Class of 2004 Abstract / Objectives: To assess students’ knowledge of HIPAA and to address the null hypotheses that knowledge scores on HIPAA-related questions did not differ by class year, months of work experience, or HIPAA training and work experience. Methods: This project used a cross-sectional survey design with a self-administered questionnaire distributed by the investigators in a classroom setting. The questionnaire consisted of 13 multiple-choice questions to assess students' knowledge of HIPAA as well as four descriptive items. The questions addressed the following HIPAA categories: general principles of HIPAA; minimum necessary standards for use of protected health information (PHI); permitted uses and disclosures of PHI for treatment, payment, and health care operations; personal representatives and PHI; PHI for marketing; and public health activities and PHI. The questionnaire was tested for content validity and item reliability. First, second, and third year pharmacy students who were enrolled during the spring 2004 semester and attended class the day the questionnaire was administered were eligible to participate. Results: Scores were derived for the 13 multiple-choice questions and mean scores for the three classes were compared using Kruskal-Wallis 1-way ANOVA by ranks. Pearson correlation coefficients were calculated for scores versus months of work experience. Spearman rank correlations were used to compare knowledge scores with the following: (1) work experience and HIPAA training, (2) work experience and no HIPAA training, (3) no work experience and HIPAA training, or (4) no work experience and no HIPAA training. ANOVA and Tukey’s tests were used to assess any differences between the HIPAA categories. Implications: Students training at experiential sites must be familiar with the HIPAA requirements. This assessment provided important curricular feedback to the College.

According to the U.S. Department of Health and Human Services (HHS), patients and providers do not understand the Health Information Privacy and Accountability Act (HIPAA). Non-compliance with HIPAA is primarily due to confusion, along with insufficient understanding. HSS has taken measures to simplify the language they use to communicate HIPAA, however, they have not taken steps that consider if one's culture, religious and social perspectives, institutional training, credentials, and comprehension of legal terminology affects medical providers and non-clinical administrative personnel's abilities to understand HIPAA. This research uses bibliometrics to examine the literature from January 2010 – September 2020 that addresses HIPAA's use of legal terminology, literacy level, and institutional training, along with religious and social perspectives, and credentials of medical providers and non-clinical administrative personnel. A total of 107 articles were examined, 42 were assigned article influence scores with values that were less than 1.00, which is a below-average influence score for the article. There were 29 articles with values equal to or above 1.00, which translates to an equal or above-average influence score. The remaining 36 articles did not have article influence scores and were assigned values as not available. Results of the review of the literature indicate that legal terminology, literacy level, training, credentialing and religious and social perspective had no or little effect in understanding HIPAA.

Agile project management is most often examined in relation to software development, while information security frameworks are often examined with respect to certain risk management capabilities rather than in terms of successful implementation approaches. This dissertation extended the study of both Agile project management and information security frameworks by examining the efficacy of implementing a security framework using a nontraditional project management approach. Such an investigation is significant because of the high rate of failed IT projects, gaps in the current security framework implementation literature, and increased regulatory pressure on Health Insurance Portability and Accountability (HIPAA)-covered entities to become compliant with the HIPAA Security Rule. HIPAA-covered entities have struggled to achieve HIPAA compliance since the Act's enforcement date. Specifically, academic medical centers have struggled to achieve and authoritatively document their compliance with the HIPAA Security Rule. To aid HIPAA-covered entities in confirming and documenting their HIPAA Security Rule compliance, the HITRUST Alliance has published the Common Security Framework. Thomas Jefferson University selected the Common Security Framework to help them assess and document their HIPAA Security Rule compliance. However, there is a documented gap in the literature on successful methods for implementing information security-related projects, particularly HIPAA compliance. In this single-case case study, the author examined the implementation of an Information Security Framework based on Agile values. Specifically examined were the values of (a) individuals and interactions over processes and tools; (b) working software over comprehensive documentation; (c) customer collaboration over contract negotiation; and (d) responding to change over following a plan. The results of this investigation indicated that an information security framework implementation based on Agile values is a viable approach for successfully implementing the Common Security Framework at an academic medical center.

