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This is one of those situations where the subjective analysis takes over.

If a practice uses Win 98 workstations, and the environment where the letter
might be left on screen is not a high traffic area, then a policy that you
minimize the window might be a "reasonable" approach.

It is far too easy to expound on all the technological enhancements that are
going to make us more secure, but the reality is that, a good analysis of
exposure, policies and procedures to address the problems, and regular
training to enforce those may be all that is required to handle the
situations.
------------------( Forwarded letter 1 follows )--------------------
Date: Thu, 24 Oct 2002 10:23:09 -0400
To: [EMAIL PROTECTED]
From: Marshall.E.Fryman[mfryman]@futuraintl.com.inet
Sender: [EMAIL PROTECTED]
Reply-To: [EMAIL PROTECTED]
Subject: Privacy issues

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The privacy regulation draws attention to a reasonable effort to maintain
the privacy of patient's information except on a "need to know" basis. If
we take the premise of a doctor's office where Person A types a letter to a
patient containing confidential information. If Person A then walks away
from their terminal, I would reasonably conclude that there should be some
sort of password-protected screen saver that automatically pops up to blank
the screen so that anyone passing by can not read said letter. If this
workstation is setup using Windows 9x, is it also reasonable to claim that
this machine is not securable? If I reboot the Win 9x machine, I can bypass
any password that was originally setup on this machine and still read the
letter. If I upgrade this machine to Windows NT / 2000 / XP, it is no
longer possible to bypass the security system. This is clearly a more
secure environment, but has anyone attempted to define if this falls within
the "reasonable" precautions that a practice should take?

Anyone have any ideas? I have talked to CMS and they said that they were
not really qualified to answer the question. Their initial reaction was
that this was an issue of security not privacy, but they later changed
their mind and said it might fall within the "reasonable" clause.

Thanks,
Marshall


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on this listserv therefore represent the views of the individual participants, and do 
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