Verge Health: A GRC Model for Healthcare Industry That Works

Dr. Mark Crockett, CEO

Amidst the numerous and evolving compliance challenges in the healthcare industry, there is a clear need to entrench a governance and risk management system that operates in a coordinated and systematic fashion following processes gleaned from other high-risk industries like nuclear power and the airlines. Understanding this growing need, South Carolina-based Verge Health launched its Governance Risk and Compliance (GRC) strategy with the ultimate aim of ensuring patients remain safe and protecting margins for healthcare organizations to allow them to continue quality care. The firm’s proprietary GRC model adopts a comprehensive approach to ongoing, connected management of governance, risk and compliance, for hospitals and other healthcare organizations to ensure they remain survey ready--- but more importantly, patient ready.

In an interview with CIO Applications, Dr. Mark Crockett, CEO of Verge Health shares his vision for the healthcare arena and provides insights on the importance of GRC to this industry.

On Implementing GRC in the Healthcare Space

One of the biggest challenges that exist to implementing GRC in the healthcare space include the fact that people in healthcare are often unfamiliar with GRC.

In addition, the healthcare arena has some unique challenges when embracing traditional GRC concepts. For instance, many of the physicians treating patients in hospitals are not employees but independent contractors. Traditional governance structures will struggle without taking into account complexities of credentializing and privileging as key components. In addition, many core functions are not captured electronically, and those that are typically do not integrate with one another. This issue hinders hospitals from gaining comprehensive knowledge about contractors, and makes it challenging to deploy true GRC. Understanding these pertinent challenges in a care delivery setting is the basis for why Verge Health developed an automated surveillance and rounding system to ensure effective implementation of GRC in healthcare systems across three core areas including organizational compliance, patient and employee safety and practitioner management.

Trends influencing the Healthcare Industry

From my perspective, the first trend transforming healthcare is that there is now a currency for delivering exceptional service. Organizations such as Cleveland Clinic provide extraordinary patient experience---and at a lower cost. They are on an absolute trajectory to consistently deliver higher quality care and that is being rewarded with real financial value. To ensure that this equation remains true in light of rising patient financial responsibility, a demand for transparency and value-based reimbursement has created an absolute requirement for GRC in healthcare.

The second trend healthcare is witnessing is a surge in advanced technologies that automate manual processes and support data-driven decision making.

At Verge Health, we make achieving and sustaining high reliability possible

More vendors are delivering cloud-based solutions that are relatively easy to integrate and create a greater availability of data. We are starting to see more companies delivering the type of technology that makes implementing GRC easier in the healthcare space.

The third trend is the growing awareness in the value of data and how it is critical to track processes and inform better decisions. GRC by its very nature is about measurement and management, and there are industry examples where GRC is honed to perfection like the airline industry. We have much to learn from people with expertise and the application of reproducible systems that can be applied to healthcare.

The Challenge of Silo’d Systems in Ensuring Safety, Quality, and Compliance

Some healthcare organizations have patient relations in a system and then another system to capture adverse events. We know from fifteen years of experience that there is a strong correlation between the two. For instance, if you bring a five-year-old to an emergency room and there is an error, it changes the patient’s experience entirely. Having a good patient relationship during adverse events and combining information into a single platform allows healthcare delivery organizations to take a much broader view of quality. This single platform approach is a strategic differentiator for Verge Health and its clients.

Rapid Implementation and Seamless Integration

We implement proven solutions to ensure that clients gain from our experience with more than 900 hospitals. We implement quickly, we follow best practices, and a large number of our clients have taken the best practices from the industry and our experience and incorporated them into clinical content solutions. For example, RWJ Barnabas, a healthcare system in the Northeast signed a contract with us in December 2016 and by May 2017 they had all of their 13 hospitals efficiently running on our platform.

We have also developed light touch integration techniques that help us in working with next-generation EMRs seamlessly. We maximize our partnerships with clients and empower them with the Converge platform. We represent solutions that premier hospitals utilize to generate real value for patients and in doing so, protect their margins.

Success Stories

A South Carolina-based healthcare system, in an effort to enhance relationships with patients and improve HCHAPS scores,hired consultants but struggled to implement the recommended process and solutions. So, we brought in the Verge Health compliance strategy to oversee the changes and improve their patient experience goals. After implementing our GRC process, the client was able to conduct 7,800 audits in the Converge Platform and get to a point where they could reduce variability.

We also helped a hospital system in Southwest with its review process to enhance patient relations. After implementing the Converge Platform, the client redefined its entire process in order to receive meaningful real-time feedback from its patients. Based on patient feedback, the client has improved processes and dramatically enhanced communication with patients.

The Verge Health Journey

Over the years, Verge Health has continued to make significant investments in technology and has recruited executives from across the HIT industry. Most recently, we have completed several innovative projects and moved our entire platform infrastructure to AWS. These changes have allowed Verge Health to offer unparalleled security, and drive toward a ‘big data” strategy that is already having significant impact on the care delivery process.

In the future, we will be increasing our developmental partnerships and leveraging big data to improve services for our clients.