The #HCBiz Show! - SoundSage

On this episode, we talk with Matt Hollingsworth, CEO of Carta Healthcare, about ChatGPT.

If you've been reading the headlines, and maybe even experimenting with Chat GPT yourself, but don't quite grasp what's going on, then this episode is for you.

Mat gives a not-too-technical, high-level explanation of what's going on under the hood so that you have proper context for the discussion.

Then, Matt outlines the potential benefits, and potential harms, of applying ChatGPT in healthcare.

Finally, Matt shares his experience launching Carta Healthcare, including how he convinced VCs that software plus services could scale better than a pure SaaS offering in this space.

This is a good one. I'm honestly not sure in which part of this conversation I learned more.

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Medicaid Transformation. 1115 waivers. Delivery System Reform Incentive Payment (DSRIP) programs. Expansion. Contraction. We’ve been at this for a long time. Why isn’t Medicaid transformed already?

Well… it turns out that this is really difficult work.

First off, there are complex political and ideological issues. Even if we all agree that we want the best healthcare for every American – a conceptually easy outcome to rally behind – we don’t all agree on what that looks like, how to get there, or how to pay for it.

Second, it takes a long time for policy levers to play out in the real world. That makes it exceedingly difficult to measure the success of our programs, which further exacerbates the first issue.

Add in a bunch of multi-billion-dollar entrenched institutions, technology hurdles, and social determinants of health, and you are still just scratching the surface of the many issues that need to be addressed and aligned to “succeed”.

But all is not lost. We’ve learned a lot over the past 30-40 years, and we’ve made progress in many areas. There are approaches and mental models that have led to certain levels of success. And today’s guest has been participating in and observing many of them over the past few decades.

Today we talk with Alan Weil, Editor-in-Chief of Health Affairs, the nation’s leading health policy journal.

Alan takes us through the history of Medicaid Transformation from the early 1980s on. We discuss the approaches taken, the thinking behind them, and the many factors that influenced their success. We explore the conflicts and hurdles, the friction and confounders, not to define a path forward, but to give the listener a more productive framing from which to build.

This is admittedly a bit more of a philosophical discussion than what we usually have on this show. However, I feel we’ve taken a practical approach to the philosophical exploration and yielded actionable advice on how to adjust your frame.

Please do let us know what you think!

For full show notes and links, visit: https://thehcbiz.com

And of course, find everything from Health Affairs at: https://www.healthaffairs.org/

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Cleveland Clinic recently announced that they would begin charging for certain patient-initiated messages. This flies in the face of everything the industry is talking about when it comes to patient engagement and value-based care.

At the same time, it is quite unreasonable to think that a doctor should be available for questions at any time, for free.

How can we protect the clinicians' time AND provide the patients with the care and attention they need?

And why are we moving away from value-based care?

Craig Joseph, MD, Chief Medical Officer of Nordic Consulting Partners, and Matt Lambert, MD, Chief Medical Officer for Curation Health join Don Lee to share their take.

Craig's article that led to this episode: To charge or not to charge

For full show notes and links, visit https://thehcbiz.com

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Don and Shahid discuss NCQA's Health Innovation Summit (November 2022) and FHIR Dev Days (June 2022). They explore these events as examples of how to interpret what you hear at conferences, in industry media, and even on podcasts like this.

The discussion covers a lot of ground including:

What is NCQA?
What is HEDIS?
What does it mean to move from Electronic Clinical Quality measures (ECQM) to Digital Quality Measures (DQM)?
Can FHIR really do all that!?
Specified, but not implemented (this is important)
Why is it hard to innovate and sell innovations in the quality measure space?
How are health equity and social determinants of health factoring into quality measurement?

It's a fun conversation, but... take it with a grain of salt.

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On this episode, we talk with Ray Dogum, MS, MBA about the state of blockchain and web3 technology in healthcare. Ray is the producer and host of the Health Unchained podcast where he discusses blockchain developments in healthcare with industry experts.

There was quite a hype cycle around blockchain in healthcare that has died, but there is still real development being done and plenty of opportunity to create value in the future.

We’ll break down the pockets of success that are happening today and talk about where things could be headed in the future.

For complete show notes and links visit: https://TheHCBiz.com

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Some people tell doctors that anything more than a cup of coffee is a conflict of interest. What about executives? Is it ok to take them out to lunch? What about a trip to the Super Bowl? Is there a line? Where is it?

On this episode, Don and Shahid discuss a recent LinkedIn discussion where a healthcare executive called shenanigans on himself and his colleagues for accepting gifts.

The gift is a symptom... not the underlying issue.

Tune in to find out what the issue is and how to fix it. Plus, learn why Don hates RFPs and how we can do those better too.

