Managing risk in the healthcare space is becoming increasingly complex..
Hospitals and healthcare systems are growing and becoming more decentralized, forcing claims and risk professionals to monitor activity across multiple facilities and functional areas.
Claims and risk professionals must ensure timely communications with stakeholders, including hospital boards and surveyors, as well as the patients and families who have entrusted those facilities with their healthcare needs. These same professional must also meet – and sometimes enforce – not only local guidelines and policies, but also state and federal regulatory reporting guidelines, often across state lines.
A great deal of this stress stems from inefficient communication and a lack of collaboration among key stakeholders. There is friction in locating medical records, reading/forwarding e-mails, and managing financials and other documentation across disparate and most often siloed systems.
If risk professionals could only make those interactions more efficient, they'd not only reduce their risk and loss costs, but also free up valuable time to proactively manage risks in their healthcare environment.
This was the challenge we decided to take on at Trideo. By creating three systems that work together, we aimed to capture an adverse event that may occur at the hospital floor level – all the way through its potential resolution as a law suit.
Capturing, reviewing and reporting a hospital event should be done through a click of a button. It shouldn't require re-entering data into another system, which not only takes up valuable time but also increases the probability of inherent data entry errors while the information is being re-transcribed by a healthcare professional.
We set out to solve this problem not by creating yet another “IT” system. Instead, we based Trideo's design on best practices associated with reporting adverse events from the hospital floor, the claims and litigation management design on our own experiences and challenges our clients face in managing large complex claims, and the need to timely report any claim resolution to CMS for compliance with Section 111 reporting guidelines.