The ever-transforming world is transforming the medical needs of individuals. Healthcare audits must keep facilities aligned with these new requirements and federal regulations. It is a multi-pronged process that involves:
- Assessment of patient care quality
- Analysis of the professionals involved
- Testing the thoroughness of the organization’s policies
- Assessment of the revenue cycle management
- And other aspects
However, maintaining a comprehensive view of multiple disparate factors during the audit process is tiring. Confusion ensues when no system is in place and large quantities of data are difficult to sort through. That is why audit management tools in healthcare are gaining a lot of ground.
In this guide, we will go over the significance of audit management tools in healthcare, the types of audit management tools, and the key features to look for when looking for the right audit management tool for your organization.
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What is the Significance of Audit Management Tools?
There are multiple elements at play whenever healthcare auditing is concerned.
On the one hand, care for regulatory compliance has to be taken, which is complex, considering the many changes it may undergo. On the other hand, there are also data security and privacy issues that must be addressed.
Furthermore, technology is evolving over time, and auditors must keep up with it. Staying abreast with modern technologies is also important for auditors to prevent rampant fraud and other related issues.
When considering all these factors, it becomes important for software-based solutions that offer quick access to data, make the data more comprehensible, and offer tools that make audits more streamlined. With such audit management tools in hand, regular audits become easier, which works in favor of healthcare facilities seeking more efficiency, productivity, and revenue.
What are the Types of Audit Management Tools in Healthcare?
The types of audit management tools are different based on the needs of an organization. However, the following are the most common audit management tools in use by healthcare organizations:
Compliance Management Tools
These tools help healthcare organizations ensure that their operations match the regulatory requirements of regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and HITECH. The tool tracks how much effort a healthcare facility puts into complying with the regulatory authorities.
Risk Assessment Tools
With risk assessment tools in healthcare, the focus is on finding and assessing the potential pertaining to compliance, data security, and patient safety. Risk matrices are used in these tools to prioritize and categorize risks within a healthcare organization. This categorical representation of risks helps healthcare organizations develop risk management measures quickly.
RAC Tracking Tools
A Recovery Audit Contractor (RAC) is a government program that identifies and corrects improper payments made in Medicaid or Medicare systems. Tools like rac tracker are third-party applications that the government enters into contracts with to find underpayment and overpayment requests. This tool assists with tracking audit requests, monitoring audit progress, managing documentation, overseeing compliance, managing requests for information, and more.
Internal Audit Software
As the name suggests, internal audit software facilitates internal audits within an organization. From its workflow management to its finances to how patients are treated, every element of a healthcare organization comes under a particular kind of internal audit application.
Quality Management Systems
Much like the internal auditing tools, Quality Management systems encompass multiple applications. They focus on ensuring that everything from patient care to regulatory compliance to overall organizational performance is top quality.
EHR Auditing Tools
Almost all of the healthcare records now available are digitized, And to audit the quality of these records, a specialized Electronic Healthcare Record (EHR) software is necessary. It monitors patient care, tracks changes related to patient’s medicine, and ensures that confidential healthcare information is secure.
Incident Management Tools
Incident Management tools help healthcare organizations watch over and manage incidents and breaches. They keep a record of every incident in a document format, helping with the investigation and the development of corrective actions.
Patient Satisfaction Survey Tools
Some healthcare audit applications are aimed at providing patients with optimal healthcare facilities. These tools focus on developing a questionnaire for patients and recording responses. Healthcare organizations can use these responses as feedback to make their healthcare facilities better.
Document Management Tools
Because there are multiple forms of audits at play when healthcare facilities are concerned, there is a need for systems that categorize and collate audit information related to these elements properly. Document Management tools help with this. They also offer protection to these docs by implementing features such as access control, version management, and more.
Key Features that Healthcare Audit Management Tools Should Have
Since healthcare is such a critical niche, there are some qualities that every healthcare audit management tool must have.
- Comprehensive compliance monitoring – All healthcare audit tools should comprehensively monitor if a healthcare facility complies with HIPAA, HITECH, or other regulations.
- Simplified Interface – An auditor doesn’t need to be a technical savant to use the audit management tool. Applications must be simplified so that all the options can be interacted with easily.
- Automated Audit trails – Healthcare auditing tools must feature automated audit trails to see how well a healthcare facility has performed compared to the last time it was audited. It helps with finding key issues within healthcare organizations.
- Integration with existing systems – It is important that the audit management tool is flexible enough to be integrated with existing systems. That way, none of the healthcare facility’s existing functions are compromised.
- Real-Time Alerts – It is important that the healthcare audit tool provides real-time alerts. There should be no delay in an information update, and all the data should be available on time.
- Access Controls – There should be access control features available in the audit management application so that only key personnel can look at the details.
- Scalability – The healthcare audit application should scale with the needs of the healthcare facility.
Rapid changes in technologies, coupled with stringent compliances, have made it important for healthcare auditors to get some help from healthcare auditing applications. These applications are of several kinds, serving different needs.
However, the selected healthcare audit software must have key features like comprehensive compliance monitoring, ease of access, and real-time alerts. With the right audit system, a healthcare facility’s operations are never compromised.