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There's no business case for doing the right thing in healthcare. Fortunately, being patient-first is the right thing to do and can be good for business too.

Today we talk with Brian Sanderson, national healthcare management leader at Crowe LLP and author of the new book, The Patient-First Revolution. In it, Brian provides a blueprint for hospitals to skyrocket net revenue by boosting patient experience (#HCBiz listeners can grab a free copy of the book here).

Brian explains it's important to think about more than short-term financials. Yes... you need to operate efficiently and run a sound business… those are table stakes. The hospitals and health systems that take it to the next level will do so by playing the long game and being patient-first.

This conversation continues our ongoing exploration of the Healthcare Delivery Organization Innovation Lifecycle Ontology (HDO-ILO). Brian helps us understand how to make the case for prioritizing patient-first practices and how to set and manage expectations within the organization. This, of course, is a critical early step for any healthcare innovation effort.

For full show notes and links, visit https://thehcbiz.com

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It's easy to experiment with new tech and produce products that look and sound innovative. It's much harder to tie your innovation efforts to strategic objectives with measurable outcomes and then scale the solution across your organization. The former leads to "death by pilot". The latter makes a difference in people's lives.

We need a more disciplined approach to innovation if we want to make a difference.

In this episode (Ep. 201) we introduce the concept of the Healthcare Delivery Organization Innovation Lifecycle Ontology or HDO-ILO. That's a fancy way of saying that we are attempting to codify what we've learned over the past 200 episodes and through our decades of Health IT / Digital Health innovation experience.

You can find the current draft here:

Healthcare Delivery Organization Innovation Lifecycle Ontology (HDO-ILO)

Our goal is to help the industry move from a haphazard way of innovation to one that is more thoughtful, deliberate, targeted, measurable, and repeatable.

And we need your help!

There are several asks for the community throughout this episode. Please send us your ideas and experiences. We'll bring you on to share them with the #HCBiz community and we'll incorporate them (with credit) into the HDO-ILO.

Let's innovate on purpose, and with purpose. Together...

Find more at: https://thehcbiz.com/201-building-an-innovation-lifecycle-ontology/

Watch this episode on YouTube

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On this episode, Don Lee and Shahid Shah celebrate 200 episodes of The #HCBiz Show!

We discuss what we've done over the past 6 years and tell you where we're headed next.

In a nutshell, we're going to work to codify what we've learned about innovation in healthcare over the past 200 episodes and in our decades of deploying digital health solutions.

We're steering the effort, but we need your help. There will be plenty of ways to get involved.

Thanks for learning with us over the past 200 episodes. Here's to 200 more!

Oh... and we're on YouTube now too if you prefer the visuals: The #HCBiz Show! - YouTube

Learn more at https://TheHCBiz.com

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There’s no shortage of development when it comes to AI and ML in healthcare. The technology is already powerful and continues to advance. The challenge, as always, is getting things into the clinical workflow. And doing so at scale.

Nuance has a plan to help innovators and health delivery organizations find alignment and get the right tools integrated into the clinical workflow quickly.

Nuance started with ambient intelligence in the sensory realm. In computing, ambient intelligence (AmI) refers to electronic environments that are sensitive and responsive to the presence of people. Today, Nuance’s Dragon Ambient eXperience (DAX) can capture and code the natural conversation as it occurs between doctors and patients. Soon, ambient sensor tools will be able to see what’s going on in the exam room too.

Building on the sensory tools, Nuance’s somatic ambient intelligence will allow AI to help doctors understand what’s happening inside the body too. And that starts with imaging.

The Nuance Precision Imaging Network (PIN) is designed to integrate imaging insights into the broader healthcare ecosystem and facilitate the use of AI to inform precision diagnostics and therapeutics. In short, Nuance is allowing innovators to deploy their models on top of existing infrastructure in healthcare delivery organizations across the country. And in doing so, they are making it much easier for healthcare delivery organizations to experiment with these models. A real win-win that could accelerate the integration of ambient intelligence into the clinical workflow.

On this episode, we talk with Peter Durlach, Executive Vice President, and Chief Strategy Officer at Nuance, about the technology, the strategy, and the roadmap. Plus, we discuss the AI Collaborative Nuance launched with The Health Management Academy.

Full show notes and links: https://thehcbiz.com/199-ambient-intelligence-peter-durlach/

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Nuance has a plan to help innovators and health delivery organizations find alignment and get the right tools integrated into the clinical workflow quickly.

Building on the sensory tools, Nuance’s somatic ambient intelligence will allow AI to help doctors understand what’s happening inside the body too. And that starts with imaging.

