establishing security policies, training employees on HIPAA compliance, and using technical solutions like role-based access control and encryption. The conclusion emphasizes that while new technologies benefit healthcare, privacy and security must be ensured.
This document outlines the key components of training for healthcare managers on confidentiality and privacy. It discusses HIPAA regulations regarding protected health information and patient privacy rights. Technological advances have increased privacy issues, so employers must balance monitoring employees with individual privacy rights. Managers should communicate privacy and confidentiality policies clearly to employees to avoid misunderstandings and ensure standards of conduct are followed. Adhering to relevant laws and communicating expectations are essential for protecting patient and employee privacy.
This document outlines the key components of a training for healthcare managers on confidentiality and privacy. It discusses HIPAA regulations regarding protected health information, privacy issues exacerbated by technology, and the importance of monitoring employees and clearly communicating expectations. Managers must incorporate privacy and confidentiality standards into organizational policies to comply with laws like HIPAA and balance business and employee interests. Communicating these policies is essential.
This document discusses stakeholders in healthcare and their perspectives, as well as key developments in health information technology (IT) policy and adoption in the United States. It outlines major public health IT initiatives and frameworks, such as meaningful use stages and health information exchange. The document also examines issues in consumer health informatics, including roles of information and communication technologies and examples like personal health records and social media.
Implementation of Data Privacy and Security in an Online Student Health Recor...Kato Mivule
Kato Mivule, Stephen Otunba, Tattwamasi Tripathy, Sharad and Sharma, "Implementation of Data Privacy and Security in an Online Student Health Records System", Proceedings at the ISCA 21th Int Conf on Software Engineering and Data Engineering (SEDE-2012), Pages 143-148, Los Angeles, CA, USA
The document summarizes the agenda and discussion topics for a listening session on developing a Health IT Strategic Framework. The session aimed to get input on key topics like creating a learning health system using health IT, defining meaningful use of EHRs, necessary policies and infrastructure, and ensuring patient privacy and security. The document outlines goals, principles and objectives for each topic to guide the discussion.
This document summarizes privacy, security, and professionalism considerations for digital communications among health care professionals and between professionals and patients. It discusses how HIPAA and state laws apply to electronic communications. Encryption is recommended but not required under HIPAA. Professionals must take care to send information to the right recipient and patient. Communications should maintain professional standards regardless of format. Guidance from medical societies can help set policies for using digital tools. The document also briefly discusses FDA regulation of mobile medical apps and acceptance of data from patients.
1)Health data is sensitive and confidential; hence, it should .docxteresehearn
1)
Health data is sensitive and confidential; hence, it should be kept safe. Data security is one of the critical activities which has become challenging for many organizations (Frith, 2019). Due to technology advancements, people can save their health data online. Similarly, people are also able to share data with close friends or any other person of interest. Using online platforms to store the data has brought a lot of benefits. The primary benefit is the fact that individuals can share data with medical experts easily. By, this the medical experts will be able to assist the sick people if possible. The data is always accessible as long as one is authorized.
I read different articles that shared information concerning health data breaches. Various health organizations have been affected by data breaches (Garner, 2017). A good example is the University of Washington Medicine. This organization reported that 974,000 patients' data was affected. The attack was noticed by a patient who found some files containing personal information on public sites. The patient then notified the organization, which claimed that some employees made some errors, which led to the leakage. The files were accessible through Google, so the organization had to ask Google to remove the data. Fortunately, the files were removed from the search list, and this occurred in January 2019.
It was risky to let the files containing personal information available on the website (Ronquillo, Erik Winterholler, Cwikla, Szymanski & Levy, 2018). The organization was lucky that the data breach was not significant, and hence, the patients were not significantly affected. It is good to ensure that files containing health data are handled carefully to avoid some problems. In keeping the health data secure, it is good to ensure that the systems are well-protected. The systems can be protected by making use of firewalls which prevent unauthorized people from accessing them. During the data sharing process, a health organization should ensure that the information is encrypted. Encryption prevents unauthorized people from understanding the message that is being shared using different channels. Users should make sure that they use strong passwords.
2)
Protection of patient’s information is the top most priority of health care providers and professionals. Patient’s health information contains personal data and their health conditions hence the federal laws requires to maintain security and privacy to safeguards health information. Privacy, as distinct from confidentiality, is viewed as the right of the individual client or patient to be let alone and to make decisions about how personal information is shared (Brodnik, 2012). Health data is usually stored on paper or electronically, in both these ways it is important to respect the privacy of the patients and hence follow policies to maintain security and privacy rules.
The Health Insurance Portability and Accountabili.
Public Health Informatics, Consumer Health Informatics, mHealth & Personal He...Nawanan Theera-Ampornpunt
Presented at the Health Informatics and Health Information Technology Course, Doctor of Philosophy and Master of Science Programs in Data Science for Health Care (International Program), Faculty of Medicine Ramathibodi Hospital, Mahidol University on October 24, 2017
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...Nawanan Theera-Ampornpunt
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 10, 2021
6/29/2016 library.ahima.org/PB/DataStandards#appxA
http://library.ahima.org/PB/DataStandards#appxA 1/20
Data Standards, Data Quality, and Interoperability (2013
update)
Remove from myBoK
Editor's note: This update replaces the 2007 practice brief "Data Standards, Data Quality, and Interoperability."
Data quality and consistency are critical to ensuring patient safety, communicating delivery of health services, coordinating
care, and healthcare reporting. Assessing the quality and consistency of data requires data standards. This practice brief
provides health information management (HIM) professionals with a clear understanding of data standards as a tool to
enable interoperability and promote data quality.
The online version of this practice brief [...] is accompanied by an appendix that provides HIM professionals with a list of
standards to reference in data dictionary development, electronic health records, the exchange of health information, and
general data management processes to ensure information integrity and reliability. Evaluation of data validity, reliability,
completeness, and timeliness are accomplished through a combination of human and machine processes in healthcare, and
the list of data standard sources is a helpful reference guide when more detailed information is required.
Data Standards and Regulatory Framework
Data standards are "documented agreements on representations, formats, and definitions of common data. Data standards
provide a method to codify invalid, meaningful, comprehensive, and actionable ways, information captured in the course of
doing business." Rules to describe how the data is recorded to ensure consistency across multiple sources is another way to
think of data standards. Without data standards and data quality, the future of interoperability is bleak. Data fields and the
content of those fields need to be standardized.
Standards development organizations (SDOs) address a variety of aspects of health information and informatics. For
example, the American Society for Testing and Materials (ASTM) and Health Level Seven (HL7) target clinical data
standards. Insurance and remittance standards are a focus of the Accredited Standards Committee (ASC) X12. Standards to
transmit diagnostic images are developed through Digital Imaging and Communications in Medicine (DICOM). The
National Council for Prescription Drug Programs (NCPDP) represents pharmacy messages.
The Institute of Electrical and Electronics Engineers (IEEE), HL7, ASTM, and others develop data models and
frameworks. See the table on page 65 for a breakdown of regulatory agencies responsible for working with the American
National Standards Institute (ANSI) to drive data standards to achieve interoperability.
The AHIMA Leadership Model states that HIM professionals should serve as the leaders in healthcare organizations and in
their professional community for ensuring that data content standards are identified, understood, implemented, a.
6/29/2016 library.ahima.org/PB/DataStandards#appxA
http://library.ahima.org/PB/DataStandards#appxA 1/20
Data Standards, Data Quality, and Interoperability (2013
update)
Remove from myBoK
Editor's note: This update replaces the 2007 practice brief "Data Standards, Data Quality, and Interoperability."
Data quality and consistency are critical to ensuring patient safety, communicating delivery of health services, coordinating
care, and healthcare reporting. Assessing the quality and consistency of data requires data standards. This practice brief
provides health information management (HIM) professionals with a clear understanding of data standards as a tool to
enable interoperability and promote data quality.
The online version of this practice brief [...] is accompanied by an appendix that provides HIM professionals with a list of
standards to reference in data dictionary development, electronic health records, the exchange of health information, and
general data management processes to ensure information integrity and reliability. Evaluation of data validity, reliability,
completeness, and timeliness are accomplished through a combination of human and machine processes in healthcare, and
the list of data standard sources is a helpful reference guide when more detailed information is required.
Data Standards and Regulatory Framework
Data standards are "documented agreements on representations, formats, and definitions of common data. Data standards
provide a method to codify invalid, meaningful, comprehensive, and actionable ways, information captured in the course of
doing business." Rules to describe how the data is recorded to ensure consistency across multiple sources is another way to
think of data standards. Without data standards and data quality, the future of interoperability is bleak. Data fields and the
content of those fields need to be standardized.
Standards development organizations (SDOs) address a variety of aspects of health information and informatics. For
example, the American Society for Testing and Materials (ASTM) and Health Level Seven (HL7) target clinical data
standards. Insurance and remittance standards are a focus of the Accredited Standards Committee (ASC) X12. Standards to
transmit diagnostic images are developed through Digital Imaging and Communications in Medicine (DICOM). The
National Council for Prescription Drug Programs (NCPDP) represents pharmacy messages.
The Institute of Electrical and Electronics Engineers (IEEE), HL7, ASTM, and others develop data models and
frameworks. See the table on page 65 for a breakdown of regulatory agencies responsible for working with the American
National Standards Institute (ANSI) to drive data standards to achieve interoperability.
The AHIMA Leadership Model states that HIM professionals should serve as the leaders in healthcare organizations and in
their professional community for ensuring that data content standards are identified, understood, implemented, a ...
