This Q&A with compliance expert, Lisa Herota, RHIA, CHC, CHIAP, CHPS, CCS covers best practices for a data-savvy compliance leader. Learn about realistic compliance metrics and how to share them effectively. Read more about Lisa’s background and experience at the end of this blog. 

Question 1 – How do you define value in the context of healthcare compliance? What kinds of value can compliance create? 

Lisa Herota – Compliance has a positive impact on financial, clinical and operational outcomes when we manage compliance well overall, not just by avoiding penalties.  

We help the organization safeguard the mission and reputation by: 

• Protecting revenue  
• Enabling ethical growth 
• Maintaining patient safety 

We do this all while also making our leaders feel more confident. They can make informed decisions through a compliance mindset, versus just worrying about how we’re going to avoid a penalty. 

Q 2 – Can you share examples of how you’ve created value or seen others do it? 

LH – One approach I’m proud of is strengthening organizational trust and reputation by developing a culture of compliance. This happens through:  

• Rounding and being present in the organization 
• Doing trainings  
• Partnering with leaders, medical staff, employees and even patients 

I’ve taken compliance teams from being the department where ideas go to die or the “Department of No” to being seen as a function that engages and supports. We became a resource that leaders want to bring to the table at the beginning of projects and discussions as a support versus just somebody to call when things go wrong. 

Q 3 – How do you measure and quantify compliance value?  

LH – I love data. I preach data, data, data to all compliance leaders. There are lots of different metrics we don’t think about, but many times, we just look at how we avoid fines. 

Actually, compliance has a lot of data for leaders to study. We can:  

• Look at percent of applicable regulations implemented on time.  
• Look at number and severity of audit findings or corrective action plans implemented.  
• Trend reported issues and how quickly those issues were resolved.  

Compliance Metric: Tracking the Near Misses 

Something that compliance leaders don’t think about often enough are the near misses. We usually think about these situations in patient safety and quality. But many times, compliance can help with close calls, and we should track those.  

Compliance Metric: Financial Value from Correct Regulation Implementation 

Common examples of financial value derived from correctly implementing new regulations include: 

• Reductions in external legal expenses 
• Decrease in denials and claw backs or repayments 
• Additional revenue capture  

Compliance Metric: Operations Staff Hours Saved 

You can talk to your operational leaders about how their team workloads benefit, especially if you have good regulatory change management tools with reporting and dashboards. Many times, I’ve tracked the number of hours saved that operational leaders don’t have to spend reading through regulations to decipher and interpret them.  

Department heads save valuable time when we provide them with tools like policy templates, implementation information, and the interpretation of the regulation itself. So, the hours compliance saves other department leaders is a good metric, too. 

Hard for Compliance to Quantify: Harm Avoidance  

It’s difficult for compliance professionals to quantify how they help the organization avoid harm. It’s definitely easier for revenue-generating departments to show their value, because they can measure the revenue they drive.  

But compliance often concentrates on how we avoid fines, and it’s hard to prove we’ve truly avoided something when the attitude is “Maybe we wouldn’t have gotten that fine anyway, regardless of what we do or don’t do.” That’s why I focus on other metrics. 

Q 4 – Who needs to know about the value that compliance creates, and how do you communicate that? 

LH – That’s a great question. There are various levels across any health system or organization that need to know the value that compliance has created, but the way you report it is going to look different based on whom you’re talking to.  

Talking to the Board 

When I’m presenting to my board or board committees, I target risk mitigation trends, assuring them we’ve got this. I use heat maps that show risk rankings, prioritization and key regulatory risk areas. I use implementation rates or key issues identified and resolved. When I’m talking to my board, I highlight how compliance work aligns with the strategic priorities of the organization.  

Talking to the Executive Team 

But when I’m talking to my executive team, I might get a little more granular with how many reduced denials or repayments or how many claw backs we avoided. Also, that metric about saving frontline leaders’ time, because that affects their operational teams as well as alignment with patient safety, quality and patient experience goals. A key metric is showing executive leaders how compliance ties into all the other objectives that the organization is trying to accomplish.  

Talking to Operational Leaders and Frontline Teams 

It’s a very different story when I’m talking to operational leaders or frontline staff.  With them, I focus on how I’m helping them succeed:  

• Fewer surprises related to regulations that apply to them 
• Reduced fire drills from reactive implementations versus steady, methodical implementation of regulatory change. 
• With good policies, procedures and training 

With frontline staff, it’s all about what compliance does. Proving compliance value is about showing them how we:  

• Impact their day-to-day reality. 
• Make changes to protect them and their patients. 
• Help make their work easier and safer. 

Really, it’s all about how we help support them and affect their day-to-day work. 

