The healthcare sector is complex and always shifting. It is currently grappling with growing concerns about compliance, new approaches to medical insurance, and new technologies, which effect everything from how we keep track of patients and protect patient data to diagnostics. For this reason, whether you are a medical secretary, medical technician, nurse or doctor, ongoing workplace training is critical. Indeed, in a sector where the consequences of making mistakes is always high, training must be a priority. In today’s post, we look at the top three challenges currently facing people who work in the healthcare sector and discuss how learning management systems can be used to deliver the critical training needed to respond to these challenges in an effective manner.
Challenge 1: HIPAA Compliance
While few practices are ever audited for HIPAA (Health Insurance Portability and Accountability ACT) violations, it is nevertheless essential to follow HIPPA’s complex regulations. These regulations are designed to ensure that the security of healthcare information (e.g., confidential patient records) is never compromised, but mistakes do happen. Between 2009 and 2013 alone, an estimated 800 data breaches compromised the information of 29 million patient records in HIPAA-related violations. What are the consequences of a HIPAA violation? Fines range from a mere $100 to a high of $50,000 (with annual caps at $1.5 million). Of course, when the security of patient data is breached, fines are not the only consequence—medical practitioners also risk losing the trust of their patients.
When it comes to HIPAA, not surprisingly, the major challenge facing healthcare providers regards electronic data. After all, today, most medical records are electronic (and in some offices, exist on paper and in electronic form). While it may be easy enough to develop a firewall to ensure the security of online patient records, dealing with the presence of mobile devices and social media in the workplace raises an entirely different set of problems and ambiguities. Indeed, mobile devices in particular can pose major threats to patient data security. For example, since nearly every cell phone now has video and audio-recording functions, there is a constant risk that confidential information (conversations between doctors and patients) can be recorded, hence compromising patient data. But employees who use social media platforms at work may also violate HIPAA rules without even realizing they are in violation. If a receptionist snaps a picture of “Mrs. D” on her phone and then tweets the photograph with the caption, “Mrs. D turned 100 today and is doing great!!!”, the receptionist has committed a HIPAA violation. Likewise, if a practice employee snaps a picture of their quinoa salad and it happens to be on top of a patient file and they subsequently circulate the picture of the salad (along with any partial data visible from the file), they are in violation of HIPAA.
- Ensure all new employees in the practice (from cleaning staff to doctors) undergo extensive training in HIPAA.
- Require employees to participate in refresher training on HIPAA at least once every 12 months; use a learning management system to deliver this required training.
- Designate one employee (or a team) to ensure that all new and modified HIPAA regulations are communicated to everyone in the practice in a timely manner.
- Carry out internal audits on a regular basis to ensure all HIPAA guidelines are being followed.
Challenge 2: Disease Control
The 2014 Ebola outbreak, while well contained in the U.S., nevertheless put many hospitals and medical clinics on the defensive. First, many of the medical practitioners infected while working overseas were U.S. trained. Were they following proper protocols and infected outside the work environment, or was the infection acquired due to the improper use of protective equipment? In the U.S., the outbreak also revealed that not all medical facilities are well prepared to deal with a potential outbreak of Ebola or another highly infectious and potentially deadly disease (e.g., SARS). Given that the Centers for Disease Control and Prevention estimates that there are 1.7 million healthcare-associated infections each year in the U.S., all signs point to the fact that across the healthcare sector, more needs to be done to prepare practice employees to deal with highly infectious diseases and the possibility that it’s only a matter of time before the U.S. experiences a major disease control crisis.
To ensure that contagious diseases don’t spread in medical facilities, it is critical that facilities take all necessary precautions to prevent their spread and not simply when there is a known outbreak of a highly infectious disease circulating somewhere in the world. Precautions include having separate rooms available in which to isolated patients, personal protective equipment (which meets the CDC’s guidelines) available for doctors and nurses caring for patients who have or may have an infectious disease, dedicated patient care equipment and facilities to clean and store such equipment, and advanced protocols for managing other patients and visitors to a facility during an outbreak.
- Ensure all new employees in the practice are aware of the CDC’s guidelines on infectious diseases and the medical facilities own regulations and protocols.
- Dealing with an outbreak is not a daily situation; to ensure everyone knows what to do if and when an outbreak occurs, use simulations to train staff.
- To minimize the impact of the training on the regular functioning of the clinic and to ensure that training can happen on a regular basis (e.g., as new staff or new regulations are introduced), adopt virtual simulations.
Challenge 3: Volume- to Value-Based Reimbursement
Following the introduction of the Affordable Care Act (ACA), a growing number of public and private payers have started to move from pay-for-volume to pay-for-value. What does this mean? In short, pay-for-volume is about quantity while pay-for-value is about the quality. Theoretically, pay-for-value would reduce superfluous treatments and encourage doctors to address issues in the most effective manner from the onset, since they will be reimbursed for quality of care rather than the frequency with which they see patients. A doctor who sees a patient five times for the same bout of pink eye would not necessarily make more money than a doctor who finds a way to treat the infection effectively from the onset. Of course, assessing value in medicine is tricky. If someone is chronically ill, there may be no way to effectively treat the patient and the patient may not see much value in the doctor’s interventions, since they are still chronically ill. Thus, while the approach has its supporters, the difficulty of defining “value” in relation to healthcare means the move also raises many challenges. Among the challenges raised by volume- to value-based reimbursement is a growing demand on healthcare providers to delivery high-quality care within a more restricted budget. This means that assessing the effectiveness of care will become increasingly important in the coming years, and this means training medical staff to keep track not only of patients but the short- and long-term effectiveness of all interventions carried out with patients.
- Ensure all practice employees understand both the philosophy and practice guiding value-based reimbursement models.
- Ensure all nurses and doctors as well as other practice employees are evaluating all aspects of care and recording this data; use a central system to ensure that feedback provided by all members of the care team can be analyzed on a relational level (e.g., the data should be able assess how triage services impact physician care and overall quality of care)
- Building on collected data, develop protocols for selecting the most effective and affordable treatment from the onset.
- Provide training to help all members of the care team break old habits (e.g., go-to diagnoses or treatment recommendations) that may not support the pay-for-value models.