The #HCBiz Show!
Don Lee and Shahid Shah
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A practical podcast on the business of healthcare w/ hosts Don Lee and Shahid Shah. The premise behind #HCBiz is that we can't "just innovate". Sure, you may have a great idea, an all-star team and execute flawlessly, but if you don't understand the complex dynamics of the healthcare business you'll never get traction. We'll identify the issues that impede change, explain why they exist and find ways to work with them, through them, or around them. In short, we'll help you create space for innovation in healthcare through technology (HealthIT | HIT | Digital Health) and workflow. We'll also explore health policy, administration and the psychology behind it all. Finally, we help you align your ideas to business incentives, market them to healthcare leaders and get the sale.
Check out all of our podcasts, videos and blog posts here: http://thehcbiz.com/
Produced by Glide Health IT LLC in partnership with Netspective Media.
Available episodes
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1 day ago
Empower the Care Team to Empower the Patient with Omar Nagji
There is a lot of attention being paid to the patient experience, and rightly so. However, we haven’t paid enough attention to our clinicians and caregivers and what they need to guide our patients thru that experience.
Providers struggle to keep up with the increased touchpoints and questions without the proper tools. That increases stress and deepens the crisis of burnout amongst clinicians. Worse yet, it leads to unanswered questions and missed opportunities to meet our patients where they are.
It turns out that doing this job halfway is worse than not doing it at all.
On this episode, we talk with Omar Nagji, Chief Commercial Officer at Memora Health, about how to close the gap and provide clinicians with the tools and support they need.
Memora Health was founded on the idea that you must support the workforce in any attempt to improve the patient experience. Omar walks us through their approach to doing just that. This includes digitizing care journeys, deploying chatbots to automate the “easy stuff”, and escalating to clinicians at the right time.
Listen in to hear best practices on digitizing patient journeys, reducing friction in communication between patients and providers, and how to tie it all together in a meaningful way.
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May 6, 2022
Applying AI and ML to Help the Humans of Healthcare Achieve Better Outcomes - Prashant Natarajan
Digitization means taking paper charts and putting them into EHRs. Digital transformation means leveraging the digital asset to do something we never could before. Applying AI/ML in healthcare will be one of the primary ways we carry out that digital transformation.
Today we discuss all of this with Prashant Natarajan, VP of Strategy and Products at H20.AI and co-author of the new book Demystifying AI for the Enterprise.
Prashant tells us our goal for digital transformation is to "help the humans of healthcare achieve better outcomes". That means better experiences and outcomes for patients, providers, administrators, and more.
And if we want to achieve that goal, we'll need to combine the best of AI and ML with the best of the humans and the best of our organizations to create symbiotic intelligence.
For full show notes and links, visit: https://thehcbiz.com/192-applying-ai-ml-to-help-the-humans-of-healthcare-achieve-better-outcomes-prashant-natarajan/
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Apr 27, 2022
Do You Know Where Your Patients (and Money) Are Going? with Ray Deiotte and Sean O'Malley
Most health systems don’t understand their own referral networks or patient flows. From an overall fiscal standpoint, they may know who their best and worst physicians are but there’s little clarity on what’s happening in the middle. Where are patients going for procedures? Who is sending them there? And what’s the financial impact to the health system? Not knowing makes it difficult to make sound strategic decisions.
The good news is that the data exist. The bad news is that few health systems have figured out how to harness it.
Today we talk with Ray Deiotte and Sean O’Malley, co-founders of Monocle Insights. They’ve pulled together industry data that allows them to map provider referral patterns and customer journeys. Their mission is to help health systems, entrepreneurial physicians, and anyone else who manages a network of physicians shed light on their network’s behavior. These insights help drive better decisions around incentives, alignment, M&A, contracting, and more.
Targeted learning:
Health systems, clinicians, and network managers will learn:
* That data and methods exist to examine referral patterns and customer journeys
* When properly harnessed, this information can provide a significant strategic advantage
Startups and entrepreneurs will learn:
* That the first objection is often a lie designed to make you go away
* How to design a low friction sales process that allows for a quick “proof of value”
For full show notes and links: https://thehcbiz.com/
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Apr 19, 2022
Modernizing Medical Training with VR and AR - Dr. Ryan Ribeira
We've been training medical personnel in the same way for decades, Virtual Reality (VR) and Augmented Reality (AR) are poised to change that.
We talk with Dr. Ryan Ribeira, founder and CEO of SimX, about the opportunity to modernize and expand our approach to medical training.
We discuss how that is already happening at many of the major medical institutions in the U.S., the opportunities to expand access to training and to cover more nuanced situations that are difficult to replicate using traditional simulation techniques.
That said, VR/AR training is young and far from a silver bullet. Accordingly, we explore the areas where AR/VR is not the answer. At least not yet.
This episode will get you up-to-speed on the status of VR/AR medical training in the field, educate you on its strengths and weaknesses, and put you in a position to continue to explore this emerging technology.
For full show notes and links visit: https://thehcbiz.com/190-modernizing-medical-training-with-vr-ar-dr-ryan-ribeira/
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Apr 12, 2022
Escaping the Tyranny of Fee-For-Service Healthcare - François de Brantes
The recent dust-up over Direct Contracting and its ultimate rebranding as the ACO REACH model may have led some to believe that our path forward is unclear. That couldn't be further from the truth.
On this episode, we talk with François de Brantes, Senior Vice President of Episodes of Care at Signify Health, about where we are on the pathway to escaping the tyranny of Fee-For-Service healthcare.
It's tyranny because it prevents us from delivering care the way we want to and need to. Advanced Alternative Payment Models like ACO Reach allow organizations to separate payment from delivery, stop focusing their efforts on top-line revenue, and begin to operate like typical P & L driven companies. The promise, of course, is that this will change the way healthcare is delivered in the U.S., improve outcomes and lower costs.
We discuss:
- Has utilization and payment returned to pre-pandemic norms?
- Why are commercial carriers lagging behind Medicare and Medicaid in launching Advanced Alternative Payment Models?
- Will the shift to value and consumer-centric delivery methods like telemedicine diminish uncompensated care?
- Is it possible to be proactive and patient-centric in Fee-for-service?
- Are provider systems ready for AAPMs?
- Can employers band together to create enough demand for AAPMs in the under-65 commercial market?
- What were the arguments against the Direct Contracting Model?
- Did they have merit?
- What changes were made to Direct Contracting as part of the rebrand to ACO Reach?
- How does this dust-up over Direct Contracting confirm we are on a bi-partisan, unwavering march toward value and never going back?
- Why did Signify Health acquire Caravan Health?
For full show notes and links: https://thehcbiz.com/189-escaping-the-tyranny-of-fee-for-service-healthcare-francois-de-brantes/
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Apr 5, 2022
Tokenization: Stop Sending All that PHI - Sequent at ViVE 2022
Healthcare orgs share large amounts of PHI with 3rd party vendors. They share it for analytics, rev cycle management, call center services, and more. It's a necessary part of the business. But you know what isn't necessary? Sharing everything!
There is a very disrespected requirement in HIPAA called minimum necessary. It means exactly what it says... you should share only that which is needed to do the job (typically under treatment, payment, or operations). In my experience, the default is to just send everything. It's lazy. It's wrong. It's risky. And it's completely unnecessary.
We recently spoke with Joan Ziegler, CEO, and Chris Hottinger, VP of Healthcare, at Sequent about their 3P Secure tokenization platform. It uses the technology behind your credit card chips to secure data in motion, rendering it worthless to the bad guys. It also provides healthcare organizations with a way to finally adhere to the minimum necessary requirement in HIPAA.
On this episode, we discuss the value that tokenization brings to healthcare. We also explore Sequent's journey from FinTech to healthcare.
It's an instructive conversation about how to bring technology from other sectors into healthcare, and how to avoid walking into the buzzsaw that surprises many new entrants.
This is the final of our 5 interviews recorded at ViVE 2022 in Miami.
For full show notes and links:
https://thehcbiz.com/188-tokenization-stop-sending-all-that-phi-sequent-vive-2022/
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Mar 30, 2022
How to Build Your Own Customer - Alex Yarijanian at ViVE 2022
It's difficult for Digital Health startups to find alignment between their innovations and the complex business realities of healthcare. That is why this show exists. We discuss it in nearly every episode.
Today's guest has a novel approach to solving that alignment problem. Alex Yarijanian and the team at CareNodes have decided to build their ideal customer. That's right. CareNodes is an MSO and accelerator of sorts. They find promising digital health innovations and then build a market for them. They'll start a medical practice, put their own clinicians in it, negotiate contracts with health plans, align it with NCQA certifications, and more. All of this is done to ensure that the digital health innovation has the ideal landing place, and is put in the best possible position to succeed.
This one is unique. I'd love to hear your thoughts on it!
For full show notes and links:
https://thehcbiz.com/187-build-your-own-customer-alex-yarijanian-vive-2022/
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Mar 24, 2022
The Continued Push Towards Virtual First Healthcare - Karsten Russell-Wood at ViVE 2022
Virtual-First thinking and telehealth adoption exploded during the pandemic. Since necessity was the driver there is some expectation that demand and use will scale back as the pandemic wanes. Yet today's guest tells us that is not what's happening in the field.
We spoke with Karsten Russell-Wood at ViVE 2022, and he's seeing the opposite . Not only is demand steady, but hospitals are evaluating all their workflows to see what else they can do with telemedicine.
Karsten serves as the Chief Marketing & Experience Officer for Equum Medical. Equum is a telehealth-enabled provider service delivery company. They provide much-needed clinical resources to hospitals and health systems all over the country via telehealth. Given the industry's struggles with staffing shortages and clinician burnout, Equum's services are in high demand.
We discuss:
- What's driving the continued demand for telehealth
- How Equum is approaching the market
- The importance of delivering a full solution to your customers and partnering with others to make it happen
- The need to innovate in our business models, pricing, and partnerships just like we do with our products
For full show notes and links: https://thehcbiz.com/186-continued-expansion-of-virtual-first-healthcare-karsten-russell-wood--vive2022/
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Mar 21, 2022
How to Be a Good Partner to Health Systems - Ed Marx at ViVE 2022
There's a difference between being "just another vendor", and being a true partner to your customers. Ed Marx has thrived on both sides of this equation, first as a health system executive and now as the Chief Digital Officer at Tech Mahindra / The HCI Group. We sat down with Ed at ViVE 2022 to hear what he has learned about good vendor/health system partnerships.
For full show notes and links: https://thehcbiz.com/185-how-to-be-a-good-partner-to-health-systems-ed-marx-vive-2022/
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Mar 15, 2022
Selling Clinical Decision Support - Dr. Yair Saperstein at ViVE 2022
AvoMD is a no-code platform that allows users to create clinical decision support apps that integrate directly into their workflows.
We caught up with Dr. Yair Saperstein, co-founder, and CEO to learn a bit about their platform and approach. Plus, we dig into the keys to gaining attention as an early-stage startup, being a good partner from the sales process onward, and the importance of answering questions.
You’ll learn:
* Why most EHR alerts are ignored
* The 5 Rights of Clinical Decision Support (CDS)
* Why “No” can be a good thing in the early stages of a sale
* The importance of identifying your champion (and enabling them to do most of the selling for you).
* How to properly answer questions and address concerns during the sales process
* Plus, several more tactical nuggets that’ll help you close more deals.
This episode is part of a series recorded at ViVE 2022 in Miami Beach, Florida, March 6-9, 2022.
Visit https://TheHCBiz.com for full show notes and links.
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Mar 6, 2022
Empowering Healthy Aging in Place with Blooming Health
Our population is aging. According to the Urban Institute:
“The number of Americans ages 65 and older will more than double over the next 40 years, reaching 80 million in 2040. The number of adults ages 85 and older, the group most often needing help with basic personal care, will nearly quadruple between 2000 and 2040.”
And the aging population continues to drive national healthcare spending.
If we’re ever going to reign in our healthcare spending, then we will need to find ways to take better care of our aging population.
According to the team from Blooming Health, medical care is only part of the solution. We need to connect people, especially those from underserved communities, with the resources that will help them thrive. That means addressing their food, housing, safety, and security needs. And it means finding ways to give them meaning and purpose.
That’s where Blooming Health comes in. They exist to empower healthy aging in place. They help community-based organizations (CBOs) align older adults with the resources they need to thrive. Their technology is designed to meet the elderly where they are and strives to remove friction from the process at every step.
On this episode, we explore what it takes to meet older adults where they are, speak to them in the language they prefer, and track results in a way that enables the health system to appropriately invest in their well-being.
Learn more: https://gobloominghealth.com/
Contact: team@gobloominghealth.com
For full show notes and links: https://thehcbiz.com/183-empowering-healthy-aging-in-place-with-blooming-health/
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Feb 10, 2022
How Healthcare Leaders Can Get Involved with Startups – Alan Pitt
Whether you’re an administrator, clinician, or executive, if you’ve built a career in the healthcare industry then you have skills, knowledge, and connections that most digital health startups lack. On this episode, we talk with Dr. Alan Pitt, a physician, entrepreneur, and investor, about how to put your hard-earned healthcare industry expertise to work as a digital health advisor.
For full show notes and links: https://thehcbiz.com/182-how-healthcare-leaders-can-get-involved-with-startups-alan-pitt/
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Jan 27, 2022
Commercializing Physical Products in Healthcare - Jason Kang - Kinnos
We tend to talk mostly with software startups about commercialization and sales. What do things look like for a startup selling a physical product? And a physical product that’s very relevant during the pandemic at that?
That’s exactly what Jason Kang and the team at Kinnos are doing right now. Kinnos’ product, Highlight®, colors bleach, and bleach wipes bright blue, providing instant visual confirmation of coverage, then fades in minutes to remind users of contact time. Studies show using Highlight for Bleach Wipes for just a few weeks can improve cleaning scores by 70%.
Given that we’re in the midst of a global pandemic, and cleaning and safety are top of mind, it would seem that this is Kinnos’ time to shine. And while that’s true, commercialization in healthcare is hard. We talk through what’s worked, and what’s not in terms of getting the attention of hospital buyers including a sample technique that yielded 70+ leads in a very short time.
There are a lot of go…
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Jan 11, 2022
Building the First FDA Approved Autonomous AI in Healthcare - Dr. Michael Abramoff and Seth Rainford
Have you ever had an idea that you just had to make real? No matter what it took… no matter what obstacles were in your way… no matter how many times people told you no… you just couldn’t stop until it existed? Well, this is one of those stories. It begins with an idea in 1988 and leads to the first-ever autonomous AI to be approved by the FDA for diagnosis without physician input.
Dr. Michael Abramoff is a neuroscientist, a practicing physician, and holds a Ph.D. in Artificial Intelligence and Machine Learning. I know… slacker. In 1988, Michael was working on artificial intelligence during his residency and began to think a computer could diagnose diabetic retinopathy. Given the technology available at the time, this idea may have been a bit of a stretch. Still, Michael set out to prove it could be done.
On this episode, we talk with Dr. Michael Abramov and Seth Rainford about the 30-year journey that led to the founding of Digital Diagnostics, and the first-ever FDA-appr…
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Dec 14, 2021
Making Machine Learning Available to the Masses – Dr. Taha Kass-Hout – AWS
We talk about ML and AI quite a bit on this show. Our angle is always to avoid the hype and help you find the practical applications that you can put to work right now. Today’s episode is a great extension of this ongoing conversation. We talk with Dr. Taha Kass-Hout, Chief Medical Officer and Director, Machine Learning at Amazon Web Services about how they are trying to bring ML to the masses.
We discuss:
* What’s needed to use machine learning at scale with cost efficiency, performance, and accountability.
* The challenges in analyzing healthcare’s largely unstructured data.
* The practicality of bringing AI/ML capabilities directly to the hospitals, health systems, medical offices, etc.
* How should CIOs and other buyers evaluate ML solutions? How can they tell what is real and what is hype?
* Detecting bias, drift in models, and drift in data in machine learning.
* Tooling for privacy, security, and compliance.
* The importance of owning and controlling your o…
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Dec 1, 2021
The No Surprises Act is Full of Surprises - VBP in 2022 with Gail Zahtz - Part 4
The No Surprises Act intends to prevent patients from getting burned with huge, unexpected bills for medical services. It is a needed law – medical bills are the #1 cause of bankruptcy in the U.S. And it’s certainly noble in its intentions.
However, the healthcare machine works in unexpected and unintuitive ways. It has a way of moving surprises when we try to eliminate them. In this case, we may exchange surprise bills for new health access and health equity issues. And we will certainly create new surprises for the business. The law requires new and overhauled workflows, enhanced capabilities and technologies, and a solution to that pesky Provider Directory problem.
Oh… did I mention it goes into effect on January 1, 2022?
Giddy up!
On this episode, I talk with Gail Zahtz, CEO at PropHealth, as part of our ongoing Value-based Payment in 2022 series about The No Surprises Act. We’ll explore:
* What is the No Surprises Act?
* Who is affected? (Spoiler: The entire healt…
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Nov 22, 2021
Doctors Just Took a Pay Cut - VBP in 2022 with Gail Zahtz - Part 3
The Centers for Medicare & Medicaid Services (CMS) released the 2022 Medicare Physician Fee Schedule and Quality Payment Program final rule on November 2, and there are big changes to physician payments. In particular, the Medicare conversion factor, which forms the basis for payments to clinicians, will be lowered by 3.7%. There’s nuance in calculating the payments, but you can sum this up as most doctors will take a pay cut in 2022. And since the final rule goes into effect on January 1, 2022, doctors will begin feeling the cuts in Q1 revenue. The rule is specific to Medicare, but there are plans to push similar changes in Medicaid and we all know commercial payers tend to follow CMS’ lead. We believe this change will have a ripple effect across the industry.
On this episode, I talk with Gail Zahtz, CEO at PropHealth, as part of our ongoing Value-based Payment in 2022 series about what doctors can expect in terms of Medicare FFS payment come January 1, 2022. We discuss this as a…
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Nov 18, 2021
Are We Crying Wolf? VBP in 2022 with Gail Zahtz - Part 2
We planned to discuss quality measures but shifted to address a very important piece of listener feedback after the preview and Episode 1. The comments came from a doctor in the audience and I know there are many more doctors and healthcare administrators who feel the same way.
The feedback, in short, is that we’ve been hearing about the move to value for 10 years. We’ve invested in it through several evolutions and it still hasn’t come to fruition. The key is to rebuild trust between the government and those delivering the care- whether hospitals, payers, providers, or innovators. Otherwise, they won’t trust enough to act.
Gail Zahtz, CEO of Prop Health, and I discuss this commentary in the context of this series.
Thank you to the listener who provided this feedback. I hope this discussion is helpful.
And to everyone else listening in, send us your thoughts, questions, and comments to don@thehcbiz.com.
Full show notes and links: https://thehcbiz.com/176-crying-wolf…
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Nov 3, 2021
Health Equity is Population Health - VBP in 2022 with Gail Zahtz - Part 1
There’s a lot of unknowns as we head into 2022, but one thing is certain: Health Equity will be a major focus for CMS and CMMI. Gail Zahtz, CEO of PropHealth, tells us that “value-based payment models have failed to deliver on the promise of health equity” and that is a major reason why CMMI paused so many models earlier this year. When the next iteration of value-based payment arrives, you can bet that health equity will be front and center. And for that, we prepare.
“Fee-for-service says you get paid to fix a broken arm. Value-based care says everybody's tripping on the sidewalk and breaking their arm – let’s fix the sidewalk. Health equity says we're going to fix the sidewalk everywhere.” Gail Zahtz, CEO, PropHealth
This is the first episode in a 5-part series: Everything You Need to Know About Value-Based Payment Models to Prepare for 2022 with Gail Zahtz. On this episode, we take a deep dive into everything health equity to lay out what is known, what is unknown,…
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Oct 21, 2021
Series Preview: Everything You Need to Know About Value-Based Payment Models to Prepare for 2022 with Gail Zahtz
What is going on with Value-based payment models in healthcare? We’ve been talking about it for years and despite all the chatter and investment, uptake has been slow. Now, the CMS Innovation Center (CMMI) has put many of its models on hold including the Direct Contracting Geo model that we covered earlier this year. Does this mean we are moving away from value-based payment models? Absolutely not! In fact, things are going to start moving much more quickly towards value in 2022.
The #HCBiz Show has partnered with Value-based Contracting expert, Gail Zahtz to bring you a 5-episode series that will tell you everything you need to know about value-based payment models to prepare for 2022.
Get all the details here: https://thehcbiz.com/174-vbp-2022-series-preview-gail-zahtz/
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Sep 30, 2021
Communicating Healthcare to Humans with Talya Miron-Shatz
We're less rational, less logical, and less deliberate than we like to believe. We have biases and regularly use heuristics, or mental shortcuts, to make our decisions. Most of the time we aren't even aware it's happening.
Every actor in healthcare has these tendencies. Health systems have biases that influence doctors. Doctors have biases that influence patients. And of course, patients have biases too.
These compounding biases create challenges when presenting information, defining care pathways, or trying to help patients find their optimal path.
On this episode, we talk with Talya Miron-Shatz, PhD, who is a leader in research at the intersection of medicine and behavioral economics, and the professor and founding director of the Center for Medical Decision-Making at Ono Academic College in Israel.
