How Hospitals Are Handling Compliance In A Resource-Constrained Environment

By Nick Culburtson

CEO of Protenus, leveraging AI to reduce risk and improve patient trust for healthcare systems across North America.

This past year, healthcare has experienced unprecedented obstacles and struggles, but it also has displayed its unparalleled strength. In a pandemic or national emergency, healthcare should always favor accessibility to data and collaboration in order to foster data exchange — even if there is some risk. It’s those data linkages that are essential for triaging the crisis and ultimately getting ahead of it, whether it’s contact tracing, epidemiology or rapidly developing necessary medical interventions.

It can be imperative to sacrifice some individual rights for what we believe to be the common good. At the same time, we are still obligated, professionally and ethically, to do what we can to enforce compliance regulations that reduce institutional risk and help ensure 

In December 2019, a poll by the nonpartisan Pew Research Center showed that Americans were concerned about healthcare affordability and the addiction crisis. By March 2020, all these concerns took a backseat to the risks of Covid-19. Within weeks, hospitals were forced to eliminate elective procedures to make room for acutely ill patients and to protect their staff and others from the highly contagious disease. 

Once the threat of the coronavirus became a national emergency, the pandemic quickly revealed vulnerabilities in the American healthcare system, which had to change immediately in order to have a fighting chance at 

The essential point here is that hospitals had to change their way of doing business almost overnight. There was no time for long meetings and careful decision-making. Things had to happen quickly, and decisions had to be made immediately. Yet, for an industry that is historically known to be slow to adopt paradigm shifts, it made the necessary changes in order to ensure its response was proactive, not reactive, to the current challenges. Such changes included setting up field hospitals in nonmedical facilities, hospitals reallocating staff to other areas of the organization, and instituting telehealth services to better serve their patients. 

Increased Financial Vulnerability

While the pandemic highlighted that the industry can, in fact, change quickly when necessary, it also exposed the financial vulnerability of the healthcare system. This situation may seem counterintuitive because healthcare has always seemed like one of the most stable industries in the country. However, when faced with the rapidly increasing demand for ICU beds, ventilators, and other equipment while also having to halt revenue-generating elective procedures, hospitals were left in a financial crisis

This crisis resulted in furloughing key roles of those in the healthcare sector, especially those within compliance. Eliminating, even temporarily, compliance personnel can increase the risk profile of the organization. These teams are critical in reducing institutional risk. Without them, organizations may fall victim to myriad incidents that could significantly damage a hospital or healthcare clinic. With the current financial stress on health systems due to Covid-19, a single breach could be a major blow to an already struggling hospital.

Looking ahead, healthcare must learn to operate in a lean environment while still delivering the level of care the U.S. healthcare system is known for. For compliance programs, this will mean ensuring organizational policies and procedures with even fewer resources than they are accustomed to. 

Threats Persist

Covid-19 has not only introduced new resource challenges for healthcare compliance teams, but it has also presented new data vulnerabilities as well.

But technology has helped large organizations respond to the data challenges created by the pandemic. For example, the Center for Systems Science and Engineering at Johns Hopkins University created a real-time dashboard to track infections and deaths worldwide.

The tech industry has also applied artificial intelligence (AI) to help with contract tracing and vaccine development. While these types of advancements have been instrumental in understanding the scope of the pandemic, data vulnerabilities remain an issue.

Covid-19 patients have become especially vulnerable to breaches as the general public is increasingly interested in clinical outcomes and any possible community exposure. In early September, it was revealed that former employees of Hennepin Healthcare had viewed George Floyd’s healthcare records without authorization. Insider snooping is one of the possible spikes in privacy violations as hospital staff become curious or concerned about co-workers who have tested positive for Covid-19. These challenges around the availability and accessibility of patient data increase the burden of compliance teams, with already few resources. 

AI Allows Teams To Do More With Less

Healthcare will continue to make quick decisions as the industry grapples with the ongoing pandemic, and it will continue to use patient data to make critical decisions on how to best care for patients and its workforce. With the increased risk that accompanies this kind of data sharing, it will be crucial for organizations to best leverage their resources to maintain compliance. 

Leveraging a centralized compliance program is an efficient and cost-effective way for compliance teams to harness their resources and ensure their organization’s policies are being enforced. This unique program allows teams to achieve a single-pane-of-glass view, providing the ability to view incident alerts and monitor the case status from generation through resolution. This insight also allows teams to better understand unique data trends within their organization and prevent future compliance incidents from occurring. Organizations should also leverage resources and technology that can quickly adapt to the evolving needs of the pandemic and review 100% of auditable events to identify risky behavior. 

As healthcare continues to endure the ongoing ramifications of Covid-19, there will be increased vulnerabilities and risk associated with the data sharing and collaborations necessary to combat this devastating illness. However, the pandemic has shown us that healthcare can move quickly and make decisions to ensure its response is proactive — not reactive. 

Healthcare compliance has the opportunity to leverage this agent of change and quickly shift the compliance paradigm to one that is proactive, ensuring organizational compliance even in the resource-constrained environment of the pandemic.

Read More: https://www.forbes.com/sites/forbestechcouncil/2020/12/07/how-hospitals-are-handling-compliance-in-a-resource-constrained-environment/?sh=589b8d832c77

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