Running Head THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 1.docxtodd521
Running Head: THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 1
THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 9
The Health Information Exchange (HIE) in U.S
Yehyun Park
Purdue University
01/02/2019
The impetus of Health Information Exchange in U.S
Health Information Exchange (HIE) is an information system that promotes a secure sharing of critical information as well the inclusive access critical medical information about a patient electronically (Abdelhak et al, 2014). One merit of the use of such electronic systems in the U.S is that they occur in different verities. The HIE also offer different types of services. Evidently, a recent development has enabled the HIE systems to promote the Marketplace and regional institutional services concerning the health sector. The merit of HIE applications included the improvement of speed, Quality, safety and reduced relative prices of charge per patient for care. This is made possible by the quick sharing of critical information among the doctors, pharmacists, nurses among all the relevant health personnel. The HGIE systems are such that, they are technically enabled to provide quick response to information demand with the relevant urgency and thus aids in the making of vital patient’s data and medical progress devoid of medical errors, readmissions, and duplicate testing. The resulting system has a generally improved diagnosis.
HIE enables three line of services in general: directed exchange, Query-based Exchange a consumer-mediated exchange services. Direct Exchange is the sending or receiving data electronically in the aid of coordination by caregivers. Whenever heath care provider wants to consult with other providers about a planned care, they employ the Query-based exchange while consumer-mediated Exchange enables patients to manage through control of the use of their personal information (Abdelhak et al, 2014). The availability of the three forms of health information Exchange makes the strong point of HIE since their integration in use is guided by some predetermined policies, technology, principles, and policies provision which have already been piloted before. The three forms are completely available throughout. With the Consumer-mediated Exchange system, the patient can be able to monitor the use of his personal medical information by their care provider. The patients can make a participation in their care enhancing through providing alternative providers with their heath condition, describe their heath information give the health missing or incorrect information, track and manage their own health.
Describe basic HIE organizational structures, architectures, and services
The commonly known architecture types of HIE includes the centralized hybrid and the federated models of HIE. The centralized HIE model is enabled with one Clinical Data Repository (CDR). The CDR is managed by HIE authority that is under the governance of the representatives from the relevant hospitals (Abdelhak .
Health information technology (Health IT) is an area of information technology that includes the design, development, creation, use and maintenance of information systems for the healthcare industry. Automated and compatible healthcare information systems will continue to improve healthcare and healthcare, reduce costs, increase efficiency, reduce errors and increase patient satisfaction, and optimize cost recovery for outpatient and inpatient health care providers.
Ehr by jessica austin, shaun baker, victoria blankenship and kayla borokayla_ann_30
This document provides an overview of electronic health records (EHR) including what they are, key components, considerations for implementation, and security and costs. It discusses that EHRs provide a centralized digital patient record accessible by healthcare providers. The eight essential components that must be included are things like health information, order entry, decision support, and administrative functions. Proper implementation requires input from various stakeholders like medical staff, IT, and leadership. Security and privacy are also important considerations, as are the financial costs of purchasing and maintaining an EHR system.
Similar to PSYC 3500 Strategies for Enhancing Learning and MemorySelf-Evalu.docx (20)
Your employer is pleased with your desire to further your educatio.docxwoodruffeloisa
Your employer is pleased with your desire to further your education and would like you to inform other employees about the process of online education; however, she still has questions about applying. Using proper memo format, and Figure 6-1 of the textbook, explain the process of applying for a degree at CSU. Use word processing software, such as Microsoft Word, to create your memo.
Your response should be at least 200 words in length. You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.
Pfeiffer, W., & Adkins, K. (2012, 109-110).
Technical communication fundamentals
. Upper Saddle River, NJ: Prentice Hall.
.
Your finished project, including both elements of the paper, should .docxwoodruffeloisa
Your finished project, including both elements of the paper, should be approximately 12 to 14 double-spaced pages, not including the cover or reference pages but including the abstract, submitted as one document. Make sure you present an introduction and a conclusion tying together both aspects of the paper. Follow the guidelines in either Course Content or in the conference. You must post your selection in this conference. The paper is due at the end of week 8 and must be submitted in your Assignments folder. Review the late policy above. The paper will not be accepted late.
.
Your first task is to find a public budget to analyze. It is suggest.docxwoodruffeloisa
Your first task is to find a public budget to analyze. It is suggested you focus on a city/county department, a small municipality/township, a school district, a special district (such as a forest preserve district, stadium district, or water district), a community college, a small public university, or a single state agency.
Be sure not to choose a budget that is too large to analyze in one written exercise. Most budgets are readily available on the institution’s website or by contacting the budgeting/finance department. Many local libraries will also have these documents.
In your analysis, you should address the following items/questions:
Offer a brief overview of your chosen agency. What are its primary functions and roles in the community?
What are the primary expenditures for your chosen agency?
How do these expenditures determine public policy priorities?
Has the agency’s budget increased or decreased since last year? What does this indicate about the success of the agency and its ability to deliver services?
Is the agency allocating resources wisely?
What recommendations would you offer, in terms of resource allocation, for the agency in the future?
The entire budgetary analysis should be 8 to 10 pages in length and should be submitted in Unit VIII. The Final Project
must incorporate no fewer than five (5) peer-reviewed journal articles to bolster your analysis of the budget. You should be able to apply the theories learned in class to your case. The project must conform to APA format, and all sources must be properly cited and referenced.
.
Your essay should explain the trip from your personal point of view,.docxwoodruffeloisa
The essay should be written from your personal point of view about the trip, explaining your experience and what you learned without just listing historical facts or timelines. It should discuss your impressions of the location, any surprises or disappointments, and any knowledge or wisdom you gained from the trip.
Your dilemma is that you have to make a painful medical decision and.docxwoodruffeloisa
Your dilemma is that you have to make a painful medical decision and
to explain, in writing, who benefits from what you decided, who gets
denied a needed benefit, and why. The document is to be in the form of
an official memorandum that will be kept for the record and could be
potentially read by not only your Peer Review Committee, but also
possibly those involved in charitable fundraising to support hospital
development and others with financial interests in the choice made.
Include in the document the utilitarian ethical philosophy of John
Stuart Mill (The Ethics of Consequences) and ONE OTHER ETHICAL
PHILOSOPHER of your choice and use both of those philosophies to bolster your decision.
We can do John Stuart Mill and Jeremy Bentham for the two utilitarian ethical philosopher. They said: The Principle of Utility from Bentham and Mill expressed in ethical form is this: “We should act in such a way as to maximize the happiness of everyone affected by our actions.” This was a radical idea, because it included no references to religion and had a purely human focus. It was also teleological (learn this new word), because it focused only on the consequences of decisions.
This paper will be at least two double spaced pages but
limited to three pages. Remember both professional written form and
potential audience, as well as tone when writing this sensitive paper.
Your assignment is to make the decision using utilitarian ethics and
then to write it up in the form of a Memorandum for the hospital
records.
The Memorandum should be at least two double-spaced pages with a
maximum of three pages, in memorandum form, ready to become an
official item of record.
Scenario You Decide
One of the great ongoing situations that calls for ethical decision
making is the reality that there is almost always a greater need for
something than there is a supply to meet the need.
For our assignment and scenario, the demand is the life-and-death
situation of the need for transplantable organs and the rather small
and transitory supply. Hard decisions need to be made, and there is
little time to think things through. These are emergency situations.
Transplantable organs become available on short notice--usually
because a donor has died for reasons unrelated to the organ. They need
to be removed and transplanted very quickly because they only remain
fresh for a limited period. Then there is the whole complicated issue
of tissue type matching. There is also an ongoing concern about how
long recipients can wait.
Scenario:
Ok, Lead Surgeon, its time to do what you do the best!
You are the Lead surgeon in a major hospital, and by virtue of your
seniority you are also the key decision maker for transplant cases.
Right now you have three people who are waiting and hoping for a
suitable heart to become available. Your call phone rings suddenly,
and you are notified that a heart has become available- meaning that
you need to make a quick yet sound decision about which patient wil.
your definition of moral reasoning. Then, compare two similarities.docxwoodruffeloisa
your definition of moral reasoning. Then, compare two similarities and two differences in moral reasoning across the two cultures you selected. Finally, describe two culture-specific factors that might lead to these differences and explain how.
and the two cultures that I selected is Muslim and India's
.
Your company is in the process of updating its networks. In preparat.docxwoodruffeloisa
Your company is in the process of updating its networks. In preparation for the upgrade, your CEO has requested that you write a white paper (search term: White paper template) explaining the various telecommunication technologies. Begin by explaining basic telecommunication channel characteristics (minimum 5). Next discuss at least three network types (for example: Local Area Network/LAN). Then differentiate between client/server networks and peer to peer networks. Finally, recommend a network type and identify and describe three types of telecommunications hardware that will be required to set up this network. Conclude by explaining three things the company can do to secure their network.
.
Your company has just announced that a new formal performance evalua.docxwoodruffeloisa
Your company has just announced that a new formal performance evaluation system will be used (effective immediately). One of your supervisor's anniversary date is coming up and the human resources (HR) manager has asked you not only to rate this supervisor but to develop a grading form to use for her and other supervisors.
Assess the leadership, interpersonal skills, and earned values on other areas of concentration you deem necessary to rate the overall performance of any supervisor you have worked with, observed, know of, worked for, been supervised by, or supervised. Include your objective reasoning for eachassigned grade with an explanation of one or more sentences.
For example, on a scale of 1–9 (superior performance), you rate the supervisor as a 4; your explanation might be as follows:
Rarely held department meetings
Poor verbal communication skills
Uses foul language when counseling employees
.
Your CLC team should submit the followingA completed priority.docxwoodruffeloisa
Your CLC team should submit the following:
A completed priority analysis
Determination of which project is to be undertaken first, along with a summary of why the project was chosen, including an explanation of the relationship between the project and the organization’s mission, vision, and objectives
I AM ONLY RESPONSIBLE FOR QUESTION TWO.
Please see attachment for completed project.
.
Your classroom will be made up of diverse children. Research what va.docxwoodruffeloisa
Your classroom will be made up of diverse children. Research what varying cultures are represented in your community and the school/district resources that are available to support families. Also, include additional resources that may not be directly provided by the school or school district.
Write a 500-750-word plan for community culture that will support families in the school/district. Include information about the varying cultures in the community.
