Christina's Considerations

Health IT ROI - Value to the Enterprise and Patient

Building Out Your Health IT ROI - The Value to the Enterprise and the Patient This latest article for HIMSS Clinical Informatics Insights explores how enterprise portals can help hospitals tie disparate systems together, so that the data and information already being collected can be used (meaningfully).  Going beyond the typical departmental information systems, it also addresses the accommodation of non-traditional Health IT technologies, such as, remote monitoring, telemedicine and social networking technologies.

Telemedicine: A Public Service Announcement

If you are like me and feel we need to start educating consumers on the power of telemedicine, then please share this video.  It was created by my friends at @CTELTweets, so let them know what you think!

 

Patient Engagement & Their Experience: The Virtual Touch Points

My new collegues at Tower seem to like the fact that I envision and write about the application of technologies to improve the work that has to get done in hospitals.  Since my work is now focused on re-defining patient experiences across all touch points (physical and virtual), we created a paper that highlights opportunities to engage consumers and patients using technologies for an enhanced web experience.

Patient Engagement and Their Experience: The Virtual Touch Points was prepared just in time for this week's Patient Experience Conference and it ties my long-term passion for improving care for the benefit of our patients to the role of information technology.  

The paper explores the drivers for transforming the way healthcare organizations engage consumers, patients and their families and the web-based opportunities across the continuum of care from pre-admission through post treatment follow-up and across all departments.  It describes how virtual engagement can enhance patient experiences and satisfaction with provider encounters.  It also highlights the role of key technologies, such as, enterprise portals, social media, mobile applications, business intelligence and telehealth.

According to our CEO, Sue Sutton, RN, PhD, “It is important to address the needs of patients where they are in their experience and tie disparate information systems together to present a seamless interaction for patients and their family caregivers.  Providing access to self-management tools and creating opportunities to help enhance their encounters with the system contributes to more engaged and accountable patients.”

The team at Tower has helped expand my view of technology applications, which we all agree, is an important strategy to enhancing today’s patient experiences, as well as, contributing to more efficient business and care processes, better outcomes and lower costs.

Trusted Source: Certified Medical Apps and Products

Not long ago I referenced Continua in an interview about securing and optimizing iPads and don't believe I've included them in a blog post.  So, it is probably a good time to share a little more information.

Continua is a pioneer in establishing industry standards and security for interoperable connected health technologies such as smart phones, gateways and remote monitoring devices. They were established established six years ago with the mission to empower information-driven health management and facilitate the incorporation of health and wellness into the day-to-day lives of consumer.  Their 250 members represent companies from around the world; including Intel, Microsoft, IBM, GE Healthcare, and Cisco.

The risk manager in me recommends that apps be downloaded from trusted sources, so I was really pleased to learn that they are certifying medical apps, as well as, devices and services for personal health management and healthcare delivery. Their certification is granted to technologies that meet their guidelines and to date, 45 diverse products have been certified.  This includes weight scales, glucometers, and blood pressure monitors.  Their first Apple mobile solution enables developers to build custom health applications and connect with other certified personal health devices and facilitates integration with various interoperable servers to relay health information.

While there is no absolute protection, this is a good start!

 

Apps for Heart Attack and Stroke Prevention

The Office for the National Coordinator recently announced the winners of their "One in a Million Hearts Challenge," which invited developers to create software applications aimed at promoting heart health. The contest supports HHS' Million Hearts Initiative and the goal to prevent one million deaths from heart attacks and strokes over the next five years.

The winning apps are: 

• THUMPr,  first place, enables users to easily create personal heart health profiles and provides individualized heart health recommendations based on the Million Hearts Initiative's ABCS framework, which stands for aspirin, blood pressure, cholesterol and smoking cessation ($50,000 prize);
• mHealthCoach, second place, incorporates 11 unique data feeds, supports social media integration, peer communities, and fitness groups to educate users about heart health ($20,000 prize); and
• Wellframe, third place, focuses on patient engagement, evidence-based information and resources, targeted and actionable information and ease of usability to provide heart disease risk assessments, social comparisons, educational information and preventive care notifications ($5,000 prize).

The challenge was designed to foster innovative health IT solutions that empower patients to pursue healthy lifestyles and improve their heart health.  These new tools go a long way toward engaging patients and their families to take a more active role in their care and will, hopefully, also contribute to fewer admissions/re-admissions and a better experience with the healthcare system.

