Erin Osbourn, MSc, CHCIO, CDH-E, PMP

... And *just like that*... after 5 years... Wal-Mart shuts down its Health Division..! It looked Easy... Big Money 🤑💸... right..? As recently as 12 months ago, the Division was in "Expand / Growth" mode. Their original Plan in 2018 was to open 4,000 Medical Offices all over America. Woah - Not So Fast.. 🐎 Wal-Mart discovered one of the Biggest Challenges in Healthcare - Getting Paid (and the related paperwork Trail). And it looks like that it’s More Work than they're interested in doing for the Money 💰 (that they could eventually get). They're going to be Closing All 51 of their current Health offices across the Country, including Arizona and Missouri. This also means they've scrapped Plans on their 28 New Health Offices across the US, which would have DOUBLED their office footprint. Q - think Amazon will come to this Same Conclusion 🤔 and shutter THEIR Health Services..? Thoughts...?? #HealthIndustry #MedicalProvider #BarriersToEntry #WalMart #ReimbursementChallenge https://lnkd.in/dWbV9796

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Something for people to consider, which most people probably don't - especially applicable if you use your phone for navigation. In short, you data consented on many apps on your phone that aggregate and sell your data, and one of those buyers could be your insurance company. When some of the companies were offering discounts to drivers who "plugged in" a monitoring device for driving tracking, this is a more insidious approach, but very likely is happening. More and more I want to go to a de-googled basic or non-smart phone to cut the chains. While there is a great convenience to these mini computers in our pockets, there are costs we are just starting to become more aware of. https://lnkd.in/g2x49ZiU

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Smart move by Allegheny Health Network - and likely one that others will follow. #GenerativeAI systems are so powerful and effective in conveying information that not only will businesses and organizations of all types fill follow. And as developing #ChatGPT-style systems become easier, its likely we will each have our own personal #AI. #aiinnovation https://lnkd.in/eaqAZCFT

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Assuming the chart is accurate, or close. Let's realize that insurance provides no treatment and other than paying the bills does exactly nothing for health. They like to call themselves health plans, so we don't call them bill payers. Then there are many other forms of intermediary that also do not provide any care or health. The system has converted from transactions to financially support caregiving, into caregivers and patients supporting profit taking transactions. This is upside down.

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In healthcare we have a BAA, which after due diligence, should leave culpability with the vendor. A new facet that needs to be looked into during the due diligence process is what LLM is being used, how will my PHI not flow to the open market LLM, and the need for future compliance. I think the rush into the void of AI!!!!!!, is perhaps at an infancy stage and requires a maturity due to the nature of PHI. We are entrusted with our patients private information, we need to treat it as such.

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Strategy & Process Development are creative endeavors. It’s a dare to imagine what might be possible. It’s an extension beyond our selves to see from the perspectives of others. It’s telling the story with data and code that moves the mission forward. It’s a catalyst for business development and sustainability. Strategy & Process Development amplify the beautiful work already being done by so many and make the whole greater than the sum of its parts. We’re looking for team members who are willing to dive in and help us cultivate the ins and outs of some really impactful initiatives; from innovations in training to advances in usability.

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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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Here is a disruptive idea we have been working on: Moving payments for ED clinicians from fee-for-service to global budgets. There is an opportunity to potentially test this in Maryland if we can get the stakeholders aligned. Here is an article on the topic we just published in Annals of Emergency Medicine Payment Innovation in Emergency Care: A Case for Global Clinician Budgets with Jonathan Oskvarek Arvind Venkat Bernard Black Ali Moghtaderi Marika Kachman Nishad Rahman Dr. L Anthony (Tony) Cirillo Arjun Venkatesh Dhimitri Nikolla. Emergency department should be thought of (and paid like) fire departments. Fire departments are paid a fixed amount and are paid for fire safety, not by the fire. The same applies to EDs, we should be paid to take care of a communities' needs and to prevent ED visits and to make sure people are ok afterwards. Makes sense, right? Michael Bond American College of Education Aisha Terry (formerly Liferidge) Michael Silverman Alison Haddock, MD, FACEP Ryan Stanton Robert Glatter, MD Gabe Kelen, Click this link for the article: https://lnkd.in/g7bfp-hz

