Podcast

Keeping Your Knowledge Compliant for Ever-Changing Systems and Regulations with Rosemary Kirk

Maintaining compliance in healthcare’s constantly changing systems and evolving regulations can be a lot for any organization. In this podcast, our own Rosemary Kirk discusses the challenges that come up for healthcare organizations as they navigate the world of staying inside the official parameters. She also goes into what’s needed to provide quality care and for the healthcare industry to run smoothly.

Transcript

Pete Wright:
Hello, everybody, and welcome to Connected Knowledge from Upland Software on TruStory FM. I’m Pete Wright.

With mounting regulations across all levels of government, healthcare professionals face a complex web of compliance requirements. To provide quality care while staying compliant, organizations need new approaches for managing institutional knowledge. But how?

Today Rosemary Kirk, our own senior solutions consultant, is back, and she is going to help us explore practical strategies to leverage knowledge management systems for regulatory compliance and operational excellence.

Rosemary Kirk, welcome back.

Rosemary Kirk:
Thanks for having me.

Pete Wright:
So healthcare, it seems to have a lot of masters in the regulatory space. Can you set the table a little bit for us about what exactly the pressures look like for someone managing knowledge in the healthcare space?

Rosemary Kirk:
Oh, yeah. Those pressures are coming from all directions. Like you said, there’s federal and state level regulations telling you how things are supposed to happen and how things are supposed to be done. Yet those can change sometimes on an hourly level, never mind a daily basis. But then all of your internal customers, if I can use that word, of their pressures of needing to hire new hires and needing to keep them not only compliant, but get them competent up and running quickly and all of those pressures. And not to mention that the patient experience has changed significantly in the last three years, let’s say, and that’s changed the expectations that patients have as well of what their experience should be.

Pete Wright:
You just said, did I hear you right, when you said that regulations can change on an hourly level?

Rosemary Kirk:
It definitely did during the pandemic.

Pete Wright:
Oh, my goodness.

Rosemary Kirk:
And so now, there’s almost that expectation of you were able to adapt before, you should be able to do it now, even though the pressures, obviously the global pandemic in that situation has changed as far as urgency is concerned. But that there was that kind of belief of, well, you adapted, so now you’ve adapted.

Pete Wright:
That’s amazing.

Rosemary Kirk:
You may notice things like Teladoc or tele professionals, of being able to have a doctor’s appointment over the phone or over a Zoom meeting or something along those lines. A lot of organizations and healthcare organizations and practitioners have maintained that. Even though it’s not deemed, quote-unquote, necessary any longer, it’s become now just part of their standard operating practices.

Pete Wright:
Once you reframed that for me, that suddenly is the cascade of pressures, not just for how we deliver care and how we manage our practical operations, but how we hire on the fly. You talk about the pandemic, hiring and managing staff and personnel and getting trained on the fly, incredibly complicated. So, what does the landscape look like right now? How do you see healthcare organizations managing their knowledge?

Rosemary Kirk:
They’re struggling a bit, in my opinion. I’m speaking generally because there’s obviously exceptions. But I’m finding that healthcare organizations still treat knowledge very much like they did in the kind of 90s and early 2000s—using SharePoint-type repositories that have dozens of Word docs and PDFs that themselves are probably dozens of pages long, training departments that still use PowerPoint presentations, and then give people job aids and quick reference guides and all of those types of things.
There seems to be that still kind of general mentality of let’s firehose as much information as possible during that new hire training, sit them down next to a subject matter expert for a few days to have them kind of observe and pick up habits, whether those habits are good or bad can be argued as well. And then that idea of them just turning that associate loose and, oh, they’ll remember it because they went through training. And it’s definitely having its issues because the healthcare industry isn’t immune to the same hiring and retention issues that are currently being demonstrated nationwide.

Pete Wright:
It seems like a high-jump, low-ceiling scenario that you’re describing to me—that the pandemic will have exercised so many brand new muscles in organizational flexibility and yet they don’t seem to have really stuck.

Rosemary Kirk:
That’s what I’m seeing as well, yes, is that they made those adjustments. And don’t get me wrong, there are other technologies within medical care and within healthcare that have jumped leaps and bounds. But when it comes to still that basic kind of system knowledge, step-by-step instructions, policies, rules, things that kind of your average associate, like a scheduler or a biller need at their fingertips, it’s not easy for them to be able to find that information, nor be confident that what they’re looking at is the latest and greatest version.

Pete Wright:
I just got a letter from my healthcare facility that I lost my doctor. My doctor went to a VC- funded private healthcare institution, membership-only healthcare. It’s like a gym. I don’t know what they do over there. I can’t get in. And it got me thinking a lot about the nature of agility and the changing function of business operations in healthcare. What does it mean to be agile in the healthcare market today? Because you’re talking about training and getting people up-to-speed, onboarding and turnover, and now we’re dealing with entirely new business structures that run into conflict with a very long history of healthcare operations in this country. What does it look like today to adapt?