Full show notes and links: https://thehcbiz.com/199-ambient-intelligence-peter-durlach/

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It is now widely accepted that socioeconomic issues like food, housing, transportation, and more, directly drive health outcomes in the U.S. These issues hinder access to quality healthcare, and create obstacles to education and stable employment. In the former context, they are often referred to as the Social Determinants of Health. In the latter context, we might consider them the Social Determinants of Success.

One organization that sees it this way is Ultimate Medical Academy (UMA) – a nonprofit healthcare educational institution based in Clearwater, Florida. UMA has instituted what it calls a “culture of care”. That means they are fully committed to addressing the socioeconomic issues that make it difficult for students to apply, attend, and learn at their schools. UMA is committed to providing the support its students need to thrive inside and outside of school.

The culture of care is grounded in a commitment to diversity, community development, and a lifetime of support pledge to every student.

They do this, of course, because it is the right thing to do. But it is also perfect for business! Good for their business as the word of mouth from past students becomes a powerful recruiting tool. And good for the business of health care too. After all, their students will know firsthand the value of receiving this type of support and they will bring it into the healthcare workforce with them. Who better to fix our SDOH issues than those who have already overcome them?

We discuss this, and much more with Rebecca Sarlo, Associate Vice President, and Director of Ultimate Medical Academy’s Clearwater Campus where she oversees both the academic and operational functions at the campus.

For full show notes and links, visit https://TheHCBiz.com.

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There are many areas where customer service is lacking in healthcare, but few are more egregious than the medical records request process. It’s frustratingly slow, needlessly opaque, and contributes to patient safety issues and staff burnout. And it’s making most of our health systems look bad.

Today’s guest is not just calling for a better customer service experience in the medical records request process… she is creating the tool to help get it done.

Grace Cordovano is a board-certified patient advocate who knows the medical records process inside and out. She’s helped countless patients navigate the health system and has felt the needless pain of the medical requests process firsthand. Over and over and over again. Now, she’s teamed up with our own Shahid Shah to build Unblock Health.

Unblock Health is a comprehensive suite of patient advocacy services designed for patients and consumers who are determined to be empowered in their health care journey and are no longer willing to accept traditional barriers to their information. And it will help Health Information Management (HIM) professionals track medical record requests and process them more efficiently too.

This is one of the lowest hanging fruits in healthcare transformation. And one that could immediately, and drastically improve the patient experience.

For full show notes and links visit: https://thehcbiz.com/197-medical-records-requests-as-critical-customer-service-issue-with-grace-cordovano/.

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Last year we learned how Nayya was using data to help employees pick the best health plan. Founder and CTO, Akash Magoon told us that they were “restacking the financial odds in favor of American Families.” We loved that mission, and apparently, the market did too. Nayya has grown tremendously since we spoke and recently raised $55M in Series C financing.

Now that Nayya has helped us pick our plans, they are taking the next logical step to help Use them.

On this episode, we talk with Satvik Gadamsetty, Engineering Manager for the Use squad at Nayya. Satvik helps us to understand why this step is important, how they are approaching it in a data-driven way, and how their engineering approach maintains focus on the consumer as their north star.

In addition to getting to know more about the Use product, you’ll learn about the engineering principles that are being applied to make it a reality. We discuss telemetry, deployment, prioritization, and much more.

For full show notes and links, visit: https://thehcbiz.com/196-engineering-to-your-north-star-satvik-gadamsetty/

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It's natural to reach for advanced analytics, machine learning, and other potentially transformational technologies in healthcare. That’s especially true in oncology where speed to diagnosis and speed to care are critical. However, there are fundamental data needs that must be mastered if we are going to be successful.

Today we talk with C.K. Wang, Chief Medical Officer at COTA about these fundamentals:

A surprising number of physicians and health delivery organizations still do not fully grasp the importance of data nor how to use it to enhance care delivery
Many provider organizations cling to a disabling view of HIPAA and other privacy laws that make them slow to share critical data when it's needed most
Data completeness and data fidelity issues continue to fly under the radar due to issues 1 and 2

Bottom line: You cannot hope to succeed in risk-based models until you stop putting all your patients into the same bucket. And you can’t do that until you’ve mastered these data fundamentals.

Learn how COTA helps its customers overcome these issues and puts them on a path to succeed in value-based care.

Plus, we take a look at how COTA is helping the Miami Cancer Institute explore racial and ethnic disparities in the diagnosis and treatment of cancer.

For full show notes and links, visit: https://thehcbiz.com/195-the-data-fundamentals-that-enable-value-based-care-c-k-wang/

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MedTech and Life Sciences commercialization expert, John Giantsidis of CyberActa, assesses the current regulatory environment around Medical Devices, the Internet of Medical Things (IoMT), and wearables. John shares best practices on how to gain regulatory approval and how to make compliance part of your company’s culture. Plus, he provides actionable advice on how to generate evidence and provide your prospects with quantifiable proof of value.

