Healthcare in Sweden is provided in several different ways – through a system of choice of care, contracted agreements, and activities run by the regions themselves. Together, these form an important part of how healthcare is organized and delivered to patients. Regardless of the form of operation, this places high demands on the regions' monitoring and control. To ensure that healthcare providers comply with agreements, that reimbursement systems are used correctly, and that care is of high quality, the regions need to work in a structured manner with auditing and monitoring of operations.
An important part of the regions' follow-up work
Most healthcare providers, regardless of whether they operate within the healthcare choice system, through contracted agreements, or independently, deliver high-quality care and work in accordance with applicable requirements and guidelines. At the same time, a complex system with many actors, different reimbursement models, and varying working methods means that the regions need effective tools for follow-up. Medical record reviews are an effective follow-up tool that can be used for this purpose.
A systematic and structured review of medical records may include, for example:
- compliance with agreements and regulations
- medical quality and patient safety
- reporting and compensation models
Systematic reviews provide the regions with fact-based data for identifying risks, improving the quality of care, and ensuring that public resources are used appropriately.
Sirona supports regions in audits
Sirona has extensive experience in supporting regions in assignments involving the review and follow-up of healthcare operations. Our assignments combine medical, organizational, and financial analysis to provide a comprehensive picture of the operations.
The audits can cover everything from in-depth follow-ups and journal reviews of individual healthcare providers to broader reviews of entire healthcare areas or contract forms. This may involve activities within a healthcare choice system, procured healthcare, or the regions' own activities. The aim is both to identify any deviations and to contribute to the development of the regions' follow-up work.
Audits in digital healthcare
One area where the need for follow-up has increased is digital healthcare. Digital healthcare services have quickly become an important complement to traditional forms of care and contribute to increased accessibility for patients. At the same time, new working methods and reimbursement models mean that the regions need to develop their follow-up methods. Sirona has recently conducted audits of digital healthcare providers, focusing on areas such as care processes, medical quality, and contract compliance.
Audits also provide support for healthcare providers
Audits can also be a valuable tool for healthcare providers themselves. Through independent review, businesses can receive support in their quality assurance work and ensure that the organization is operating in accordance with agreements, regulations, and medical guidelines.
In this way, audits can contribute to both increased transparency and continuous operational development – thereby strengthening the quality of healthcare.
Would you like to know more about Sirona's work with healthcare provider audits and how we can support you in this work? Contact Shadi Abbas, acting CEO at Sirona.
