Readers Write: What Separates Winners from Losers in Population Health Management? Three Lessons

What Separates Winners from Losers in Population Health Management? Three Lessons
By Billie Jo Nutter

Billie Jo Nutter is CEO of Chordline Health.

There’s an alarming range of success and failure in population health management initiatives, with an ROI that spans from -$244.65 to $1,592.48 per year. As healthcare providers and health plans accelerate investments, ensuring organizations have the right data, tools, and processes to improve risk identification, care management, and value will be vital.

One area of untapped opportunity, according to pwc: driving payer-provider collaboration with a single care plan that is customized to each patient’s needs.

To get there, health plans and health systems must understand where breakdowns in population health management typically occur, how to evaluate their approach, and ways to drive better results.

Breaking Down Population Health Pain Points

Lack of trust and cynicism are two of the biggest factors that get in the way of payer-provider collaboration around population health, according to healthcare C-suite leaders who attended an HFMA population health colloquium last fall. Transparency  around population health data, analytics, outreach, and referrals can help unlock collaboration, but only if the data used to inform population health analyses and care management response are credible and actionable.

One way to build trust in population health data is by aggregating data from multiple sources, including community service organizations, to gain a whole-picture view of the patient, including the patient’s health-related social needs. Another is to tap into another organization’s data to compare a population against a similar population. This process can help uncover best practices in care management for a specific group. In instances where providers and payers are collaborating around population health management, it can also help to:

• Align resources for more effective care management.
• Point to opportunities to better manage multiple chronic conditions.
• Uncover instances where medication management could be streamlined, avoiding adverse effects and unnecessary costs.

Trust also comes down to the ability to use the data at the point of care to improve patient outcomes and to demonstrate the impact that was made in ways that all key stakeholders can understand. This is an area where the data must not only be credible, but also be delivered in such a way that clinicians can determine, at a glance, the health risks that a patient faces and the interventions that offer the best chance to improve health.

In addition, clinicians and value partners, like health plans, need to see the impact that they have made, such as the number of people for whom they have helped to avoid hospital readmissions or progression of disease. This level of clarity reinforces professional satisfaction. It also motivates all stakeholders to do more to strengthen the health of a population.

How can healthcare providers and health plans collaboratively develop a population health management approach that delivers clear wins for both stakeholders and their patients?

• Use shared data to develop a single care plan. Just as some providers leverage data from academic medical centers to better understand what works and what doesn’t in strengthening the health of specific populations, access to health plan data gives providers a more complete view of a patient’s healthcare utilization and care costs. From there, data scientists can not only analyze and forecast a population’s health needs, but also strengthen patient engagement in ways that improve overall health. That’s especially important for adults with chronic conditions, whose risk of hospitalization is two to eight times higher than that of adults without chronic disease.
• Explore innovative approaches to managing chronic conditions, especially within managed Medicare populations. When high-risk patients are identified, bring care managers from the health plan and the health system together to design and implement strategies for care coordination. Then, leverage technology for remote monitoring and support. One essential element for success: a population health analytics platform that can integrate with any data system. This ensures that no matter where a care manager or clinician works, that person has the same data view to make care decisions and view progress.
• Make it easy for clinicians to view population health data directly within their workflows. Intuitive patient dashboards can put population health data at clinicians’ fingertips, empowering them to understand the top factors that influence the patient’s health and population health. Such dashboards can also point to opportunities to reduce care costs, such as by highlighting medication prescribing trends for a particular population and ways to bring these patterns in line with evidence-based practices. One tip for success: make sure the dashboard offers flexible data filtering options to support the clinical team’s needs and enable the team to report on progress and opportunities in a variety of ways.

By taking a collaborative approach to population health management, health systems and health plans can more effectively improve the health of target populations while enhancing clinical workflows, patient outcomes and professional satisfaction.

Readers Write: Six Foundations of Highly Productive Technology Teams: How to Handle System and Talent Transitions

Six Foundations of Highly Productive Technology Teams: How to Handle System and Talent Transitions
By  Mark Thomas

Mark Thomas, MS, MBA is CTO of MRO.

There is one certainty in healthcare IT. Teams, tasks, and technology will always change. Maintaining a productive and efficient team culture during these transitions is essential to keep up with today’s fast-paced and connected health IT ecosystem.

A well-developed technology culture ensures optimal outcomes through months of high-volume activity, such as EHR conversions, and during regular day-to-day operations. And by focusing on high productivity, health system CIOs build a solid foundation to weather our industry’s inevitable shifts in strategic initiatives and organizational leadership.

This article explores six principles of developing a technology team culture for high production and resilience in healthcare. The leadership journey begins with flexibility and the willingness to accept change.

Embrace change and inspire flexibility

One of the most important qualities of a high-production culture is the ability to evolve. Effective technology leaders exhibit flexibility and welcome changes that drive positive outcomes for the team. This involves personal accountability at all levels to challenge barriers and work toward common goals.

A recent example is our company’s deliberate decision to rebrand the “IT” team to the “Technology” team. Rebranding the name of the department was a simple, yet effective way to help the team transition away from IT ticket-takers to strategic business outcome thinkers.

By fostering an environment where change is accepted and encouraged, CIOs ensure their systems and processes remain adaptable and responsive to advancing business needs.

Use data-driven decision-making

Predictability is important for sustaining high productivity. But predictability is often elusive during times of dramatic change and system transition. Savvy healthcare CIOs use data to build a bridge between opposing forces — doubt and certainty.

Whether with clients, partners, or internal stakeholders, data is a proven guide to effective technology leadership decisions. Teams make more informed decisions and remain focused on outcomes when performance can be tracked against data-driven commitments.

A variety of metrics can be used to measure the impact of team culture. This includes use of the Westrum culture survey, delivery predictability, and alignment of talent with skills and interests. By continuously monitoring these metrics, organizations can ensure teams are performing well and remain engaged and motivated. This data-driven approach enables the organization to make informed adjustments and sustain high productivity over time.

Finally, rewarding transparency when teams go off track further reinforces a culture of honest and continuous improvement.

Build composable and collaborative teams

Organizing teams around domains that require cohesive changes fosters a composable culture. This means aligning teams with a common backlog and driving toward shared outcomes.

This approach, coupled with a systems-thinking mindset, ensures that each team understands its role within the broader system and takes personal accountability for its contributions. By empowering teams to self-regulate, technology leaders also quickly identify necessary shifts and improvements to maintain high productivity.

Encourage extreme ownership for optimal availability

In today’s 24/7 plugged-in healthcare environment, system availability is non-negotiable. The concept of extreme ownership holds teams accountable for their systems end to end, from implementation to bringing disabled systems back online.

Eliminating handoffs and ensuring continuous monitoring helps teams proactively address issues before clients are affected. This cultural shift drives significant technological progress and ensures systems experience upmost reliability.

This type of accountability model eliminates reliance on project managers. Teams and individuals are directly responsible for their outcomes, fostering a sense of pride and ownership while delivering remarkable improvements in release frequency and quality.

Use telemetry and feature flags to support scalability

All systems must be scalable to enable future growth. Build telemetry into every step of the development life cycle, providing visibility into system performance and identifying bottlenecks.

Feature flags are another proven tool for health IT leaders. With these flags, technology teams release features at a controlled pace that enables organizations to scale effectively. This continuous improvement mindset should be ingrained in the team culture to ensure the organization is able to grow alongside new technological capabilities and industry demands.

Gather direct feedback from end users

A user-focused culture is essential for delivering valuable products. Routine inspections and direct feedback from end users are integral to the development process.

Teach your technology teams to speak the language of the business for each department or service line they support. Knowing the proper vernacular (e.g., nursing, laboratory, revenue cycle) helps teams effectively communicate with stakeholders and translate technical requirements into business value.

