The Role of Risk Assessment and Compliance in Healthcare Organizations

May 8, 2023 · READ

As a professional focused on risk management and compliance in healthcare, we can’t understate your job’s day-to-day frustrations and complexity. You’re tasked with navigating federal and state or provincial mandates, implementing new technologies, and protecting sensitive patient data while keeping your patients safe and your organization compliant and operating smoothly. It’s a daunting task, but it’s crucial to your healthcare organization’s success.

As is the case with most industries across the board, healthcare organizations are integrating new technology and solutions rapidly. Tools such as electronic health records are quickly becoming commonplace, partly because federal mandates strongly encourage healthcare providers to integrate these systems but also because several studies have found these solutions to be genuinely valuable. The potential benefits of smart technologies for healthcare include improved patient outcomes, reduced healthcare costs, and increased access to healthcare services.

In this article, we’ll explore the risks that healthcare organizations face in light of the rapid pace of technological change. We’ll look at the benefits of electronic health records and other new tools and the risks of storing more patient information digitally. We’ll discuss how compliance in healthcare is a crucial factor in navigating these risks, and how failure to comply with regulations can result in significant fines, regulatory pressure, and corrective action. We’ll also explore how practical risk assessment and healthcare compliance efforts can help organizations improve their operations and thrive in the modern healthcare environment. So, let’s dive in!

What is compliance in healthcare, and why is it important?

Compliance in healthcare is defined as the act of following rules, regulations, and standards set forth by governing bodies, such as federal and state/provincial agencies, to ensure patient safety, protect sensitive patient data, and avoid legal and financial consequences. The importance of compliance in healthcare lies in ensuring patient safety (through regulations and frameworks such as HIPAA), reducing risks and errors, improving outcomes, protecting healthcare organizations from legal and financial consequences, and promoting a culture of transparency, accountability, and ethical behavior.  

Electronic health records are just the tip of the iceberg, with everything from mobile devices to new communication tools completely transforming healthcare operations. Doctors are better equipped than ever to perform their jobs better and do so with greater transparency and fewer redundancies due to better coordination with other healthcare providers. The increasing prevalence of digital healthcare technologies is driving a shift towards a more personalized, proactive, and patient-centric approach to care.

Still, healthcare organizations face a number of new risks. While new technology can significantly improve operations, it can also lead to unrealized threats. For example, the more patient information that’s stored digitally means, the more data that unauthorized individuals could access, whether it’s a cybercriminal who steals passwords or simply nosey staff members who abuses their power to look at sensitive records. As we continue to innovate and modernize healthcare through technology, healthcare compliance teams will also need practical solutions to address new regulatory challenges associated with adopting AI and robotics.  

Compliance is also a huge factor because of all the federal mandates that necessitate healthcare organizations to integrate new technologies and take other actions. Noncompliance with regulations could result in significant fines, more pressure from regulatory agencies, and other corrective action. To avoid these risks, it’s important to understand the compliance landscape and take steps to ensure that your organization is compliant. The bottom line is that risk assessment and compliance efforts are crucial to success in the modern healthcare environment.

Risk management vs.  compliance in modern healthcare

As McKnight columnist Rebecca Lowell notes, although corporate compliance and risk management are two different practices, they are tied together in a number of ways and are both necessary for success in the healthcare setting.

Effective risk management and compliance efforts both help healthcare providers identify potential problems and existing obstacles, develop protocols for investigating the failure of various controls and programs and come up with potential solutions that may correct the problem. With both risk management and compliance efforts, failure can also have a disastrous effect on the organization.

“With so many potential risks, it is incumbent upon health care providers to create an evaluation and auditing system that analyzes both subjective and objective data,” Lowell explains. “This data may be gleaned from a wide variety of sources, such as admissions records … state and/or federal survey results, patient and visitor satisfaction surveys, employee exit interviews and individual incidents.”

“Trends will emerge by analyzing this information over a period of time, and these trends will provide further clues as to where problems or potential problems exist,” Lowell adds.

With healthcare providers facing more threats and compliance issues than in the past, it’s crucial that these organizations prioritize their risk assessment and management efforts. This can go a long way in helping them improve operations, even despite regulatory burdens.

What is the role of risk assessment in healthcare compliance management?

Risk assessment is a critical component of healthcare compliance management as it helps identify potential risks to patient safety, data privacy, financial stability, and regulatory compliance within the organization. By conducting regular risk assessments, healthcare organizations can identify areas of vulnerability, prioritize their resources, and implement mitigation strategies to reduce the likelihood and impact of adverse events.

In identifying potential problems and existing obstacles, healthcare providers can develop protocols for investigating the failure of various controls and programs and come up with potential solutions that may correct the problem. Effective risk assessment can also help organizations comply with regulations and guidelines, promote a culture of safety and accountability, and ultimately improve the quality of care and patient outcomes.

How to Run a Successful Risk Assessment Workshop Read Now

How Resolver helps organizations simplify compliance in healthcare

Resolver’s Compliance Management software applications can provide your healthcare organization with an effective solution to manage both IT and regulatory compliance by reducing operating costs, simplifying the tracking of regulatory changes, increasing efficiency and agility through automation, and promoting collaboration and a centralized repository for risks related to regulatory requirements and controls. By investing in compliance management, organizations can also build better public relations and increase stakeholder confidence while being viewed more favorably by regulators.

To see how it works in action, book a custom demo to see how Resolver can meet your healthcare compliance needs.

Resolver healthcare customer case studies:


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