Jeffrey Pan

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.

3

2 Comments

In a recent report, only ~20% of healthcare executives claimed that they fully trust their data. At Fullsteam Health, we think that % is way too low. We're committed to reversing this trend with our automated data curation platform which was initially developed at Duke to address this very issue and allow for fast access to data that is needed and that has been cleaned, grouped, and continually monitored. https://lnkd.in/epWvPTDV

21

6 Comments

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.

3

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

12

1 Comment

AccendoWave - A Pain #Data Company More recently, the federal government has begun using the QIS program and QRS parameters to advance health equity. Federal rules now require all marketplace insurers to adopt a strategy for reducing health disparities and to stratify certain clinical data by race and ethnicity. While state-based marketplaces (SBMs) have authority to supplement these federal minimum QIS and QRS standards with state-specific quality rules, most have hewed closely to the federal default approach. California and Washington are notable exceptions. Each has implemented a customized QIS program and robust data collection standards to identify and reduce racial and ethnic health disparities. Time to Focus on - #Pain not being Believed. A Root Cause Health Equity Problem. A Top 4 Global Health Equity Solution and Top 15 Global Remote Monitoring Company, AccendoWave, benchmarks objective brain wave pain data (specialty, gender, age) and has nine #pain databases: Emergency Department, Maternal Health, Oncology, MSK, Medical Surgical, ICU, #Women, Adults, #Seniors to eliminate bias, improve outcomes and reduce health care costs. If desired, AccendoWave can also create customized pain databases for partners that can be accessed on the Datavant platform.

5

The MedCity News article highlights the issue of data fidelity in healthcare. Despite the vast amount of data generated, much of it is unreliable, hindering effective decision-making. Challenges include fragmented systems and poor patient identity matching. Solutions proposed include investing in master data management (MDM) systems, complying with the Cures Act, and improving data accuracy to handle future data influxes. Legislative measures like the Match IT Act aim to improve data standardization and interoperability, essential for leveraging data for improved patient outcomes and operational efficiency. https://lnkd.in/epytxJWv #healthcare #healthcareit #healthcaredata #bigdata #ehr #emr #his

1

Walmart Exits Healthcare Market: RPM Steps Up to Fill the Gap... Walmart's departure from the healthcare market, including its virtual health care services, will leave a void in care services for underserved communities. While hospitals and primary care providers (PCPs) remain the backbone of our healthcare ecosystem, their resilience is rooted in the trust relationships they've built with patients. This trust is a cornerstone of effective care, and RPM can help hospitals and PCPs extend their reach. RPM uses digital technologies to monitor patients' vital signs, health data, and other relevant information remotely, enabling healthcare providers to deliver timely interventions and preventive care. By leveraging RPM, we can: - Increase access to care for underserved communities - Detect health issues early, preventing complications - Deliver personalized care plans - Reduce healthcare costs - Empower patients to take a more active role in their healthcare As we move forward, RPM can help address the disparities in healthcare access and ensure that everyone has access to quality care, regardless of their zip code or background. Let's harness the power of RPM to create a more equitable and accessible healthcare ecosystem! #RemotePatientMonitoring #Telehealth #DigitalHealth #HealthcareAccess https://lnkd.in/eD7CcaEm

31

5 Comments

If you’re a payer grappling with the best ways to manage care and costs as utilization rises and reimbursements slow, you will gain a lot of useful insights in a few short minutes with this video discussion I have with Mohamed Diab, MD, President of CVS Accountable Care. Dr. Diab brings unparalleled population health experience, supporting 70,000+ providers and 1 million attributed lives in Medicare risk-sharing models in rural, suburban and urban geographies across the United States. One key takeaway: It takes more and better data, especially social determinants, to build complete pictures of patients that are essential to delivering higher-quality care at lower costs. What’s more, it takes all of us, Dr. Diab says, to tackle this fundamental roadblock to transforming healthcare. “We definitely are not where we want to be as an industry when it comes to our healthcare data,” he told me. “It’s not easy but everyone needs to speak up about the need for better data.” Please tune into this new Abacus Insights Health Planning video Powering Accountable Care with Better Data and Analytics. It will be worth your while. 

26

Healthcare interoperability experts from Redox attended Snowflake Data Cloud Summit a few weeks ago. Read about their 3 top takeaways around AI, real-time data, and those pesky siloes. https://lnkd.in/efqrEKBY #datacloudsummit #aidatacloud #datacloud #healthcare #healthtech #interoperability #fhir #hl7

38

1 Comment

With so many AI-enabled healthcare options, it is time for some collective wisdom on what solutions are truly helping patients. What practical implementations have made a significant difference in your practice? Join the conversation. Tell us what you have seen that is changing the game in AI-enabled care! #AIHealthcare #HealthTech #Innovation

57

5 Comments

I’ve been given advice that the fastest way to monetize HER Heard without charging the end user (woman) is trackers and selling data. Instead, I’d like to build something more trustworthy. I don’t want to be in a headline like this. If you are not paying, then you are the product (you/your data are being sold). There are newer ways to deindentify data or even to aggregate things women search for that can be of interest to various stakeholders. In theory that could be okay to sell, but in a post-Roe world with laws encouraging bounty hunting, I am vetting the choices ahead. I am all for moving fast, without breaking things.