Strategic Planning and IT

I recently joined forces with some other powerful consultants at Tower, a national consulting group focused on re-defining patient experiences across all touch points (physical and virtual).  I'm particularly excited to have the opportunity to leverage my many years experience on the front lines of healthcare delivery to guide institutions as they transform their patient experience -  as perceived by the patient. 

Tower engages top-level executives who are responsible for the operations of the enterprise, as well as, ‘patient-facing’ staff and others across the organization to enhance operational processes and change the organizational culture to achieve long-term transformation of patient experiences.  And, a recent article in Healthcare IT News offering 5 tips for creating a strategic plan for IT provides some insight as to how we look at the role of technology in the hospital workplace of the future.

1.  Think about the patient experience

2.  Consider best practices

3.  Remember the staff experience

4.  Don't forget about social media

5.  Employ integrative planning

The list above provides just a glimpse, so also read the full article

 

Southern California HIMSS Annual Healthcare IT Conference

The Annual Healthcare IT Conference of the SoCal Chapter of HIMSS is coming up quickly on April 4th in Los Angeles.  It is a great networking and learning event for healthcare professionals, but it is also a wonderful opportunity to meet some of those who are new to the health IT workforce.

So check out the program agenda  and register today!  Highlights include:

• Jack Lewin, MD, CEO of the American College of Cardiology speaking on the State of the EHR Union: Where Are We?  Where Are We Going? When Will We Get There?
• How EHR Will Empower Patients and Family with Linda Macomber, Assistant Professor, School of Health and Human Services, National University and Clinical Reviewer/Juror, Certification Commission for Health Information Technology (CCHIT)
• Janet Marchibroda, MBA, Chair, Bipartisan Policy Center Health IT Initiative on Affordable Care Act’s Impact on Health IT: A Bipartisan Perspective
• A Health Information Exchange Update with California RHIO and HIE experts 
• Workshops:
  • Ambulatory EHR: Pros and Cons
  • Accountable Care Organizations/Patient Centered Medical Home
  • Career and Job Search Strategies

 

Securing and Optimizing Your iPad Experience

The hospital risk manager in me is at it again!  It has been wonderful to think through the emerging technologies and share the risks I see along with available solutions.   

My latest contribution to a HealthcareIT News article almost seems to be an unintentional follow-up to my wildly popular post on Tablets in Healthcare.  If you are an iPad user, especially those of you applying it to your work in healthcare, I urge you to review these 10 simple ways to secure and optimize your iPad:

1. Use the password, auto-lock, and auto-erase functions smartly
2. Limit access to confidential information to that on VPNs when in a public place or on unsecured networks and disable the Blue Tooth function after use
3. Permanently mark or engrave your iPad to help with identification
4. Consider cases with tethered locks
5. Only download apps and open files from trusted sources
6. Look for apps that take advantage of the iPad's native capability
7. Consider GPS tracking technologies or apps to help locate a lost or stolen iPad
8. Consider a mobile device management (MDM) solution for security and convenience
9. Ensure any apps downloaded are optimized for an iPad
10. Carry adapters for iPad to VGA and HDMI

It is all about protecting the patient's health information and securing the data we entrust to our providers!

 

Financial Impact of Breached Protected Health Information

I believe we all realize that as the industry moves to electronic health records, patients' PHI is more susceptible to exposure. Last year, in an article on the cost of data breaches, I referenced the a project of the American National Standards Institute (ANSI) and 100 industry leaders who were tackling the big question what can healthcare organizations do to better protect patients' information?

They first needed to understand the value of patient protected health information and then could develop a method for healthcare organizations to estimate breach costs, so they can make appropriate investments to better protect PHI security.  The result is their report:  The Financial Impact of Breached Protected Health Information: A Business Case for Enhanced PHI Security.

It includes tools to estimate the overall potential costs of a data breach to an organization, and provides a methodology for determining an appropriate level of investment needed to strengthen privacy and security programs and reduce the probability of a breach.  A detailed example of costing a PHI breach using the PHIve method is also provided.

Template RFP for App Development

mHIMSS recently shared a template RFP that can help organizations identify capable firms to provide application (app) development services.  But, I'd like to back up a minute and stress the importance of the planning process and developing a clear purpose and functional requirements.

This basic planning worksheet can help you get started and ensure that the type of app you envision is truly needed and worthy of the investment of resources.  It should also help you minimize the risk of costly re-work or development of an unusable app.

