According to research, the global healthcare sector is set to reach a value of over $10.059 trillion by the end of 2022 and is one of the most crucial contributions to society which needs to be regulated in order to ensure the safety and care of millions of patients worldwide.
The tiniest details, ranging from the protection of confidential data and accurate documentation to the performance of safety-critical procedures, must be kept in check.
Like every industry, healthcare also has a set of rules and regulations to make sure everything runs smoothly.
Thus, healthcare compliance deals with the legal, ethical, and professional standards that all people and processes involved in the sector must comply with. These mandates are quite complex in nature and are subject to frequent change, requiring shifts in the operational workflow, and much more.
Including a virtually never-ending list of elaborate rules and regulations, healthcare compliance can be somewhat challenging to understand. However, with the help of the few key examples listed below, you will be able to familiarize yourself with the subject.
Social Security Act: Looks over the funding and other essentials for the Child Health Insurance Program, Medicare, Medicaid, and much more.
Health Insurance Portability and Accountability Act (HIPAA) – 1996: This particular statute aims to protect patients' privacy by complying with organizations to ensure the security of patients' medical data.
Health Information Technology for Economic and Clinical Health (HITECH) Act: An extension of HIPPA, this particular law was enacted in 2009 and lists the compliance standards for health IT, which deals with the use of electronic health records.
Physician Self-Referral Law (Stark Law): Under this act, physicians are prohibited from referring their patients enrolled in Medicaid or Medicare to a medical entity or provider with whom the physician or a member of their household has a direct financial relationship.
False Claims Act: Under this act, it is illegal for medical providers to make false claims to a federal payer. It also allows those not affiliated directly with the government (such as relators or whistleblowers) to take the offender to court on behalf of the U.S government.
Anti-Kickback Statute: The goal of this ordinance is to promote medical decisions independent of financial constraints or benefits. Thus, under this act, medical care providers and organizations are prohibited to receive monetary profit for patient referrals if all of the treatment is being taken care of by the federal government.
Interoperability and Patient Access Final Rule: This rule provides patients with more control and access to their technological health information.
Patient Protection and Affordable Care Act: In order to protect the social and financial rights of patients, this rule was passed recently implemented to provide a modern approach for insurance and Medicaid.
Hospital Price Transparency Final Rule: Aiming to ensure that medical treatment does not cost patients an arm and a leg, this rule specifies that hospitals and medical care organizations fully disclose their costs and health plans.
When it comes to keeping a vigilant eye on compliance standards, there are a few authorities that stand out, such as the Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA).
These are responsible for regulating the distribution and manufacturing of medical services, medications, and biological services and ensuring their safety from the manufacturing and shipping to the point of injection.
As mentioned, healthcare compliance is an essential process that ensures that all processes run smoothly without any hindrances. Besides that, many benefits come with complying with healthcare statutes, not only for the patients and medical care organizations but the federal government as well.
Healthcare compliance keeps a vigilant eye on the monetary system of the industry, and this prevents the misuse of commercial insurance dollars, which keeps the sector free from corruption.
When it comes to the healthcare sector, many issues regarding billing and medical coding may arise, which can be detected earlier on with a state-of-the-art compliance program and resolved accordingly.
Moreover, compliance programs help organizations build a positive image by showcasing that the hierarchy and its employees pay close attention to patients' rights and are fair and just in all of their dealings. Other than that, healthcare facilities can avoid facing unnecessary sanctions by the government if they adhere strictly to its drafted rules.
Since the main objective of healthcare compliance is to protect the rights of patients, there is no doubt that the right compliance program will improve the credibility of an organization. Patients will be keener to opt for healthcare when they know that everything is working in their favor.
To determine the performance of a healthcare facility, it is crucial to have a well-established compliance reporting process.
The compliance with standards issued by the federal government or state is showcased via writing compliance reports and presenting statistics to qualified auditors appointed to review them. After a thorough process, these professionals pass the verdict on whether the healthcare facility is actually complying with the rules.
However, there is no hard and fast rule for drafting a compliance report, and the format varies from one organization to another or from state to state as well.
