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Technology Plays an Important Part in Compliance

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May 5, 2014

These days, most health care providers have adopted compliance and ethics programs that include some or all of the following:

  • A Code of Business Conduct
  • Compliance and Ethics Policies and Training
  • A hotline for reporting potential improprieties
  • Misconduct investigations

Corporate Compliance and Ethics Week is a national week-long event, traditionally held the first full week in May, which highlights the importance of ethics and compliance in the workplace. Its purpose is to help employees make appropriate business decisions that may affect relationships with co-workers, customers, suppliers, business partners, legislators, and regulators.

“For health care providers, the goal is to reduce fraud and abuse, and improve quality of care,” said Sandy Cunningham, VCPI Director of Program Management Office (PMO), Service Desk, Professional Services and Field Services.

Compliance and ethics programs should be designed to prevent and detect violations of applicable regulations and laws by the agents, employees, officers, and directors of a healthcare organization.

“It’s doing the right thing, even when you think no one is looking," said Cunningham.

Technology plays a key role by supporting a provider’s ability to actively audit and monitor employee activity.

“Use technology as leverage to improve quality outcomes, starting with the areas of greatest risk for the provider,” added Cunningham. “Don’t try to boil the ocean.”

High-risk health care areas include:

Compliance_and_ethics_table

VCPI recommends the following proactive technology tips to health care providers in developing and monitoring their compliance initiatives:

  • Use truly integrated clinical and billing software applications whenever possible
  • Eliminate redundant data entry
  • Effectively use dashboards and decision support systems
  • Achieve consumer (resident and family) engagement through portals and social media
  • Use business intelligence in your Quality Assurance and Performance Improvement (QAPI) program for a data-driven, proactive approach
  • Leverage interoperability and health information exchange (HIE) to manage transitions of care, decrease hospitalizations, achieve medication reconciliation, and decrease unnecessary and duplicative procedures
  • Designate a Compliance Officer
  • Design and implement a formal, documented compliance program
  • Identify and address risk areas, including those directly related to the use of technology
  • Develop internal controls and an auditing and monitoring program
  • Educate and train, monitor and act based on outcomes
  • Leverage technology wherever possible

Talk to your Account Manager or Sales Manager to learn more about how VCPI can help you address your compliance requirements: Submit a form or call 877.908.8274.