Frequent feedback loops with end users are also encouraged to ensure constant refinement and alignment with departmental needs.

With these six principles in mind, CIOs turn their leadership focus to individuals within and across their teams, ensuring the right people are in the right roles to drive technical excellence.

Translate Culture into Sustained Productivity

A new talent management strategy is the final cornerstone of its high-production culture. Instead of traditional promotion paths that elevate individuals based on technical skills, consider identifying specific strengths, interests, and weaknesses that suggest positions as individual contributors or talent managers.

By embedding these principles into your team’s culture, organizations create an environment where high productivity is both achievable and sustainable. Hospitals and health systems looking to embark on a similar journey should apply these strategies to transform their technology culture and achieve exceptional results.

Readers Write: The Future of Healthcare Data: Unveiling the Potential of Vector Databases

The Future of Healthcare Data: Unveiling the Potential of Vector Databases
By Faiyaz Shikari

Faiyaz Shikari is CTO of HHS Tech Group.

Healthcare information technology (HIT) leaders are the last people who need to be convinced of the transformative power of data in healthcare. However, many leaders may have given little thought to a pervasive industry problem that limits the potential of HIT to fully deliver the value that it is capable of — the traditional relational databases that have served the industry well for decades are reaching their limits when it comes to managing the ever-growing complexity and volume of healthcare data.

This is where vector databases emerge as a game-changer, offering a paradigm shift in how we store, analyze, and leverage healthcare information.

Traditional databases excel at storing structured data, neatly organized in rows and columns. But healthcare data is a different beast. It encompasses a rich tapestry of patient demographics, medical history, lab results, imaging data – often in diverse formats and constantly evolving. Vector databases tackle this challenge head-on by representing these diverse data as “vectors,” mathematical entities with magnitude and direction. This allows for efficient storage and retrieval of complex information, particularly for tasks like patient similarity analysis and drug discovery.

Imagine a scenario where a physician is treating a patient with a rare disease. With traditional databases, pinpointing similar cases might involve laborious manual searches. Vector databases, however, can analyze a patient’s unique medical profile and identify others with similar vector representations, potentially leading to faster diagnoses and treatment options. This personalized approach empowers physicians to move beyond a one-size-fits-all model and tailor care to everyone’s needs.

The potential of vector databases in healthcare extends far beyond patient similarity analysis. Consider the realm of drug discovery, a notoriously time-consuming and expensive process. Vector databases can store and analyze vast datasets of molecular structures, accelerating the identification of potential drug candidates. By comparing the vector representation of a disease target with potential drug molecules, researchers can prioritize promising avenues for further investigation.

Furthermore, vector databases play a crucial role in unlocking the potential of artificial intelligence (AI) in healthcare. AI algorithms thrive on large amounts of diverse data, and vector databases can provide the efficient foundation for their operation. Imagine AI-powered systems that can analyze medical images with unprecedented accuracy or predict potential health risks based on a patient’s unique profile. Vector databases can empower these powerful tools, paving the way for a future of data-driven precision medicine.

The new AI algorithms use two main components. Sparse vectors handle exact word matching, like traditional keyword search, such as identifying specific symptoms in a patient. Dense vectors capture overall meaning and context, like how our brains understand language, such as grasping the overall health profile of a patient. These algorithms employ a method called Reciprocal Rank Fusion to blend results from both approaches, ensuring precise matching and contextual understanding.

The impact is evident in several practical scenarios. For customer support, AI-powered chatbots can find relevant information from knowledge bases, providing faster, more accurate responses. In legal research, lawyers can quickly locate relevant case law and legal documents, understanding both terminology and legal concepts. In medical diagnosis, healthcare systems can search medical literature for studies and case reports matching symptoms and patient context. For content recommendation, streaming services and online retailers can offer more accurate recommendations, understanding user preferences and broader trends.

Integrating any new technology requires careful consideration. Security and privacy remain paramount in healthcare. Vector databases must be designed with robust security measures to ensure patient data remains confidential. Additionally, establishing clear guidelines for data governance and ownership will be crucial for fostering trust and promoting responsible use of this powerful technology.

In conclusion, vector databases hold immense potential to revolutionize healthcare. From enabling personalized medicine to accelerating drug discovery, these innovative databases offer a future where data truly empowers better patient care. As we navigate this exciting landscape, collaboration between healthcare professionals, data scientists, and cloud computing companies will be essential to unlocking the full potential of vector databases and ushering in a new era of data-driven healthcare.

Readers Write: A New Industry Standard: How the VBPR IG Is Advancing Value-Based Care

A New Industry Standard: How the VBPR IG Is Advancing Value-Based Care
By Michael Pattwell

Michael Pattwell is principal business advisor for value-based contracting at Edifecs.

The introduction and adoption of the HIPAA transaction standard X12 837 for electronic claim submission revolutionized the way providers were reimbursed in the early 2000s. This standard eliminated administrative overhead for both payers and providers by shifting from paper-based claim submission to electronic submission, reducing claims processing time, errors, and reimbursement turnaround. The standardized structure allowed healthcare providers and payers to communicate efficiently and accurately in a universal format while maintaining security and privacy standards.

Fast forward two decades and the transition from fee-for-service to value-based care has necessitated a new shift. To address this challenge, a new open industry standard has been published to facilitate this transition to value-based care. This standard was designed and developed by the HL7 Da Vinci Project.

The Da Vinci Project is a private sector initiative that addresses the needs of the value-based care community by leveraging the HL7 Fast Healthcare Interoperability Resource (FHIR) platform. The HL7 FHIR platform enables payers, health systems, and other industry participants to identify and enumerate healthcare business use cases that involve managing and sharing clinical and administrative data between industry partners.

On June 17, 2024, The Da Vinci Project published its newest business use case called the “Value-Based Performance Reporting (VBPR) Implementation Guide (IG).” The VBPR IG is designed to support a standards-based exchange of financial and quality performance data based on contractual performance measurements agreed to by payers and providers. The VBPR IG is designed to leverage the existing FHIR resources created for other business use cases. The VBPR IG profiles the “measure report” resource. This existing FHIR resource is profiled by the VBPR IG as is and consumed using the FHIR framework that facilitates this interoperability standard.

This new VBPR IG interoperability standard is designed to solve many of the challenges payers and providers have faced implementing value-based care contracts over the past decade. Some of the challenges that can be solved by implementing the VBPR IG include:

• The timely tracking of performance across contractual measures. It is difficult, if not impossible, for providers to understand how well they are performing prior to various settlement dates.
• Lack of a standard format for value-based care contract performance reporting. There is variation in metrics and methodologies used across payers including financial terms, quality measures, attribution, and reconciliation periods. Reconciling the numerous reports providers receive from multiple payers in unstructured formats. This process is time intensive because reports come from various portals.

The immediate goal of the VBPR IG standard is to enable payers to summarize provider performance across different categories, including lines of business, contracts, populations, quality measures, financial metrics, and reporting periods on a scheduled and ad-hoc basis. Based on the calculated performance scores, incentives are calculated and distributed to providers as rewards or penalties, encouraging continuous improvement in care quality and efficiency.

Solving these critical business problems with value-based care contract transparency and standardization will accelerate the transition away from a fee-for-service reimbursement model to the value-based care model. This will lead to the ultimate goals and objectives to encourage superior care, enhance patient outcomes, and lower costs by compensating providers according to their quality performance, as opposed to the quantity of services provided.

So, what is next for the multi-stakeholder VBPR IG Team at The Da Vinci Project? The next release is is in development. Future releases will continue to extend the VBPR IG and include consuming and leveraging additional FHIR resources. These additional resources include, but are not limited to, CRD IG – Coverage Requirement Discovery and DTR IG – Document Templates and Rules.

