Ryan Howells

🚨 🚨 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.)

Glad to share our upcoming Gainwell Technologies webinar on how our team is leveraging automation and advanced analytics to tackle #SDoH head-on. By harnessing technology, we're gaining deeper insights into state needs, streamlining interventions, and ultimately improving health outcomes. #HealthcareInnovation #DataDrivenHealthcare

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It’s full steam ahead in the US towards an interoperability. We will be speaking to John Halamka, M.D., M.S. Steven Posnack and Paul Wilder at our Health Services Daily Connected Care Summit to find out more about the work they are doing in the US and the outcomes it is delivering. #onc #21stcenturycuresact These new certification criteria, which would improve public health response and advance the delivery of value-based care, focus heavily on standards-based application programming interfaces to improve end-to-end interoperability between data exchange partners (health care providers and public health organizations or payers). The health IT for public health-oriented certification criteria were developed in tandem with the Centers for Disease Control and Prevention (CDC) to support its ongoing Data Modernization Initiative. Similarly, the health IT for payer-oriented certification criteria were developed in coordination with the Centers for Medicare & Medicaid Services (CMS) to support technical requirements included in the CMS Interoperability and Prior Authorization final rule (89 FR 8758).

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It seems that the government is serious about finally realizing the vision of true health data interoperability. The attached Point-of-Care Partners blog post describes the recently released HTI-2 Proposed Rule which is another step in the fruition of that vision. Point-of-Care Partners can help your healthcare organization stay ahead of the waves of regulatory activity around interoperability. Let me know if you are interested in learning how.

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Now that our HIT industry has spent nearly 40 years figuring out how to effectively pass data between sites, settings, and institutions of care (and while that journey isn't completely over, we're well on our way), we can finally turn and look farther down the road and consider what's next. In my view, advancing process consistency, agility, and change is that horizon. The BPM community is focused on that challenge, and having recently transitioned into HL7 as HL7 BPM, is squarely trying to take this on. With today's press release, HL7 is truly open-for-business in this space. Thanks to the OMG for nurturing this work along and for HL7 for having made our next home for this effort. So much to do! https://lnkd.in/dAF96g3n

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Insightful post from Blake Madden highlighting this graphic from McKinsey & Company. The biggest takeaway for me is the underinvestment in AI relative to the potential impact. There are reasonable explanations for these results.... ethical AI considerations, concern over the maturity over the tech and models, etc. However it likely falls on the vendor community who needs to provide recommendations on how to best implement and adopt AI for the health system AND how to measure ROI/impact. Fortunately I've been able to share Ambience Healthcare 's best practices for adoption and measuring ROI and that alone seems to be a differentiator with our clients. Hopefully other companies will follow the lead and guide health systems on how and where to invest to maximize the impact of AI!

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This article by Heather Landi at Fierce Healthcare is a great start with good insights, but it barely scratches the surface of this new rule by the Office of the National Coordinator for Health Information Technology (ONC). The #HTI2 rule is the first time #payers have a path for certification. In addition, there are requirements for #ai algorithms. If history is any indication, this could really change the game.. There are now certification criteria for: #PatientAccessAPI #providerDirectoryAPI #PayertoPayerDataExchangeAPI #provideraccessAPI and #priorauthorizationsupportAPI

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What will drive adoption of #AI have a read on this recent HHS report. New use cases provides clinicians with the technology to provide better patients care. #CDW #healthcare #strategy

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🚀 Excited to be tagged in Dylan Reid(Moskowitz) announcement about the FY24 LEAP in Health IT! This initiative marks a significant leap towards integrating #AI and #BehavioralHealth in our healthcare systems, aligning perfectly with the urgent need for innovative health IT solutions. The focus on enhancing health care data quality for AI applications and accelerating health IT in behavioral health settings is not just timely but critical. These efforts by the ONC to push for scalable, interoperable health IT solutions could dramatically improve care coordination and patient outcomes. 💡 I'm particularly intrigued by the emphasis on developing lightweight IT solutions for behavioral health—a sector that has long awaited such forward-thinking integration. It's an area ripe for impactful innovations that could reshape patient care dynamics. Hats off to the teams at HHS and ONC for driving this change. Looking forward to the transformative projects that will emerge from this initiative. 🔗 For more details on the funding opportunity and how to apply, check out the full announcement here: HHS LEAP in Health IT Announcement https://www.hhs.gov/news #HealthcareInnovation #DigitalHealth #HHS

