Risk management in healthcare has especially high stakes. In addition to risks related to operations, finances, and reputation, healthcare organizations must consider those that can be a matter of life or death. Hospitals and health systems work tirelessly to ensure the health and safety of their patients. The right healthcare risk management software will help them achieve that goal.
No matter what an organization hopes to improve—from claims management to incident reporting to clinical rounding—an integrated healthcare risk management information system (RMIS) offers the right solutions for improving patient well-being and finding organization-wide success. Read more about the many aspects of risk management in healthcare.
- Patient Safety & Quality
- Claims & Insurance
- Healthcare Enterprise Risk Management (ERM)
Patient Safety & Quality
Medical error is the third-leading cause of death in the United States. This includes process errors, planning errors, and failures to act. With the right reporting and workflow tools, integrated healthcare risk management software eliminates human error and allows clinicians to work in lockstep to provide better patient care.
To effectively address adverse events and near misses, hospital risk managers need an informed understanding of what constitutes such incidents. This starts with having the technology to efficiently report them. Integrated data tools—such as data surveillance, patient safety event reporting, and enterprise-wide near miss/unsafe condition reporting—that contain simplified forms with clear instructions make data collection efficient and straightforward.
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Enterprise risk management (ERM) programs require focused planning and commitment from a range of stakeholders within an organization. However, even organizations with the best intentions can see ERM efforts fall to the wayside as more pressing day-to-day issues take precedence.
In the article Leveraging Technology To Drive Sustainable ERM Initiatives, Origami Risk’s Josh Newsum discusses the powerful role of risk management technology in keeping ERM initiatives on track, as well as how organizations can achieve the best results, regardless of where they are in the process.
Read the article in Risk Management →
As the hospital burnout crisis continues to make headlines, healthcare organizations are in need not only of solutions that address the consequences of burnout, but also strategies for preventing burnout in the first place. As discussed in part 1 of this series, the right healthcare risk management technology can play a role in efforts to ensure physicians are more fully engaged. Physicians who feel connected to the core purpose of their work are less likely to burn out, and more likely provide quality patient care.
Another approach to addressing clinician burnout is the establishment of an organization-wide plan to monitor, analyze, and, ultimately, prevent the condition from occurring. Efforts to mitigate burnout will likely come from many directions within an organization, but to streamline the process and get everyone on the same page, a logical but perhaps unexpected place to start is with the hospital risk management team. Healthcare risk managers can play a crucial role in successfully preventing burnout by viewing burnout like the other risks they manage, developing a healthcare enterprise risk management (ERM) framework, and leveraging the technology they already work with on a daily basis.
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Increased rates of accident severity. Rising claim costs. Insurance coverage that is either more expensive or harder to secure. As risk managers grapple with these and other fleet management challenges, measures such as a renewed focus on training and driver safety, an improved understanding of the cause of accidents that lead to claims, and the ability to pull together a complete and accurate list of fleet exposure values are essential components in reducing fleet-related costs.
Given the range of departments and the number of people typically involved in the management of fleet vehicles, implementing and measuring the efficacy of such initiatives is easier said than done. By extension, the number of software systems, spreadsheets, and paper-based processes an organization uses to capture and store fleet-related data can make it difficult to monitor progress, identify trends, and report on successes. By consolidating this data in a central location that is linked to claims, policies, certifications, training records, and more, a RMIS can help better manage the risks associated with a commercial fleet.
#1 A RMIS can consolidate all fleet vehicle data
Data silos are an all-too-common issue for many organizations. This can hold especially true for those with an extensive fleet of vehicles, whether owned or leased, that directly employ or contract with drivers.
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Those working in the healthcare industry are no strangers to constant change. A healthcare risk management program and the right technology can help to effectively monitor risk across specialties and improve patient safety. Origami Risk’s Bill Schwacke spoke to Future of Personal Health about the intersection of risk management and the healthcare industry.
Risk management software is used in various industries. How is it applied to healthcare?
Risk management software is at the center of a healthcare organization’s approach to risk, safety, claims, and insurance. The software can define the provider’s approach to risk by linking, organizing, and distributing data from independent, critical functions to provide an organizational view of risk.
Can you elaborate on the correlation between patient safety and risk management software?
Patient safety and risk management software are often linked due to the nature of the data involved. While they often work independently, there are insights that can be discovered when linked together. These insights can improve quality of care and reduce claims/insurance costs for the organization.
Read the full article in Future of Personal Health.
Workplace burnout has become so common across industries that, as of May 2019, the World Health Organization (WHO) recognizes it as an occupational phenomenon in its International Classification of Diseases Handbook.
In the healthcare industry, burnout is a reality and is described by those on the front line in alarming terms. According to a NEJM Catalyst survey Immunization Against Burnout, “83% of respondents — who are clinicians, clinical leaders, and health care executives — call physician burnout a ‘serious’ or ‘moderate’ problem in their organizations.” Based on survey results like these, a report titled A Crisis in Health Care: A Call to Action on Physician Burnout called physician burnout “a public health crisis.”
Burnout has reached crisis level for many reasons, including its prevalence and its effect on staff turnover. But it’s had unexpected consequences for patient care, as well. A JAMA Internal Medicine study concluded that physician burnout doubled the odds of an adverse patient safety event. According to the report, this includes “unsafe care, unprofessional behaviors, and low patient satisfaction.”