If you’re developing a new medical device, IoMT, or wearable solution, then this episode is for you.

The Summit on Embedding Privacy in Digital Health

For full show notes and links: https://thehcbiz.com/194-privacy-and-security-by-design-john-giantsidis/

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There is a lot of attention being paid to the patient experience, and rightly so. However, we haven’t paid enough attention to our clinicians and caregivers and what they need to guide our patients thru that experience.

Providers struggle to keep up with the increased touchpoints and questions without the proper tools. That increases stress and deepens the crisis of burnout amongst clinicians. Worse yet, it leads to unanswered questions and missed opportunities to meet our patients where they are.

It turns out that doing this job halfway is worse than not doing it at all.

On this episode, we talk with Omar Nagji, Chief Commercial Officer at Memora Health, about how to close the gap and provide clinicians with the tools and support they need.

Memora Health was founded on the idea that you must support the workforce in any attempt to improve the patient experience. Omar walks us through their approach to doing just that. This includes digitizing care journeys, deploying chatbots to automate the “easy stuff”, and escalating to clinicians at the right time.

Listen in to hear best practices on digitizing patient journeys, reducing friction in communication between patients and providers, and how to tie it all together in a meaningful way.

Full show notes and links: https://thehcbiz.com/193-empower-the-care-team-to-empower-the-patient-with-omar-nagji/

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Digitization means taking paper charts and putting them into EHRs. Digital transformation means leveraging the digital asset to do something we never could before. Applying AI/ML in healthcare will be one of the primary ways we carry out that digital transformation.

Today we discuss all of this with Prashant Natarajan, VP of Strategy and Products at H20.AI and co-author of the new book Demystifying AI for the Enterprise.

Prashant tells us our goal for digital transformation is to "help the humans of healthcare achieve better outcomes". That means better experiences and outcomes for patients, providers, administrators, and more.

And if we want to achieve that goal, we'll need to combine the best of AI and ML with the best of the humans and the best of our organizations to create symbiotic intelligence.

For full show notes and links, visit: https://thehcbiz.com/192-applying-ai-ml-to-help-the-humans-of-healthcare-achieve-better-outcomes-prashant-natarajan/

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Most health systems don’t understand their own referral networks or patient flows. From an overall fiscal standpoint, they may know who their best and worst physicians are but there’s little clarity on what’s happening in the middle. Where are patients going for procedures? Who is sending them there? And what’s the financial impact to the health system? Not knowing makes it difficult to make sound strategic decisions.

The good news is that the data exist. The bad news is that few health systems have figured out how to harness it.

Today we talk with Ray Deiotte and Sean O’Malley, co-founders of Monocle Insights. They’ve pulled together industry data that allows them to map provider referral patterns and customer journeys. Their mission is to help health systems, entrepreneurial physicians, and anyone else who manages a network of physicians shed light on their network’s behavior. These insights help drive better decisions around incentives, alignment, M&A, contracting, and more.

Targeted learning:

Health systems, clinicians, and network managers will learn:

That data and methods exist to examine referral patterns and customer journeys
When properly harnessed, this information can provide a significant strategic advantage

Startups and entrepreneurs will learn:

That the first objection is often a lie designed to make you go away
How to design a low friction sales process that allows for a quick “proof of value”

For full show notes and links: https://thehcbiz.com/

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We've been training medical personnel in the same way for decades, Virtual Reality (VR) and Augmented Reality (AR) are poised to change that.

We talk with Dr. Ryan Ribeira, founder and CEO of SimX, about the opportunity to modernize and expand our approach to medical training.

We discuss how that is already happening at many of the major medical institutions in the U.S., the opportunities to expand access to training and to cover more nuanced situations that are difficult to replicate using traditional simulation techniques.

That said, VR/AR training is young and far from a silver bullet. Accordingly, we explore the areas where AR/VR is not the answer. At least not yet.

This episode will get you up-to-speed on the status of VR/AR medical training in the field, educate you on its strengths and weaknesses, and put you in a position to continue to explore this emerging technology.

For full show notes and links visit: https://thehcbiz.com/190-modernizing-medical-training-with-vr-ar-dr-ryan-ribeira/

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The recent dust-up over Direct Contracting and its ultimate rebranding as the ACO REACH model may have led some to believe that our path forward is unclear. That couldn't be further from the truth.

On this episode, we talk with François de Brantes, Senior Vice President of Episodes of Care at Signify Health, about where we are on the pathway to escaping the tyranny of Fee-For-Service healthcare.

