Brian Cotter

Harmonizing healthcare - solving for the asymmetries and inefficiencies between payers, providers and patients I participated in to a 2 day healthcare & health insurance conference this week https://lnkd.in/gPAAQzh7 Made friends with some seriously senior execs and industry leaders, however the content and learning was equally valuable: Key takeaway is that there are massive asymmetries and inefficiencies that exist between payer and provider (as well as between patients and both providers and payers). These asymmetries and inefficiencies lead to bad behavior on the part of all three parties which lead to waste and huge inflationionary problems with the most vulnerable demographic and the government left to pick up the bill. If we can successfully execute our group level deals with insurers and healthcare providers, we may have a unique opportunity to not only solve for patient experience, but also the harmonization of the whole healthcare system. This currently doesn’t exist but I suspect if a player cracked it that it would tend towards a monopoly.. Perhaps the healthiest monopoly in the world. Damian Delaney Yamin Gröninger Peiru Teo KeyReply #genai #healthtech

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John Dionisio, our Chief Information Officer, manages the entirety of SOMOS’ digital infrastructure that connects patients to our healthcare providers and wards off cybersecurity threats. Both John and Dr. Chen focused on this work during the pandemic and now as SOMOS builds a Social Care Network. Hear from John in his own words at a @cityandstateny panel last month discussing the importance of digital health infrastructure: https://lnkd.in/dJTBPM6V #somoscare #somoshealth

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70% of hospitals participate in healthcare interoperability. Healthcare #interoperability is growing across hospitals, but gaps remain, especially in data exchange with long-term care and behavioral health providers. CapMinds offered health information exchange(#hie) and health interoperability (#fhir, #hl7, #mirthconnect) to its various clients across the specilaity including #behavioralhealth #mentalhealth

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🚨 🚨 The decision over cost to obtain medical records using FHIR API in #claimsmanagement and #litigationmangement is happening. 1. Seeking comment on threshold condition for Attorney requests. (P. 531) 2. Seeking comment on fees for TEFCA Sub participants. (P.561) 3. Info session July 17 (Not likely on fees for injury claims and litigation.)

A health care organization's strategic building blocks are its market, clinical and financial data, but as the number and complexity of data sets increase, merely housing these data together isn’t enough. You need the Sg2 CARE Grouper to unlock the insights your data hold to drive your organization forward and compete in your market. The Sg2 CARE Grouper... ➡️ Helps you unify your data and put them into a language that strategists, clinicians and executives understand ➡️ Has user-friendly software that incorporates easily into many environments—from individual desktops to batch processing on a server Learn how you can analyze your data in new ways here https://bit.ly/3S8rOUj

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Healthcare’s Data Problem: So Much Data, yet So Little Data Fidelity. As the volume of healthcare data accelerates, health system leaders must take critical steps to elevate the quality, completeness and accessibility of data they capture, manage and aggregate. https://lnkd.in/gzX_rccM

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Health tech executives are still parsing through ONC's 1,067-page proposed rule to advance industry data-sharing standards. In this Fierce Healthcare article, health IT experts share some of their initial takeaways about the wide-ranging policy draft. https://bit.ly/4f1zT6A #healthcare #interoperability

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What is the bottom line if you have financial responsibility for a provider group? Your competitors have the ability to know your contracted rates for everything you do. That's the bad news. The good news is that you can know theirs to help you in your next negotiation.

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𝐓𝐡𝐢𝐬 𝐢𝐬 𝐬𝐨 𝐢𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 𝐭𝐨 𝐭𝐡𝐞 𝐋𝐓𝐏𝐀𝐂 𝐜𝐨𝐦𝐦𝐮𝐧𝐢𝐭𝐲. But the ruling could also have broader implications for data privacy and particularly around the use case of analytics companies having broad access to patient health information. I can imagine that this might also have implications for LLM training data, as AI continues to march throughout the healthcare ecosystem. Real Time Medical Systems alleges that PointClickCare (PCC) is blocking its access to EHR data by using security ciphers. Real Time claims this is an anti-competitive move following PCC's expansion into post-acute analytics. A judge appears likely to block PCC's actions, emphasizing the need for data access to improve patient care as mandated by the 21st Century Cures Act. This may enhance interoperability, but there is a lot to consider. Thank you Brendan Keeler for bringing this important topic to light.

