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The Evolution of Healthcare Enterprise Risk Management (ERM)

Over time, healthcare systems began to make the connection between various areas of risk – even if not readily apparent to laymen.  What does an ambulance company and an answering system have to do with a surgeon?  Well, when patients experience unexpected complications after surgery and cannot reach a doctor, they might call the ambulance.  If the ambulance takes too long, the complications might get worse, leading to serious injury.  An otherwise uneventful surgery just led to a million-dollar lawsuit against a surgeon who performed a technically sound operation because the “enterprise” broke down.

The scenario above is not uncommon.  And when it occurs, it might prompt different reactions. Some surgeons might look within their own policies and procedures to tighten their fiefdom – drawing bright legal lines between their responsibilities as surgeons and the other entities along the continuum of care.

Others will look beyond their practice and develop vertical and horizontal partnerships or capabilities that can help prevent complications.  Value-based care is creating a unique and unprecedented opportunity to build enterprise-wide best practices.  Perhaps unknowingly, these practices can effectively merge, or even eliminate a host of risks – from regulatory, to professional to financial.  The nation’s legal frameworks have been slow to adapt to healthcare’s transition from fee-for-service, but providers need not wait for antiquated regulations to change before building sustainable risk structures. 

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