Advancement in technology has fostered dramatic changes in all sectors of the economy and the healthcare sector is not an exception. The healthcare sector can now say goodbye to repetitive, time-consuming, and mundane tasks thanks to AI and automation. Hence, patients’ care and quality medical services become a top priority and importance.

However, the integration of AI and automation of the healthcare sector isn’t limited to just performing repetitive tasks and streamlining tedious routines. In most cases, automation becomes the medical staff’s helping hand in organizing patients’ data and transmitting information remotely and instantly.

Nevertheless, healthcare companies mustn’t get carried away by the vast potential of automation in the healthcare industry. It is important to remain compliant with essential data regulations and restrictions. The reason for these regulations? Healthcare data are very sensitive and delicate, hence, the reason to protect them against hackers and cyberpunks. Therefore, there are severe consequences for not following up on these regulations and doing things wrong with the data.

Today, one of the vital regulations every healthcare company must stay compliant with is HIPAA. And lucky enough, a perfectly integrated robotic process automation can help protect health data and create HIPAA-compliant workflows within the healthcare sector.

HIPAA compliance and what does it mean

The Health Insurance Portability and Accountability Act of 1996 otherwise known as HIPAA is a United States legislation that provides regulations for how healthcare companies secure and manages Protected Health Information (PHI) and patient data. It is a sequence of standards that oversee the disclosure and use of Protected Health Information.

Healthcare organizations and vendors like medical device companies, SaaS solutions, and health tech companies must implement all HIPAA measures to be certified HIPAA compliant and work with patient information and data.

who have to be hipaa compliant?

What is Protected Health Information?

Protected Health Information (PHI) is demographic health data that is established, collected, stored, or delivered by HIPAA-covered organizations and their business associates concerning the outlay of patient care, healthcare policies, and expenses for healthcare services.

PHI consists of previous, present, and even prospective health information about the medical conditions (both physical and mental health) of a patient. This health information can be delivered in three distinct forms: electronic records, spoken information, and physical records.

The PHI also includes health histories, health records, medical bills, lab test results, and demographic information like patients’ names, phone numbers, addresses, phone numbers, financial information, Social Security number, photos of the face, medical records, and so on.

Ensuring the confidentiality of this Protected health information is key and to do that, HIPAA-covered organizations will have to put in place administrative, technical, and physical measures as stipulated by the HIPAA Security Rule.

What are the primary HIPAA compliance rules?

The HIPAA regulation consists of various types of HIPAA rules and these include;

HIPAA rules

The HIPAA Compliance Privacy Rule

The privacy rule outlines the criteria for patients’ rights to Protected Health Information. Some of the privacy rule criteria include healthcare providers’ rights to deny access to PHI, patients’ right to access PHI, the contents of Notices of Privacy Practices, and so on.

Every one of these criteria ideally should be documented and stored in the company’s HIPAA procedures and policies and the company’s employees should be educated on these criteria every year.

The HIPAA Compliance Security Rule

The security rule outlines the criteria for the safe handling, transmission, and maintenance of electronic PHI. The security rule applies to both covered organizations and business associates. Just like the privacy rule, every one of these criteria ideally should be documented and stored in the company’s HIPAA procedures and policies and the company’s employees should be educated on these criteria every year.

The HIPAA Breach Notification Rule

The breach notification rule outlines the criteria that apply to both covered organizations and business associates in the event of a data breach where ePHI and PHI are concerned. Healthcare companies are mandated to report and document both types of breaches.

The HIPAA Omnibus Rule

In 2013, the Omnibus rule established the most important modifications to the criteria affecting both the HIPAA Security and Privacy rules. This new rule enhanced the power of the Office for Civil Rights to execute the regulations and to charge fines if violated. The HIPAA Omnibus Rule states that business associates have to remain compliant with the HIPAA regulations while also outlining the procedures of Business Associate Agreements (BAAs).

The Business Associate Agreements (BAAs) are contracts that need to be finalised between a covered entity and business associate before ePHI and PHI is shared or transferred.

What are the most common HIPAA compliance violations?

Many healthcare companies have been found guilty of violating HIPAA violations. Some are due to ignorance, honest mistakes, or a breach in their security system.

