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Doug Williams, Chief Operating Officer at HMS

Payment Integrity: Is AI The Real Answer to Reducing Overutilization?

by Doug Williams, Chief Operating Officer at HMS 11/06/2019 Leave a Comment

How AI is making unnecessary testing a thing of the past

Some experts estimate that $200 billion is wasted each year on unnecessary or excessive medical testing and treatment. This could be up to 40% of the unnecessary spending in the system today.  Despite the extreme focus to reduce the total amount spent on healthcare, why does extensive spending on unnecessary or excessive tests or procedures continue? The easy answer is because it is often difficult to spot what is unnecessary or excessive. There are certainly moments when overutilization of
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Accounting for Inherent Vulnerabilities in Healthcare Blockchain Adoption

by Rich Herrington EVP, Client Success Team Leader at SoftServe 11/05/2019 Leave a Comment

Accounting for Inherent Vulnerabilities in Healthcare Blockchain Adoption

In the digital economy, every industry runs on data. In the healthcare industry, there is no greater need than to have total view and capitalization of data. But this need inherits others—the need for security, transparency, and interoperability.  In an industry rife with inefficiencies and systemic vulnerabilities (e.g. counterfeit prescription drugs), the benefits of using blockchain to address these needs cannot be ignored. The application of this technology will provide secure
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Fueling EHR Innovation by Outsourcing e-Prescribing Development

by G. Cameron Deemer, President of DrFirst 11/05/2019 Leave a Comment

Fueling EHR Innovation by Outsourcing e-Prescribing Development

Health IT software – and EHRs in particular – are widely criticized for their inefficient workflows and unfriendly user interfaces. Unhappy end-users may blame EHR vendors for failing to deliver great software, perhaps not realizing that health IT companies struggle to balance limited financial and human resources and must choose between meeting ever-changing regulatory demands and creating innovative updates that improve the user experience.  Consider this: every year, vendors must make dozens
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Provider Credentialing: A Problematic Process Driving Costs and Delays

by Jim Dougherty, CEO and Co Founder at Madaket Health 10/31/2019 Leave a Comment

Provider Credentialing: A Problematic Process Driving Costs and Delays

On a typical day, the average physician sees about 19 patients for roughly 22 minutes each. That’s a busy day and anything that interrupts that schedule is a problem for them and their staff.  One of the things that does disrupt that rhythm is payer paperwork, which is a significant driver of administrative burden and waste in healthcare. Administrative transactions between providers and payers include a wide range of tasks performed by many different entities, but one piece of the puzzle
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How Intelligent Automation Can Address 3 Revenue Cycle Challenges

by Joe Polaris, Senior VP of Product and Technology at R1 RCM 10/30/2019 Leave a Comment

3 Things Patients Want From Their Healthcare Financial Experience

Artificial intelligence (AI) has received a lot of buzz and been positioned as the central healthcare technology needed to solve many financial challenges and digitally transform internal operations. However, if you’re looking for practical solutions that can address variable activities and complete work with a high level of quality, today, healthcare organizations should look to intelligent automation.   Here’s why:  True AI attempts to mimic human cognition. As such, AI remains
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HIT Governance: 7 Key Metrics For Your Quarterly Report Card

by Gerry Blass is President and CEO of ComplyAssistant 10/29/2019 Leave a Comment

HIT Governance: 7 Key Metrics for Your Quarterly Report Card

Healthcare organizations use data to support decision-making for nearly every area of operations. But what about your security and compliance strategy? What metrics are the most valuable to determine how your organization should allocate funding for health IT projects related to governance, risk, and compliance? Top Seven Metrics to Gather For A Quarterly Report Card With an ocean of data at your fingertips, it’s best to determine the metrics that will best support your strategy, and any budget
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3 Myths About Robotic Process Automation in Healthcare, Debunked

by Jason Warrelmann, Global Director of Healthcare and Life Sciences, UiPath 10/28/2019 Leave a Comment

3 Myths About Robotic Process Automation in Healthcare, Debunked

Patients’ wellbeing should be the central focus of healthcare. Unfortunately, this isn’t always the case. Studies show that doctors spend almost half their time on data entry and more than half of their workdays managing records instead of caring for patients. Add this lost time to the fact that healthcare in the United States is already understaffed – averaging 2.5 healthcare practitioners to every 1,000 patients – and it’s easy to see that something’s got to give to bring
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How to Build A Tech-Enabled Flu Immunization Program That Works

by Andrew Reeves, COO at BioIQ 10/25/2019 Leave a Comment

How to Build A Tech-Enabled Flu Immunization Program That Works

While the weather is warm, preventing the flu is usually not top of mind for most healthcare consumers. But for health plans, it’s never too early to start planning for the impending 2019-2020 season. Ideally, people will be vaccinated in the early fall, allowing sufficient time to build antibodies before the season is in full swing.  One of the challenges faced by health plans is designing a flu immunization program that addresses the low vaccination rates for adults in the U.S. Among adults
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Analysis: Why EMRs Will Not Replace Enterprise Imaging IT

by Steve Holloway, Director at Signify Research 10/25/2019 Leave a Comment

Why EMRs Will Not Replace Imaging IT

The growing influence and uptake of electronic medical records (EMRs) in healthcare have driven debate over the future role of specialist clinical and diagnostics software. With interoperability in the health sector still a major challenge, many health providers are looking to simplify their IT systems, consolidating to fewer software platforms and few vendor partners. With recent extensive and long-term investment in EMR systems, some healthcare providers considering the EMR as a potential
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How Value-Based Care is Changing the Way You Build Digital Health Companies

by Sean Walker, Partner at The Bowdoin Group, Josh Gottlieb (Managing Director, Digital Health) at The Bowdoin Group, and Michelle Mattson-Hamilton, Associate Principal at ST Advisors 10/24/2019 Leave a Comment

After years of talk, fee-for-service payment models are finally being challenged in a real way. With value-based care, providers are reimbursed based on patient health outcomes rather than the number of patients they see, which has begun to pass the burden of cost from insurers and employers to providers and patients. Fundamentally, value-based care requires vendors as well as providers to operate differently, but new revenue models and a new approach to hiring deserve special consideration. In
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