Remember to keep the intended device, user and workflow in mind throughout the process and involve users in the planning, vetting and testing processes. And, don't forget to build in the necessary safeguards to protect confidential information.

If you do create a new app, like Community Health Network's Pillbox, feel free to share a link on this post so we can check it out!

BYOD or BYOT

Just before HIMSS12, I learned about BYOD/BYOT (Bring Your Own Device/Technology).  Evidently, businesses and some healthcare organizations are encouraging, or allowing their employees, to use their latest and greatest (personal) mobile gadgets (smartphones, tablets, etc) to connect into their information systems. 

Now, it may seem that this policy will help reduce equipment costs and allow employees to use the latest technology, but it makes my Mobile Governance and Tablets in Healthcare posts even more important reads for healthcare leaders.  Why, because the organizations may find themselves paying out much more for costs associated with data breach assessments, reporting, fines, liability, etc.

For those of you who like data, consider iHealthBeat's report on a healthcare mobility survey that found:

• 85% of respondents said their organization has a BYOD policy, but the organizations vary in the amount of data they allowed personal mobile devices to access.
• 53% of respondents said their organization only allows personal mobile devices to access the Internet;
• 24% said their organization provides personal mobile devices with limited access to hospital applications; and
• 8% said their organization provides personal mobile devices with full access to the hospital network (Dolan, MobiHealthNews, 2/23).

Additional findings include:

• EHR applications are the most widely supported application on mobile devices, with 60% of respondents saying their organization supports the use of mobile EHR apps. The next most widely supported mobile apps include picture archiving and communication systems, secure messaging and voice-over IP (Computerworld, 2/24).
• More than 75% of respondents said their organization provides Internet access to patients and hospital visitors, but 58% said they use open networks without password protection to do so (Jackson, FierceMobileHealthcare, 2/23).

My hope is that these organizations (especially the 8% allowing full access to their network and the 15% without a policy) have already implemented the necessary safeguards to protect their systems and personal health information from accidently beaches, malicious attacks and HIPAA violations.

What I saw/learned at HIMSS12 - Highlights

It has taken me a while to catch up and recover from being at HIMSS12 last week, but I've finally had a chance to sit down and reflect on what I saw and learned during that busy week.  So below are my higlights:

• Thoughts from Biz Stone: 
  • Opportunity can be manufactured! You can create it!
  • Creativity is a renewable resource. It is infinite! Challenges are fun puzzles; not problems!

• Thoughts about the Future from the Smith and Hobbs presentation on Clinical Mobile Applications: 
  • 500 million people are expected to manage health concerns with smartphone apps by 2015 according to Research 2 Guidance 2010.
    
  • "Drive discovery about behavior, adapting to person and optimizing behavior"
  • The convergence of biology and machine
  • We need to establish risk model taxonomies for consumers, providers and manufacturers for safe & secure apps.
  • We need sensors to pick up signs that an intervention is needed in healthcare, just like our cars are doing today.

• CMS' ICD 10 and Version 5010 Implementation Timeline widget

• Guam HIE Project that demonstrate its Secure Messaging capabilities using the Nationwide Health Information Network Direct Project for coordinated care and disaster communications.

• Kaiser Permanente launched its new Mobile Optimized kp.org app giving members access to their medical records, refill prescriptiosn, appointments and messaging via mobile devices.

• Learned about iTriage's ER CheckIn smartphone app service that hospital staff of incoming patients. iTriage is the same one that made it to my list of top apps for the flu season late last year.

• The There's an App for That presentation demonstrating apps for vision, hearing, sleep, sobriety test, contractions/labor, smoking cessation, heart rate, spirometry, Airstrip, AED, allergy alert, EKG, podiatry, and more.

• The Patient Safety Company promoted their cloud environment and apps for safety and risk.  Also, help you develop your own apps. 

• Seeing MicroBloggingMD a microblogging platform used for secure hospital communications.

• Learning about Happitique which classifies apps for professionals which helps with the sorting process of the thousands of available apps and provides an enterprise mHealth solution. 

• Talking to several people about the move toward BYOD (bring-your-own-device) and the associated risks (including data security) in healthcare environments. (Stay tuned for an BYOD post to come.)

• Experiencing my first "hat interview" as tweeted by @EHRworkflow

• Learning about HealthInfo Island, Health Support Coalition, Cancer Co-Op, AIDS and HIV Support, etc  -- communities on the virtual world 2nd Life.

