Rajesh Aggarwal MD PhD FRCS FACS

Are you ready to stay the course, even when the finish line keeps moving? I want to share a story about a journey that took nearly two decades to complete. I represented a group of New York hospitals facing a complex Medicare payment issue. Our strategy required us to pivot between regulatory and legislative avenues multiple times, highlighting the importance of adaptability in any long-term plan. It took: ✅Patience ✅Tenacity ✅And unwavering confidence In our evolving strategy to ultimately succeed after 20 years. Remember, real change takes time. But with a resilient mindset, you can navigate any challenge and achieve your objectives. Stay confident and adaptable in your pursuits! #PersistencePays #LeadershipLessons #StrategicPlanning #AdaptAndOvercome

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Digital health funding has increased this past quarter according to Digital Health New York's (DHNY) newly released Healthcare Innovation Report. DHNY takes an in-depth look at the investment trends and opportunities in the sector while exploring the future of telehealth, the role of AI/Gen AI in healthcare, and regulatory insights on virtual health monitoring enforcement. Read the latest: https://lnkd.in/ehWrP9k6  #DigitalHealth #HealthTech 

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⚠️ Errors in healthcare data entry can have serious consequences. Relaymed automatically inputs POC test results from the device to your EHR, this means no more printed reports, and no need to decipher someone’s handwriting. 🚨If errors do slip through, Relaymed flags them, notifies your staff, and makes it easy to correct issues. 📽️ Learn more about how Relaymed can automate your workflow, streamline processes and enhance patient safety at https://bit.ly/4bQhQhb #healthtech #POCtesting #EHRintegration

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Natural Language Processing (NLP) enhances mental health care by analyzing text and speech to detect emotional states and mental health issues. It can identify suicidal ideation, depression, and anxiety, often more accurately than traditional methods. This allows for timely interventions and personalized care, improving patient outcomes. Summery: In 2020, Clarigent Health, a spinout from Cincinnati Children’s, launched an app that uses NLP to analyze speech and identify vocal biomarkers of suicidal risk. The HIPAA-compliant listening tool is designed to provide clinical decision support to mental health professionals. That project was built on work by John Pestian, neuropsychiatric AI scientist who runs a research lab at Cincinnati Children’s. Pestian has been developing machine learning methods for identifying patients at risk of suicide for more than two decades. Using speech samples from therapy sessions and notes from people who died by suicide, Pestian and colleagues demonstrated in 2020 that AI algorithms could detect suicidality with up to 90% accuracy. Also at that time, Talkspace was publishing its own research with NYU Grossman School of Medicine researchers. The feature was officially rolled out in 2019. The analysis runs in real time on messages sent by patients in their encrypted virtual therapy room and triggers an alert to the therapist, allowing them to respond with the appropriate intervention. The key is having a human in the loop. #unitedseniorassociation #USA #eldercare #FDA #seniorliving #ADA #AI #NIH #patientcare #compliance #hospitals #OIG #healthcare #HHSOIG #digitalhealth #HSS #CMS #assistedliving #nursinghomes #seniorcare #medicare #seniorcitizen #homehealthcare #caregiver #dementia #inhomecare #seniorhealth #kloekorby #alzheimers #mentalhealth

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Baffled by the healthcare system? Join Michael Navin & myself for an amazing #podcast #onlyhealthcare Listen on nearly all platforms for our new regular discussion series hitting #transparency and more!

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What equity frameworks does your organization use? Have you seen the Agency for Healthcare Research and Quality's "Practical Guide for Implementing the Digital Healthcare Equity Framework"? AHRQ takes an intentional approach to considering equity throughout the digital healthcare lifecycle aims to promote improvement in: • Clinical outcomes such as mortality, morbidity, and health/quality of life • Process outcomes such as care continuity, care coordination, and care quality • Healthcare experiences such as patient satisfaction/engagement and provider satisfaction/engagement #HealthcareEquity #ClinicalOutcomes #PatientExperience https://lnkd.in/eTA9d9Gn

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Health care spending in the US is projected to have grown 7.5 percent in 2023, much faster than the nominal GDP growth rate of 6.1 percent, according to the wonks at CMS. About 17.6% of the share of the nation’s economy is now devoted to health spending or about $4.8 trillion. The entire GDP if the UK is about 2.3 trillion pounds or just shy of 3 trillion dollars. https://lnkd.in/eg_yK8yK

