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Healthcare Compliance Management: What we have learnt in 2021

Stressful compliance image
Guest Author
July 15, 2022
1 min read
Stressful compliance image

What a year it has been. 2021 has been a challenging year for both Australian aged care and healthcare providers. The COVID-19 pandemic has reshaped every aspect of life, especially for the healthcare industry.

Healthcare compliance management has become more critical than ever. Governments around the world have implemented COVID-safety measures to help curb the numbers. However, rules, regulations and laws about COVID precautions vary globally.

However, these regulations and restrictions are a little more complex in Australia – they vary across states. Healthcare providers are expected to maintain smooth operations to keep patients and residents safe while ensuring complete compliance.

While there was a lot of tension, loss, trials and tribulation, there was also technological innovation, collaboration and adaptation. Compliant healthcare organisations have repeatedly proved they could manoeuvre the challenges brought about by the pandemic.

As a healthcare compliance management platform, below are some of the challenges and lessons learnt while ensuring Australian healthcare organisations remain compliant and covid-safe.

Why is there so much focus on compliance in the healthcare industry?

Of course, compliance management isn’t a new kid on the block. Many other sectors such as agriculture, education, retail, and others are governed by compliance. So, why is there such a strong focus on healthcare compliance in 2021?

Unlike the other industries, the stakes are higher for a healthcare organisation. If an employee, for instance, doesn’t follow protocol or goes against any government regulations, they might end up causing harm to a patient, visitor, or another staff.

Significance of COVID-19 on healthcare

On top of that, the pandemic has further highlighted the importance of healthcare compliance management. COVID-19 has made many recipients of healthcare vulnerable to contracting the virus. This pushed for a greater need for stricter regulations and restrictions within the healthcare industry.

Organisations cannot afford any non-compliance as they would have to face unnecessary fines, damage to reputation and even forced closure in severe cases. As such, compliance to state regulations such as social distancing measures, visitor restrictions and scheduled visits are necessary for Australian healthcare organisations to remain covid-safe.

In addition, the healthcare industry is a very fast-paced environment. As a result, regulations and restrictions are ever-changing. The changing covid situation further compounds this. In Australia, regulations and restrictions vary across the different states. For example, at some point, Western Australia may allow visitors to aged care facilities but are barred from visiting in Victoria.

Hence, emphasis on compliance, especially healthcare compliance management, was amplified in 2021. On top of complying with COVID-19 visiting and social distancing regulations, healthcare providers face increased privacy and security concerns.

With COVID-19 vaccination becoming mandatory for visits to healthcare facilities, organisations have to collect, verify and comply with Australian privacy standards. This thus further heightens the importance and need for healthcare compliance management.

Another often overlooked area of healthcare compliance is billing compliance. Incorrect or late billing can negatively affect patients’ and residents’ financial experience. Additionally, healthcare organisations have to mitigate costly fines and penalties if they cannot comply with any regulations.

As such, healthcare compliance has always been the core focus of healthcare. With the onset of COVID-19, compliance has emphasised its focus and importance. Proper healthcare compliance management is critical for organisations to deliver a positive patient, resident and visitor experience.

Healthcare Compliance Management
Compliance challenges in 2021

Let’s take a look at some compliance challenges throughout 2021

The most significant challenges the healthcare industry faced in 2021 due to the ongoing pandemic are as follows. They include ever-changing visitor restrictions, vaccination mandates, healthcare policy and regulation changes, emerging and adopting technologies, and ensuring the well-being of healthcare staff.

With these few challenges in mind, let’s delve into the different challenges faced by the aged care and healthcare industry, respectively.

Aged Care

Aged care organisations must adhere to Aged Care Quality Standards (AQCS). The ACQS comprises of 8 standards:

  1. Consumer dignity and choice
  2. Ongoing assessment and planning
  3. Personal care and clinical care
  4. Services and supports for daily living
  5. Organisation’s service environment
  6. Feedback and complaints
  7. Human resources
  8. Organisational governance

When found non-compliant, aged care organisations risk getting fines and being put on the non-compliance register. Additionally, when the Aged Care Commission identifies a non-compliance provider, the commission will notify them and any regulatory actions taken in response.

Healthcare compliance management for aged care is complicated further along with the ever-changing COVID-19 restrictions. These restrictions change with time and state as well. For instance, New South Wales might allow two visitors during each visit, but Victoria might only allow one visitor per visit. These nuances in regulations make it challenging for aged care organisations to keep up and maintain compliance.

Not only do aged care facilities need to comply with visitor restrictions, but also with new COVID-19 vaccination mandates and requirements. Vaccination became mandatory for aged care workers from September this year. In addition, all staff must be partially or fully vaccinated before they begin work.

There is a challenge of collecting and verifying vaccination evidence before allowing people into their facilities. If organisations fail to validate people’s vaccination evidence correctly, they face up to a $100k non-compliance fine depending on their state.

Without a healthcare compliance management tool, aged care organisations will have to incur higher labour costs to hire more administrative manpower to manage the complex compliance requirements. They would also need to account for more paperwork to remain compliant.

Hospitals

Likewise, Australian hospitals also face similar compliance challenges and issues.