Rosemary Kirk:
To kind of paraphrase that real estate term, communication, communication, communication. I don’t think healthcare organizations can live any longer and function in the silos that they’ve always had—where each department is just sort of doing its own thing and at its own pace. The ones that I’ve seen are successful are when representatives from each of those departments frequently meet and they discuss changes. And not only just the changes themselves, but how it impacts each of those groups.
I’ve seen organizations time and time again make a change to some sort of process, let’s say in their contact center, but they don’t consider how that change impacts something downstream. So it might be something like, oh, well, when Pete calls and schedules an appointment, we used to have to not only collect his insurance information, but spend time kind of verifying that not only is it active, but whatever service he’s getting is covered and how much is it covered. But you know what? We need to shave some seconds off of our call handling time to meet some of our service level agreements. So, let’s just gather the insurance info and we’ll let billing or claims or somebody else down the line figure out what’s covered and what’s not. Not realizing that by the time it lands in the hands of the billing department or the claims department, you’ve already had your appointment, you’ve already had your service, and now they’re finding out you’re not covered for that service you just had and you’re going to get this giant bill in the mail, and so now you’re going to be upset. And so it’s causing this sort of chaos that could have just been saved if they just spent those extra few seconds verifying your insurance.

Pete Wright:
Wow.

Rosemary Kirk:
So, it’s that idea of rather than having, again, individual departments making these decisions on their own about, “oh, we’ve got to make this change because we were told about this new thing,” getting together and really communicating to ensure that everything is, you’re recognizing the pros and the cons, and then you’re adjusting that accordingly.

Pete Wright:
In terms of when you talk about the dramatically sort of fluctuating changes in the healthcare organizations, and mergers and acquisitions and all the kinds of turnover, how do you use your knowledge management tools and expertise to remain compliant in such a chaotic environment?

Rosemary Kirk:
Absolutely. Because I think a lot of times when people hear compliance and healthcare, they’re thinking more like malpractice, those types of things, where compliance can be, like we said, just as simple as when you schedule someone’s appointment, you need to verify their insurance in this way and follow these particular steps. And if you don’t, then you’re not compliant with that procedure, those types of things. So absolutely, having not only the communication, some sort of governance, that open easy way to be able to collaborate on any sort of changes, but having a single source of truth, a knowledge management system that’s easy for everyone to be able to intuitively access and be able to distinguish at a glance what they need to do.
I mentioned before healthcare organizations still very much live in Word docs and PDFs because,0” oh, well, our auditors need to have an SOP,” a standard operating procedure that they have to review. But if I’m a scheduler in a contact center and I’m expected to take a hundred to 150 calls a day and seconds are ticking away, I can’t open up a 75-page Word doc and kind of riffle through it to figure out what that particular step is. I need to be able to get to something quickly at my fingertips. So not only is it about communicating and building up that single source of truth, but having it intuitive and efficient as well.

Pete Wright:
So it sounds like what you’re saying is there are two levels of compliance, right? There’s the malpractice compliance, there’s HIPAA compliance, right? There are all the sort of regulatory body compliance levels. But are you suggesting there is also, when you look at internal or departmental or organizational standards of compliance, that maybe if the auditors still need the PDF SOP that you keep that, but essentially we need two systems? Essentially, we need systems that talk to each other that can both answer the questions of the frontline scheduler and the regulatory bodies that are coming in from time to time to scour our stuff?

Rosemary Kirk:
What we’re doing at Upland is creating kind of that one-stop shop—that single source where you can have one system that makes those auditors happy because it’ll provide that information in the format that they want and see version history and all of those types of things. But it also can allow the users to access information in the channel that they want, whether that’s a website, almost an intranet-type thing, or a chatbot, or almost more of a traditional training manual standard knowledge management system-type format, too.

Pete Wright:
We’re going to talk all about that. I feel like I have one more question that is percolating here, and it’s around transitioning to digital records and the friction of paper. Have we made that transition? Is everything searchable now?

Rosemary Kirk:
I’d like to think so, but actually at Upland, we also have a product that works with faxing, and it’s amazing how much faxing is still alive and well in the healthcare industry, not to mention legal and a couple others as well. So, I don’t think paper is dead yet, but I’d like to think for at least a training department, the learning and development, those types of folks where you need that step-by-step instruction, rules, guidelines, scripts even, I think that we’ve finally gotten away from paper.
It’s just, again, the kind of format in which it’s delivered really needs to be taken a look at. Because I think what’s happened a lot of times, especially still in healthcare, is that sure, that document’s not on paper, but it’s still digitally several pages long. There’s still a lot of scrolling and that control+F and a lot of people will say, “Well, how do we search for it faster?” And it shouldn’t really be about the search. It should be about the find.

Pete Wright:
Oh, that should be on a T-shirt, Rosemary.
So, give me some guidance to maintaining large healthcare organizations’ sort of corpus of information in this context. What are you doing to make sure that organizations are trained up in maintaining their data for optimal internal and external and regulatory compliance?