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Prateek Sharma, MD, FASGE, ASGE President-elect and Chair of the AI Task Force, met with U.S. Representative Ami Bera, MD (CA-6th) to discuss ASGE priorities related to AI in Healthcare. Rep. Bera, cofounder of the Health Care Innovation Caucus and member of the House Task Force on AI, issued a RFI on the intersection of AI and healthcare. During the meeting, Dr. Sharma highlighted ASGE’s mission to seamlessly integrate AI into GI care, enhance patient outcomes, and drive innovation in gastroenterology through cutting-edge AI solutions. In the RFI, Rep. Bera stated that “if used responsibly AI has the potential to transform efficiency of patient are, improve health outcomes, lower costs and make other advancements in the field.” ASGE agrees and will be responding to the RFI. The RFI will provide vital information to the AI Task Force on the current state of AI in the healthcare industry. Rep. Bera is a strong advocate on issues related to physician payment and prior authorization, and in 2023 he received the ASGE Congressional Service Award for his efforts. #GIEndoscopy #Endoscopy

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Physicians face a looming pay cut again next year as CMS proposes to cut the conversion factor for the 5th straight year in 2025! But there's a potential silver lining for ACO participants. CMS is proposing a new advance payment system to reward high-performing providers. This could transform how providers, especially safety-net providers invest in clinical care. Here's how it works: ☑ Early Shared Savings ↳ High-performing ACOs can claim a share of savings early. ↳ This provides immediate financial relief. ↳ Encourages investment in clinical improvements. ☑ Boost for Safety-Net Providers ↳ Targets providers with limited resources. ↳ Enables them to join ACOs and share in savings. ↳ Promotes more comprehensive patient care. ☑ Whole-Person Care ↳ Funds can cover hearing, vision, and dental care. ↳ Supports behavioral health and social determinants. ↳ Integrates various aspects of patient well-being. ☑ Operational Improvements ↳ Advance payments to support hiring and improved operations. ↳ Enhances care coordination and preventive measures. ↳ Aims to reduce hospitalizations and associated costs. _This is the story they are selling but tough to buy given the 5 straight years of cuts to professional services._ ☑ CMS's Funding Approach ↳ Funded by reallocating existing Medicare savings. ↳ Savings generated from reduced hospitalizations and efficient care. ↳ Reinforces the focus on cost-effective healthcare. ☑ Measuring Cost Savings ↳ CMS will track healthcare spending and hospital admissions. ↳ Detailed reports will analyze savings from ACOs. ↳ Benchmarks and performance metrics will gauge success. ☑ CMS's Long-Term Goals ↳ CMS wants all Medicare beneficiaries in value-based care by 2030. ↳ This proposal could reverse the trend of dwindling provider ACO participation. ↳ Focuses on improving health equity and cost management. Will this policy reshape Medicare ACO participation and improve patient outcomes? Time will tell. But a point of contrast from years' past is increasingly health systems have built or bought the capabilities necessary for success in these programs. And all of this occurs in a background of increasing frustration on the part of lawmakers with the dismal results of the experiments emerging from the Center for Medicare and Medicaid Innovation (CMMI). Congress also has grown intolerant of years of annual Medicare cuts for professional services. This has prompted consideration of a wider-scale overhaul to reimbursement under the program for US seniors. How do you think this advance payment approach will impact providers? Another dud or something worth paying attention to?

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In any #patientexperience scenario, ACCESS is number one. Agree? You're the Chief Marketing Officer at any health system USA. Your C-suite just signed a deal with private equity to move primary care to concierge medicine. Your charge is to drive conversions for people to pay $2000 to $4000+ for prime access to a physician. As CMO, you do what you are told to do. Your target audience is easy. People with the means to pay extra. In any region or location, you know who they are. Tracking and measurement is simple, too. The CFO will know how to validate this ROI. The bigger question...is this trend to shore up and protect traditional primary care the right thing to do? * Will it improve access? No * Will it lessen consumer demand for physicians? No * Does it solve health equity issues? No * Is it about 'health' or chronic disease management? No * Are patients the priority? No. They are directed to other options and urgent care if they can't afford the concierge deal. * Does it sound more like socialized medicine? Yes. (e.g. - in the UK, you can buy individual private insurance while the masses are left to the government's cumbersome national health plan.) * The 'haves' vs. the 'have nots' continues to grow? Yes * Does the provider really make any revenue? ?? * Do private equity firms fill their coffers? Yes * Do the comments in the article make you cringe? Yes, yes! As I've reported previously, the patient experience is suffering. We all talk the latest good game to solve the problem. Is this the answer? #healthcare #hospitals #primarycare #physicians #patients