Identify how selected resources can provide positive support for families. This assignment can be presented as a brochure or document; be creative.
.
Your business plan must include the following1.Introduction o.docxwoodruffeloisa
Your business plan must include the following:
1.
Introduction of the proposed business;
2.
Description and explanation of the type of business entity that is best for your business;
3.
Description of the specific steps needed to be followed to successfully and legally start the business;
4.
A draft of a valid contract with a vendor, supplier, customer, etc. that illustrates all elements of a contract and takes into consideration some of the topics discussed in the contract chapters;
5.
Possible ethical considerations for your business, including any social responsibility plans or attitudes that your business will embrace;
6.
Description of a possible disagreement that could be encountered among the partners or investors and shareholders; and
7.
Illustration of the various ways the disagreement could be resolved (referring back to the formal documents, such as the articles of incorporation or the partnership agreement).
This paper must be 1,500–2,100 words, double-spaced, Times New Roman font or similar, and include at least 3 citations/sources in current APA format.
.
Your assignment is to write a formal response to this work. By caref.docxwoodruffeloisa
Your assignment is to write a formal response to this work. By carefully describing subject matter, medium, form, and context, you should be able to arrive at a thoughtful well -defended interpretation of the piece. (1) Describe it . Thoroughly. If it is representational, what is the subject matter depicted? If it is non -representational, say so. What does it look like? What is the medium? Have we studied/do you know anything about the process that resulted in the work? What size is it? Is it a 2 -dimensional or 3 -dimensional piece? Which formal elements stand out to you? What are the colors being used? Be as descriptive as possible. (2) Contextualize it . What is the title? What is the name of the artist who created it? Do you know anything about the artist? Is there a statement giving you more information? In which year was it made? Where is it being displayed as you are looking at it? How is it being displayed? Are there other works by the same artist there to give you more context? Can you compare and contrast it to other works you’ve seen elsewhere or studied ? (3) Interpret it. Based on your description, what do you think the artist was trying to say? It may be difficult to separate this interpretation from the descriptive process and it is okay if the two aspects are interwoven. (4) Respond to it. Though I am not interested in merely hearing whether or not you like the piece, I also want you to meaningful respond to the work. As art -critic Peter Scheldahl proposes, a question more valuable to ask yourself can be, “If I were someone who did like this piece, why would I like it?” Who is its intended audience and are you among that audience? Why did you choose this particular piece? What does it make you think about? Why do you think that the artist made the choices that she or he did? Do you agree with all of those choices? Is the artist’s intention clear/well -executed? How do you feel about the way in which the work is being displayed? Would it be more suitably exhibited somewhere else or alongside different work? This part of the paper may contain judgments, but at this point they will be well founded. Never make a proclamation without continuing the sentence with the because… Your response should be a minimum of one and a half double -spaced pages, 12 point font. If you are thorough in your description, you should find that you easily exceed this length.
Name of this Artwork: The Black Ring
.
Your assignment is to write about the ethical theory HedonismYour.docxwoodruffeloisa
This assignment asks students to write a graduate-level critical review summarizing the ethical theory of hedonism and how it relates to ethical and unethical behavior in the criminal justice system, supported with additional research. Students must discuss how hedonism, which focuses on pleasure as the ultimate good, is applied to criminal justice practices and decision making.
Your assignment is to write a short position paper (1 to 2 pages dou.docxwoodruffeloisa
Your assignment is to write a short position paper (1 to 2 pages double spaced, or roughly 250-500 words) answering ONE of the following two questions:
(1) How much appropriation do you think is justifiable in creating new works of art which draw on previously existing source material? As case studies, consider Nina Paley’s use of Annette Hanshaw’s music in
Sita Sings the Blues
and Shepard Fairey’s adaptation of an Associated Press news photograph for his 2008 Barack Obama “Hope” campaign poster. In each case, do you feel the artist was right or wrong in the way they used the material? Were the corporate entities involved right or wrong to claim their copyrights gave them the power to suppress these works?
-OR-
(2) When an artist freely adapts material that is strongly associated with a culture other than his or her own, does that artist have a special responsibility to avoid offending some members of that culture? Would the same standards apply to an artist from within the culture? As a case study, consider Nina Paley’s contemporary retelling of the Ramayana epic in
Sita Sings the Blues
. Some Hindus condemned the film while other Hindus applauded it. When, if ever, should an artist compromise his or her vision in deference to interest groups claiming offense?
Whichever question you choose, you may argue pro or con or somewhere in between, but whatever side you are on, you should avoid emotional rants and baseless charges. Summarize each side’s position, and use specific evidence and sound reasoning to support your case. Your writing will be assessed according to the amount of time and thought you put into the work, the persuasiveness of your reasoning, and the clarity of your writing. You may refer to outside sources if properly cited, but do not copy from websites or other authors; use your own words. As always, grammar, spelling, and style count; be sure to proofread your paper for any mistakes.
.
Your assignment is to report on a cultural experience visit you .docxwoodruffeloisa
Your assignment is to report on a "cultural experience" visit you make during this term. The experience should be done in person. (If this is impossible, contact the instructor to arrange for an alternative assignment.) You may not report on a cultural experience from prior to this class. After the visit, write a 500-800 word report about the visit and what you learned.
You should attend or visit one of the following.
a museum or display of art, culture, or technology
a sculpture garden
a significant or notable architectural site (if there is explanatory material there to help you understand it)
a music concert
a street art festival
a play, poetry reading or other spoken word performance
a dance performance
an important or notable historical site (if there is explanatory material there to help you understand it)
a religious service, ceremony or ritual for a religion very different from yours, if you practice (for instance, if you are Christian, you may not go to another Christian denomination's service)
other displays or performances
may
be acceptable.
Check with your instructor for approval beforehand.
After your
cultural experience visit,
write a report that includes the following information. (Please number the sections of your report to match):
Name and location of the museum, site, or event. If there is on-line information about the site or performance, include a link.
Type of museum, site or event. For example, is it a portrait museum, a poetry slam, an outdoor Shakespeare festival performance? If you attended a performance, name the performer or the piece. Be specific about
what
you attended,
when
, and
where
.
Briefly describe the general setting.
Describe
one or more parts or aspects
of the experience—for example, a particular work of art, cultural artifact, song, dance section, scene in a play, costumes or lighting, one particular actor or vocalist—that you found especially interesting. Explain what impressed you, and why. Your reaction can be positive or negative, as long as you offer an explanation for your reactions.
Identify and use at least two things you've learned in class to that you can connect to your experience. For example, if you visit a museum, you might point out the architectural style, discuss an artist you've learned about in the course, tie in your experience with a class discussion, make use of a concept presented in a class assignment. We've learned how visual arts and musical arts ( hearing are and can be different as you get a differen experence from it), also we have learned that different experiences bring different meaning and different ways of seeing things.
Include photos or links to images on a web page to help convey the information.
How did the experience engage your feelings or emotions, if at all? What does this tell you about human culture
Reflect on the relevance--if any--of your experience to your everyday life.
.
Your assignment is to create a Visual Timeline” of 12 to 15 images..docxwoodruffeloisa
You are assigned to create a visual timeline of 12-15 images that chronologically illustrates the growth of American art from pre-Columbian cultures to modern art of the 1950s. You should select artists such as Jacob Lawrence, Georgia O'Keeffe, Andrew Wyeth, George Bellows, or Elizabeth Catlett that best represent America's artistic heritage. Provide a brief introduction explaining your selection process and labeling each image with the artist, title, dimensions, medium, and date.
Your annotated bibliography will list a minimum of six items. .docxwoodruffeloisa
Your annotated bibliography will list a minimum of
six items
.
Four
of them must be from credible, academic, peer-reviewed sources that you find as you do research for the final essay.
The remaining two
sources must be credible, but they can come from sources other than academic journals if you wish. When you write, use standard MLA typographic and citation format, and then extend each Works Cited entry with a summary of the major arguments in the essay you have read. Each summary must contain
a minimum of 100 words
.
If desired, append a list of “Works Consulted” for sources used that are
not
peer-reviewed.
Basic MLA Style Format for an Annotated Bibliography
Format your page and list of citations in the same way you would a normal Works Cited page, then add your annotation at the end of it.
Title your bibliography “Works Cited” at the top of the page. Center it, but do not put it in bold face type.
Put entries in alphabetical order, not the order in which they have been assigned.
Use hanging indents
, as shown below. That is, the first line of the citation starts at the left margin. Subsequent lines are indented 5 spaces.
As with every other part of an MLA formatted essay, the bibliography is
double spaced
throughout.
The
annotation is a continuation of the citation
. Do not drop down to the next line to start the annotation.
The
right margin is the normal right margin
of your document.
There is a right way and a wrong way to write up these entries.
Don’t “report”
the arguments the author makes or tell readers the order in which those arguments are presented and count all of that reporting and listing as “summary” or annotation. Instead, restate in your own words the claims made by the writer in his/her essay.
Wrong way to do it
: "Marotti introduces his argument in the first section of the essay; then he moves on to talk about Petrarchan conventions. He ends the essay by talking about the political ramifications of Shakespeare's sonnets."
Right way to do it:
"Marotti’s argument here is that the sonnet genre must be understood in three ways: by examining the text itself, by examining the text in relation to others of its kind, and by exploring the social/historical environment in which it was published and circulated . . ."
Sample Annotations
NOTE:
These entries provide models of both format and content. They summarize—rather than “report”—the essay described.
Marotti, Arthur F. ""Love is Not Love": Elizabethan Sonnet Sequences and the Social Order."
ELH
2(1982): 396-428. Marotti’s argument here is that the sonnet genre must be understood in three ways: by examining the text itself, by examining the text in relation to others of its kind, and by exploring the social/historical environment in which it was published and circulated. Using those criteria, he argues that we should understand sonnet sequences as more than just a collected string of Petrarchan love poems. The 16
th
century sequences suddenly fell out o.