• And, getting an update from Zac on Louisiana's HIT/HIE activities.

But, the absolute best part of the week was finally meeting several of my blogger friends in person! Talking with them in person gave us a chance to bring our relationship full circle.  Some I just met this past year, but I've known two since first starting to blog in 2005 -- @hospitaltony and @techguy.

Convergence of HIE and Social Media

The San Diego Beacon eHealth Community is one example of how we are starting to see the convergence of health information exchange (HIE) and social media technologies.  They recently shared the details of their pilot study, which is designed to use SMS technology to improve childhood immunization rates. Highlights include:

• Purpose:  determine the impact and cost effectiveness of text messaging to improve child vaccination rates (all, on-time by age 19 months)
• Parents of childrent 9 - 13 months who speak either English or Spanish will be recruited.
• Participants receiving the intervention will receive monthly text message reminders to schedule or keep an existing appointment for their child's 15- and 18-month well-baby visits, as well as, educational messages.
• The control participants will only receive general milestone and health information during the study period.
• Some messages for both the intervention and control groups require a response (making the communications bi-directional.)

In addition, the involvement of a cell phone (mHealth) also makes this another great example of the convergence of telehealth and HIE.

Stage 2 Meaningful Use Has Arrived

The Notice of Proposed Rulemaking (NPRM) for Stage 2 meaningful use has been posted and it outlines the next stage of meaningful use for the Electronic Health Record (EHR) Incentive Programs, which are administered by CMS. 

The Office of the National Coordinator for Health Information Technology's (ONC's) NPRM was delivered to the Federal Register on February 22 at the same time as the CMS NPRM, and the policy is finalized. Additional news about the ONC proposed rule will be released once it is posted and the rules will publish on the same day.

CMS has developed a fact sheet to give providers an overview of the rule and how Stage 2 expands upon Stage 1 of meaningful use. 

I'm co-chair a workgroup for HIMSS to prepare comments related to governance issues in the NPRM. I'll also contribute to an American Telemedicine Association group review.  So, feel free to share any issues that you see. 

To learn more about meaningful use visit the CMS EHR Meaningful Use Overview web page.

HIMSS So Cal Healthcare IT Conference

Just as I'm getting ready to experience the big HIMSS Conference, the Southern California Chapter has released its agenda for their upcoming Healthcare IT Conference in Los Angeles.  

The conference is a great opportunity to hear from National and California leaders on HIEs, EHRs and Meaningful Use, wireless health IT applications, development of the HIT workforce and job search strategies, and accountable care organizations. It is also a perfect networking event.

I'm excited for the opportunity to return to my roots in Health IT and participate on the HIE panel. Register here to join us at the Center for Healthy Communities at the California Endowment near downtown Los Angeles on April 4, 2012 from 8am to 4pm.  I hope to see you there!

Mobile Governance

The executive summary of the HIMSS Mobile Technology Survey report had a somewhat alarming statistic -- only 38% of respondents noted that they have a mobile technology policy in place that regulates use of mobile devices and outlines the organization's mobile strategy.  I'm not so surprised, because it is a bit of déjà vu with social media policies. But, this does bring up the need for more attention by healthcare leaders to mobile governance.

While use and strategy are important, an organization's policy should also address data security and safeguards to minimize the risk of breaches and the release of PHI.  A recent study from CompTIA revealed that one-third of healthcare providers are already using mobile devices to access EHRs (and the PHI contained within).  And, not too surprisingly, another survey  found that medical residents are more like than established doctors to use smartphones for clinical purposes.

The result is an environment ripe for unintentional consequences. I addressed some mHealth governance and policy considerations in a previous post on tablets and revisit them here, as well.  

• Explore the availability of mobile technologies in their environment (and ecosystem) to identify any risks.
• Determine whether the risks can be managed -- allowing patients, employees, providers and others to realize the value and benefits offered by application of the new technology.  
• Balance usability, preferences, security, & budgetary concerns
• Explore mobile security and mitigation considerations then develop and clearly communicate the organization's policies. (specific policy considerations are detailed in the full post)

Beyond EHRs and other data systems, more and more doctors are engaging with patients through social media platforms - which are hard to separate from mobile devices. And, any healthcare professional can easily use apps to upload PHI - think DropBox!  This points to the importance of including social media considerations in your review of mobile technologies.  It is also another friendly reminder for those of you who haven't already created your organization's social media policy; to do so.

