From compliance personnel to compliance tech

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Jesse Wood
Jesse Wood

Business process management systems are playing a shining new role in healthcare situations, especially for compliance officers and personnel. These platforms are giving large and small healthcare providers an opportunity to improve their patient outcomes and overall revenues while still meeting the rigorous standards set by the industry and the government.

Today, business process management guides the use of data and analytics, overall company workflows, software integration, and the rules that govern access to and dissemination of information to practitioners, patients, families, and other members of healthcare teams.

We see the inclusion of BPM in healthcare as part of the paradigm shift that necessitates new protections in the digital realm. These start with document management software and other platforms that incorporate automation to reduce human error and allow information to stick to strict governance and compliance rules.

Everything is changing, and healthcare is one area that must get everything right whenever possible.

Using BPM in healthcare

Healthcare organizations are perhaps the most process-driven service the average person will interact with this year. They're also the business that will likely have the most difficulty and requirements in order to remain compliant with state and federal regulations.

BPM can help the healthcare industry seek out and reduce errors, improve revenues, and deliver improved patient care outcomes. Rolled up in all of that are regulations around data and documentation, such as file formats and integration needs, which can be answered with document management software.

BPM is designed to improve data-intensive processes that are often the jobs of compliance officers. Structured and dynamic operations managed by BPM add great value to the overall healthcare process by combining individual talent with process automation rules and easy support to execute validated next steps.

For example, BPM impact areas include activities in claims processing, where compliance and reporting are extremely strict. Deploying BPM that works with document management software can ensure claims teams follow all of the right guidance, and the automation software generates required documents as teams move through each step.

Claims get processed more efficiently and appeals are monitored and recorded appropriately. Everything is placed into the right form and the right section—all of which is collated together and saved—through automation in the DMS.

Big data and big teamwork

Compliance officers are now part of every single team a company has, making a significant paradigm shift as their roles move from interactions to technologies. Big data and analytics are allowing major healthcare players to analyze more customer information for sales, marketing, retention, relationship management, and product expansion, all on top of improvements for outcomes.

Technologies that track patient information are playing a larger role in every aspect of business, but this data is extremely sensitive in healthcare situations. That means compliance officers and techniques are required to touch each business unit and can't be left to just those trained with a pure compliance background.

Technology is forcing teamwork — which works well for the future of compliance — but it can make the transition difficult for teams just now looking into analytics and compliance platforms. That's why it is recommended to bring a document management software platform into BPM, creating redundancies to improve protections.

What's next for compliance

Compliance officers started to see a spike in hiring and demand in 2012, according to the Wall Street Journal, spurred by significant increases in fines and penalties. The demand coincided with a swift upshot in salary rates as well.

This rise that came some four years ago has created a unique situation for us today. Now, the demand for compliance offers still outstrips the supply. That means companies are hiring whenever possible and are looking at consultation services to meet their needs in order to avoid problems and often prevent fraud.

The other change impacting the future of compliance is that the high demand has caused people to look for creative solutions, often turning to tech and automation. Automated technologies such as DMS simplify document creation and tracking, allowing risk and compliance activities to be undertaken by people in other roles such as Chief Technology Officers.

These technology-focused roles are incorporating compliance into their realms because software can do much of the checking that's required. This means a compliance officer may be part of an overall technology team and would reduce compliance-specific roles in favor of technological checks and improvements at even large healthcare organizations.

Technology is creating a paradigm shift because the document management software and other business process management practices are growing roles and capabilities. Every employee is working in tandem with technology, not just compliance, and that means there are more opportunities to automate rules and systems that keep everything appropriate in any situation.

Jesse Wood is the CEO of Lehi, Utah based eFileCabinet Inc

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