Rosemary Kirk:
I think it goes back to like we were saying before of that communication—that idea of you can’t really live in silos anymore. So, really having kind of a governance group, some call it a center of excellence, where you’re ensuring that there’s not only buy-in from the top of the org chart down. Everybody understands and knows kind of why knowledge management is important, how those non-compliance issues can impact the organization. And again, not just malpractice, but that idea of letting Ms. Wright know about her insurance coverage in the front of time, but also, again, establishing that structure, that team to ensure that it’s easy to be able to have consistent ways to deliver information.
Because you also want to think about things like an associate career path. Yes, we’re hearing about struggles of hiring and maintaining those new hires, but we also recognize that sometimes in health insurance, or health insurance and healthcare, we’re hearing of some folks that have been there 15, 20, 25 years. So that idea of a governance and a continuous kind of interdepartmental communication means that you can ensure that as someone is going through that career path, they don’t have to relearn how their knowledge management system works or where to find their info. It’s all still in that single source of truth, and it just speeds up that training and that competence a lot faster.

Pete Wright:
Yeah, amazing. Then let’s talk about what you’ve got going on with Panviva.

Rosemary Kirk:
Yeah, absolutely. Panviva is kind of that perfect example, if I can say it, of that single source of truth. And, in fact, several dozen healthcare organizations, just in the US alone, use it as both that training manual and that on-the-job performance guidance tool. Some of our customers call it the Guide on the Side because one of the popular kind of templates and ways of delivering information only takes up about a third of the user’s screen. So, they don’t have to kind of alt+tab or toggle between their systems of record and then the step-by-step instructions that they have. But going along our topic today, it’s very popular in healthcare and in financial services because of its compliance capabilities. All of the information is role-based and it’s layered. So, those new hires can find kind of those details that they need, but that more seasoned experienced representative or employee can get what they need as well.
It’s not just all text like you would find in the Word and PDFs. There’s process maps and icon navigation, great analytics to track everything that not only the users are doing, but what the authors and admins are doing as well. So, it’s making all those auditors and compliance folks still happy with all that version history. But it also doesn’t have to be agnostic. It can integrate with CRMs and EHRs and IVRs and chatbots and such. So, it can feed all of those different channels and maintain that consistent messaging throughout the entire organization.

Pete Wright:
This is unprecedented right now, Rosemary. You are the beneficiary of a brand new segment on this show. I’m very excited to introduce you to it. It is the Show Feedback Section, and I have a question from a listener, Rama, who wrote in something, specifically, I think we want to talk about the human interaction with keeping people up-to-date. Here’s the question. What is the most effective strategy to keep reps up-to-date on the latest information? How do you handle it when technology fails and information isn’t accessible on a call? Now, we’ve got the Guide on the Side with Panviva, but is there ever a scenario when reps or schedulers are awash at sea?

Rosemary Kirk:
Well, I would hope the system would never crash on them. We would never want anything like that because often Panviva is also used as that communication tool. We can talk for hours about the perils of email, especially when you’re talking about a high productivity-type associate, who is supposed to be on the phones and assisting their patients and such. They can’t be looking at their email all the time. So we’ve seen definitely that shift of using Panviva kind of homepages or landing pages to just have a quick sentence or two. “Hey, this system is down,” or, “Hey, we’re getting calls about X, Y, and Z,” and those types of things. And having that flexibility of allowing someone like a team lead or a supervisor to be able to send out that notification, rather than needing kind of an IT system administrator.
So, I know our knowledge bases are broken up that way that you can have that governance team that we talked about maintain things like policies and procedures and such, but have the team leads and other folks within each department have their own ways to be able to communicate and notify of any sort of changes or updates or things like that as well.

Pete Wright:
Well, and that gets to the benefits of releasing yourself from the perils of version control, right? When the knowledge base is always up-to-date, then making sure that your reps are up-to-date on the latest information, I assume, is effortless.

Rosemary Kirk:
Absolutely. And it gives those reps that confidence of they don’t have to second-guess anymore. They know that everything they’re looking at is that latest and greatest. Because I know we’ve all had jobs that we’ve done them for years and years. And after a while, you think you know more than what your technical resource does or what your digital resource does.
So, it takes a lot of burden, too, off of people of not having to feel like they’re the person that everybody has to go to in order to ask questions about things. They can contribute to this knowledge base, so then everybody can share in that information as well.

Pete Wright:
Fantastic. Rosemary, thank you for coming back, for being the beneficiary of our unprecedented new segment Listener Feedback. It’s very exciting.

Rosemary Kirk:
Happy to have it.

Pete Wright:
Very exciting. Thank you so much.
Where would you like to send people? I’ve got some links that we’re going to put into some of the resources on Upland’s site. Is there any place specific you really want to target listeners to visit to learn more about what you’re up to?

Rosemary Kirk:
Yeah. Come check out the Panviva product on the uplandsoftware.com website.

Pete Wright:
Easy enough. Links in the show notes.
We appreciate all of you downloading and listening to this show. Thank you for your time and your attention. As you heard, we’d love to hear what you think. Just swipe up in your show notes, look for the feedback link to send guest questions to any of our past guests, and we will do our best to get them answered. On behalf of Rosemary Kirk, I’m Pete Wright, and we’ll see you right back here next week on Connected Knowledge.