The privacy and security risks to which home care agencies are susceptible have been well-publicized recently. Data breaches affecting home care and home health providers continues to rise, with some reports showing incidents up 83% in the last ten years. As our industry continues to grow and evolve, it has never been more important for providers to understand the risks that they face and to implement practices designed to mitigate them.
Potential data breaches represent only one aspect of security and compliance risks facing providers. Home care agencies must maintain compliant with regulations including HIPAA, while their use of data and deployment of technologies like mobile solutions and virtual visits continues to proliferate. Behind these compliance obligations lies the risk of fines and penalties, and the risk of claims from plaintiff attorneys who comb these regulatory proceedings in search of clients for potential cases. According to this HHCN article, home-based care accounted for more than 20 percent of claims against nurses in 2020 – up from about 12 percent just five years prior.
While ensuring that your data is secure from misappropriation is at the core of your security efforts, the new reality is that this is no longer sufficient. The reliability and integrity of the data that documents the care provided and performance of your staff adds new requirements to be able to audit and track approvals and authorizations. You and your technology partners need to align your risk management practices and co-operation in order to achieve meaningful reductions in risk.
Staying compliant within the systems where an agency operates
Home care agencies and the partner they choose to maintain their electronic health record systems and all related functionality must work together to “complete the circle” that is modern HIPAA compliance. Data residency, security, encryption and robust control systems must be implemented by software platform providers, while home care service providers are responsible for managing access and device privileges, permissions and passwords. So, it becomes critical to know not only how to ensure internal data integrity, but also how that EHR system archives, secures, validates and produces historical records – and how the agency fits into that process.
A capable technology partner will, for starters, work in tandem with a home care provider to meet all customer compliance obligations under HIPAA.
As data-driven home care takes greater root each passing year, it is increasingly vital to have a foundation of security and compliance in place. This is particularly important considering the data requests that agencies will face in perpetuity. Patient and care recipient records are becoming the source of increasing scrutiny and the subject of a wide variety of requests, including auditors from insurers and other payers, family members who have questions about care levels, and regulatory agencies in connection with audits and reviews.
These additional layers of stress can begin to erode operations and efficiency, so it’s imperative to have a process in place that securely archives validated records – as deep a level of documentation as possible – in order to produce information in a seamless fashion.
How technology enables risk management in home care
Part of this approach to secure, compliant record keeping is an agency safeguarding vital administrative systems – ensuring that all billing, payments and collections are accurate and timely; maintaining up-to-date certification among all caregivers; and other key elements that can expose risk.
Whatever software is underpinning operations must be deep and detailed so an agency stays financially and clinically compliant, as businesses can face audits that require data integrity, time stamps and audit trails on both billing and clinical sides. This can help prevent misinformation mistakenly feeding imprecise claims or inappropriate services that are clear red flags to auditors.
Legacy software systems can make accessing information or claim stamps difficult if not impossible, especially where data is moving through other channels like health information exchanges and specialty solution providers. On the other hand, tech with a strong infrastructure and clear information pathways makes responding to requests, and maintaining security and compliance, easier.
This, of course isn’t a one-and-done situation; instead, agencies and their tech partners must work in tandem over time to maintain best practices, evolve security elements as needed, and tweak custom features like access controls (roles and permissions) – particularly when on- and off-boarding employees.
A quick pro tip: trust your system to a technology partner that is SOC-2 compliant. This standard ensures they have secure policies and procedures in place to govern the security, availability, integrity, confidentiality and privacy of data stored in the cloud.
Ultimately, maintaining a strong focus on risk management means an agency forges an earned reputation for being responsible and trustworthy on behalf of clients and their families. And that is part-and-parcel with the delivery of high-quality care.