Tie Compliance Work to Strategic Goals for Value Recognition 

To overcome compliance reporting roadblocks, I go back to tying compliance’s work directly to the organization’s strategic goals. Just connect what we do to what the organization is focused on. Show how what we do impacts quality, CMS, star ratings, financial stability, the growth of new service lines and innovation.  

We need to connect what we do to optimizing and streamlining those goals and processes. 

Q 5 – What feedback have you had about compliance metrics and value? 

LH – One of the stories I love to share is about the day I was presenting a regulatory change management dashboard to my board. The very first time, I showed them that over the course of a year, the compliance team had touched over 535 regulations. It was the height of Covid, and when I presented that dashboard, board members just sit back in their chairs almost with a collective sigh.  

And they said, with the data you present, we can see what’s happened to the organization. We’re not just hoping we’re compliant. Now we can prove it. We can show that the organization truly is operating in a compliant manner. That was one of my biggest takeaways from frontline leaders.  

Other feedback I’ve received includes: 

• “I feel like compliance is supporting and partnering with me, not just telling me no or being a barrier.” 
• “When we streamlined compliance tools, that really helped support compliance functions.” 
• “Compliance saves us time and work by not having to review, interpret and decipher complicated regulations.” 

Leaders feel confident knowing we’re not missing anything and that they’re being supported. 

Be a Confident, Data-Driven Compliance Leader 

Wouldn’t you like to feel the same way about your compliance program? Reach out and we’ll show you some of the compliance management tools mentioned in this blog. 

About the Author 

Lisa Herota is a seasoned healthcare executive with over two decades of experience leading high-impact initiatives in compliance, privacy and health information management (HIM). She brings a strategic, data-driven approach to safeguarding organizational integrity. 

Throughout her career, Lisa has held pivotal leadership roles at several medical systems. Her expertise spans the full spectrum of healthcare operations, from managing complex ICD-9 and CPT coding systems, to overseeing departmental budgets and navigating rigorous accreditation standards. 

Lisa is a recognized expert in regulatory change management and is passionate about transforming compliance from a “policing” function into a proactive business partner. She holds an impressive array of professional certifications that underscore her deep technical knowledge, including: 

• RHIA: Registered Health Information Administrator 
• CHC: Certified in Healthcare Compliance 
• CHIAP: Certified Healthcare Internal Audit Professional 
• CHPS: Certified in Healthcare Privacy and Security 
• CCS: Certified Coding Specialist 

Beyond her technical skills, Lisa is a dedicated advocate for building a culture of compliance. She leverages her background in research and data compilation to provide executive leadership with insights to make informed, ethical and growth-oriented decisions.

Download our Latest Whitepaper

Sign-up for our Weekly Newsletter

Qualified compliance professionals do the heavy lifting for you, simplifying regulatory change management  

The post Beyond the Penalty: What Metrics Should Healthcare Compliance Officers Track?  first appeared on YouCompli.

The job of an Expert Compliance Professional requires very specific skills and strengths. When an ECP does their job well, hospital compliance teams’ benefit. This blog dives into the qualifications and background of one of YouCompli’s compliance professionals. 

Meet the Experts Behind Our Regulatory Intelligence Services 

Question: What skills and talents do you bring to this role? How did you gain the knowledge to perform your job?  

Bethanne VanderMolen – I bring a unique combination of clinical, compliance, and leadership skills to this role. My foundation as a speech pathologist taught me precision, documentation accuracy, and patient-centered care—skills that naturally translate into compliance oversight.  

As I advanced into leadership roles such as Rehab Director, VP, and Corporate Director of Rehab, I developed expertise in regulatory interpretation, risk mitigation, and the ability to build programs that balance operational goals with ethical and legal standards. 

Leading teams in therapy and then developing into a Chief Compliance Officer and Director of Risk Management in the senior care space sharpened my ability to engage diverse stakeholders and create regulatory frameworks, while my experiences outside of healthcare—working at Disney, teaching marching band, and coaching youth sports—taught me how to inspire teams, simplify complex concepts, and foster a culture of accountability in fun but effective ways. 

I gained my knowledge through both hands-on experience and formal professional development. Every step of my career, whether solving compliance challenges in healthcare, motivating students and athletes, or leading teams in high-pressure environments, has equipped me with the tools to not only interpret regulations but also make them meaningful and actionable for those I serve. 

Q – What achievements are you proud of in this or other roles? Share examples of how you bring value to your job and customers.  

BVK – I am most proud of the consistent impact I’ve made in my day-to-day work, where small improvements accumulated into lasting change. I think I’ve always had the ability to stack small wins and still see the big picture. I’ve always been willing to step in and do the work of multiple people when needed, keeping employees and patients in mind while balancing operational demands with compliance standards. 

