What is HIPAA?  Most people see HIPAA and assume that it is a confidentiality law.  That is partially correct, but was not the original intent of the law.  The Health Insurance Portability and Accountability Act  became a law in 1996.  The purpose of the law was to promote the continuation of health insurance coverage as people moved from job to job.  With all this moving of information, it was recognized that the original Privacy Act of 1974 was not sufficient to protect patient confidentiality, so an additional Privacy Rule was added to HIPAA and implemented in 2001.  Health care facilities had until 2003 to comply with the Privacy Rule, which protects personal information, otherwise known as Protected Health Information (PHI).  The Privacy Rule requires that PHI remain confidential and can only be shared with consent from the patient.  Patients are asked to sign a “release of information” form before any private information can be shared with other doctors, health care professionals, insurance companies, and other vendors. 

The Privacy Rule has limitations.  In certain cases, private information can be shared without permission, such as subpoenas, cases of child abuse or neglect, or victims of crimes.  In most cases, however, your permission should always be obtained before private information is shared.

With the growing use of the electronic medical record, many people are afraid that their private information might be shared without their permission.  To be honest, it can and does happen.  Privacy breeches occur on a regular basis and identity fraud does occur in health care.  The best thing that you can do to advocate for your own privacy is to:

1.  Request to view your medical record and check for any errors.

2.  Report anything suspicious (e.g., inappropriate bills, calls from debt collectors, etc.) to your medical provider and/or insurance company.

3.  Request an “accounting of disclosures”.  This is a summary of the people who have had access to your medical record.  Most providers will provide a free accounting disclosure once every 12 months.

For more information and suggestions, please see the following website: http://www.consumer.ftc.gov/articles/0171-medical-identity-theft

Valerie J Connor, MA CCC-SLP

As a speech-language pathologist, it would be a shame not to mention that May is Better Speech and Hearing Month!  The American Speech and Hearing Association promotes better speech and hearing all year long, but May is dedicated to awareness of communication disorders.  Nearly 1 in 6 people suffer from communication disorders and the number of Americans with hearing loss has doubled in the last 30 years (ASHA, 2014).  That means that nearly 40 million Americans have some sort of speech and language disorder.The key to treating communication disorders and hearing loss is early detection.  What are some signs to look for?

In Children:

•       Infants:

–      if they don’t respond to sound or recognize faces

–      If they are not making any sounds by nine months

•       Toddlers:

–      if they seem frustrated

–      if they are not able to follow directions

•       Preschool:

–      if they are not understood by family and peers

–      If they are not able to follow directions

•       School Age:

–      if they are not understood by teachers or strangers, or are embarrassed by their speech

–      if they have trouble putting words into the right order (spoken or written)

In Adults:

If you suspect that someone has a communication disorder, it is best to consult a speech and language pathologist.  They will provide a screening and make recommendations for treatment options.  Concerns about possible strokes and/or hearing loss should be brought to your primary care physician.

While communication disorders are very common, they are also often treatable.  Early detection is the best key to success.  It never hurts to ask a professional for their opinion or advice!

For more information about early detection of speech and hearing problems, please see:

http://identifythesigns.org/the-signs/

Valerie J Connor, MA CCC-SLP

ASHA (2014).  The prevalence and incidence of hearing loss in adults.  Retrieved from http://www.asha.org/public/hearing/Prevalence-and-Incidence-of-Hearing-Loss-in-Adults/

The Patient Self-Determination Act was passed in 1990 in an effort to increase awareness of patient rights.  For many years, the Patient Bill of Rights was followed by most health care facilities, but in 2003, the American Hospital Association adopted the Patient Care Partnership, which summarizes patient rights into several categories:

1.  High quality hospital care:  patients have the right to expect considerate and respectful care from health care professionals.

2.  Clean and safe environment: patients can expect that health care facilities maintain appropriate levels of cleanliness, including clean equipment and wearing gloves.

3.  Involvement in your care: 

•       To be informed of treatment options, as well as benefits and risks

•       To be able to refuse treatment options

4.  Protection of privacy:  All health care facilities must comply with HIPAA’s Privacy Rule, which requires the safeguarding of any protected health information.

5.  Help when leaving the hospital: assistance with any follow-up care required.

6.  Help with billing claims.

It is important to know your rights as a health care consumer.  Don’t ever be afraid to ask questions, request clarification, or to stand up for yourself in a health care setting.  Your involvement in your own care is essential for a positive outcome!