Nonetheless, it is of utmost importance that your healthcare facility adheres to the report structure and information desired by the individuals looking after your compliance standards.
Compliance reporting enforces facilities to focus on effective protocols and documentation, which not only helps to keep everything organized but also improves their communication and collaboration with various other healthcare providers. Additionally, if any unforeseen problems arise, the organization is ready to present its documented proof which simplifies the whole process. On top of that, maintaining a good record will also open the doors to new and improved opportunities for the organizations when federal agencies update their compliance standards.
An effective compliance management system also enables organizations to weed out any suspicious activity, thus reducing the percentage of illegal and unethical conduct to a great extent.
The most significant goal of any healthcare facility is to make their patients feel protected, comfortable, and cared for at all times, and staying on top of compliance reporting practices can help ensure their exemplary care, provide patients with error-free diagnosis, and the proper treatment for their ailments.
Although compliance reporting may seem to be a daunting task for healthcare organizations, it has been made easier with the advancement of technology.
At present, there is a wide range of software available that can aid medical care providers, facilities, and organizations to keep a check on their systems. However, finding the ideal technology stack for your organization can be a challenge since you must ensure that all of its characteristics and functionalities align with your requirements and the expertise of your staff while simultaneously monitoring the reporting process in an effective manner.
Healthcare organizations must keep a detailed record of their data, whether it consists of the database of patients, the performance of various devices that ensure the proper storage of medication and machines for diagnosis or treatment, or the interaction of various healthcare providers. Since we are in the 21st century, it is fitting for this whole system to be automated, making the use of software absolutely crucial. Not only this, but the computational properties will help keep issues such as human error and potential communication breakdown at bay by notifying the organization beforehand.
Other than that, the use of technology helps facilities save the money and time they spend on manual processes for compliance reporting, such as data logging, medical coding, billing, and report making.
An example of a versatile, easy to operate software is Sonicu.
It is a Cloud-based platform hosted on Amazon Web Services, which takes the burden of monitoring systems as well as collecting and managing data and compliance reporting off the organization’s shoulders so that they can focus their precious time on other important tasks.
This robust software offers its users the following outstanding features:
All these features make the program an ideal choice of compliance reporting in healthcare. Moreover, you can also take advantage of the following features when you opt for a Sonicu subscription:
Sonicu is an IT company that deals with all the prospects of remote monitoring applications with its integrated software from A to Z, helping its clients to manage and protect the environment, assets, and processes of their company.
Producing precise, real-time data and fail-proof alarm systems, Sonicu's precise sensors pick up anything, be it a rise in temperature or a dangerous rise in relative humidity.
All of these prominent features allow businesses and other facilities such as healthcare to stay on top of their management and compliance standards.
Moreover, Sonicu enables its clients to devise a custom plan that meets their specific needs and helps improvise, saving precious time, effort and money. Not only this, but supervisors can stay stress-free, as they can monitor the happenings of their work environment even from the comfort of their homes or on the go via their personal devices as well and can prevent any sort of mishap earlier on.
One of Sonicu’s core objectives is its customer service.
Their high-class support professionals are always on standby, waiting to provide their services related to any issues that arise even after the installation of the whole system – this ensures that everything runs smoothly and patients receive the exemplary care they deserve.
Without a doubt, compliance reporting is a crucial process in any industry, especially the healthcare sector, which revolves around high-risk and safety-critical processes. Complying with the federal standards not only benefits the facility but their patients as well, who can expect to receive exemplary treatment at all times.
Thus, in order to keep things aligned, it is crucial to have a vigilant eye on all of the systems tied to the healthcare network. The daunting task of compliance reporting in healthcare can be made easier with the help of the various software programs available on the market today. However, Sonicu is the best fit for compliance reporting in healthcare with its distinguishing characteristics.
With the SoniCloud Dashboard, viewing the complete monitoring of the healthcare facility is easier using any device with 24/7 access to the data. This not only helps in ensuring that the healthcare facility is functioning as needed, but it also helps to analyze the data and make decisions more effectively to enhance the efficiency of the facility in the future as well.