What is Healthcare Compliance Policy Management?
Healthcare compliance policy management is an important part of healthcare administration because it helps healthcare organizations and their workforces comply with applicable regulations, standards, and best practices that govern the healthcare industry. However, the effective management of healthcare compliance policies is not without its challenges.
Healthcare compliance consists of complying with mandatory standards of federal laws such as HIPAA, OSHA, and the conditions for participation in Medicare and Medicaid, state privacy regulations (i.e., the Texas Medical Records Privacy Act), and voluntary standards such as the Joint Commission Accreditation Standards and the HITRUST Common Security Framework.
To support compliance activities, healthcare organizations develop compliance policies that cover elements of their activities such as patient care, data security, workplace safety, and workforce conduct. Systems are put in place to monitor workforce compliance with the policies, and sanctions are applied to workforce members who violate the compliance policies.
The Importance of Effective Healthcare Compliance Policy Management
Most healthcare organizations have multiple federal, state, and industry regulations to comply with, but some of the standards within the regulations preempt or duplicate standards in other regulations. It may also be the case that some regulations (I.e., the Colorado Privacy Act) exempt healthcare organizations from some compliance obligations, but not others.
Determining which standards apply in which circumstances and locations can be a daunting prospect, but it is important to effectively manage healthcare compliance policies in order to avoid legal issues, regulatory sanctions, financial penalties, and reputational damage, while maintaining patient confidence, quality of care, and a motivated workforce.
The Challenges of Maintaining a Policy Management System
Developing an effective healthcare compliance policy management system is only the first stage. Due to the number of mandatory and voluntary standards healthcare organizations have to comply with, staying up to date with new, amended, and removed standards can be a challenge – notwithstanding that most policy changes will require additional workforce training.
To overcome these challenges, healthcare organizations need a robust compliance program. The program should be supported by technology to relieve the administrative burden of managing policies, tracking compliance, and provide real-time reporting. An automated policy management system can also automate many of the tasks associated with healthcare compliance policy management to allow system administrators to focus on other areas of healthcare administration.
The Future of Healthcare Compliance Policy Management
The future of healthcare compliance policy management will likely involve an increased reliance on technology. As healthcare becomes more digital, the need for robust data security and privacy policies will only increase. Compliance software will become even more sophisticated, with features like artificial intelligence and machine learning to help predict and prevent compliance issues.
Healthcare organizations that are already experiencing challenges with compliance policy management should reach out to software vendors to discuss automating a policy management system. With a robust healthcare compliance program and the right use of technology, healthcare organizations can effectively manage their compliance policies and navigate the complex regulatory environment of the healthcare industry.
