Transparent Love

I spent an hour yesterday in a meeting with a group who represent a significant number of healthcare providers in our state. The meeting was largely productive, and as a bonus one of the participants mentioned something that set off an interesting train of thought. What she did was paraphrase a classic IT tech support call--- the one that starts with “I don’t know anything about computers…. And I don’t want to know.”

For a computer user the issue is that the process needs to be transparent. The user doesn’t care about the hardware and how it works. To her it is just a tool, like a toaster or a lawnmower, something that helps to get the work done, not the work itself. Good systems have a high degree of user transparency.

Here’s what she was trying to say. The same skills that made her a good nurse made her resistant to HIPAA regulations. Anything that seems in anyway to interfere with caring for the patient, or even requires her attention during the process is an aggravation. For her, the system is not transparent, and so she resents it.

There was a lot of talk among providers and other interested parties about the recent AHIMA survey, and most of us noticed the 18% in compliance number, but maybe the most important overlooked fact was that the number one pain for most providers was education and training. Front line providers resent and fear HIPAA, often overreact to warnings, and soon burn out on trying to figure out what they are supposed to do or not do, and lapse back into their old habits and judgments.

To combat this, make certain your training is done in a fashion that is engaging and relevant. If the training answers the basic question “What’s in it for me?” in a positive and usable way, and provides an open exchange of ideas, questions, and examples that are instantly recognizable and applicable to those on the front line, then the training will succeed, and the process of everyday compliance will become transparent to the provider.

Another aspect of this transparency thing is making certain that the systems for compliance are designed with this same transparency in mind. Anything that requires extra steps or judgments from the front-liner steals from this goal. The ROI on properly set up systems, whether technical or organizational is clearly demonstrable with the simplest of napkin-back calculations, but for some reason there is a blind spot for many of us when it comes to any kind of regulation compliance. HIPAA privacy in particular was designed to allow compliance with common-sense measures. There is no need for convoluted, Byzantine structures to comply. One of the examples I use in trainings is a company that sells sound reduction equipment to pharmacies. The Plexiglas barriers, phone baffles and white-noise generators cost thousands of dollars, and no doubt provide near bullet-proof protection from accidental oral disclosure of PHI. But so does a tape line and a hand made sign that reads “Please wait behind this line.”

Design your systems and training with transparency in mind, and you will reduce your workforce frustration and resistance, and increase the quality of your care, which in the long run is why you got into this business to start with.