As healthcare practices continue to face the challenges imposed by high operational costs and overwhelmed staff, the demand for virtual administrative assistants has increased. While outsourcing certain operations, such as billing, is not a new practice, virtual assistants are being hired to handle administrative tasks such as appointment scheduling and insurance verification, allowing office staff and providers to focus on other office functions.
A virtual assistant is an individual who works remotely and has access to electronic medical records and other technological services of the practice. By working remotely, these independent contractors can help businesses reduce costs. It is important to note that a virtual assistant is different from an “AI assistant,” which utilizes artificial intelligence (AI) to automate tasks, such as an AI scribe.
Within healthcare, there are third-party agencies specializing in virtual assistants who act as intermediaries between you and potential contractors. These agencies have a vast network of resources, often spanning various countries, providing access to a diverse pool of experienced and skilled professionals. These companies thoroughly assess the necessary competencies, conduct interviews, and conduct comprehensive background checks on applicants before adding them to their resource pool. The goal of using these agencies is to find a virtual assistant who is well-matched to effectively meet the specific requirements of your practice.
When considering hiring virtual assistants, it is essential to be aware of the following key points.
1. Choose and vet the right candidate for your practice. Even if using a third-party vendor, conduct a thorough screening process to ensure the virtual assistant has the necessary qualifications and experience in the tasks you are asking them to be involved with. Verify their education, certifications, and any relevant background checks. It is recommended to have legal counsel review any agreements with third-party agencies and the hiring of a virtual assistant.
2. Implement a Business Associates Agreement. Ensure you have a Business Associates Agreement (BAA) with the appropriate entity involved in the remote process.¹ The BAA outlines the responsibilities of the virtual assistant (business associate) in safeguarding protected health information (PHI) and ensuring compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations.
3. Defining roles and responsibilities. It is important to clearly communicate the specific tasks and responsibilities assigned to the virtual assistant, while also outlining any limitations on their scope of practice. To ensure a comprehensive understanding of their role in patient care and the boundaries they must adhere to, provide detailed instructions and guidelines. Create a job description and clearly define job duties, including when the virtual assistant should seek assistance from the office staff.
4. Maintain regular communication and supervision. Consistently evaluate the job performance of virtual assistants. Maintain open lines of communication to address any concerns or questions, and provide feedback and guidance. Consider patient input to address identified issues. By promptly addressing these concerns, you can help mitigate risks and ensure the delivery of quality and safe healthcare services by the virtual assistants.
5. Implement training and oversight programs. Ensure that the virtual assistant has the training and experience in the tasks you are asking them to be involved with.¹ Provide ongoing training to keep the virtual assistant updated on the latest regulations, protocols, and best practices. Regular check-ins and performance evaluations can help identify and address any issues promptly.
6. Have a contingency plan in place. Develop a contingency plan to address potential disruptions, absence of the virtual assistant, or technical issues. This plan ensures continuity of care and minimizes potential risks to patients.
Virtual assistants offer technological benefits but also bring challenges to cybersecurity and adherence to HIPAA regulations. HIPAA established national standards involving the confidentiality, integrity, and availability of electronic PHI. Compliance with HIPAA regulations prevents data breaches and unauthorized access to patient records, which can lead to significant legal, financial, and reputational consequences.²
Out-of-state virtual assistants may handle patient information across state borders, which can introduce additional privacy and data protection challenges. It is essential to implement robust data security measures and ensure compliance with applicable privacy laws to protect patient information during transmission and storage.
Implementing HIPAA-compliant practices with virtual assistants:
1. Establish reliable technology infrastructure and connectivity: Reliable technology infrastructure and connectivity are crucial when utilizing virtual assistants. Ensuring that the virtual assistant has access to stable internet connections, secure communication channels, and reliable technology platforms is important to mitigate the risk of service disruptions or compromised data transmission. If your virtual assistant uses public Wi-Fi, the risk of your business being compromised is significantly higher.³
2. Provide secure communication channels: Have virtual assistants connect to your network through virtual private networks (VPNs). VPNs enhance security for remote workers accessing the company’s IT network. VPNs mask IP addresses and encrypt connections, ensuring secure data.
Consider adding a two-factor authentication password system for an additional layer of security. Require password updates regularly.
Enforce role-based access controls (RBAC) for virtual assistants, ensuring that only authorized individuals access sensitive patient information.
Utilize strong encryption methods to protect data against cybercrime. Install antivirus, ransomware, spyware, and malware protection on all company devices.
3. Conduct a risk assessment: Regular risk assessments should be conducted on how PHI is managed remotely. Evaluating the remote use of individual devices for accessing, storing, and sharing electronic health records should be regularly undertaken.4 Keep records of your risk assessment and HIPAA risk analysis for any necessary audits.
4. Implement contingency plans: Develop a contingency plan with backup protocols to address potential disruptions, such as the virtual assistant being unavailable, or technical issues.
5. Secure CyberRisk insurance: Utilizing technology to connect virtual assistants with your medical practice and confidential PHI increases the risk of breaches. Ensure you have adequate coverage.
As technology has advanced, the virtual assistant has evolved. Outsourcing certain workflow tasks can be a cost-effective solution for a busy medical practice, leading to improved patient care services. However, it’s important to acknowledge that there are potential risks that come with these benefits. Prioritizing preparation and risk mitigation when adopting new technologies is crucial for ensuring the safety of both you and your patients.
Deborah Kichler, RN, MSHCA, is a Senior Risk Management and Patient Safety Specialist. Questions or comments related to this article should be directed to DKichler@CAPphysicians.com.
References
¹Practice Compliance Solutions. (2022, November 24). “Virtual Assistants – Legal but Beware.” https://practicecompliancesolutions.com/virtual-assistants-legal-but-be…
²Mijares, A.L. (2024, November 26). “Ensuring HIPAA Compliance: The Critical Role of Virtual Medical Assistants.” https://unity-connect.com/our-resources/blog/virtual-medical-assistants…
³Mijares, A.L. (2023, September 21). “Mitigating Risks: Exploring the Viability of Hiring Virtual Assistants from Mexico.” https://unity-connect.com/our-resources/blog/virtual-medical-assistants…
4Saleem, Sharmeen. (2024, January 20). “Healthcare Virtual Assistants to Stay HIPAA Compliant: Key Steps.” https://www.puredome.com/blog/healthcare-virtual-assistants-to-stay-hipaa-compliant