The Benefits of a Custom Healthcare Compliance Solution

The Benefits of a Custom Healthcare Compliance Solution

December 9, 2021
December 9, 2021

The definition of healthcare compliance is deceptively simple. Healthcare compliance is the process by which healthcare organizations meet or exceed regulatory, reimbursement, legal, ethical, and professional standards. Compliance is essential in protecting the health and safety of patients and staff, but it is also essential to building trust with patients, consumers, physicians, payors, regulators, and employees.

Compliance is important, but made challenging by the sheer volume of regulations and regulators. Further complicating the issue is the constantly evolving nature of these regulations and a pandemic that has caused even more rapid change in the regulation of safety and reimbursement. Unique regulations by care setting and jurisdiction make the regulatory landscape even more difficult to negotiate.

Custom Solutions – Why They Work

It is important that an organization's compliance solution to ensure the organization is keeping abreast of changing regulations, protecting against malicious phishing attacks as well as creating a socially responsible environment for patients and staff. Healthcare organizations have plenty of things in common, but they also have unique qualities and challenges that make a cookie-cutter approach to compliance a recipe for compliance missteps. So why should your organization have a custom compliance solution?

  • A threshold advantage is simply avoiding sanctions for failing to have an effective compliance program. The Office of the Inspector General (OIG) has demonstrated a lack of tolerance for weak or ineffective compliance programs. Custom solutions demonstrate a clear commitment to effective compliance management.
  • Demonstrable processes – In addition to simply avoiding sanctions, healthcare organizations need to be able to effectively demonstrate their compliance to regulators and to each other. A database of documents can help organizations provide these documents at a moment's notice. Customized solutions help ensure that your organization can meet all documentation requirements.
  • Unique industry and unique providers – There simply are not other industries that are all that similar to healthcare. In addition to being quite different from other industries, healthcare providers can be quite different from one another. Compliance solutions that were not built with the healthcare industry in mind or solutions that are not able to address the unique nature of a specific type of provider, municipality or care setting are likely to simply miss some of the compliance issues that your organization is likely to face.
  • Employees as partners in compliance – The best compliance programs can be spectacularly undermined by a single employee being careless with protected health information or clicking on a link in an email that should have been recognized as suspicious. Educating all employees to recognize and mitigate risks should be an essential part of your custom solution.
  • More efficient processes – Efficiency matters in most industries, but it is mission critical in healthcare. Technology means that compliance can be easier and faster to deal with for employees, thereby freeing them up to focus on other essential parts of their jobs. That same technology makes it fast and efficient for leaders to insure that employees are current on compliance training requirements. Technology can also improve the speed at which organizations can respond to compliance deficiencies once they have been identified.
  • Trust, but verify – Customized compliance solutions can provide routine checks to ensure compliance as well as early detection of non-compliance.  

In healthcare, it may be impossible to completely eliminate risk, but a strong healthcare compliance solution that is customized to the unique needs of your organization is the best and first line of defense.