In the first part of a two-part series, we examine the main drivers of hospital staff burnout, its far-reaching consequences for healthcare organizations and patients, and how the right technology can play a key role in reducing its widespread nature.
Understanding burnout and its consequences
The WHO officially defines burnout as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
- feelings of energy depletion or exhaustion;
- increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
- reduced professional efficacy.”
Burnout affects clinicians on an individual level, delivering the mental and physical exhaustion mentioned above. Far from being only a staff issue, burnout has profound effects on hospitals and patients.
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CHICAGO—Origami Risk has been recognized as one of “Chicago’s Best and Brightest Companies to Work For®” by the National Association for Business Resources (NABR). The award marks the fourth consecutive year Origami Risk has been cited by NABR, including national honors and previous awards in Chicago and Atlanta. In gaining this recognition, Origami Risk now has earned over 20 workplace awards in recent years. The honors showcase its commitment to hire and retain the insurance industry’s top talent to provide the highest level of service to its customers.
“We’re honored to be recognized again by the National Association of Business Resources,” said Jon Nichols, chief operating officer, Origami Risk. “Our focus on delivering the highest quality of customer service has always depended on our ability to attract and retain the industry’s most talented people as well as to support them with the environment, tools and culture they need to be successful.”
According to NABR, only companies that distinguish themselves as having the most innovative and thoughtful human resources approach can be bestowed this honor. An independent research firm evaluates each company’s entry, based on key measures in various categories. They include: Compensation, Benefits and Employee Solutions; Employee Enrichment, Engagement and Retention; Employee Education and Development; Recruitment, Selection and Orientation; Employee Achievement and Recognition; Communication and Shared Vision; Diversity and Inclusion; Work-Life Balance; Community Initiatives; and Strategic Company Performance.
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The onboarding process can be challenging for both TPAs and their clients. Migrating data from one claims management system to another is often a difficult, resource-draining part of that process. Wesley White’s article 10 Data Migration Best Practices For Any Organization summarizes the extent of the challenge:
Migrating data to a new information management system from multiple sources is a complex and often headache-inducing undertaking. Data migration is often necessary to keep up with technological advancements and industry standards, but it requires great effort. Data from various storage areas—both onsite and in the cloud—must be evaluated, analyzed, cleaned up and organized before it can be combined and reconciled.
The right technology can help to reduce the tremendous burden that data migration places on new clients. It can also transform the onboarding process and showcase the unique insights, savings, and benefits your organization delivers. As White notes, “It doesn’t have to be as hard as you may think to get past these challenges and successfully migrate your data.”
Assisting with the pre-migration phase
Research from the independent research firm Bloor paints an ominous picture of data migration projects. Of these projects, 37% exceed budgets, 67% take longer than expected, and 84% fail to meet expectations. In Why do so many data migration projects end in disaster?, Colin Rickard, a data management director with Experian, is asked to explain the high failure rate. “Often there has just not been enough analysis done at the start, so you end up with a lot of data problems at the end,” he responds.
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When does maintaining an up-to-date library of workers’ compensation state forms become too great of a bureaucratic burden for your claims adjusters or administrative staff? The most straightforward response is this: The more states in which your organization handles workers’ comp claims, the greater the challenge of staying on top of form revisions and additions.
Time and resources could certainly be allocated to more important activities. In the International Risk Management Institute, Inc. (IRMI) article Workers Compensation Bureaucracy Drives Costs, Mark Walls and Kimberly George cite training and education as two such examples:
One of the goals of workers compensation regulations is to ensure that injured workers are paid benefits in a timely manner at the correct rate and that they have access to appropriate medical treatment,” write Walls and George. “There was a time when payers had offices located in most states with adjusters handling only that state. Now, with most payers utilizing multistate adjusters, payers must be constantly training and educating their adjusters to ensure that they understand all of the nuisances of the different states that they handle.
For organizations looking to reduce the bureaucratic burdens their adjusters face, Origami Compliance offers a secure, API-based solution that integrates with any claims management system to provide immediate access to a single-source, up-to-date library of state and federal workers’ comp claim forms. Without leaving the claims system, an adjuster can quickly find the right form based on state or category. And when that form is selected, form fields automatically populate with claim data and a PDF version is generated.
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Risk assessments and heat maps remain central components in most enterprise risk management (ERM) programs. Yet there is considerable debate about their effectiveness and both tools have no shortage of critics. In 2011 Howard Sklar, a Forbes contributor, outlined one of the most popular criticisms regarding companies that viewed risk assessments as a document instead of a risk management process. He noted, “Companies that fail in this way are often trying to check the risk-assessment box on their program. That’s fine, as far as it goes. At first glance, a risk assessment seems like a low-ROI effort. You put in time and potentially money, and you get back a piece of paper laying out what you already know.”
Similarly, others deride heat maps as nothing more than “colorful guesses.” Brian Priezkalns, in the not-too-subtly titled article, Why I hate Heat Maps, says “Heat maps are just a terrible terrible terrible way to understand, communicate about, and decide how to respond to risks. They either mess up what you already knew, or they hide the fact you are too ignorant to make a rational decision. Everything that can be done with heat maps would be done better with actual numbers.”
If these tools have such fierce critics, then why are they still central to most ERM programs? In this article, we’ll examine what drives the limitations, and the key missing ingredient that turns them into powerful assets. … read more