In terms of larger achievements, I’m proud to have built two rehabilitation divisions from the ground up, as well as comprehensive compliance programs that continue to guide organizations long after my tenure.  

I’ve successfully navigated high-stakes challenges, including OCR breach investigations, Medicaid litigation, and regulatory and billing audits, often with positive outcomes that protected the organization, our employees, and our patients. I’ve also authored hundreds of clinical, administrative, and personnel policies that gave teams clear guidance and consistency.  

Perhaps one of the accomplishments I value most was leading compliance efforts during COVID. Much of that work happened behind the scenes with an amazing clinical consultant and director of operations—rewriting processes overnight, interpreting rapidly changing regulations, and ensuring patient care continued safely—but it kept our organization compliant and moving forward through a crisis. 

Across every role, I’ve found pride in building solutions, protecting patients, and making compliance meaningful for the people who rely on it. 

Q – What do you like about working in this role and in this company?  

BVK – What I enjoy most about this role and this company is the people. I genuinely like working with a team that is supportive, flexible, and kind—it makes even the tough days easier and the good days even better. I also really connect with the mission of helping compliance professionals succeed, because it means the work I’m doing has a ripple effect beyond just my own role. It feels good to know that what we do here is both meaningful and practical, and I appreciate being in an environment where collaboration and kindness are part of the culture.  

And on a more personal note, I love the flexibility of working remotely. It allows me to coach on the side and spend more time with my daughter. That balance makes me both happier and better at what I do. I love that I can log off in time to get to practice. Compliance and coaching both come down to teamwork, knowing your job, strategy, and keeping everyone playing by the rules. 

Q – What do you think is important for our customers to know about what you and what you do? 

BVK – I want customers to know that I bring clinical, management, and compliance experience to help make their work easier and more effective. I combine practical solutions with all the lessons I’ve learned along the way. I want customers to know that we are working hard to support them and reduce their stress. They are on our mind throughout the process; from the moment we pick up the reg through to the user interface. They can feel confident in my experience because I have been in their shoes as a clinician, manager, and compliance professional. 

Q – Any other thoughts? 

BVK – I got into healthcare as an SLP because it combined art and science. Helping someone with communication, cognition, and swallowing disorders requires an artistic soul because those are intimate human experiences. In my first job, however, I was confronted with the element of compliance in such an impactful and meaningful way that it changed the course of my career.  

I now like to think of compliance as both science and art: precise, but also human-centered. Our backgrounds are what help us make content that is usable, relatable, and trustworthy. We are what connects you to the regulations so that you can make it meaningful to your organization.  

Fun Facts 

Previous roles – SLP, Rehab Director, Rehab Consultant, VP of Rehabilitation, Corporate Director of Rehabilitation, Compliance Officer/Director of Risk Management 

Degrees, certificates, special training, etc. – University of South Carolina (Biology/Chemistry) and Medical University of South Carolina (MS Rehabilitation Sciences/Communication Sciences and Disorders); CHC; CHPC; CCC-SLP; RAC-CTA; CC; OSHA/General Industry 30; RAMP Certified 

Life Outside Compliance 

Jobs in other unrelated industries – Speech and Language Pathologist (SLP)/schools, percussion instruction, Disney, various administrative roles  

Family – Married to David, with one daughter, Kahlan. One awesome Shih-Tzu (Teddy “The Flash”). 

Hobbies and interests – Coaching, fantasy sports, sports card collecting, drums. Just hanging out with the family, playing games, etc.  

Download our Latest Whitepaper

Sign-up for our Weekly Newsletter

Schedule a quick overview

• One Compliance Pro’s Regulatory Change Management Process    by Amy Laufmann, MBA
• Five ways to show how healthcare Compliance delivers value by Jerry Shafran
• Revenue Cycle Management Compliance: Ensuring… by Maya Turner, CPMA, CPCO, CFPC, CPC, CPC-I, AAPC
• 12 key metrics for compliance officers looking to… by Kenneth Zeko, JD, CHC
• Transforming Compliance to a Department of Yes  by Lisa Herota, RHIA, CHC, CHPS, CCS Compliance & Privacy Officer
• Three Strategies to Align Compliance with Revenue Cycle  by CJ Wolf, MD
• How the Three Lines Model Strengthens Healthcare Compliance by Kenneth Zeko, JD, CHC
• Mitigating Conflicts of Interest that Drive Profit… by Susan Thomas
• Navigating Compliance Responsibility: A Foundation… by Amy Laufmann, MBA
• New Regulation– Now What? Step-by-Step Guide to… by Amy Laufmann, MBA

The post Q&A with a Healthcare Compliance Expert   first appeared on YouCompli.

