title: HIPAA Compliance with Mobile Devices Among ACGME Programs.
abstract: To analyze self-reported HIPAA compliance with mobile technologies among residents, fellows, and attendings at ACGME training programs. A digital survey was sent to 678 academic institutions over a 1-month period. 2427 responses were analyzed using Chi-squared tests for independence. Post-hoc Bonferroni correction was applied for all comparisons between training levels, clinical setting, and specialty. 58 % of all residents self-report violating HIPAA by sharing protected health information (PHI) via text messaging with 27 % reporting they do it "often" or "routinely" compared to 15-19 % of attendings. For all specialties, 35 % of residents use text messaging photo or video sharing with PHI. Overall, 5 % of respondents "often" or "routinely" used HIPAA compliant (HCApps) with no significant differences related to training level. 20 % of residents admitted to using non-encrypted email at some point. 53 % of attendings and 41 % of residents utilized encrypted email routinely. Physicians from surgical specialties compared to non-surgical specialties demonstrated higher rates of HIPAA violations with SMS use (35 % vs. 17.7 %), standard photo/video messages (16.3 % vs. 4.7 %), HCApps (10.9 % vs. 4.9 %), and non-HCApps (5.6 % vs 1.5 %). The most significant barriers to complying with HIPAA were inconvenience (58 %), lack of knowledge (37 %), unfamiliarity (34 %), inaccessible (29 %) and habit (24 %). Medical professionals must acknowledge that despite laws to protect patient confidentiality in the era of mobile technology, over 50 % of current medical trainees knowingly violate these rules regularly despite the threat of severe consequences. The medical community must further examine the reason for these inconsistencies and work towards possible solutions.
authors.affiliation: University of California San Diego School of Medicine, San Diego, CA, USA.
authors.forename: Randall
authors.initials: R
authors.lastname: McKnight
authors.affiliation: Mary S. Stern Fellowship, 538 Oak Street, Suite 200, Cincinnati, OH, 45219, USA. Orrin.Franko@gmail.com.
authors.forename: Orrin
authors.initials: O
authors.lastname: Franko
mesh_terms: D016494:Computer Security; D003219:Confidentiality; D020408:Health Insurance Portability and Accountability Act / Q000331:legislation & jurisprudence*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D000068997:Smartphone / Q000706:statistics & numerical data*; D060756:Social Networking; D060145:Text Messaging / Q000706:statistics & numerical data*; D014481:United States
keywords: HIPAA compliance; Mobile devices; Physician communication