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Risk adjustment ensures providers are paid fairly in capitated payment models, allowing them to deliver appropriate care to all patients. However, if done poorly, it can worsen health inequities by misallocating resources. In my work, I've seen the importance of accurately predicting future healthcare costs to ensure providers can care for healthier and sicker patients. Risk adjustment modifies payments based on patients' characteristics and health conditions. This method uses statistical models to assign risk scores, adjusting payments accordingly to reflect the expected cost of care. One challenge we face is inconsistent data and coding practices, which can affect the accuracy of these adjustments. Traditionally, risk adjustment focuses on factors like age and chronic conditions. However, incorporating social determinants of health—such as housing stability and food security—is essential for fair compensation. These factors impact health outcomes but are often excluded due to data standardization issues. To better support providers and reduce inequities, it’s crucial to design and implement risk adjustment models carefully, incorporating comprehensive data and considering social factors. This approach ensures we can continue to deliver high-quality care to all patients, regardless of their health needs. #Healthcare #Hospitals #doctors #hospitals #CommunityHealth

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The Covid-19 pandemic highlighted significant challenges in the U.S. public health data ecosystem, emphasizing the need for electronic, standardized, and interoperable data sharing. Despite progress in connecting public health and healthcare IT systems, more work is needed. This commentary explores the benefits of modern interoperability, key policies, and technology advancements essential for a connected data ecosystem, and the challenges ahead. Read more: https://lnkd.in/g94N_jip #Healthcare #PatientSafety #PublicHealth #EMR #HealthIT #Interoperability #Cybersecurity #Policy #NationalHealth #NationalSecurity #Regulations #BiohackingVillage #BHVconnect #BHV

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I am (remotely) attending the Cancer Research Data Exchange Summit, which is a fascinating combination of government, provider, and health IT organizations & people. It is good to see such a confab dedicated to the proposition that we need to facilitate and accelerate better interoperability & exchange of cancer research data. #onc #fhir #interoperability #codex #mcode #oncology

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This is insanity and no serious business person would admit this can continue. It is terrible for the consumer and overtime will create a collapse in our national healthcare system that will destroy the providers. Already almost 20 percent of our hospitals are in serious financial condition and 40% of health systems are losing money. Currently 60 percent of consumers cannot afford their basic needs. "Overall, OACT projects that national health spending will have risen from 2023’s estimated $4.8 trillion to $7.7 trillion by 2032. By that year, non-government sponsors of healthcare will comprise 51% of the total spending—about on par with 2022’s 52%." What is the answer an e-medical marketplace that the consumer, employer and providers can all win. Lower cost of healthcare while keeping providers financially healthy. HealthQRS will be participating with an e-medical marketplace that already has over 1 million consumers and by next year will have over 11 million consumers. #emedicalmarketplace #transparency #loweradministrativecosts #healthcarecost https://lnkd.in/eTNzGVeE

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ACOs have limited time left to shift to electronic quality reporting. While some are prepared, many are not. Gain insights from a valuable webinar by MRO offering guidance on this critical transition. #accountablecare #mssp #ecqm Watch the webinar here: https://lnkd.in/eACyXHUB

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Big news in #digitalhealth reimbursement in the US! Centers for Medicare & Medicaid Services proposes new payments for digital health under CY2025 PFS draft rule. Here's what you need to know: ✅ New codes for remote therapeutic monitoring ✅ Expanded coverage for principal illness navigation ✅ Increased reimbursement for chronic pain management ✅ New codes for caregiver behavior management training ✅ Permanent coverage for certain telehealth services (more work to be with regards to #telehealth approvals / expansion for allied health professionals) These changes signal a strong push towards modernizing healthcare delivery and embracing #virtualcare models. It's a move in the right direction for providers, patients, and digital health innovators! The proposal highlights the importance of digital tools in enhancing patient care and provider efficiency, paving the way for the broader adoption of digital health solutions. Would love to hear others' take on these proposed changes. How do you think they'll impact the healthcare and #healthtech landscape? Stakeholders are encouraged to provide feedback on the draft rule during the 60-day comment period, ending on September 9th. Read more here: https://lnkd.in/gxJkCtmk and here: https://lnkd.in/gpvUHCpb