This blog goes deep into regulatory intelligence for healthcare, guided by the expert commentary of longtime compliance veteran, Bethanne K. VanderMolen. [See bio at end.] It covers everything from reg intel basics to how the overall process works to AI’s potential contribution. 

Question – What does regulatory intelligence in healthcare mean, and what do expert compliance professionals do? 

Bethanne VanderMolen – Regulatory intelligence is an organized process that keeps healthcare systems in line with the copious regulatory agencies and legislative bodies directing healthcare. The full regulatory change management process supports operational decision making, compliance program updates, risk mitigation, policy maintenance, and strategic planning. 

As Expert Compliance Professionals (ECPs), we gather, analyze and apply information about new and revised regulations, guidelines and enforcement trends to help organizations maintain compliance and guide strategic decisions.  

While we do a lot of systematic monitoring, the work goes beyond that. The regulatory intelligence life cycle isn’t complete unless you turn that information into action.  Know what’s changing, understand the effect on your organization, and respond! 

Q – What do you think is important for clients to know about regulatory intelligence work? What is something most people might not realize? 

BV – Regulatory intelligence is dynamic and requires vigilance when reviewing changes. Google alerts are not a regulatory strategy or risk management program. Yes, we use tools and tech, but real regulatory intelligence takes interpretation. AI cannot do this work. I spend a lot of time reading between the lines to know not just what a rule says, but what it means.  

What people might not realize is that we review a lot of material that never goes anywhere. That’s just as much a part of this job. 

Q – What does a regulatory intelligence expert or ECP do? What kind of background do you need?  

BV – An ECP is part detective, part translator and part strategist. We constantly scan federal and state laws, guidance, enforcement trends and policy, and review and analyze regulatory updates.  

There isn’t a single path to becoming a compliance intelligence professional. A background in healthcare is very helpful, along with certification in healthcare compliance. You must have a strong regulatory background, meaning you have had to personally review, interpret and act on regulatory updates (not simply be subject to such changes). You really need that hands-on involvement in policy monitoring, regulatory change management, procedure updates, etc. 

Q – What skills and strengths are needed to do well in this role? 

BV – A regulatory intelligence professional must be detail-oriented and self-motivated. You must be an analytical thinker with strong reading comprehension. You see the big picture, and you’re tech-friendly. 

About the Regulatory Intelligence Process 

Q – Tell me about the process used to review and extract regulatory requirements.  

BV – These are the steps in our regulatory intelligence process: 

• First, log the item in the tickler file. Then I conduct my “first read” so I know what I’m reviewing and can identify if these are updates, new information, etc. I figure out who issued the reg, their authority, and if the update is proposed, final or advisory. I might also flag some items that may require a deep review. 
• Develop an “Extras sheet” that I can use to develop my screening questions, categories and tasks. This usually involves identifying some key words that will help me build these pieces. I also identify who it affects and check the enforcement dates. 
• Find any other relevant documents. Sometimes you need to locate older versions or comparison documents from the state, various boards or federal government. 
• Second read: Highlight changes and identify items with operational impact. Eliminate unnecessary information. Note items that may be “of interest” to a provider. 
• Develop the customer’s compliance tool using the highlighted changes. This will focus on the updates or new information that they need to know.   
• Review for standardization items. We try very hard to keep every tool’s format and language consistent between the various compliance professionals developing the tools. The group agrees to a set of guidelines that keep style, language, and grammar consistent.  
• Check my work. 
• Create in the YouCompli system using all the above. 
• Submit to validator and revise as necessary. (A validator checks our work and provides support and a sounding board.) 
• Track through tickler. 

Q – What’s the hardest part of regulatory intelligence services as a job? What do you like most? 

BV – There are times when regulatory agencies write conflicting things or make mistakes in their text. Then you must do a lot of research to figure out what is “right.” That’s the hard part. It can also be challenging at times to figure out what is really being communicated and then appropriately simplifying for the customer and making sure you’re not leaving anything on the table. 

I love this job. It’s very flexible. When I’m stuck on something, I can move to a different task or assignment. That helps a ton when you’ve been working on a large reg that requires a lot of review. Knowing you can leave it and sleep on it is a great benefit to the job.  

I also like the people. I can honestly say this is one of the few jobs where people are genuinely pleasant to work with and supportive of one another.  

Benefits and Outcomes 

Q – What do regulatory intelligence services offload from compliance teams?  

BV – I have been a compliance “department of one” with little to no support or resources. The responsibility for managing every regulatory update from every agency affecting our organization was overwhelming.  

What these regulatory intelligence services offload are the tasks of scanning all agencies for updates. You feel like someone is supporting you. What you do with the information is up to you, but not having to search for it or worry that you may have “missed” something is amazing. 