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Clarivate has partnered with HealthWise Data to integrate Social Determinants of Health (SDoH) attributes into our Real-World Data repository. This strategic collaboration enhances our ability to analyze patient demographics and behaviors, providing deeper insights that will drive better population health outcomes and promote healthcare equity. Discover how this partnership empowers professionals in life sciences, healthcare, and research to make a meaningful impact on patient care. Read more: https://lnkd.in/eQtYNUAr #HealthcareInnovation #SDoH #ThinkForward #HealthcareEquity #DataInsights

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𝐃𝐞𝐬𝐩𝐢𝐭𝐞 𝐰𝐡𝐚𝐭 𝐛𝐮𝐳𝐳𝐲 𝐩𝐫𝐞𝐬𝐬 𝐫𝐞𝐥𝐞𝐚𝐬𝐞𝐬 𝐭𝐞𝐥𝐥 𝐲𝐨𝐮, 𝐚𝐮𝐭𝐨𝐧𝐨𝐦𝐨𝐮𝐬 𝐀𝐈 𝐚𝐠𝐞𝐧𝐭𝐬 𝐰𝐢𝐥𝐥 𝐍𝐎𝐓 𝐛𝐞 𝐦𝐚𝐢𝐧𝐬𝐭𝐫𝐞𝐚𝐦 𝐟𝐨𝐫 𝐝𝐢𝐫𝐞𝐜𝐭 𝐜𝐥𝐢𝐧𝐢𝐜𝐚𝐥 𝐜𝐨𝐧𝐯𝐞𝐫𝐬𝐚𝐭𝐢𝐨𝐧𝐬 𝐰𝐢𝐭𝐡 𝐩𝐚𝐭𝐢𝐞𝐧𝐭𝐬 𝐚𝐧𝐲𝐭𝐢𝐦𝐞 𝐬𝐨𝐨𝐧. Mobile & Web 2.0 provided the tech needed to automate patient education and engagement over the past 15 years (e.g. SMS, email, app-based content)... … yet even today, most providers still don’t do this (except for the most basic interactions, e.g. emailing a static PDF). AI agents will allow us to automate back-and-forth conversations with patients in the coming years… … and I predict most providers won’t do this for a very long time. The barrier to implementation in the Web 2.0 age was never technology. Technology won’t be the barrier in the age of AI agents either. What technologists and pundits who have never operated inside the healthcare environment fail to appreciate is that technology - whether it’s a simple SMS reminder or full-blown AI agent - generally automates or replaces existing workflows that humans have already accepted and adopted. E.g. AI agents already have and will continue to replace the majority of technical support at businesses precisely because day-to-day customer support was being done by a human. But when was the last time your doctor or nurse called you daily to monitor how you were doing? Or messaged you daily to remind you about key steps in your treatment plan? If your answer was “never” (which I suspect is the case for the vast majority of us)... then that’s our problem right there. I’ve lived this firsthand because SeamlessMD has been a leader in enabling digital patient education and engagement since the Mobile & Web 2.0 age, and although adoption has been increasing, it’s still not the standard of care. Not because of a lack of tech - which has been there for a while now. But because we had to evangelize to physicians, nurses and the whole provider team that even though they never called a patient daily to keep them on track, they should let software automatically do this… for a workflow they never did themselves. This new workflow that most agree would be better for patients… but still, even in manual or analog form, isn’t yet the standard of care. And of course, AI agents have an additional barrier that Mobile & Web 2.0 didn’t have: increased and unknown liability risk due to lack of control over the exact output (e.g. risk of hallucinations). So no - despite what press releases or technologists tell you, AI is not replacing nurse or physician clinical conversations anytime soon. There’s still a paradigm shift over the idea of caring for patients between clinical encounters that's still in progress. So for better or worse, similar to how Mobile and Web 2.0 transformed retail, banking and even healthcare operations before it transformed clinical care… so too will AI transform everything else before direct clinical care.