Members of HL7’s Da Vinci Project will continue to advance the HL7 FHIR standards and collaborate with all industry stakeholders to accelerate the adoption of a digital future across healthcare. The Da Vinci Project founders and private sector partners are supporting the implementation of the VBPR IG and looking forward to seeing it in action across the industry.

Readers Write: The Advantages and Misconceptions of Being a 1099 Contractor in Health IT

The Advantages and Misconceptions of Being a 1099 Contractor in Health IT
By Eric Utzinger

Eric Utzinger is co-founder and chief commercial officer of Revuud.

Are you a health IT professional who is debating between the freedom of being a 1099 contractor and the stability of a W2 employee? Understanding the nuances can make all the difference in your career path.

Each option offers distinct advantages and misconceptions, particularly within the healthcare industry. I will delve into the specific benefits and clarify common misunderstandings about being a 1099 contractor compared to a W2 employee in health IT.

Advantages of Being a 1099 Contractor in Health IT

• Flexibility and control. Health IT contractors enjoy unparalleled flexibility. They can set their own schedules, choose projects that are aligned with their expertise, and often work remotely. This autonomy is invaluable for navigating the demanding schedules that are often required in healthcare settings.
• Potential for higher earnings. 1099 contractors in health IT frequently have the potential to earn more than their W2 counterparts. They can negotiate competitive rates that are based on their specialized skills and experience without the constraints of a fixed salary. Additionally, deductible business expenses can significantly lower their taxable income.
• Diverse opportunities. Working as a 1099 contractor in health IT allows professionals to diversify their experience across various healthcare organizations. This exposure to different systems, workflows, and clinical environments enhances their skill set and professional growth.
• Tax benefits, Health IT contractors can leverage substantial tax deductions, including expenses that are related to home offices, travel, professional development, and health insurance premiums. These deductions provide financial advantages that are not typically available to W2 employees.

Misconceptions About Being a 1099 Contractor in Health IT

• Lack of Stability. It’s often assumed that 1099 contractors lack job stability in health IT. However, skilled contractors can maintain a steady stream of projects by establishing relationships with multiple healthcare facilities or organizations. The demand for specialized health IT expertise ensures ongoing opportunities.
• No benefits. Contrary to common belief, 1099 contractors in health IT can access benefits like health insurance and retirement plans, albeit through individual arrangements. They can purchase health insurance through marketplaces and establish retirement accounts such as IRAs or Solo 401(k)s, ensuring financial security.
• More taxes. There’s a misconception that 1099 contractors in health IT face higher tax burdens. While they do pay self-employment taxes, the ability to deduct business expenses often offsets these taxes. With strategic tax planning, contractors can effectively manage their tax liabilities.
• Isolation. Some perceive health IT contractors as isolated due to their independent work status. However, technological advancements and collaborative platforms enable contractors to engage in virtual healthcare teams, participate in professional networks, and attend industry conferences, fostering connections and support.

Advantages for Health Systems

• Flexibility in scaling workforce. Health systems benefit from the flexibility of engaging 1099 contractors, allowing them to scale their workforce based on current needs without being bound to a set number of hours. This adaptability helps save time and money, ensuring that resources are used efficiently.
• Improved workforce management platforms. The rise of 1099 arrangements has driven the development of marketplace platforms that offer better workforce management solutions for clients. These platforms often take on and manage risks similarly to staffing companies, providing a reliable and streamlined process for hiring and managing contractors.
• Fair and efficient time tracking. Unlike traditional staffing models, 1099 contractors are not always pushed to work a standard 40-hour week. This ensures that contractors only track and bill for actual hours worked, leading to fairer time management and cost savings for healthcare organizations.

Evolving Trends and Future Outlook for Health IT Contractors

• Increasing demand for specialized expertise. As healthcare systems continue to adopt advanced technologies and digital solutions, the demand for skilled health IT contractors is expected to rise. Contractors with expertise in areas such as electronic health records (EHR), telemedicine, cybersecurity, and data analytics will find ample opportunities in the evolving healthcare landscape.
• Embracing remote work and virtual collaboration. The COVID-19 pandemic accelerated the adoption of remote work and virtual collaboration across industries, including healthcare. Health IT contractors can capitalize on this trend by offering remote services and supporting healthcare providers with virtual solutions that enhance patient care and operational efficiency.
• Shifting regulatory landscape. Healthcare regulations and compliance requirements are constantly evolving. Health IT contractors must stay abreast of these changes and offer solutions that ensure data security, patient privacy, and regulatory compliance. Contractors who can navigate and adapt to regulatory shifts will remain in high demand.

Conclusion

Choosing between being a 1099 contractor and a W2 employee in health IT hinges on personal career goals and preferences. Both options offer unique advantages and challenges within the healthcare industry. By understanding these nuances and dispelling misconceptions, health IT professionals can make informed decisions that align with their professional aspirations.

Readers Write: Why RCM is the Most Interesting Opportunity in Healthcare

Why RCM is the Most Interesting Opportunity in Healthcare
By Kim Waters

Kim Waters, MBA is principal advisory at CereCore.

Revenue cycle management (RCM) isn’t for everybody, but it certainly is for me. I actually enjoy talking to someone about their revenue cycle plans and opportunities. In fact, I maintain that RCM is the most interesting opportunity in healthcare. If you can’t relate, perhaps the reasons I’ve listed below will convince you. If you agree, I hope that you will share new reasons to add to my list.

Research supports RCM opportunities. In a 2023 study, HFMA reported on the rising cost of claims, with as much as 60% of claims not resubmitted and the average denial rate’s total percentage of gross revenue at 11%. What’s more is that they found that the cost per claim appealed is $118 and the denial rate is increasing 20% year over year. In an era when budgets are tight and margins are lower, organizations need to improve on these numbers to survive and eventually thrive.

Opportunities for improvement can be easy to see. Reconsider any processes or solutions that:

• Are still accomplished on paper.
• Involve a fax machine.
• Have not changed in the last five years.
• Are repetitive.
• Don’t involve peer or higher-level review.
• Consistently receive low engagement scores.
• Are not documented.

Every organization has opportunities for quick wins, while other areas for improvement may not seem so obvious but are just as promising.

Reporting is key. The best RCM decisions are made based on actionable data. On average, healthcare organizations use around 30 vendors across the revenue cycle. Disparate data sets complicate clear, actionable reporting and limit the ability to see patterns and identify areas of opportunity. RCM leaders need effective reporting and road mapping tools to tell their story, presenting a fresh vision around the use of technology and resources and the impact they can make.

Important processes are up and downstream from revenue cycle. From patient access, financial clearance, provider documentation to discharge and final payment for services, RCM processes run through the entirety of a patient’s experience and involve touchpoints with all the departments that a patient’s care requires. This presents complexity and opportunity for RCM, starting with adoption of a unified vision and strategy, change management practices, governance policies, and system interoperability development.

Each organization holds different improvement opportunities. The areas to focus on are a matter of an organization’s current state, their strategic goals, the needs of their community, and their competitive position. That’s what makes it fun. No two systems are alike, but sound revenue cycle management processes can support any endeavor and improve financial performance. In turn, improved financial performance is fundamental to realizing improved quality, outcomes, and all the meaningful reasons we chose healthcare in the first place.

The Healthcare Financial Management Association (HFMA) recently released the Revenue Cycle Technology Adoption Model (RCMTAM), a benchmarking framework to help healthcare’s financial leaders design a personalized RCM modernization roadmap, with the goal of correlating technology improvements to financial performance. RCMTAM is specifically for healthcare and is providing much-needed insight and direction for uncovering and addressing opportunities.

RCM calls for compassion. Working on improvements to revenue cycle management processes looks and feels like improving cash flow, increasing reimbursement rates, reducing denials, and enhancing overall performance. All of the above play a part in the delivery of care to the people who entrust their care to your organization. What’s a more interesting opportunity than that?

