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1 Encrypted Version 2.1 General Level Instructions HIPAA Compliant Solution for Secured Communications via Created by National Billing Center LLC Page 1 of 8

2 Table of Contents 1. Description 2. Decrypting Files 2.1 Download App 2.2 Register App 2.3 Open Encrypted File 3. Encrypting Files 3.1 Register with Us 3.2 Encrypt Files 3.3 Send Page 2 of 8

3 1. Description The use of traditional is not considered to be a HIPAA-compliant communication method because the message and its attachments (if any) travel from the sender s server to the recipient s computer in an unencrypted form. Currently there is only one solution to this dilemma: the use of secured services. Such services are HIPAA compliant; however, they present an entirely different set of issues for healthcare organizations. Secured services require the recipient to open a browser window, type a user ID and password. Only then can the user view the inbox. This is far from an ideal solution, especially for smart phone users, as the process is inconvenient and cumbersome. When the user sees the inbox of the secured service on a smart phone, the s subject and text of the body is significantly smaller compared with the phone s native application. Since text is barely readable, the user will usually resize the browser window and then will spend even more time scrolling around. Secured services are a significant burden on a hospital s IT department: 1) A new set of servers must be established. 2) Greater maintenance and vigilance of user accounts becomes necessary. 3) New associated procedures must be created and followed. Finally, doctors, nurses and other healthcare professionals unanimously desire a single point of entry in mobile phone usage, as opposed to the navigation of a multi-stepped protocol. Our solution fully resolves these issues. Here is an example of how it works Let s say that a hospital sends an to a Dr. John Smith and it contains the following text: Dear Dr. Smith, this is a reminder that you have a surgery tomorrow at 9AM. Patient is Sarah Brown, MRN# Her recent x-ray and transcribed followup visit are attached. In addition, assume that the hospital user then attaches the following files: a. xray_12345.bmp (Bitmap) b. followup_12345.doc (Microsoft Word document) 2. At this point, the and attachments are instantly encrypted and automatically converted to the following format: a. Message.HCEF b. Attachment1.HCEF c. Attachment2.HCEF 3. Hospital computers can then send these 3 files to through its regular communication method. It is 100% HIPAA compliant because the above files are now all encrypted within the (rather than being re-routed to a different server). Page 3 of 8

4 4. Dr. Smith uses his native application on a mobile device to receive that from the hospital. He taps the first file (Message.HCEF), and our App seamlessly decrypts the text of a message on a background, and shows the text on the mobile device screen. He taps the second file, and again, our App quickly decrypts first attachment, and shows file xray_12345.bmp within a native mobile phone application (capable of opening a BMP file). The same goes for the second attachment. is also a perfect way to broadcast automatic messages such as: 1. Patient lists 2. Appointment schedules 3. Emergency notifications Incorporation of this technology into a hospital s computer system will not present any difficulties for the hospital s IT department. We will provide them with the SDK (Software Development Toolkit) which contains samples and instructions for Linux and Windows systems. We also will provide any support which they might need. Depending on the hospital s computer system and preferences of their IT department, our Encrypted Solution (incorporated into the hospital s system) could be seen as a new menu item on their Internet browser or new button on the application. Also, it could be fully hidden: for example, if the hospital clerk uses Microsoft Outlook, they might decide to alter the functionality of the Send button, and then the clerk works as usual, but all components and attachments of the are automatically encrypted (instantly and on a background) prior to the sending of the . Page 4 of 8

5 2. Decrypting Files These instructions assume that the hospital (that sends you s) is affiliated with our organization and uses our Encrypted solution for file encryption Download App. We have developed 3 programs for the following devices: a) App for iphones (ipods, ipads, etc) b) App for Android cell phones c) App for Windows based laptops and computers (yes, Outlook is supported too) All of the above programs are free and can be found in the respective stores (itunes or Google), or they can be downloaded directly from our web site at It is certainly not a problem if you have more than one device. You can simply install the App on any number of devices and on any combination of them App Registration You need to register the App only once, though no harm results if you were to register it in multiple instances, even from the same device. You will not be able to register the App unless there is at least one sent to you from the hospital that is affiliated with our organization and uses our Encrypted solution for file encryption. Registration is required in order for the App to record your address and telephone number. The App will decrypt ONLY files intended to be sent to the registered address. This means that if you forward your (that contains HCEF encrypted files) to another address, the recipient of that will be unable to open HCEF files unless he/she registered the same App with the same address. The reason to enter your telephone number is that we are currently working on adopting this technology to SMS (in addition to ), and once that takes place, you won t need to re-register your App or even change anything on your device. Page 5 of 8

6 The registration process is very simple and consists of a single screen. Tap the icon of the App and the following appears: a) Enter your phone, then address, then 4-digit numeric password. b) Click the Register button That is all! At this time the App notifies you that you are successfully registered. You can close the App and you will most likely never see it again. All tasks conducted by the App after this point will be run in the background, invisible to the user. Note. Please make sure that the password you pick is easy to remember. The reason for the password is to protect you. If another person (who accidentally received your ) has obtained our App and is trying to register it, then he/she will need to enter your phone number/ address and your password in order to successfully register. It is much harder compared with entering just a phone number and address. In addition, our servers will count the number of unsuccessful attempts to register, and block that person after certain limit is reached Open Encrypted File This is the easy part. Check your the way you have been always doing it. Do you see HCEF file(s) attached to it? a) Windows users: double click the file b) Android users: tap the file c) i-os users: tap our icon located to the left of the file name, then select Open in Decrypto Page 6 of 8

7 3. Encrypting Files These instructions assume that you are an IT person in the hospital that is affiliated with our organization Register with Us Sign up with our solution and we will set you up with the system within 15 minutes. As part of the registration process, you will receive the following credentials: a) URL that contains API for file encryption b) User ID of your organization c) Password You will also receive a sample PHP script (similar to above) that you can use to encrypt files. Encryption of the single file takes a single trip to our server via HTTPS POST method. To be HIPAA compliant, such a trip should be made using security sockets (SSL), so that all uploaded and downloaded data is encrypted as it travels to/from our servers. 3.2 Encrypt Files Each message consists of the subject, body and zero or more attachments. If any of that data contains patient-related healthcare information, then it must be encrypted. Each component of the message should be converted into the HCEF file. Remember that the file name cannot Page 7 of 8

8 contain PHI as well. Also remember that the file should always end with.hcef. Finally, make sure that the file does not contain more than one dot; otherwise, some devices might not recognize it as an HCEF file. Here are some examples: Good File Name Bad File Name Reason Message.HCEF Message.Body.HCEF Double Dot Patient_X-Ray.HCEF Patient_X-Ray.HCF Invalid Extension Followup_visit.HCEF Followup_John_Smith.HCEF Do Not Include Patient Name _Subject.HCEF _Subject-ATTN!!!.HCEF Invalid Character (!) 3.3 Sending s Now you are ready to send s using any tools you have already been using and that you are comfortable with. Remember - encryption keys are based on the address of the receiver so if you need to send the same message to more than one doctor, you need to encrypt that same message individually for each doctor. Page 8 of 8

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