Your business plan must include the following1.Introduction of .docxwoodruffeloisa
Your business plan must include the following:
1. Introduction of the proposed business;
2. Description and explanation of the type of business entity that is best for your business;
3. Description of the specific steps needed to be followed to successfully and legally start the business;
4. A draft of a valid contract with a vendor, supplier, customer, etc. that illustrates all elements of a contract and takes into consideration some of the topics discussed in the contract chapters;
5. Possible ethical considerations for your business, including any social responsibility plans or attitudes that your business will embrace;
6. Description of a possible disagreement that could be encountered among the partners or investors and shareholders; and
7. Illustration of the various ways the disagreement could be resolved (referring back to the formal documents, such as the articles of incorporation or the partnership agreement).
This paper must be 1,500–2,100 words, double-spaced, Times New Roman font or similar, and include at least 3 citations/sources in current APA format.
.
you wrote an analysis on a piece of literature. In this task, you wi.docxwoodruffeloisa
you wrote an analysis on a piece of literature. In this task, you will write an analysis (
suggested length of 3–5 pages
) of one work from the disciplines of visual art or music. Choose
one
work from the list below:
Classical Period
Art:
• Exekias,
Achilles and Ajax Playing a Dice Game
(Athenian black-figure amphora), ca. 540−530 BCE
• Praxiteles,
The Aphrodite of Cnidus (Knidos)
c. 350 BCE
• Alexandros of Antioch,
Venus de Milo
, between 130−100 BCE
• Apollodorus of Damascus,
Trajan’s Column
, c. 107 CE
• After Leochares,
Apollo Belvedere
, c. 120 CE
• Agesander, Athenodorus, and Polydorus of Rhodes,
The Laocoön Group
, Late 2nd Century
Renaissance
Art:
• Leonardo da Vinci,
Annunciation
, c. 1472
• Titian,
Bacchus and Ariadne
, c,1520
• Hans Holbein the Younger,
The Ambassadors
, 1533
• Marcus Gheeraerts the Younger,
Queen Elizabeth I (Ditchley Portrait)
, c. 1592
Music:
• Josquin des Prez, Mille Regretz (French Chanson), c. 1521
• Giovanni Pierluigi da Palestrina,
Sicut Cervus
(motet), c. 1581
• Thomas Morley,
Now is the Month of Maying
, 1595
• John Farmer,
Fair Phyllis
(English Madrigal) 1599
NeoClassical (Art) / Classical (Music)
Art:
• Antonio Canova,
Psyche Revived by Cupid’s Kiss
, c. 1777
• Jacques Louis David,
The Death of Socrates
, 1787
• Sir John Soane,
Bank of England
, 1788–1833
• Ingres,
La Grande Odalisque
, 1814
Music:
• W.A. Mozart, Piano Concerto No. 20 in D Minor, K. 466 – “Romanze” (second movement), 1785
• W.A. Mozart, Overture to
The Marriage of Figaro
K. 492, 1786
• Franz Joseph Haydn, Symphony No. 94 in G Major (
Surprise
), 1792
• Ludwig van Beethoven, Symphony No. 5 in C Minor, Op. 67,”Allegro con brio” (first movement), 1804–1808
Romanticism
Art:
• Henry Fuseli,
The Nightmare
, 1781
• John Constable,
The Hay Wain
, 1821
• Eugene Delacroix,
The Death of Sardanapalus
, 1827
• J.M.W. Turner,
Slave Ship
, 1840
Music:
• Franz Schubert,
Erlking
D.328 (Lied), 1815
• Hector Berlioz,
Dream of the Witches’ Sabbath
from
Symphonie fantastique
, 1830
• Clara Schumann,
4 pieces fugitives
, Op.15, 1853
• Bedrich Smetana,
The Moldau from Má Vlast
, 1874
Realism
Art:
• Gustave Courbet,
The Stone Breakers
, 1849
• Rosa Bonheur,
The Horse Fair
, 1852-1855
• James Whistler,
Arrangement in Grey and Black, No.1: Portrait of the Artist's Mother
, 1871
• Édouard Manet,
A Bar at the Folies-Bergère
, 1882
Music:
• Stephen Foster,
Old Folks at Home
,1851
• John Philip Sousa,
The Stars and Stripes Forever
, 1896-97
• Giacomo Puccini,
Madama Butterfly
, 1904
• Julia Ward Howe,
The Battle Hymn of the Republic
, 1862
Use the link near the bottom of this page to access direct links to the works listed above.
Once you have selected and viewed the work, you will create a paragraph of descriptive writing with your personal observati.
You work for a small community hospital that has recently updated it.docxwoodruffeloisa
You have been asked to analyze the efficiency, security, and privacy of your hospital's recently updated electronic health record system and provide a 5-7 page executive summary report to the COO. The report should examine the emergence of health technology and EHRs since HIPAA, analyze current trends in health records and charting as they relate to advances in technology, and assess how modern patient record systems can support operations through privacy, quality care, cost administration, and records access and retention.
The chapter Lifelines of National Economy in Class 10 Geography focuses on the various modes of transportation and communication that play a vital role in the economic development of a country. These lifelines are crucial for the movement of goods, services, and people, thereby connecting different regions and promoting economic activities.
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) Curriculum
PSYC 3500 Strategies for Enhancing Learning and MemorySelf-Evalu.docx
1. PSYC 3500 Strategies for Enhancing Learning and Memory
Self-Evaluation Template
Name:
Date:
*Level choices: Non-Performance, Basic, Proficient, and
Distinguished (please refer to the Scoring Guide for
descriptions of each level)
Criteria
Level
Comments
Describe techniques for enhancing learning and memory using
relevant theories.
Define a population of interest and learning and memory issues
related to that population.
Describe strategies for enhancing learning and memory for the
selected population.
Apply course readings, including peer-reviewed resources, to
presentation.
Conduct a self-evaluation of this assignment using the scoring
guide and identifying the proficiency level for each criterion.
Apply critical thinking and communication skills concerning
learning and memory in a manner that is scholarly, professional,
and respectful.
2. Apply current edition of APA style, including in-text citations
and full references for sources.
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2 Fall
2017 • (10.5195/ijt.2017.6231)
A SYSTEMATIC REVIEW OF RESEARCH STUDIES
EXAMINING TELEHEALTH PRIVACY AND SECURITY
PRACTICES USED BY HEALTHCARE PROVIDERS
VALERIE J. M. WATZLAF, PHD, MPH, RHIA, FAHIMA,
LEMING ZHOU, PHD, DSC,
DILHARI R. DEALMEIDA, PHD, RHIA, LINDA M.
HARTMAN, MLS, AHIP
DEPARTMENT OF HEALTH INFORMATION
MANAGEMENT, SCHOOL OF HEALTH AND
REHABILITATION
SCIENCES, UNIVERSITY OF PITTSBURGH, PITTSBURGH,
PA, USA
ABSTRACT
The objective of this systematic review was to systematically
3. review papers in the United States that examine current
practices
in privacy and security when telehealth technologies are used by
healthcare providers. A literature search was conducted
using the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses Protocols (PRISMA-P). PubMed, CINAHL
and INSPEC from 2003 – 2016 were searched and returned
25,404 papers (after duplications were removed). Inclusion and
exclusion criteria were strictly followed to examine title,
abstract, and full text for 21 published papers which reported on
privacy and security practices used by healthcare providers
using telehealth. Data on confidentiality, integrity, privacy,
informed consent, access control, availability, retention,
encryption, and authentication were all searched and retrieved
from
the papers examined. Papers were selected by two independent
reviewers, first per inclusion/exclusion criteria and, where
there was disagreement, a third reviewer was consulted. The
percentage of agreement and Cohen’s kappa was 99.04% and
0.7331 respectively. The papers reviewed ranged from 2004 to
2016 and included several types of telehealth specialties.
Sixty-seven percent were policy type studies, and 14 percent
were survey/interview studies. There were no randomized
controlled trials. Based upon the results, we conclude that it is
necessary to have more studies with specific information about
the use of privacy and security practices when using telehealth
technologies as well as studies that examine patient and
provider preferences on how data is kept private and secure
during and after telehealth sessions.
Keywords: Computer security, Health personnel, Privacy,
Systematic review, Telehealth
BACKGROUND AND SIGNIFICANCE
When in-person meetings and paper-based health records are
4. used, healthcare providers have a clear idea about how to
protect the privacy and security of healthcare information.
Providers see each patient in a private room and the patient
records
are locked in a secure office setting which is only accessible to
authorized personnel. When the healthcare practice is moved
to the Internet, as in the case with telehealth, and all
information is electronic, the situation becomes more complex.
Most
healthcare providers are not trained in protecting security and
patient privacy in cyberspace. In cyberspace, there are many
methods that can be used to break into the electronic system and
gain unauthorized access to a large amount of protected
health information (PHI). Therefore, the information security
and patient privacy in telehealth is at a higher risk for breaches
of
PHI. For instance, from 2010 to 2015 it was found that laptops
(20.2%), network servers (12.1%), desktop computers (13%),
and other portable electronic devices (5.6%) made up 51 percent
of data sources of all healthcare data breaches that affected
more than 500 individuals (Office of the National Coordinator
for Health Information Technology, 2016).
PHI is highly regulated in the United States. The most familiar
regulation impacting healthcare facilities and providers is
the Health Insurance Portability and Accountability Act
(HIPAA) of 1996 (US Department of Health and Human
Services,
2013). HIPAA is a federal law that provides privacy and
security rules and regulations to protect PHI. The HIPAA
Privacy Rule
is an administrative regulation created by the Department of
Health and Human Services (DHHS). It was developed after the
US Congress passed HIPAA, and went into effect in 2003.