Talya is the author of the new book Your Life Depends on It: What you can do to make better choices about your health. In it, Talya shines a light on the barriers we all face when ma…
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Sep 9, 2021
Spin-offs and Joint Ventures: Another way to Innovate with The Clinic by Cleveland Clinic
There are many ways to innovate within an existing organization. However, it can be difficult to move as fast as you’d like within the constructs of an established business model and culture. For one, it’s difficult for your team to innovate on top of their “day job”. Second, it can be difficult to hire and incentivize the right people to drive the innovation within your existing constructs. These are the types of issues that the folks at Cleveland Clinic identified as reasons for not innovating fast enough in telemedicine. They decided that if they were going to pick up the pace, they were going to have to take a different approach.
The Clinic is a joint venture between Cleveland Clinic and Amwell that connects patients with Cleveland Clinic physicians for online second opinions. Together they are using the latest telemedicine technology to, as CEO Frank McGillen put it, “unlock access to the world’s best medical care”.
On this episode, we talk with Frank McGillen, CEO…
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Aug 11, 2021
Office Hours: Does My Software Need FDA Clearance (SAMD)?
On this edition of #HCBiz Office Hours, Don and Shahid talk with Yuma Nambu, Chief Strategy Officer (CSO) at CROSS SYNC.
CROSS SYNC is a Japanese startup whose medical data analytics software, “iBSEN”, enables hospital ICU’s to automate the monitoring of patient vitals and motions continuously to assist healthcare professionals in identifying acute deterioration as early as possible.
The platform relies on multimodal AI capabilities that combine time-series vital analytics from physiological monitors and patients’ motion analytics from live video feeds including facial recognition and motion detection.
As CROSS SYNC looks to expand globally, and into the U.S. market in particular, what are the regulatory requirements for their software? Will they need FDA SAMD Clearance to deploy iBSEN in the U.S?
Don, Shahid, and Yuma discuss FDA/SAMD regulatory requirements in detail. Plus, they expand on the idea to explore the more important question all digital health startups face: Ho…
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Jul 16, 2021
Financial Advice for Early Stage Digital Health Startups w/ Kristian Marquez
We spend a lot of time talking about how to align your startup’s vision with the realities of the business of healthcare. You can have the best idea in the world, but if you don’t properly validate your offering with customers, clearly and concisely explain the value it will bring them, close deals, and deliver on your promises then it will amount to nothing. Each of these steps is critical to your success. However, you can get many of them right and still fail. The best way to prevent this fate is by tying them all together with a financial plan that’s based on reality and considers the long-term goals for your startup.
Today we talk with Kristian Marquez, CFA, Managing Director for FinStrat Management, Inc. about how to properly manage your startup’s finances. The good news is that you don’t have to be perfect. Kristian tells us you should expect to get a lot of it wrong and have to clean it up along the way. That’s ok. His advice: go bare-bones in the beginning when it…
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Jul 9, 2021
The Art of the Possible: Doing Health System Innovation Right with Houston Methodist Center for Innovation
Just about every health system has an innovation program, but how do they know if it’s making a difference? That’s the question we set out to explore with the team from Houston Methodist Center for Innovation. On this episode we talk with:
* Michelle Stansbury, Vice President of IT Innovation
* Brad Shaink, Administrative Director of Digital Innovation
* Josh Sol, Administrative Director of Ambulatory Innovation
They walk us through:
* Innovation Expectations: How do you set expected goals, OKRs, KPIs, etc.?
* Innovation Discovery: Where do you find solutions?
* Innovation Evaluation: How do you evaluate solutions before you pilot them?
* Innovation Pilots and Early Adoption: How do you pilot your solutions?
* Innovation Procurement: RFPs, templates, etc.
* Innovation Diffusion: Implementation, integration, etc.
* Innovation Recognition: How do you recognize teams that are doing things well?
* Innovation Failure: How do you know if an innovation has failed?…
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Jul 2, 2021
The AWS Diagnostic Development Initiative with Grace Kitzmiller
Early in the pandemic, Amazon Web Services (AWS) launched the Diagnostic Development Initiative (DDI) to help organizations around the world accelerate diagnostics research and development. In the first phase of the initiative, AWS awarded $8 million in computing credits and technical support to 87 organizations in 17 countries. Some of the highlights include:
* Stanford University School of Medicine’s smartwatch app that detects early signs of COVID-19
* Ilumina’s identification of viral mutations through next-gen sequencing
* Chan-Zuckerberg Biohub used Machine Learning to estimate the number of unreported COVID-19 Cases
* University of British Columbia & Vancouver General Hospital applied machine learning to CT scans to identify indicators of COVIOD-19 and detect more severe progression of the disease. Then they open sourced the model.
Today we’re talking with Grace Kitzmiller, Principal Product Manager of AWS Disaster Response about the next round of DDI. AWS w…
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Jun 27, 2021
Multicultural Patient Engagement to Improve Clinical and Business Outcomes with Abner Mason
A major driver of health disparities is that the system does not typically account for the differences in the culture, language, and experience of the patients it is charged to serve. Today we talk with Abner Mason, Founder, and CEO of ConsejoSano about the importance of customizing engagement to match the multicultural realities of your patients. Abner tells us that it’s not about translating, but “creating content based on culture; based on deeper factors than language”. And it’s effective. ConsejoSano is helping payers and providers get their patients into clinics and closing gaps in care. This of course leads to better outcomes, lower costs, and increased revenue for practices.
Key topics include:
* What does it mean to create a more equitable and just healthcare system?
* How has COVID shone the light on the problems in our system?
* How do the Social Determinants of Health (SDOH) factor into health equity?
* Is there a willingness for providers and health plans…
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Jun 9, 2021
Healthcare Costs, Pricing, and Consumerism w/ Steve Ambrose
Price transparency and healthcare consumerism are top of mind for many operators and observers of the healthcare industry. On the surface, these topics sound great. Of course, we want to enable patients to be good consumers of healthcare. However, as we’ve seen so often on this show, aligning the obvious with the realities of the business of healthcare is no small feat. Today we’re talking with Dr. Steve Ambrose about healthcare costs, pricing, and consumerism. We discuss what these terms mean and why they are important. Then we dig into examples of companies that are already making an impact on these issues. We discuss:
* Companies that are helping to lower healthcare prices like ONCOspark (24:22), GoodRX (41:05), Transcarent (48:42), Cedar (53:24), Green Imaging (55:23), and more.
* What is going on in the retail space with the likes of Walmart, Target, Amazon and others (27:07).
* And companies working to reduce administrative costs like Olive (1:04:00) and LeanTAAS (1:08…
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May 27, 2021
The Moral and Business Case for Oral Health Integration with Dr. Myechia Minter-Jordan
Poor oral health has a direct link to high risk of chronic diseases like diabetes and heart disease. It contributes to depression, poor maternal health outcomes, and death. Research shows that it increased the risk associated with COVID-19.
Yet we treat oral health as being separate from “healthcare”. 65 million Americans lack dental coverage and even Medicare provides no oral health benefits to our seniors. Worse yet, this lack of coverage contributes to healthcare disparities as black adults are nearly seven times more likely to have an unmet dental need than white adults.
But where there are problems there are opportunities. Today we’re talking with Dr. Myechia Minter-Jordan, an MD, MBA, community health champion, and the President and CEO of the newly formed CareQuest Institute for Oral Health. Myechia shares with us how her role as the head of a Federally Qualified Health Center (FQHC) helped her see the gaps in our system and the extraordinary benefits of integrating oral…
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May 24, 2021
Using AI to Make the Provider's Job Easier with Abboud Chaballout
When it comes to billing codes there are many processes and solutions that focus on the backend. They support the coders and help ensure the codes are “bill ready”. However, as today’s guest points out, there are very few solutions that exist solely to help providers put those codes in the EHR accurately and efficiently in the first place.
Abboud Chaballout created Diagnoss to untether the clinician from a clunky EHR interface when it comes to coding. Chaballout describes it as a provider assistant that reads the free-text clinical narrative as they record it and uses AI to suggest the appropriate codes needed to paint an accurate picture of their patient’s health and the nature of the care they provided. Certainly, this will improve the accuracy of coding and allow for improvements in the overall coding workflow, but that really isn’t the goal. For Abboud, it’s far more important to give the providers some relief from clicking, pecking, and guessing in the EHR.
The EHR i…
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May 10, 2021
What’s your Early Adopter Strategy? with Dr. Roxie Mooney
95% of innovations that are brought to market fail to reach an adequate level of customer adoption or financial ROI. It sounds scary, but it doesn’t have to be this way. Today we’re talking with healthcare commercialization strategist and digital health advisor Dr. Roxie Mooney, about the steps innovators can take to dramatically increase their chances of being in the other 5%.
* Why you need an early adopter strategy that focuses on the specifics needs, goals, and desires of the customers who are looking for something new and novel.
* How to avoid pilot purgatory by negotiating future sales up-front and ensuring you can get value from the pilot along the way.
* The risks of falling in love with your idea and skipping the all-important customer discovery and market validation step. And no, your mom is not a good source of feedback on your innovation.
* The benefits of being strategic with your go-to-market timing (i.e., don’t rush to market; do rush to customer feedback)…
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Apr 28, 2021
What's up with IBM Watson Health? A Discussion on the State of AI in Healthcare with Paddy Padmanabhan
IBM Watson Health came on the scene with swagger and promises. They were going to revolutionize healthcare! And now the unit may be for sale. We don't yet know what's really going on there, but the commentary surrounding this rumor provides some interesting points for discussion. What is the state of AI in healthcare? Is the industry ready for it? Will doctors use it? Is it going to kill us if it's not perfect? There's a lot to explore.
On this episode, Paddy Padmanabhan joins us to hash it all out. Paddy is the Founder and CEO at DAMO Consulting, Host of The Big Unlock podcast, and co-author of the new book Healthcare Digital Transformation: How Consumerism, Technology and Pandemic are Accelerating the Future with Edward Marx. We discuss what's working today (think administrative functions), and what may still be a ways off (think complex cancer diagnostics). Plus we get into the challenges of regulation, ethics, patient safety, messaging, and more.
About Paddy Padmanabhan
Padd…
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Apr 13, 2021
Using Data to Pick the Right Health Plan with Akash Magoon
Picking a health plan can be the biggest crapshoot of anyone’s year. It’s confusing and tedious to compare the plan benefits, the provider directories are unreliable, and even if you can figure it out, there’s no way to know how much you’ll pay for a given service from one plan to the next. So, we cross our fingers, pick the one that seems like a fit, and hope for the best. Today’s guest is trying to change all of that. Akash Magoon is Co-founder and CTO at Nayya – a company that offers personalized enrollment guidance across all employee benefits. Today we talk about how Nayya uses claims and consumer data to help consumers pick the best health plan for their situation. Their goal is to “restack the odds for American families”. That’s something we can all get behind.
As a bonus to the startups out there, we talk about Nayya’s rapid growth over the past year. Pre-pandemic it was just Akash and his co-founder, Sina. Now a seed and series A round later, they have exp…
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Mar 31, 2021
The Role of Doctors at Digital Health Startups with Sven Jungmann
What is the role of a doctor at a digital health startup? Why are they needed? What jobs will they do? How do you find one? And how can you tell if they will be a fit for your team?
If you’re a doctor considering this move, you may have similar questions in reverse. What will it be like to be a “digital doctor”? How can I find opportunities? What new skills will I need to develop? How can I tell if the digital health startup I’m looking at has a shot?
On this episode we talk with Sven Jungmann. He’s a medical doctor with additional degrees in Public Health, Public Policy, and entrepreneurship. He’s the Chief Medical Officer at FoundersLane in Berlin, Germany, where he advises digital health startups, and helps align other doctors with startups too. I can’t think of anyone more qualified to discuss this topic with!
You’ll learn:
* Why many digital health startups really do need a doctor on their team.
* What the transition is like when moving from practicing medi…
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Mar 18, 2021
A Practical Look at Machine Learning in Healthcare with Josh Miramant
Machine Learning in healthcare (and Artificial Intelligence in the broader sense) is real and is being used today. The problem is, it’s difficult to sort out what’s real and what’s hype. Opinions on the matter range from “it’s all hype and BS” to “AI is revolutionizing healthcare and replacing doctors”. The truth, of course, lies somewhere in between. Today we talk with Josh Miramant, CEO and Founder of Blue Orange Digital, to help you sort this out. After listening you’ll have clarity on what Machine Learning is, an understanding of what’s possible in healthcare today, and a practical expectation of what’s coming next.
In this conversation we’ll:
* Help you understand the terminology. What is Machine Learning? What is Artificial Intelligence? What is everyone talking about!?
* Take the “magic” out of Machine Learning and help you understand at a basic level what’s happening here.
* Layout the need for data quality and data fidelity (i.e., the usef…
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Mar 7, 2021
Direct Contracting: A Physician's Perspective with Dr. Krishnan Narasimhan
Direct Contracting is a new model from the Center for Medicare & Medicaid Innovation (CMMI, or the CMS Innovation Center) aimed at reducing expenditures and preserving or enhancing quality of care for beneficiaries in Medicare fee-for-service (FFS). At a minimum, it’s an opportunity for providers to change the way they care for Medicare FFS patients. And if the Geographic Direct Contracting Model is launched (it’s currently under review by CMS), it will be a sea change in the 10 targeted “Geo” regions. Either way, it’s worth paying attention to.
We covered the Direct Contracting model and options at length in Episode 156 with Gail Zahtz. You should start there if Direct Contracting is new to you. During that conversation, Zahtz identified plenty of areas where the model could benefit doctors and their patients. However, she identified several grey areas that make it difficult for physicians to engage with potential DCEs as the application deadline rapidly approaches (April 1…
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Feb 26, 2021
Why Aren’t We Using HIEs to Support Vaccination Efforts (and Everything Else)? w/ Niam Yaraghi
As of 2015 the Office of the National Coordinator for Health IT had awarded $548 million in grants to states to establish health information exchanges (HIE). I have no doubt hundreds of millions of dollars more have been invested in various ways since then. So, when faced with one of the most daunting healthcare data challenges of our time in the COVID-19 vaccine rollout, surely, we turned to the HIEs first. Right? Not so much, according to today’s guest.
Niam Yaraghi, assistant professor of Business Technology at Miami Herbert Business School at the University of Miami and a nonresident fellow at the Brookings Institution’s Center for Technology Innovation, recently explored the use of HIEs in vaccination efforts across the country. He tells us that “While the U.S. employed every possible resource to develop the vaccines, we are neglecting to use the best available information technologies to efficiently distribute them”.
In Yaraghi’s recent article, co-authored with Brook…
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Feb 9, 2021
Direct Contracting: It’s Coming Fast and Will Have a Big Impact on Medicare-fee-for-service w/ Gail Zahtz
CMS Direct Contracting is coming fast, is very nuanced, and full of grey. In a nutshell, 50% of Medicare patients are in Medicare Advantage (i.e., value-based care) and 50% are still Medicare fee-for-service (FFS). Direct Contracting is CMS’ bold play to quickly move many of the remaining Medicare fee-for-service (FFS) patients into value-based care.
If you’re a doctor who takes care of Medicare fee-for-service (FFS) patients, then it is going to affect you whether you’re paying attention or not. That’s doubly true if you’re in one of the 10 “Geo” model regions (Atlanta, Dallas, Houston, Los Angeles, Miami, Orlando, Philadelphia, Phoenix, San Diego, Tampa). In those regions, 100% of non-Medicare Advantage beneficiaries will have to align with one of three to seven awarded Direct Contracting Entities (DCE). DCE applications are due April 1, 2021 and all beneficiaries will be re-aligned under this fully capitated plan beginning January 1, 2022. Ya… that fast.
“There…
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Jan 29, 2021
Reimagining Public Health Data w/ Prashant Natarajan
The pandemic has exposed many weaknesses in our healthcare and public health systems, and our disjointed public health data infrastructure is certainly one of them. Like much of our healthcare data, public health data tends to be manually compiled, Excel-reliant, and lacking in critical detail needed to make good decisions. Today we talk with Prashant Natarajan, VP of Healthcare Life Sciences and Health Insurance at H2O.ai about reimagining the collection and use of public health data.
Public Health Data Topics Discussed
* The current state of our public health data infrastructure (12:20)
* Why data is the lifeblood of our society, and how it can help us make better public health decisions (22:36)
* How the pandemic has exposed our weaknesses, and how the private sector can help (28:12)
* The gaps in our public health data and opportunities for improvement (33:19)
* Enable better decision-making with demographic and socioeconomic data (40:17)
* The importance of sharing l…
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Jan 21, 2021
Deferred Care and Lower Risk Scores Could Reduce Medicare Advantage Payments in 2021 w/ Dr. Matt Lambert
The pandemic has had a tremendous impact on the business of healthcare. With states canceling elective procedures and people deferring care for fear of being exposed to the virus, hospital and medical practice revenue is down. On the flip side, many health plans are sitting on a mountain of premiums that aren’t being spent because of this deferred care, possibly leading to rebates in some cases and a ton of uncertainty in pretty much all cases. One less obvious outcome of all of this may fall on Medicare Advantage plans in 2021, and it threatens to lower payments by 4-6% in 2021.
Medicare Advantage, of course, is the rapidly growing model that’ll cover more than 24 million Americans this year. According to a recent Avalere report, these plans may be looking at both a sicker population and reduced payments in 2021 because of this deferred utilization. Here to help us understand why, and to share some advice for how Medicare Advantage plans can weather the storm is Dr. Matt Lambert,…
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Jan 14, 2021
How Will Patients Securely Connect 3rd Party Apps to Their Data Once Patient Access Rules Kick In? from Health Data Unbound
The CMS Patient Access Rules are coming. And they’re easy to cheer for. We’re giving patients their data and that’s a huge win! We all love that!
But what we don’t love is when FraudulentHealthcareApp.com collects patient data and sells it to the highest bidder to support targeted marketing, or whatever other nefarious act they can come up with. Well, the health plans don’t get to pick and choose which apps they connect to. What if their member wants to use FraudulentHealthcareApp.com? What’s their recourse? How can they educate and protect their members?
On this episode, we’re sharing another of Shahid’s recent panels. This one from Health Data Unbound, and it’s like an #HCBiz super panel as we’ve had all 4 of the panelists on the show in the past. The panel asks the question: “How Will Patients Securely Connect 3rd Party Apps To Their Data Once Patient Access Rules Kick In?” And they will be kicking in on July 1st of this year (2021).
Shahid Shah is our mod…
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Jan 6, 2021
Selling to Health Plans from the Digital Health Growth Summit
This podcast features the Selling to Health Plans panel discussion at the Digital Health Growth Summit, moderated by our very own Shahid Shah, with panelists Vijay Bhatt, Deputy CTO, Harvard Pilgrim Health Care, and Bill Friedman, Vice President of Sales, Zipari.
The panel covers some of the most important digital health technologies that health plans are interested in and how digital health startups can get health plan executives to buy the technologies they’re building. One of my favorite points is that you’ve got to de-risk the decision to buy:
* Start small and build-up
* Pilots are not bad when done right
* Show the IT department that you won’t be a pain in their neck
* Show the finance department a transparent roadmap of the true cost of ownership from implementation thru tangible ROI.
Some great advice for anyone trying to sell in healthcare.
This panel discussion complements several recent episodes:
* Episode 145: How Payers Can Master Core Administrative T…
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Dec 11, 2020
Shifting Healthcare's Culture Toward Openness and Experimentation with Red Hat's Paul Jones
The business of healthcare is consensus-driven and permissions-based. As we’ve seen time and again on this show, this culture slows innovation, stretches sales cycles, and inspires institution-first thinking. Ultimately, it’s responsible for the high costs and lousy user-experiences we’re all trying to fix.
What if healthcare went from a culture of consensus and permission to one of openness and experimentation? That’s what we’re going to explore today.
Our guest, Paul Jones, “grew up” in a large health plan where he was the prospect and buyer of health IT systems and solutions. Now, as Red Hat’s Healthcare Strategist for the Northeast US, Paul is selling innovative healthcare solutions rooted in Open Source software back into the industry he cut his teeth in.
After making this move, Paul didn’t just find open-source software, but an open culture. Looking back on his days at the health plan, this is the first thing he would try to replicate if he went back. We’re…
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Dec 3, 2020
How to Turn on the Growth Engine in Your Digital Health Startup w/ Bryan Loomis
Many digital health startups rely on sales prospecting to generate new leads. That works to a point but doesn’t scale because each deal takes a long time, and good healthcare salespeople are hard to find. Today we’re talking with Bryan Loomis, a Digital Health Growth expert and mentor, about how to design, build and execute a growth plan that generates leads in a more sustainable way.
We discuss:
* Bryan’s PAGE Methodology (Purpose, Audience, Gospel, and Experimentation) for growth
* The importance of generating marketing qualified leads instead of relying solely on sales prospecting
* Why email opt-ins are a good indicator your plan is working
* Useful tools to help you execute your growth strategy
* The proper way to reach out to prospects on LinkedIn
* How to use the assets you already have to generate content and “gifts” for your audience
* You don’t need blind experimentation, but hypothesis-driven experimentation with measures and statistics.
* And m…
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Nov 24, 2020
How Health Systems Think with Neil Carpenter
Get ready for a cold dose of reality. On this episode, we’re talking with Neil Carpenter, VP of Strategic Planning at Array Advisors and former health system Chief Strategy Officer, about how health systems think. This behind the scenes look at health system strategy, decision-making, and purchasing tells you much of what you need to know as a startup/vendor trying to sell into this market. You won’t like everything you learn, but it’ll give you a much more productive way to look at your product or service and how you fit into the cold-hard reality of health systems.