There was nothing worse in my previous lives than feeling like my days and nights had to be spent checking for changes. Or hearing a “rumor” that something was changing that you had no idea about. It was difficult to carry the stress of having to seek out all regulatory updates on my own, and no single association or board provides everything. You don’t want to let down your organization. YouCompli has your back, so you don’t have to have that stress anymore. 

I was never lucky enough to have YouCompli outside of the pandemic in my other roles. YouCompli was generous during Covid and provided their resources for free during that time. It helped me stay afloat when I was working 16-hour days, six to seven days a week. I will always be grateful. 

Evaluating Regulatory Intelligence Services 

Q – What’s important for compliance leaders to know about regulatory intelligence services? 

BV – Our regulatory intelligence services don’t just help you keep up; they put you ahead if you choose to carry the process through the entire compliance life cycle. The life cycle approach allows you to collect crucial information, then target policy changes, take action, and manage organizational risk if you use the information. In the current regulatory environment these services are becoming increasingly essential. 

The services also provide a great way to show compliance program effectiveness. If you’re utilizing YouCompli software and incorporating it into your risk management and compliance reporting processes, you can demonstrate proactive risk mitigation and value. It really helps mature your compliance department and will be valuable in any audit process. 

Good regulatory intelligence will also help operations leaders make good decisions, so it creates a great team dynamic for organizations when they use our regulatory intelligence resources. 

Q – What functionality should a compliance leader look for in a regulatory intelligence partner? 

They should look for more than just access to laws and updates. Compliance leaders should assess how well the service contributes to timely, relevant and actionable compliance decisions. 

Required functionality checkpoints for compliance partner: 

• Jurisdictional coverage 
• Timeliness 
• Context/analysis 
• Customization 
• Integration into workflow 

Q – What should health systems look for when a regulatory intel vendor says they offer these capabilities?  

• Proactive monitoring – Be certain they are monitoring what affects YOU. Also look for source transparency.  
• Impact assessment – Offers tailored results and prioritization for action. 
• Strategic plan – Look for collaboration tools. 
• Expert analysis – Check qualifications. 

Q – How do you feel about AI and regulatory intelligence? Any potential there? 

BV – Absolutely. As with all healthcare, AI is going to be a great partner for compliance. We just need to figure out how to incorporate it in a responsible and human way.  There is nothing that replaces the human experience. AI value really depends on how it is implemented. 

When I look at a reg that affects nursing homes, clinical services or therapy, there’s a personal connection that can’t be duplicated by AI. I know what the operator in the nursing home would want to know, even if it’s not highlighted by AI. I know what surveyors use and how they interpret regulatory language. I have been part of clinical action, training and policies, and understand what the clinicians need to know to do their jobs. 

But AI can provide real-time monitoring and scanning faster than humans. It can process language effectively and summarize key information such as dates, entities, etc. There’s a ton of potential for AI in this space. It’s not entirely trustworthy just yet, but it’s getting there fast! AI is going to be a powerful tool in healthcare compliance, but it needs to be well-validated and always used with human oversight.  

Want to learn more about compliance without chaos? Reach out for a look at our regulatory compliance services and software. 

About Our Expert 

Bethanne VanderMolen is a veteran compliance professional with more than 20 years of experience in the healthcare space, including compliance and regulatory intelligence. Her career path started as a clinician, where she cut her teeth as a Speech Language Pathologist. With commitment and skill, Bethanne rose from Rehab Director to Regional Director, VP of Rehab and Corporate Director of Rehab. 

In these roles, Bethanne found herself conducting surveys and writing policies, which inevitably drew her to the roles of Chief Compliance Officer and Director of Risk Management. Her subject matter expertise and hands-on experience have assisted departments and facilities through federal, state and local regulatory audits and surveys.  

Bethanne’s dedication to staying on top of these regulations and providing real-time updates and actionable guidance is second to none. Armed with extensive experience in developing and maintaining clinical, administrative and regulatory policies, she’s an excellent source of insight and advice about healthcare compliance.  

Bethanne’s expertise and commitment to the industry make her an invaluable resource for leaders navigating the complex world of regulatory compliance. Her advice is rooted in practical experience and a thorough understanding of the regulatory environment that shapes healthcare today. 