 

New Health IT Toolkit for Rural Providers

A new online toolkit will serve as a pilot program for providing health information technology (HIT) resources to rural health care providers. The toolkit was developed by the Rural Assistance Center and the National Rural Health Resource Center and is designed to help rural providers find resources for HIT, electronic health records (EHR), meaningful use and related topics.

The toolkit provides guidance with planning, setup, implementaiton and operation of a HIT infrastructure, as well as, information on training programs, funding support and management expertise.  Using the toolkit, rural communities will be able to:

• Address challenges in finding capital funding
• Provide support to community colleges to enhance training programs
• Stay informed about legislation affecting EHRs
• Leverage multiple federal resources for project development

Terry Hill, executive director of the National Rural Health Resource Center, emphasizes, “A lot of rural providers need guidance on putting an HIT system in place. This toolkit gives them a starting point and can help them get through the entire implementation process.”

 

Social Media Risks

ECRI has a fairly comprehensive overview and guide on social media that includes some great advice for hospital and other provider human resource managers.  There is also an interesting bit of information related to passwords and data security (see page 15).  My favorites on HR include:

• Be careful with what you find while screening potential employees
• Exercise care before disciplining an employee for what they write on a social media post
• Current employees may one day be former employees so make sure you have educated them on social media and their HIPAA obligations

For those of you who like multimedia, check out the ECRI's video on the guide.

Is Age Just a Number, or a Challenge to Widespread HIT Adoption?

I was interviewed for a recent article in Becker's Hospital Review that explores the common belief that older adults have more difficulty accepting and using technology.  It includes some great comments about "digital natives" and "digital immigrants" by the other interviewees.   

Speaking for myself, as a late Boomer, I can say that I certainly am a digital immigrant who has embraced technologies as I have found value to my work and life.  And, I believe that this applies to older adults in general.  There are differences in the generations and the oldest may need the most convincing and support, but it isn't that they can't incorporate technology into their daily life.

I remember older adults thinking it was a bit silly for people to carry around a cell phone.  But, once they began to realize value - they feel safer because they can call for help -- then older adults start using the technology just as anyone else.   If I'm correct, I also I believe this is how telephone adoption went.  It took a long time for it to catch on and for people to find value in the technology.  

Health IT is just one more advancement that needs to progress through the adoption cycle.

 

ACP Ethics Manual on Social Media, Catastrophes, and More

The American College of Physicians has released an update to its Ethics Manual and new or expanded sections include, among others, confidentiality and electronic health records, health system catastrophes, boundaries and privacy, social media and online professionalism.  I really appreciate the manual and have pulled out a few key points based upon the topics I cover often on this blog.

• Communication through email or other electronic means can supplement face-to-face encounters; however, it must be done under appropriate guidelines. Issuance of a prescription or other forms of treatment, based only on an online questionnaire or phone-based consultation, does not constitute an acceptable standard of care. (Exception: on-call situations) (pg 75)

• Shifting principles guide the patient-physician relationship during catastrophes and physicians need to be prepared for decision making and the just delivery of healthcare. (pg 80)

• Physicians who use online media, such as social networks, blogs, and video sites, should be aware of the potential to blur social and professional boundaries.  They therefore must be careful to extend standards for maintaining professional relationships and confidentiality from the the clinic to the online setting.  Physicians must remain cognizant of the privacy settings for secure messaging and recording of patient-physician interactions, as well as, online networks and media and should maintain a professional demeanor in accounts that could be viewed by patients or the public. (pg 81)

 

 All Changes to the Manual since the 2005 (fifth) edition

Gartner Worldwide IT Spending Forecast

I participated in this morning's Gartner Worldwide IT Spending Forecast.  Gartner, the technology research giant, brought together some wonderful speakers who shared information that I feel is important to healthcare -- especially at this moment in time.  The issues will have major revenue implications for vendors (perhaps leading to service changes) and could delay current and planned IT initiatives (EHR adoption, HIE, etc) of healthcare organizations.

The floods in Thailand in October of 2011 severely impacted fabrication facilities and this has lead to a shortage of hard drives. It is predicted that it will take at least until the 3rd or 4th quarter of 2012 for the industry to get back to meeting demand.  There is some uncertainty about this timeline.