It's tyranny because it prevents us from delivering care the way we want to and need to. Advanced Alternative Payment Models like ACO Reach allow organizations to separate payment from delivery, stop focusing their efforts on top-line revenue, and begin to operate like typical P & L driven companies. The promise, of course, is that this will change the way healthcare is delivered in the U.S., improve outcomes and lower costs.

We discuss:

Has utilization and payment returned to pre-pandemic norms?
Why are commercial carriers lagging behind Medicare and Medicaid in launching Advanced Alternative Payment Models?
Will the shift to value and consumer-centric delivery methods like telemedicine diminish uncompensated care?
Is it possible to be proactive and patient-centric in Fee-for-service?
Are provider systems ready for AAPMs?
Can employers band together to create enough demand for AAPMs in the under-65 commercial market?
What were the arguments against the Direct Contracting Model?
Did they have merit?
What changes were made to Direct Contracting as part of the rebrand to ACO Reach?
How does this dust-up over Direct Contracting confirm we are on a bi-partisan, unwavering march toward value and never going back?
Why did Signify Health acquire Caravan Health?

For full show notes and links: https://thehcbiz.com/189-escaping-the-tyranny-of-fee-for-service-healthcare-francois-de-brantes/

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Healthcare orgs share large amounts of PHI with 3rd party vendors. They share it for analytics, rev cycle management, call center services, and more. It's a necessary part of the business. But you know what isn't necessary? Sharing everything! There is a very disrespected requirement in HIPAA called minimum necessary. It means exactly what it says... you should share only that which is needed to do the job (typically under treatment, payment, or operations). In my experience, the default is to just send everything. It's lazy. It's wrong. It's risky. And it's completely unnecessary.

We recently spoke with Joan Ziegler, CEO, and Chris Hottinger, VP of Healthcare, at Sequent about their 3P Secure tokenization platform. It uses the technology behind your credit card chips to secure data in motion, rendering it worthless to the bad guys. It also provides healthcare organizations with a way to finally adhere to the minimum necessary requirement in HIPAA.

On this episode, we discuss the value that tokenization brings to healthcare. We also explore Sequent's journey from FinTech to healthcare.

It's an instructive conversation about how to bring technology from other sectors into healthcare, and how to avoid walking into the buzzsaw that surprises many new entrants.

This is the final of our 5 interviews recorded at ViVE 2022 in Miami.

For full show notes and links:

https://thehcbiz.com/188-tokenization-stop-sending-all-that-phi-sequent-vive-2022/

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It's difficult for Digital Health startups to find alignment between their innovations and the complex business realities of healthcare. That is why this show exists. We discuss it in nearly every episode.

Today's guest has a novel approach to solving that alignment problem. Alex Yarijanian and the team at CareNodes have decided to build their ideal customer. That's right. CareNodes is an MSO and accelerator of sorts. They find promising digital health innovations and then build a market for them. They'll start a medical practice, put their own clinicians in it, negotiate contracts with health plans, align it with NCQA certifications, and more. All of this is done to ensure that the digital health innovation has the ideal landing place, and is put in the best possible position to succeed.

This one is unique. I'd love to hear your thoughts on it!

For full show notes and links:

https://thehcbiz.com/187-build-your-own-customer-alex-yarijanian-vive-2022/

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Virtual-First thinking and telehealth adoption exploded during the pandemic. Since necessity was the driver there is some expectation that demand and use will scale back as the pandemic wanes. Yet today's guest tells us that is not what's happening in the field. We spoke with Karsten Russell-Wood at ViVE 2022, and he's seeing the opposite . Not only is demand steady, but hospitals are evaluating all their workflows to see what else they can do with telemedicine.

Karsten serves as the Chief Marketing & Experience Officer for Equum Medical. Equum is a telehealth-enabled provider service delivery company. They provide much-needed clinical resources to hospitals and health systems all over the country via telehealth. Given the industry's struggles with staffing shortages and clinician burnout, Equum's services are in high demand.

We discuss:

What's driving the continued demand for telehealth
How Equum is approaching the market
The importance of delivering a full solution to your customers and partnering with others to make it happen
The need to innovate in our business models, pricing, and partnerships just like we do with our products

For full show notes and links: https://thehcbiz.com/186-continued-expansion-of-virtual-first-healthcare-karsten-russell-wood--vive2022/

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There's a difference between being "just another vendor", and being a true partner to your customers. Ed Marx has thrived on both sides of this equation, first as a health system executive and now as the Chief Digital Officer at Tech Mahindra / The HCI Group. We sat down with Ed at ViVE 2022 to hear what he has learned about good vendor/health system partnerships. For full show notes and links: https://thehcbiz.com/185-how-to-be-a-good-partner-to-health-systems-ed-marx-vive-2022/

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AvoMD is a no-code platform that allows users to create clinical decision support apps that integrate directly into their workflows. We caught up with Dr. Yair Saperstein, co-founder, and CEO to learn a bit about their platform and approach. Plus, we dig into the keys to gaining attention as an early-stage startup, being a good partner from the sales process onward, and the importance of answering questions.