Confusion regarding the Health Insurance Portability and Accountability Act (HIPAA) and the Family Educational Rights and Privacy Act (FERPA) continues to be a concern for health care professionals working in the educational environment. Following the Virginia Tech tragedy and similar incidents of school violence in recent years, educational communities and governmental agencies are analyzing the balance between individual privacy and freedom versus the safety and security of all. Health care professionals working in the school environment must stay abreast of privacy regulations regarding student records while providing needed care.

abstract: In modern healthcare environments, there is a strong need to create an infrastructure that reduces time-consuming efforts and costly operations to obtain a patient's complete medical record and uniformly integrates this heterogeneous collection of medical data to deliver it to the healthcare professionals. As a result, healthcare providers are more willing to shift their electronic medical record (EMR) systems to clouds that can remove the geographical distance barriers among providers and patient. Even though cloud-based EMRs have received considerable attention since it would help achieve lower operational cost and better interoperability with other healthcare providers, the adoption of security-aware cloud systems has become an extremely important prerequisite for bringing interoperability and efficient management to the healthcare industry. Since a shared electronic health record (EHR) essentially represents a virtualized aggregation of distributed clinical records from multiple healthcare providers, sharing of such integrated EHRs may comply with various authorization policies from these data providers. In this work, we focus on the authorized and selective sharing of EHRs among several parties with different duties and objectives that satisfies access control and compliance issues in healthcare cloud computing environments. We present a secure medical data sharing framework to support selective sharing of composite EHRs aggregated from various healthcare providers and compliance of HIPAA regulations. Our approach also ensures that privacy concerns need to be accommodated for processing access requests to patients' healthcare information. To realize our proposed approach, we design and implement a cloud-based EHRs sharing system. In addition, we describe case studies and evaluation results to demonstrate the effectiveness and efficiency of our approach. / Dissertation/Thesis / M.S. Computer Science 2012

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HIPAA security compliance in academic medical centers is a central concern of researchers, academicians, and practitioners. Increased numbers of data security breaches and information technology implementations have caused concern over the confidentiality, integrity, and availability of electronic personal health information. The federal government has implemented stringent HIPAA security compliance reviews and significantly extended the scope and enforcement of the HIPAA Security Rule. However, academic medical centers have shown limited compliance with the HIPAA Security Rule. Therefore, the goal of this study was to investigate the factors that may affect HIPAA security compliance in academic medical centers. Based on a review of the literature of technology acceptance and security effectiveness, this study proposed a theoretical model that uses management support, security awareness, security culture, and computer self-efficacy to predict security behavior and security effectiveness and thus HIPAA security compliance in academic medical centers. To empirically assess the effect of the above-noted variables on HIPAA security compliance in academic medical centers, a Web-based survey was developed. The survey instrument was designed as a multi-line measure that used Likert-type scales. Previous validated scales were adapted and used in the survey. The sample for this investigation was health care information technology professionals who are members of the Group on Information Resources within the Association of American Medical Colleges. Two statistical methods were used to derive and validate predictive models: multiple linear regression and correlation analysis. The results of the investigation demonstrated that security awareness, management support, and security culture were significant predictors of both security effectiveness and security behavior. Security awareness was the most significant predictor of security effectiveness and security behavior. Due to the presence of collinearity, Pearson correlation analysis was used to develop a composite factor, consisting of management support and security culture, for the final multiple linear regression model. By enhancing the understanding of HIPAA security compliance in academic medical centers, the outcomes of this study will contribute to the body of knowledge of security compliance. The empirical results of this research also will provide guidance for individuals and organizations involved with HIPAA security compliance initiatives in health care.

This thesis is an exploration of the work I have completed during graduate study at UNO. My time has been spent investigating concepts of evaluation and the attribution of meaning. The main thrust and impetus of my art has been to explore the subjective way people interpret visual language and how that interpretation can be manipulated and undermined. By undoing these associations I hope to reveal the tentative nature of meaning.

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