You’ll learn:
* Health systems are permission oriented and consensus driven. What does that mean and how does it affect your sales strategy?
* The difference between the big-name systems and their scrappy competitors down the road.
* What is the role of a Chief Strategy Officer at a health system and how can you work with them to get your foot in the door?
* Why health systems are so focused on what’s h…
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Nov 17, 2020
Partnering with Payers - Andrew Adrian-Karlin
For many healthcare startups and established vendors, partnering with payers is a crucial part of their business plan. And as we know, selling in healthcare is hard. It’s even harder when you don’t understand how these large corporations work. What do they want? How do they set priorities? How do they make purchasing decisions? How long does that process take? The list goes on, and if you’re strategizing without this knowledge you’re going to struggle. That’s where this episode comes in.
Today we’re talking with Andrew Adrian-Karlin, Director of Business Platform Product at Highmark Health. Andrew sheds some light on how payers decide what to do and who they decide to do it with. This episode will help you build an effective framework for preparing, approaching, and successfully partnering with payers.
You’ll Learn
* What are “products” from a health insurance point of view?
* What is the purpose of health insurance? Note: This is the same question we went deep…
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Nov 10, 2020
Applying Conversational AI to Reduce Provider Burnout from HealthIMPACT Live
There’s a lot of talk about addressing physician burnout, but little practical advice about what to do. The path to action lies first in understanding the many sources of burnout, and then separating them into those that we can impact, and those we cannot.
There’s a class of burnout factors that are intrinsic to being a physician. Simply put, it’s a hard job, and it's demanding in both a physical and mental sense. But this is part of what they signed up for, and due to their passion and sense of purpose (as we discussed at length with Dr. Vivian Lee on Episode 143), most physicians are willing and able to work through them. That’s good because there’s little we in the tech/entrepreneur community can do to help.
The problems arise with the other class of burnout factors – the extrinsic variety. As a society, we have in many ways changed our deal with doctors over the past 10+ years. Under the guise of healthcare transformation, we have piled on to the existing stressors w…
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Oct 29, 2020
How Purpose-driven Interoperability and Data Quality Positioned Surescripts to Fill Communication Gaps During the Pandemic - Tom Skelton
Many private organizations have stepped up to provide support as we deal with the pandemic. Surescripts, for their part, repurposed clinical direct messaging infrastructure to help health systems communicate critical information from the frontlines to federal agencies. It’s a great story of a private organization rapidly transitioning to fill a need.
What we’d like to explore, and what we think you will most benefit from hearing, is why Surescripts was in a position to do this in the first place. And ultimately, why co-host Shahid Shah calls them “THE interoperability story of our century”.
On this episode we explore:
* Surescripts 19-year journey to build a national network that handles 19 Billion transactions per year
* How good, purpose-driven work lead to success
* Why getting the data flowing is the easy part, while data quality and workflow integration are the real problems
* How purpose-driven data quality, which we often refer to as data fidelity at #HCBiz, g…
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Oct 16, 2020
How Payers Can Master Core Administrative Transactions and Deliver a World-class Experience to their Members and Providers w/ Steve Krupa
It may seem cliché to say payers need to be more like Amazon, but the analogy provides fundamental, and surprisingly actionable insights for the health insurance industry.
Think about your experience with Amazon (or Google or Zappos, or any other organization that provides a phenomenal customer experience). Whether they're helping you find the right product, or streamlining the purchase, or dealing with a delivery problem, or a return, these organizations have made the transactions feel easy... frictionless... natural.
* If you're a payer: Ask yourself, does your front-end member experience, or back-end provider experience even remotely resemble this?
* If you're a member or provider: Does your experience with health insurance companies even remotely resemble this?
If we're being honest, approximately 100% of you are shaking your heads "No".
The reason that Amazon can provide an awesome consumer experience is because, through telemetry and analytics, they know exactly what's h…
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Sep 24, 2020
HealthIMPACT Fall Forum Preview Plus Tips on Running Virtual Events
On this episode, we discuss the HealthIMPACT Fall Forum coming up September 30th – October 2nd, 2020. Shahid Shah, our co-host and the HealthIMPACT Forum Chair, tells us it’s a “No BS and No PowerPoint” event that’s intended to be more of a conversation than a series of presentations. The goal is to get healthcare leaders together and facilitate a conversation amongst peers about the work they’re doing in the real world.
We also talk about what it’s like to host a conference virtually and the techniques you can use to simulate the best parts of in-person conferences.
What you’ll learn at the HealthIMPACT Forum (from their website):
* Building a sustainable innovation strategy in a post COVID world - lessons learned during rapid innovation deployment
* Lessons learned from the rapid deployment of telemedicine technologiesin the diagnosis and treatment of COVID and non-COVID Patients
* Digital Health’s role in addressing gaps in health equity and applications…
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Sep 11, 2020
The Long Fix: Solving America's Health Care Crisis with Strategies that Work for Everyone w/ Dr. Vivian Lee
On this episode we talk with Dr. Vivian Lee about her new book, The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone. Dr. Lee offers a fresh perspective that will strengthen your understanding of the issues facing America’s healthcare system. And while she acknowledges that our government must play a substantial role in driving systemic change, she points out how each of us as individuals, clinicians, payers, and employers all have a role to play. The book’s title suggests that we’re in for a long haul, and I agree. However, Dr. Lee offers concrete examples of driving change in the real world that can have an immediate impact on the work you’re doing today. In particular:
* What it’s like to lead a multi-billion dollar health system into value-based care for the first time?
* Why intrinsic motivators like purpose, autonomy, and mastery are more important than extrinsic motivators like compensation, and how to tap into them to motiva…
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Sep 2, 2020
Patient Centricity: You’re doing it wrong! w/ Matthew Zachary
Patient Centricity is a buzzword that’s easy to throw around, but difficult to realize. The notion itself is straightforward… build your product or service around the patient who it is intended to help. Talk with them. Incorporate their input. Understand their needs, desires, and goals. It’s so straight-forward that today’s guest tells us this is no “ah-ha” moment for healthcare, but more of an “ah-duh”.
Why do other industries do this organically, while healthcare talks about it as some enlightened idea? It’s because our healthcare system is dis-intermediated to the point where the patient no longer looks like the customer. And unfortunately, there is no business case for “doing the right thing” in healthcare. Even though our intentions are good, our end-game involves much more than an outstanding patient experience with the best possible outcome. Consequently, our thinking gets cloudy and our efforts get diluted.
Today we talk with Matthew Zachary, founder and…
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Aug 14, 2020
The State of Payer Data with Jordan Bazinsky
Payers already face a formidable challenge when it comes to internal data management. After years of consolidation in the industry, many payers have a collection of legacy systems cobbled together to run their operations. This makes data management difficult for things like claims, provider directories, and member demographics. And those are just “the basics”.
Now, as quality measurement evolves and payers experiment in value-based payment, there’s an acute need for the integration of real-time clinical data to support operations and care management. Finally, there are the CMS and ONC final rules that create new requirements for payers to share data with members and other payers.
When you put it all together, payers have a monumental data management task in front of them.
Today we’re talking with Jordan Bazinsky, Executive Vice President and Chief Administrative Officer at Cotiviti. We discuss the current state of payer data, evolving clinical data needs, and the CMS and ONC…
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Jul 30, 2020
Getting to Know eHealth Exchange - The Largest Health Information Network in the Country - Jay Nakashima
In a growing crowd of national health information networks, eHealth Exchange is one of the oldest and most connected in the U.S.. Notably, they are the primary way healthcare organizations connect with federal agencies such as the Social Security Administration (SSA), Department of Defense (DOD), and the Department of Veterans Affairs (VA). In addition, they're connected with 75% of all U.S. hospitals, more than 60 regional and state HIEs, more than 5,000 dialysis centers, and more.
Today we take a thorough look at eHealth Exchange with Executive Director, Jay Nakashima to find out what they do and to give you a sense of how they may fit into your clinical data strategy.
Topics include:
* What does the eHealth Exchange do
* Who participates
* How eHealth Exchange connects federal agencies like the SSA, DOD, and VA
* Why is the social security administration is such a large consumer of clinical data
* The difference in outcomes when you're opt-in vs opt-out
* How does eHe…
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Jul 10, 2020
Behavioral Economics Expert Explains How to Drive Massive Change with Minor Tweaks w/ Karen Horgan
Everything you’re trying to accomplish comes down to one thing… getting people to do stuff. Behavioral economics, in its simplest terms, is the study of how and why people decide to do what they do (or don’t do). Whether you’re trying to sell, get users to adopt a new system or workflow, or make your staff feel comfortable coming back to work during a pandemic, understanding behavioral economics will greatly increase your chances of success.
Today we’re talking with Karen Horgan, CEO at VAL Health about how behavioral economics is being used in healthcare today, and how it should be used going forward to drive positive behavior change throughout the industry.
No matter what you’re working on, there’s something here for you. I can think of no better investment you can make in your self and your business than gaining a basic understanding of these concepts.
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"Behavioral economics is the last mile to transform healthcare. As an industry, we have a behavioral de…
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Jul 1, 2020
Getting Ready to Go Back to Work and How Remote Patient Monitoring (RPM) Tools Can Help
Public health vs. the economy is a dangerously false dichotomy. We can protect our people AND get back to work if we accept reality and embrace science. You already know you should wear a mask, wash your hands, and practice social distancing. As we begin to go back to work and spend time with our extended families and friends, Remote Patient Monitoring (RPM) tools present an additional layer of protection that could allow us to do so more responsibly, safely, and productively.
Remote Patient Monitoring (RPM) tools, like pulse oximeters, blood pressure cuffs, Bluetooth thermometers, and others often used in chronic disease management programs, can help you baseline your vitals, offer peace of mind, and alert you at the earliest possible moment when there might be a problem.
NOTE: We recorded this episode on June 15, 2020, right before the recent spike in COVID-19 cases in many states across the U.S. Things look quite different today, but these ideas and tools still apply. Be responsib…
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Jun 24, 2020
The Novation Dynamic: 3 Pillars for Healthcare Innovation Success with Michael Ackerman
Michael Ackerman, director of the Master in Healthcare Innovation Program at The Ohio State University, believes that every innovation program must do three things in tandem:
* Innovation – filling gaps where no solution currently exists, in a way that adds value
* Renovation – quality improvement and process improvement
* Exnovation – removing functions that no longer add value; also known as de-implementation
When practiced together, and ideally led by different teams within the organization, the 3 pillars of The Novation Dynamic help us overcome the notorious friction that has slowed healthcare innovation for too long.
You’ll Learn:
* The 3 pillars of The Novation Dynamic and how to apply them in your organization
* The 3 things that make innovation so hard in healthcare and how to address them
* How to do evidenced-based innovation even though innovation is, by definition, void of evidence
* Why we’re seeing so much innovation right now during the pandem…
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Jun 17, 2020
Marketing in a Post-COVID World with Jared Johnson
The COVID-19 crisis has presented marketers with quite a challenge. Customers don't want to be sold to and no one wants to spend money. In fact, traditional marketing has been paused for fear of coming off as insensitive and out of touch. But that doesn't mean you stop. You just do it differently. The pandemic is driving marketers back to the fundamentals of relationship building and value creation. This is how you stay relevant during the crisis, and as we reopen the economy. On this episode, we talk with Jared Johnson of Shift.Health about how to get it done.
You'll learn:
* How buyers priorities have changed over the past couple of months
* The importance of "Show. Don't tell."
* What to do when your buyers don't want to be sold to
* How to understand your buyers needs when they don't want to hear from you
* What to do when the top of the funnel is blocked and the middle of the funnel is slower than ever
* How to create opportunities for your customers - and no, we don…
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Jun 10, 2020
Remote Work Environments: Much More than a COVID-19 Strategy w/ Jonathan Lieberman
The COVID-19 crisis and the resulting lock-downs across the world forced many organizations to go virtual in an instant. Some of them had sound Business Continuity (BC) and Disaster Recovery (DR) plans in place. And while they were still interrupted, they were able to move quickly and keep their people working. Others were caught off-guard and are now scrambling to make it all work.
In an industry like healthcare with reams of sensitive data and the regulations that go with it, this breakneck pace creates a ton of risk for organizations going remote. And the risks are exacerbated when they can’t provision hardware for everyone and they let their staff connect via their own devices.
On this episode, we talk with Jonathan Lieberman, CEO and Co-Founder at itopia. He tells us how virtual desktops can be deployed quickly and securely in the cloud, allowing your staff to access critical data and systems from anywhere on any device.
This approach has obvious benefits when you’re faced…
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Jun 3, 2020
Deploying Community Health Workers as a Front-line COVID-19 Solution (with a 2X ROI)
We’ve talked a lot about the importance of addressing social determinants of health (SDOH) in healthcare, and why it may be the most critical factor when it comes to lowering costs and improving outcomes… especially for vulnerable communities. For me, there is zero doubt that this is what needs to happen. However, we’ve seen very few programs that have been successful, sustainable, and scalable. That’s a big problem, and when this happens, you risk losing the attention of key decision-makers that we need to drive these new approaches forward.
If we know the interventions work, but we haven’t been able to find financial alignment within the system… then perhaps we’re doing it wrong.
Today we’re talking with someone who’s made it work. Jill Feldstein is Chief Operating Officer at the Penn Center for Community Health Workers at Penn Medicine.
They help healthcare organizations across the country start or improve Community Health Worker (CHW) programs using the Center…
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May 27, 2020
Keeping Your Innovation Engine Humming During the COVID-19 Crisis w/ Karen Murphy PhD RN
Health Systems are being asked to make changes in 2 months that would have otherwise taken years. As some business lines come screeching to a halt, others have sped to a breakneck pace. Prioritizing problems to solve and finding novel solutions have never been more essential. Here today to teach us how innovation is done at Geisinger Health is Karen Murphy. Enjoy!
Highlights from the Episode
We define innovation at Geisinger as a fundamentally different approach to solving a problem that has quantifiable outcomes. So we only work on problems.
* Pathway from nursing to government to innovation at Geisinger
* The Solution-Oriented vs The Strategy-Oriented Innovation Team
* What prioritization mistakes are hospitals and public health officials making during COVID-19?
* Innovations in behavioral health and mental health for the healthcare workforce.
* What have your frontline workers learned that can inform community reopening strategies?
* How hospitals are tracking and f…
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May 20, 2020
Direct Pay, Telehealth, Parking Lot Visits and Other Strategies for Private Practices to Survive the Pandemic
In our ongoing series around the COVID-19 crisis, we plan each episode with the specific aim of delivering you, the listener, actionable items you can do right now. To ensure that during this crisis you can solidify and strengthen your business while continuing to serve your patients at the highest level, we're bringing you two of our favorite people in healthcare. Joining us today is David Goldhill, CEO of Sesame and Dr. Allison Edwards who runs a direct primary care facility, to talk about how you can adopt the right strategies for doctors to overcome this crisis.
Highlights
* How a personal tragedy and a timely New Yorker article set David Goldhill on the path from being a top media exec to one of our leading voices in healthcare.
* Why incentives and priorities are a huge motivation and focus of David's research.
What we saw was an opportunity to create something of an alternative health economy outside of third party reimbursement. David Goldhill
* The Direct Primary Car…
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May 14, 2020
Serving Patients and Doing Business in Spite of COVID-19 w/ Tashfeen Ekram, MD
Many doctor’s offices have been closed for weeks and those that haven’t have seen massive cancellations. This episode is for healthcare providers and people working inside health offices. Today we’re going to share what we're seeing across the country in terms of closures, cancellations, and plans going forward. Joining us to help you formulate a plan, is Tashfeen Ekram, MD co-founder and chief medical officer of Luma Health.
Highlights from Serving Patients and Doing Business in Spite of COVID-19
* COVID-19 accelerating the patient first care model
* How Luma Health makes communication easier
* How CMS lifted the barriers to telehealth and remote monitoring
How can we continue to serve our patients in the way they want to be served, but at a distance?
* Making sense of cancellation data from across the country
* Clinic driven cancellations vs. patient driven cancellations
* The fine art of Mass Messaging
* Prioritizing patients with text message surveys
* R…
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May 6, 2020
Taking Friction Out of the Prescription Process with Surescripts Real-time Prescription Benefit - Dr. Andrew Mellin
Surescripts is at the center of almost all prescriptions for medications in the US. In this era, when almost no other kind of prescriptions are being allowed, how is Surescripts thinking about digital prescriptions? How has Surescripts adapted to the new needs of patients and providers at the point of care with their real-time prescription benefit? Dr. Andrew Mellin, Chief Medical Information Officer at Surescripts joins us today to show us how the right technology changes physician prescribing behavior, saves patients money, and improves trust throughout the entire system, at the same time.
Highlights
* How should providers, innovators, and developers think about digital prescriptions?
* What effect will COVID-19 have on telemedicine and e-prescribing?
* Challenges of practicing healthcare remotely.
* Surescripts is exploring opportunities to work with The Sequoia Project on PULSE
If it's not in the workflow, the chance of it being used is extremely small.
* The Tool…
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Apr 15, 2020
What you need to Know About TEFCA Right Now w/ Mariann Yeager
A year after Draft 2 of TEFCA, what has happened and where are we now? The ONC awarded a cooperative agreement to The Sequoia Project to serve as the Recognized Coordinating Entity (RCE) to develop, update, implement, and maintain the Common Agreement and the QTF. On today's episode, Shahid Shah joins your host, Don Lee to talk with the CEO of The Sequoia Project, Mariann Yeager. If you are an HIE and you want to become a QHIN (or sell to one), this episode is for you.
Highlights from What you need to Know About TEFCA Right Now
TEFCA, Trusted Exchange Framework and Common Agreement, are the rules of the road and the specific technical requirements to enable health information networks to interconnect.
* Sequoia has an HIE portfolio and is helping the ONC to implement TEFCA
* What is a Qualified Health Information Network (QHIN)?
* Minimum requirements for legal and privacy vs. technical implementation details for interoperability
* What do product managers, developers, and…
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Apr 9, 2020
COVID-19 Community Vulnerability Map w/ Dr. John Showalter
There is an urgency to utilize social determinants in healthcare decision making, especially to meet the needs of underserved populations. Jvion launched its new COVID-19 Community Vulnerability Map, a free, publicly available tool that identifies populations — down to the census block level — that are likely to experience severe outcomes requiring hospitalization when they contract the virus. The map integrates the findings of the data analysis project that Jvion conducted last week, which analyzed a representative sample of 2 million patients to understand the social and clinical risk drivers that make populations more vulnerable to viral infections like COVID-19. Joining Don and Shahid on this episode is Chief Product Officer, Dr. John Showalter to talk about the deployment and use cases of the COVID-19 Community Vulnerability Map.
Highlights
* COVID community vulnerability map – learn how limited datasets can be used to understand which communities are at risk of having…
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Mar 30, 2020
Protecting and Extending the Life of PPE with Engineered Controls
An #HCBiz Brief: Given the shortage of Personal Protective Equipment (PPE) in our hospitals due to COVID-19 and the elevated risks our medical professionals are facing every day, I wanted to share a tool I came across at an infection control conference last year that might help. This is a short PSA about an engineered control that prevents infective aerosols, sprays, and splash-back generated by suctioning. I hope you find it helpful.
https://prodaptivemedical.com/stal-shield/
And here's an interview I recorded with them at HITS 2018:
https://thehcbiz.com/ep77_prodaptivemedical_hits2018/
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Mar 27, 2020
Using Opportunity Zones to Drive Substantial Investment in SDOH w/ John Gorman
The Opportunity Zones incentive is a new community investment tool to encourage long-term investments in low-income urban and rural communities nationwide. Nightingale is accelerating the health care industry’s ability to deploy underfunded SDOH benefits by leveraging the innovative financing mechanisms of Opportunity Zones, to catalyze a new marketplace of social service providers. Joining us today is the Founder of Nightingale Partners, John Gorman, to talk about one solution that is good for society, good for patients, and good for business.
Show Notes
I like to say, social determinants of health are just four fancy words for poverty.
We hacked a Republican billionaire tax shelter to try to improve healthcare for black and brown people in inner cities.
You can never get to compliant patients who are participating in population health activities unless their basic needs get met.
* Breaking down silos to sign patients up for all available social services.
* The Community…
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Mar 19, 2020
Making Value-Based Care Work in Rural Health
Today’s episode is about how the Rural Risk-Free Solution helps rural hospitals and health systems take on risk faster to achieve value-based care. The methodology is a community / population health approach. By providing analytics on care metrics, nurse-led and team based care, and population health programs, you can improve outcomes for both communities and the hospitals. Today we have Lynn Barr here from Caravan Health to explain how it works. Highlights from A Rural Risk-Free Solution
* The rural challenges of moving from cost-based reimbursement to value-based care.
* How consolidation is putting rural clinics at risk.
We thought we were very high quality, we were the best. We were leading the country. And guess what happened? We reported our quality results. And we were the worst in the country. It was the first time we knew. Nobody had been gathering our data!
* The Rural ACO Turn Around Story
* The payment incentive system that is working against us.
* Build a s…
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Feb 5, 2020
There Are No Drug Prices in the US w/ AJ Loiacono
Drugs are way too expensive. It has got to be from someone in the middle taking up all the money. Blame the pharmacy benefits managers! Right? Not so fast. If you're like me and have gotten derailed by complicated flow charts trying to understand PBMs in the past, this is the episode for you.