You’ll learn:

Why most EHR alerts are ignored
The 5 Rights of Clinical Decision Support (CDS)
Why “No” can be a good thing in the early stages of a sale
The importance of identifying your champion (and enabling them to do most of the selling for you).
How to properly answer questions and address concerns during the sales process
Plus, several more tactical nuggets that’ll help you close more deals.

This episode is part of a series recorded at ViVE 2022 in Miami Beach, Florida, March 6-9, 2022.

Visit https://TheHCBiz.com for full show notes and links.

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Our population is aging. According to the Urban Institute:

“The number of Americans ages 65 and older will more than double over the next 40 years, reaching 80 million in 2040. The number of adults ages 85 and older, the group most often needing help with basic personal care, will nearly quadruple between 2000 and 2040.”

And the aging population continues to drive national healthcare spending.

If we’re ever going to reign in our healthcare spending, then we will need to find ways to take better care of our aging population.

According to the team from Blooming Health, medical care is only part of the solution. We need to connect people, especially those from underserved communities, with the resources that will help them thrive. That means addressing their food, housing, safety, and security needs. And it means finding ways to give them meaning and purpose.

That’s where Blooming Health comes in. They exist to empower healthy aging in place. They help community-based organizations (CBOs) align older adults with the resources they need to thrive. Their technology is designed to meet the elderly where they are and strives to remove friction from the process at every step.

On this episode, we explore what it takes to meet older adults where they are, speak to them in the language they prefer, and track results in a way that enables the health system to appropriately invest in their well-being.

Learn more: https://gobloominghealth.com/

Contact: team@gobloominghealth.com

For full show notes and links: https://thehcbiz.com/183-empowering-healthy-aging-in-place-with-blooming-health/

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Whether you’re an administrator, clinician, or executive, if you’ve built a career in the healthcare industry then you have skills, knowledge, and connections that most digital health startups lack. On this episode, we talk with Dr. Alan Pitt, a physician, entrepreneur, and investor, about how to put your hard-earned healthcare industry expertise to work as a digital health advisor.

For full show notes and links: https://thehcbiz.com/182-how-healthcare-leaders-can-get-involved-with-startups-alan-pitt/

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We tend to talk mostly with software startups about commercialization and sales. What do things look like for a startup selling a physical product? And a physical product that’s very relevant during the pandemic at that?

That’s exactly what Jason Kang and the team at Kinnos are doing right now. Kinnos’ product, Highlight®, colors bleach, and bleach wipes bright blue, providing instant visual confirmation of coverage, then fades in minutes to remind users of contact time. Studies show using Highlight for Bleach Wipes for just a few weeks can improve cleaning scores by 70%.

Given that we’re in the midst of a global pandemic, and cleaning and safety are top of mind, it would seem that this is Kinnos’ time to shine. And while that’s true, commercialization in healthcare is hard. We talk through what’s worked, and what’s not in terms of getting the attention of hospital buyers including a sample technique that yielded 70+ leads in a very short time.

There are a lot of go-to-market lessons in Kinnos’ story and we extract them for you. All the while, giving you a bit of an education in infection prevention and a lead on a valuable new product that you can share with your colleagues.

For full show notes and links: https://thehcbiz.com/181-commercializing-physical-products-in-healthcare-jason-kang-kinnos/

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Have you ever had an idea that you just had to make real? No matter what it took… no matter what obstacles were in your way… no matter how many times people told you no… you just couldn’t stop until it existed? Well, this is one of those stories. It begins with an idea in 1988 and leads to the first-ever autonomous AI to be approved by the FDA for diagnosis without physician input.

Dr. Michael Abramoff is a neuroscientist, a practicing physician, and holds a Ph.D. in Artificial Intelligence and Machine Learning. I know… slacker. In 1988, Michael was working on artificial intelligence during his residency and began to think a computer could diagnose diabetic retinopathy. Given the technology available at the time, this idea may have been a bit of a stretch. Still, Michael set out to prove it could be done.

On this episode, we talk with Dr. Michael Abramov and Seth Rainford about the 30-year journey that led to the founding of Digital Diagnostics, and the first-ever FDA-approved Autonomous AI in healthcare. Plus, we explore the challenges they continue to work through as they commercialize their product.

The journey itself is remarkable and each obstacle and resolution will be relevant to any digital health entrepreneur – especially those in AI and diagnostics.

