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  • USPSTF: More Research Needed on Routine Cognitive Impairment Screenings

    Though US Preventive Services Task Force (USPSTF) acknowledges that there may be "important reasons" to screen for cognitive impairment for adults over 65 with no recognized signs or symptoms of impairment, 10 years after its last investigation of the issue the group continues to say that more research is needed before it can reach a recommendation about the benefits and risks of the assessments.

    The recent USPSTF report does not recommend against the screenings and even asserts that some screening tools are better supported by performance data than they were during the group's 2003 review of the issue. However, the overarching message from the report is clear: "the overall evidence is insufficient" for the USPSTF to advise for or against.

    Within that general position, the task force did arrive at a few related conclusions. Among them:

    • Some drug therapies "have a small effect" on short-term outcome measures for patients with mild to moderate dementia.
    • Caregiver interventions have a "small effect" on caregiver burden and depression.
    • Exercise interventions "are not associated with serious adverse effects."
    • Acetylcholinesterase inhibitors (AChEls) can produce adverse effects, some serious.

    APTA responded to the USPSTF report during a comment period in late November 2013. In a letter based on expert member input, the association noted that a physical therapist's (PT's) screening for cognitive function can "significantly affect how [PT] interventions are communicated and delivered to the patient." While the comment letter did acknowledge that there was insufficient evidence to recommend routine screening for the public, APTA input pointed out that a patient's cognitive status "can have profound implications" on treatment approaches and outcomes in settings that involve PTs.

    Additionally, APTA suggested changes to the report, many of which were incorporated into the final document. One such change: including exercise among the nonpharmacological interventions for adults with cognitive impairment.

    HIPAA Violation Leads To $4.1 Million Judgment Based On State Law

    A protected health information (PHI) breach that violated HIPAA may now result in the same facility paying out an additional $4.1 million for violations of state privacy laws.

    According to a recent article inHealthcare IT News, a Los Angeles County Superior Court judge has approved the class action settlement that asserts Stanford Hospital and Clinics violated California's Confidentiality of Medical Information Act. The settlement stems from a 2010 breach that involved the posting the PHI of nearly 20,000 patients to a student website. The information remained on the public website for almost 1 year, and contained patient names and diagnoses.

    The Healthcare IT article reports that this was the fifth in a string of HIPAA breaches connected with the facility that affected the PHI of more than 92,000 patients. Of the 5 breaches, 4 involved the theft of unencrypted company laptops.

    HIPAA rules can be complex, but the consequences of not understanding them can be serious. APTA provides resources on compliance on APTA's HIPAA webpage.