Billions in payments disrupted. Patient care stalled. Personal data of one in three Americans exposed. The February ransomware attack on Change Healthcare, a UnitedHealth subsidiary, didn’t just shake the industry—it shattered it. It shouldn’t take massive breaches to highlight the glaring need for better cybersecurity in healthcare, but unfortunately here we are. In response, the White House is now stepping in, commiting over $50 million for the UPGRADE Program. This landmark initiative
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The Good, the Bad, the Ugly When Leveraging AI in Healthcare
Much has been discussed about artificial intelligence (AI) and the impressive proliferation of Generative AI (GenAI) over the last several months. It is staggering. As I think about the potential changes and impacts of leveraging AI and GenAI within a healthcare organization, I can’t help but think about the good, the bad, and the ugly.
Good: Ambient AI
There are many positive examples so far, where AI can improve healthcare, but one stands out for me: ambient AI technology. It’s a
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Beyond FHIR: AI’s Potential to Revolutionize Healthcare Data Insights
For decades, one of the most daunting tasks in healthcare has been managing and making sense of the vast amounts of data generated annually. From patient and outcomes data to billing and scheduling data, the list goes on and on.
The predominant challenge lies not just in quantity but like this data: much if not most of it is unstructured, i.e., data that isn’t predefined and searchable on a table, such as text messages, images, videos, audio files, and emails.
Historically, healthcare
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How to Implement Remote Therapeutic Monitoring with Success
Implementing remote therapeutic monitoring (RTM) successfully holds the key to revolutionizing healthcare delivery, enhancing patient outcomes and care efficiency. RTM leverages digital health technologies to monitor patients' conditions and adherence to treatment plans in real time, facilitating timely interventions and personalized care. This innovative approach not only empowers patients by providing them with continuous support but also allows healthcare providers to make data-driven
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From Chaos to Calm: How ER Scheduling Could Help Fix Emergency Care Challenges
Staffing shortages and rising costs leave ERs in chaos and even force some hospitals to shut down money-losing emergency departments altogether. Chaotic or closed emergency rooms not only cost lives but cut off a pipeline of new patients that provide income for hospitals and jobs for specialist physicians.
The main driver behind ER chaos and expense is a nationwide shortage of trained doctors and nurses. A single nurse often has to care for ten or more patients in the ED simultaneously,
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Moving Nurse Leaders from Task Managers to Business Leaders
As a CNO of more than 20 years, I have observed the nurse manager role evolve from what we would typically think of now as a charge nurse to that of essentially serving as the CEO of a multi-million-dollar enterprise. Nurse managers are responsible not only for clinical quality and patient satisfaction, but also for financial performance, employee engagement, operational efficiency, accreditation, regulatory standard compliance, and more. They are the linchpins to achieving hospitals’ strategic
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Harnessing AI to Navigate the Shifting Landscape of Member Engagement
The healthcare landscape continues to evolve rapidly, driven by advancements in technology and the ongoing shift towards alternative payment models. As payers navigate this increasingly complex environment, member engagement has emerged as a critical factor in ensuring the success of healthcare initiatives. Now, with the emergence of artificial intelligence (AI) in healthcare and value-based care, understanding and prioritizing member engagement has become more important than ever.
Patient
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Can Community Hospitals Weather the Financial Storm? What’s Needed
A recent survey of community hospitals found nearly 70% rate their financial health as “average” or poor.” In this environment, community hospitals must take a fresh look at their approach to patient financial engagement to protect their ability to provide needed care.
Hospital out-of-pocket collections declined sharply this year, down to nearly 48%, a Kodiak Solutions analysis shows. Moreover, more than half of write-offs — 53% — last year involved patients with some form of insurance,
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The Critical Importance of Payer-Provider Collaboration Goes Beyond Prior Authorization
The critical need to improve prior authorization processes might have reached its tipping point on Jan. 17. That’s when the Biden administration announced its new mandate — the CMS Interoperability and Prior Authorization Final Rule — designed to effectively speed up the process for Medicare Advantage patients, providers and health plans.
Speed is only one of many inefficiencies surrounding prior authorization. And prior authorization cases are only one slice of the patient
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Overcoming the Financial Costs of SDoH: 3 Ways Providers Can Help
Social determinants of health (SDoH) factors often take a financial toll on patients, making it more difficult for them to afford and access the care that they often need to overcome some of those same SDoH issues.
While providers certainly can’t wave a magic wand and make their patients’ SDoH struggles disappear, they can take a few concrete steps to help these patients pay for important care.
Improved SDoH, Improved OutcomesSDoH are defined as “the conditions in the
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