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Overcome data and integration challenges to unlock the full potential of healthcare analytics with WellStack's state-of-the-art data system. By integrating diverse data sources like EHRs, claims, and SDOH, WellStack breaks down barriers to surface actionable insights across your organization. #HealthcareInnovation #HealthAnalytics #HealthcareQuality #DataIntegration

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Check out the latest interview from CDO Magazine where Suzanne Pittacora and Himanshu Arora discuss aligning data strategy, advanced analytics, and AI in healthcare. https://hubs.la/Q02vy4Kb0 #datastrategy #AI #healthcare #CDOmagazine

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The healthcare landscape is changing FAST, and those clinging to outdated methods are falling behind. This article explores the importance of a strategic business case in digital transformation for healthcare payers. Learn how to: • Build a winning digital strategy • Craft a compelling business case with clear ROI • Unlock the benefits of digital transformation Click the link to learn how Curate Partners can be your trusted partner. We offer unmatched expertise, collaboration, and a proven track record. https://lnkd.in/ePgyxUiE #healthcare #digitaltransformation #payer #businesscase #ROI #patientsatisfaction #efficiency

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📊 The 2024 Gartner CIO and Technology Executive Survey highlights pivotal technology investments shaping the future for U.S. healthcare payers: • Core Administrative Processing Systems (CAPS) • Interoperability • Enhancing Consumer Experiences Dive into our blog by Lisa Hebert, SVP of Product Strategy and Management at HealthAxis, as she explores how these strategic investments are redefining healthcare's next frontier. Read Now: https://lnkd.in/eQ-efNeN #HealthAxis #HealthcareTechnology #Gartner #Interoperability #MemberExperience #CoreAdmin #CAPS #CoreAdministrativeProcessingSystem #SaaS #HealthcarePayers #ClaimsProcessing #ClaimsManagement #ClaimsEfficiency #ThirdPartyAdministrators #BPaaS #BPO #HealthcareInnovation #Medicare #MedicareAdvantage #Medicaid #PACE

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🌟 JUST DROPPED 🌟 Tune in as Charlie Harp explores the taxonomy of the PIQI, Patient Information Quality Improvement, framework. 📊 He breaks it down into two primary categories and four subcategories to show how they are used to analyze and address healthcare data quality challenges. Listen to the full episode now: https://hubs.ly/Q02xhsst0 Stay tuned for our next episode, where Charlie talks about Simple Assessment Modules (SAMs) and the elegant simplicity of recursive failure. #HealthTech #HealthcareIT #DataQuality #Interoperability

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Payers grapple with inaccurate data like other organization. Unfortunately it's a common problem, and it's the first barrier to care. If you can't contact someone, you can't engage, and #HealthOutcomes can suffer. Read this white paper to learn about next generation data and how other organizations are using it. https://splr.io/6040lK1Vj

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Arcadia VP of Data Operations Mary Kuchenbrod discusses challenges and strategies for managing vast amounts of healthcare data. 📊🗂 She emphasizes the need for healthcare professionals to have access to comprehensive yet concise data summaries, which enables informed decision-making. Hear more about this topic in “Unlocking Big Data,” a podcast presented by HIMSS, where Mary is joined by Julius Bogdan, VP and General Manager of Digital Health Advisory at HIMSS. 🎧 Listen to full episodes on:  Apple: https://apple.co/3MC1Zte  Spotify: https://spoti.fi/402iLVB #datamanagement #dataaccuracy #healthdata 

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