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Really good research from Healthcare Growth Partners showing a likely overcorrection in #HealthIT valuations since 2021 as the Fed shifted to a Quantitative Tightening policy. To oversimplify... we got accustomed to having easy access to capital without excessive inflation for so long, that when things got a little tighter they 'felt' a lot tighter, and we overreacted. The monetary base is still high and Health IT valuations should rebound to reflect that. Agree/Disagree? https://lnkd.in/eEq-brHp

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#SDoH is a hot topic in healthcare, but the key question is: How can we truly address these factors to create lasting improvements in patient health? Our CEO, Hillit Meidar-Alfi delves into the challenges and opportunities of implementing SDoH to promote health equity in this article from MedCity News. Here are some of the key takeaways: 🔸New data sets and analytics tools are needed. We need better data to understand the impact of SDoH on health and to track progress over time. 🔸Addressing SDoH requires collaboration across sectors. This means working together with healthcare providers, policymakers, community organizations, and others to create systemic change. 🔸There is a potential for significant return on investment. Investing in SDoH interventions can lead to lower healthcare costs and improved quality of life for all. https://hubs.la/Q02vYzCG0 #healthequity #healthcareinnovation #ThinkSpatially

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For Shame: Government Removes Requirement for Hospitals To Disclose Their ICU Occupancy . Thousands can die as a result in next emergency : https://lnkd.in/ehPpKcJ9 The COVID-19 pandemic demonstrated that US hospital and health care systems were ill-prepared for the surge of patients who overwhelmed available health care resources. The lack of available ICU beds during the COVID-19 pandemic caused likely thousands of deaths that could have been preventable . Researchers estimate that thousands of early-pandemic deaths could have been avoided were it not for this shortage. However, ICU bed supply was not the root of the problem. Although, at the peak of the pandemic, there were many hospitals across the United States with ICU units that were overwhelmingly full, there were also ICUs in the same regions that were under capacity. Rather, load imbalance—a measure of the relationship of hospitals in hospital referral regions (HRRs) that are at or overcapacity while others are under capacity—was a problem. To prevent the needless loss of human life, we recommend that all hospitals disclose their load-balance plans—such as regional transfer agreements, regionally coordinated length-of-stay, and rapid conversion of hospital to ICU beds access—on a regular basis in a public forum, such as the SEC’s risk analysis, regularly disclosed in its EDGAR data site. Although health care agencies can promulgate the disclosure, the best agency for the collection of these disclosures is the Securities and Exchange Commission (SEC) due to its globally lauded expertise in both data collection and transparent dissemination. This disclosure should be mandated for hospitals through government legislation/rules. Sadly, the CDC recently lifted its requirement for hospitals to report their COVID-19 data—including the number of COVID patients being cared for in ICUs (https://lnkd.in/egcNGMaP). As we sift through the aftermath of the COVID-19 pandemic and return to a pre-COVID way of life, government agencies that bow to industry pressure with guidance changes, like this one, open us up to avoidable deaths in future pandemics. If we hope to avoid repeating the outcomes of the COVID pandemic in future health crises, legislation that mandates hospitals’ disclosure of their load-balance plans is a must. #COVID #CDC #SEC #healthcare #transparency#ICU #rural hospitals

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🥼Bridging the Gaps in Inpatient Healthcare: Lessons Learned As a founder of a digital health company, I’ve faced critical gaps in inpatient care. Here’s what I’ve learned about addressing these challenges effectively: Key Challenges 1. Specialty Physician Shortages: A shortage of specialty physicians leads to overworked staff and longer wait times. 2. Financial Constraints: Budget limitations often prevent investment in new technologies or service expansion. 3. Outdated Technology: Many hospitals rely on outdated systems that hinder efficiency and patient outcomes. 4. Disintegrated Systems: Lack of integration between tech systems results in fragmented care. Strategies for Success 1. Start with the Lowest Hanging Fruit: Begin by tackling the most immediate issue—in our case, specialty physician shortages. Implementing telehealth for remote consultations can significantly extend the reach of specialists. 2. Develop Cost-Effective Solutions: Instead of relying on expensive out-of-the-box options, consider developing your own technology. This approach can provide advanced capabilities while keeping costs manageable. 3. Ensure Integration: Design solutions that integrate seamlessly with existing hospital systems. This minimizes disruption and enhances current workflows. 4. Leverage Clinician Expertise: Involve tech-savvy clinicians in your core team. Their insights are invaluable in creating practical and effective innovations. 5. Utilize AI for Communication: Use AI to improve clinical communication. This can enhance the quality and timeliness of care by streamlining information sharing and reducing errors. 6. Invest in Training: Prioritize training for hospital staff to ensure they can effectively use new technology. This is crucial for maximizing the benefits of any new system. Addressing inpatient healthcare gaps requires a focused, practical approach. At LIVEMED Telehealth™ we started with the most pressing issues, developed cost-effective and integrated solutions, and leveraged clinician expertise. Utilizing AI and investing in staff training has further enhanced outcomes. These strategies can help bridge the gaps in healthcare delivery, improving both patient care and hospital efficiency. #physicianleadership #digitalhealth #healthcare #medicine #healthcareinnovation #aiinhealthcare #medtech #hospitals

