The stakes in the healthcare industry couldn’t be higher. Not only does the financial health of your organization depend on effective risk management, but the physical and mental well-being of patients does, too. While a comprehensive risk management system empowers you to maintain profitability, it also gives you the operational mobility you need to deliver the kind of treatment your patients need and deserve.
However, risk management in the healthcare sector is complicated due to the sheer volume of data and the complex assortment of risks on the horizon. Integrated risk management (IRM) software simplifies your risk profile and streamlines decision-making processes. Here are five reasons why healthcare organizations should look into a risk management system.
Improve Patient Safety
You can reduce the number of medication errors, infections, diagnostic mistakes, and even patient data breaches with the right IRM software. Every risk event comes with helpful data, and you can use your IRM software to collect and analyze incident data—then reduce the chances of it happening in the future.
To illustrate, suppose your IRM software surfaces an interesting statistic when it comes to medication errors: More than 60% of the mistakes impact patients who get treatment for heart disease. By comparison, people served by the other departments have generally accurate prescriptions.
With this data, you don’t have to institute sweeping staff education or a new, expensive prescription management system across the board. You can first focus your efforts on the cardiac care unit (CCU). Once you start to see improvement—or the lack thereof—in that ward, you can make a data-based decision to implement more improvements.
Protect Profits
A healthcare organization has to manage complicated revenue cycles and billing systems, all while keeping an eye out for fraud, and IRM software simplifies this process.
Take revenue integrity and leakage as an example. It’s common for coding errors, insurance verification problems, and denied claims to chip away at a hospital’s profits. Using an integrated risk management system, you can identify which of these risks has the greatest chance of restricting your revenue stream and then take corrective action.
For instance, as the system tracks insurance verification issues, it may reveal that the majority of problems stem from patients brought into the emergency room during peak hours. This could be a result of the volume of patients billing specialists have to process, as opposed to a procedural issue within your system. So you may be able to mitigate this risk by having one or two additional billing specialists manage ER patients or double-checking the insurance verification process. In this way, integrated risk management software can diagnose hemorrhaging profits and provide an essential systematic suture.
Meet Compliance Standards
Whether it’s Medicare and Medicaid guidelines, HIPAA, GDPR, or another regulation, you can leverage IRM software to stay ahead of expensive regulatory hiccups. In many situations, complying with regulations involves managing data and making effective data-supported decisions. Often, the most important data is who has access to what, and IRM software can help you control this.
Take patient billing information as an example. According to HIPAA, you need to restrict access to this information as well as encrypt it. Also, if you get hit with an audit, you need to be able to prove you have the right data protection systems in place.
Using your IRM software, you can keep track of everyone who has access to patient billing data, as well as when they were granted permissions. You can also make sure you revoke access when necessary using data from HR regarding when employment has been terminated. In addition, you can set up a system that triggers an alert when someone needs to change their password or check which devices they’re using for two-factor authentication. And when it’s time to demonstrate compliance, you have the data within your IRM solution to show all the precautions you’re taking.
Safeguard Your Reputation
By using IRM software to reduce and mitigate risk, you enhance your reputation as a careful, thoughtful, and thorough healthcare organization. For instance, an IRM system enables you to reduce the frequency of:
- Medical coding errors
- Inaccurate patient information
- Accidents that happen in your facility
- Medical malpractice issues
Often, these kinds of problems can seep into the headlines or board meetings of key stakeholders. By systematically reducing them, you protect your reputation.
Reduce Insurance Premiums
Your insurance premiums are linked to your risk so using IRM software to reduce incidents can enable you to pay less each year. Typically, the insurance needs of one healthcare organization are different than those of others, based on the risks they have to cover. By systematically identifying and mitigating these risks, you can fine-tune your coverage so that you don’t pay for more than you need.
For instance, a hospital in southern California may have a very different climate-related risk profile when compared to a rural one in northern Vermont. The risk of snowstorms disabling power to the southern California facility is far less than it is for the Vermont campus.
At the same time, the risk of operational interruptions stemming from earthquakes may be much higher for the hospital in California.
By using IRM software to identify, track, and monitor unique risks, you can make strategic decisions that ensure you don’t overpay for unnecessary coverage—whether that’s for climate-related risks, those due to demographic differences, financial vulnerabilities, cyber threats, or other concerns.
Ventiv’s IRM software gives healthcare organizations a comprehensive risk management and mitigation tool. Because the IRM integrates data from across your operation, you can eliminate risk blind spots, better serve patients, and reduce insurance premiums—all while protecting your reputation and meeting compliance requirements. Chat with an expert to see how Ventiv’s IRM Solution is right for your organization.
