Why is Compliance Important in Healthcare?

Posted By Steve Alder on Jan 29, 2024

Compliance is important in healthcare because complying with the regulations that govern the healthcare industry can help avoid legal risks and penalties for non-compliance, protect the privacy and security of individually identifiable health information, and improve the quality and safety of patient care. In addition, demonstrating compliance with healthcare regulations can enhance the reputation of – and trust in – healthcare organizations and healthcare professionals.

Compliance in healthcare can mean different things to different people. For healthcare organizations, compliance can mean following the rules and regulations that apply to their operations. Depending on the nature of their operations, this can mean complying with (for example) HIPAA, OSHA, the Joint Commission standards, and the conditions of participation in Medicare. Most organizations also have to comply with local regulations relating to public health and emergency preparedness.

For members of organizations’ workforces, compliance in healthcare most often means complying with the organization’s policies and procedures. Although there are circumstances in which individuals can be personally liable for regulatory violations, in most cases the penalty for not complying with an organization’s policies and procedures is determined by the content of the organization’s sanctions policy (i.e., verbal/written warning, suspension, termination, etc.).

Compliance in healthcare is also important to patients. Not only are patients more likely to disclose confidential information about themselves when they feel the information will remain confidential – which can result in more accurate diagnoses and treatment plans, and better patient outcomes – but they are more likely to comply with treatment plans and therapies – resulting in less patient testing, fewer avoidable hospital visits, lower readmissions, and reduced costs for healthcare organizations.

However, although compliance in healthcare can means different things to different people, the benefits of compliance are connected. When a healthcare organization complies with regulations, it provides a safer, better educated workforce that can deliver a better standard of care to patients. When workforce members comply with organizational policies and procedures, it can reduce costs and better protect patient data, and when patients comply with their treatment plans and therapies, workforce morale and retention increases, further reducing costs for healthcare organizations.

Compliance for Healthcare Organizations

Compliance for healthcare organizations is complicated by the number of rules and regulations they have to comply with, the way regulations can overlap, and the frequency with which they can change. In larger organizations, compliance teams may be required to manage the volume of rules and regulations and the frequency with which they can change, while HR, legal, and IT teams may also be involved in developing policies and procedures and monitoring compliance with them.

Compliance for healthcare organizations is not only a legal obligation, but also a moral and ethical one. Healthcare organizations have a duty to uphold the standards of their profession and to act in the best interests of their patients. Complying with the applicable rules and regulations helps healthcare organizations deliver high-quality care that meets the needs and expectations of their patients, as well as the requirements of the law in order to avoid legal risks and penalties.

Why is Workforce Compliance Important in Healthcare?

Workforce compliance is important in healthcare because members of the workforce are the public face of healthcare organizations. By demonstrating an understanding of regulatory compliance and complying with the policies and procedures implemented by the healthcare organization, members of the workforce can build trust between patients and healthcare providers – which, not only benefits patients, but which can also result in increased workplace morale and job satisfaction.

Failing to comply with organizational policies can be professionally detrimental to workforce members. While minor violations of organizational policies and procedures might only result in a verbal warning or compliance retraining, serious or repeated violations can lead to sanctions that remain permanently on an employment record – or, in the worst cases, lead to suspension, termination of contract, and loss of license to practice.

Why is Patient Compliance Important in Healthcare?

Patient compliance, also known as medication adherence, is the degree to which patients follow the instructions of their healthcare providers. It is an important metric in the effectiveness of treatments, the prevention of complications, and the improvement of patient outcomes. However, patient compliance in healthcare is surprisingly low. According to the World Health Organization, only about 50% of patients in developed countries adhere to their prescribed therapies.

Improving patient compliance in healthcare requires a multifaceted approach that involves educating and counseling patients about their condition and treatment options, providing them with clear and simple instructions and reminders, and addressing their concerns and preferences. However, in order for this approach to work, it is necessary for patients to trust their healthcare providers – something that can be accomplished by organizational and workforce compliance in healthcare.

Improving Compliance in Healthcare

Compliance is not a one-time event, but an ongoing process that requires constant monitoring, evaluation, and improvement. Healthcare organizations need to have effective compliance programs that include policies, procedures, training, auditing, and reporting. Sanctions also need to be applied fairly and consistently. Compliance programs should be tailored to the needs and risks of each organization, and should be updated regularly to reflect the changes in the industry and to the law.

One way to improve compliance in healthcare is by deploying healthcare compliance software that can be customized for each organization’s compliance requirements. Solutions of this nature help organizations cope with multiple regulations, adapt to changing regulations, increase compliance efficiency, support growth and expansion, and improve patient outcomes. To find out if healthcare compliance software may be a solution for your organization, speak with a healthcare compliance expert.

Author: Steve Alder is the editor-in-chief of The HIPAA Journal. Steve is responsible for editorial policy regarding the topics covered in The HIPAA Journal. He is a specialist on healthcare industry legal and regulatory affairs, and has 10 years of experience writing about HIPAA and other related legal topics. Steve has developed a deep understanding of regulatory issues surrounding the use of information technology in the healthcare industry and has written hundreds of articles on HIPAA-related topics. Steve shapes the editorial policy of The HIPAA Journal, ensuring its comprehensive coverage of critical topics. Steve Alder is considered an authority in the healthcare industry on HIPAA. The HIPAA Journal has evolved into the leading independent authority on HIPAA under Steve’s editorial leadership. Steve manages a team of writers and is responsible for the factual and legal accuracy of all content published on The HIPAA Journal. Steve holds a Bachelor’s of Science degree from the University of Liverpool. You can connect with Steve via LinkedIn or email via stevealder(at)hipaajournal.com
Source: https://www.hipaajournal.com/why-is-compliance-important-in-healthcare/