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2022 was a significant year for the healthcare sector, with the most vulnerable number cyberattacks, amounting to over 700 publicly announced breaches. This paved the way for healthcare compliance standards like HITECH and HIPAA to be more widely adopted, which was crucial.
In order to prevent occurrences like data breaches and violations, healthcare compliance software basically assists hospitals and healthcare service providers in putting appropriate procedures into place and altering already-existing security controls.

By automating difficult compliance procedures, a healthcare compliance tool decreases manual labor and speeds up the compliance certification process. Risk assessment, incident response, training, audit tracking, evidence gathering, and reporting are a few examples of these actions. It also aids firms in adjusting to the frequent modifications in rules.
To help you manage your healthcare compliance needs, this article talks about healthcare compliance software, its importance, and how it can aid in hassle-free healthcare operations.

Understanding healthcare compliance software

Healthcare compliance software is a comprehensive collection of digital tools and systems created to assist healthcare organizations in adhering to a constantly evolving set of laws and regulations pertaining to healthcare compliance.

These regulations address a wide range of subjects, including pharmaceutical management (FDA), clinical documentation (CPT and ICD-10 coding), patient data protection (HIPAA), and many more. Healthcare businesses must be aware and in compliance with these standards because they are dynamic and ever-changing.

This technology increases operational efficiency, accuracy, and transparency while guaranteeing compliance with healthcare compliance laws. For healthcare organizations negotiating the intricate world of healthcare compliance, it is a vital tool. Among the regulations are the following examples:

HIPAA Regulatory Compliance:

Organizations are required under HIPAA to implement administrative, physical, and technical safeguards to securely handle patient data and restrict access to only those who are allowed. Patients can feel secure knowing that no unlawful use or unauthorized disclosure of their protected health information (PHI) will occur.

Data Security Regulations (PHI): 

TrustWave reported that on darknet sites, a single medical record is offered for $250. Thus, there is a need for healthcare compliance management software and data protection regulations that prioritize the security of protected health information.

Regulatory Compliance for FWA: 

Up-coding processes and billing for services that haven’t been used are just two instances of dishonest behavior. Organizations and payers must also put in place effective monitoring systems in order to promptly identify fraudulent activity and prevent these unlawful acts. It also means reporting any suspected fraudulent activity to the relevant authorities so they can look into it further.

OSHA Regulatory Compliance: 

One additional regulatory requirement that is essential to maintaining the health and safety of workers in a business is OSHA. This regulation mandates that businesses have appropriate ventilation systems, personal protective equipment (PPE), and training for OSHA compliance programs in order to handle hazardous products safely.

FDA, or Food and Drug Administration:

The FDA is in charge of medicines, medical supplies, and other products utilized by healthcare organizations. Making sure the aforementioned products are dependable, efficient, and beneficial to society is their main goal. The FDA also makes sure that these products are packaged and labeled accurately and clearly.

Why do companies need healthcare compliance software?

The primary role of healthcare compliance software is to help companies strengthen their policies and PHI handling procedures that directly impact the overall security posture. It does so by automating checks, streamlining workflows, and reducing human errors thereby helping them bypass steep fines and penalties.

Companies need healthcare compliance software to:

  •       Increase the effectiveness of the compliance program: As rules and laws get more complicated, compliance software can assist businesses in streamlining and streamlining their documentation and compliance processes. Conventional compliance methods leave room for human mistake. The technology used in healthcare compliance enhances operational efficiency by automating numerous of these processes.
    Increase patient privacy protection: Healthcare compliance solutions assist you in putting the appropriate safeguards in place to protect confidential patient data.

     This may entail offering guidance and keeping an eye on security measures related to physical security, encryption, and the management, transmission, and storage of medical records. Compliance involves more than just abiding by rules and laws; it also entails protecting patients’ welfare.

  •       Put in place a Zero-trust security model: Healthcare compliance software aids in the creation of strong access restrictions and the deployment of security measures. This lowers the possibility of breaches and unauthorized access by guaranteeing that only those with the necessary authorization can access critical healthcare data.

  • Promote a culture of security and trust: Healthcare compliance solutions demonstrate a dedication to compliance, which promotes confidence among investors and stakeholders. Additionally, you can implement a security-first policy for patient health information by using healthcare compliance software.

  • Cost-Reduction: It can be costly to disobey. Penalties such as high fines and court costs can quickly mount up. Businesses might potentially save a significant amount of money by investing in healthcare compliance software.

How alarming are statistics?

According to the 2023 Cost of a Data Breach Report, the average cost of a healthcare data breach was the highest among all industries at $10.93 million. Health and Human Services, in their breach report, stated that over 15 million records have been compromised by data breaches. Both reports conclude that the healthcare industry experiences more data breaches than other sectors.

2022 saw 4.1 million persons harmed by the largest healthcare data breach at OneTouchPoint, however, this number pales in comparison to the year’s major events. Oklahoma State University’s Center for Health Services received the most fine, having to pay $875,000 after its server was breached by criminal hackers. The figures above demonstrate the serious implications of non-compliance.

The corporations responsible for negligence must bear a heavy financial burden as authorities worldwide tighten up data safety acts. With ever-changing rules and regulations, it has become difficult for healthcare organizations to stay compliant.

How compliant is software safeguard?

Compliance software give protection to healthcare data in various layers:

Technical data protection measures

These include encryption, secure connections and protocols, and other application-specific safety best practices related to technology.

 Physical safeguards for data:

It is usually advised to restrict physical access to servers and other equipment that can store PHI or facilitate the exchange of sensitive data. In order to physically secure software, enterprises also need to have a good firewall and antivirus program in place.

 Administrative safeguards for the security of data:

Lastly, privacy policies and procedures, personnel management and training, notifications of privacy practices, and other actions are examples of administrative data protection.

Closing Thoughts

Concerns over the possibility of data breaches have grown along with the use of electronic health records (EHRs). Data security is now the most crucial component of regulatory compliance as a result. 

Governments all across the world have enacted laws requiring access controls, appropriate encryption, and training for staff members handling protected health information (PHI) in order to protect client data. You may keep compliance with popular standards and laws such as HIPAA by establishing a robust security posture with the aid of a healthcare compliance solution. Compliance efforts can be simplified and the efficiency of the entire process can be increased by selecting a complete compliance automation solution, such as those offered by Codewave EIT. 

Billing procedures are a critical area where regulatory compliance is essential. In the event that there is proof of fraudulent intent, fraudulent billing methods may result in serious financial fines for the providers or even criminal prosecution.
With Codewave EIT in charge, you can set your compliance program on autopilot and effortlessly comprehend and fulfill complicated compliance standards. through handling and automating repeated, complicated compliance processes.

If you want your healthcare organization to be compliant with regulations, feel free to talk to our executives. Stay updated in the landscape of healthcare industries building trust in patient data safety and security.