Customer relationship management (CRM) is often a key component for successful organizations and businesses. CRMs are a type of technology that manages an organization’s database and thus facilitates relationship-building with customers and prospective customers. In healthcare, CRM software can help strengthen relationships with patients. Results include higher patient satisfaction, better health outcomes, more effective care delivery, and reduced costs.
The Health Insurance Portability and Accountability Act (HIPAA), first introduced in 1996, required healthcare organizations to implement and maintain security controls to protect patient data. HIPAA-compliant CRMs are in high demand as healthcare organizations seek customized solutions to manage patient relationships and meet security requirements.
Welkin offers a healthcare CRM solution with multiple, seamless platforms to oversee the ongoing care of your patients in a HIPAA-compliant environment.
What’s the purpose of HIPAA?
HIPAA is a federal law that outlines security standards and privacy requirements that healthcare organizations must follow. The requirements apply to protected health information (PHI), which is health data that can be attributed to a specific individual. This information can include medical records and hospital and health insurance financial records.
In addition to securing PHI, HIPAA also allows healthcare organizations to exchange electronic health records (EHRs) more efficiently. HIPAA also provides a right of access to patients, allowing patients to direct the transmission of their PHI to themselves, another person, or another provider.
When choosing CRMs, organizations need to make sure the solution they choose is HIPAA compliant. Beyond HIPAA, CRMs need to meet additional regulatory requirements. Healthcare organizations and CRMs must comply with more than 600 regulatory requirements.
What are the benefits of HIPAA?
Healthcare organizations must comply with HIPAA. But what benefits do these privacy and security requirements provide?
Protection against identity theft and insurance fraud
Before HIPAA was established, there were no standard controls to protect PHI. Patient data was stolen, resulting in identity theft and insurance fraud. Patients faced financial losses, health insurance premiums increased, and spending across healthcare increased as a result.
HIPAA requires standardized protection of PHI, including the allowable uses and disclosures of that information. The risk of identity theft and insurance fraud has significantly decreased.
Protection against cyberattacks
Cyberattacks are attempts by hackers to destroy, disable, steal or expose information by obtaining unauthorized access to data and information systems. Healthcare organizations are a prime target for cyberattacks:
- PHI is rich with personal and financial data that enables identity theft.
- The need to access patient information remotely results in more opportunities for hackers to access systems.
- If a healthcare system hasn’t updated its software, it is more vulnerable to modern cyberattack techniques.
Data breaches and cyberattacks hit an all-time high in 2021. According to Critical Insights, 45 million individuals were affected by healthcare data breaches. This number has tripled in recent years. In 2018, about 14 million people were affected by healthcare data breaches.
PHI that healthcare institutions need to protect under HIPAA includes:
- Patient names and addresses
- Dates of patient-specific events like birth dates, death dates, admission dates, treatment dates, and discharge dates
- Medical record numbers and patient IDs
- Social Security numbers
- Health insurance IDs and billing information
- Medical histories and patient record notes
- Lab test results
- Biometric identifiers such as fingerprints, voiceprints, and retinal prints
- Photographs and other similar images
- Any other information used to identify a patient
HIPAA-compliant CRMs protect healthcare organizations against cyberattacks through components like encryption controls and secure designated access roles. Email spam filters and web filters prevent phishing attacks, which trick employees into opening a malicious file or visiting a malicious website and enabling access to a data system.
Risk analysis and management
HIPAA requires healthcare organizations to undertake a risk analysis process as part of their data security management processes. These risk analysis processes strengthen an organization’s protection against data breaches.
A risk analysis process can include, but is not limited to, the following:
- Evaluation of the likelihood and potential impact of risks to stored electronic PHI
- Implementation of appropriate security measures to address and reduce identified risks
- Documentation of chosen security measures and rationale for choosing those measures
- Maintenance of continuous, reasonable and appropriate security protections
A healthcare organization’s risk analysis process should be ongoing. They should incorporate periodic reviews of records, systems, security incidents, and potential risks as part of the process.
A fully compliant risk assessment process includes administrative, physical, and technical safeguards to protect against cyberattacks and data breaches.
Administrative safeguards should be in place and include a security management process, designated security personnel who develop and implement policies and procedures, defined information access management policies, workforce training for all employees who work with PHI, and periodic evaluation of how these procedures and policies meet HIPAA security requirements.
Physical safeguards include limiting access to facilities with PHI, ensuring authorized access is allowed, and implementing policies and procedures related to access and use of workstations and electronic devices with PHI.
Technical safeguards to comply with HIPAA are also required. These include security measures to protect PHI being transmitted over an electronic network, integrity controls to protect PHI from being improperly altered or destroyed, audit procedures to record and examine access in information systems with PHI, and access controls that only allow authorized individuals to access electronic PHI.
On-demand access to information for patients
While HIPAA is well-known for requiring providers to protect PHI, the rule also protects and enforces a patient’s right to access their health data upon request. Patients can request their PHI for their own purposes and can also request that PHI be shared with other providers or institutions.
Improved workflow and task automation
HIPAA-compliant CRMs don’t only help healthcare organizations meet security and privacy requirements. Welkin’s CRM solution improves workflow and task automation for providers and care teams, reducing the time needed for administrative and operational tasks. This frees up providers and care team members more time to focus on clinical activities and patient engagement.
Welkin automates tasks and processes, including patient intake forms, assessments, escalation pathways and provider notifications, patient and provider communications, team alerts, email sequences, and appointment and reminder scheduling.
Interested in learning more about automating these tasks and freeing up more time for providers and staff? Learn more about what Welkin offers for automation in healthcare.
Better care delivery
CRMs combine patient health records from various sources and synchronize data and information, providing a comprehensive view of a patient’s health data. Through CRMs, providers and care teams can better understand patient needs, identify behavior patterns, review prior diagnoses and procedures, and truly deliver patient-centered care plans.
In addition to bringing together clinical data, CRMs enable better care delivery through administrative and operational functions as well. As described above, healthcare automation can free up clinical and administrative staff to focus on patient care and engagement. CRMs also streamline care management efforts for providers and care teams and can support the delivery of personalized care through workflows and resources within the platform.
To build or buy? Challenges of medical CRM development
Customized HIPAA-compliant CRMs offer a wealth of benefits to healthcare organizations. However, there are challenges associated with developing a custom CRM solution. It can be expensive and time-consuming to build a CRM. Navigating the 600+ regulatory and statutory requirements that healthcare organizations must comply with can be overwhelming. In addition, skilled software developers can be hard to come by.
To address these challenges, many healthcare organizations turn to experienced vendors with a broad portfolio of satisfied healthcare customers.
Finding a reliable HIPAA-compliant CRM solution & partner
In addition to providing quality care, healthcare organizations must ensure their tools and practices align with HIPAA requirements. While HIPAA transformed protection and access around PHI, navigating it can be burdensome.
While developing a custom CRM solution in-house is one option, it can be resource-intensive and may not ultimately be HIPAA compliant. Finding a deeply experienced technology partner who understands how healthcare organizations operate can save time, money, and effort.
Welkin works with healthcare organizations of all use cases and sizes and specializes in their customizable healthcare CRM solution.
Human connection paired with great software transforms healthcare. Learn more about how Welkin can help you implement a HIPAA-compliant healthcare solution.