Readers Write: Healthcare’s Biggest Hidden Asset

Healthcare’s Biggest Hidden Asset
By Aasim Saeed, MD, MPA

Aasim Saeed, MD, MPA is founder and CEO of Amenities Health.

Health systems across the US continue to grapple with a host of financial challenges, from staffing shortages to lower reimbursement rates to increasing competition from new players in the market. However, most organizations have an unused resource at their disposal that is worth significant value and that is not leveraged to its full potential: MACC credits.

Microsoft Azure Consumption Commitment (MACC) credits are pre-purchased credits that health organizations commit to spending on Microsoft’s Azure cloud services over a specific time. If you remember the old cell phone plans before rollover minutes were introduced, you understand how these “use or lose” benefits work. It’s like buying a golf club membership that requires a minimum purchase of food or drink at the clubhouse.

MACC agreements allow customers to commit to a minimum level of Azure consumption in exchange for discounted pricing and additional benefits. But they are lost if you don’t consume the benefits within a year. You can’t carry them over.

In my opinion, these agreements are probably one of the most underutilized IT resources in healthcare. Many IT and innovation teams have forgotten about them, or don’t even know that they exist. As a result, few are using all the capacity that they paid for. We’re now six months into 2024, and chances are most MACC credits are still sitting, gathering dust. Given the financial strains facing the healthcare industry, technology teams need to use these funds before they expire at the end of the year.

Accessing a third-party app is one of the easiest, but often overlooked, ways to accomplish this. Many valuable third-party applications are available via the Microsoft Azure Marketplace. If healthcare organizations have MACC allocations that are at risk of going to waste, they can adopt these applications at no net new cost. For instance, a hospital might fold a new chatbot application, advanced online scheduling, or billing software into its MACC agreement.

The marketplace is also designed to streamline the contracting process. It allows healthcare systems and other organizations to transact automatically without having to complete a bunch of paperwork on the back end. Rather than getting bogged down in the contracting process, healthcare systems can purchase the applications directly through Azure, install them immediately, and use them to improve their operations.

Another option is to use the credits to build cloud environments. All MACC agreements come with cloud support built into the offering, which presents an opportunity for health systems to migrate some of their on-premises resources to the cloud, helping them eliminate some of the capital costs that are associated with data center refreshes. Also, the cloud presents an opportunity for hospitals to pilot new tools, paying only on a per-user basis rather than making the serious capital investments that are frequently associated with on-premises solutions.

Healthcare organizations should carefully prioritize their technology needs when using resources under their MACC agreements. This involves weighing the potential impact of new applications against factors like ease of implementation, necessary training, and ongoing management. It’s crucial to begin with a comprehensive evaluation of the organization’s overarching digital transformation goals and how cloud services can effectively align with these objectives.

By increasing awareness of their Azure commitments and actively taking advantage of these hidden assets, healthcare systems can enhance and streamline their technology environments without any additional costs to their technology budgets.

Readers Write: Revitalizing Healthcare’s Backbone by Empowering Nurse Leaders

Revitalizing Healthcare’s Backbone by Empowering Nurse Leaders
By Russ Richmond, MD

Russ Richmond, MD is co-founder and CEO of Laudio. 

Nursing remains one of the most challenging parts of the healthcare ecosystem. Frontline nurses who are contending with understaffing and concerns for patient care continue to raise alarms and exit their roles.

Beset with high turnover and burnout rates, nurse managers constantly grapple with handling high spans of control and associated challenges without sacrificing patient care, quality, and organizational outcomes. A recent report noted that 20% of nurse managers are contemplating leaving their positions, and that the average nurse manager stays in their role for just two years. These figures point to deeper structural issues with the current state of nursing leadership roles and the overdue need to bring technology to these problems.

Another recent report that was co-published by the American Organization for Nursing Leadership (AONL) noted that the median span of control for nurse managers is 46 direct reports, making genuine engagement with team members on a day-to-day basis nearly impossible. Even more startling, 25% of all inpatient nurse managers have over 78 direct reports, further hindering meaningful manager-employee engagement.

The report also drew a direct correlation between nurse managers with large spans of control and higher rates of burnout, turnover, and incremental overtime on their teams. These consequences have real financial implications for health systems, especially as staffing costs and turnover continue to be some of the largest detractors from financial and organizational stability in healthcare. Better support for nursing leaders results in higher engagement scores among their teams and reduced turnover, both of which are targets of numerous initiatives among health systems.

As an industry, we frequently discuss transformation in healthcare, especially in a post-COVID environment, and how we need to work differently to improve outcomes for our patients and organizations. Yet the people who have the most direct impact in linking C-suite goals with frontline action are often overlooked. Few tools exist today to directly enable frontline nurse leaders to handle increased workloads while maintaining strong connections with their teams, which drives positive outcomes across the board. The same report referenced above noted:

• A strong correlation between the number of purposeful leader engagements (e.g., regular check-ins, recognition, celebrations) with team members and crucial metrics like higher team retention.
• A lack of span-breaking assistant managers with roles that are designed to share administrative burdens and support people processes.
• An absence of deep HR, IT, and nursing department partnerships to enable nurse leaders with the right tools to achieve broad job responsibilities.

To date, innovation in nursing has primarily centered on clinical areas, with novel technologies like virtual nursing and remote monitoring of patients taking priority over investments that enable leaders to propagate broad operational and people-based positive change within their teams. This focus must expand and transition to a holistic approach that is aimed at easing the burden frontline nurses and their leaders face today.

A few examples of how organizations can use new approaches to create a broad positive impact across nursing teams include:

• Use intelligent technology to automate much of the rote people work that frontline leaders perform today to allow them to their time where it matters most – on purposeful engagements with their teams.
• Automate clinical documentation wherever possible to reduce administrative burden through solutions that simplify EHR workflows.
• Introduce innovative leadership models to reduce spans of control and enable leaders to have more humanizing relationships with their team members and the work they do (e.g., dividing large departments into multiple parts, leveraging assistant nurse managers to break spans of control, utilizing nurse educators to lead professional development activities and continuing education around the nursing profession).
• Allow flexibility for team members by implementing new and improved staffing and scheduling practices that center on team member preferences and wellbeing needs versus long-standing industry norms.
• Build the right programs that frontline leaders can use to guide team members through established career paths and advocate for the professional development and skill expansion of team members.

Supporting nurse leaders has a quantifiable impact on organizational outcomes. Senior leadership teams have the opportunity to significantly improve metrics around nursing engagement and retention through purpose-built innovation. Moving the needle at the highest levels requires change that starts at the foundation – supporting, enabling, and empowering nurse leaders with the right processes and resources to drive success. Technology has the ability to redefine work and to scale the impact of leaders on organizational outcomes. Our nurse managers need these solutions now more than ever.

Readers Write: The Role of Human-Centric AI in Virtual Patient Observation

The Role of Human-Centric AI in Virtual Patient Observation
By Christine Gall, RN

Christine Gall, RN, DrPH, MS is chief nursing officer at Collette Health.

The integration and expansion of artificial intelligence (AI) in healthcare has certainly seen its fair share of controversial conversations. Discussions about the potential benefits of utilizing AI to mitigate healthcare worker burnout, improve workflow and process efficiency, and enhance patient safety are met with reservations about the impact of AI being used carelessly or without precision.

Human-centric AI can address some of the concerns related to the algorithmic nature of task automation in traditional AI. The industry has seen a strong shift towards human-centric AI in hospitals for the purpose of prioritizing human needs and augmenting human capabilities rather than replacing them. The nursing community is eager for technology that supports the top priority of nurses — providing excellent and safe care to their patients.

In recent years, AI has enabled the healthcare system to implement revolutionary advancements for the betterment of both frontline healthcare workers and patient safety, particularly in the arena of patient observation.

