The U.S. health care system loses more than $100 billion a year to fraud, waste, and abuse, and by some estimates several times that. We have known this for decades. What is new is that the technology to catch it has finally caught up. The question is no longer whether the tools work; it is whether the institutions processing and paying the faulty claims will finally use them.
What the system is actually losing
Three different problems get lumped together, so it is worth
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Health IT & Digital Health-Opinion | Op-Eds | Guest Columns | Analysis, Insights - HIT Consultant
The Real Truth About Zero Data Retention: What AI Coding Tools Actually Promise in a HIPAA-Compliant World
A developer on your team is debugging a scheduling algorithm. They paste a function into an AI coding tool that references a patient's Medicaid eligibility window. Did that data just get retained? Logged? Used for training? For most engineering leaders, the honest answer is: they don't know.
That knowledge gap has a cost. IBM's Cost of a Data Breach Report found that 63% of organizations lack formal AI governance policies, and as AI tooling becomes embedded in everyday development
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The Future of Pharmacy Procurement:
From Purchasing Function to Data-Driven Strategy
With drug prices soaring, shortages intensifying, and government-mandated cost-sharing in question, hospital-system pharmacy procurement is becoming an increasingly fraught enterprise. Pharmacy leaders are routinely expected to deliver on critical outcomes, including financial performance, operational resilience, and regulatory readiness.
Health systems – with margins currently hovering around 2% and cash reserves plummeting – are pressuring pharmacies to shore up institutional viability.
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How AI is Helping Healthcare Leaders Translate Patient Experience Data into Action
Every time a patient visits a healthcare facility, there is a treasure trove of information about their experience that could improve patient safety measures and lead to better outcomes.
Patients’ care experiences go far beyond clinical care. A patient recovering from surgery for a few days may interact with more than a dozen providers, specialists and staff. The patient may be moved from a surgical unit to a medical unit or an inpatient rehabilitation facility. They may be discharged
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Pharma Is Deploying AI Faster Than It Can Understand Its Risk
A year ago, integrating AI-powered clinical workflow tools could take months of review and planning across disparate teams within a pharmaceutical company's IT, security, and risk teams. Today, with the proliferation of tools that have less than a month of onboarding and can provide immediate value to clinical teams, the way risk is approached has changed. For better or worse, AI capabilities are outpacing the security programs meant to govern them, and many companies are simply assuming risk
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Combined GI Endoscopy Has a Quality Assurance Gap. At Current Volume, That Gap Has Institutional Consequences.
Combined GI endoscopy is already standard practice across many US health systems. When both procedures are clinically indicated, around 65% of patients undergo them in the same session or close window: one prep, one sedation, consolidated throughput.
The efficiency logic is sound, but what the operational analysis hasn't fully accounted for is the risk that sits inside that efficiency gain. Upper GI and lower GI are not equivalent procedures in their quality infrastructure. Colonoscopy has
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Healing Without Drugs: A Promising Future for Alzheimer’s Patients
Of the medical diagnoses that cause anxiety, sorrow, and despair for patients and their loved ones, Alzheimer’s is near the top of the list. An incurable condition that slowly robs people of memory, identity, and independence, Alzheimer’s puts immense financial and emotional burdens on families.
That may be changing for more than 7 million Americans living with the disease, and the hundreds of thousands more who are newly diagnosed each year. A new wave of scientific and technological
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OBBBA Requirements | Behavioral Health Clinics Must Modernize Their Technology Now
The implementation of the 2025 One Big Beautiful Bill Act (OBBBA) left community clinics that rely on Medicaid patients at a critical juncture. The bill introduced new policy variables that will affect clinics unevenly across the country, with facilities in Medicaid expansion states likely to experience a more pronounced impact.
CEOs and leadership teams face significant decisions. What are the bill’s most pressing provisions? How are Medicaid expansion and non-expansion states affected
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The Silent Signals of Burnout: What Workplaces Miss About Employee Mental Health
The Federal Aviation Administration restricts how long commercial pilots can be in the air, mandates minimum rest between flights, and caps hours flown per month and per year. The science of fatigue played a large role in the development of these rules to protect pilots.
Fatigue isn’t the only factor in a pilot’s mental well-being. Imagine if, just before a long flight, they learned their best friend died. That kind of news could raise a person’s stress response in a measurable way.
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We Spent a Decade Filling EHRs. It’s Time to Make Them Pay Us Back.
A few years ago, a physician I worked with told me that her young daughter had started greeting her at the door with a question: “Mommy, how many charts do you have to finish today?” Her daughter had learned that the higher the number, the less of her mother she was going to get that night.
That story has stayed with me through more than two decades in clinical informatics, because it captures something the data has been telling us for years. Recent research from the American Medical
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