Case Study — HIPAA

Background

This document is a business case study that addresses the complexities associated with satisfying federal requirements outlined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The Health Insurance Portability and Accountability Act (HIPAA) of 1996 was enacted by Congress to create a national standard for protecting the privacy of patients personal health information. The law requires healthcare entities that use electronic means to process transactions, which include health information, to use standardized forms and a universal code system for illnesses and treatments. The regulation also requires new safeguards to protect the security and confidentiality of an individual's protected health information.

The Situation

Confusion and diversified opinions surround HIPAA and seem to be growing daily.  Professional newsletters and journals, as well as the public media , all report that health care providers are overwhelmed by fear and confusion.  The good news for companies is that compliance is relatively simple and achievable. The most important news is that organizations need to become compliant as soon as possible. The main issues surrounding the fear and confusion are that organizations tend to fear and resist change. Organizations feel they do not need to become HIPAA compliant if they do not transmit bills electronically. This is based on a narrow understanding of the HIPAA regulations. The lack of clarity, and the unpredictability of the HIPAA regulations have led many professionals to recommend that all health providers strive to meet the new regulations. Simply put, HIPAA will most likely become the standard, and organizations choosing not to meet the regulations will either be left behind, or even worse put themselves at risk for civil and legal penalties.

The vast majority of HIPAA standards are related to business process and policy reform within the U.S. healthcare system. As part of HIPAA compliance, all health care stakeholders have been forced to scrutinize their existing business processes and systems to bring them into compliance. Compliance with HIPAA standards is not just a goal, but also a way to operate your business in a new and efficient manner. HIPAA includes policies and procedures, business contingency, privacy and security measures, personnel security, access control, and awareness and training.

The Solution

Conuity can help you address your HIPAA issues and improve the business processes associated with HIPAA regulations. Conuity’s solutions enable you to improve and maximize the performance within your organization. Not just in meeting the letter of HIPAA compliance, but employing a standard best-practice business process system to meet the requirements of the business. This includes assessing the extent to which the organization complies with the privacy, security, administrative, and transaction standard requirements of the Health Insurance Portability and Accountability Act of 1996.
HIPAA is good business practice. Despite the dread and confusion surrounding HIPPAA regulations, the end result is that HIPAA is a requirement, and stands for good, solid practices and low operational costs. HIPAA provides higher assurances concerning privacy and confidentiality of patient records, it mandates informed consents, provides clients with the rights to view their records, provide the patient with details on who has been provided access to their information, and to even amend their clinical records. Compliance with HIPAA protects your organization from legal threats, but implemented properly it will also improve the quality, integrity, and performance of your organization while reducing operational costs.
Conuity’s products are designed to reduce the manual processes associated with healthcare services. Our comprehensive solution brings information to users insuring that tasks are delegated to appropriate personnel with the proper access level, making it easy for them to get the information they need, when they need it, and to make the most informed decision.

The Results

• Insure that individuals have access to the most appropriate information, when they need it, in order to make more informed decisions
• Define who may access and use health information
• Set alerts and notifications for situations
• Manage cost, quality and risk
• Provide patient access to medical information
• Eliminate manual processes
• Improve business process while bringing the organization into HIPAA compliance.
• Reduce paperwork freeing the organization to focus on patient care and revenue-generating activities
• Support auditing of information access and dissemination
• Empower management to measure performance and quickly implement change to improve business processes
• Identify areas where process and policy can be used to improve the performance of the organization