AJ Loiacono, CEO of Capital Rx, is a new PBM injecting some much-needed trust back into the system. By starting fresh and denouncing business as usual, AJ is giving control back to self-insured entities while looking after the community and specialty pharmacies that historically haven't had negotiating power. Don is joined by Shahid today and the tough questions are coming in hot! Enjoy!
Highlights
* What do you mean by, "There are no drug prices in the US"?
* The dangers of an inefficient market.
* Does the PBM have an inherent conflict of interest?
If someone is being prescribed a $50,000 medication, my company makes $5. If someone's being prescribed a million dollar medication, my c…
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Jan 14, 2020
Interoperability 2.0 with Niko Skievaski
The interoperability promise of a shared, longitudinal medical record has so far focused on connecting health systems to each other. With the growing investment and constant new entrants of SDOH solution vendors, a new wave of interoperability challenges are becoming apparent. How does your health app connect to an EHR? Will new anti-data blocking legislation help or hurt SDOH startups? In this wide-ranging conversation, Don Lee and Shahid Shah talk with Niko Skievaski, President and Co-Founder of Redox, about his team’s solution to interoperability and why health information exchanges (HIEs) are only part of the answer.
Highlights
* One API to link them all.
* FHIR is a language, not an API.
* Redox helps you scale your integration infrastructure without scaling your team.
* Interop with Epic: Then and Now.
* B2B relationship building through Interface Analysts.
HIEs are designed to facilitate the movement of data to follow a patient, Redox shares data between health…
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Jan 9, 2020
Headwinds Impacting the Shift to Value-Based Care with Kyle Swarts and Dr. Matt Lambert
Health systems have been working hard to lay the foundation for taking on a larger case mix of value-based contracts. 75% of health systems surveyed said they are ready to accept downside risk in the next two years, up from 42% in 2015. As health systems are discovering, value-based care reimbursement is more complicated and requires a new level of specificity in documentation. The question is, are health systems really ready to take on downside risk while continuing to manage FFS contracts?
Today we have Kyle Swarts, Chief Growth Officer, and Matt Lambert, MD, Chief Medical Officer from TrustHealthcare to help us answer that question. We discuss challenges and opportunities facing health systems as they embrace the shift to value. Enjoy!
Highlights from Headwinds Impacting the Shift to Value-Based Care
* It's time for providers to take on risk.
* Everyone has a population health department but fee-for-service is still driving your overall strategy.
* The threshold for makin…
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Dec 18, 2019
A Playbook for Social Care Providers with Juliette Price
The quantification of how social determinants effect health has finally put enough pressure on healthcare organizations to force action. Finally discovering what social workers have known for years, the health sector is on the verge of providing a permanent revenue stream for Social Care Organizations who previously relied on grants and charitable donations. For your organization to develop health partnerships, Juliette Price from Helgerson Solutions Group says you need to answer three questions as clearly and completely as possible.
First, What problems are you trying to solve and how do you propose solving it?
Second, Who is your target population?
And Third, How do you measure your impact?
Clarifying this value proposition is the only way to allow hospitals and health systems to calculate how much money you will actually save them and ultimately how many lives will be improved.
This is a wide ranging conversation and with lots of great takeaways. Enjoy!
Highlights from…
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Dec 4, 2019
Designing an Innovator Network for Hospitals with Amy Stevens
For long time listeners of this show, you know we’re in the business of helping entrepreneurs understand how to create use case alignment, how to get over the hump of defeating good marketers with a not so good solution, and how to get the right tools in the hands of people who need them. The hurdles involved with getting permission and building consensus around which new tech to bring in slows down diffusion and implementation of needed solutions.
Well today we’re looking at a new platform that gets targeted information to health system leaders who are driving meaningful change in their organization. On this episode, Don and Shahid speak with Amy Stevens, Executive Vice President of Provider Solutions and Avia Connect at Avia. In addition to the platform, Amy also gives us an update from earlier episode we did with David Smith, on the Medicaid Transformation Project and how the first couple behavioral health and community health projects are going. Enjoy!
Highlights from, “…
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Nov 27, 2019
The State of Remote Patient Monitoring w/ Sam Liu of VivaLNK
The design solutions from the consumer wearable market are making this next generation of remote patient monitoring devices ready for mass adoption. With the solutions you’ll hear about today and CMS finally finding a method to pay for them, hospitals and patients will soon agree that remote monitoring could be the key to a more holistic healthcare solution.
With successful physician adoption strategies like the one we heard from Henry Ford Health System, more developers will be utilizing remote monitoring services from our guest today. In this episode, we talk with Sam Liu, Vice President at VivaLNK.
VivaLNK provides medical wearable sensors designed to monitor human vitals and biometrics. VivaLNK’s IoT sensor platform is quickly becoming the Amazon Cloud of remote healthcare sensors by making it very simple for healthcare developers to capture patient data for their own applications.
Whether you’re looking to implement your own remote monitoring program or you want to see ho…
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Nov 26, 2019
Addressing SDOH in the Community: Baby Cafés with Rev. Diann Holt
Maternal mortality rates are steadily on the rise in the U.S. – the only developed nation where that’s true. The maternal mortality rate in 48 states and the District of Columbia increased by 26.6% between 2000 and 2014—from 18.8 to 23.8 per 100,000 live births. Hidden in those statistics is great racial disparity, where African American women are 3-4 times more likely to die in childbirth than white women.
The CDC recommends exclusive breastfeeding for about 6 months and cites benefits such as the reduced risk for Asthma, Obesity, Type 1 diabetes, and many more problems that the healthcare system is working earnestly to address.
According to DONA International, a Doula is “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible” and that “countless scientific trials examining doula care demonstrate remarkably…
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Nov 13, 2019
Tying SDOH Factors to Clinical Outcomes with Erin Benson
We’ve been talking about Social Determinants of Health for a couple of years now and I think we all got the basic concept: For the best health outcomes, we need to combine healthcare with social care.
”A doctor might prescribe to you the best care in the world, but if you can’t afford it or you can’t get to it because you don’t have a car, you might just not be able to follow those recommendations.”
Today we can happily say there are solutions that implement best practices for addressing SDOH in the doctor's office. The main questions now are how does it work and how does it integrate into my workflow? That’s exactly where we start today. LexisNexis Risk Solutions has built out an impressive suite of solutions to integrate SDOH best practices into your organization and here to tell Shahid and I about it is their Director of Market Planning, Erin Benson. In this episode, we go deep into a case study on medication adherence and have some needed conversations around data e…
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Nov 6, 2019
Enhancing Diagnostic Accuracy with Art Papier of VisualDx
It’s said that 10-20% of all medical diagnoses are wrong. That’s a bit scary, but it’s not surprising. Medical diagnostics is inherently complex, the medical literature is always expanding, and doctors, like all humans, grapple with availability bias – they diagnose diseases they know instead of diseases they don’t. Diagnostic accuracy is clearly a problem.
Today’s guest is Art Papier, MD. Art is the co-founder and CEO of VisualDx. According to Art, there are common diseases and rare diseases, and there are common presentations and rare presentations. The bulk of diagnostic errors are made on common diseases with rare presentations. The goal of VisualDx, a clinical decision support system, is to “augment the brain” of physicians and help them make better diagnoses at the point of care.
On this episode, you’ll learn:
* The importance of being crystal clear on why you exist as a company. What problem are you trying to solve?
* Why and how most diagnosis errors oc…
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Oct 14, 2019
Environmental Services Optimization Playbook (ESOP) at HITS 2019
If we’ve established anything on The #HCBiz Show, we’ve established that healthcare is complex. And with a million priorities, each with its own complexity, it can be difficult to know if you’re doing any of it right. So, we do the best that we can with the knowledge, resources, and tools at our disposal, and put out the fires when they occur.
This, of course, can be very problematic when the work is more complex than it seems. And that is certainly the case when it comes to Environmental Services (EVS). We outlined the complexity of the issue at HITS 2018 with
The Environmental Services Optimization Playbook (ESOP) is a multi-disciplinary, cross-industry initiative to support reliable design (standardization of evidence-based practices) for environmental cleaning and disinfection in health care facilities in alignment with AHE Standards, to reduce the risk of HAI (healthcare-associated infection). As project lead Aaron Jett puts it, “it’s like bringing Coke and Pepsi toget…
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Oct 8, 2019
Who’s Got the Patient’s Back? with Patient Advocate Grace Cordovano
The healthcare system is not designed to serve patients. It may have started out that way, but it’s best we confront or current reality.
That’s not to say that the people working inside of this industry are bad. Not at all. Some of the best, most generous, and caring people I’ve ever met work in healthcare. Unfortunately, they, like the patients they serve, are merely inputs to a complex national healthcare system that’s evolved to serve itself and its ever-growing appetite for trillions of American dollars.
I don’t blame anyone for this. If you look at the history of how the system evolved, it makes a ton of sense that we’ve ended up here. And I’m encouraged by some of the emerging trends in the industry to pay for value, coordinate care and address the social determinants of health (SDOH). We'll get better, but it’ll take time.
In the meantime, what will I do if I or one of my loved ones gets sick? Like really, chronically sick where we need tight coordination acro…
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Sep 24, 2019
Ultraviolet Disinfection for High-Touch Hospital Surfaces with Proximity at HITS 2019
“Don’t find customers for your products, find products for your customers.” Seth Godin
That’s one of my favorite quotes and it’s exactly what Proximity did when they looked across the 1,500 healthcare facilities they were already serving with wall-mounted workstations and medication storage carts. They saw a ton of high-touch surfaces that were not being cleaned regularly and that were likely contributing to the spread of healthcare-associated infections (HAI). This observation led them to launch their UV-CLEAN line of products that automate the sterilization of high-touch surfaces like keyboards in the hospital. It’s an automated disinfection device that uses UV-C energy to inactivate microorganisms at the genetic level by scrambling their cellular DNA (link below if you want to see what that looks like under a microscope).
On this episode, we talk with Steve Reinecke and Jeremy Goza of Proximity. They explain the risks these high-touch surfaces pose to hospital staff an…
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Sep 18, 2019
Environmental Infection Control with Sodexo at HITS 2019
The costs and human impact of healthcare-associated infections (HAI) are well known and have been well documented on this show. And as we’ve seen there are industry best practices and proven science to help us prevent and control HAIs. Yet, running an Environmental Services (EVS) unit at a hospital is no easy task. How do you pick the right people, and train and retain them? What products should you use? How should you use them? How will you stay on top of the constantly changing regulatory landscape? And how will you keep up with the evolving science, technology, and best practices to ensure you’re doing all you can to protect your patients?
On this episode, we talk with Brooke Hossfeld, Infection Prevention Specialist and Jeff Bennett, Director of Marketing about Sodexo Healthcare’s infection control protocol, Protecta. With Protecta, Sodexo Healthcare aims to address infection control at acute-care hospitals with a full-service model that covers staffing, training, product, p…
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Sep 16, 2019
The Behavioral Side of Infection Prevention with Sanjay Saint at HITS 2019
Usually, we know what we need to do. But doing it is hard and we struggle. This is true for individuals. It’s true for organizations. And it’s true in healthcare, especially when it comes to behavioral side of infection prevention.
Sanjay Saint, MD, MPH addressed these issues in the opening keynote for the HITS 2019 conference in Buffalo, NY. We caught up with him at the event to discuss:
* What can we learn from the experiences of Ignaz Semmelweis?
* How to address the adaptive/behavioral component of infection prevention
* Addressing the culture and sub-culture so that we do the right thing every single time
* The power of being present with your patients and how to use rituals to get you there
* Understanding the significance of your interactions with the patient
* Creating a culture of excellence that polices itself.
Sanjay Saint, MD, MPH, is the Chief of Medicine at the VA Ann Arbor Healthcare System and the George Dock Professor of Internal Medicine at the Univ…
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Sep 12, 2019
Pay for Success in Social Innovation w/ Ruth Ann Norton
The evidence is clear. Addressing the social determinants of health can dramatically improve health outcomes and reduce spending in healthcare, social services, education, criminal justice, and more. The problem is that not all interventions can be isolated and measured, and the value is not always realized by the entity that pays the bill. This creates a tremendous amount of friction that prevents us from moving forward on initiatives that we all agree should happen. That’s where Pay for Success comes in:
Pay for Success (PFS) financing models are cross-sector partnerships in which funders pay upfront for a social service and then a government, healthcare, or other back-end payer repays the investment if, and only if, predetermined outcomes are met.
On this episode, we talk with Ruth Ann Norton, President & CEO of the Green & Healthy Homes Initiative (GHHI), about how they’re using Pay For Success to enable social innovation across the country. We discuss:
* GHHI’s history…
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Aug 29, 2019
Driving Down Pharmacy Spending w/ David Henka
Pharmacy Benefits Managers, better known as PBMs, are your classic middle-men. First, they buy medications from pharma manufacturers. Then they bundle those medications into formularies and sell that service to employers, plan sponsors and health plans. The problem is, there’s no transparency into how much PBMs pay for the drugs, and there’s a complex rebate system layered on top of that. With dug costs on the rise, it’s no wonder that many characterize PBMs as the bad guy, nor that the feds are taking aim at their business model.
Today’s guest tells us not to count on regulation to fix this. First of all, the pharmaceutical industry has strong ties to Washington and a very powerful lobby. That’s going to hold up any proposed regulation. Secondly, the regulations fail to address the underlying issues driving pharma costs today. But there is something we can do right now. David Henka, President and CEO at ActiveRADAR, tells us how they’re using reference pricing and therape…
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Aug 15, 2019
The Medicaid Transformation Project with David Smith - Part 2
Missed part 1? Check it out here: The Medicaid Transformation Project with David Smith - Part 1.
The Medicaid Transformation Project (MTP) is a national effort to transform healthcare and address related social needs for the most vulnerable. Throughout this two-year mission, health systems will implement innovative solutions that address challenges like behavioral health and substance use disorder. MTP aims to create long-term systemic impact over the next 10 years with the goal of improving the health of 75 million Americans.
On this episode, we talk with David Smith, who is the Project Executive for the Medicaid Transformation Project. David tells us how Avia, in partnership with healthcare leaders and Andy Slavitt, is on a mission to change the health and care of the Medicaid population by leveraging digital solutions and innovative care models to more effectively and efficiently meet its needs.
The Medicaid Transformation Project with David Smith – Part 1 discussed the theor…
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Aug 9, 2019
The Medicaid Transformation Project with David Smith - Part 1
The Medicaid Transformation Project (MTP) is a national effort to transform healthcare and address related social needs for the most vulnerable. Throughout this two-year mission, health systems will implement innovative solutions that address challenges like behavioral health and substance use disorder. MTP aims to create long-term systemic impact over the next 10 years with the goal of improving the health of 75 million Americans.
On this episode, we talk with David Smith, who is the Project Executive for the Medicaid Transformation Project. David tells us how Avia, in partnership with healthcare leaders and Andy Slavitt, is on a mission to change the health and care of the Medicaid population by leveraging digital solutions and innovative care models to more effectively and efficiently meet its needs.
There’s a lot to get into here, including:
* Who is Avia and why are they a good candidate to tackle this problem?
* How did Andy Slavitt get involved?
* Why does Medicaid n…
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Jul 22, 2019
Innovation with a Purpose: Jeremiah Gray of EarthSafe
There are two types of innovation.
First, there’s innovation in the underlying technology, tools or components that can be used to do something. Let’s call it local innovation. This ussually starts as experimentation with new ways of doing things just to see if it’s possible… to see what happens. It does not start with a specific problem and can be completely fueled by curiosity and a sense of wonder. Local innovation is important because it creates new opportunities that didn’t exist before. However, it is not the type of innovation that leads to real change in the world and we can get into trouble when we pretend that it is.
Second, there’s innovation in the way we actually do our jobs. Let’s call this systems innovation. Systems innovation must start with a problem that needs to be solved. The problem, or current state, is clearly defined and the cost to the system is well known. The desired state is also well defined, and we at least have a plan for how we will meas…
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Jul 11, 2019
Selling to Health Systems: Advice for Digital Health Startups (Part 2)
Part 2 of 2 - What happens when you take an experienced digital health buyer and an experienced digital health seller and have an honest conversation about the process of bringing new innovations into a health system? You get lots of not-so-obvious, but tremendously valuable insight into how to cross the moats successful health systems have been forced to build to keep you out.
Co-host Shahid Shah recently published a post with Brian Van Winkle on The Healthcare Blog titled: Perspectives on Working with Healthcare Systems for Digital Start Up Companies | Part 2. Shahid, an experienced digital health innovator played the role of the seller. Brian Van Winkle, an expert on bringing new technology into hospitals, played the buyer.
On this episode, Shahid and I discuss the key points from that interaction and tie them back to the principles we’re always talking about on The #HCBiz Show!
In part 2 we explore topics including:
* Getting the right people in the room
* Consultative se…
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Jul 3, 2019
Why HIEs Will Lead the Way on Healthcare Quality Measurement w/ John D'Amore
I've been saying it for years. The regional Health Information Exchange (HIE) should be your first stop for interop. That's especially true when it comes to quality measurement. Patients are going to get care in many settings and their data is going to be stored in many EHRs. According to today's guest, a sick Medicare patient may see 6-7 doctors in a given year! Proper quality measurement will require every hospital and every practice to proactively connect with one another AND solve the underlying data quality problems. FACT: It'll never happen.
I know what you're thinking. That's why we need to have interoperability in healthcare, right!? Well, as Thomas Edison said, "opportunity is missed by most people because it is dressed in overalls and looks like work." Healthcare interoperability has already been solved, but it requires a lot of hard work and we don't like that.
The good news is that there are strong HIEs operating across the country and they're in the business of doing t…
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Jun 27, 2019
Selling to Health Systems: Advice for Digital Health Startups (Part 1)
What happens when you take an experienced digital health buyer and an experienced digital health seller and have an honest conversation about the process of bringing new innovations into a health system? You get lots of not-so-obvious, but tremendously valuable insight into how to cross the moats successful health systems have been forced to build to keep you out.
Co-host Shahid Shah recently published a post with Brian Van Winkle on The Healthcare Blog titled: Perspectives on Working with Healthcare Systems for Digital Start Up Companies | Part 1. Shahid, an experienced digital health innovator played the role of the seller. Brian Van Winkle, an expert on bringing new technology into hospitals, played the buyer. On this episode, Shahid and I discuss the key points from that interaction and tie them back to the principles we’re always talking about on The #HCBiz Show!
We explore topics including:
* How health systems make decisions
* How health systems contract
* What it mea…
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Jun 19, 2019
Building Water Systems: The Sustainability and Public Health Nexus
Legionella outbreaks, which can cause the deadly Legionnaires’ disease, are on the rise. In 2017, the U.S. Centers for Disease Control and Prevention (CDC) reported 7,500 Legionnaires’ disease cases. Within the general population, 10% of those affected will die. In a healthcare setting, the death rate jumps to 25%. And according to the CDC, 9 out of 10 Legionella outbreaks were preventable. Sound building water health plans in a hospital/healthcare setting are critical.
Think about that… we have an engineering problem that’s causing 7,500 people to get sick every year, and there’s a known solution that can prevent 90% of it. How would we respond if 7,500 people were injured in bridge collapses each year? It’d be all over the news and we’d demand a solution. Well, that’s what we have with water systems in hospitals and long-term care facilities. This is a big deal.
That’s why NSF International and the National Association of Environmental Health (NEHA) are partnering…
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Jun 12, 2019
Decision Support for Selecting Digital Health Tools
Selecting digital health tools is tricky. There are thousands of innovators vying for your attention and dollars. They all promise to help you “get back to doing what you do best, caring for patients” (side note: I think that one has run its course – let’s move on marketers). But how can you be sure they’re selling something that will work for you?
That’s where Medigy comes in. It’s a decision support tool for selecting digital health tools. Our very own Shahid Shah is behind this one, and he’s created a platform that enables quantitative analysis of digital health tools to help you make objective purchasing decisions based on clearly defined objectives and key results, or OKRs. That’s fancy talk for: What does it do? Who is it for? How is it objectively measures and validated?
Shahid describes it as a kind of eternal digital health innovation challenge where innovators share they’re latest and greatest so that end-users and industry influencers can pick the winne…
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Jun 3, 2019
No BS and No PowerPoint: HealthImpact East in NYC
A great way to align your vision with the realities of the business of healthcare is to test your ideas and assumptions at conferences. Unfortunately, many of these events peddle hype and highly curated sales pitches rather than actionable intelligence that’ll help you get things done (or get to the “No”, which may be even more important to you right now). Sure, you’ll get valuable networking done in most cases, but we want you to get the most bang for your buck (and time) so you can get back to innovating and giving us great stories to cover. That’s why we told you about the Expo.Health event last week. And this week we’re sharing another event that’ll be very much worth an innovator’s time: HealthImpact East in NYC on June 12 and 13, 2019.
Co-host Shahid Shah has been involved with this one since its start in 2011. If you’re a fan of The #HCBiz Show, then you know that Shahid gets to the point very effectively. As the on-stage facilitator, you can count on Shahid t…
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May 30, 2019
Expo.Health with John Lynn
There are 100s of healthcare and Health IT conferences every year. Most of them are visionary. That is, they focus on the future. On what might come.