Download our Latest Whitepaper

Sign-up for our Weekly Newsletter

Schedule a quick overview

• One Compliance Pro’s Regulatory Change Management Process    by Amy Laufmann, MBA
• Five ways to show how healthcare Compliance delivers value by Jerry Shafran
• Revenue Cycle Management Compliance: Ensuring… by Maya Turner, CPMA, CPCO, CFPC, CPC, CPC-I, AAPC
• 12 key metrics for compliance officers looking to… by Kenneth Zeko, JD, CHC
• Transforming Compliance to a Department of Yes  by Lisa Herota, RHIA, CHC, CHPS, CCS Compliance & Privacy Officer
• Three Strategies to Align Compliance with Revenue Cycle  by CJ Wolf, MD
• How the Three Lines Model Strengthens Healthcare Compliance by Kenneth Zeko, JD, CHC
• Mitigating Conflicts of Interest that Drive Profit… by Susan Thomas
• Navigating Compliance Responsibility: A Foundation… by Amy Laufmann, MBA
• New Regulation– Now What? Step-by-Step Guide to… by Amy Laufmann, MBA

The post Q&A: Regulatory Intelligence with a Healthcare Compliance Expert  first appeared on YouCompli.

Healthcare compliance/accreditation professional Amy Laufmann, MBA, has held a variety of quality and compliance roles for over ten years in multiple settings. Currently the Client Success Manager at YouCompli, she works with healthcare organizations across the country every day, from single-state healthcare systems to systems spanning nationwide. She shares her experience not only having worked in the field, but also the knowledge and insight gained from supporting organizations using the YouCompli compliance software to manage regulatory compliance changes in their organizations. 

Let’s Talk Regulatory Change Management and Compliance Software

In this expert interview, Amy shares insight surrounding compliance management software (like YouCompli) and examples of what it takes for organizations to be successful.

Question: What are the advantages of using compliance software?

Amy Laufmann: Compliance software allows for automation number one, and then accountability.

As far as automation is concerned, the software offloads manual tasks from compliance teams. Essentially, automation skips the manual process of fighting through all the noise and duplications to find out what regulations apply and then delivers it directly to the department accountable for completing the work.

It brings you quickly and directly to the point of starting the compliance work that needs to be done in response to regulatory changes.

YouCompli helps compliance teams start at that point, as they are alerted to regulatory changes that impact their organization. They also get information on what needs to be done to share directly with the impacted departments.

Q: How Do You Know if You’re Catching All the Right Regs?

AL: I remember working at an organization where we had just hired a new Chief Compliance Officer, who was meeting with our team. He asked how our team ensures that we’re monitoring all applicable federal and state rules, and updated accreditation standards.

The team was silent, because despite our best efforts, the process of listserv notifications and the endless newsletters and different compliance organizations did leave concern that something could easily be missed. I’m not going to lie… despite my best efforts, the thought of “What did I miss?” really did surface occasionally.

It’s important to note that software automation eliminates the challenge of simply finding all the rules and regulations that organizations need to be aware of before even getting started doing the work.

Special Care Needed for State Regulatory Changes

Additionally, state regulatory changes are not always the easiest to monitor, track and implement. Often, hospital associations and government relations departments help get important bills on the radar of compliance teams.

However, government websites or other legislative tracking web applications are essentially online libraries. Their results often include bills both passed or not, supported or opposed, and it can be very cumbersome to translate that information into where bills are in the process, which are passed, failed, signed by the governor, etc.

If you know what you’re looking for, great. If you need to find out what should be on your radar, you can very easily miss something and have difficulty finding what you need, especially for those things that may be a bit more obscure, like healthcare transportation.

How Compliance Software Provides Closed-Loop Accountability

That brings me to the second advantage, accountability. Compliance software provides accountability for those folks responsible for implementing the regulatory change and clearly identifying what work has been done in order to comply.

Compliance software has tools built within it to manage that workflow. It can alert staff when they’re assigned work related to regulatory changes, as well as those who need to monitor that work when it’s been done.

Compliance is all about closing the loop and documenting what’s been done, and compliance software automates this process through workflow to ensure the loop gets closed.

Q: It sounds like compliance teams could use help. What features should organizations look for in a compliance management tool?

AL: Compliance management software must include all the regulators you care about. It has to include both federal and state rules and regulations and centralize that information to ensure it funnels into your organization from one source. If I’m going to invest in a compliance solution, it must eliminate the need for me to care about any other noise when it comes to monitoring regulatory changes.

In addition to one source of truth, the ability to have workflow is crucial, as compliance work is typically a very manual process of spreadsheets, tracking, notes and emails scattered across many different places in an organization.

Compliance software should include workflow that allows compliance teams to assign tasks, provide information, and track regulatory work. It should maintain that information within reach of not only compliance teams, but other stakeholders like managers and directors who may want oversight on work impacting their teams, as well as completion status.

Guidance About Compliance Reporting Tools

Lastly, compliance management tools should include the ability to report on the state of compliance work within an organization. What if you could see on-demand and in real time all regulatory work assigned, in progress and complete without having to pull information from multiple spreadsheets, departments, forms, etc.