Of our 180 episodes, this is one of my favorite stories so far. It’s fascinating, entertaining, and incredibly useful. I hope you benefit from it as much as I did.

Dr. Michael Abramoff, MD, Ph.D. is the Founder and Executive Chairman of Digital Diagnostics

Seth Rainford is the President and COO at Digital Diagnostics

For full show notes, links, and resources: https://thehcbiz.com/180-first-fda-approved-autonomous-ai-in-healthcare/

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We talk about ML and AI quite a bit on this show. Our angle is always to avoid the hype and help you find the practical applications that you can put to work right now. Today’s episode is a great extension of this ongoing conversation. We talk with Dr. Taha Kass-Hout, Chief Medical Officer and Director, Machine Learning at Amazon Web Services about how they are trying to bring ML to the masses.

We discuss:

What’s needed to use machine learning at scale with cost efficiency, performance, and accountability.
The challenges in analyzing healthcare’s largely unstructured data.
The practicality of bringing AI/ML capabilities directly to the hospitals, health systems, medical offices, etc.
How should CIOs and other buyers evaluate ML solutions? How can they tell what is real and what is hype?
Detecting bias, drift in models, and drift in data in machine learning.
Tooling for privacy, security, and compliance.
The importance of owning and controlling your own data.
The problems caused by bad training data

...

For full show notes and links: https://thehcbiz.com/179-making-machine-learning-available-to-the-masses/

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The No Surprises Act intends to prevent patients from getting burned with huge, unexpected bills for medical services. It is a needed law – medical bills are the #1 cause of bankruptcy in the U.S. And it’s certainly noble in its intentions.

However, the healthcare machine works in unexpected and unintuitive ways. It has a way of moving surprises when we try to eliminate them. In this case, we may exchange surprise bills for new health access and health equity issues. And we will certainly create new surprises for the business. The law requires new and overhauled workflows, enhanced capabilities and technologies, and a solution to that pesky Provider Directory problem.

Oh… did I mention it goes into effect on January 1, 2022?

Giddy up!

On this episode, I talk with Gail Zahtz, CEO at PropHealth, as part of our ongoing Value-based Payment in 2022 series about The No Surprises Act. We’ll explore:

What is the No Surprises Act?
Who is affected? (Spoiler: The entire healthcare industry… especially providers… and around 221 million Americans)
What is required to happen?
What workflows are needed to support this?
What unintended consequences could play out?
Why and how providers will be left holding the bag.
What providers, and the entire industry in general, needs to do right now.
How this fits into our conversation on VBP in 2022.

This may be about as negative as I’ve ever been on this show. I love the intent of the No Surprises Act, but I’m fearful for what’s going to happen because of it. If you can explain this in a way that makes it ok, please reach out.

For full show notes and links: https://thehcbiz.com/178-the-no-surprises-act-is-full-of-surprises-vbp-in-2022-with-gail-zahtz-part-4/

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The Centers for Medicare & Medicaid Services (CMS) released the 2022 Medicare Physician Fee Schedule and Quality Payment Program final rule on November 2, and there are big changes to physician payments. In particular, the Medicare conversion factor, which forms the basis for payments to clinicians, will be lowered by 3.7%. There’s nuance in calculating the payments, but you can sum this up as most doctors will take a pay cut in 2022. And since the final rule goes into effect on January 1, 2022, doctors will begin feeling the cuts in Q1 revenue. The rule is specific to Medicare, but there are plans to push similar changes in Medicaid and we all know commercial payers tend to follow CMS’ lead. We believe this change will have a ripple effect across the industry. On this episode, I talk with Gail Zahtz, CEO at PropHealth, as part of our ongoing Value-based Payment in 2022 series about what doctors can expect in terms of Medicare FFS payment come January 1, 2022. We discuss this as another example of CMS trying to make Fee-for-Service less “comfy” and expedite the move to value-based payment models. Gail helps us to understand what options exist and we lay out a framework for how to evaluate those options.

This is a heavy episode, and there are no clear answers. However, there is a known direction and a viable path forward. We’ll try to get you moving in the right direction.

For full show notes and links: https://thehcbiz.com/177-doctors-just-took-a-pay-cut-vbp-in-2022-with-gail-zahtz-part-3/

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We planned to discuss quality measures but shifted to address a very important piece of listener feedback after the preview and Episode 1. The comments came from a doctor in the audience and I know there are many more doctors and healthcare administrators who feel the same way.

The feedback, in short, is that we’ve been hearing about the move to value for 10 years. We’ve invested in it through several evolutions and it still hasn’t come to fruition. The key is to rebuild trust between the government and those delivering the care- whether hospitals, payers, providers, or innovators. Otherwise, they won’t trust enough to act.