For more information regarding the Patient Care Partnership, please see: http://www.aha.org/advocacy-issues/communicatingpts/pt-care-partnership.shtml

Valerie J Connor, MA CCC-SLP

Many readers of this blog are focused and dedicated on living a healthy lifestyle.  We try to keep an exercise routine, make healthy food choices, and keep our stress level down.  This focus on healthy living is commendable and certainly worth the effort.  One thing that many of us tend to ignore or prefer not to think about is an abrupt change in our health, such as an accident or sudden illness.

While these topics can be a little depressing, they are certainly worth a few minutes of your time.  Who will make medical and financial decisions for you if you are not able to make them yourself?  Who will provide for your spouse or children if you are not able to do so?  What will happen to your organs if you are no longer able to use them?  All of these questions are important to consider.  If you are sick, or even worse, unconscious, would you want your family members burdened with the need to make these decisions for you?

Luckily, we have several ways for you to provide the answers to these questions!  Advance directives are legally binding documents that express your wishes in case you are unable to speak for yourself.  Remember the case of Terri Schiavo?  The medical fight between her husband and her parents would never have reached the Supreme Court if she had only taken time to fill out a living will.  Know someone who has benefitted from a donated organ?  That gift was provided by someone who is a registered organ donor.  Millions of organs are wasted every year because we don’t take time to register as organ donors.

So, what options are available to you?

1.  Living Will – this is a document that you fill out as a competent adult.  You make choices as to what type of services you would like in the case of a severe accident or illness (e.g., life support vs no life support).  The best place to obtain a living will document is from your local hospital.  Simply request the form, fill it out, have it notarized, and return it to your primary care physician.  It’s as simple as that!

2.  Power of Attorney – within a living will, you will designate someone to be your Power of Attorney.  That person will make decisions for you regarding finances and any health decision that you don’t specify in your living will.  Most people choose a spouse or adult child to be their Power of Attorney, but the choice is up to you.  Be sure to tell the person that they have been chosen – this isn’t something that should come up as a surprise.

3.  Uniform Anatomical Gift Act – anyone over the age of 18 can register as an organ donor.  Generally, this indication is made on your driver’s license, but you can also include your wishes on a living will or within your medical record.  Millions of people are waiting for organs, so please consider becoming an organ donor today!

For more information on advance directives and organ donation, please see these websites:

http://www.organdonor.gov/index.html

http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3289

Valerie J Connor, MA CCC-SLP

As a little girl my family would head up to the annual Wisconsin state fair for some good eats and fun on the rides. Shortly after we paid our entrance fee, we would run to stand in the long line at the sweet corn-on-the-cob tent. I remember the person would take our order and dip the entire corn-on-the-cob into the huge vat of butter and wrap it in a small piece of wax paper with some napkins that would soon be soaked in butter. I would then take the salt shaker and sprinkle the corn with salt. My mouth would be watering as I went to take a bite. When I finally took that bite, my mouth had little fireworks going off of it as there was a mix of sweetness, saltiness, and of course fat. I devoured that corn in a matter of minutes. Man, those were the good days. Now, I use much less butter and even request them not to dip the corn in butter. I hardly even sprinkle the salt on the corn. So you may ask, “Why should I not add butter and salt to my corn-on-the-cob? What is so special about eating corn by itself?” 

Corn is a starchy vegetable, which means it has more carbohydrates than non-starchy vegetables such as green beans or carrots. This is not bad as carbohydrates provides you with energy and keeps your intestinal tract happy as fibers are within corn. Additionally, corn contains antioxidants (touched on in the strawberry blog), but these antioxidants differ depending upon the color of the corn (i.e. white, yellow, purple, or red). Since I live in the mid-west the most common color corn variety is yellow. Yellow corn has antioxidant properties derived from carotenoids, specifically lutein and zeaxanthin (1).  Corn also contains B-vitamins, phosphorous, and manganese (1). So the next time you stand in the long line to get a corn-on-the-cob ask for no butter and do not use the salt to savor all the nutrients packed within that corn.

