Encounter data such as diagnosed clinical conditions and services, or items delivered to healthcare consumers to treat these conditions is the key to success for all healthcare organizations participating within the government space. Whether doctors or hospitals are submitting data for medical services rendered under Medicare Advantage, the Affordable Care Act’s state exchanges or Medicaid, encounter data is used for payment reimbursement and reconciliation between the health plan and the
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Health IT & Digital Health-Opinion | Op-Eds | Guest Columns | Analysis, Insights - HIT Consultant
Are EHRs A Guard Against Human Nature?
Because we have big brains and have been to the moon and have invented remarkably complex stuff, the idea persists that human beings are inherently rational. This idea is both untrue and ironic, but not in a black-fly-in-the-chardonnay way.
Rational beings, by definition, would make decisions based on proven, reliable data and learned the reason. Most of the time, human beings use impulses, moods, emotions and urges to make decisions, all the while believing they are the reincarnation of
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AI Will Continue to Improve Healthcare, But Only If We Can Trust It
While the public perceives artificial intelligence as futuristic, AI is already intertwined with healthcare today. As a PwC report observed, AI is transforming numerous aspects of healthcare, from medical training and research to wellness and treatment. But while AI is already supercharging our capabilities (it’s 30 times faster and 99 percent accurate when reviewing mammograms, reducing the need for unnecessary biopsies, for example), AI is also supercharging the disparities that are baked into
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Beyond Healthcare Data; Shifting the Focus to Non-Healthcare Data
The recently proposed information blocking rule from the ONC and CMS has thrust interoperability into the spotlight like nothing has in recent years, making it a hot topic for media fodder, and a major concern for organizations — necessitating renewed attention to data-sharing practices.
The conversation surrounding this new rule has implied that information blocking is the result of healthcare organizations intentionally withholding data. However, more often than not, information blocking is a
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Do We Know When Medical Devices Fail?
Since 2015, the FDA and the US Department of Homeland Security have been releasing warnings about products that due to their vulnerabilities threaten patient safety. This includes MRI machines and drug infusion pumps that supply patients with a wide diversity of drugs, including insulin, antibiotics, chemotherapy drugs, and pain relievers. The interconnectivity of smart devices with medical clinical systems leaves them vulnerable to security breaches just like any other networked computing
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Leveraging AI and Machine Learning to Advance Interoperability in Healthcare
(Left- Wilson To, Head of Worldwide Healthcare BD, Amazon Web Services (AWS) & Patrick Combes, Worldwide Technical Leader - Healthcare and Life Sciences at Amazon Web Services (AWS)- Right)Navigating the healthcare system is often a complex journey involving multiple physicians from hospitals, clinics, and general practices. At each junction, healthcare providers collect data that serve as pieces in a patient’s medical puzzle. When all of that data can be shared at each point, the puzzle is
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How Multi-Payer Portals Incent Providers to Better Manage Their Data
Mark Martin, Director of Payer Solutions for Availity
Value-based healthcare demands meaningful payer-provider collaboration. However, burdensome administrative processes and inefficient solutions stunt the ability of payers and providers to share data, manage risk, validate credentials, process claims, control costs and optimize the consumer experience.
These information bottlenecks are most acute in the area of provider data management (PDM). Each year, payers and providers spend more than
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5 Key Factors for Developing A Customized Tool for Capital Project Planning
Off-the-shelf software, such as the kind used for basic accounting or word processing, is typically great for meeting standard business needs. It can be challenging to use commoditized software to assist with more complex calculations or decisions, such as those involving major capital projects, without significant thought, preparation and execution of utilizing higher-level functions.
Specialized, big-ticket and enterprise-critical projects that depend on software tool analytics and assistance
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How Software Solutions Can Help ASCs Maximize the Revenue Cycle in 2020
In the modern health care environment, health care executives must be careful custodians of precious resources. Yet in December 2018, 26 percent of hospitals still lacked an effective healthcare revenue cycle solution. Other research has found that over 60 percent of hospitals and health systems are not realizing optimal value from their electronic health record (EHR ) system, causing the organizations to collaborate with other vendors and outsourcing companies to improve revenue cycle
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Health Data Privacy: Why Eroding Public Trust Harms Medical Research
Using Data Privacy to Empower Health Research
The importance of data security and data privacy policies have recently come under scrutiny due to revelations around Google’s Project Nightingale. The initiative with Ascension, the nation’s largest nonprofit health system, granted Google access to medical records of more than 50 million individuals in 21 states and may hinder the trajectory of health discovery by eroding “consumer” trust.
While historically it might have been a safe harbor to
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