Looking forward is important, and frankly, a lot of fun, but it’s not going to change the way you do business today. That’s why John Lynn created Expo.health, and he’s here to tell us what we can expect from the next installment happening in Boston from July 31 – August 2, 2019.
Expo.Health is an opportunity for everyone to collaborate together on solutions that they can do today rather than opining about what’s going to happen in five or ten years from now. John Lynn, Founder of HealthcareScene.com and Expo.health
And when you’re focused on solutions for the near-term, it’s important to bring the whole team together. That’s why Expo.health is designed to serve the CIO and everyone that reports to them (especially the director level) at hospitals, health systems, large practice groups, and long-term care facilities (LTC…
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May 21, 2019
Taking Aim at Phony Doctor Reviews w/ Ted Chan
Fraudulent doctor reviews are a real problem. Ted Chan experienced it first hand while trying to help a loved one find a doctor online. In Ted’s words: “We found reviews that we thought were false or fake… so thought there was a opportunity to really represent the patient”.
And that’s exactly what Ted did when he launched CareDash in 2016. His goal was to create a healthcare provider directory and review site that was committed to transparency for both doctors and patients. Ted’s idea has resonated and CareDash has grown from 10,000 unique patients visits per month in March of 2018 to over 1,000,000 today.
On this episode, you’ll learn how CareDash identifies fraudulent doctor reviews and what they do about them. You’ll also learn how CareDash uses good SEO practices, online advertising, and quality content to drive their incredible growth.
This episode was recorded at the HITMC 2019 conference in Boston, MA.
Check out the full show notes and related content here: h…
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May 10, 2019
Visions of Disruption: What’s expected of Amazon in Healthcare?
Amazon has been a hot topic in healthcare for at least a year. And for good reason. With the acquisition of PillPak, the Haven initiative with JP Morgan and Berkshire Hathaway, Alexa HIPPA compliance, and the announcement that they’ll accept Health Spending Accounts (HSA), it’s clear that Amazon has big plans for healthcare.
When I was at the Healthcare IT and Marketing Conference (HITMC) in Boston last month, I got to talking about this with Jack Murtha and Tom Castles of Inside Digital Health and the Data Book podcast. To us it seemed like the industry was putting a lot of stock into everything Amazon was doing, or might do, and that many people see them as a potential savior for our dysfunctional healthcare system.
We didn’t question whether Amazon has the chops to shake things up in healthcare. Nor did we question the attention they’re getting. We did wonder if the high expectations of them were reasonable. We wondered if that optimism bordered on silver-bullet thinking.…
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May 3, 2019
The CMS NPRM: Opportunities from the Payer Perspective
The CMS NPRM (Notice of Proposed Rule Making) is much more interesting than many of the past interop-related rules. That’s because it gets specific. It gets specific about technology by calling out FHIR APIs. It gets specific about use cases, such as patient access to data, payer to payer interoperability for administrative data, etc. And surprisingly, it gets specific about collaboration by suggesting that all health plans look at the Da Vinci project and consider implementing its use cases.
On this episode, Don Lee and Shahid Shah examine the CMS NPRM from the payer perspective. Our goal is to help you understand what opportunities exist within the rule, and we explore topics such as:
* How health plans can benefit by making administrative data (i.e. claims) available to their members via 3rd-party app vendors. It can lower their long-term technology costs and improve their members’ perception of their service.
* Why good health plans should be thrilled with the requirement…
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Apr 16, 2019
HCLDR, Access 2022, and more with Colin Hung
On this episode, we discuss the power of online communities like
#HCLDR, a new push for healthcare interoperability in Canada called Access 2022, and much more. Our guest is Colin Hung, CMO and editor at HealthcareScene.com, and founder of #HCLDR.
Online Communities:
#HCLDR is a weekly tweet chat (Tuesday’s at 8:30 PM EST) that has been going strong for 7 years. It attracts an international audience of 150-200 people who generate 1,500-3,000 tweets and up to 12 million impressions.
This community, plus others like #HITsm were a huge influence on my path in healthcare and Health IT. In fact, The #HCBiz Show! started as the #HCBiz tweet chat. These communities provide a surprisingly effective way to network and learn new ideas, and they lead long term relationships. Ultimately, they took me to Toronto for this interview.
Canada has national healthcare… and still struggles with interoperability!?!?
That’s right! Interoperability is not magically “fixed” in a single pay…
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Apr 10, 2019
The Path to Healthcare Interoperability
There's a lot happening on the healthcare interoperability front:
* HIMSS has released a new definition for interoperability
* The CMS proposed rule is stacked with interesting use cases and is highly focused on making data available to patients.
* The ONC proposed rule attempts to address data blocking.
* Both proposed rules promote FHIR APIs.
* Emergency Triage, Treat and Transport (ET3) Model provides a business context for interoperability with a focus on outcomes.
Don and Shahid discuss each of these and pull out the actionable threads. This conversation sets up the next several episodes where we'll identify the opportunities that are being created and share ideas on how you can capitalize on them.
See full show notes and links here: https://thehcbiz.com/the-path-to-interoperability/
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Apr 3, 2019
Building a Social Network for Patients and Caregivers
On this episode, we talk with Brian Loew, founder and CEO at Inspire. They've built a social network for patients and caregivers that provides a safe place for them to share their stories and learn from people like them. And it empowers patients to raise their hands and volunteer to participate in research that could advance treatments for their disease.
It definitely fits the #HCBiz template for a solid healthcare business: Good for patients. Good for society. Good for the business of healthcare. Listen in to find out how it works, how trust is built and maintained, and how it is all sustained.
Check out the full show notes and links here: https://thehcbiz.com/social-network-for-patients-and-caregivers/
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Mar 27, 2019
Top 10 Things to Ensure Success in a Value-based Healthcare World
The transition to value-based healthcare is official. It’s happening. The only question now is how painful the road will be, and how effective we’ll be in improving outcomes and controlling costs.
The fate of your healthcare organization will largely be determined by how you decide to proceed. Will you embrace value-based healthcare and enter into it on your own terms? Or will you sit back and wait, and ultimately be forced into it?
On this episode, we hear from Jason Helgerson, founder of Helgerson Solutions Group and former Medicaid Director for the State of New York. Jason shares with us his top 10 list of things you can do (should do? must do?) to ensure success in a value-based healthcare world. Unsurprisingly, sitting by and waiting for it to pass, didn’t make the cut.
This keynote address was recorded at the VBP Forward conference held in Buffalo, NY on February 20 & 21, 2019. Jason goes into great detail on each of the 10 items and provides examples for how they work i…
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Mar 11, 2019
Deep Medicine with Dr. Eric Topol
The way we practice medicine today is broken. We prioritize the business and treat the patient as nothing more than a cog in our great machine. According to today’s guest, ” we have an emotional breakdown, with disenchanted patients largely disconnected from burned-out, depressed doctors.” Dr. Eric Topol calls this epidemic “shallow medicine”. It’s driven by runaway healthcare costs and an insatiable drive for increased efficiency and profits, and unfortunately, is largely the way we deliver healthcare today. Because of this, Topol says, “patients exist in a world of insufficient data, insufficient time, insufficient context, and insufficient presence.”
But, Dr. Topol is optimistic. He believes that Artificial Intelligence (AI), while still finding its place in medicine, and still mostly unproven in real-world clinical situations, can create the space we need to change course.
In his new book, Deep Medicine, Dr. Topol makes an optimistic, but realistic argument for ho…
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Feb 10, 2019
Healthcare Is Not Quite Digitized w/ Bill DeStefanis
We've effectively digitized medical record via EHRs, but the healthcare industry still relies heavily on paper for many of its workflows and supporting documents. On this episode, we talk with Bill DeStefanis, Director of Product Strategy at Nuance about how and why paper is still widely used in healthcare, how we can keep it secure, and how we can effectively integrate it into our digital workflows.
About Bill DeStefanis:
As Nuance’s Director of Product Strategy, Bill brings more than 20 years of experience in the software industry to the position. He is responsible for defining Nuance Imaging product strategy and vision. During his time at Nuance Bill has lead product management teams designing solutions that automate document workflows. Before joining Nuance, Bill was held various product management positions in companies developing voice recognition and natural language processing applications. He holds an MBA from Suffolk University.
About Nuance:
We are reinventing the…
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Jan 31, 2019
Value-based Payment: Progress, Trends and Direction w/ Jason Helgerson - 089
On this episode, we talk with Jason Helgerson, founder of Helgerson Solutions Group and Former Medicaid Director for New York and Wisconsin. Jason shares his perspective on Value-based payment progress and direction tells us who needs to get involved and how, and we discuss how to measure success. That is, how will we know if value-based payment has been adequately deployed, and more importantly, how will we know if it's working?
This episode is sponsored by VBP Forward:
VBP Forward will host its inaugural conference February 20-21, 2019 in Buffalo, NY at the Hyatt Regency Buffalo. The conference will bring together over 200 professionals who serve Medicaid and Medicare special needs or complex populations or have an interest in that value chain. Participants will gain insight into the next generation of value-based payment and will be provided with a roadmap for their path towards effective value payment for special needs populations. In addition to clinical providers, VBP Forward…
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Jan 28, 2019
Healthcare's Value Based... Experiment? w/ Guest Host Janae Sharp
What's the difference between value-based care and value-based payment? How can we attribute outcomes and cost savings to specific innovations in care delivery? Does anyone really know what they're doing? What do the patients think? Who needs to be at the table to figure this all out?
On this episode, guest-host Janae Sharp asks Don Lee and Shahid Shah about the VBP Forward Conference happening in Buffalo on February 20th and 21st. And we try to break down what's really happening in the move from Fee For Service to Value-based healthcare.
See full show notes at https://thehcbiz.com/ep88-value-based-experiment/
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Jan 16, 2019
What's Driving Consolidation in Healthcare? w/ Amanda Hansen, AdvancedMD - 087
Mergers and acquisitions activity in healthcare ranked third behind energy and media entertainment in terms of total deal volume in the first half of 2018. And from what we can tell, things didn't slow down after that. Of course, you have the big deals like CVS-Aetna, Cigna-Express Scripts, and Amazon-Berkshire Hathaway-JP Morgan. And the much-hyped entrance from tech giants like Apple. But we're also seeing a ton of consolidation in specialty practices, software companies and more. The rise of value-based payment is certainly a factor, but the market is complicated and there are many, less obvious factors at play.
On this episode, Amanda Hansen, Vice-President of Strategy and Business Development for AdvancedMD breaks down the M&A activity and industry trends to help us understand what's happening, and why.
For more information about this episode, and full show notes, visit: https://thehcbiz.com/ep87-healthcare-consolidation-amanda-hansen
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This episode is sponsored by VBP Forwa…
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Dec 29, 2018
The Future of Value-Based Payment w/ François de Brantes of Remedy - 086
On this episode, we talk with François de Brantes, Senior Vice President of Commercial Business Development at Remedy, about the future of value-based payment. François shares with us the importance of transparency, measurement, and responsibility and tells us why payment reform is such an effective lever to drive change. You'll hear about models that have been successful, how employers are driving change, and what you can expect from the next generation of value-based payment. In addition, François shares his insights on how we can account for the social determinants of health (SDOH) in our program design. This section led to a significant "aha" moment for me and underscores the importance of incorporating community-based organizations (CBOs) more tightly with our traditional healthcare delivery system.
View full post and show notes on the web
François de Brantes will be a keynote speaker at the inaugural VBP Forward Conference in Buffalo, NY on February 20th and 21st, 2019.
Th…
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Dec 19, 2018
Lessons on Selling in Healthcare w/ Dom Cappuccilli - 085
Selling is hard. Whether you're selling an idea, service or product, you've got to get to the core of the issue quickly or you'll lose your audience. And the challenge is notoriously exacerbated by the risky, regulated and complex healthcare system you're selling into. That's why we're talking with Dom Cappuccilli from The Clean Sell. Dom's a storyteller turned sales guy who's been successful in both inside / direct sales and enterprise sales. Dom shares some of his most important lessons from the journey like:
* How to avoid common sales mistakes like over-reliance on your deck
* Why no-one cares about your solution and how to get to the core of their problem with needs alignment
* How to use relevance hooks to earn the right to share more
* Why you should always reach out to 5 or more people at a large organization (and no... they won't get mad at you)
There's much more too. At the end of the day, Dom shows us that these aren't lame sales tricks to get what you want. No. Th…
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Dec 11, 2018
HITS 2018 Recap w/ Dr. Kelly Reynolds and Savannah Hatt - 084
This episode is part of our in-depth coverage of the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN that took place September 18-20th.
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On this episode, we wrap-up our coverage of the HITS 2018 conference. We talk with HITS board members Dr. Kelly Reynolds and Savannah Hatt about what we learned at the 2018 conference, what's next for the HITS Consortium, how you can get involved, and what to expect from the HITS 2019 conference in Buffalo, NY.
Show notes:
2:32 A great time in Nashville
3:33 Summary of the insights you missed at HITS 2018
4:58 How clean is clean enough?
6:47 A Bundled Systems approach: Designing for Clean.
7:55 After measuring how healthcare facilities are achieving reductions in hospital-acquired infections (HAI), HITS has assigned quantitative values to infection prevention investments called Clean Credits. As you layer different interventions into your system, Clean Credits will quantify what your expected ROI…
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Nov 29, 2018
Healthcare Trends: A Crossover w/ David Shifrin and The Future of Health Podcast - 083
This is a crossover episode with David Shifrin from The Future of Health Podcast and Health:Further. We cover three main topics that have been coming up a lot on our podcasts:
Care Transitions
* Anytime a patient is moved from one care delivery location to another you need to have contextualized data exchange.
* If care coordinators don’t have the right data, how could the patient?
* How can technology help educate patients and increase discharge instruction adherence?
* Telehealth for post-discharge follow-ups. Use telehealth for increased touchpoints and a better doctor-patient relationship.
* Bruce Greenstein former HHS CTO, says we must address high utilizers. When you fix big spenders, you free up money for innovation.
Clinical Decision Support
* How do you help providers be more effective at their job?
* A reliable, unbiased assistant to help evaluate data more quickly. Examples: ILÚM Health Solutions, VisualDX.
* Still skepticism around layering another…
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Nov 15, 2018
Addressing SDOH One Factor at a Time w/ Dr. Virginia Gurley - 082
The social determinants of health (SDOH) are a hot topic in the healthcare industry. And rightly so:
"Social, economic, and environmental issues have been shown to influence the length and quality of life by 50%, according to community health research. In comparison, only 20% is tied to the clinical care provided to community residents."
Virginia Gurley, Sr. Vice President and Chief Medical Officer at AxisPoint Health
But SDOH is not a new concept - it's just modern terminology for something called Social Epidemiology. What's new, is the ability to apply SDOH data to expand existing predictive models of risk stratification. By identifying the patients that are at the highest risk both clinically and socially, you can help care coordinators get much more tactical and concrete about supporting the individual.
On this episode, Dr. Virginia Gurley, Sr. Vice President and Chief Medical Officer at AxisPoint Health joins us to explain how to put SDOH data to work.
Read the full post here…
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Nov 6, 2018
4 Industry Waves Impacting the Medical Practice w/ Ken Comée of CareCloud - 081
If you're a medical practice, 4 major industry waves are rocking your boat. New demands bring new opportunities for fast practices that can quickly get physician alignment around a strategy that will maintain physician autonomy and increase reimbursement. Equally as important, the patient expectation has changed. They demand convenience and flexibility and want to interact with their care in new and innovative ways. Physicians can accept this, or ignore it at their own peril.
I'm fortunate to be joined today by Ken Comée, CEO of Carecloud who will shed some light on these 4 waves:
* Migration to a modern, cloud-based infrastructure
* Practice consolidation
* Value-based care
* Consumerism and the new patient expectation
We break down what the 4 waves are, what they mean for practices and how practices can capitalize on the change. Enjoy!
0:56 What does CareCloud do and who do you do it for?
2:40 The smartphone has changed everything. What do doctors need to do to moderniz…
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Oct 31, 2018
How to Launch and Grow a Virtual Care Service w/ Henry Ford Health System and Vidyo - 080
Virtual Care. Telehealth. Telemedicine. Whatever you call it, there are very real benefits to patients and health systems when you do Virtual Care right. But there are many obstacles too. On this episode, we talk with Courtney Stevens, Director of Virtual Care at Henry Ford Health System and Brian Young, Director of Healthcare Solutions Marketing at Vidyo about how to develop a Virtual Care strategy, gain buy-in from clinicians and patients, deliver service and measure success along the way. They provide a comprehensive overview of the process from start to finish with actionable advice about what to do at each step of the journey. Highlights from "How to Launch and Grow a Virtual Care Service"
1:36 Henry Ford Health System is celebrating 100 years of helping patients!
3:00 Vidyo specializes in digital enablement. They manage a portfolio of capabilities that allow doctors to deliver care digitally.
4:15 Is it Telehealth or Telemedicine? Neither. It's Virtual Care.
9:58 What does vi…
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Oct 25, 2018
HCAHPS and the Patient Safety vs. Patient Satisfaction Conundrum w/ Christine Greene and Maurits Hughes from HITS2018 - 079
This episode is part of our in-depth coverage of the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN that took place September 18-20th. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures a patient's satisfaction with the quality of their care during their stay at the hospital. It measures things like staff communication and attentiveness, discharge information, food service, and the hospital environment. These are important measures and every hospital should strive for excellence in each of them (we talked about this in our last episode). However, and as is often the case in healthcare, the HCAHPS survey can have unintended consequences.
Typically, the Environmental Services Department (EVS) is given responsibility for the hospital environment portion of the score. And this too makes sense. They're the ones clea…
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Oct 24, 2018
Clean Air and Patient Satisfaction w/ Samantha Kitchen of Radic8 from HITS2018 - 078
This episode is part of our in-depth coverage of the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN that took place September 18-20th. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.
There are plenty of reasons to be concerned with air quality in the hospital environment. The obvious ones are related to patient safety, but as we move toward a more consumer-directed healthcare system and as CMS continues to incentivize a positive patient experience through HCAHPS surveys (Hospital Consumer Assessment of Healthcare Providers and Systems) and other programs, it's important to address patient perception too.
On this episode, we're talking clean air and patient satisfaction with Samantha Kitchen, Director at Radic8 Ltd. Sammy explains how a well-placed air quality system can eliminate air contaminants, alleviate foul smells that leave a bad impression, and give patients peace of mind. A few highlig…
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Oct 17, 2018
Preventing HAIs at the Source w/ Al Wickheim and Laura Barker of Prodaptive Medical Innovations from HITS 2018 - 077
This episode is part of our in-depth coverage of the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN that took place September 18-20th. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.
Benjamin Franklin told us that “an ounce of prevention is worth a pound of cure”. Healthcare-associated infections (HAI) cost U.S. hospitals as much as $45 Billion per year. We've covered many of the ways you can combat HAIs and we just spoke with Michael Rochon (also at HITS 2018) about how to improve our hospital cleaning procedures. Proper hospital cleaning and disinfection certainly satisfies the Franklin axiom, but what if we step back further. How did the contaminants get on the hospital surfaces in the first place? What if we could prevent some of that? Well, that's exactly what today's guests are doing. Many common healthcare procedures create sprays and splashes that spread contaminants to walls, ceili…
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Oct 17, 2018
Bringing Science to the Art of Hospital Cleaning w/ Michael Rochon from HITS2018 - 076
This episode is part of our in-depth coverage of the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN that took place September 18-20th. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.
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Hospital cleaning is one of the most important activities in Infection Prevention and Control. However, chemical cleaners that aim to kill all of the microbes aren't always as effective as you might think. At least not by themselves. And they have some serious side-effects too. Today's guest is Michael Rochon, a pioneer chemical formulator and President of Process Cleaning Solutions Ltd. Michael explains why physical cleaning followed by disinfecting may be the best approach. It allows us to reduce the microbes to a safe level while lessening the side-effects of harsh chemicals on the hospital environment. Plus, and this is really fascinating, it reduces the spread of microbes that become immune to the chemica…
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Oct 10, 2018
Why Healthcare Needs a Systems Approach with Jason "The Germ Guy" Tetro from HITS 2018 - 075
This episode is part of our in-depth coverage of the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN that took place September 18-20th. Check out all our HITS 2018 episodes here, and look for more throughout the month of October. Adapted from Jason "The Germ Guy" Tetro's Opening Keynote at HITS 2018
Have you ever written the perfect checklist? You left no stone unturned and accounted for every possible step that needed to occur. You trained your staff. Everyone was understood and was on board. But you still failed.
Today’s guest would tell you that you failed because you took a systematic approach when you really needed a systems approach.
A systematic approach takes all the facts into consideration and manifests itself as guidelines, a checklist or standard operating procedure (SOP). It’s based in science and best practice. On paper, it makes all the sense in the world.
A systems approach considers much more. How does your guideline…
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Oct 8, 2018
Quality Talks 2018 Preview | Andy Reynolds | NCQA - 074
When it comes to healthcare conferences, it's easy to get stuck in an echo chamber. Too often it's the same ideas about the same topics from the same people. That's why I found last year's Quality Talks event so refreshing. NCQA brought together a varied set of speakers and topics that were guaranteed to offer a fresh perspective to anyone who attended - they certainly did for me. Plus, as a 1-day event, it was easy to get in and get out without disrupting my entire week, and the deep, TED-style talks were a welcome break from the typical stream of panel discussions.