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"At its core, patient-centered care is about ensuring that healthcare systems and all of their processes are fundamentally designed around the patient’s needs or their experiences or their preferences. And this approach goes beyond just treating diseases or managing health conditions. It’s about considering patients as active participants in their own healthcare, which means that any sort of treatments or healthcare plans we develop, it’s not about just focusing on clinical guidelines alone, but how do we deeply integrate that with the individual’s lifestyle or their cultural background or their personal preferences into how those treatments are actually planned and executed." -Shanil Ebrahim To hear more about what Patient-Centered Care really means, listen to Episode 110 of The Healthcare Leadership Experience: https://lnkd.in/eZi9b8zY SpendMend #healthcareleadership #patientcenteredcare #hospitals #patientfirst #qualitycare

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Edition 3 of "The Surgeon's Record" presented by Commons Clinic. Welcome to the first in a three-part series on the current state of specialty care delivery. The foundation laid here will begin charting a path toward sustainable VBC with a focus on 3 Pillars of Innovation: - Value-based Payment Models - Migration to ASCs - Thoughtful Implementation of Technology Part 1 in this series takes a deep dive into the existing MSK VBC models including why sustainable success has been elusive (flavored by my own experience in CMS' BPCI-A program). The usual features are here too: quick takes on popular topics from the last week, the weekly poll, and a jaw-dropping visual (teaser: it's a "has to be seen to be believed" EOB from an inpatient joint replacement). #medicine #healthcare #health #vbc #valuebasedcare #msk #healthcareinnovation

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Healthcare's siloed and often useless data comes from leaders failing to focus on what's measured ACROSS services and partners, including how data will be used to compare services and attribute both clinical and financial outcomes. Nerd alert! 🤓 This issue is oddly rarely discussed as per Andy's post, given those of us who understand how data is collected, analyzed, monitored, and used see this gap all the time. It's true for public health systems too (maybe more so). Lack of clarity around measuring collective impact is one of the main gaps Just Whole Care fills for clients, many of whom have no choice but to ask these questions because of limited funding and being treated as fringe CBO's (they're the 'partner' or 'grantee' health systems want, though not as a their measured driver of impact, no. That's to be saved for the health system's value-based contracting credit.). This issue also keeps the State of California and its Medi-Cal managed care plans from true population health management, which we know we're pumping hundreds of millions into through CalAIM. Today the term "data governance" largely focuses on policies and procedures for WHO CAN ACCESS data, HOW and WHEN, as well as how data will be managed technologically.  The WHY and WHO ELSE are barely discussions, short of what payers and funders demand (see California's field-leading Data Exchange Framework: https://dxf.chhs.ca.gov/). Reasons being, the main goal of today's data governance is to ensure the 'right' people get the 'right' data at the 'right' time for the 'right' reasons. It's basically about a single clinician's use to not screw up + CYA for HIPAA and other laws. Not about patients or collaboration. Reactivity and greed over planning and sharing...BORING! As noted by Effie Andrikopoulou, MD MBA FACC FASE, investments in digital health solutions are failing for this very lack of data governance that addresses WHO IS RESPONSIBLE AND ACCOUNTABLE for selecting metrics, and monitoring them across service lines for the quality of collection (accuracy, volume, and impartiality of information), as well as their impact...not just the impact of each service, but also the impact of the measurement process on patient and workforce wellbeing (often more negative than executives accept). There's clearly no one responsible and accountable to address Graham Walker, MD's concern that digital health vendors may be piling the burden of proving their value proposition onto clinical staff -- a big no no. A lot seems pretty in labs and VC meetings, but in the real world, if staff feel put upon by greed and a lack of evidence, they'll silently revolt. In the end, it's all another version of healthcare's myopic, binary thinking: it's either my measure or yours, it can't be both. Digital's just good until proven bad. Either no one's accountable or everyone is...huh? Health drivers aren't binary. Let's stop acting like our data should be. #digitaltransformation #datascience

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“This was a 5 minute masterclass on how to run one of the largest, most complex health systems in the country.”, comment by Craig Limoli on the post. Agree. Everyone who interacts with hospitals in their line of business needs to watch this. #healthcare #healthcarefinance #healthcaremanagement #hospital

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