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The ONC's proposed HTI-2 rule represents incremental progress in enabling more seamless data sharing between providers, payers, and public health agencies. 👉 Certification criteria for public health software to enable seamless data sharing 👉 Updates to data standards to capture more robust information, including social determinants of health 👉 New API requirements for payers to streamline prior authorization and benefits data exchange 👉 Stronger EHR cybersecurity requirements - e.g., multifactor authentication and encryption While not a panacea, this rule represents a positive step towards a more interoperable, secure health data ecosystem. By establishing common standards and interfaces, it should reduce friction in data exchange across stakeholders. As a market research consultant, we often hear the frustrations from providers and payers around the lack of seamless data exchange, and this rule addresses some of those pain points - e.g.,: 🔹 Upgrading public health agency systems to align with certified EHRs should improve real-time data collection and analysis for population health 🔹 The proposed API requirements could help with streamlining prior authorizations (a major administrative burden) 🔹 Capturing SDoH data has been a challenge; expanding standards to include more robust SDoH data in clinical workflows is vital These new requirements will help agencies more efficiently collect, integrate, and analyze data. The inclusion of health equity elements is also noteworthy. But of course, the devil is in the (implementation) details. Providers and payers will need to enhance their systems and workflows to comply. Overall, this is a welcome effort to break down silos and enable more holistic health insights. 𝗖𝘂𝗿𝗶𝗼𝘂𝘀 𝘁𝗼 𝗵𝗲𝗮𝗿 𝗼𝘁𝗵𝗲𝗿𝘀' 𝘁𝗮𝗸𝗲𝘀 - 𝘄𝗵𝗮𝘁 𝗲𝘅𝗰𝗶𝘁𝗲𝘀 𝗼𝗿 𝗰𝗼𝗻𝗰𝗲𝗿𝗻𝘀 𝘆𝗼𝘂 𝗺𝗼𝘀𝘁 𝗮𝗯𝗼𝘂𝘁 𝘁𝗵𝗶𝘀 𝗽𝗿𝗼𝗽𝗼𝘀𝗲𝗱 𝗿𝘂𝗹𝗲? 𝗛𝗼𝘄 𝗱𝗼 𝘆𝗼𝘂 𝘀𝗲𝗲 𝗶𝘁 𝗶𝗺𝗽𝗮𝗰𝘁𝗶𝗻𝗴 𝗽𝘂𝗯𝗹𝗶𝗰 𝗵𝗲𝗮𝗹𝘁𝗵 𝗿𝗲𝗮𝗱𝗶𝗻𝗲𝘀𝘀 𝗮𝗻𝗱 𝗵𝗲𝗮𝗹𝘁𝗵 𝗲𝗾𝘂𝗶𝘁𝘆 𝗲𝗳𝗳𝗼𝗿𝘁𝘀? #healthequity #healthcare #interoperability #patientdata #EHR #cybersecurity #SDoH #datasharing ------------------------------------------------------------------------------------------ PS: Hey there! I'm Jess, a market research consultant specializing in the healthcare and animal health industries. I help clients navigate market complexities and capitalize on growth opportunities through customized research and analysis. If you're interested in discussing how current and emerging trends could impact your business or strategy, let's connect!

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ASCENSION HEALTH "DATA-PRIVACY-CRISIS"--MAY 8, 2024. I wonder what role "Digital-Tracker-Codes" may have played in this crisis? (See CNN Article below). For those of you who follow my LinkedIn Blog-Posts, you may have noticed a prior Post of an article which revealed that "21 USA Healthcare Service Providers" are engulfed in either Class Action Lawsuits or Federal Gov Agency investigations of "Digital-Data-PRIVACY" breaches. The article further revealed that the worm-hole of data-PRIVACY-Access, was Digital-Tracker-Codes, being used within the Healthcare Service Provider's digital-marketing plans. Here at Didgebridge, we are in process of explaining to the industry, that this "digital-tracker-code-privacy-risk" in marketing is so completely unnecessary today. These antiquated marketing tools of the 25 year old Web2.0, porous marketing era seem strikingly out-of-place in our current era of Consensual, data-PRIVATE, marketing. (See article below). If any healthcare service provider would like to learn more about how we might be of service, I'd welcome a discussion. (See---MSN article below) https://lnkd.in/gHZXKQa7

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In 2016, the Cures Act introduced information blocking and set of rules and exceptions around what information blocking is - and isn't. It's a KEY part of partnerships with EHRs and other healthcare technology. One of the issues, is it's very gray. One of those reasons is because even though you can file complaints, there's currently no plethora of case law to go look at for precedent like there is for anti-kickback. (though aks can be gray too). Information blocking is so gray that in the government's own FAQs around what consitutes information blocking their answer to whether a situation is IB is it requires a "case-by-case assessment of the circumstances." That's great and fair - things do need to be determined based on the facts at hand but it can make it difficult to see how they apply in practical scenarios. If you're curious to hear more, I've got 2,200 words dropping Monday in my newsletter, Talking Health. Link in the comments. #digitalhealth #partnerships

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