The healthcare industry has especially high stakes when it comes to risk management. The risks aren’t simply business- or reputation-related, though those are important. The most significant ones can be a matter of life or death. Patient safety is at the heart of every hospital’s risk management program and, because of this, a generic risk management information system (RMIS) may not be up to the challenge.
Hospitals and healthcare organizations may consider using a generic RMIS for a variety of reasons. Perhaps another part of the organization is already using one, so it seems simpler and cheaper to stick with the same system. Although using a single platform across an organization is typically a logical approach, given the healthcare industry’s uniquely critical needs, this approach may not cover the healthcare setting’s unique needs and thus can fail, adding more hassle, expense, time, and risk not only to your organization, but also to your patients.
In terms of both the software and the service team supporting that software, a dedicated healthcare risk management solution offers clear advantages over a generic RMIS. This gives healthcare organizations greater insight for staying on track and, ultimately, improving patient safety.
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A 2016 analysis published in BMJ revealed that medical error is the third-leading cause of death in the United States. This includes process errors, planning errors, and failures to act. Martin Makary, a health policy expert at Johns Hopkins and an author of the analysis, explains that the “complex medical system” in the U.S. “sometimes lacks transparency that results in the wide variation in quality of medical care that is the endemic problem in safety.” Makary also notes that “safety nets are missing and standardization is lacking.”
At the heart of this standardization problem lies outdated technology and confusing systems. Many healthcare providers continue to use lagging systems that don’t efficiently collect or analyze data. Furthermore, a mix of legacy and new systems makes for potential conflicts that add to the confusion and fortify workplace silos. Without the sharing of information, organizations fail to see big-picture strategies and solutions that could help prevent medical errors and increase patient safety.
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Data Breach Today offers predictions in What’s Ahead for Health Data Privacy, Security in 2019? While the article focuses primarily on health data, a few key trends apply more broadly and are likely to resonate with all types of organizations.
Prediction: Disruption from regulatory changes is likely
Rebecca Herold, author of 19 books on information security and CEO of The Privacy Professor consultancy, begins the list of predictions by examining the potential for agency updates to HIPAA. “Based on continued pressure from local, state and federal government agencies, law enforcement, researchers and others to ease the sharing of patient and mental health data by removing the need to obtain patient consent, I expect to see OCR issue proposed HIPAA updates,” she notes.
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Risk management in healthcare is a topic that is gaining increasing importance. A large driver of this attention is the shift from fee-for-service to value and outcome-based models. An article in the New England Journal of Medicine’s (NEJM) Catalyst blog notes, “For these reasons, hospitals and other healthcare systems are expanding their risk management programs from ones that are primarily reactive and promote patient safety and prevent legal exposure, to ones that are increasingly proactive and view risk through the much broader lens of the entire healthcare ecosystem.”
This demand for an expanded view of healthcare risks has fueled the demand for Enterprise Risk Management (ERM) solutions. The road to fully functional ERM programs, however, has proven to be a challenging one for most healthcare organizations. The NEJM Catalyst article cites a report from Healthcare Financial Management Association (HFMA) that states, “Despite the growing importance of programs today, and the raised awareness of their importance, many healthcare providers have been slow to adopt a more sophisticated approach… The current state for most providers falls between ‘basic’ and ‘evolving’ maturities for ERM programs.” … read more
Origami Risk’s 2018 User Conference, held last week, utilized a new format that not only placed a premium on client presentation of use cases, but also focused on digging into “how” presenters managed to implement their specific solutions. Listening to a diverse set of cases, several common trends emerged.
1. Transparency is key
Many of those presenting echoed the need to establish transparency and accountability in their processes. You can’t measure what you can’t see, and you can’t improve what you don’t measure. The most obvious culprits were paper-based procedures—everything from workplace safety “coaching cards,” to incident intake reports. Spreadsheet-centric workflows, such as data-heavy values collection efforts, also failed to identify the “who, what, when, and where” type of information required to make any process fully transparent.
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The pressure to do more with less is constant. But delaying an honest evaluation of your risk management information system (RMIS), while an understandable temptation, can lead to compressed timelines, rushed decisions, cost overruns, and additional grey hair.
Industry consolidation is forcing changes both good and bad. Regardless of whether you elect to stay with your current system or make a move, the worst-case scenario is to find yourself boxed in because you ran out of time.
There are a few critical factors a risk manager should take into account to ensure they are in the driver’s seat. Your time is limited, but your options don’t have to be.
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A flexible, intuitive interface. Software expertise combined with insurance and risk experience. A collaborative approach to implementation that’s different by design. When selecting a Risk Management Information System (RMIS) that meets your needs, each of these elements is important, but in today’s market, these are baseline requirements. The critical factor influencing the choice of a system should be the answer to the following question: Will this technology drive meaningful business results?
Measurable outcomes are what really matter. The right RMIS must prove capable of contributing to your team’s ability to more efficiently analyze risk and insurance data, prevent losses, control claim costs, streamline renewals, and reduce your organization’s total cost of risk. If it cannot, what’s the point?
For some examples of the impact that partnering with Origami Risk has had on the business results of a few of our clients, please read on.
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A major 2016 Workers’ Compensation benchmark study found that one of the largest differentiators of high-performers versus all other groups was the use of Evidence Based Medicine (EBM) guidelines. Users of EBM data were more than 4X more likely to be top performers than those who did not. The same study included a survey asking “What are the greatest obstacles to achieving desired claim outcomes?” Respondents ranked “Psychosocial/comorbidities” as the number one issue. … read more