Find an Answer

FAQ Public And Commercial

Back

Why should I consider a focused specialty case management program such as Heart Failure Management?

Heart failure accounts for 11 million physician visits each year, more hospitalizations than all cancers combined, and contributes to approximately 287,000 deaths annually. About 5 million Americans of all ages suffer heart failure, and around 500,000 new cases are diagnosed each year. Nearly 1.4 million heart failure patients are under 60, with the annual incidence approaching 10/1,000 after age 65 (American Heart Association). There is no cure for heart disease, so effective condition management is critical.

KEPRO’s heart failure program is modeled after the infrastructure and principles of our oncology program. It incorporates the nurse counseling process of assessing members and collaborating with each participant’s physician, planning and implementing appropriate interventions to address gaps in care, promoting effective cost management tactics, and evaluating the targeted results and outcomes of the programs, all aligned with heart failure guidelines. Heart failure case management plans are created and adjusted based on the physician’s defined stage of failure and functional classification.

Maximizing participant quality of life and functional status and reducing avoidable healthcare utilization are the primary program goals. They are accomplished by enabling participants to modify their behaviors, and improve self-monitoring and management skills critical to managing a chronic condition. We work as an extension of each participant’s physician to:

  • Ensure prescribed treatment plans are consistent with evidenced-based protocols
  • Remove barriers preventing participant compliance with prescribed treatment plans
  • Educate participants on their conditions, complications and management plans
  • Manage all co-morbidities that may harm quality of life and heart failure outcomes
  • Educate particpant about managing stress and better coping with their conditions
  • Facilitate health care power of attorney, advance directives, and end of life planning

Our case managers build a strong relationship with the participant’s physician to realize program goals. They continuously assess clinical, social, economic, and behavioral health status and use motivational interviewing to facilitate behavioral change and compliance. Our case managers also monitor medication compliance and efficacy, and recommend home monitoring devices to assist higher risk participants in managing their heart failure.

Find an Answer

Please describe KEPRO data security that ensures member information is protected.

As an organization that is charged with storing and transferring Protected Health Information (PHI), KEPRO is bound by HIPAA regulations, and is accustomed to managing the security and privacy of PHI. KEPRO currently exchanges data successfully and confidentially via secure encrypted means in support of all of our federal, state, and local government programs, and with commercial clients.

KEPRO has been implementing and supporting systems that require medical record, data security, and transmission for more than a quarter of a century, and has always placed primary importance on using systems that allow for fast and efficient connectivity, while still providing the highest level of data and system security. Our proven internal and external policies and protocols ensure compliance with state and federal laws and regulations, as well as any additional security measures you may require.

We have a stringent KEPRO Comprehensive Confidentiality Plan that governs our processes. KEPRO’s Privacy Officer, Security Officer, and the Compliance Officer have ultimate responsibility for oversight of the processes and procedures contained in the KEPRO Comprehensive Confidentiality Plan.

KEPRO's system is secure. Our information systems are secured by an in-depth strategy that utilizes multiple layers of operational, management, and technical controls to protect KEPRO assets. We also employ software programs designed to prevent unauthorized use by staff or outside entities.

All KEPRO information systems employ common security controls such as Firewalls, Anti-virus, Role Based Access, FIPS 140-2 Encryption for mobile devices, and the requirement of strong passwords. Information system users are assigned a security role based upon access requirements relevant to their positions and information/program privileges.

The HIPAA Security Rule requires entities to implement information systems that control access to healthcare and related systems. KEPRO adopts a subset of NIST 800-53 Rev 3 Security controls to maintain compliance with HIPAA. Based on these security standards, KEPRO mitigates risk to its Information system by focusing on such controls as:

  • Log-In Security. HIPAA security requires the use of secure User IDs and the use of passwords. KEPRO requires multiple account authentication processes within its information systems to verify the identities of our end-users. KEPRO's policy requires strong passwords that are changed frequently.
  • Access Control. HIPAA requires one of the following: Context Based Access, Role Based Access, or User Based Access. User Based Access is part of the Log-In Security component. KEPRO's Role Based Access gives individual users access relevant to their function in the organization.
  • Audit Trail. HIPAA requires the use of an audit trail to identify who accesses PHI. KEPRO systems track those who change the patient record, the date and time the record was modified, and the specific information changed. The system includes a read only audit trail that captures each time a system user views a case.
  • Session Time-out. KEPRO information systems account for session inactivity by locking screens after 10 minutes of inactivity.
  • KEPRO's physical space is secure. KEPRO’s computer, telephone, and hardware systems are located in climate controlled rooms with fire-suppression and electronic locking system. We allow only authorized access to the room.
  • KEPRO focuses training on confidentiality and security issues. All KEPRO employees undergo rigorous training on security and confidentiality of PHI. We have successfully provided this training to all staff regardless of their respective roles/duties.

KEPRO Headquarters

See all locations

777 East Park Drive, Harrisburg, PA 17111
Toll-free: 800.222.0771
Phone: 717.564.8288
Fax: 717.564.3862