Minimize Risk in HIPAA Compliance with IDP

Most Common HIPAA Violations To Know

By Susheel John, CMO of ibml 

The normalization of telehealth, lingering concerns about the COVID-19 virus, and a shortage of hospital staff have all led to a uniquely challenging time in healthcare. 

Alongside these challenges comes all the paperwork and processing systems necessary to make the industry run smoothly. Document processing in healthcare is challenging. The necessity and amount of documentation coupled with a lack of streamlining across hospital systems creates significant complexity. 

On top of needing secure databases to store personal identification data and private medical information, the healthcare industry needs updated methods for gathering that data. Many hospital systems still use physical paperwork that is eventually stored in digital systems. And this process of converting physical paperwork into digital information is time-consuming and leaves significant room for human error. 

In 2021, the global investment in healthcare innovation doubled to $44 billion. In the same year, nearly 80% of healthcare providers in the US said they were planning to invest in digital health and artificial intelligence tools to support staff and caregivers over the next five years. 

But not all tech is created equal, and healthcare professionals must prioritize a few specific things when evaluating document processing technology for their organizations. 

Enhance Patient Care and Administrative Outcomes

When looking for intelligent document processing (IDP) solutions, selecting a system that will ultimately benefit your patients is essential. Through IDP, patients’ information from documents is accurately and quickly transcribed into an Electronic Health Records (EHR) system, which providers can access faster and at any time. This information can help providers make better-informed decisions, leading to better diagnoses and patient care. It also helps reduce the duplicative paperwork patients are asked to fill out, from appointment to appointment. 

In a 2019 survey of health leaders, the Medical Group Management Association (MGMA) found that 89% of their organizations still use fax machines for everyday tasks, such as sending and receiving referrals, sharing records with other providers, and communicating test or lab results. Critical patient information from these faxes needs to be transcribed to the EHR systems, and confidential Personal Health Information (PHI) is unsecured in faxes. With that much manual data entry, the margin for error increases significantly. And an error in patient records can be costly for the patient’s health due to inaccuracy of treatment and the organization’s reputation due to potential HIPAA violations. 

Implementing digital access to records and document sorting means that hospitals and medical offices alike will have better-organized systems, which relieves some administrative burden as well. Allowing health care administrative staff and caregivers more time to focus on patient care ensures better patient outcomes.

IDP and HIPAA Compliance

Insurance providers, TPAs, PBMs, insurance brokers, and agents are obsessed with HIPAA compliance, as penalties for non-compliance can be substantial. Claims processing is worrisome for these parties because claims can include a lot of personal health information. All of this electronic PHI being stored in and moving across various networks to third parties is subject to HIPAA. 

HIPAA violations are a potential threat for small- and medium-sized businesses that support healthcare providers and the health insurance industry. And with claims surging 3.5 times over in 2021, there is more opportunity for error than ever before. To identify and flag a document or recorded communication that contains PHI requires detailed attention to the 18 unique identifiers of PHI, and then this data must be safeguarded and handled according to HIPAA requirements. To do this manually is not only inefficient but, again, leaves vast potential for human error.

A good intelligent document processing system enables insurance carriers (and the business process outsourcing providers that serve them) to automate the classification and recognition of documents and data fields that contain PHI information using Artificial Intelligence (AI) technologies. AI-powered Redaction can also identify critical PHI info and redact the data from documents before exchanging documents with different parties involved in claim processes. It also provides secure access to the right people at the right time over a secure cloud and on-prem systems, which decreases the risks associated with handling sensitive information manually and better complies with regulatory mandates like HIPPA. Additionally, it helps increase profitability, reduce risk and enhance responsiveness to customers.

The Healthcare Automation Market 

Healthcare automation—or the process of increasing efficiency and accuracy in day-to-day medical activities by employing software, robotics, or wearable technologies—is only set to rise in the coming years. In 2021, the global artificial intelligence in healthcare market was valued at $10.4 billion—and it is expected to grow at a compound annual growth rate of 38.4% from 2022 through 2030. McKinsey predicts that as much as half of current work activities across industries will be automated by 2055. 

Every aspect of healthcare delivery is influenced by this automation—patient registration, details about treatment and procedures, payment paperwork, and more. After the chaos that the global pandemic brought upon the healthcare industry, many are increasing automation and investing in healthcare technologies that will help alleviate some of the burdens on health workers. 

An effective intelligent document processing and capture solution allows providers to automate unstructured data to glean better insights, lower administrative costs, improve customer service, lower the risk of error, speed up auditing and reporting, and more. You can’t afford to use outdated methods and tech in a field that has massive impacts on everyone. Integrating effective IDP is the way forward.

About Susheel

Susheel John is the VP of marketing and strategy for ibml. He has over 25 years of global experience in the intelligent information capture solution industry. Prior to joining ibml in 2018, he spent 22 years at Kodak-Alaris and Kodak Ltd as Managing Director of Asia Pacific Region and leading Product Management. Susheel has worked with a diverse client base spread across multiple countries globally and built strong businesses in his career. His diverse experiences have help build an immense wealth of knowledge in solving customer problems relative to information capture. Susheel is a thought leader and speaker at industry events. Susheel is a self-motivated senior executive with demonstrated success in both tactical and strategic roles. He is passionate about building successful, sustainable, and profitable businesses.