You’re exhausted from the tumultuous day. Your day started out just like any other one- showering, waking up the kids, getting breakfast and lunch ready for the family, shoving breakfast in your mouth as you raise your voice for the third time telling the kids to get into the car as they will be late to school, and getting yourself into the office, only 5 minutes late this time, not too bad. At the office the day is anything like you would expect, your first e-mail of the day is not good and it goes down from there. You skip lunch, again, as you have meeting after meeting and cannot get a minute to yourself. You cannot wait to leave the office and finally 6pm rolls around. You’re excited to get home to give your family a hug, and sit down to a wonderful dinner. Then you think, “Uh-oh I didn’t exercise. Gosh, I’m exhausted and just want to relax.” But the guilt sweeps you over and you think, “Ok, I will exercise. I will eat dinner with the family and go for a quick run, they will not mind so much.” However, when you get home and tell your family your plan for exercising, your family has different thoughts and they do not want you to leave for that run. So, you start thinking one day without exercise is not so bad, but then you missed 2 days this week due to late-night events at your work and the kids’ school. Ugh if there were only 2 of you, then you would be able to accomplish everything without breaking a sweat. But wait, there is an idea, one so genius it may just work. You propose to your family, “Why don’t we all go for a run?” They first look at you like you are from a different world, but then one of your children says, “Sure Mom, that sounds like a fun idea. What a great way to spend family time.” You leap for joy inside your mind and you’re pretty sure you let out a little yip. You finally figured out how to do it all by incorporating your family in a healthy, fun way.

The moral of this story- exercise can fit into your busy life with a little bit of creativity 

Living in the mid-west I get excited for May as I know summer is just around the corner and the luscious fruits are ready to be picked at the local farm. What is my favorite fruit for May? Strawberries! My favorite treat as a child was mashed strawberries with milk and a touch of sugar. I remember stealing a few fresh strawberries and savoring the sweet, juiciness of them. As you could imagine those strawberries did not last in our house for very long.

Little did I know at the time the benefits of consuming these fruits, but my body thanks me. Did you know strawberries are not only low in calories and fats, but also have many nutrients and phytochemicals? Phytochemicals are considered a wide variety of compounds made in fruits and vegetables. Two phytochemicals found in strawberries are anthocyanins and ellagic acid (1).  In addition to these powerful phytochemicals, strawberries also contain antioxidants- vitamin A, vitamin C, and vitamin E. These nutrients help protect your body against infectious agents, free radicals and reactive oxygen species (1). 

Thought we were done? Nope. Strawberries contain a variety of other micronutrients such as folic acid and potassium to name a few. Who would have thought 1 little strawberry could pack such a powerful punch?!  So the next time you think about having a sweet treat for snack or a dessert consider picking up some strawberries (1 serving = 4 medium sized strawberries).

On a beautiful Saturday morning you wake up feeling happy for finally there is a clear, sunny day; a perfect grilling day. You prepare your meat with your favorite spices- garlic, onion powder, pepper, and a dash of salt. The grill is already going and you cannot wait to eat this savory hamburger with a side of fresh greens. You’re about to place the delicate meat onto the grill when a voice inside your head yells out, “WAIT”. You pause as you want to hear what is going to be said. The voice inside your head continues, “Don’t you remember the news report about the dangers of grilling meat?” Your hopes dash as you recall this news report. You gingerly place the meat back onto the plate and rush inside your house to the computer. You open up your favorite search engine site and type in, “Dangers of grilling meat.” There it is, the dreaded report you wished never popped up. You scan the report and see, “grilling meats at a high temperature create two chemical compounds: heterocyclic amines (HCAs) and polycyclic aromatic carbons (PAHs)”(1) “NO, how could this be?” You yell out. But you are intrigued, so continue reading. You read that HCAs are formed when cooking meat at high temperatures such as on the grill. They are found at the highest concentration in charred or burned parts of the meat. Thus, when you eat the grilled meat, HCAs will be consumed as well(1). PAHs are formed when juices from meat drip onto coals or other hot surfaces and create smoke. Thus, you can obtain PAHs from breathing in these fumes and eating the grilled meat(1). You find some positives to reduce the amount of HCAs and PAHs from grilling such as cleaning the grill from leftover products that were burned or charred, cutting off the pieces of meat you char or burn, precooking foods prior to grilling, and placing a vinegar or lemon marinade on the meat prior to cooking(1). You shake your head as even though these techniques are good for reducing these chemicals, you still are not satisfied. You bang your head on the computer, defeated as you are not going to enjoy your meat. However, you have an idea. You scan the news report again and again. Yup, it clearly says, “grilling vegetables and fruits are safer as they do not produce these chemicals”(1). YES!!  You can finally use that portable mushroom sitting in your frig. The grilling day is saved.