5. The HIPAA Privacy Rule only applies to healthcare providers
that conduct electronic billing transactions but is effective for
both paper and electronic health information. It is a set of
national standards that addresses the use and disclosure of PHI
by a
covered entity such as a healthcare organization as well as
establishing privacy rights for individuals on how their PHI is
used
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2
Fall 2017 • (10.5195/ijt.2017.6231)
and shared. Its major objective is to protect the flow of health
information while at the same time providing high quality
healthcare.
The HIPAA Security Rule went into effect in 2005 and regulates
only electronic health information. It is a set of national
standards that protects an individual’s electronic health
information that is created, received, used or maintained by a
covered
entity such as a healthcare organization. It requires the
administrative, physical, and technical standards to be adopted
so that
confidentiality and integrity of electronic PHI is protected.
6. In addition to HIPAA, there are many other federal and state
laws that govern the use and disclosure of health
information. Of these laws, HIPAA and the Health Information
Technology for Economic and Clinical Health (HITECH) Act of
2009 have provided the most specific regulations for the
protection of privacy and security of health information in the
United
States. However, some state regulations may be even more
stringent, such as requiring a consent form for disclosure of a
patient’s own medical record when HIPAA does not require
consent (Rinehart-Thompson, 2013). The HITECH Act includes
changes to the HIPAA Privacy and Security rules that focus
mainly on health information technology and strengthens
standards for the privacy and security of health information. It
went into effect in 2010 but some parts of the act have different
compliance deadlines (Rinehart-Thompson, 2013).
For this article, we adopted the Health Resources and Services
Administration’s (HRSA) 2015 definition of telehealth: “the
use of electronic information and telecommunications
technologies to support long-distance clinical health care,
patient and
professional health-related education, public health and health
administration. Technologies include videoconferencing, the
Internet, store-and-forward imaging, streaming media, and
terrestrial and wireless communications” (Health Resources and
Services Administration, 2015). The HRSA definition was used
because it aligns with our purpose, which is to provide a
systematic review of published papers that pertain to privacy
and security provisions used by healthcare providers when
deploying telehealth technologies in the United States.
Our previous experiences in interacting with telehealth
providers suggest that the providers do not always know the
best
7. practices to use to decrease the risk of privacy and security
issues in telehealth (Cohn & Watzlaf, 2012; Watzlaf, 2010;
Watzlaf, Moeini, & Matusow, 2011). Many of the features
within the free, consumer-based video and voice communication
systems that were evaluated did not demonstrate to the
providers using them that the information was private and
secure
(Watzlaf & Ondich, 2012). Also, many of the telehealth
providers did not know the best practices to use to educate
consumers
on privacy and security (Watzlaf, Moeini, & Firouzan, 2010;
Watzlaf, Moeini, Matusow, & Firouzan, 2011).
Through our past work, audit checklists were developed to
determine if a system supports HIPAA compliance (Watzlaf et
al., 2010; Peterson & Watzlaf, 2014). The 58-question checklist
is specific to Information and Communication Technologies
(ICTs) (Watzlaf et al., 2010). There are already methods and
tools available for healthcare providers to evaluate the security
and privacy features of telehealth systems they are currently
using. Now, it is necessary to conduct a systematic review on
the
status of privacy and security provisions that are used by
healthcare professionals when deploying telehealth services to
see if
they are using the tools and guidelines available to them or if
they incorporate new systems to evaluate privacy and security
within telehealth systems.
OBJECTIVES:
1. Evaluate, from published papers, what privacy and security
measures were addressed when healthcare providers used
telehealth technologies.
2. Compile best practices and guidelines for healthcare
8. professionals using telehealth technologies.
MATERIAL AND METHODS
SEARCH STRATEGY
A systematic literature search was performed on papers
published between 2003 to 2016. The sources used in the search
included PubMed (Medline via PubMed; National Library of
Medicine, Bethesda, MD; started in 1966) CINAHL databases
(indexing from nursing and allied health literature) and INSPEC
(a scientific and technical database developed by the
Institution of Engineering and Technology).
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2 Fall
2017 • (10.5195/ijt.2017.6231)
Briefly, our literature search strategy combined synonyms for
telehealth with privacy and security across healthcare
professionals. The list of synonymous terms was voluminous.
Some examples of synonymous terms for telehealth included
telemedicine, telepathology, telerehabilitation; synonymous
terms for privacy and security included confidentiality,
encryption,
access control, authentication; synonymous terms for healthcare
9. professionals included physicians, clinicians, nurses,
occupation therapists. Language restrictions included those
papers written in English only. In addition, reference lists were
reviewed manually from relevant original research and review
papers.
These searches returned 21,540 papers from PubMed and 4,785
papers from CINAHL, and 591 papers from INSPEC for
a total of 26,916 papers, of which 1,512 were duplicates. After a
review of titles and abstracts, 21 papers were reviewed in full
text (Figure 1). After the first round of article selections, one
third of the papers were found to be international. Papers were
then restricted to those in the United States since HIPAA and
HITECH are laws that are enforced in the United States only
and
these laws are a major influence in privacy and security in the
US.
The protocol for this study was based on the Preferred
Reporting Items for Systematic Review and Meta-Analysis
Protocols (PRISMA-P). The PRISMA-P contains 17 items that
are considered essential as well as minimum components to
include in systematic reviews or meta-analyses. PRISMA-P
recommends that each systematic review include detailed
criteria
using the PICOS (participants, interventions, comparisons,
outcome(s) and study design) reporting system (Moher et al.,
2015). Details of the full protocol have been previously
published in Prospero and the International Journal of
Telerehabilitation
(Watzlaf, DeAlmeida, Zhou, & Hartman, 2015; Watzlaf,
DeAlmeida, Molinero, Zhou, & Hartman, 2015).
STUDY ELIGIBILITY
To be eligible for this systematic review, published papers had
to meet all the following criteria:
10. 1. Published papers that included research, best practices, or
recommendations on the use of telehealth and privacy or
security.
2. Published papers that included any type of health care
professional using any available telehealth for their clients with
a focus on privacy and/or security, HIPAA and/or HITECH.
3. Published papers with full text in English.
4. Published papers where research or recommendations focused
on the US only published between 2003-2016.
5. Existing solutions/best practices to privacy and security
challenges, HIPAA compliance (qualitative and quantitative)
in telehealth use.
Figure 1. A flow diagram of the search and selection process.
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International Journal of Telerehabilitation • Vol. 9, No. 2
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Figure 1 description: Figure 1 depicts a flow diagram of the
search and selection process. First box a top: Articles
11. identified
through database search (N=26,916), PubMed (n=21,540),
CINAHL (n=4,785), INSPEC (n-591). Arrow to box below:
Articles
after removing duplications (n=25,404); arrow to the box to the
right: Duplicate records (n=1,512). Next arrow to box below:
Articles after first round filtering (n=406); arrow to the box to
the right: Articles removed by reviewing titles and abstracts
(n=24,998). Next arrow to box below: Articles after second
round filtering (n=50); arrow to the box to the right: Articles
removed by reviewing full texts (n=356). Next arrow to box
below: Articles included after ATA guidelines are added
(n=61);
arrow to the box to the right: Articles removed by evaluating
the security and privacy contents (n=40). Last arrow to the box
below: Articles included in systematic review (n=21).
EXCLUSION OF PAPERS
Papers were reviewed and excluded in different phases:
• Phase I: Duplicates Removed. A total of 26,916 papers were
found in the three databases and 1,512 were removed
as duplicates to yield 25,404 papers.
• Phase II: Articles Removed by Reviewing Title and Abstract.
A title/abstract review was conducted, first by two
independent reviewers. A third reviewer was used to resolve
disagreement (24,998 excluded, to yield a total of 406
papers).
• Phase III: Articles Removed After Reviewing Full Text. A full
text review of 406 papers was conducted by all three
reviewers (356 excluded, 50 papers remained).
12. • Phase IV: American Telemedicine Association Guidelines
Added. Since the American Telemedicine Association
(ATA) guidelines were not returned from the original search
because they were guidelines and not peer-reviewed
articles, they were added into the original list (50) because of
their focus on telehealth, privacy and security (11
added. Total of 61 papers).
• Phase V: Articles Removed by Evaluating Security and
Privacy Content. A review of these papers to examine
security and privacy contents yielded 40 exclusions. And
eventually, a total of 21 papers were included in the final
systematic review.
In the initial title/abstract review the major reasons for
exclusion were:
1. Papers were published before HIPAA was enforced in 2003
2. Studies were not conducted in the US and therefore did not
abide by HIPAA/HITECH
In the full text review the major reasons for exclusion were that
the papers did not include both telehealth and a major
aspect of privacy and security related to telehealth use.
DATA EXTRACTION PROCESS AND QUALITY
ASSESSMENT
All search results were exported into EndNote libraries.
EndNote is a bibliographic management system. De-
duplications
were performed by using the method described by Bramer et al
(Bramer, Giustini, de Jonge, Holland, & Bekhuis, 2016).
Studies were removed if they were found to be duplicated. The
PDFs of the papers reviewed were stored in a shared Box
account (i.e., a secure cloud content platform in which users can
13. share large documents as well as collaborate, Redwood City,
CA).
Each article meeting the inclusion criteria was reviewed and its
characteristics documented using a standardized pre-
tested data extraction form. The data extraction form captured
the following data items: the three large goals of privacy and
security (confidentiality, integrity, and availability); the
specific techniques for achieving these goals (authentication,
encryption,
access control, physical security, policy, database backup, error
detection, anti-virus, software patches, secure system design,
intrusion detection); and the methods in each system (study
designs, settings, and outcomes).
The reference librarian performed the search and only provided
the title, abstract and year to the reviewers. The two
reviewers (DD, VW) independently read the title and abstracts
of the identified papers and determined eligibility based on the
specified inclusion/exclusion criteria. To better know how to
appropriately search the article titles and abstract, two of the
reviewers (DD and VW) conducted a pilot study by using a
small sample (n=100) of papers, made the selection and then
discussed the results against the selection criteria. From this
pilot study we could determine that we applied the same
selection criteria for our search strategy.