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All intractable problems follow the same pattern. Cyril Northcote Parkinson described this pattern as the "Law of Triviality" in his 1958 book, "Parkinson's Law: The Pursuit of Progress." The Law of Triviality grows out of an observation about how people apply themselves to problems that are out of their depth. Using the example of a committee—tasked with the designing a nuclear power plant—that instead spends the majority of its time discussing the design of the "bike shed" next to the plant, Parkinson highlights the human tendency to bow out of the big problems that seem intractable and focus, instead, on smaller problems that are solvable. In our fractious political climate, it's easy—and seductive—to believe that the reason we are not solving big problems like healthcare, climate change, or immigation is that there are dark forces on both sides of the debate promoting malicious agendas and drawing all of us, inexorably, into some kind of global cataclysm. "Hanlon's Razor" offers a simpler explanation than global conspiracy: "Never attribute to malice that which is adequately explained by stupidity." I would propose that we merge these two insights into a single truth that would go something like this: "Never attribute to malice—or, even to stupidity—something that can be explained by the Law of Triviality." #ValueBasedCare is the belief that behavior follows incentives, and that many of the problems with the our for-profit healthcare system can be solved by aligning physician incentives to the healthcare outcomes you want (healthy people living healthy lives with a minimum amount of expensive interventions) and not the behavior you don't. And you really would have to be mad not to favor this. All the same, Value-Based Care is, in one respect, just the same old #bikeshedding in a nice, clean pair of scrubs. While we want to align the incentives that physicians and healthcare organizations receive to reward the kind of choices we want to see (better outcomes and earlier intervenions) and penalize the kind of expensive and self-serving choices that we don't, I hope we also understand that physician choices are the bike shed, not the nuclear power plant, of #PopulationHealth. The choices that physicians make pale in importance to the choices that individuals, companies, and governments do. Whether it's about diet and exercise, exposure to toxins, or the factors that lead to "food deserts," the problem we lack the will to solve is always the one that most needs solving: how does a free and democratic society agree to make better choices for all when the choices that we need to make are not always profitable, not always convenient, and often come dressed in circumstances that are unavailable to the poorest and most vulnerable? "But we can only solve the problems we can control, and we can't control people!" And, of course, that is true. It's a hard problem. But building a nuclear power plant is hard too. Isn't it.

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How Analytics is helping Walmart in its fight to remain America’s Biggest Retailer competing with Amazon and other retailers like ALDI USA and Target. From Sarah Nassauer in The Wall Street Journal. "Decoding confusing consumer data has become a central tool in Walmart’s effort to grow, say executives. They increasingly rely on a team of data scientists and researchers whose goal is to “represent the objective voice of the consumer,” according to Jennifer Acerra, who leads the group as vice president of consumer insights and strategy for Walmart U.S.  Over the past year her team zeroed in on a term that underpins much of Walmart’s current U.S. strategy: “customized moderation.” It means shoppers are moderating spending in certain areas based on their needs, not just spending less overall. As the acute chaos of the pandemic receded, the research team’s data also revealed an opportunity. Walmart’s customer satisfaction scores were dropping in part because Walmart was attracting more high-income shoppers. These consumers were more vocal than other shoppers when they didn’t like what they found. To upgrade stores, executives have made plans to better stock shelves, improve customer service and checkout times, and highlight more products like trendy furniture and clothing that appeal to affluent shoppers in stores they visit most frequently" Hat tip: Jennifer Acerra and her data science/analytics team at Walmart https://lnkd.in/ej5wKj9P

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As many talk about what's wrong with healthcare, feeling hopeless, and powerless, others are joining a movement to reinvent healthcare. Yesterday Healthcare Reinvention Collaborative hosted another monthly event with dozens of participants, all eager to connect, build trusted networks, and collaborate to reinvent healthcare. Together, we CAN build a network of networks, share information, and move together toward a healthcare system that supports relationships over transactions, that builds a new paradigm with that core, and delivers on the components of the quadruple aim, not just the cost cutting efforts that have driven the nightmare of the last 45 years. The current system is perfectly built to deliver current results: way behind other nations, poor coverage, bankrupted patients, archaic electronic systems at tremendous cost, high error rates, burned out caregivers. HRC will build a network of networks of innovators to accelerate evolution in the healthcare sector. Healthcare Reinvention Collaborative, #systemchange, #innovation, #burnout, #twoloops, #paradigmshift

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The recent EY Health Pulse Survey reveals that technology advancements are enhancing member engagement and access to health care services. The increased engagement is translating into tangible improvements in care. Executives report that members are expressing a heightened sense of control over their health management, encountering fewer obstacles when seeking health information, experiencing lower nonpayment rates and expressing greater overall satisfaction with their health care. - Health insurance executives report that digital health care technologies, such as wearables, remote monitoring and telehealth, are beginning to yield significant benefits. - As these technologies continue to evolve, so should cybersecurity innovation measures despite the rising costs. #digitalhealth #payer #innovation https://lnkd.in/eWReasJN

