Summary
In a short span, healthcare compliance mandates have transformed into a sophisticated web of regulations. Initiatives such as HIPAA and HITECH were key initiatives that helped curb disparities by encouraging the adoption of electronic health records and implementing outcome-based clinical standards. With COVID-19 sweeping across the socio-economic landscape, healthcare compliance mandates are no longer an afterthought but have become the norm. It has therefore become the responsibility of healthcare leaders to be transparent and find the right balance between compliance and innovation to progress responsibly in a post-COVID world.
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What started out as efforts to curb Medicare and Medicaid fraud, has transformed into a sophisticated and comprehensive web of regulations that spans the entire healthcare ecosystem. The compliance-inspired evolution isn’t just subjected to technology. In essence, it’s more related to changing workflows, service designs, clinical processes, and the way healthcare institutions function.
Taking all this into consideration here’s how compliance mandates have evolved for the better.
Changes to Compliance Mandates – And Its Influences
If you were to ask healthcare professionals about the compliance mandates that brought about significant changes to the way their institutions function, they’d attribute it to initiatives like Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH). In 2009, when HITECH came into play, healthcare entities were mandated to focus on “improved patient care.” HITECH sought to curb disparities and bridge gaps by encouraging the adoption of electronic health records and implementing outcome-based clinical standards.
This spurred the implementation of electronic health records (EHRs) that contained patient-level operational data. Suddenly, healthcare entities could now analyze datasets and share information at a level that enhanced decision-making. The implications were broad, with systems and software providers expanding their offerings to support the new standards. But more so, HITECH heralded the era of accountability. Almost every regulatory body sought to regulate the security of health records in the wake of new-found digital applications.
The COVID-19 Impact
Nothing matches the widespread disruption that the COVID outbreak caused. Telehealth, among other new technologies, was thrust into the spotlight. A study by the US’s HHS reported a 63-fold increase in the number of visitors accessing health care remotely – all while the sector was on the heightened alert for deadly coronavirus throughout 2021.
In the past two years, regulations have been highly volatile, and stakeholders across the ecosystem were forced to re-examine their processes and assess how they can function to achieve favorable outcomes amidst such a calamity. For instance, the Centers for Medicare and Medicaid Services (CMS) provided “blanket waivers” and had to redefine the criteria for individual waivers. Likewise, the US Food and Drug Administration (FDA) revised its regulations to better accommodate the unique nature of product exchange during the pandemic-imposed restrictions and the ever-looming danger.
Now healthcare compliance mandates are no longer an afterthought but have become the norm. They have evolved with the socio-economic landscape, the growing technological adeptness, and finally due to the increasing body of evidence and research.
Lessons for CEOs, CIOs, and Compliance Officers
It is the responsibility of leaders across the healthcare delivery sector as well as the healthcare technology sector to take up the mantle of transparency. In the post-COVID world, it’s become essential to zealously seek ways to innovate, and optimize processes and technologies that can help healthcare organizations through their transformation journey. And more importantly, it’s necessary to do so without overlooking compliance directives. As for the upcoming products and solutions, it’s good to keep an eye out and begin testing them as soon as the technology is ready. After all, being compliant is not a zero-sum game. One must find the right balance between compliance and innovation to progress responsibly.
Drop us a line, and let’s discuss that balance around innovating, ideating, and experimenting with the latest and greatest technologies in healthcare coming your way.