Since I enjoyed it so much last year, I decided to give you this short episode to preview the 2018 event. My guest is Andy Reynolds, Assistant VP of Marketing and Communications at NCQA and the master of ceremonies at Quality Talks. Andy tells us about Quality Talks 2018, the tracks and speakers and explains what NCQA is trying to accomplish with the event.
Quality Talks 2018 takes place on October 22, 2018, in Washingto…
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Oct 2, 2018
The New Patient Journey and its Impact on Healthcare Marketing w/ Carrie Liken of Yext - 073
The patient journey has changed drastically in the past 5 years and it's having an outsized impact on healthcare marketing. You know about the "Google-effect", but did you know that 83% of patients are not going to the hospital website to research doctors and services? And now with Alexa, Apple Car Play and Android auto, voice-first is adding a brand new wrinkle. In short, there are many ways for your patients to find you and if you aren't managing the digital landscape, then you're missing out. Proper branding across channels makes it easier to be discovered and signals to your patients that your company is trustworthy.
On this episode, me and Shahid Shah are joined by one of healthcare's leading experts on the patient journey, Carrie Liken. Carrie is the Head of Industry for Healthcare at Yext, and she helps us sort it all out. The New Patient Journey and its Impact on Healthcare Marketing
1:51 How has the patient journey changed in the last five years? What sort of impact is it ha…
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Sep 19, 2018
Robotic Surgery: Business Cases, Benefits and Myths | Dr. Roger Smith | The Nicholson Center - 072
Robotic surgery is a loaded term. Just reading the words can bring Hollywood-inspired images of fully autonomous robot doctors to mind. But that's not what's happening in the industry today. The "robots" are merely tools used by doctors, just like a stethoscope or a scalpel. And they have some interesting use cases and value propositions to health systems. For example, they can act as a great equalizer by helping young surgeons perform subtle movements that would otherwise take them years to perfect. But there's a flip side. Studies like this one from Stanford question the value of robotic tools that yield similar results and raise costs. There's truth to that, but as always, there's nuance and the headlines don't always mean what suggest. Imagine that.
On this episode, Shahid Shah and I are joined by Dr. Roger Smith, Chief Technology Officer for Florida Hospital's Nicholson Center for Surgical Advancement. Dr. Smith took a break from profiling surgical robots in his Robot Of The Day…
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Sep 12, 2018
Transforming the Prescription Decision Process Between Physicians and Patients w/ Surescripts CEO Tom Skelton - 071
Unanticipated high out-of-pocket prescription costs negatively impact patient safety and may lead to increased healthcare spending later. According to the Truven Health Analytics-NPR Health Poll for Prescription Drugs (June 2017), the most cited reason by respondents who did not fill their prescription was cost (67%).
Prior-authorization is another hurdle, and when it's required, according to today's guest, medication adherence drops precipitously.
In general, medication treatment failures due to a variety of issues, including medication non-adherence and friction from prior-authorization are a big problem in U.S. healthcare. Patients don't get the care they need and it costs the healthcare system an estimated $500-672 Billion each year (Note: It's often said that medication non-adherence costs $300 Billion - and I referenced that number on the show, but that's a bit hazy as this article explains).
The bottom line is this: administrative functions, high drugs prices, and increased o…
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Sep 3, 2018
The California Provider Directory Utility w/ Jon McBride & Rajan Shah - 070
We've talked extensively about the problem with provider directories. It's a fundamental issue in healthcare administration and many of our processes are built on top of it. I've called it healthcare's ultimate death by paper cut. Now, we're starting to see new solutions in the market. Last week we looked at an open-source industry solution. This week we're looking at the statewide effort in California.
California's Senate Bill 137 (SB-137), the "toothiest" provider directory law to date, set the stage for a state-wide collaboration that would have been otherwise difficult to attain. Today I'm joined by Jon McBride, CTO at Integrated Healthcare Associates and Rajan Shah, VP of Business Development at Gaine Healthcare to learn more about California's Provider Directory Utility and find out what happens when you get the entire healthcare industry rowing in the same direction to solve a well defined problem.
3:25 The Integrated Healthcare Association convenes diverse stakeholders to sol…
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Aug 22, 2018
An Open Source Industry Platform for Provider Directory | Gunjan Siroya | RosterSource - 069
We've talked extensively about the problem with provider directories. It's a fundamental issue in healthcare administration and many of our processes are built on top of it. I've called it healthcare's ultimate death by paper cut. Today we're going to talk about solutions. On this episode, I talk with Gunjan Siroya, Principal Partner at Netspective, about RosterSource. It's an open source industry platform that enables physician roster data exchange across systems and organizations, securely and in real-time.
0:00 Setting the stage for today's discussion on Provider Directories.
3:14 What is RosterSource? RosterSource enables you to communicate securely without additional burden to the provider or practice.
6:19 How do you send data from provider to payer without extra work? RosterSource created a platform for exchanging real time physician demographics through a centralized hub that can be accessed by whoever the provider allows.
8:37 Each practice or health system has a Node. Thi…
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Aug 15, 2018
Cost Savings Opportunities on the Business Side of Healthcare | The CAQH Index | Reid Kiser and Dr. Kristine Burnaska - 068
$11.1 Billion. That's how much, according to the 217 CAQH Index, the healthcare industry could save by transitioning to fully electronic administrative transactions. The transactions are for things like claim submission, eligibility and benefit verification, pre-authorization, etc. These are clearly defined standards and many of them are widely adopted. This is real interoperability in healthcare and it's in place today. Yet, not everyone is participating. Why is that? How can we expand adoption and realize the tremendous value that's available for the taking? And what can we learn from this process to help us achieve real interoperability in other areas of healthcare?
My guests today Dr. Kristine Burnaska, Director of Research and Measurement at CAQH and Reid Kiser, Lead Researcher of the 2017 CAQH Index tell us how the CAQH Index measures the cost of administrative transactions in healthcare and gives us a detailed look into the industry's progress. More importantly, they help us to…
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Aug 7, 2018
HITS 2018 - A Catalyst for Change in Infection Control - 067
Controlling the transmission of infections isn't one person's job and it can't be measured with a few key performance indicators. It's breaking down barriers to allow for collaboration between all interested parties. And that's exactly what's being done at the Healthcare Infection Transmission System (HITS) Conference this September 18-20th in Nashville, TN.
Today I'm joined by Dr. Christine Greene, Principal Research Investigator for the Sanitation and Contamination Control unit of the Applied Research Center at NSF International and Dr. Kelly Reynolds, Professor and Chair of the Community, Environment and Policy Department at the College of Public Health, and Director of the Environment, Exposure Science and Risk Assessment Center at the University of Arizona. We discuss the challenges and opportunities in infection control and prevention as well as get a sneak peek of what's to come at this year's HITS Conference. Enjoy!
NOTE: Find extensive coverage from The #HCBiz Show! on Infec…
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Aug 2, 2018
Finding the right words - Stacey Richter - Relentless Health Value Podcast - 066
How do you get everyone to stick to the strategy? With doctors, CEOs, and Congress all trying to move healthcare forward, where is the progress? This week's discussion dives deep into the components of making change happen. From shared understanding to aligned incentives, Stacey Richter from the Relentless Health Value Podcast and I explain why change is so hard and how to get everyone working towards a common goal.
0:43 Everything in the industry is viewed very differently by different parties. There are different, sometimes conflicting incentives for each party. When you understand their motivations, you start to understand why certain moves make sense.
2:57 If you don’t have a language you can’t have conversation.
4:43 Organizations are realizing they need to work together. If you can’t talk about shared priorities it’s really difficult to collaborate.
6:49 Transparency is becoming more known as consumers start to have access to pooled information. The cascade to transpa…
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Jul 26, 2018
The Right Kind of Patient Education - Stacey Richter - QCHealth - 065
What a patient does at home during the time between doctor visits has the largest effect on the outcome of their care. The instructions doctors and nurses give patients at the point of care varies greatly and give health systems an opportunity. Stacey Richter, Co-President of Aventria Health Group and host of The Relentless Health Value podcast joins me to talk about her new company QCHealth and how patient education can have a huge affect on quality metrics.
2:04 Are we defining patient education?
4:02 What is outcome guided engagement?- care plan is series of outcomes, how do we get people to remember what we’re saying, sometimes they don’t remember appointments either.
7:30 What does evidence based medicine say are engagement opportunities along the patient pathway?
9:40 What needs to happen during that moment in time? Does the patient know the WHY behind their treatment plan?
13:20 Patient education is currently everywhere. It’s a commodity. But education needs to be med…
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Jul 19, 2018
LexisNexis and AMA Collaboration on Provider Directory | Dara Prince-Olsen | Tammy Weaver | 064
Patients are buying health insurance based on misleading information. Incomplete or incorrect provider directories can obstruct patients from accessing care. Additionally, the healthcare industry is building its administrative workflows on top of this bad provider data, creating all types of inefficiency. Today on the podcast I'm joined by Dara Price-Olsen and Tammy Weaver to discuss the LexisNexis and AMA collaboration on Provider Directories. We hear a story early on showing how easy it is to be fooled into purchasing a restrictive or needlessly expensive plan. We also get into the details on how claims data can give us new insights to help fix this problem.
Check-out our extensive coverage of the problem with and attempts to fix the Provider Directory issue.
2:02 Background of the provider directory issue: patient access and administrative burden.
4:50 Consumers are having coverage issues making it hard to shop for healthcare due to incorrect info.
6:44 The patient perspective.…
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Jul 7, 2018
Internet Marketing for Healthcare Practices - Garrett Smith - 063
Even the best doctors in the world can have their patients stolen away by savvy online marketing. Practices are doing their patients a disservice by not doing everything they can to prevent that from happening. In this episode, I sit down with Garrett Smith, CEO of InboundMD and author of Book Now! Internet Marketing for Healthcare Practices, to discuss how everyone from large practices to solo docs can improve their online marketing. Garrett lays out an easy-to-use checklist to rev your marketing engine from 0-60 in as little as 1 hour a week. Get ready to take notes. Your future patients will be glad you did.
1:00 How InboundMD provides an all in 1 marketing solution for healthcare practices.
3:27 Even if your patients search specifically for you, they’re going to see other docs right next to you. You STILL have to stand out. Two scenarios...
8:23 The patient decision-making process is not happening on your page. There are lots of online nooks and crannies. You must have a large…
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Jun 29, 2018
How to pitch a journalist before a conference - Jeff Byers - Healthcare Dive - 062
Having a great product is not always enough to be news worthy. It is much easier to get noticed at a conference when you know what journalists are looking for. On this episode, Shahid and I get a behind the scenes look at how to hack healthcare news. Jeff Byers, Associate Editor at Healthcare Dive, tells us how he spots trends, how to pick which conferences to attend and shares dozens of tips for how to get your company's story placed above the fold.
1:25 How you can reach out to get PR before a conference.
2:47 The journalist's conference to-do list: Writing, networking, industry knowledge gain, promotion, source building, assignments, interviewing individuals.
5:47 Categories of story topics for HIMSS vs HLTH
7:51 Does Healthcare Dive try to set the agenda for what everyone should be talking about or do you do more reporting on and explaining what is already out there?
11:10 Deciding which topics to write about is the biggest struggle. Do you write what you as the writer care ab…
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Jun 25, 2018
The Role of a CMO at a large EMR Vendor - Dr Betty Rabinowitz - Nextgen Healthcare - 061
Software that supports EMR needs to change and evolve at the same pace as medicine. Getting clinicians on the front lines the tools they need to make decisions is a team effort. On this episode, Shahid and I sit down with Dr. Betty Rabinowitz to talk about her new position as CMO at NextGen and how her team plans to improve the lives of those who practice medicine and those they care for.
1:16 Dr. Betty's journey from primary care to startup to Nextgen CMO.
4:40 How the physician perspective can improve the EMR implementation.
6:25 Should physicians be building software, advising the product team, or treating patients? Which physicians fit best into these roles?
9:03 The 3 tiers of tech-savvy clinicians. How do we ensure all voices are heard?
11:04 One of the main roles of a CMO in a software company is as a skilled guide who can filter the signal from the noise.
13:45 The most important focus for any med tech company: What’s best for the patient?
14:15 Analyzing evidence from…
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Jun 23, 2018
TEFCA, Interoperability, and an Industry's Unreasonable Expectations w/ Niam Yaraghi - 060
In the rush to implement EHR and meaningful use, did we forget about interoperability? Congress thinks there should be more to show for the billions of dollars already spent on EHR. Now, they've asked the Office of the National Coordinator (ONC) to give guidance for the future. On this episode, Shahid and I sit down with Niam Yaraghi to discuss what TEFCA is and what it means for interoperability and the business of healthcare.
The problem with all this is that no one can clearly articulate what interoperability (or data blocking for that matter) is. In reality, healthcare has already solved interoperability about as well as any other industry. If you show me two parties who want to exchange data, and are willing and able to fund the effort, then I'll show you interoperability.
Further, there are robust regional Health Information Exchanges (HIE) throughout the U.S. And as I have said many times before, the regional HIE is the only near-term option to solving for interoperability in…
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Jun 19, 2018
Automating Healthcare Data Collection | Adam Klass | VigiLanz - 059
Electronic health records were built to help organize notes but only recently have developers begun to tap their true potential. Providers can now be aided at the time of service with actionable healthcare intelligence to support a variety of initiatives. From decision support to adverse event prediction, Adam Klass gives us a glimpse of how VigiLanz is improving care and saving doctors time.
This episode was recorded at the Health IT Expo. You can find more of our coverage of the conference here.
:30 Introduction to Adam Klass and VigiLanz – How we automate manual data collection.
1:09 What data VigiLanz helps collect and how do they use it?
3:11 Who does this help most?
4:24 The 3 Pillar Services – Infection Prevention, Pharmacy best practices, Antimicrobial Stewardship.
6:31 What’s coming next: Predictive intelligence and time of service alerts in your EHR.
8:43 What do administrators need to know? Your EHR was not built to help reinforce best practices.
10:04 How do y…
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Jun 18, 2018
What you don’t know about your data CAN hurt you | Jeff Garbus | Soaring Eagle - 058
How much money would your business lose every second your database is down? How long would it take to get it back up and running? Would you be able to answer these questions on your own? Probably not. That's why Jeff Garbus started Soaring Eagle Database Consulting. In this episode, Jeff takes us on a fast-paced journey through the ultimate data management insurance process and shares some of the most common issues CIOs get blind-sided by. Don't lose focus and get your pens out because you will be talking about this with your team first thing tomorrow.
This episode was recorded at the Health IT Expo. You can find more of our coverage of the conference here.
0:33 "I'm a database geek." - Intro to performance, tuning and scalability.
2:33 CIO’s call me and say, "Give me a check-up!"
3:10 What you don’t know about your data can hurt you! Top 2 things CIOs need to be thinking about right now, so it doesn't burn you in the future. Is your data retrievable? Data corruption used to be…
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Jun 9, 2018
Casino Loyalty Programs and the Healthcare Experience - Vishal Agarwal - CareCognitics - 057
Thinking about the endless paperwork, long wait times, and confusing bills at the doctor's can make even healthy people feel like their luck ran out. Just because it's not concierge medicine doesn't mean it can't be concierge service! In this episode Vishal Agarwal, Co-Founder and COO of CareCognitics, shares with us how his years in the casino industry have taught him to give patients the VIP treatment and make the doctor's office feel more welcoming.
0:51 What does CareCognitics do?
1:33 What can the casino industry’s loyalty program teach healthcare? A master class in the logistics of customer service. What does the casino do when it’s not your lucky day?
5:45 We know chronic conditions need to be managed. Why not give them the concierge service?
8:33 Loyalty programs, like healthcare, work best with the right incentives.
9:48 Which incentives do patients prefer and which incentives should doctors use?
11:40 How CareCognitics enables customer service that drives patient en…
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Jun 7, 2018
Innovation Centers, VR and Clinical Decision Support | UCHealth, AgileMD and Health Scholars at the Health IT Expo - 056
Leading healthcare providers are always looking for new ways to help their patients and bend the cost curve. New technology companies are always looking for early adopters to try their products. You'd think it'd be easier to match them up, but if you've been on either side of that equation then you know how hard it actually is. On this episode Vice President of Innovation at UCHealth, Julie Reisetter takes us through how her team finds the right partnerships for her health system. We also hear from existing UCHealth partners Borna Safabakhsh, CEO of AgileMD and Cole Sandau, CCO of Health Scholars on the innovative work they're doing and what it's like to partner with a health system.
This episode was recorded at the Health IT Expo. You can find more of our coverage of the conference here.
Julie Reisetter – VP of innovation at UC Health
0:00 Introduction to UCHealth
2:00 Origins of UCHealth and big problems they were trying to solve: Wayfinder into hospital, EMR user experience,…
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Jun 7, 2018
Healthcare IT Entrepreneurs’ Dilemma: Surviving the Valley of Death - Dexter Braff at the Health IT Expo - 055
It is the Healthcare IT Entrepreneurs’ Dilemma. In order to become a Unicorn, you either have to survive or take a long detour around the Valley of Death, that strange netherworld where the value of your company can actually drop once you become marginally profitable. As counter intuitive as that may seem, it is strangely logical once you realize that valuation – especially in technologically innovative sectors – is rooted far more in “behavioral economics” than rigorous math. On this episode, Dexter Braff explains the phases of value a health IT company can anticipate and the challenges – and opportunities – it may face as it moves through them.
This episode was recorded at the Health IT Expo and is based on a breakout session by the same title that Dexter Braff led there. The description rove is adapted from the conference program.
Show Notes:
1:40 Who is Dexter Braff and the Braff Group
2:07 Stages of a company: Concept, Maybe Baby, There’s a there there, Breakou…
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Jun 5, 2018
Validating Performance Claims in Healthcare - Linda Riddell - Validation Institute - 054
When the promises of workplace wellness programs and population health analysis don't live up to expectations, lack of trust can stifle growth for the entire sector. Linda Riddell tells us how to bypass savvy marketing to help employers and health systems evaluate if vendors' claims match reality. Care Innovations' Validation Institute is rescuing outcome measurements by rigorously checking the math and methods before giving their stamp of integrity.
Show Notes:
1:35 – What is the Value Institute? – Review of outcome measures
5:50 – Meaningful outcome measures – Simple questions with big predictions
7:12 – The holistic approach to measuring the health of a population and how third parties work with employers.
9:50 – Direct vs. indirect measures of health in a population: challenges and expectations for employers
10:45 – Data protection, 3rd party vendors, neutral middle man, confidentiality
13:10 – Validation Institute origin story
14:45 – First customers and…
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May 30, 2018
What exactly is Precision Medicine? with Prashant Natarajan
The promise of AI-driven precision medicine creates confusion around what problems can be solved with data. After a lengthy career as an expert consultant helping industry leaders hone the scope of their big data projects, solutions designer Prashant Natarajan focuses our attention to what precision medicine can do by first defining what it actually is (and isn't). Prashant discusses the definition of precision medicine as he defined in Multidisciplinary Approach to Head and Neck Cancer, and gives the CIO advice on how to prepare their team and tool sets to put it into practice.
Show Notes:
3:25 Details on Prashant's current work, "Demystifying AI for the Enterprise"
4:13 What is Precision Medicine?
5:43 Important concepts in Precision Medicine.
11:20 Why Social Determinants of Health matter more than you think.
13:40 What is NOT Precision Medicine?
16:50 How Precision Medicine effects the healthcare analytics team.
21:25 What data does Precision Medicine use to develop the ind…
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May 21, 2018
052 - The ever-changing world of security and privacy | David Harlow and Niam Yaraghi
On this episode, we welcome back two long-time friends of the show to talk privacy, security and HIPAA. David Harlow and Niam Yaraghi join me and Shahid for a wide-ranging discussion that includes:
* Niam's recent report: How HIPAA omnibus rules effectively reduced the number of data breaches among health care providers’ business associates
* Europe's General Data Protection Regulation (GDPR) and how it applies to the U.S. healthcare system.
* The difference between a systems approach and a data approach to security and privacy
* How privacy might be seen as a facet of patient safety and how that could change the approach
* Breaking down myths about the value of stolen health data (and some ways it can be valuable to organized crime)
* Dealing with privacy when the business model is to share (i.e. the Facebook scandal)
* How can we expect privacy when we are the product?
* What can we / should we expect from companies like Facebook when it comes to privacy?
* What…
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May 2, 2018
051 - Delivering Cost and Risk Data at the Point of Care | GT LaBorde | IllumiCare
We've always asked a lot of our doctors. Now we're asking them drive value based care. The question is, are we giving them the right tools and the right information to succeed?
On this episode we talk with GT LaBorde, CEO of IllumiCare. They've built a platform that empowers clinicians with real-time cost and iatrogenic risk data – at the point of care. Here are some of the key topics we discuss:
* What's missing from our current healthcare economy and what problems does that cause?
* Why has this problem persisted and what needs to be done about it?
* Should doctors consider the cost of care?
* What information should we give doctors at the point of care to help them make the best decisions for their patients?
* How can doctors stay up-to-date on how much medications cost when they're changing all the time?
* How much variation do you see in costs between similar doctors in different hospitals? In the same hospitals?