Compliance software should allow your organization to identify the department, date ranges, status type, or even users and the associated regulatory work.

Reporting within compliance software can help you:

• Identify the state of assigned, in progress, overdue, and completed regulatory work.
• Spot bottlenecks where compliance work is not progressing.
• Are there users, departments, or types of regulations that are going unaddressed?
• Spot departments or individuals who address compliance work in a timely manner and keep their impacted areas in compliance with regulatory changes.
• Who deserves recognition and kudos for getting the work done?
• Facilitate communication and credibility for compliance teams as experts on the state of compliance within their organizations.

Recap: What to Look for in Compliance Management Software

In summary, compliance management software should provide:

• Single source of information to ensure your organization is reviewing all necessary regulatory changes, that is, all the regulatory information your organization needs to know.
• Workflow automation to assign, monitor and complete regulatory work.
• Centralized database to store all information and documentation to implement regulatory changes.
• On-demand reporting to observe all regulatory work, current state and departmental impact for both high-level teams like leadership, as well as detail-level reporting to monitor work assignments by department, user or effective dates.

Compliance Management Goal: Eliminate as Much Risk as Possible – And Software Helps

Healthcare organizations and the compliance teams within them won’t often come out and say it, but 100% compliance 100% of the time just isn’t possible. It is nearly impossible to be ahead of the regulatory change game all of the time and have everyone in an organization compliant with every rule and regulation on the books.

If that were the case, things like billing errors, overpayments, self-disclosures, ADRs and plans of correction would cease to exist.

The point is to eliminate as many potential areas of compliance risk as possible. Compliance software lends itself very well to getting the high value/high risk/high impact regulatory work addressed but still doesn’t let regulatory changes less likely to cause reputational damage or severe financial penalties fall off the radar. It ensures that when capacity and resources are available, those changes too are addressed.

Compliance software like YouCompli provides a valuable, comprehensive picture of the landscape in your organization.

Q: How fast can you go live with compliance software in an organization?

AL: This is a question I get asked all the time, and if I’m honest, I have a love-hate relationship with it. First, let me say if an organization were to purchase YouCompli, ultimately, I could have the software live and sending you notifications of all regulatory changes the same day your desired regulators, jurisdictions and users are identified.

The challenge here is not how quickly we can flip the switch and provide the software to you. It’s really identifying the organization’s goals in using the software in order to either support or improve upon them when we turn on the software.

Launching compliance software within healthcare organizations can be as simple or as complicated as they wish it to be. My job is to help organizations understand how the software works to support and improve their regulatory change management processes.

Four Requirements for Quick, Successful Regulatory Software Roll Out

A lot of the success or failure of this process has to do with a few common themes within a timeframe that’s realistic for the health system.

• Strong support from leadership and communication from senior leaders clearly outlining expectations and processes for utilizing compliance management software.
• Compliance teams have good manual processes in place and want to optimize their efficiency and eliminate time spent on manual work.
• Organizations have clear roles and expectations for responsibility in completing regulatory work in existing structures.
• Compliance is viewed as a part of operations but needs a framework of standard processes and automation to support their efforts.

Integrate with Existing Compliance Processes or Start from Scratch?

When You Have Processes

When organizations have a good foundation to manage work related to regulatory changes, compliance software can almost immediately support that process and make it much less time-intensive by automating all manual parts of the existing framework.

When You Need Processes

For organizations needing compliance software to support a new process or to build a framework for ensuring regulatory work is completed, the software is still quite simple to implement. We provide a framework outlining the process, steps involved and required information, so your organization has an outline for success from day one.

Q: What Do You Need to Roll Out Compliance Software?

AL: Implementation and roll out depend on an organization’s ability to provide the following information:

• Jurisdictions and Regulators: What federal regulators, MACs, and state jurisdictions apply to your organization? (YouCompli provides a list for your organization to select/include in your system.)
• Regulatory Assignments: What do you want the workflow process to look like?
  • Centralized Assignments: All regulatory changes are funneled through compliance teams for review before assigning task work to impacted departments.
  • Decentralized Assignments: All regulatory changes are funneled directly to identified department leaders who are responsible for managing and completing regulatory work specific to their department. (YouCompli provides a “regulatory rolodex” for you to identify department-level, automated assignments.)
• Software Administrator and General User Training Sessions:
  • YouCompli administer training typically consists of one 45- to 60-minute session for leaders who will use the software to manage and oversee regulatory work.
  • YouCompli general user training sessions include a 30-minute overview of how to use the software to complete any assigned regulatory work.

Q: What Should You Know about Software Training and Ease of Use?

AL: Ease of use and training are worth noting because ultimately everyone wants the software to be used.

