Today’s healthcare system is broken—mostly operating as a “sick care” system that too often manages disease or symptoms without regard for the interconnectedness of the human body or the factors that serve at the root causes of disease. Care often consists of “quick fixes” and prescription-heavy treatments that don’t address these root causes. This “sick care” model prioritizes throughput and procedures over genuine health and wellness, leaving patients and providers feeling disconnected and
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Epic UGM 2024: 3 Enduring Takeaways
Epic's Users Group Meeting (UGM) this year made one thing clear: AI adoption is accelerating, and fast. The developments we’re seeing are pushing the entire ecosystem of providers, payers, and patients to adapt. As a leader in AI medical coding, I see significant and exciting implications for leaders in health IT and revenue cycle management.
With a month of distance from UGM, what are the top three takeaways still shaping conversations and opportunities? Here are my takes and what they
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Generative AI and Healthcare: Pragmatic Considerations for Proof of Concept Frameworks
In pure technology terms, there is no better example of an idealized solution in search of problems than AI in healthcare. Does it have great promise? Absolutely. Will it move from pilot to production-ready to solve a broad range of critical industry and organizational level problems rapidly, even this year? Unlikely. But hype cycles usually outpace reality when it comes to usability and the early adoption of highly disruptive technologies. The promise of AI in the healthcare
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How AI is Transforming Hospitals: From Administration to Patient Access
Artificial Intelligence (AI) is often hailed as the frontier of technological advancement, and its impact on healthcare is profound. As a relatively young discipline straddling the line between computer science and sophisticated analytics, AI is increasingly becoming integral to hospital operations. But the true question remains: how is AI revolutionizing the way hospitals function? And perhaps more importantly, what does this mean for the future of patient care? To better understand the
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High Stakes of Digital Transformation in Healthcare: Why Build vs. Buy Matters
There has never been more pressure for health systems to invest in digital transformation, especially when it comes to strengthening the consumer experience, according to a recent Deloitte survey. Key findings from the research suggest that existing digital offerings available through health systems are not adequately meeting consumers’ needs.
For instance, Deloitte found that while health systems do a good job of meeting consumers’ access and care needs “within the walls,” their
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Best Practices for Conquering Data Management Challenges in the Pharma Industry
Managing data effectively can be challenging in any context. But it's especially difficult in an industry like pharmaceuticals, due both to the sensitivity of the data and the severity of consequences that result from data management mistakes.
What can pharma companies do to implement an effective data management strategy? There are no simple answers, but as I explain below, there are best practices that can help optimize the way pharmaceutical businesses collect, integrate, analyze and store
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Overcoming Population Health’s ‘Trust Factor’ for Effective Case Management
As population health initiatives for Medicare and Medicaid members pick up steam, one of the biggest obstacles to care transformation remains a lack of trust among healthcare’s key stakeholders.
It’s an issue leaders must address—starting at the user level—if they are to strengthen health outcomes for the country’s most vulnerable patients.
Unlocking value from population health management depends on stakeholders’ trust in the data that drive population health insights and the
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Healthcare Cybersecurity: Combating Complexity with Advanced Analytics
Almost weekly, we see headlines about cyber incidents disrupting patient care, compromising patient privacy, or both. The growing interconnectedness of the healthcare ecosystem, combined with heavy reliance on third-party providers, is amplifying the impact of these incidents. This interconnectedness is not only expanding the attack surface but also increasing vulnerabilities across the entire sector, as seen in recent high-profile attacks on UnitedHealth Group's Change Healthcare and Ascension.
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The Future of Medicaid: 4 Considerations for MES Modernization
More than 75 million people access comprehensive and cost-effective care through Medicaid, including low-income families, older adults, and individuals with disabilities or chronic conditions.
Given the program’s importance in addressing the health needs of vulnerable populations, optimizing the experiences of Medicaid members and providers is critical. How they interact with the program can impact many outcomes, from member access and care utilization to provider participation and
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Transforming Insurance Verification and Authorizations with AI
Across many healthcare organizations, front-office staff face a significant dilemma: patients seeking help only to be told that their health insurance verification and authorization process could take several days or even months. According to a study by the AMA, more than nine in ten physicians recently surveyed said that prior authorization negatively impacts patient clinical outcomes and, often, leads to treatment abandonment.
This issue mainly arises because current, manual insurance
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