In late 2023, a multi-hospital health system in the Southeast saw a sudden spike in payer requests for documentation. The compliance team had been running routine retrospective audits, but the pace of incoming denials and takebacks began to outstrip their ability to respond. Within six months, the organization reported more than $11 million in at-risk revenue and a doubling of external audit activity.
Despite their best efforts, the system was playing defense.
This story
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Health IT & Digital Health-Opinion | Op-Eds | Guest Columns | Analysis, Insights - HIT Consultant
Why Ambient AI is Now a Deciding Factor in Clinician Recruitment
Health systems nationwide are grappling with a critical and intensifying challenge: how to attract and retain the next generation of clinical talent.
With the physician shortage not showing signs of slowing down, organizations are in dire need of new strategies to retain the talent they’ve cultivated, while also appealing to younger clinicians who will be essential to meeting the rising demand for care.
Unlike many of their more seasoned counterparts who may be comfortable with
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From Chatbots to Agents: How GPT-5 is Reshaping Healthcare and Pharma
Pharma is embracing GPT-5, shifting AI from chatbot to enterprise agent as it accelerates productivity amid regulatory challenges.
Large pharmaceutical and biotech companies have spent the last couple of years running specific pilots involving artificial intelligence (AI). Learnings from these forays have formed a basis for AI readiness and a guide for industry to weave generative AI into enterprise strategies. Even regulators have been experimenting with AI to offset staff shortages and
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Why AI in Healthcare ERP is the Biggest Opportunity for Cost Reduction
When most healthcare executives hear about artificial intelligence, they think of drug discovery or clinical trials, but the bigger opportunity is happening behind the scenes. Enterprise resource planning (ERP) systems are the backbone of finance, supply chain and compliance, and they’re beginning to leverage AI to transform how healthcare companies understand and act on their data.
By 2025, most major ERP platforms will ship with built-in AI features, but the question is how advanced and
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ACOs Must Lead on Specialty Care to Control Costs
Both the greatest strength and weakness of the ACO shared savings (MSSP) model is its focus on primary care, particularly chronic disease. ACOs have put patients with diabetes, hypertension, and other conditions usually handled through primary care physicians at the center of care coordination, population health, and care management. But as CMS Value-Based Care’s central goal has shifted to cost control, ACOs will need to broaden scope to optimize specialty care. TEAM (Transforming Episode
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Is Your Patient Portal Obsolete? Why a Basic Portal No Longer Meets 2025 Patient Expectations
The goal of a patient portal is to facilitate patient engagement – to give patients a more integral and active role in their own healthcare.
But recent research shows that 65 percent of patients believe that coordinating and managing healthcare – two areas where a portal should be helping – is overwhelming and time-consuming. This friction can have an impact on care outcomes: 54 percent of patients believe their health would be better if they had more support navigating the healthcare
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“How to Make Wound Recovery and the Healing Process More Accessible in America”
My great-grandfather developed a diabetic wound that ultimately led to a series of amputations, and, not long after, to his death. His story is tragically common: every year, millions of Americans suffer from chronic wounds that could have been managed or healed with timely, adequate care. Instead, they progress to amputation and premature death. The stakes are high. Within a year of a diabetes-related lower-limb amputation, nearly 1 in 5 patients will die.
The toll is
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Life or Death Logistics: Why 1 in 5 Donated Organs Are Not Transplanted Due to Communication Failure
In organ transplantation, timing isn’t just critical. It is the difference between life and death. Every transplant is a race against the clock, requiring precise coordination among donor hospitals, transplant centers and surgical teams. Yet despite the stakes, the system designed to save lives is often hindered by something deceptively simple: poor communication.
The problem: Outdated tools in a high-stakes process
Even as medicine advances, many transplant teams still rely on fragmented,
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How AI Frees Nurses and Clinicians to Focus on Care and Quality
It is no secret that clinical staff, particularly nurses, are under constant demand to do more with less. While AI has generated plenty of headlines for its promise to revolutionize care delivery, its true value will be measured by how it supports those on the front lines.
For nurse abstractors, whose work is essential for quality reporting, registry submission, and clinical decision-making, AI can offer something truly impactful. Time.
As more hospitals and health systems deploy AI-driven
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Integrating Narrative Medicine into Elder Support Programs
There has never been a greater need for more comprehensive and compassionate approaches to elder care as countries struggle to support aging populations everywhere. Clinical and custodial frameworks still dominate elder support programs. Still, narrative medicine, a complementary and profoundly human-centered field, presents a chance to change how we interact with and care for senior citizens.
Narrative medicine, initially developed in academic medical settings, strongly emphasizes the
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