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Reviewers were blind to journals, study authors and institutions.
Any disagreements between the reviewers were resolved
by a third reviewer (LZ). Inter-rater reliability was measured
using the Cohen’s kappa statistical test (k). An inter-rater
Kappa
score was assessed during the first round of the paper selection,
to ensure a Kappa score at or above 0.8 as measured by
Cohen’s Kappa (k) statistical test. Full-text of studies making
this first cut were reviewed.
Three reviewers screened these for inclusion/exclusion criteria.
Selection disagreements were resolved through
discussion and reasons for excluding studies were recorded. A
form, developed in Excel, was used to extract data from
selected studies and included the author, year of publication,
reference; study design and sample size; setting; privacy and
security descriptions; primary outcomes; study limitations,
HIPAA compliance, and best practices. Reviewers assessed the
overall quality of evidence for every important outcome using
the GRADE four point ranked scale: (4) High; (3) Moderate; (2)
Low; (1) Very low (Balshem et al., 2011). Full papers were used
as evidence for decisions about the quality of evidence and
the strength of recommendations. Any differences in the
grading were assessed and discussed in several meetings with
investigators until full consensus was reached.
DATA SYNTHESIS
Quantitative analysis of the data from the papers was limited
due to the lack of quantifiable data in the privacy and
security literature. However, subcategories with similar
15. characteristics received more in-depth comparisons.
Investigators first
broke the data into qualitative themes that related to privacy,
security and administrative content. Each of those areas were
broken down into subthemes such as patient rights, use, and
disclosure for privacy; technical and physical for security; and
organizational and education/training/personnel for
administrative. Then, specific content within the 21 papers
were reviewed
closely and categorized across each of those themes and
subthemes.
RESULTS
REVIEWER AGREEMENT
For the 25,404 entries reviewed by 2 reviewers the percentage
of agreement was very good with the observed value of
99.04% and the 95% CI between 98.91 to 99.16 calculated per
the Wilson efficient-score method. For the Cohen’s kappa, the
observed kappa is 0.7331 and the 95% CI are 0.7009 to 0.7653.
Although the kappa is lower than 0.8, this still suggests
substantial agreement (Fleiss, Cohen, & Everitt, 1969).
TIME PERIOD AND TYPE OF STUDIES
A total of 21 papers (Watzlaf & Ondich, 2012; Watzlaf et al.,
2010; Watzlaf, Moeini, Matusow, et al., 2011; Peterson &
Watzlaf, 2014; Paing et al., 2009; Cason, Behl, & Ringwalt,
2012; Daniel, Sulmasy, & for the Health and Public Policy
Committee of the American College of Physicians, 2015; Naam
& Sanbar, 2015; American Telemedicine Association, 2009,
2011, 2014a, 2014b, 2016; Hall & McGraw, 2014; Garg &
Brewer, 2011; Brous, 2016; Mullen-Fortino et al., 2012; Nieves,
Candelario, Short, & Briscoe, 2009; Putrino, 2014; Demiris,
2004; Demiris, Edison, & Schopp, 2004) were selected for this
16. systematic review. These selected papers were published
between 2004 to 2016, in which 29 percent of them were
published
between 2011-2012. The papers included several telehealth
specialties such as telerehabilitation, telepsychiatry, teletrauma,
telenursing and tele-diabetes. Sixty-seven percent were
guideline/policy/strategy type studies, with three using a survey
or
interview method (14%). Other studies included a usability
study, a systematic review, a pilot study and an opinion piece.
There were no randomized controlled trials found that focused
on privacy and security in telehealth (Table 1).
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Table 1. Overview of Reviewed Studies
Overview of Studies
19. Pilot
Opinion
Systematic/literature review
14 66.7
3 14.3
1 4.8
1 4.8
1 4.8
1 4.8
Total 21 100
DESCRIPTIVE ANALYSIS OF ALL STUDIES
A quantitative analysis of the privacy, security, and
administrative areas that were discussed in the papers is
summarized
in Table 2. All studies discussed some aspect of privacy and
security. Sixty-seven percent addressed patient rights to include
informed consent, accessibility, confidential communications,
or the patient’s ability to amend their information. Thirty-eight
percent addressed use and disclosure to include how video
sessions are retained, authorizations for release of information
to
other countries, websites, and third parties, accounting of
disclosures, purging and/or deletion schedule of files on mobile
devices and audio and video muting to maintain privacy. Sixty-
20. seven percent of the studies addressed the technical aspects of
security to include encryption, two-factor authentication, data
backup, storage and recovery to meet HIPAA requirements,
National Institute of Standards and Technology (NIST) and
Health Level-7 (HL7) recommendations. However, only 38
percent
addressed the physical aspects of the telehealth session to
include a secure server location, back-up generator and
maintaining a secure physical environment for where the
telehealth session is held. One of the studies contained a
systematic
review of telemedicine security and found poor reporting of
methodologies for telemedicine technologies and security
measures. Fifty-two percent of the papers did not discuss the
organization of privacy and security through policies,
procedures, Business Associate Agreements (BAAs) or
compliance audits, however, 67 percent addressed the need for
education and training of providers, patients and technical
support workforce.
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Table 2: Privacy, Security, and Administrative Content
21. Privacy, Security,
Administrative Content
# %
Privacy
Patient Rights
Yes, addressed
No, not addressed
Use and Disclosure
Yes, addressed
No, not addressed
14 66.7
7 33.3
8 38.1
13 61.9
Security
Technical
Yes, addressed
No, not addressed
Physical
Yes, addressed
No, not addressed
22. 14 66.7
7 33.3
8 38.1
13 61.9
Privacy, Security,
Administrative Content
# %
Administrative
Organization (policies)
Yes, addressed
No, not addressed
Education/Training/
Personnel
Yes, addressed
No, not addressed
10 47.6
11 52.4
14 66.7
7 33.3
Table 3 provides a detailed summary of all papers for privacy,
security and administrative content. Most of the patient
rights content dealt with providing verbal or written informed
23. consent in simple, easy to understand language and to have
providers discuss the risks of privacy and security when using
telehealth. Use of audio/video muting and a secure physical
environment was also discussed to be included in the consent
for treatment so that the patient understands how their
information during and after the telehealth session is private.
Use and disclosure was not as clearly addressed, although
several papers stated that access to patient information should
only be granted with proper authorization, and there was a
need to have this discussed with the patient so that they
understood ownership of the data before the telehealth session
begins. Encryption and two-factor authentication were other
major areas addressed in the papers. Some papers did provide
details as to the types of encryption to use as well as meeting
HIPAA and NIST requirements and recommendations. Data
backups, storage of the video files, and the ability to keep them
secure was also discussed. Other areas addressed included a
review of consumer-based free systems and the importance of
healthcare providers’ understanding of which telehealth
technologies meet federal, state, and local laws. Other areas
mentioned included performing an overall privacy and security
assessment of the telehealth system and to maintain security
solutions specific to the telehealth system, making sure that
confidentiality and security are a primary concern. Many of the
papers expressed the need for overall provider and patient
awareness, education and training and policies on keeping
telehealth information private and secure, and policies that
specify
who can be included in the telehealth session. Other papers
expressed the need for maintaining a BAA with the vendor
providing the telehealth system. Some papers addressed the
need for more research on the effectiveness of telemedicine to
include telehealth security training, legal liability, HIPAA
compliance and the importance of an independent assessment of
overall privacy and security. Some of the papers described the
lack of current scientific studies around privacy and security in
24. telehealth and the need for more studies that demonstrate the
effectiveness of best practices in privacy and security of
telehealth (Table 3).
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Table 3: Detailed Summary of All Papers for Privacy, Security
and Administrative Content
Privacy Security Administrative
Article Title, Year
Journal
Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
25. (authorizations,
accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
Education/
Training/
Personnel
(American
Telemedicine
Association,
2009)
Evidence Based
Practice for
Telemental Health
Policy
Keep physical
surroundings private
26. using audio/video
muting; Considered
essential to easily
change from public to
private audio mode.
(American
Telemedicine
Association,
2014a)
Clinical
Guidelines for
Telepathology
Policy
Unauthorized persons
should not have
access to sensitive
information.
Use audio/video
muting, and easily
change from public to
private audio mode.
Consideration
should be given to
periodic purging or
deletion of
telepathology files
from mobile
devices.
Data transmission must
27. be secure through
encryption that meets
recognized standards.
Mobile device use
requires a passphrase
or other equivalent
security feature, multi-
factor authentication,
inactivity timeout
function with
passphrase or re-
authentication to access
the device after timeout
is exceeded (15
minutes).
Give providers the
capability to use
remote wiping if
device lost or stolen.
Back up or store on
secure data storage
locations. Do not
use cloud services if
they cannot comply
in keeping PHI
confidential.
Mobile devices
should be kept in
the provider’s
possession when
traveling or in an
uncontrolled
28. environment.
Those in charge of
technology should know
technology security.
Mobile devices should be
kept in the provider’s
possession when traveling
or in an uncontrolled
environment.
(American
Telemedicine
Association,
2016)
Practice
Guidelines for
Informed consent:
discuss with patient
about the telehealth
session and use simple
language especially
when describing all
If transmission data are
stored on hard drive,
use Federal Information
Processing Standard
(FIPS) 140-2 encryption
AES as acceptable
Those in charge of the
technology should educate
29. users with respect to all
privacy and security options.
Educate patients on the
potential for inadvertently
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2017 • (10.5195/ijt.2017.6231)
Privacy Security Administrative
Article Title, Year
Journal
Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
(authorizations,
accounting of
disclosures, de-
30. identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
Education/
Training/
Personnel
Teleburn
Policy
privacy and security
issues such as
encryption, store-
forward transmissions
of data/images,
videoconferencing etc.
Key topics should
include confidentiality
and limits to
confidentiality in
electronic
31. communications; how
patient information will
be documented and
stored.
levels of security.