Continual patient observation is an important tool to enhance patient safety for at-risk patients. Nurse staffing shortages, paired with ever-rising patient acuity, makes continual observation nearly impossible without the help of technology. Many patients in acute care settings are at high risk for falls and accidental self-harm. Human-centric AI-powered virtual patient observation is designed to sharpen the focus of the virtual observer to patients who begin to demonstrate risky behaviors so they can redirect the patient or call for assistance to prevent these events from happening.

A recent study from the American Organization for Nursing Leadership Foundation’s 2024 Longitudinal Nursing Leadership Insight Study found that 20% of nurses want to see an increased utilization of virtual nursing. Virtual patient observation specifically is driving a lot of innovative care practices. The end goal is to leverage human-centric AI to ensure patients’ and clinicians’ safety and well-being, as well as bolster the support systems for caregivers to optimize operational efficiency.

Imagine if hospitals could place a nurse in every single hospital room for an entire shift. That would be wonderful if it was possible. Hospitals have started gravitating towards human-enabled digital innovations that can provide a virtual observer in patient rooms. Virtual observation stations can be placed in rooms, hallways, and main corridors for seamless line of sight of the patient by the virtual observer, and human-centered AI is able to proactively signal subtle changes in patient activity that might lead to patient injury if not redirected. Human-centric AI enables technology to augment and enhance clinician capabilities by extending their reach with the virtual observer, allowing them the reassurance that all of their patients remain in a safe environment even when they are not physically present.

With the application of human-centric AI, providers and nurses can gain insight into overall patient well-being, including sleep patterns, movement, and state of repose. Proactive alerts, enhanced workflows, and intelligent video management provide nurses and caregivers with greater time to practice at the top of their knowledge and expertise, as each patient is continually monitored by virtual colleagues. The insights gained, paired with the uninterrupted observation, is a game-changer not only for hospitals but for the nurses who are caring for patients day in and day out.

Built-in AI tools have been developed to strengthen the impact of virtual observers. Presence detection features alert observers who may look away from their screens for too long and guide them back to focus through increasingly prominent alerts. This technology ensures that the attention of virtual observers remains on their patients, improving patient safety. This feature also supports improved buy-in from hospital leaders with the assurance that the virtual observers are always attentive to their patients.

One of the most important aspects of healthcare is the communication between patient and healthcare provider. Virtual observation powered by human-centric AI is designed to improve contact and communication between the patient and their entire healthcare team. When patients are at their most vulnerable, continuous observation and contact promote patient safety and security. Additionally, nurses and healthcare workers benefit from extended connection to their patients, with virtual observers providing an environment of safety. Patients experience more interaction with the virtual observers, which can enhance their positive perceptions of care.

It is an unfortunate reality that nurses face increased violence in the workplace. A recent National Nurses United report found that 8 in 10 nurses (81.6%) have experienced at least one instance of workplace violence within the past year and nearly half of nurses reported an increase in workplace violence in their unit. Healthcare workplace violence ranges from physical abuse to verbal threats. Virtual observation solutions can improve security for staff as well as patients by utilizing security staff trained in violence mitigation. They can alert a nurse that a patient is exhibiting signs of escalation prior to the nurse entering the patient’s room so that they may execute de-escalation tactics to prevent a violent encounter.

As more hospitals and health systems gravitate towards virtual patient observation solutions, the overarching objective is to improve care delivery for caregivers and enhance safety for patients. Human-centric AI technology can extend the reach of caregivers with continuous virtual observation of patients, ultimately protecting their safety and improving their experience.

Readers Write: How to Re-Imagine Clinical IT Support

How to Re-Imagine Clinical IT Support
By Chris Wickersham

Chris Wickersham is assistant VP of customer support at CereCore.

No one would argue that achieving provider satisfaction is a top goal for those of us who work in healthcare IT support. We also know that when employees on your IT support teams are happy, they provide better, higher quality service.

This led me to consider: how could I achieve both clinician satisfaction and employee satisfaction? What if a slightly different approach to IT service desk operations could lead to more efficiency and productivity for my help desk analysts and their satisfaction?

I began my career working as a healthcare IT analyst and have walked the halls of care settings providing support during go-lives. I have experienced first-hand how minutes matter when troubleshooting IT issues and that streamlined clinical workflows allow care teams to deliver higher quality patient care.

My quest to rethink IT support has been evolving over the past several years and has led to the creation of a clinical service desk. We implemented this service desk model with Epic-based facilities at HCA Healthcare. The results have been a win for clinicians and providers because they have been getting their issues resolved more quickly, and my analysts are working at the top of their license, especially those providing level 2 Epic support.

How is this possible? Here’s a peek into the building blocks of my IT support model.

First, spend time analyzing your organization’s goals for IT support and identify common challenges. I wanted to baseline provider, clinician, and even patient satisfaction as it relates to IT issue resolution and the effects on hospital operations. For example, if the hospital routinely experiences issues with printing discharge instructions, that will impact the timeliness of patients being discharged, patient and clinician satisfaction, and the efficiency of patient throughput.

We analyzed metrics from a variety of perspectives. What were the high-volume issues reported by providers, clinicians, and revenue cycle employees? Did we have recurring workflow challenges or training opportunities? What about EHR-build related incidents?

One of the toughest parts for healthcare IT support can be getting back in touch with a provider or clinician for additional information and follow-up. So, we examined the issue intake process for data quality and efficiency. Was enough information or the right type of information being collected during the first call? If we had had better data to begin with, could we have resolved the issue more quickly for a busy provider or clinical staff?

Next, we evaluated the tools and training. Looking at our high-volume issues in particular, would additional analyst training have helped with resolving the issue at the first point of contact? Would a different level of access enable the level 1 analyst the ability to resolve the issue sooner? Did we have an effective IT service management tool that allows for next-level analysis? Were there configuration, knowledge base, or workflow improvements within the ITSM that could help analysts resolve more issues during the first contact?

Healthcare IT is a team sport. That’s why we took a hard look at our culture and looked for ways to encourage more collaboration among all levels of our analysts. In fact, one of the key drivers in the evolution of our clinical service desk for Epic support has been the focus on “shifting left” the issues handled by our level 2 and level 3 analysts.

Our level 2 and level 3 application support and clinical informatics resources were finding it difficult to focus on project work. Their bandwidth for heads-down time to make progress on Epic initiatives often was limited because they were pulled into resolving support issues.

We began finding opportunities to cross-train and collaborate more. We also developed a training program to bolster application and workflow understanding. We made a significant investment in training our analysts through the Epic certification process, focusing on key workflows where we needed to increase our knowledge base and pairing the interests of service desk analysts with Epic certification opportunities. This training and collaboration have been key to making our shift left strategy a reality.

Finally, we established key performance indicators (KPIs) and reporting metrics to measure the effectiveness of training, analyst access changes, and process improvements. I focus on quality measures, such as first-contact resolution and customer satisfaction and the ability to shift support work left from level 2 to level 1.

If your organization is building an internal clinical service desk, prepare for the significant and intentional investment required, along with a willingness to let go and trust the process of building your own talent pipeline. Be ready to measure results so you can ensure you’re reaping the benefits of your investment and configuring your resource model appropriately.

When executed thoughtfully, the benefits of long-term operational efficiencies, improved clinician satisfaction, and happy employees are well worth the effort.

Readers Write: Healthcare’s Digital Leap: The Game-Changing Benefits of Online Marketplaces

Healthcare’s Digital Leap: The Game-Changing Benefits of Online Marketplaces
By Eric Utzinger

Eric Utzinger is co-founder and chief commercial officer of Revuud.

Digital marketplaces have become a transformative force across various industries, redefining how people transact and interact. From Uber to Airbnb, these platforms have revolutionized sectors and sparked trends like the gig economy and micro-entrepreneurship. 