* Is there any link between cost and quality in he…
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Apr 25, 2018
050 - A Blueprint for the Next Generation Health Ecosystem | Dave Chase | The Health Rosetta
We're celebrating our 50th episode by interviewing one of my favorite healthcare thinkers, Dave Chase. Dave shares his vision for the next generation health ecosystem, and talks about the many ways the Health Rosetta is driving that change, including their involvement in the upcoming Health Value Awards. We cover a lot of ground, including:
* Why we need to rethink business models that have been in place since World War II
* Why you should never automate a broken process
* Aligning what's right for the business of healthcare with what's right for the patient
* How healthcare leaders can learn from what happened to the newspaper industry
* What are the major push backs against the Health Rosetta concepts and are they being relaxed?
* Why the employer healthcare market is the key to scaling fixes in the healthcare system
* Why the health plan industry's worst nightmare is employers realizing they are actually the insurance company
* How do we get employers to demand inno…
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Apr 19, 2018
049 - Tracking Physician Burnout | Janae Sharp | The Sharp Index
On today's episode we're talking with Janae Sharp. Janae is a physician suicide survivor and the founder of the Sharp Index. The Sharp Index has a mission to reduce physician suicide and provide meaningful tools to improve provider quality of life.
The epidemic of physician suicide is costing us lives. Not only the lives of physicians themselves, but also patient lives. If we do not care for the caretakers, how many more lives will we lose to medical error? The cost of physician suicide has carried a heavy toll on me and especially my children. It is our hope that the system will improve, and that the physician community can have better support. Technology can enable the human connection necessary to combat the loneliness of burnout and grief at the loss of our doctors.
- Janae Sharp, CEO, Sharp Index
Janae is on a mission to help physicians directly and to help healthcare organizations support their clinicians. We talk about:
* Janae's story and why she decided to launch the Sha…
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Apr 5, 2018
048 - Practical Innovation at the Health IT Expo | John Lynn
We're big fans of practicality at The #HCBiz Show! Don't get me wrong... we love disruptive innovation and cutting age tech as much as anyone, but we love getting things done RIGHT NOW a lot more.
We're glad there are smart folks out there building the tools that'll change the game in 10-20 years, but our job is to give you the information you need to get things done when you go to work on Monday. That's why you'll see us touch just lightly on the cutting edge, and then dig incredibly deep on the here and now.
So, it should come as no surprise to you that we're excited about today's guest and topic. On this episode, we talk with John Lynn, founder of Healthcare Scene and the brand new Health IT Expo happening May 30 – June 1, 2018 in New Orleans. The Health IT Expo is a conference that's focused on practical innovations that you can implement today as opposed to moonshot ideas that may affect you 10 years from now. That's beautiful. Isn't it?
John's a great interview and we cover…
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Apr 2, 2018
HIMSS18-15 | Nathaniel Lacktman | Asynchronous Telemedicine | Foley & Lardner LLP
This interview is part of our HIMSS18 coverage and was recorded live on the showroom floor.
On this episode I talk with Nathaniel Lacktman, Health Care Partner and Chair of Telemedicine Industry Team and Digital Health Group at Foley & Lardner. He's also one of the nation's leading voices on telemedicine laws and business models.
Nate gives us a quick primer on why startups and entrepreneurs shouldn't put legal issues on the back-burner, especially when it comes to fraud and abuse. He tells us how we can avoid big problems down the road by coming up with a business model that establishes legally acceptable ways to grow and that takes the laws of all 50 states into consideration. This portion of the conversation echoed the advice Dexter Braff gave us a few episodes back about how to build a company that others want to invest in.
Nate also makes predictions about where the telemedicine market is headed. He's very excited about asynchronous telemedicine and makes a compelling case for…
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Mar 27, 2018
HIMSS18-14 | Stuart Goldberg, M.D. | Cota | Precision Payment
This interview is part of our HIMSS18 coverage and was recorded live in the exhibit hall.
On this episode we talk with Stuart Goldberg, MD, Chief Scientific Officer at Cota. Dr. Goldberg tells us all about Cota's physician-led journey to organize and classify real-world evidence about every type of cancer. This effort led to something they call the Cota Nodal Address (CNA), and it's enabling health systems to get very specific about the types of patients they're treating, the costs associated with them, and the outcomes being achieved. This apples-to-apples comparison allows Cota to identify variation and address it in ways that are beneficial to the provider, payer and patient. It enables a concept Dr. Goldberg calls "Precision Payment", which in turn enables proper bundled payment design, and precision medicine.
And Cota is not only physician led, but the payers are on board too. Literally. Horizon Blue Cross Blue Shield lead their Series A funding round. Plus, they just closed a $…
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Mar 26, 2018
HIMSS18-13 | Jay Holley | Uber Health |
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode we talk with Jay Holley, Head of Partnerships at Uber Health. As a founding member of the Uber Health team, Jay works to ensure that Uber can provide reliable, HIPAA-compliant transportation solutions striving to ensure that transportation is not a barrier to healthcare.
Uber Health partners with healthcare organizations to provide reliable transportation for patients. The dashboard allows healthcare professionals to order rides for patients going to and from the care they need. Jay and I discuss:
* How it works
* How HIPAA plays in
* Servicing patients without smart phones
* Who benefits and how
* Jay's thoughts on a recent study that suggested ride sharing services didn't reduce no shows
Learn more at https://www.uberhealth.com/ and click the green Get Started button to enr…
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Mar 21, 2018
HIMSS18-12 | Travis Moore & Matt Gove | Kyruus | Provider Data and Patient Access
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode we talk with Travis Moore, SVP of Market Solutions at Kyruus and Matt Gove, Chief Consumer Officer at Piedmont Healthcare, about provider data and patient access. We discuss how to address provider data inconsistencies across systems so that you can enable a better patient experience. Topics include:
* Self-scheduling and why your patients are ready for it
* Call-center scheduling
* Doctor-to-doctor referrals and in-office scheduling
* Why at Piedmont Quick Care Retail Clinics in Walgreens more than 50% of the volume is booked online.
The big take away for me is that patients are ready for online scheduling and they want to be seen on their own terms. This is evident in Piedmont's high online booking rates, a preference to have a scheduled time even at walk-in retail clinics and…
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Mar 19, 2018
Demystifying Big Data and Machine Learning for Healthcare | Prashant Natarajan | HIMSS18-11
On this episode, we chat with Prashant Natarajan, an innovation and product leader, best-selling author on Big Data, Analytics, Machine Learning and AI, and, if I do say so myself, an all-around swell guy! Prashant takes a very pragmatic approach to demystifying big data, ML and AI and shows us that it all starts with the data. He introduces us to the concept of data fidelity, which is the appropriateness of data for a purpose. That concept is so important to grasp. It allows us to get started where we are, drive towards value over time and enables us to get value from innovative tools like machine learning an AI.
We don't spend all our time in the data weeds. Prashant also tells us how we can operationalize big data, machine learning and artificial intelligence and align it with the current and future needs of healthcare. It can support us in our fee-for-service and value-based contracts. It enables consumerism and patient engagement. It can help employer groups drive change. In shor…
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Mar 15, 2018
HIMSS18-10 | Sean Cassidy | MIPS & QPP | SA Ignite
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode, we chat with Sean Cassidy, Chief Product Officer at SA Ignite. We discuss MACRA, MIPS , and QPP strategy for providers and practices, changes to the MIPS program under the new federal budget, and the importance of establishing a culture of quality now, regardless of where MIPS is headed.
Spoiler alert... you're going to be in value-based programs one way or another.
About Sean Cassidy
Sean is an experienced health IT leader with a passion for incubating and growing data and analytics focused software businesses. Prior to joining SA Ignite, he led the development and growth of Charlotte based Premier’s enterprise analytics and ZirMed’s value based care businesses. As Senior Vice President and General Manager of Initiate System’s healthcare business, Sean was a member of the manag…
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Mar 14, 2018
In Need of (Clinical Decision) Support | Dr. Lucas Schulz | UW Health & ILÚM Health Solutions
On this episode, we chat with Dr. Lucas Schulz (@LucasTSchulz), infectious disease and critical care pharmacist at University of Wisconsin Health. Luke is also an adviser to ILÚM Health Solutions - an infectious disease (ID) platform and real-time information service that supports patient management decisions, quality programs, and better outcomes through:
* Clinical collaboration and ongoing quality consulting
* Program level insight
* Point-of-care clinical decision support
Luke helps us to understand:
* What it means to be an infectious disease and critical care pharmacist
* How to establish an Antimicrobial Stewardship program and which health system teams/departments are involved
* How a platform like ILÚM helps you move from anecdotal to evidenced-based medicine
* How to deliver high quality care and simultaneously deal with the business and financial pressures of running a health system
This interview is part of our HIMSS18 coverage. We'll be talking with tho…
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Mar 13, 2018
HIMSS18-08 | Dexter Braff | The Braff Group
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode we catch up with Dexter Braff of The Braff Group. Dexter shares advice for Health IT entrepreneurs on how to stay focused while big players keep making big announcements. And there have been plenty of big announcements:
* Apple Health Records
* Amazon, JP Morgan Chase, Berkshire Hathaway Partner to disrupt healthcare
* Uber and Lyft want to take you to the doctor
* The Whitehouse has a new plan for interoperability
* Apple is launching its own medical clinics
Dexter tells entrepreneurs to pay attention, stay focused and don't panic, plus a lot more good advice.
You can hear more from Dexter on two recent and very popular episodes:
* Episode 28: How to Analyze the Health IT Market
* Episode 30: Why You Should Always Be Preparing to Sell Your Company
And, checkout the res…
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Mar 12, 2018
HIMSS18-07 | Miki Kapoor | Tea Leaves Health
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode, we chat with Miki Kapoor, President of Tea Leaves Health. We discuss:
* How consumer engagement is driving health system strategy
* The challenge of balancing fee for service and value-based revenue streams as the system continues to transform
* The importance of establishing a direct and continuous feedback loop with your patients.
Checkout the rest of our HIMSS18 Interviews here.
About Miki Kapoor
With two decades of experience exclusively in healthcare – operations, finance, strategy and policy – Miki Kapoor has a notably broad perspective on the U.S. healthcare system.
Most recently, Mr. Kapoor was the President of Everyday Health, a publicly-traded company that was acquired in a $465 million transaction in 2016. As part of aggressively scaling Everyday Health while mo…
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Mar 9, 2018
HIMSS18-06 | Matt Fisher | Healthcare lawyer, podcaster & SMA
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode we chat with Matt Fisher (@Matt_R_Fisher), Healthcare Corporate Regulatory lawyer, host of Healthcare de Jure and HIMSS 18 Social Media Ambassador.
You can find all of our HIMSS '18 Interviews here.
About the Healthcare de Jure
Tune in as we serve up the hottest healthcare issues of the day, all from a legal point of view. From public policies and Federal initiatives to privacy and security, join host Matt R. Fisher as he and his guests discuss a smorgasbord of topics, giving hospitals, physicians, vendors and patients a seat at the table. Matt’s virtual conversations can be listened to on demand or heard on air. So don’t miss a minute of what’s on the menu.
About HEALTHCARENOWRADIO.COM
HealthcareNOWradio.com is an Internet radio station operated and produced as part of Answers…
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Mar 9, 2018
HIMSS18-05 | Brian Mack | Great Lakes Health Connect & SMA
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode we chat with Brian Mack, Manager, Marketing and Communications at Great Lakes Health Connect and HIMSS 18 Social Media Ambassador.
You can find all of our HIMSS '18 Interviews here.
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Mar 8, 2018
HIMSS18-04 | Charles Webster | Mr. Workflow and SMA
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode, we chat with Mr. Workflow, Chuck Webster (@wareFLO). If you're at HIMSS then Chuck needs no introduction. He's the one that 3D printed that glitter tiara on your head :)
For everyone else, Chuck is THE workflow expert and has been evangelizing the value of workflow and business process management in healthcare for a long, long time. He's also a social media innovator who's always testing out new stuff like blab, periscope (he put me up on a 360 live cam while I was working on this post in the HIMSS press room), and now VR.
Chuck is 1 of 20 HIMSS 18 Social Media Ambassadors.
Check out Chuck's work at the Healthcare Business Process Management blog. And be sure to follow him on twitter at @wareFLO.
HIMSS '18 Coverage
Checkout the rest of our HIMSS18 Interviews here.
Subscribe to We…
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Mar 6, 2018
HIMSS18-03 | Kelly Thompson and Dan Chavez | SHIEC
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode, we're talking with Kelly Thompson, CEO of the Strategic Health Information Exchange Collaborative (SHIEC) and Dan Chavez, Executive Director at San Diego Health Connect.
About the Strategic Health Information Collaborative (SHIEC)
SHIEC is a national collaborative representing health information exchanges (HIEs). The organization already represents 60 HIEs, and these HIEs collectively cover more than 200 million people across the U.S., well over half of the American population.
http://strategichie.com/
@SHIEClive
About Kelly Thompson
As SHIEC CEO, Kelly Hoover Thompson is responsible for working collaboratively with SHIEC’s members and board of directors to develop and actively advance an organizational strategy that ensures SHIEC’s success. Her goal is to elevate the awareness…
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Mar 6, 2018
HIMSS18-02 | Dr. Betty Rabinowitz | NextGen Healthcare
This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.
On this episode, we're talking with Dr. Betty Rabinowitz, Senior Vice President of Solutions Analytics at NextGen Healthcare.
Dr. Betty Rabinowitz is one of the founders and the former CEO of EagleDream Health, the software analytics solutions company acquired by NextGen Healthcare in August, 2017. EagleDream Health comprises cloud-based analytics and population health management solutions that drive meaningful insights across clinical, financial, and administrative data to optimize ambulatory practice performance.
Quality Systems, Inc., known to its clients as NextGen Healthcare, provides a range of software, services, and analytics solutions to medical and dental group practices. The company’s portfolio delivers foundational capabilities to empower physician success, enrich the patient care experie…
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Mar 5, 2018
HIMSS18-01 | What to expect this week
I'm at HIMSS '18 in Las Vegas. I'll be here all week and will do my best to bring you along with me. Here's the plan:
1. I'll post a new show each day at HIMSS recapping what I experienced/learned the day before. Make sure you're subscribed at your favorite podcast source so you don't miss them. Most popular:
http://bit.ly/HCBiz-iTunes
http://bit.ly/HCBiz-GooglePlay
http://bit.ly/HCBiz-Stitcher
http://bit.ly/HCBiz-Spotify
2. I'll grab impromptu interviews at the various events, in the hallways, at the meetups and happy hours and include them in #1. If you're around and you want to participate just let me know.
3. I'll be recording shorter than normal spots with vendors and thought leaders throughout the week and releasing those as 10-15 minute #HCBiz Bytes from HIMSS18 in the days and weeks after the conference.
I'll be covering/attending:
* Power Press Party (Sunday)
* HIMSS/SHIEC INTEROPERABILITY & HIE SYMPOSIUM: FACILITATING PERSON-CENTERED INTEROPERABLE HIE TO…
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Feb 21, 2018
032 - Legionella: A Manageable Risk for Health Systems | Dave Purkiss and Joseph Cotruvo | Legionella 2018
Today we're talking about a widespread issue that's extremely important to the business of healthcare, and probably not on your radar: Legionella. And more specifically Legionellosis, which is the most significant waterborne disease in the U.S.
Legionellosis accounts for thousands of hospital admissions and many deaths. It has a 10% mortality rate for those infected and that rate goes up as high as 25% in a healthcare setting.
The good news is, it's controllable. In fact, it's largely an engineering problem that has known, low-tech controls.
Related: Checkout our entire Infection Prevention and Control series
Given the prevalence of the issue, the high mortality rate and increased risk in healthcare settings (especially in LTC), CMS now says that Hospitals must develop water management policies to prevent Legionnaires' disease. They're calling for hospitals to do a risk assessment, implement a water management program and specify testing protocols. The approach sounds like it would…
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Feb 11, 2018
031 - Apple Health Records and Amazon/Berkshire/JP: Will they Matter?
There were two huge Digital Health stories in the past few weeks. Apple Health Records
First we were introduced to Apple Health Records. This new feature will allow consumers to download their health records from participating providers directly to their iPhone. Some industry observers see it as a huge step forward in the liberation of our health data and the transformation of the healthcare industry. Others see it as little more than a publicity stunt that'll ultimately end up in history's innovation waste basket next to Google Health. Amazon, Berkshire Hathaway and JP Morgan
Just a few days later we were told that Amazon, Berkshire Hathaway and JP Morgan had teamed up and plan to disrupt healthcare. Once again, we split ourselves into two groups. The first group sees this as a promising sign that American businesses are finally stepping up and taking responsibility for the devastating growth in healthcare spending. They hope these titans can figure it out and set the course for the…
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Jan 31, 2018
030 - Why You Should Always Be Preparing to Sell Your Company | Dexter Braff | The Braff Group – Part 2
You've heard of "Always Be Closing", right? Well today we'll tell you why you should at least "Always Be Preparing" (to Close).
Every entrepreneur can and should learn the ways of the M&A market and use that knowledge to inform the way they build their company. That's true if you hope to exit someday because it'll drive decisions that make your company more valuable later. And it's true if you plan on staying in your business for the long haul. Investors have battle-tested methods for determining what's valuable and what's risky. As the current and future investor in your company, you should be applying those tests and addressing the results along the way.
On this episode, we're once again talking with Dexter Braff, President of The Braff Group, one of the nation’s leading health care merger and acquisition advisory firms. We dig into Dexter's process for evaluating companies and find out how he determines if they'll demand attention on the open market. Dexter shares valuable insig…
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Jan 24, 2018
029 - JPM18, WinterTech, Startup Bundles & More
On this episode we recap the 36th Annual J.P. Morgan Healthcare conference (#JPM18), the Health 2.0 WinterTech event and talk about the "festival" that J.P. Morgan Week becomes in San Francisco. We cover the trends and topics coming out of the festival and use them as a jumping off point to discuss the next wave of digital health investment and innovation.
What you'll learn:
* What is the J.P. Morgan Healthcare conference?
* What is the Health 2.0 WinterTech Event?
* Who attends these events and how do you get value from them?
* How you can take part in the festival even if you're not invited to the main show.
* The trends and topics coming out of the festival and what they mean for Health Systems, Investors, Innovators and Startups
* Who are the "Strategics"? What are they investing in? And why are they starting to invest in earlier rounds?
* What are the major Health System strategies and why are they still so "muddled"?
* How and why you should develop pipelines fo…
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Jan 18, 2018
028 - How to Analyze the Health IT Market | Dexter Braff | The Braff Group – Part 1
To be understood, seek first to understand.
It applies in life, and it applies when you're trying to gain traction with an innovative product, solution, or workflow in the Health IT market. Why? Because there are too many draws on your customers' attention. If you want them to take the time to understand you, then you'd better position yourself where they already are, or will soon be looking. In short, get to know your market.
On this episode, we're talking with Dexter Braff, President of The Braff Group, one of the nation’s leading health care merger and acquisition advisory firms. Dexter walks us through the analysis his team performed on the Health IT market and shares with us key insights they uncovered along the way. They studied 300-400 transactions, identified patterns of consolidation, and used their findings to re-categorize the entire Health IT market. You'll benefit from understanding the process they went through, and you'll get to take a few shortcuts via the insights…
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Jan 4, 2018
027 - Health Benefits as a Strategic Opportunity | Chris Skisak | HBCH
Read this on the web
Have you ever wondered why your employer buys your health insurance for you? They don't get involved in car insurance, home owners, etc. Why healthcare? To understand that, you have to go all the way back to World War II.
When the federal government froze wages during WWII, employers needed a way to compete for employees. As it turned out, benefits weren't included in this freeze and became a great way to attract talent. And then, as often happens, inertia took over and we just kept doing it that way. For a while, that wasn't such a big deal, but then healthcare costs began to explode. And it happened so quickly that before we realized it, companies like Starbucks were spending more on health benefits than on coffee beans. Healthcare is now one of the top P&L items for every business in the U.S. Unfortunately, most C-suites aren't looking at it as a strategic opportunity. Instead, they task ill-equipped benefits managers with trying to find the best "deal" and j…
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Dec 7, 2017
026 - Community Governed Healthcare That Works | Jim Rickards MD, MBA
People like to say things like "If you've seen one healthcare system, then you've seen one healthcare system" or "every community is different". That may be true on some level, but these are really just excuses to keep doing things the same old way. In fact, most communities are exactly the same when it comes to the most important issues facing the U.S. healthcare system.
If you pick any random community across the country and examine their healthcare delivery system, you'll find that:
* Traditional healthcare delivery accounts for only 10-20% of health outcomes. Social Determinants of Health (SDOH) drive the rest.
* Healthcare costs are growing in an unsustainable manner
* There's heavy competition between the players in the community and limited collaboration
* Governments, companies and individuals are struggling to pay for it all
On this episode, Jim Rickards MD, MBA tells us the story of how Yamhill County, Oregon is addressing these issues through their Community Care…
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Nov 30, 2017
QM02 - Digital Quality Measures 2.0 | Rick Moore | NCQA
On this episode, Rick Moore, CIO at NCQA, joins us for a discussion about what's next for digital quality measurement. Rick likes to call this Digital Quality Measures 2.0 and you can see it coming to life in NCQA's eMeasure Certification (eMC) program. The program aims to take burden away from health plans and auditors by establishing a process for generating standard supplemental data for HEDIS measures. This will enable software vendors, providers, HIEs and others to more effectively and efficiently provide needed clinical data without all the manual chart pulls (you can see the certified vendors here).