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🆕 Episode: Continuing our recap of HIMSS 24, host Angelo Kastroulis sat down with Nicholas Stepro of Arcadia. In this clip, they touch on the topics of value-based care, social determinants, and AI in the healthcare setting. You can catch the full podcast with this link 👇 or on any major platform. https://lnkd.in/eYt2suhf #healthcare #data #analytics #sdoh #ai #himss24

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📡 What’s ambient signal, and how can it help address social determinants of health? Arcadia’s Chief Product and Technology Officer, Nicholas Stepro, explains in this episode of the Counting Sand Podcast. 🎙️ Give it a listen to learn how: ➡ Data and analytics provide an understanding of performance and identify areas for improvement in healthcare ➡ Artificial intelligence can be used to enhance healthcare efficiency and effectiveness ➡ Trust and transparency can lead to the adoption of AI in healthcare

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Manatt, Phelps & Phillips, LLP's take got me: "CMS is recognizing the role of digitally enabled care in improving access and outcomes." They also propose these new models "present health tech companies with opportunities to target new markets" because of the new/extra funding—such as viewing state Medicaid offices as new partner opportunities, which I've been seeing a lot of talk about recently in my feed. What do you think? I guess being in New Mexico, where almost half of our state is covered by Medicaid, Medicaid and MCOs have been a primary strategic partner/target market for 15+ years, and a somewhat omnipotent source driving most investment and initiatives. ------------------ More about the models: The Transforming Maternal Health (TMaH) model will issue agreements to up to 15 state Medicaid agencies to develop and implement a whole-person approach to pregnancy, childbirth, and postpartum care. The Innovation in Behavioral Health (IBH) model will develop and implement state-administered approaches which integrate behavioral, physical, and social supports to coordinate and manage care for Medicare and Medicaid beneficiaries with moderate-to-severe mental health conditions or substance-use disorders (SUD). I thought to myself, "wait, aren't we already doing that?" But they clarified: through the new models, CMS is encouraging states and providers to invest in technology and supporting infrastructure. ------------------ 🎉 What I'm excited about: Continued support for entities to get connected and the continued case for HIEs to expand their capabilities. Specifically, EHRs, HIEs, and remote patient monitoring (RPM). AND.... 🎉 "Additionally, CMS will support states with implementing data infrastructure to enable collection of Health-Related Social Needs (HRSN) data and referral to support resources." ------------------ 🤯 What I didn't realize: "It is estimated that only 6% of behavioral health facilities and 29% of substance use disorder treatment centers in the U.S. utilize EHRs, whereas nearly 4 in 5 office-based physicians (78%) leverage an EHR platform today 🤯 I'm having a hard time following along with all the new models coming out of CMMI, though 😉 Interesting piece all around, good info.

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It’s safe to say that it’s widely understood across healthcare that the success of big data analytics and other advanced models hinges on the data used to fuel them. Poor data and information = lackluster results. So with this understanding, why do we see providers still struggle with inadequate data and eventual care delivery? Quite frankly, obtaining quality data is complex and time-intensive. It leaves providers stuck on an island so to speak. It’s why for the next several years, a priority for healthcare providers is and will continue to be for a long time, quality data availability. We can’t work forward with advanced analytics or AI without the right fuel to power the engine. This will be at the top of the do-to list. #AdvancedAnalytics #AI #Technology

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ICYMI: Our CEO Rajaie Batniji spoke at Fortune Brainstorm Health this week on value-based care and AI. Thanks to Christina Farr, Sachin H. Jain, MD, MBA, and Brent Nicholson for an insightful discussion! “So much of how we talk about AI in healthcare is focused on replacing humans, and I think that’s totally wrong. Our approach to AI development is to automate the routine tasks so that we can allow our care team to spend as much as possible with patients. Second, let’s automate the identification of which patients are going to benefit from certain services so that we can spend our time targeting the appropriate groups. That’s where you have step-change in improving access to care.” Watch the recording here: https://wymrk.co/3KdruPb

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Agilian's CEO, Jamey Harvey, put together a great overview of the Medicaid Health Equity Ecosystem. It's packed with both information and perspective of a true expert in the intersection of Medicaid, health equity, and digital liberation. This is the first part of the presentation... definitely worth asking for part two! #digitalliberation #Medicaid Agilian.com

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Latest thoughts on clinical decision support systems and clinical practice guidelines. This is personal to me because of an acute injury I had, and the care I received was vastly different from 2 health systems. Thoughts? #CDSS #CIO #HealthIT #Leadership

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