The PADS Framework for Compliance and Security - Part 1
March 14, 2016

Gabriel Lowy
TechTonics

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The PADS (Performance Analytics Decision Support) Framework recommends a more strategic approach to user experience and application performance. Providing superior user experience consistently is a clear competitive differentiator on the path to achieving the three components of higher return on investment (ROI). These components are:

1. Reducing costs

2. Enhancing productivity

3. Generating incremental revenue streams

But deeper intelligence into the application delivery chain can also help companies meet compliance and security requirements more effectively in order to achieve their risk management objectives. Industries such as healthcare and financial services are under increasing regulatory pressure to demonstrate systems efficacy and security for protecting sensitive personal information and resilience against market disruptions.

Below we highlight new regulations in these two industries that underscore the risks companies face when they don’t have a good handle on user experience or application performance across the application delivery chain.

Healthcare: Pressure to Improve Patient Outcomes at Lower Costs

Major reforms are driving the healthcare community to leverage technology in a manner that provides for a timely and secure exchange of information related to patient care.  The Affordable Care Act has resulted in upgrades to existing data exchange services, deployment of new ones, and the incorporation of mobile access and communication between providers and patients.

Among the drivers are new measures that estimate the effectiveness of health plans. The National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set (HEDIS) sets performance metrics on provider quality of care. The data required to calculate HEDIS scores come from many different sources, such as clinical applications and pharmacy and medical data claims systems.

Many health providers and plans have been focused on the International Classification of Diseases, Tenth Edition (ICD-10). ICD 10 is a clinical cataloging system that went into effect for the U.S. healthcare industry on Oct. 1, 2015. Providers, coders, IT professionals, insurance carriers, government agencies and others use ICD codes to properly note diseases on health records, track epidemiological trends, and assist in medical reimbursement decisions. These codes must be consistent across systems to ensure proper classification in diagnoses.

Providers are also occupied with Meaningful Use stage 2 (MU2), which is the second phase of the Meaningful Use incentive program. MU2 is designed for eligible providers to demonstrate their progress toward meaningful patient engagement using state-of-the-art healthcare IT and methods best suited to their practice.

The Centers for Medicare and Medicaid Services (CMS) established criteria that eligible professionals, hospitals and critical access hospitals must meet in order to continue to participate in Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.

Common themes of healthcare reform are patient engagement and the information exchange with external stakeholders. These include secure communication with patients, collaboration with other providers and an exchange of information with registries. Each organization is required to track, monitor and report on their efforts to meaningfully use technology to meet quality of service measures.

The Health Insurance Portability and Accountability Act (HIPAA) defines electronic personal health information and what covered entities and business associates must do to secure and protect it via the Security Rule. This includes conducting annual assessments of security and compliance with 42 specific safeguards, covering Administration, such as policies and procedures, Physical, such as access to the workplace where personal health information (PHI) is commonly used, and Technical, such as encrypting PHI data at rest and on the move.

Stellar user experience and application performance among and between constituent systems are critical to ensure systems efficacy and accurate scoring, as well as consistent diagnoses to reduce errors and improve patient outcomes. It also facilitates regulatory compliance for all stakeholders throughout the healthcare ecosystem.

Read The PADS Framework for Compliance and Security - Part 2, covering the global securities market.

Gabriel Lowy is the founder of TechTonics Advisors, a research-first investor relations consultancy that helps technology companies maximize value for all stakeholders by bridging vision, strategy, product portfolio and markets with analysts and investors
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