The healthcare industry is experiencing its own revolution. Just as Uber changed transportation and Airbnb altered accommodation, digital marketplaces are shaking up healthcare. With over 150 online marketplaces today, while the concept isn’t entirely new, its application in healthcare is innovative. 

These platforms simplify the process of buying, selling, and hiring healthcare resources, transforming how doctors, nurses, medical equipment, medical coding, and IT services are managed. Let’s delve into how these marketplaces are enhancing healthcare’s efficiency, cost-effectiveness, and accessibility.

Boosting Access to Talent: Doctors and Nurses

• A bigger talent pool. Finding the right healthcare professionals used to be a local affair, often limited by geography and specific recruitment agencies. Enter marketplaces like LocumTenens.com and Vivian. These platforms expand the reach, allowing hospitals and clinics to connect with specialists and nurses from all over the country, or even the world. This broader talent pool ensures they can find the perfect fit for their needs.
• Faster hiring. In healthcare, time is of the essence. Traditional hiring processes can be slow, involving multiple steps and heaps of paperwork. Digital marketplaces streamline everything, providing robust platforms where job openings can be posted, and qualified professionals can apply directly. With features like instant messaging and credential verification, hiring becomes much quicker and more efficient.
• Flexibility and scalability. Marketplaces offer unmatched flexibility. Healthcare facilities can easily find part-time, temporary, or per-diem staff, allowing them to scale their workforce according to patient volume and seasonal demand. This adaptability helps manage operational costs and maintain high standards of patient care without the burden of overstaffing.

Revolutionizing Medical Coding

• Access to specialized coders. Accurate medical coding is crucial for billing and regulatory compliance, but finding specialized coders can be challenging. Marketplaces like The Coding Network connect healthcare providers with experienced coders who specialize in various medical fields, ensuring accuracy and compliance.
• Cost savings. Marketplaces offer competitive pricing for coding services, often cheaper than traditional staffing agencies. This cost efficiency is achieved through dynamic matching of supply and demand, reducing the overhead costs associated with conventional hiring processes.
• Scalability and flexibility. Medical coding needs can vary, especially with changing healthcare regulations or peak periods. Marketplaces provide the flexibility to scale coding services up or down as needed, allowing healthcare providers to manage their workload efficiently without long-term commitments.

Advancements in Healthcare IT Services

• Access to specialized IT talent. The digital transformation of healthcare requires specialized IT skills, from electronic health record (EHR) management to cybersecurity. Traditional hiring methods can limit the search for such talent. Marketplaces offer access to a pool of IT professionals with the expertise required for healthcare projects, ensuring providers find the right match for their highly technical needs.
• Cost efficiency. Hiring IT professionals through marketplaces often leads to significant cost savings. These platforms eliminate many overhead costs associated with full-time hires, such as benefits and long-term contracts. Healthcare providers can hire IT experts on a project basis, paying only for the services they need.
• Agility and speed. The rapidly evolving landscape of healthcare technology demands quick, agile responses. Marketplaces provide an efficient way to bring in IT professionals for short-term projects or to address immediate issues like system upgrades or security breaches. This agility is crucial for maintaining the integrity and functionality of healthcare IT systems, allowing organizations to scale their IT departments up or down when needed.

Conclusion

Digital marketplaces are revolutionizing healthcare by offering a more efficient, cost-effective, and flexible approach to managing resources. From doctors and nurses to medical equipment, coding, and IT services, these platforms provide numerous benefits over traditional methods. They democratize access to talent and resources, enhance transparency, and streamline processes, ultimately leading to improved patient care and operational efficiency.

As healthcare continues to evolve, embracing the advantages of marketplaces will be key for providers aiming to stay competitive and deliver high-quality care.

Readers Write: Strengthening the Net: The FTC’s Expanded Reach on Health Data Protection

Strengthening the Net: The FTC’s Expanded Reach on Health Data Protection
By Chris Bowen

Chris Bowen, MBA is founder and CISO of ClearData.

The Federal Trade Commission (FTC) recently finalized changes to the Health Breach Notification Rule (HBNR), signaling a move from fragmented, independent privacy and security measures towards a unified, collaborative defense. This new rule puts patients and consumers in the driver’s seat of their privacy and serves as a call to action for companies that create, collect, manage, and use health information, providing a potent deterrent against vulnerabilities that could expose their data.

Understand this: The FTC’s stance is unwavering and authoritative. It demands not mere compliance, but the utmost adherence to rigorous standards of care and caution in handling confidential health information.

The Health Breach Notification Rule mandates that vendors of personal health records and associated entities that are not covered by HIPAA must inform individuals in case of a breach with unsecured data. If a third-party service provider to these entities experiences a breach, it must inform the entity, which then notifies the individuals. The Rule also outlines the specifics of when, how, and what to notify in the event of specific breaches.

HBNR specifically applies to personal health record vendors and other entities that offer products or services through them, and third-party service providers to them. It covers a variety of platforms from health apps to wearable technologies. Unfortunately, 81% of Americans assume that all protected health data that is collected by digital health apps is protected under HIPAA.

In May 2023, the FTC proposed amendments to the Health Breach Notification Rule (HBNR) to clarify its scope regarding the collection of consumer health data by health apps and related technologies. The finalization of these changes is an unambiguous signal to the digital health ecosystem that the integrity of healthcare data is non-negotiable. No longer can firms hide behind the complexities or nascent nature of digital health technologies; the time to comply and protect is now, and the FTC has implemented rules that leave no uncertainty about the seriousness of the endeavor.

The updated HBNR ushers in several key shifts that set a higher standard for security and transparency. First among these is the expanded content required in a breach notification to patients. This move is not merely bureaucratic; it aligns with the growing demand for clarity and accountability that patients and providers alike require to maintain trust in the face of technological unknowns.

The Commission has made significant revisions and clarifications to the rules governing health apps and technologies that are not covered by HIPAA, enhancing the protection of personal health information (PHI). Among these changes are revised definitions to emphasize the rule’s application to health apps, clarification on what constitutes a “breach of security,” and a more precise scope for “PHR related entities” that includes those offering services via online and mobile platforms.

Additionally, the final rule expands the methods and content of breach notifications to consumers, including the use of electronic communication and detailed information on the breach’s impact.

It also adjusts the timing for notifying the FTC in the event of a breach, setting strict deadlines to ensure prompt action. These updates mark a significant step forward in securing PHI and underscore the importance of compliance and clear communication in the digital health space.

The FTC’s action demands not just compliance, but leadership — leadership in technological integrity, transparency, and fortitude in the face of cyber threats. Change will require investment, invention, and unwavering commitment, but the benefits extend far beyond mere regulatory peace of mind. In championing cybersecurity, we champion the future of healthcare, a future that is secure, trusted, and resilient. Digital health entities that fall short will find themselves lacking not just in regulatory compliance, but also in the trust and investment of a discerning public.

Consumer Protected Health Information is not just a term. It embodies the very essence of what is ours, our narratives of health, history, and future.

The time has come for a unified front in healthcare cybersecurity. We, the technologists, innovators, lawmakers, and guardians of the healthcare digital landscape, must rise to this challenge with unity and tenacity.

It is time for every digital health company, every healthcare professional, and every policymaker to reassess, reinvent, and redouble their efforts in cybersecurity. The FTC’s changes provide the roadmap. It is now up to us to ensure a future where patient data is as secure as the healthcare we strive to provide.

The stakes are too high, the threats too real, and the need for action too pressing.

Readers Write: Health Tech Innovation Requires Accurate Person Matching

Health Tech Innovation Requires Accurate Person Matching
By Jitin Asnaani

Jitin Asnaani, MBA is chief product officer of Rhapsody.