6

Last Friday, we chatted with Carrie Liken and Christian J. Ward to discuss #AI and how its innovations are impacting #healthcare. Carrie explained the importance of recognizing that #providerdata is actually "#inventory." Understanding the intricacies of these data -- especially in the patient journey -- will be key for organizations taking a leap forward in combining quality patient care with cutting-edge AI #technology. Listen to the entire podcast here: https://okt.to/nzuYEW #HealthTechnology #ArtificialIntelligence #HealthcareMarketing #GEO #SEO

8

This is a cautionary tale that points to the crux of bringing virtual care and telehealth to primary care: do you have a clear, efficient, scalable reimbursement model for your tech or do you not? While having a reimbursement strategy at the core of any digital health business model is a make or break criteria, defining reimbursement pathways is often overseen or assumed to be a self fulfilling prophecy once the tech hits the market. It is not. You can have the best tech in the world (throw as much AI into the mix as you want) and even with a bullet proof value proposition, clinical studies, consumer centric service design, a pressing client need and deep pockets: if your reimbursement strategy does not work, the business won’t work. It’s not easy to get reimbursement strategies right: within specific markets conditions can change (today you might have a reimbursement code, tomorrow you might not - and vice Versa) and things get extremely complicated when scaling across multiple markets, jurisdictions and geographies. https://lnkd.in/gXFRzJXQ

39

5 Comments

There’s a category we believe is getting too little attention when it comes to AI in healthcare: AI Clinical Documentation Integrity (CDI) While AI ambient scribes and autonomous medical coding solutions have gotten most of the headlines, we’d argue AI CDI is equally impactful when it comes to quality care and accurate billing. For those not familiar, CDI ensures that clinical documentation accurately reflects the patient’s medical condition and the provided care. Historically, CDI was a manual slog, with dedicated CDI specialists, nurses, and physicians painstakingly reviewing patient charts to ensure documentation supported the care delivered. Today, AI is reshaping this landscape. While it’s still early days, we’re seeing three primary approaches to applying AI when it comes to CDI: 1️⃣ CDI + ambient scribing—an AI ambient scribe and AI CDI assistant operate simultaneously, generating comprehensive notes and surfacing codes for physicians to review at the point of care. (Example: Ambience Healthcare’s AutoCDI) 2️⃣ CDI via real-time diagnosis support—diagnoses are suggested at the point of care based on clinical data in the EHR, with auto-generated documentation and audit trails. (Example: Regard) 3️⃣ CDI via an AI-driven post-coding / pre-billing review—the entire patient record is ingested and analyzed against what is coded, surfacing suggestions for revenue and quality opportunities. (Example: SmarterDx) To date, AI in healthcare has focused primarily on administrative use cases. With the increasing adoption of AI CDI solutions, we’re now taking a step closer to clinical workflows. As clinicians get used to AI-suggested diagnoses in the CDI context, it will be interesting to see if this increases their comfort with AI playing a role in clinical care. Here's our working list of AI CDI vendors. Anyone else we should add? • Ambience Healthcare • Brellium • Iodine Software • Regard • Semantic Health • SmarterDx   

96

6 Comments

Bravo California! AI is an essential tool for leveraging next-gen technology to ensure health equity. Dynamic language models can enhance confidence & security for non-native language speakers accessing coverage & benefits. Additionally, these tools enable clinicians to curate tailored care plans for optimal outcomes. This is just the beginning! #AI #HealthEquity #DynamicLanguageModels #OptimalOutcomes 10Pearls

4

This is an interesting article because EHR companies, like Epic and Oracle's Cerner, have made siloing data a major part of their business model. Overall, I like EPIC’s ability to review records from other EPIC shops. It also has a nod to interoperability with its “Care Everywhere“ feature. However, this is often a disorganized and outdated collection of information. Using it requires a ninja level of both tech expertise and medical knowledge possessed mainly by younger physicians and chief residents. I am a fan (and advisor) of companies like Zus Health focused on user-friendly, comprehensive, and up-to-date interoperable health care data tools.

57

25 Comments

Also don’t outsource your hospital’s core services to a GPO ran by foreign PE… I do find it so odd that Vizient’s own contracts couldn’t stand on their own so they had to create a aggregation group with Mayo Clinic called Capits. (https://lnkd.in/gpiVDKvn) Which by the way Mayo Clinic is being sued because not only does Mayo control pricing on supply chain contracts for Vizient, but guess who controls pricing on their self insured insurance plan. (https://lnkd.in/guvx5mqr) Oh and as of November of last year Mayo Clinic lead their state in adverse healthcare events. (https://lnkd.in/gXsPi2sw) Should I go on or have I made my point clear on why Oklahoma hospitals should not blindly follow Vizient, Captis, and the Mayo Clinic?

5

2 Comments

We just announced a sneak preview of the next big thing for our practice product: DSO Analytics  What is it you may ask? This is the first AI-powered analytics suite built specifically for DSO’s. It enables executives to transform mountains of data into actionable insights to improve their organization’s performance, from case acceptance and productivity rates to treatment planning efficiency. Leaders can get a comprehensive view of their entire organization or drill down to see the performance of a clinic or specific provider level to uncover opportunities for education to improve patient care. In short, it’s a game changer for DSO leaders.https://https://lnkd.in/eKP6QKJb

15

1 Comment

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

219

48 Comments