Additionally, the eMeasure test process is now approved as the only alternative to the Project Cypress toolset in the ONC Health IT Certification Program.
Rick sees great opportunity ahead for a few reasons:
* The community is more engaged (vendors, providers, payers)
* The government has backed off (a bit) on mandating specifically how things will be done
* There are more o…
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Oct 26, 2017
024 - How to Listen Your Way to the Future of Healthcare | Dr. Chesley Richards | CDC
They say that civilization advances by extending the number of important things we can do without thinking about them. To me, that's the promise of technology and it's particularly true when it comes to artificial intelligence and machine learning. Still, not everyone sees it that way. Some worry that they'll be replaced. Others take offense to the fact that they're seen as replaceable. But just like the rise of ATMs led to an INCREASE in the number of bank tellers, we'll see AI drive unpredictable, and generally positive change in the healthcare industry. Some will be displaced, but if they're open to it they'll be in a position to take on new and even more valuable roles that we can't even imagine today.
Side note: AI may just help us deal with the projected doctor shortage.
I know what you're thinking: That's big talk from an industry that recently gave you the EMR. That's fair, but there is a way to do this right. And that's what we're going to talk about today.
Today's guests a…
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Oct 10, 2017
QM01 - Quality Measures: Past, Present and Future | John D'Amore - Diameter Health
On this episode, we talk with John D'Amore. John is Founder, President and Chief Strategy Officer at Diameter Health and has been working on Quality Measures in healthcare since the early 2000s. Yup, pre-EMR quality measures!
John takes us on a fascinating journey from paper based quality measurement (see RHQDAPU... at least we've streamlined our acronyms!) to the dawn of electronic measurement. via the Electronic Medical Record (EMR). He explains why the single-EMR approach made sense in the hospital, but how the industry was hurt when it decided to apply that approach in the ambulatory setting. Finally, John describes the future state where quality measures are calculated from a longitudinal patient record that encompasses all the care a patient has received. This, of course, calls for a trusted central authority to do the aggregation, data remediation and reporting. Perhaps, an HIE?
It's a complex story and John delivers it well. We dig through all that and so much more, including…
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Sep 28, 2017
022 - Quality Talks 2017 | Andy Reynolds | NCQA
Quality...
What does that mean in healthcare? How can it be measured? Is it the same for everyone? Who gets to decide?
These are just a few of the incredibly difficult questions that the healthcare industry is grappling with as we enter the age of value-based care. The decisions we make about quality in the coming years will have significant and lasting impact on the future of our industry. This is a conversation that's very much worth having.
On this episode, we bring you another conference preview. Our intention is to help you find unique learning and networking opportunities that complement the normal programming on The #HCBiz Show! With our Quality Measure series just around the corner, this one is a particularly good match.
The National Committee for Quality Assurance (NCQA) is bringing Quality Talks to Washington D.C. on October 16th, 2017. This 1-day event is designed to address some of the most difficult questions around healthcare quality. NCQA will bring us 10 speakers ac…
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Sep 20, 2017
021 - Building a Health IT Leadership Team | Drew Ramsey | Valor Partners
The healthcare industry has lots of problems, lots of money and is in a constant state of change. With those characteristics, it's no wonder startups are throwing their hats in the ring in increasing numbers. The theory is that they'll take some technology or process that's just killin' it in every other sector, apply it in healthcare and profit. The reality they find is quite different. Even with a great product, the notoriously long sales cycles, counter-intuitive financial incentives and policy-driven Health IT strategies converge to deliver a very strong message... you need help.
On this episode, we talk with Drew Ramsey, a partner at Valor Partners and the head of their healthcare division. Drew specializes in placing executives and sales leaders in startups and venture-backed firms that are bringing Health IT products to market. As you'll hear, Drew's success measure is not just placement, but long-term success. That means that he and the team at Valor are very picky about who t…
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Sep 13, 2017
Take it to the Cloud: A Look at Hybrid Data Storage in Healthcare | Laz Vekiarides | ClearSky Data
The entire healthcare industry went digital in a very short time. We've barely got our arms around the mountains of data created every day in our transactional systems (i.e. EMR, Scheduling, RCM, etc.). Now the genomic, patient-generated and device-generated data is starting to flow. Take all that, mix it up with some HIPAA, a few parts ransomware, an uncompromising need for on demand data and reliability, the almost-dogmatic refusal to ever let go of a single piece of information, and the rapidly expanding need for new insights, and you'll start to get a glimpse of the state of healthcare data today.
Enterprises must find a way to reap the benefits of all this "big data" without getting paralyzed in the complexities of managing it. Today's guest believes that data storage is ripe for innovation and that a hybrid cloud approach may be the best path forward. A hybrid solution combines the speed, reliability and comfort of an on-premises infrastructure with the scalability and convenien…
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Aug 22, 2017
019 - HITS Conference Preview w/ Dr. Christine Greene and Dr. Kelly Reynolds
The most important thing we do on The #HCBiz Show! is confront reality. We don't complain about how things are, or how they ought to be. We know that's a dead-end. Instead, we examine our current situation and identify our obstacles. Then we come up with practical ideas for how to work through, under, around, or with those obstacles. That's the only reasonable approach for an innovator. Dealing with obstacles to Infection Control
The Healthcare Infection Transmission Systems (HITS) conference (and the consortium behind it) gives us a wonderful example of this #HCBiz philosophy in action. The HITS consortium knows that the science and technology exist to make significant strides in Infection Prevention and Control (IPAC) and Healthcare Associated Infection (HAI) reduction. They also know that, while the benefits of the solutions seem obvious to many, it's not a slam-dunk to get health systems to adopt them in meaningful and sustainable ways. There are many reasons for this, and as usua…
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Aug 7, 2017
PD08 - The Patient Perspective on Provider Directories - Tam Ma - Health Access California
Healthcare is the most intermediated business in the history of the world. There's always someone, and usually several someones, in between the clinician and the patient. Similarly, while most of us working on the business of healthcare will enthusiastically agree that we do this for the patients, we spend very little time talking about them. Of course, I'm not referring to the "front-lines" of healthcare delivery (i.e. doctors, nurses, etc.) or even their immediate support team at the hospitals and clinics. I'm talking about those of us who are working in the background to enable "healthcare transformation". While we try to fix provider directories, calculate quality measures and otherwise streamline the business of healthcare, we're regularly focused on the complex, technical details of those problems. The concept of the patient is usually abstracted. Even when we talk about things like "covered lives", we tend not to discuss them as actual people; as our grandparents or brothers or…
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Jul 26, 2017
PD07 - Going Deep on Provider Directory - Dave Marotz - Surescripts
How do you eat an elephant? One bite at a time.
That may be the best advice I can give the healthcare industry at this point.
On this episode, we talk with Dave Marotz, Director of Directory Services at Surescripts to break down the Provider Directory concept into its component parts... "capability style".
We go deep on the technical and architectural hurdles that need to be overcome to progress Provider Directory. You'll learn about:
* The various standards-based approaches that have been/are being attempted.
* New wrinkles on provider context and how we may need to know what the truth was about them at a certain point in time (i.e. rights to dispense a prescription).
* What should be shared? Who should own the "shared data"?
* Why it's hard to get something as simple as proper provider names.
* Strategies for identity proofing and identity resolution.
* Decomposing the conceptual master provider directory into its component parts
* The various industry and commercia…
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Jul 17, 2017
PD06 - How to Tap Existing Processes for Provider Data | Martin Dunn | Gaine Healthcare
This week's guest is Martin Dunn, CEO of Gaine Healthcare. Martin frames up the current state of provider data and directory issues quite well with this quote:
"It doesn't matter how much you regulate the docs, It doesn't matter how much you've threatened the docs. It doesn't matter how much you incent the docs to pull this information together for you. If you ask questions that are difficult to answer, difficult to understand, impossible to keep up with because the doctors and the physicians and the provider organizations just don't have the systems in order to give you that information, you're not going to get it."
Sticks Won't Fix Provider Data
So, we can't just beat the doctors into submission (pun intended)? What about SB-137? That law has "teeth" to hold the providers accountable. Not so fast, says Dunn. The first provision is that payers can withhold payments for providers who don't respond in a timely manner with quality data (Bill Barcellona called this "the Hammer Provisio…
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Jul 11, 2017
PD05 - Approaching Provider Directory as a Data Quality Problem | Andrew Kobylinski | BetterDoctor
Friedrich Nietzsche argued that there are no facts, only interpretations. It seems that this idea holds true for provider data too. Today's guest is Andrew Kobylinski, Head of Platform at BetterDoctor. Andrew tells us that the provider directory issue is first and foremost a data quality issue. At the heart of data quality, he says, is metadata that explains where the information came from, what it means, when it was updated, and more. This metadata is the interpretation and without it, your facts are pretty much useless. According to Andrew, "collecting the data is one-half of the problem. It's actually the easier half. The other half of the problem is taking the data that you've collected and sharing it with all the stakeholders that need it in the format they can actually consume and trust".
Andrew admits that there's a fair amount of complexity in the context (i.e. interpretation) of provider data and that it does make for an interesting challenge. However, he thinks the healthcar…
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Jun 29, 2017
014 - Accelerating Digital Health for Social Good | Christian Seale | Startupbootcamp Miami
Life can be hard for entrepreneur's in healthcare. Sure, we've seen an increase in Digital Health investment over the past few years, but it remains exceedingly difficult for new companies to prove their value, align with complex reimbursement models and get that first customer. That's where Digital Health Accelerators like Startupbootcamp Miami come in. They're in the business of aligning startups with specific customer needs, and in doing so, can help founders make big leaps in a short amount of time.
This episode's guest is Christian Seale. He's the founder and Managing Director at Startupbootcamp in Miami, which focuses on Digital Health. More specifically, they focus on Digital Health Startups that can make healthcare more equitable, efficient and accessible. We'll talk with Christian about how you can build valuable companies that are fun and profitable, AND deliver a ton of social good.
This is a fun interview with an interesting back-story. We cover a lot of ground including:…
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Jun 20, 2017
PD04 - Are We Asking Providers the Wrong Questions? | Ron Urwongse | CAQH
On this episode, the fourth in our ongoing Provider Directory Series, we continue to unravel the "why" behind provider directory inaccuracies. One major theme that's emerged is that we have a context gap between health plans and providers. That is, even when we're asking the right people at the right time, we might be asking the wrong questions.
Our guest, Ron Urwongse, a Senior Product Manager at CAQH, explains how adding a level of specificity to our questions can yield dramatically different results. For example, if you ask a provider if they work at an office, they may say yes even if there's only a slight chance they ever will (i.e. to cover for a colleague). The tendency, Ron explains, is that providers play defense - they don't want to have a claim denied if they ever do submit one from that office.
By adding some specificity to our questions, we could cut down on the confusion. How often do you work at this office? Or, do you accept new patients at this office? Are bound to y…
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Jun 13, 2017
PD03 - Provider Data: What is Known and What is Assumed? | Mark Martin - Availity
There are two kinds of Provider Data
Explicit provider data comes directly from the providers, their groups or even their IT systems (i.e. EMR, RCM, etc). Since this data is coming from the source, it's assumed to be up-to-date and accurate. However, as we learned in episode 11 (PD-02) there are subtleties and complexities to consider. For example, there are scenarios where it's best to go straight to the provider and others where you must talk to the group instead. You see, there are contractual complexities that change the context of the information. The context of the data is as important as the data itself.
Implicit provider data comes from secondary activities that involve the provider. For example, we can use claims data to make certain assumptions. You should be able to look at claims data and see what facilities they work in. If they submit a claim for a procedure done at facility X, then they should be listed at facility X on our provider directory. Right? Riiiiight???? Not…
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Jun 6, 2017
PD02 - A Provider-side Approach to Provider Directories plus SB-137 | Bill Barcellona (CAPG)
The national provider directory discussion is clearly focused on the patients and health plans. It focuses on the patients because they're the consumer of this information and without it, they can't make educated decisions when buying health insurance. The conversation focuses on health plans because they're the ones being held accountable for making the information available to consumers. To effectively address this issue, we also need to take a good hard look at things from the providers' point-of-view. That's what this episode is all about.
We'll talk with Bill Barcellona, Sr. VP for Government Affairs at CAPG, which is a national association that represents physician organizations who practice capitated, coordinated care. Bill does an excellent job of sharing the providers point-of-view on the provider directory issue and shows us how provider groups can take the lead on cleaning things up. Bill also tells us about California's SB-137 and explains how it's putting pressure on both…
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May 30, 2017
PD01 - Provider Directories: How Hard Can This Really Be? | Don Lee and Shahid Shah
In 2016 we saw new provider directory regulations from CMS and several states, including the particularly "toothy" SB-137 in California. The new rules are intended to hold health plans accountable for any inaccurate and/or incomplete information in their provider directories. The national conversation is focused intently on the consumer side. That is, bad information makes it difficult for patients to make educated decisions when they select plans and can lead to access issues down the road.
The consumer issues are real, but only scratch the surface of the overall provider data problems we face.
* Health plans and provider groups struggle to keep each other up-to-date making communication more difficult and less efficient.
* Even departments within the same organization have trouble staying in sync and that leads to all types of problems in our day-to-day operations.
* Government and regulatory bodies are hindered in their efforts to ensure appropriate access and coverage in ou…
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May 24, 2017
IPAC-08 The Patient Hot Zone | Darrel Hicks
Darrel Hicks is internationally recognized as one of the subject matter experts in infection prevention and control as it relates to cleaning. He has written and published numerous articles in professional and healthcare related journals as part of his commitment to providing a cleaner, safer and healthier indoor environment.
Darrel has a specific interest in soft surfaces and what he calls "The Patient Hot Zone". That is the hospital bed and the 36" around it. There are high-touch surfaces here that can be difficult to clean and require some imposition on the patient (i.e. cleaning their bed rails while they're in the bed).
Today we'll learn about:
* The Patient Hot Zone
* Cleaning soft surfaces
* How proper cleaning can improve patient satisfaction scores (I.e. HCAHPS)
* The new CMS / Joint Commission requirements for patient mattresses – which came into effect January 1, 2017 – provide a new challenge to healthcare accreditation and safety/quality programs.
* How 1…
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May 16, 2017
IPAC-07 Understanding Infectious Agents in the Environment | Dr. Syed Sattar and Bahram Zargar
What happens to an infectious agent once it leaves the human body? Well, it ends up in our cars, airplanes, food, water and soil. If we know how that contagion behaves "in the wild", then we'll be able to kill it, filter it, or otherwise prevent it from proliferating, and potentially improve the lives of millions of people in the process. This is the study of Environmental Microbiology and it's a topic that today's guest has spent more than 30 years trying to understand.
Dr. Syed Sattar is Professor Emeritus of Microbiology at the Faculty of Medicine, University of Ottawa. He is also a co-founder and Chief Scientific Officer at CREM CO. He's a world-renowned expert who regularly advises national and international agencies like the World Health Organization (WHO), and private-sector companies.
We're also joined by Bahram Zargar, CEO of CREM CO. This is a company built on top of Dr. Sattar's extensive body of work that aims to speed the assessment, development, and promotion of innovat…
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May 9, 2017
IPAC-06 Redefining Sepsis | Michael Ackerman
Sepsis is not an infection. Rather, it's your bodies overwhelming reaction to an infection and can lead to some serious health issues. In fact, sepsis is the #1 cause of death for patients in hospitals.
Sepsis definitions and protocols have been around for some time, but have been undergoing major changes. Additionally, sepsis is under scrutiny from CMS at the federal level and is subject to public reporting in many states. All of this, plus the importance of quickly diagnosing and treating the condition puts clinicians in a difficult spot. Many times they'll find themselves treating to the protocol, even when their clinical instincts suggest something else.
In that regard, sepsis proves to be a very instructive topic in our never-ending quest to unravel the business of healthcare.
On this episode, we'll talk with Michael Ackerman who's an Acute Care Nurse Practitioner and an Associate Director and Professor at Niagara University School of Nursing. Michael is an expert on the topic…
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May 2, 2017
IPAC-05 Lessons on Infection Control and Healthcare Sales from the Man with the High-Tech Pillow | David Woolfson
There are two things I can say for sure. First, healthcare-associated infections (HAI) cause a lot of suffering and cost a lot of money. Second, it's really hard to sell into healthcare, even when you have an innovative product that attacks a well-known problem in a common-sense way. On this episode, we get to dive into both of those things. Infection Control and Environmental Surfaces
Over the past decade, substantial scientific evidence has accumulated indicating that contamination of environmental surfaces in hospital rooms plays an important role in the transmission of several key HAIs. Environmental surfaces contribute to cross-transmission of pathogens. These surfaces include both nonporous (hard) surfaces and soft surfaces such as bed linens, gown, mattress, etc. The more a patient comes into contact with a surface, the more important it is to keep it clean. Well, what happens if you can't keep your pillows clean? Many standard issue hospital pillows allow pathogens to enter th…
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Apr 26, 2017
IPAC-04 Shining a Light on C. diff - Christian John Lillis
Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), often called C. difficile or C. diff impacts 453,000 people every year. And with 29,000 associated deaths, it takes more lives than AIDS and drunk-driving combined. Yet, most people have never even heard of it. That's a big problem because you can't protect yourself from a threat when you don't even know it exists.
The impact on the business of healthcare is significant too. A study published in the American Journal of Infection Control found that C. diff-associated diarrhea (CDAD) increases hospital costs by 40% per case (an average of $7,285 ) and puts those infected at high risk for longer hospital stays and readmissions. Some even believe those numbers are likely underestimated.
C. diff presents us with an interesting problem at the cross-section of Infection Prevention and Control (IPAC). It's an environmental bacterium that's found pretty much everywhere and is difficult to kill, but it's usually held in check by the good bact…
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Apr 18, 2017
IPAC-03 Why Hand Hygiene Matters - Tamás Haidegger
Hand hygiene is the number one line of defense when it comes to controlling the spread of healthcare-associated infections (HAI) and infectious disease. Since we know that antibiotic and antimicrobial resistance is on the rise, and few new antibiotics are being developed, it becomes exceedingly important that we prevent people from acquiring these infections in the first place.
Checkout our extensive coverage of the Infection Prevention and Control (IPAC) space
We know that hand-washing is effective when done right, and we know that when monitored, we do it right. In fact, right after we recorded this podcast the Jama Network showed us that patient mortality decreased during unannounced accreditation surveys at US Hospitals. The point is that you can expect what you inspect. Episode 004 (part 3 of our IPAC series):
On this episode, we get into the details with Tamás Haidegger and discuss:
* Why hand hygiene is so important
* How the struggle to get it right goes back to the 18…
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Apr 12, 2017
IPAC-02 Using Barrier Technology to Stop the Spread of Infectious Disease - Rik Heller
Rik Heller is a serial entrepreneur and founder of Wello. A self-confessed technology and healthcare geek, Rik has also been called the Grandfather of Active RFID and holds many patents in this area that are licensed globally. With a background in math and electrical engineering, he has been working in healthcare since 1989.
In 1999 Rik Heller founded FreshLoc and became a pioneer of environmental monitoring for compliance and reporting in the healthcare industry. Freshloc is a remote temperature monitoring technology for hospitals, pharmacies, laboratories, and other healthcare entities to help comply with temperature related safety regulations.
More recently, Rik has pursued interests in infection prevention and control, founding Wello. There he has developed, among other high-tech digital solutions, a hands-free, self-service fever screening, identification and notification platform that is focused on controlling entry of potentially contagious persons to very high-risk patient ar…
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Apr 10, 2017
IPAC-01 Infection Prevention and Control with Niall Wallace and Michael Diamond
The #HCBiz Show first address the topic of Healthcare Associated Infections (HAI) in July 2016 when we asked Infonaut founder Niall Wallace the question: Why are we losing the battle to hospital-acquired infections? From that post/interview:
Hospital Acquired Infections (HAI) are a big deal in US healthcare:
* They cost U.S. hospitals as much as $45 Billion per year.
* On any given day, approximately one in 25 U S patients has at least one infection contracted during the course of their hospital care
* In 2011, there were an estimated 722,000 HAIs in U.S. hospitals and 75,000 of the patients died.
This issue impacts everyone who enters a healthcare setting whether they be patients, clinicians, administrators or guests (and anyone that comes into contact with them after that). It drives tremendous spending and resource usage. Improving infection prevention and control would easily check all the boxes of the triple aim (better patient experience, better population health, and lo…
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Apr 1, 2017
Introducing The #HCBiz Show! A Practical Conversation on the Business of Healthcare
Co-hosts Don Lee (@dflee30) and Shahid Shah (@ShaidNShah) introduce the podcast and tell you what to expect in 2017.
The premise behind #HCBiz is that we can't "just innovate". Sure, you may have a great idea, an all-star team and execute flawlessly, but if you don't understand the complex dynamics of the healthcare business you'll never get traction. It'll seem that the system is broken and the people inside of it are irrational. You'll swear that it just doesn't make any sense at all. Well, we're here to tell you that it always makes sense. There just happens to be a dozen or more counter-intuitive, conflicting incentives that are driving the behavior that confuses you. Our job is to help you identify those incentives, break them apart into smaller, more manageable chunks and devise a plan to work with them, around them, and possibly even use them to your advantage. It's like one big innovation serenity prayer and it applies to anyone who's trying to drive change in healthcare from…
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