This article defines Agile Compliance and provides the rationale behind why this approach will likely become the dominant compliance methodology in 2014 and beyond. The article also discusses the problems that Agile Compliance solves more effectively than linear methodologies and why your existing HIPAA compliance methodology may be DOA.
The foundational premise is that Agile is more effective at responding to an environment that contains an unknown and quickly evolving set of requirements and challenges. For starters, let's review a non-exhaustive list of the changes that we know are currently transforming the healthcare industry.
Agile started out as a software development methodology in response to a growing need for a more flexible approach to attack increasingly difficult open ended problems in an environment where the rate of innovation and time pressure were both increasing. Due to its effectiveness, Agile has now moved into a host of other disciplines including marketing, business planning, product launches, etc.
One Hundred & Fifty (150) Years of Change in Five (5)?
Before proceeding with a "laundry list" of transformational changes currently sweeping the healthcare industry, let's acknowledge that the "fee for service" model, as a compensation mechanism, is an abomination that is at least 150 years old and should have been killed off years ago.
In no other service industry that I can think (except perhaps for government) are providers rewarded for doing work no matter the outcome. It's like taking your car to the garage to get the brakes fixed and the mechanic wants to get paid the full amount despite the fact that it wasn't the brakes that need "fixin."
George Bernard Shaw in his essay and play The Doctor's Dilemma (circa 1906) correctly analyzed the absurd and perverse nature of "fee for service" model at the turn of the 20th century. Although this compensation model is currently undergoing much needed change, it is STILL the dominant compensation mechanism in the U.S. and won't "fold its tents and disappear into the night" without a fight.
Here's a non-exhaustive of list of the radical changes that the healthcare industry is currently coping with:
- Transition to a Pay for Performance compensation model;
- Transition to Electronic Health Records;
- Transition to ICD-10 billing standard;
- Impact of the Affordable Care Act;
- Requirement to report Quality Measures;
- Requirement to deliver on the promise of pricing transparency;
- Transition to Mobile Health and BYOD;
- Transition to increasing use of Telemedicine;
- Coping with industry consolidation because of increased mergers and acquisitions; and
- Using Big Data and sophisticated analytics to manage the health of a population instead of focusing almost exclusively on the individual.