| Although U.S. federal guidelines and regulations to protect medical client privacy are specified in great detail throughout a number of publications, they are not presented in a manner readily applicable to small healthcare offices. This study examined the degree to which office administrators and other personnel understand and implement the Healthcare Insurance Portability and Accountability Act (HIPAA) Final Security Rules, and whether healthcare personnel might benefit from a structured, prescriptive approach to HIPAA compliance. This study included literature reviews using web searches, professional organization articles, physical university stacks, and the Capella online library on the current state of HIPAA compliance along with an examination of the latest thinking in usability theory and practice. These reviews, coupled with interviews with usability professionals, led to the development of a 2-phase, 5-step formative and summative methodologies that guided the development of a prototype tool. The Doc- Assist tool consists of 4 documents: a discussion and resource guide, a step-by-step guide, a compliance checklist for completed tasks, and a PowerPoint tutorial. The 1st draft of the tool was reviewed by a security professional and 2 usability practitioners. This draft was revised then reviewed for readability and general usability by 2 professionals not associated with the healthcare industry and 3 healthcare professionals. A clinic manager and 2 of his staff, who had little or no experience in information systems security, participated in an interactive review for obscure wording. The tool was revised then reviewed by separate focus groups of 6 usability professionals and 6 healthcare information security specialists and revised accordingly. Requests to participate in an onsite review of the tool were sent to 125 randomly chosen clinics, of which 17 agreed to participate and 3 returned completed evaluations. The 49-item review questionnaire addressed 5 areas of usability, and each item used a 1--10 rating scale for a highest possible score of 490. The average score was 476. The study suggests that the Doc-Assist tool will be effective in guiding clinics to HIPAA compliance and can serve as a model for other process improvement challenges. Suggestions for additional research and tool improvement are provided. |