Elsevier’s “Clinician of the Future” report shows that nearly as many clinicians agree the widespread use of digital health technologies will enable the positive transformation of healthcare (70%) that believe digital health technologies will be a challenging burden (69%). This means health tech must innovate to maximize the positive while minimizing the burden.

The pressure is on to build solutions that capture the potential to revolutionize healthcare and address the increasing challenge of accurately managing and leveraging the data generated from these innovations.

Healthcare generates about 30% of the world’s data volume and is growing with a compound annual growth rate faster than any other industry. Sources for this data explosion are numerous and diverse, including primary care facilities, hospitals, clinics, pharmacies, consumer-generated data, plus IT systems such as EHRs, patient registries, radiology information systems, and medical devices. This brings an immense opportunity and challenge.

As health tech companies onboard data from this expanding number of sources, it becomes increasingly harder to confidently manage and reconcile identity data. In fact, studies indicate that errors in matching records to the correct person occur up to half of the time.

Correctly managing person data and tying the data together is non-trivial. To maintain trust in the data-driven solutions provided, clinicians and patients must be able to interpret and use all this data. Health tech companies are responsible for each piece of information they collect, regardless of where it’s generated. Consequently, internal teams and even customers are forced to spend time resolving duplicates, which increases total cost of ownership and reduces trust in data quality.

Consider the example of an at-home glucose monitoring device. To make the device data actionable, information must be obtained not only from the device but also directly from the consumer, the provider managing diabetes care, a pharmacy, and an insurance provider. Each source uses a different system with inconsistent data cleanliness.

Complicating this further, a person may be known by variations of their name in different systems –John, Jon, or Johnny, for example. The complexity in matching all data from various sources and formats into a single, clean record makes the potential for error and the strain on data stewards’ time extremely high.

Enterprise Master Person Index (EMPI) technology emerges as a critical element in overcoming these challenges. By offering a centralized repository for identity information that also adds a layer of science to improve match rates, EMPI facilitates accurate person matching across diverse systems while ensuring data integrity and interoperability. This centralized approach streamlines data management processes and enhances the reliability of electronic records, ultimately leading to better clinical outcomes.

Advanced EMPI solutions leverage AI and machine learning capabilities to further enhance data accuracy by automating the linking of person records. By mimicking human decision-making processes, these solutions reduce manual intervention, improve data consistency, and increase efficiency in data management workflows. This not only saves time and resources, but also enhances the overall quality of healthcare data.

For health tech companies building innovative technologies and data-driven applications, an EMPI is foundational to ensuring data accuracy within their solutions. This builds customer trust around the quality of information delivered by or powering, the product, especially when ingesting, integrating, and reconciling data across multiple sources.

When considering whether to buy or build an EMPI solution, health tech companies must weigh the benefits of leveraging a reliable EMPI partner against the costs and complexities of in-house development. Partnering with an established EMPI provider can accelerate time to market, ensure scalability, and mitigate risks associated with infrastructure development, allowing companies to focus on their core competencies and innovation.

Effectively managing person data is essential for driving innovation and improving patient outcomes. By leveraging advanced EMPI technology, health tech innovators can effectively manage person data and improve data accuracy and consistency, aiding their customers in enhancing the quality of care provided while maintaining trust in their data-driven solutions.

Readers Write: ATA 2024 Spotlights How Collaboration, AI, and Patient-Centricity Will Define Telehealth’s Future

ATA 2024 Spotlights How Collaboration, AI, and Patient-Centricity Will Define Telehealth’s Future
By Amy Window

Amy Window is vice president of strategic alliances at Infermedica.

The American Telemedicine Association’s (ATA) annual conference united experts to discuss how technology is transforming telehealth. While recognizing that technology is just one facet of the solution, attendees emphasized its vital role in improving care quality and access, with collaboration and AI adoption surfacing as central topics.

Among the themes emerging from ATA Nexus 2024:

• Technology-driven healthcare. While technology is pivotal to medicine’s future, it’s not a standalone solution but rather part of a comprehensive approach. To truly impact healthcare, we must look beyond the tech itself and consider how it interacts with evolving human behavior.
• Radical collaboration. Transforming healthcare demands collaboration rather than circumventing existing systems. Partnerships can align goals and uncover innovative solutions that enhance care quality and accessibility. Companies are increasingly joining forces to offer end-to-end telemedicine platforms spanning the patient journey, with health systems favoring unified solutions over piecemeal offerings.
• AI adoption. Integrating AI should be a top priority, given its potential to boost efficiency and predictive power in healthcare. However, maximizing its impact and ensuring adoption by professionals and consumers alike will require refined implementation strategies. Building trust and developing responsible AI practices were key topics at the conference.
• From patients to consumers. As telemedicine shifts to a consumer-centric model, understanding and catering to the choices and expectations of healthcare consumers is paramount. Empowered consumers demand personalized, convenient care options, and providers must rise to meet their evolving needs. This means treating virtual encounters with the same care and attention as in-person visits and offering a variety of care modalities. Virtual appointments are every bit as important as face-to-face visits.

Attendees stressed the importance of treating telemedicine with the same thoughtfulness as in-person care. To truly personalize and improve the convenience of care, providers must offer diverse care modalities, meet patients where they are, and let them choose their preferred methods. Seamless, patient-centric technology will be essential to achieving this.

The spirit of “radical collaboration” was palpable, with companies increasingly partnering to provide comprehensive telemedicine solutions across the patient journey. In some cases, this entails corporate mergers, but often it’s just good old collaboration. Health systems are abandoning point solutions in favor of unified platforms. Building trust and developing responsible AI practices were also major topics.

The well-publicized nursing shortage put virtual nursing in the spotlight. AI and video allow nurses to efficiently monitor more patients remotely, alleviating strain while enabling the delivery of high-quality care. AI is also being leveraged to reduce administrative burdens, enabling clinicians to focus on delivering exceptional care.

Additional growth opportunities include AI-powered triage in call centers, where non-medical operators use care navigation technology to appropriately direct patients, as well as self-triage and care navigation tools for patients themselves.

Delivering seamless, personalized experiences that meet patients where they are will be essential as telemedicine becomes increasingly consumer centric. Carefully integrating AI and other technologies through strategic collaboration will be crucial to shaping the future of healthcare.

The innovations and insights from ATA Nexus paint an exciting picture of what lies ahead for telemedicine, and I’m looking forward to seeing what’s on the horizon at ATA 2025.

Readers Write: Interoperability’s Last Mile – Universal Patient Consent and Access is Holding Us Back

Interoperability’s Last Mile – Universal Patient Consent and Access is Holding Us Back
By Lew Parker

Lew Parker, MSIS, MBA is chief technology officer of Arrive Health of Denver, CO.

As always, the latest round of health technology conferences has inspired us with new ideas for the application and value of interoperability in healthcare. The combination of existing and new technology offers tremendous potential to impact patient outcomes and provider experiences. There’s one last mile we’ve yet to cross, however – our business policies haven’t caught up to our technology, and we’ve fallen short on the key step for how true data sharing will work.

Healthcare interoperability is meant to create transparency, giving providers and patients the information that they need to make decisions about all types of things, including diagnoses, treatments, costs, and more. We’ve made great strides in developing technology to standardize how we share data, such as HL7 and FHIR, at a granular level. There are also shining examples of interoperability at work to tackle specific challenges, such as using real-time prescription benefit (RTPB) data to support patient affordability and adherence.

What’s needed to cover interoperability’s last mile is a federated, decentralized way to authenticate, access, and, most importantly, verify consent to that data.

This isn’t an impossible task or pie-in-the-sky recommendation. Think about when you register a website domain. You purchase the domain from a single registrar, point it to your server, and every DNS instantly knows where to route traffic. The registration isn’t centralized, but it is handled in a way that makes the ownership and access, managed by one registrar, available to all for verification and use.

