The healthcare industry is one of the most regulated industries in the nation, and as this industry becomes more complex through technological advances, compliance, and regulations must expand. Sensitive and personal information is held within healthcare facilities, and breaches to these facilities can be detrimental. Additionally, compliance regulations for conduct, malpractice, and referrals can result in hefty fines and even a loss of license for medical professionals. Here, the healthcare facilities workflow experts at SCLogic discuss regulatory compliance for healthcare facilities and how you can ensure your team has a comprehensive understanding of compliance laws to ensure a confident and successful future. 

How Does Healthcare Regulatory Compliance Differ from Other Industries?

In the previous installments of our regulatory compliance series, we provided a general overview of what regulatory compliance is, as well as industry-specific articles for government agencies and commerce corporations. While both industries, especially government agencies, have unique compliance regulations that must be followed, healthcare is a beast all its own. For healthcare facilities, you are dealing with a variety of compliance, including scientific-based information, conduct with patients, internal conduct with other healthcare providers, credentials, payments, data, and more.

 First, there are multiple federal organizations that help regulate the healthcare industry, including the Department of Health and Human Services (HHS), the Office of the Inspector General (OIG), the Food and Drug Administration (FDA), and the Drug Enforcement Administration (DEA). While this may seem like a significant number of federal regulators, these are just a few of the organizations that have a say in the healthcare field. Other organizations include: 

•  The Joint Commission (TJC) – an independent, not-for-profit organization that accredits and certifies over 22,000 healthcare organizations and programs in the U.S., including hospitals and healthcare organizations that provide office-based surgery, behavioral health, home healthcare, laboratories, and nursing facilities.
  
• The National Association for Healthcare Quality (NAHQ) – an organization dedicated to healthcare quality professionals, offering the only accredited certification in healthcare quality (CPHQ), along with extensive educational programming to prepare a coordinated, competent workforce.

Are There Specific Non-Compliance Laws for Healthcare Facilities?

In addition to federal regulatory organizations for healthcare facilities, there are also many regulations healthcare institutions must follow to remain compliant. While there are well-known acts such as the Social Security Act and Health Insurance Portability and Accountability Act (HIPAA), there are also specific regulations related to technology and financial requirements for healthcare facilities. Some of the major healthcare regulations institutions must follow include: 

• Health Information Technology for Economic and Clinical Health Act (HITECH) – used to expand HIPAA, HITECH promotes the adoption and meaningful use of health information technology, while ensuring the electronic transmission of health information is done securely and within HIPAA standards. 
•   Anti-Kickback Statute – this prohibits organizations and providers from receiving financial benefits from patient referrals if the federal government may be charged for part or all the cost of the services. This helps to prevent the influence of financial gain on medical treatment decisions by providers. 
• Physician Self-Referral Law (Stark Law) – this prevents physicians from referring patients with Medicare or Medicaid to a provider with whom the physician or member of the physician’s family has a financial relationship.

There are extremely tight regulations for physicians and other healthcare professionals to prevent an individual or group financial gain. With the complexities of insurance and the general concern from patients, healthcare professionals present a level of authority that must be used to better their interactions and support their patients, not distort their care plan for personal financial gain.

How Can You Prepare & Enact a Comprehensive Compliance Plan?

When improving or enacting your compliance plan, it is important to build a comprehensive strategy that your entire team can utilize to prevent any mishaps or miscommunication. Time, training, and continuous communication about the importance of compliance will eventually make compliance an integral part of your team’s daily tasks. 

Additionally, there are many other ways your team can prepare for compliance in the future, utilizing external resources provided by healthcare compliance corporations and entities. For example, the OIG provides a monthly Work Plan, which outlines audits and evaluations that may take place during the upcoming fiscal year. While your team should be well-versed in all areas of healthcare compliance, this will give you an idea of which areas you should touch upon for the upcoming quarters. Furthermore, your team should conduct internal threat analyses frequently to identify gaps in which you can improve, therefore avoiding potential compliance slip-ups. Thankfully, healthcare compliance software and the implementation of modern and secure technology can help alleviate compliance worries.

How Does Technology Improve Your Compliance Practices?

While implementing technology into your healthcare facility is surely an adjustment, the benefits facilities’ workflow solutions bring greatly outweigh the initial changes. First, facilities technology provides extensive historical and current data, which assists with compliance and potential liability. For example, consider you’re working in a lab setting and transferring samples across a healthcare campus. By utilizing software such as Intra, you can monitor every touchpoint for that package. If the samples are misplaced or altered, your team has a clear package history to protect you and identify where this issue may have occurred. 

Additionally, implementing a facilities workflow solution reduces human error and streamlines daily tasks that may otherwise hinder compliance. For large-scale facilities handling a significant number of files, assets, or materials, working with multiple single-solution software programs not only increases the time it takes to transfer information but increases the likelihood of reporting errors. Through Intra, our configurable workflows integrate with an extensive number of platforms to create an all-in-one, secure solution. 

See How SCLogic Can Improve Your Healthcare Compliance Practices

As a company whose mission is to continuously create the best facilities management software for our customers, we are extremely conscious of how important it is to develop configurable software for each industry we serve. With over twenty-five years of serving customers in the healthcare sector, we have remained deeply in tune with your changing needs. When you choose SCLogic, you are working with a passionate and knowledgeable small business that prioritizes relationships with each customer. As your team grows and new technology emerges, we’ll be right there to help guide your team to success. To learn more about how SCLogic can improve your compliance strategy, email [email protected] or schedule a demo with one of our team members today. We look forward to working with you!