Pre-boot authentication
should also be used.
storing data and PHI;
intention to record services;
methods of storage; how
PHI will be shared with
authorized users and
encrypted for maximum
security; recordings will be
streamed to protect
accidental or unauthorized
file sharing or transfer.
(American
Telemedicine
Association,
2014b)
Core Operational
Guidelines for
Telehealth
Services Involving
Provider-Patient
Interactions
Policy
Healthcare providers
should provide to the
patient verbal/written
32. information related to
privacy and security;
potential risks and
confidentiality in easy
to understand
language, especially
when discussing
encryption or potential
for technical failures;
limits to confidential
communication,
documentation and
storage of patient
information.
Access to
recordings only
granted to
authorized users.
Stream to protect
from accidental or
unauthorized file
sharing/transfer.
Privacy Features
should include:
audio, video
muting, easily
change from
public to private
mode, privacy of
the mobile device.
33. Multi-factor
authentication; inactivity
timeout function; keep
mobile devices with
provider always; wipe or
disable mobile device if
lost or stolen.
Audio, video and all
other data transmission
should use encryption
(at least on the side of
the healthcare
professional) that meets
recognized standards.
Use software that has
appropriate verification,
confidentiality, and
All devices should
have up to date
security software,
device management
software to provide
consistent oversight
of applications,
device and data
configuration and
security, backup
plan for
communication
between sites and
discussed with the
patient. Only allow
one session to be
34. open at one time
and if there is an
Establish
guidelines for
periodic purging or
deletion.
Providers should give
guidance to patients about
inadvertently storing PHI
and how best to protect
privacy. Discuss recording of
services, how information
will be stored and how
privacy will be protected.
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Privacy Security Administrative
Article Title, Year
Journal
35. Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
(authorizations,
accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
Education/
Training/
Personnel
Should also discuss a
policy for the patient
36. sharing portions of this
information with public
and written
agreements may be
needed to protect both
the patient and
provider.
security measures.
If services are recorded,
store in a secure
location and make
accessible to authorized
users only.
attempt to open an
additional session
the system will
automatically log off
the first session or
block the second
session from being
opened.
Session logs should
be secured in a
separate location
and only granted to
authorized users.
Back up to or store
37. on secure data
storage locations.
Do not use cloud
services if they
cannot comply in
keeping PHI
confidential.
Brous, 2016)
American Journal
of Nursing
Policy
Nurses must meet
medical information
and patient privacy
requirements of
HIPAA, as well as
state privacy laws,
organizational policies,
and ethical standards.
Devices that contain
PHI must meet security
requirements, and
wireless
communications must
have cybersecurity
protection; electronic
files must be stored in a
manner that ensures
All providers should be
educated on how to prevent
data breaches when
38. communicating information
via telehealth, transmitting
images or audio or video
files electronically and on
how to respond when they
do occur.
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2017 • (10.5195/ijt.2017.6231)
Privacy Security Administrative
Article Title, Year
Journal
Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
(authorizations,
39. accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
Education/
Training/
Personnel
privacy and
confidentiality since
audio and video
recordings are
susceptible to hacking.
To meet HIPAA standards
any systems that transmit or
store electronic information
about patients must be
operated and monitored by
40. computer technicians with
expertise in security
measures. Also, all health
care providers should check
state privacy laws which can
be more stringent than
HIPAA. The National
Telehealth Policy Resource
Center provides state-
specific information on laws,
regulations, reimbursement
policies and pending
legislation.
(Cason et al.,
2012)
International
Journal of
Telerehabilitation
Survey
44% of providers
surveyed expressed
concerns with privacy
issues
40% of providers
surveyed expressed
concerns with security
issues
Need for secure and
private delivery
platforms
Personnel shortages in
41. telehealth delivery
(Daniel et al.,
2015)
Annals of Internal
Medicine
Policy Position
Paper
Skype not
considered HIPAA
compliant since no
BAA with Microsoft.
Skype was
noncompliant with
Oklahoma Health
Care Authority’s
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Privacy Security Administrative
42. Article Title, Year
Journal
Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
(authorizations,
accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
Education/
Training/
Personnel
43. policy.
(Demiris et al.,
2004)
Telemedicine
Journal and e-
Health
Interview
Research Study
18.7% need for digital
images to be captured
and store in EHR at
point of care.
56.2% did not believe that
security and privacy risks
would be increased when
using telemedicine; 31.2%
said they did not know
enough to respond to the
question; and 12.5 %
believed there could be
increased risk.
9.3% said technical support
not readily available;
All providers were not
influenced in their ability to
ask questions due to
concerns over security or
privacy.
44. Further education is needed
on this topic.
(Demiris, 2004)
International
Journal of
Electronic
Healthcare
Policy Overview
Privacy, storage,
transmission of images
and maintenance of
video/audio recordings
and other PHI must be
examined and
addressed as
transmission of this
data over
communication lines
Access to
ownership of data
must be
addressed with
the patient since
some patients
share this data
with a web server
owned by a third
party that allows
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International Journal of Telerehabilitation • Vol. 9, No. 2 Fall
2017 • (10.5195/ijt.2017.6231)
Privacy Security Administrative
Article Title, Year
Journal
Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
(authorizations,
accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
46. data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
Education/
Training/
Personnel
have concerns of
privacy violations.
providers to log in
and access their
patient’s data.
(Garg & Brewer,
2011)
Journal of
Diabetes Science
and Technology
Systematic
Review
Many telemedicine
researchers are
unfamiliar with the field
of security in general.
The authors found
47. instances of poor
encryption standards,
designs of
communication
protocols with no proof
of security, HIPAA or
HL7 compliance.
Reliability and
availability of the
systems are key since
many provide critical life
supporting systems for
people with diabetes
and other chronic
illnesses. Data integrity,
the quality of security
research, network
security and
cryptography all need to
be improved as well,
per this systematic
review of security of
telemedicine systems.
Most of the papers in the
systematic review of security
in telehealth did not address
training, legal liability, or
HIPAA and HL7 compliance.
Another area that was
neglected was research on
availability or the measures
used to ensure availability of
telehealth systems.
(Hall & McGraw,
48. 2014)
No federal agency
has authority to
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Fall 2017 • (10.5195/ijt.2017.6231)
Privacy Security Administrative
Article Title, Year
Journal
Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
(authorizations,
49. accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
Education/
Training/
Personnel
Health Affairs
Policy
enact P&S
requirements to
cover the entire
telehealth
ecosystem and
these authors
advocate for the
Federal Trade
Commission (FTC)
50. to do this.
(Mullen-Fortino et
al., 2012)
American Journal
of Critical Care
Survey Research
179 nurses that use
telemedicine were surveyed
and 11% of nurses surveyed
believe it is intrusive; 27%
believe it decreases patient
privacy and 13% believe it
creates a feeling of being
spied upon. It is important
to change these perceptions
of nurses for telehealth
technology to expand.
(Naam & Sanbar,
2015)
Journal of Hand
Surgery
Policy
Verbal or written
informed consent
required from patients
or representative’s
office visit
Establish policy
and procedure
(P&P) by
51. physicians and
hospitals on use of
telemedicine that
include patient
education materials
that explain what
the patient can
expect using
Community-wide education
for patients and providers on
PHI and maintaining privacy
and confidentiality when
using telemedicine
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2 Fall
2017 • (10.5195/ijt.2017.6231)
Privacy Security Administrative
Article Title, Year
Journal
Type of Study
52. Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
(authorizations,
accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
Education/
Training/
Personnel
telemedicine.
(Nieves et al.,
2009)
Military Medicine
53. Pilot Study
All transmission
protocols were
compliant with HIPAA. It
included Tandberg 880
MXP video
conferencing equipment
and used Integrated
Services Digital
Network (ISDN) or the
hospitals Internet
Protocol (IP) network
lines with a bandwidth
speed of >384 Kilobits
per second (Kbps).
Audio and image quality
were also suitable for
use in clinical services.
(Paing et al.,
2009)
Current
Psychiatry
Reports
Summary of
studies/
policy
Families should sign a
release for
communication and
consent for treatment
for children; mental
health professional
54. should discuss HIPAA
provisions with each
client as part of the
informed consent
process.
Adolescents were
concerned about
whether someone
could tap into the lines
Videotapes of
telehealth
sessions are an
official part of the
medical record.
Transmission protocol
meets HIPAA
requirements
Videotapes kept in
secure storage
Practice the 4 C’s:
Contracting,
Competence,
Confidentiality and
Control (Koocher)
when managing
potential risk;
Policies must
specify who can be
included in the
session especially
55. those off camera.
More studies on
confidentiality, technology
issues needed
Provide sufficient manpower
for technological support
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2
Fall 2017 • (10.5195/ijt.2017.6231)
Privacy Security Administrative
Article Title, Year
Journal
Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
56. Use & Disclosure
(authorizations,
accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
Education/
Training/
Personnel
to hear them.
(Peterson &
Watzlaf, 2014)
International
Journal of
Telerehabilitation
Policy
Checklist includes
57. accessibility,
amendment, retention
of PHI.
Checklist includes
requests for PHI,
sharing of PHI
with other
countries and
websites.
Checklist includes
encryption, user
procedures, audit
system activity such as
username, password
(PW), additional
authentication, overall
assessment
Check cloud based
solutions to make
sure secure
Checklist includes
the need for BAAs
for telerehabilitation
store and forward
companies and if
direct identifiers of
PHI included a
Data Use
Agreement (DUA)
required under
HIPAA
58. Use Privacy and Security
(P&S)
checklist
to evaluate
system/
employees before use
(Putrino, 2014)
Current Opinion
of Neurology
Opinion
When designing
telemedicine systems
confidentiality and
security are major
concern. Designing
video game driven tele-
rehabilitation (VGDT) is
no exception. Patient
data should be de-
identified and never
stored on the patient’s
local device. Data
should always be
encrypted when
streaming across a
network.