For another example, look at how SSL certificates facilitate secure communications across the internet through a federated registry system, where trust is decentralized yet universally acknowledged. Over 100 trusted certificate authorities are providing this service. By applying a similar federated model to healthcare, we can enable seamless access to data while respecting the autonomy of individual entities within the network. Imagine what our world, and patient experience and outcomes, would look like if we achieved this same level of trust and access.

In a federated model, the focus shifts from establishing a single centralized governing body to an alliance of healthcare entities that agree on shared policies and standards for data use and access. Much work has been done to create these types of alliances, and we should leverage existing organizations if possible. This would:

• Create a single place for healthcare entities and partners to ping for information once patient consent is given.
• Streamline access to data, removing firewalls that we experience today because of contract or independent business policies.
• Foster innovation by providing an easy way to grant data access to trusted partners.
• Pave the way for patients to access, understand, and plan their healthcare in a single place.

In this future scenario, RTPB data has new potential. RTPB surfaces millions of real-time patient events a day, events like me getting a new prescription or having a prior authorization approved, that others could use to improve care delivery, lower costs, connect me to community resources, and a million things I have not thought of myself.

Without a unified way to provide access to this data, however, these opportunities to make my experience better cannot happen. Instead, to gain access to real-time information, each innovator and partner must establish 1-to-1 relationships and partnerships, each with their own policies, contracts, and requirements. Our systems become complicated and cumbersome as we must codify this variability into our interoperability applications. This ultimately slows down, and in many cases prevents, access to the very data that is needed to drive progress and health outcomes.

I am extremely proud of our industry for our interoperability achievements, and I remain positive about what’s to come. I also believe covering the last mile and achieving true interoperability in healthcare is going to require us to think more broadly and collaboratively about not only how we share data, but how we use it. It remains to be seen if TEFCA can provide the federated model that is required for success.

Readers Write: Unification of Content Will Unlock the Next Phase of Healthcare Innovation

Unification of Content Will Unlock the Next Phase of Healthcare Innovation
By Greg Samios

Greg Samios, MBA is president and CEO of clinical effectiveness of Wolters Kluwer Health. 

The pressures and challenges in the healthcare environment are numerous, from dealing with financial constraints to coping with severe staffing shortages. The situation is concerning and getting worse: 16.7% of healthcare facilities anticipate critical staffing shortages, one in four nurses plan to exit the profession because of overwork and understaffing, and disruption from cyberattacks has put many healthcare facilities on the brink of closure.

The stark reality is that 60% of physicians’ questions go unanswered daily and more than one in every 20 patients experiences preventable harm, incurring costs that are associated with medication errors of approximately $42 billion USD globally. 

Yet healthcare executives must strive to deliver the best possible patient care amidst continually evolving circumstances. The shape of healthcare has changed with new care delivery models for where and how healthcare is provided, from retail clinics to virtual health. Within this cyclone of change, healthcare enterprises are seeking scalable solutions that can not only improve patient outcomes, but also drive care team efficiencies and reduce care variability.  

Each day, healthcare providers turn to information and technologies to make care decisions and educate patients. Content and data underpin the continual information stream, but too often that content is based on disparate technologies that lack harmony, leading to inconsistent care decisions and inefficiencies that may exacerbate care variability.

In many cases, this disconnect is the result of solutions being added at different times to address different needs while forgetting to consider how they fit into the clinical workflow. For example, as COVID-19 arrived, many healthcare providers pivoted quickly to solutions to support remote and virtual care out of necessity. For many organizations, this resulted in relying on “best for need” vendor solutions to fill in immediate gaps, but not necessarily best address long-term, enterprise level goals. Today, however, like many industries, healthcare is looking for fewer vendors in seeking consistency, efficiency, and cost savings. 

Looking at this issue, the unification of content is a necessary next step for healthcare to facilitate seamless decision-making at the point of care and across the healthcare ecosystem. Harmonized content makes healthcare delivery easier for all members of the healthcare team, who can access the same information for treatment, drug dosing, and patient education to support better care.

Having consistent content also creates a vital underpinning to support and coordinate high quality patient care and eliminate care variability as healthcare adopts innovative technologies such as generative AI. In fact, both physicians and consumers have expressed concerns about the source of the content that is driving GenAI healthcare solutions, making it even more critical that there is a trusted and unified content solution for healthcare.

Unified content and solutions help align care teams and administrators to work together, rather than in disparate workflows, to deliver the best care for patients and position themselves for success in meeting current and emerging health challenges.

Readers Write: It’s Time to Rethink Healthcare’s Reliance on Legacy Tech Amid Cyberattacks

It’s Time to Rethink Healthcare’s Reliance on Legacy Tech Amid Cyberattacks
By Tom Furr

Tom Furr is founder and CEO of PatientPay of Durham, NC.

One of the biggest questions surrounding a large-scale cyberattack in healthcare this spring is one that healthcare is hesitant to confront. Why did it take more than a month to get these systems up and running again?

We would never hear of a financial institution being unable to restore operations for such a long period of time, despite the fact that financial data, just like healthcare data, is an attractive target for cyberattack, with losses totaling more than $12 billion over the past 20 years.

But as financial institutions take a hard look at ways to de-risk technologies to bolster their defense against cyberattack — including by investing in cloud and edge computing and implementing zero-trust architecture to protect legacy tools from threats, partnering with technology hosting companies for their security solutions such as AWS’s Cloud Security, Oracle Cloud Security and Azure Cloud Security —healthcare has been slower to make the move to the cloud.

One study found that while 86% of healthcare organizations have experienced data theft of some type, just 47% of sensitive data in healthcare is stored in the public cloud, compared with 61% across industries, according to research by Skyhigh Security. While 56% of healthcare organizations surveyed by Forrester increased cloud spending between 2022 and 2023, most are focusing on moving electronic medical record (EMR) systems to the cloud. While it makes sense to start with the EMR, leaders shouldn’t overlook the need to move other on-premises systems and applications to the cloud, too, including legacy systems.

A few years ago, a HIMSS survey quantified healthcare’s reliance on legacy systems. It found that 73% of organizations still operate legacy systems even though leaders say that these systems also present the third-biggest security risk to organizations. Insiders refer to these systems as “basement tech.” They have been around so long that few members of the IT team know how to operate them, yet they’re expensive to retire, so they keep chugging along, often in the basement of a facility. I guess now that costs from the most recent breach are starting to become public, it appears retiring old systems might not be that expensive after all.

If a system were hosted in the cloud, it would have access to all the latest security protections as they are released. Even better, there would be multiple layers of security surrounding a system in the cloud. If one layer were penetrated during a cyberattack, there would still be security wrapped around the root code for the system. Even if cyberthieves were to penetrate the root area of the system, the nature of the cloud means access to the system is still possible. The vulnerable system could be shut down, with the same functions spun up in another area of the cloud within minutes, limiting downtime.

We never hear someone say, “I couldn’t access my bank account for a month because of that cyberattack.” So why do we accept that this can happen in healthcare?

The truth is, we shouldn’t. Not when providers’ livelihoods are at stake, with many physicians digging into their personal savings to keep their practices afloat. And let’s not forget the patient impact, with the most recent large-scale cyberattack forcing consumers to pay cash for expensive drugs or endure long waits for needed prescriptions, among other impacts.

The impact of the latest healthcare cyberattack will likely be felt for months, going beyond claim processing and payment to impact functions such as real-time eligibility checks and more. As the industry assesses the damage, providers must also double down on prevention.

Now is the time to take a hard look at what’s holding your organization back from cloud investment, the level of expertise needed to chart a path forward, and the types of investments that will best protect your organization from a breach in an era of increased cyber risk. Your organization’s reputation and its ability to maintain continuity in care depend on these actions.