x Patient notification costs (e.g., employee time, printing,
x Bill write-offs, if patient owed money
x Credit monitoring and identity theft monitoring for each
patient for a year or more
x Legal fees
x Forensic investigation
x Time and effort of staff
x Call center support for patients affected by the breach
x Media consultants
The soft costs tend to be reflected in a decrease in market
share. The problem is that it is difficult to discern whether that
decrease stems from the breach. It is somewhat uncommon for
patients to completely shift their care to a different hospital fa-
cility. Changing physicians is much easier. The rate of patient
churn is much higher than the average customer churn in other
industries, indicating willingness on the part of patients to move
to different providers.
Facing ROI Reality
The one certainty about ROI is that it will change and continue
to evolve as healthcare delivery, regulations, and reimburse-
ment changes and evolves. And HIM professionals are at the
center of its transition.
1. Office for Civil Rights. “Enforcement Results by Year.”
2. Tripathi, Micky. “First-Hand Experience with a Patient
Data Security Breach.” December 3, 2011. www.histalk-
3. Symantec. “2010 Annual Study: U. S. Cost of a Data Breach.”
March 2011. www.symantec.com.
Jan McDavid is general counsel, and Rita Bowen is privacy officer and senior
vice president of HIM, at HealthPort.
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