Speaking of the YouCompli solution specifically, the software is easy-to-use and provides step-by-step instructions guiding users through the process of completing assigned work. It includes on-demand training videos directly linked to those steps, as well as responsive and proactive support not only during implementation, but throughout your time using the YouCompli software.

This support comes directly from our team of industry experts who provide credible, reliable and actionable information. The support crew includes people who’ve worked directly within healthcare compliance, as well as attorneys.

So, when I’m asked how quickly can we go live with YouCompli, the answer is as fast as you’d like. However, to set your organization up for success, I most often recommend identifying a timeline that aligns with ensuring your software is well-utilized and that you get the most value from configuring it.

Q: Do healthcare organizations need to be concerned about privacy and security with compliance tools?

AL: YouCompli specifically is a cloud-based software that enables organizations with web access to use standard username and password access. The software lets organizations easily assign and manage user roles and provides the ability to control what those different roles have access to in the solution.

We also set up Security Assertion Markup Language (SAML) which allows the software to authenticate users on an organization’s network and bypass password entry entirely.

The compliance software is not HIPAA-compliant and should not be used to store protected health or confidential information. This is something you will always want to check for any software your organization evaluates.

Most importantly, you want to ensure that the security and privacy that a compliance tool does or does not provide is clearly communicated to all users.

Q: Any Additional Thoughts to Share?

AL: Healthcare compliance is complex. It touches every department within a healthcare system, but it is often an underdeveloped program. I think despite all of the advancements in technology, tools and applications, finding software that actually works for healthcare compliance teams is difficult, and the value of finding a great one is underrated for this particular field.

I currently work for YouCompli, and of course I’m going to be promoting that solution, but I think it’s important to note that I’m only a YouCompli Client Success Manager because first I was a YouCompli client.

My passion for improving access to technology and tools to support regulatory compliance teams and helping them get the most value and support when using software is why I’m here.

I’ve worked at health systems using YouCompli, and I’ve worked at health systems for quite some time without YouCompli. I’ve experienced first-hand the vastly significant difference it made for compliance teams and the organizations they serve, and I can’t imagine working directly in compliance without it ever again.

Q: Ready to Take the Next Step Towards Confident Compliance?

With so many capabilities and benefits, what’s holding you back from learning more about compliance management software and confident compliance? Here are other resources you might want to look at.

White Paper: Empowering Compliance Officers to Drive Better Health and Business Outcomes – How effective regulatory change management practices help healthcare organizations mitigate risk

White Paper: The Opportunity for Compliance to Create Value for Healthcare Organizations – Best practices for demonstrating how compliance makes an impact

White Paper: Doubling Your Impact: Demonstrating Compliance’s Value and Shaping Culture – Best practices for proving your value in five key areas.

Amy Laufmann is client success manager at YouCompli. She has 10+ years of experience in healthcare compliance and operations, and is passionate about helping healthcare organizations operate better and deliver better patient outcomes.  

Take Free RL3M Assessment (Regulatory Lifecycle Management Maturity Model)

RL3M Assessment

Download our Latest Whitepaper

Sign-up for our Weekly Newsletter

Qualified compliance professionals do the heavy lifting for you, simplifying regulatory change management  

---

27 Ungated Resources for Compliance Leaders and Teams 

Compliance professionals sometimes feel undervalued in comparison to other functions in their organization. They think leaders and colleagues don’t really understand what they do.  

These resources will help. Packed with ideas, tips and recommendations, these pieces were written by professionals with many years of compliance experience. 

You can quickly skim for articles that relate to your needs and interests. Bookmark this page as a reference for future questions or projects.

Visit Now

---

• One Compliance Pro’s Regulatory Change Management Process    by Amy Laufmann, MBA
• Five ways to show how healthcare Compliance delivers value by Jerry Shafran
• Revenue Cycle Management Compliance: Ensuring… by Maya Turner, CPMA, CPCO, CFPC, CPC, CPC-I, AAPC
• 12 key metrics for compliance officers looking to… by Kenneth Zeko, JD, CHC
• Transforming Compliance to a Department of Yes  by Lisa Herota, RHIA, CHC, CHPS, CCS Compliance & Privacy Officer
• Three Strategies to Align Compliance with Revenue Cycle  by CJ Wolf, MD
• How the Three Lines Model Strengthens Healthcare Compliance by Kenneth Zeko, JD, CHC
• Mitigating Conflicts of Interest that Drive Profit… by Susan Thomas
• Navigating Compliance Responsibility: A Foundation… by Amy Laufmann, MBA
• New Regulation– Now What? Step-by-Step Guide to… by Amy Laufmann, MBA

The post Expert Advice: Compliance Software Q&A with a Compliance Professional  first appeared on YouCompli.