Healthcare risk management software: One size does not fit all

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.

Service

A generic RMIS vendor will have a steep learning curve

The healthcare environment, unlike other risk management environments, must fit within a clearly defined framework, making it particularly challenging for a generic RMIS to measure up. Without previous knowledge of the healthcare industry, service team members familiar only with a generic RMIS will need to play catch-up. Most likely, this education process will fall to you and your team. Explaining the ins and outs of the healthcare industry and its specific processes—not to mention how that all ties into a risk management program—takes an incredible amount of time and energy, both of which could be spent on organizational strategy and improving patient safety.

One can draw parallels between this and service team turnover. As the article A stranger is calling — The impact of RMIS service team turnover points out, you may be “forced into a position of reeducating new members of the service team on both the hows and the whys.” And if issues crop up down the road, you may find yourself “investing an inordinate amount of time and energy helping these newer team members figure out where things went wrong.” In short, you’ll be tasked with additional work and receive less support.

A healthcare risk management service team offers tailored support

A service team with specific healthcare experience offers essential benefits from implementation on. They will know best practices to follow when implementing a RMIS for use in a healthcare setting. They’ll also be familiar with the other software and functionalities you may already be using daily—such as electronic medical records (EMR), HL7 compliance, patient look-up, and medication formulary look-up. Both will contribute to a more seamless integration and better ongoing support.

The right healthcare risk management service team will also be familiar with your more granular healthcare needs and solutions. They will understand patient safety incidents, which are quite different from employee safety incidents or location safety incidents. They’ll also be up-to-date on rapidly changing healthcare laws and trends. All of this ensures they will have the appropriate expertise to select the optimal solutions that address your real-world challenges and allow for continued growth.

Product design and functionality

A generic RMIS reacts to risk

Most RMIS platforms aren’t designed with healthcare in mind, nor does healthcare factor into long-term development plans. This may mean that key trends in the industry get overlooked and functionality related to those trends gets placed on the backburner. The stakes are too high for this.

Without healthcare-specific incident reporting and data collection, hospitals and other organizations may fail to meet compliance demands, compromise patient health and safety, and jeopardize their own reputation and financial standing. As the article The Importance of Healthcare Risk Management points out, a lack of proper oversight could lead down the path to a malpractice crisis similar to that of the early 2000s, a time when “[h]ospitals were being hit with higher settlements and more plaintiff verdicts. This led to higher insurance rates and decreased availability of some specialties.”

Even if a generic RMIS has the ability to make adjustments for specific healthcare risk management needs, such updates could be time-intensive and expensive. The ever-changing nature of the healthcare industry means that time for updates and adjustments is in short supply. Building every functionality from the ground up is ineffective and doesn’t allow for the platform to scale as quickly as an organization requires.

Finally, as discussed in the article In a RMIS, the details matter, “Some software companies focus on massive end-of-year updates so they don’t have to push major feature releases and functionality upgrades into the following year. This makes for a nice ‘wow’ factor but compromises prioritization.” These annual updates also serve a large customer base, therefore remaining a primary focus for a generic RMIS software company. This inevitably takes resources away from developing the unique solutions needed for healthcare risk management.

Healthcare risk management software answers specific needs and helps manage risk

The right healthcare risk management solution will feature solutions and a workflow tailored to the healthcare industry and your organization’s challenges. This includes:

Flexible functionalities and processes. Healthcare risk management software should be able to replicate your workflow process, not force you to work within the product’s preconfigured workflow. A true healthcare risk management system will include functionalities like patient safety event reporting that can be accessed from any device, and claims that can include multiple defendants. Although all healthcare companies may share similar goals, your organization will have its own processes, and procedures. A flexible healthcare risk management information system like Origami Risk will allow you to set up rules specific to your needs, based on your existing workflows, that will trigger automatic notifications when an incident is reported from a particular location or reaches a certain severity level, ensuring the appropriate parties are kept informed and held accountable for taking steps to address it.

Root cause analysis. As discussed in 5 ways healthcare risk management improves patient safety, when healthcare risk management software simplifies data collection and puts automation into place:

“[Hospital risk management] staff are freed up to look deeper and focus on trends in order to make better strategic decisions for improved patient quality. The Prometheus Research article 10 Healthcare Quality Improvement Trends You Can’t Ignore states, “With the help of big data and smart analytics, we are at a point in healthcare [where] we can make a near-certain prediction about possible complications a patient can face, their possible re-admission, and the outcomes of a care plan devised for them.”

Healthcare risk management software should take over administrative burdens associated with costly RCA processes and provide tools that allow you to turn data into insight. Origami Risk leverages the following root-cause methodologies to help make better strategic decisions and enhance your quality programs:

  • Fishbone: a visual display of contributing factors, broken down by category
  • RCA2: the Root Cause Analysis and Action method seeks to “understand what happened, why it happened, and what needs to be done to correct the problem, and then to take positive action to prevent it from happening again,” according to RCA2: Improving Root Cause Analyses and Actions to Prevent Harm
  • 5 Whys: this technique explores the cause-and-effect relationships underlying a particular problem.

Healthcare insurance management. A healthcare risk management solution should be able to manage all facets of the industry’s complex insurance requirements. As employed physician insurance becomes increasingly complicated due to an influx of hospital mergers and acquisitions, you’ll likely need a system with:

  • consistent and easy-to-manage patient safety event reporting
  • smooth claims processing
  • straightforward document management

Origami Risk features seamless batch uploading, keyword searching, organization-wide accessibility, and quick document retrieval. As a bonus, simplified document management makes patients happier, too.

Healthcare compliance. Healthcare risk management software—backed by a team of healthcare experts–must keep up with the industry’s complex web of compliance standards and laws. Origami Risk is compliant with HL7, a set of international standards “for the exchange, integration, sharing, and retrieval of electronic health information.” Origami also has a deep understanding of the American Society for Healthcare Risk Management’s (ASHRM) eight risk domains, which helps inform and guide enterprise risk management (ERM) within an organization.

Origami Risk offers industry-leading software with exceptional, healthcare-specific service

Built-in healthcare specific solutions like industry standards coupled with flexibility for long-term growth, Origami Risk’s cloud-based healthcare risk management software is equipped to handle the unique realities of the industry. Our team of healthcare risk management experts will guide your organization from implementation on, providing tailored insight into how to best leverage the system for your organization’s challenges and goals.

Contact us below to get in touch with our healthcare team.