Hospitals in Australia are evaluated based on the safety and quality of care; which often includes topics such as

  • hand hygiene compliance,
  • unplanned readmissions,
  • hospital-acquired complications and adverse events as well as,
  • potentially preventable hospitalisations (PPHs).

Australia’s health system’s quality and safety metrics are of utmost importance to all patients, their families and carers, and clinicians and health service managers.

Besides complying with the above quality and safety requirements, hospitals must follow COVID-19 regulations. Just like aged care regulations, hospitals also face ever-changing rules. In addition, these COVID-19 rules vary between states, such as visiting hours and duration.

Similarly, hospital staff, contractors, and visitors must abide by mandatory COVID-19 vaccination rules set by the different states. These vaccination requirements for hospitals are also different based on states and timeline.

Without a healthcare compliance management system to help hospitals manage these complex compliance needs, they are faced with the arduous task of complying with ever-changing regulations manually.

Healthcare Compliance Management
Digitisation of the healthcare compliance industry

Digitisation of the healthcare compliance industry

Along with the problems the pandemic has ignited, it has also shed light on the limitations of the healthcare and aged care industry’s traditional systems. Never before has the industry been shaken to its core like the present. It has simultaneously exposed its burgeoning need to embrace and change its stance on innovation adoption.

Healthcare and aged care organisations struggle to cope with the pandemic and the increased regulation that came with it. However, many of these organisations also often harbour reticence toward incorporating new technology into their workflows, viewing innovation or tech as unfamiliar and foreign.

However, innovation and digitisation aren’t AI-driven shiny bots replacing the human touch. Instead, it is about embracing a new era of technological improvements that can and will revitalise the industry for the better.

This pandemic thus highlighted the importance of a healthcare compliance management system for aged care and healthcare facilities. A compliance management tool can help facilities automate the compliance process, such as facilitating visitor check-in, collecting and validating COVID-19 vaccination and automating compliance with changing regulations.

What tools help organisations maintain healthcare compliance?

After understanding the importance of digitising healthcare compliance, let us look at the different healthcare compliance management tools that can help healthcare and aged care organisations streamline their process while maintaining complete compliance.

Visitor Management System

One tool to help providers achieve compliance is a visitor management system. There is always a constant flow of visitors, staff and contractors in aged care facilities and hospitals. While this wasn’t a problem pre-pandemic, social distancing rules have made it more difficult for facilities to manage and control a large crowd onsite.

This is where visitor management systems come into play. They ensure everyone going in and out of the facility is accounted for. Using the visitor management system, visitors can pre-book their visits and show up during their stipulated time. Visitors will also fill up health declaration forms mandated by the Australian government.

Staff can also check in via the system and ensure they don’t have COVID-19 symptoms before starting their shift. In addition, a visitor management system will ensure there won’t be a long line of visitors or patients waiting to enter.

This is an essential aspect of healthcare compliance management as it helps reduce the risk of overcrowding and ensure social distancing. Moreover, with so many visitor management systems in the market, some of them, like Zipline’s, can help automate organisations’ compliance processes.

Thus, a visitor management system is imperative for Australia’s aged care and healthcare organisations to fully comply with ever-changing regulations.

Healthcare Compliance Management
Zipline’s Vaccination Management Workflow

Vaccination Management System

Another healthcare compliance management tool recommended for aged care and healthcare organisations is a vaccination management system. However, while HR tools are suitable for collecting vaccination evidence, they aren’t up to par with platforms specifically made for vaccination management.

With vaccination mandates still differing from state to state, a lot can change in a matter of days and weeks. This thus makes it challenging for organisations to keep up. Additionally, organisations have to incur higher labour costs to hire more manpower as they would need to collect and manually verify the evidence is real.

Hence, organisations are recommended to get a vaccination management solution rather than to use their current HR tool. Vaccination management solutions can help aged care and healthcare organisations optimise and streamline the vaccination collection and verification process.

Visitors, staff, contractors, patients and volunteers can upload their vaccination evidence before their visit. When the evidence is uploaded, the system will automatically verify the validity of the evidence. Once verified, the evidence will be stored.

If someone uploads a fake vaccination certificate, the system will reject it and alert admin staff. No one will be allowed to enter the facility until a proper vaccination certificate the uploaded.

Further, a specialised vaccination management system will keep track of the ever-changing vaccination requirements. Organisations will be alerted of any changes and automatically implement these changes to ensure 100% compliance.

This healthcare compliance management tool is necessary for the Australian aged care and healthcare industry to remain compliant and avoid unnecessary penalties.

Contractor Management Software

Contractor management software is vital for organisations to keep track of contractors going in and out of the facility. It also helps organisations manage workplace compliance. For example, contractors must go for courses and renew them as and when needed.

There are many certifications and documents when it comes down to healthcare contractor compliance. Contractors have to undergo different training and maintain their certifications. During onsite, organisations need to collect and store these documents. They also need to ensure records don’t go out of date.

This healthcare compliance management tool will handle aged care and healthcare organisations contractors’ pre-qualification process. Additionally, contractor management software can help organisations monitor contractor compliance. It ensures every licence, insurance, and qualification is up-to-date.

Leading into the New Year

2021 has been a challenging year for the aged care and healthcare industry. However, one positive thing is the digitisation of the industry. While organisations struggle with compliance, healthcare compliance management solutions helped executives and leaders through 2021.

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