HIPAA violations

The need to automate healthcare workflow

To help remain HIPAA compliant and minimize security risks while also facilitating a successful doctor-patient relationship, many healthcare companies are beginning to embrace automation and integrate RPA within their system.

According to reports, approximately 50% of a healthcare company’s budget is squandered on inefficient processes while the financial benefits that come with implementing automated workflow are venomous. Across the United States, healthcare companies have saved between $37M and $59M in the space of five years.

RPA HIPAA compliance

Some of the primary reasons why healthcare workflow needs to be automated include;

1. Preventing HIPAA violations with automation and RPA

Penalties for HIPAA violations are quite severe, be it the healthcare company’s fault or not. For example, the penalty for violating HIPAA by sending PHI to the wrong contact or patient is a fine of $50,000.

The common tone of hospitals and clinics is not calm and of pleasant attitudes, hence, omissions and errors as regards document-related issues aren’t far-fetched. The steps and procedures required to fill and enter specific information approved by patients are usually long and involve chasing people down to get approvals. All these usually lead to skipping some procedures and making the simplest errors.

However, by perfectly implementing RPA and automating healthcare workflow, patients’ data are automatically transferred and processed. This reduces the risk of violating HIPAA regulations while also erasing the need for administrators to perform repetitive and mundane tasks. About 80% of medical professionals claim that automation and electronic prescriptions have significantly reduced the level of human interaction and time taken to finalize the paperwork.

2. Poorly-managed patient flow

A continuous and steady patient flow prevents delays in patient care deliveries and overcrowding. However, when it comes to reality, that’s usually not the case. Hospitals, most especially the emergency department, are often overcrowded with patients having to hang around due to lengthy wait times.

This reality is a reflection of one of the most time-consuming workflows in hospitals; getting approvals. All documents that deal with PHI need to be approved and signed by healthcare professionals or administrators which usually takes so much time.

This is the space where RPA and automation need to fill. With workflow being automated, doctors, administrators, patients, and so on can sign, finalize and exchange paperwork in real-time without the need for physical interactions. The bot(s) automatically inform parties involved to sign, review and fill out documents depending on the conditions set by the healthcare company.

3. Burnouts

One of the major complaints from medical professionals is burnout. Today, we can better understand medical professionals burning out due to the Covid pandemic. Even during periods of a less severe health dilemma, 50% of healthcare professionals still suffer from burnout.

The most common reason for burnout? The additional workload of administrative paperwork such as billing, overseeing, and reporting documentation. However, with automation, burnout of healthcare professionals is considerably minimized since robots take care of the administrative paperwork.

In fact, there’s been a report that healthcare companies that fully automate their processes audit patients’ records in approximately 1.4 hours compared to 4 hours using human resources.

4. High risk to medical personnel

The risk to medical personnel has also been considerably reduced courtesy of many healthcare companies integrating RPA within their system. The risk medical professionals who are subjected to moving very close to sick patients and stake contracting diseases has been minimized via automation.

Frankly, that’s the reality of every doctor and it’s impossible for them to totally avoid patients. However, healthcare companies now look for ways to preserve the health and energy of medical practitioners through automated workflows.

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By integrating RPA, there’s no need to reschedule meetings with patients to clarify details and complete necessary paperwork. Healthcare professionals can access, authorise and send patients’ data and information at the comfort of their offices or homes from any device.

HIPAA compliance with RPA – conclusion

With all being said, it is evident that the integration of RPA and the automation of healthcare workflows is the better thing to do. At Flobotics, we are a group of experts who are vast in analyzing healthcare processes, recognizing automation opportunities, establishing necessary infrastructures, and developing sustainable and stable robots.

Recognizing how important being HIPAA compliant is for healthcare companies, by providing RPA consulting services, Flobotics centralizes healthcare data and processes while offering the flexibility to scale up or down whenever necessary. With RPA, healthcare companies can control and oversee the entire ecosystem better and much more closer.

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Michał Rejman

Chief Marketing Officer at Flobotics. Communication strategy consultant for tech and process automation buff. Remote work evangelist, surfer, and doggo lover.

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