This means:

• There will be storage and server component shortages.  Storage will not be cheap and providers will need to be efficient.
• Virtualization (the cloud) may be a more affordable option.
• We can expect longer lead times for delivery, backlogs and double ordering of products.
• We can expect an increase in costs over the short term (re-assess those budget projections you made last year)

One lesson that comes from this situation is to have multiple geographic locations for the manufacturing of components to help prevent business disasters like this one.  In this case all of our (the world's) eggs (hard drives) are manufactured in one basket (Thailand).

PC and software spending is down due to the downturn in the economy.  But, there was one bit of good news that I pulled from the discussion on software.  Spending on software (tools) for collaboration is increasing.  Companies are investing in technologies that will help them stay competitive and this means tools that will help their employees collaborate will reduce the need to bring on additional people. 

Now, I've been seeing this in other industries and have started to see it trickle into healthcare.  With health reform upon us, I hope my friends in the hospital start thinking a little more out of the box and how they too can leverage collaborative tools (aka social media) to improve efficiency and effectiveness in the workplace.

Top 11 Trends for 2012 in Healthcare Data

A look ahead at healthcare data points to increased risks, regulatory expectations and reputational fallout.  So it was a pleasure that I could contribute to a list of the top 10 trends for 2012 in healthcare data.  And, I really do appreciate so may news organizations carrying the story.  

My hope is that by increasing awareness of the risk among both healthcare providers and consumers, the necessary safeguards will get implemented.  The top 2012 predictions in healthcare data are:

1. Healthcare organizations will not be immune to data breach risks caused by the spread of mobile devices in the workforce
2. Class-action litigation firestorms are imminent
3. Social media risks in healthcare will grow
4. Cloud computing is not a panacea; technology is outpacing security and creating unprecedented liability risks
5. Growing reliance on business associates will create new risks
6. Organizations risk reputation fallout
7. Mobile will explode in healthcare 
8. Increased emphasis on willful neglect leads to increased enforcement of HIPAA
9. Privacy and security training will be an annual requirement
10. Rise in  fraudsters will increase fraud risk education
11. Healthcare organizations will turn to cyber liability insurance

See PR Newswire for the complete release.

Telehealth, the Cloud and BI — oh my!

My guest blog post for Health IT Exchange made it onto their list of top 7 community blogs of 2011. Telehealth, the cloud and BI — oh my! includes my post on the importance of connecting health IT with disaster planning and others addressing some of my favorite topics - telehealth, meaningful use, health information exchange, the cloud and medical devices.  

Their list of top 2011 blogs also also includes something new for me - voice commands on mobile devices. I've been watching my teenage daughter, who has a form of dyslexia, speak into her new phone (Christmas present) to text her friends.  It has gotten me thinking... 

To all of my readers, I wish you a very happy and healthy new year!

EHR Pitfalls

My latest article for HIT Exchange Magazine, titled EHR Pitfalls, is drawn from a lively HIMSS LinkedIn Group discussion (via social media) that has lasted for over two years.

It all started with a fairly straight-forward question -- "what are the top ten reasons why EMR/EHR implementations are failing?"  Since then, there has been a great deal of technical discussion, a couple of disagreements and even one or two heated debates.  But, the body of work that continues to grow is truly amazing.

The EHR Pitfalls article pulls some of the pearls of wisdom together and blends key themes to present an overview.  As always, I welcome your comments and feedback on this article.

Mobile Resources for Managing Risks

My last post on data security highlighted the role of the growing use of unsecured mobile devices and this keeps me watching for tools that can help hospitals and other providers manage the risks. I did come across a couple of impressive resources a few weeks ago and had the opportunity to see demonstrations. If you have any first-hand experience with these technologies, feel free to share your observations and feedback with my readers. 

The first one is BoxTone, a platform for managing apps and mobile devices.  It was also mentioned in a recent H&HN article. Their whitepaper Mobile Devices and HIPAA Compliance: Guidance for Securing & Protecting ePHI does a nice job of outlining the risks (first column) and mitigation strategies (second column) from CMS guidance on remote use of and access to ePHI.  The third column outlines item-by-item how BoxTone can support providers with the implementation of appropriate strategies.

The second technology is Accellion's platform for secure collaboration and mobile file sharing. Their white paper, 8 Critical Requirements for Secure, Mobile File Sharing and Collaboration, highlights the risk that dropbox-type (such as DropBox) file sharing services present to any healthcare organization or professional.   They also offer evaluation criteria for any solution.

So, while I'm impressed by what I saw offered from these two companies, I'd really like to hear from anyone who has applied or used their products.  If you know of other similar platforms, feel free to suggest them, as well.