(Watzlaf et al.,
2010)
International
Journal of
Checklist includes
59. accessibility,
amendment, retention
of PHI, BAAs;
Checklist includes
requests for PHI,
sharing of PHI
with other
Checklist includes
encryption, user
procedures, audit
system activity such as
Maintain secure
transmissions while
the session is
conducted and when
Form team of health and
legal professionals to
evaluate system for HIPAA,
state, and local
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2 Fall
2017 • (10.5195/ijt.2017.6231)
60. Privacy Security Administrative
Article Title, Year
Journal
Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
(authorizations,
accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
Organizational
(policies, BAAs,
auditing)
61. Education/
Training/
Personnel
Telerehabilitation
Policy
Informed consent
needed to be signed
by patients to include
privacy and security
issues of telehealth
system
countries and
websites,
Incident response
needed
username, PW,
additional
authentication, overall
assessment; follow
security standards
recommended by NIST
such as not using
username and PW for
anything other than
telerehabilitation
communication,
changing it often, using
strong usernames and
PWs, no computer
62. viruses, and
consistently
authenticate user
communication
stored and released
to internal and
external entities
requirements; educate and
train all personnel
(Watzlaf, Moeini,
Matusow, et al.,
2011)
International
Journal of
Telerehabilitation
Policy
Examined accessibility
and retention of PHI by
employees and others.
Examined
requests from
legal, sharing of
information with
other countries,
websites.
Encryption, antivirus
and audit and security
system evaluation was
examined.
63. 128-bit Advanced
Encryption Standard
(AES) Secure Real-
Time Transport Protocol
(SRTP) recommended
by NIST. Only 50% of
companies reviewed
use some form of
encryption.
70% of companies
made no mention of
Sharing of
information was not
always addressed
in vendor policies
Used a HIPAA compliant
checklist for top 10 Voice
over Internet Protocol (VoIP)
companies
Most of the companies did
not include all items on the
checklist in their policies.
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64. International Journal of Telerehabilitation • Vol. 9, No. 2
Fall 2017 • (10.5195/ijt.2017.6231)
Privacy Security Administrative
Article Title, Year
Journal
Type of Study
Patient Rights
(access, amend, right to
confidential
communications,
informed consent etc.)
Use & Disclosure
(authorizations,
accounting of
disclosures, de-
identification of
data etc.)
Technical
(encryption, access
control, authentication,
data backup, storage,
recovery)
Physical
(secure server
location, backup
generator etc.)
66. entity.
Develop clear,
understandable
privacy and
security (P&S)
policies into the
patient consent
form
Policies should
describe the P&S
of the conferencing
session and
describe how it will
restrict: employee
access to technical
problems;
information to other
users; retention of
session; and
sharing of
information with
other websites,
countries and other
third parties without
patient consent.
Form a team and use the
HIPAA checklist to ensure
compliance before using a
telehealth system.
Review the P&S policies of
each system before use.
67. Ask questions of the
telehealth company not
addressed in the policy.
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2 Fall
2017 • (10.5195/ijt.2017.6231)
DISCUSSION
This systematic review of privacy and security practices that
healthcare providers may use with telehealth technologies
has shown that privacy and security is a concern across all types
of specialties such as telerehabilitation, telenursing,
teletrauma, and telepsychiatry. All providers need to make
privacy and security of utmost concern when conducting a
telehealth session.
The papers suggest that most of the work has been policy and
strategy pieces with no experimental or quasi-experimental
studies represented. In both survey research studies conducted,
healthcare providers had concerns over privacy and security
68. in telehealth and that it can be intrusive for the patient. In an
interview study, it was found that providers did not believe that
telehealth increased the risk of privacy or security concerns
although some did not know enough to answer the question fully
and thought there could be increased risk. These studies alone
show that there is uncertainty on this topic.
Many healthcare providers may not know all the many aspects
of privacy and security within telehealth and need more
education and training as well as technical support personnel to
help them in these areas. Many of the policy studies stated
that policy and procedure (P&P) as well as education and
training are needed for all healthcare providers and technical
support personnel to prevent breaches of PHI.
These papers also stated that healthcare professionals need to
know state, regional, and national laws and regulations,
legal liability, HIPAA/HITECH and HL7 compliance, as well as
measures used to ensure availability of PHI to the proper users.
Methods were also discussed regarding how audio or video
recordings are to be stored, maintained and accessed to protect
patient privacy, and how mobile devices used in telehealth
sessions are to be reinforced to protect the privacy and security
of
patient information.
The most detailed information surrounding informed consent for
a telehealth session was found in the ATA guidelines and
recommendations and discussed how maintaining privacy and
security within the telehealth session must be included in the
informed consent in easy to understand language especially
when discussing encryption, authentication and other methods
to
maintain confidential communications between provider and
patient. The use of audio and video muting as well as the ability
to
69. quickly change from public to private audio mode so that
unauthorized users may not see or hear what is being
communicated
was also discussed throughout the ATA guideline papers.
There does not seem to be consensus about the use and
disclosure of PHI in telehealth since some systems will allow
sharing with certain groups as part of their privacy policy.
HIPAA, however, states that proper authorizations are
warranted
when there are requests for information and an accounting of
disclosures is necessary when PHI is shared. However, there
still seems to be some uncertainty as to what parts of the
telehealth session will be kept, for how long, how they will be
maintained and where they will be stored.
If the telehealth sessions are recorded and kept with the
electronic health record (EHR) then proper authorizations are
necessary when PHI is requested. However, there is no standard
method for how this is done. Some systems may convene a
telehealth session and not store any of the information that was
transmitted. Some may record the session but then destroy
the recording after the session is over. Some may record and
store the session or even transmit the session to a third party for
additional treatment and consultation. Some type of standard
process in this area is needed.
Security measures such as encryption and authentication were
addressed, but not all papers provided a standardized
description of the encryption methods used or the best methods
for authentication. Very few papers addressed the importance
of an independent audit on the telehealth system for privacy and
security features by an outside entity.
LIMITATIONS
There were some limitations to our systematic review. Due to
70. time constraints the grey literature, such as dissertations
and other unpublished reports, other databases listed in the
protocol, vendors or authors (also mentioned in the protocol)
were
not searched. Also, as mentioned previously, only English
language articles were reviewed.
International Journal of Telerehabilitation • telerehab.pitt.edu
International Journal of Telerehabilitation • Vol. 9, No. 2
Fall 2017 • (10.5195/ijt.2017.6231)
CONCLUSION
In summary, more scientific research studies are needed to
determine the best practices in privacy and security
surrounding telehealth. Experimental studies that address the
effectiveness of privacy and security evaluations of the
telehealth system, proper informed consent that discusses the
privacy and security aspects of the telehealth session with the
patient as well as testing of access control, disaster recovery
and risk analysis of the telehealth system are essential to
improve the practices of the entire telehealth team.
Best practices that are consistent across all types of telehealth
services for all healthcare providers are needed to address
71. all privacy and security issues. Privacy and security aspects are
just as important as providing a clear and trouble-free
telehealth session and a privacy and security evaluation should
be performed before the telehealth system is used with a
patient. Tools used to assist healthcare providers on what they
should look for when deciding on a telehealth system are
needed. This systematic review results informed the need for
and subsequently led to the development of a best practice tool
that will enable healthcare providers to assess privacy and
security features of the telehealth technologies they are
planning to
use. Hopefully, this tool will move healthcare providers one
step closer to enabling best practices in privacy and security in
telehealth.
ACKNOWLEDGMENTS
This research was supported in part by the National Institute on
Disability, Independent Living, and Rehabilitation
Research (NIDILRR) grant #90RE5018 (RERC from Cloud to
Smartphone: Empowering and Accessible ICT). Systematic
Review Registration: PROSPERO: CRD42015020552
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80. One concern about visual presentations is that the technology
used to create them can be used in such a way that it actually
detracts from the message rather than enhances it. To help you
consider carefully how your message is presented so that it
reflects care, quality, and professionalism, consider the
information provided in the remaining slides.
NOTE: This presentation serves as an example in itself, by
utilizing all of the guidelines mentioned.
Outline
Writing
Organization
Audience
Design
Images
Bullets
Tables
Font
Speaker Notes
The following topics will be covered:
Writing
Present ideas succinctly with lean prose.
Use short sentences.
Use active, rather than passive voice.
Avoid negative statements, if possible.
Avoid double negative entirely.
Check spelling and grammar.
81. Use consistent capitalization rules.
Organization
Develop a clear, strategic introduction to provide context for
the presentation.
Develop an agenda or outline slide to provide a roadmap for the
presentation.
Group relevant pieces of information together.
Integrate legends and keys with charts and tables.
Organize slides in logical order.
Present one concept or idea per slide.
Use only one conclusion slide to recap main ideas.
Audience
Present information at language level of intended audience.
Do not use jargon or field-specific language.
Follow the 70% rule—If it does not apply to 70% of your
audience, present it to individuals at a different time.
Design
Use a consistent design throughout the presentation.
82. Keep layout and other features consistent.
Use the master slide design feature to ensure consistency.
Use consistent horizontal and vertical alignment of slide
elements throughout the presentation.
Leave ample space around images and text.
Images
When applicable, enhance text-only slide content by developing
relevant images for your presentation.
Do not use gratuitous graphics on each slide.
Use animations only when needed to enhance meaning. If
selected, use them sparingly and consistently.
Bullets
Use bullets unless showing rank or sequence of items.
If possible, use no more than five bullet points and eight lines
of text total per slide.
Tables
Use simple tables to show numbers, with no more than 4 rows x
4 columns.
83. Reserve more detailed tables for a written summary.
Font
Keep font size at 24 point or above for slide titles.
Keep font size at 18 or above for headings and explanatory text.
Use sans serif fonts such as Arial or Verdana.
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Speaker Notes
Summarize key information.
Provide explanation.
Discuss application and implication to the field, discipline or
work setting.
Document the narration you would use with each slide.