Editor’s note: Halina explains the essence of compliance with health software and lists the data security measures that help achieve this, such as controlling access to data, security audit of infrastructure, and more. If you need guidance on compliance with your healthcare organization or want to implement safe and compatible medical software, you can contact the ScienceSoft team to healthcare IT consulting.
At the federal level, organizations such as the Occupational Health and Safety Administration (OSHA), Department of Health and Human Services (HHS) i Office of the Inspector General (OIG) oversee compliance by health care providers with relevant rules and regulations. The HHS Office of Civil Rights enforces the Law of portability and liability of medical insurance (HIPAA). Title II of this law describes the policies and procedures for maintaining the privacy and security of personal information of patients and medical personnel by the health care provider and affiliated business entities. Sanctions for violating information security in organizations operating in the medical industry rank from $ 100 for “unintentional infraction” to $ 1.5 million for “willful negligence”.
At the health organization level, a board of directors usually creates a dedicated compliance committee or hires a health compliance officer to oversee compliance. The role of these professionals is to ensure that the healthcare organization conducts its business in full compliance with state and federal laws and regulations applicable to the medical industry, as well as the organization’s internal standards. The general need for compliance agents is anticipated grow up more than 8% between 2016 and 2026.
Compliance by healthcare organizations extends to all peripheral elements of patient care delivery, such as medical billing, reimbursement, and so on. Let’s look at some of these elements in more detail.
It is estimated that $ 2.6 billion loss was attributed to fraud and health abuse only during fiscal year 2019. And that doesn’t just refer to billing for services not provided: recoveries also include billing for mutually exclusive services, medically unnecessary services, and so on. The compliance committee must ensure that the healthcare provider does not violate the False Claims Act and facilitate the establishment of trusted billing protocols.
Healthcare organizations often establish partnerships with health compensation centers that check that medical claims are correct before sending them to insurance companies. Because health information centers deal with IHP, they should also act in accordance with HIPAA regulation.
During the reimbursement procedure, an error may lead to the disclosure of patients’ personal data to third parties. For example, a few years ago in New York, more than 500 people were affected by the misuse of theirs Protected health information (PHI). The health insurance subcontractor had a software error that caused rejection letters (including people’s names, addresses, diagnoses, etc.) to send to the wrong patients.
The software used by healthcare organizations must provide data encryption capabilities to prevent unauthorized parties from altering, destroying, or exploiting sensitive information. It is important to note that data encryption peacefully can reduce the performance of a healthcare application. The solution to this problem is file-level and block-level encryption. Data encryption in transit it does not affect the performance of the application so that users notice it.
Restricting access to medical applications by the “roles” of users (e.g., administrator, patient, physician) helps protect the personal data of patients and medical staff from access by unauthorized users. Among the measures to control access for patients and medical staff, different access rights can be applied: access of each user to the application with full or limited right to read, modify, delete information, etc. User authentication helps secure a person’s identity before giving them or their ePHI access (using passwords, login codes sent to smartphones, etc.).
To ensure the security of medical applications, IT infrastructure, and all data transmitted and stored, a healthcare organization should plan and conduct periodic vulnerability assessments and penetration testing of relevant IT infrastructure components and software.
While implementing healthcare software, the healthcare organization must develop policies and procedures to protect ePHI from alteration or destruction. It will help ensure data integrity and patient safety.
During the transmission of ePHI over an electronic communications network, third parties should remain inaccessible. To protect data from unauthorized access, it must be transmitted over a secure protocol and over a secure network connection.
Ensure compliance with your healthcare organization
Failure to comply with regulatory requirements can result in heavy penalties for a healthcare organization and undermine the trust of its customers. If you need professional assistance in any aspect of HIPAA-compliant software development and implementation, you can turn to ScienceSoft. healthcare IT consultants.