This past year, California became the latest (and largest) state to legislatively mandate an all-payer claims database (APCD). As the name implies, an APCD is a statewide repository of all claims information from a state’s health care payers, including both commercial and government.
The intent of an APCD is to help policymakers and others better understand the drivers of health care use and costs and spot usage trends across networks, facilities, and geographies. An APCD could also help assess
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Health IT & Digital Health-Opinion | Op-Eds | Guest Columns | Analysis, Insights - HIT Consultant
Five Lessons Learned From Building A CRM for Pharma
We all know the pleasure of interacting with technology that does exactly what it’s designed to do. Whether it’s getting to your destination via Waze, reserving dinner through OpenTable or making an electronic payment through Venmo, applications that work have one important thing in common: they are designed with a purpose and are the true experts in getting exactly that thing done seamlessly.
But professional industry software, especially when it comes to healthcare, is a lot more complex.
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Artificial Intelligence’s Need for Health Data – Finding An Ethical Balance
With doctors’ time in short supply, one area in which AI-driven tools could help transform healthcare is by increasing diagnostic accuracy. AI-driven diagnostic tools, especially in areas like cardiology, have the potential to save the healthcare system money and most importantly save lives. They are developed using incomprehensibly large datasets and can, therefore, discover patterns that are invisible to the human eye.
For example, echo-based tools combined with deep clinical insight,
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Google-Ascension: Why Is HIPAA Probably Not Being Violated?
- Various arrangements between Google and systems including the Mayo Clinic, University of Chicago, and Ascension draw concern and fears of Google just taking multitudes of personal information about thousands or millions of individuals.
- Despite the most common statement being that Google is stepping around HIPAA, the most likely answer is that Google (and really many other technology-based vendors) can receive the data as a business associate.
- Why is HIPAA probably not being violated?
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EMR Replacement: Abstraction or Data Migration?
Most healthcare organizations have already managed the transition from paper to electronic medical records. It was time-consuming, challenging and nerve-wracking. But with the first-generation of EMRs approaching the end of their usefulness, with mergers and acquisitions requiring the adoption of new systems (most incompatible with the legacy systems), with the advent of new government standards, more rigorous legal requirements and higher expectations associated with “value-based care” and
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Price Transparency: Why Hospitals Need to Focus On Understanding Their Data
This year, hospital price transparency took a front seat after CMS issued a new set of rules and requirements. While they haven’t been written into law just yet, these rules will help set a framework for the kinds of requirements that are likely to become standard soon. With that in mind, now is the time to begin preparing for the inevitable. Creating a proactive response to the new changes as well as the evolving competitive environment and expected a response from consumers is essential for
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Privileged Only: Is Digital Health Tech A Solution for Elites?
Healthcare disruptors are betting the farm on digital health technology, and they have the funds to validate their enthusiasm. Investments in digital health startups came in at a staggering $8.1B at the end of 2018, marking an increase of 42% from 2017. While investments are slowly beginning to level out in 2019, analysts see this as a sign that the industry is maturing; not, as some thought, as a signal of pending collapse.
Health tech has been touted as the cure-all for financial
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Disruptors or Interrupters? How Apple Is Faring In Their Healthcare Initiatives
Key Highlights
- Part one of our new in-depth series on Apple, Google, and Amazon's latest healthcare efforts since our last report in April 2019.
- A look at Apple's recent healthcare developments, as well as an analysis of what goes beyond the news.
Over the last few decades the “digital age” has enabled many garage-based startups to transform into sustained successes by targeting problems that begged to be solved digitally. Sometimes their leaders identified and resolved
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Solving Healthcare’s Data Challenges With Storage-As-A-Service
Managing healthcare data is a special kind of a nightmare for IT professionals. First, the industry is highly regulated. The Health Insurance Portability and Accountability Act (HIPAA) requires strict attention to a complex set of rules governing access, security and privacy. A failure to follow them can result in heavy fines and ruined careers.
Then, there’s the problem of capacity, because, in healthcare, not only is the amount of data doubling every two to three years, but individual files
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Payment Integrity: Is AI The Real Answer to Reducing Overutilization?
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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