Gail Zahtz, CEO of Prop Health, and I discuss this commentary in the context of this series.

Thank you to the listener who provided this feedback. I hope this discussion is helpful.

And to everyone else listening in, send us your thoughts, questions, and comments to don@thehcbiz.com.

Full show notes and links: https://thehcbiz.com/176-crying-wolf-vbp-in-2022-with-gail-zahtz-part-2/

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There’s a lot of unknowns as we head into 2022, but one thing is certain: Health Equity will be a major focus for CMS and CMMI. Gail Zahtz, CEO of PropHealth, tells us that “value-based payment models have failed to deliver on the promise of health equity” and that is a major reason why CMMI paused so many models earlier this year. When the next iteration of value-based payment arrives, you can bet that health equity will be front and center. And for that, we prepare.

“Fee-for-service says you get paid to fix a broken arm. Value-based care says everybody's tripping on the sidewalk and breaking their arm – let’s fix the sidewalk. Health equity says we're going to fix the sidewalk everywhere.” Gail Zahtz, CEO, PropHealth

This is the first episode in a 5-part series: Everything You Need to Know About Value-Based Payment Models to Prepare for 2022 with Gail Zahtz. On this episode, we take a deep dive into everything health equity to lay out what is known, what is unknown, and how you can build flexibility into your business operations and systems to ensure that you are ready for whatever comes next. Key topics include:

Why have value-based payment models failed to deliver health equity?
What is digital equity and why is it important?
Why risk is not the solution on its own especially when you’re only changing the financial model for those you already serve.
Risk scoring.
Alignment! Alignment! Alignment! That is… patient, provider, and payer alignment.
Serving health nomads.
The importance (and lack) of race, ethnicity, and gender data.
Health equity and value for the Native American community.
The value of Federally Qualified Health Centers (FQHC) and how we can use them as a model to design Gail’s “Upside-down ACO”.
How to design a community pilot that is effective and sustainable (i.e., good for the patients AND good for the business).
How to design your data systems to support health equity initiatives.

Quality measures are next in our 5-part series designed to get you ready for value-based payment in 2022. Subscribe and stay tuned!

For full show notes: https://thehcbiz.com/175-health-equity-is-population-health-vbp-in-2022-gail-zahtz-part-1/

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What is going on with Value-based payment models in healthcare? We’ve been talking about it for years and despite all the chatter and investment, uptake has been slow. Now, the CMS Innovation Center (CMMI) has put many of its models on hold including the Direct Contracting Geo model that we covered earlier this year. Does this mean we are moving away from value-based payment models? Absolutely not! In fact, things are going to start moving much more quickly towards value in 2022.

The #HCBiz Show has partnered with Value-based Contracting expert, Gail Zahtz to bring you a 5-episode series that will tell you everything you need to know about value-based payment models to prepare for 2022.

Get all the details here: https://thehcbiz.com/174-vbp-2022-series-preview-gail-zahtz/

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We're less rational, less logical, and less deliberate than we like to believe. We have biases and regularly use heuristics, or mental shortcuts, to make our decisions. Most of the time we aren't even aware it's happening.

Every actor in healthcare has these tendencies. Health systems have biases that influence doctors. Doctors have biases that influence patients. And of course, patients have biases too.

These compounding biases create challenges when presenting information, defining care pathways, or trying to help patients find their optimal path.

On this episode, we talk with Talya Miron-Shatz, PhD, who is a leader in research at the intersection of medicine and behavioral economics, and the professor and founding director of the Center for Medical Decision-Making at Ono Academic College in Israel.

Talya is the author of the new book Your Life Depends on It: What you can do to make better choices about your health. In it, Talya shines a light on the barriers we all face when making health and medical choices and provides actionable solutions for patients, doctors, and policymakers. We'll explore these solutions to help you make better and more informed decisions for yourself and your family. And for you builders out there, we'll also share guidance on how to better present information, whether it be to doctors or administrators or to the patients themselves.

For full show notes and links: https://thehcbiz.com/173-communicating-healthcare-to-humans-with-talya-miron-shatz

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There are many ways to innovate within an existing organization. However, it can be difficult to move as fast as you’d like within the constructs of an established business model and culture. For one, it’s difficult for your team to innovate on top of their “day job”. Second, it can be difficult to hire and incentivize the right people to drive the innovation within your existing constructs. These are the types of issues that the folks at Cleveland Clinic identified as reasons for not innovating fast enough in telemedicine. They decided that if they were going to pick up the pace, they were going to have to take a different approach.

The Clinic is a joint venture between Cleveland Clinic and Amwell that connects patients with Cleveland Clinic physicians for online second opinions. Together they are using the latest telemedicine technology to, as CEO Frank McGillen put it, “unlock access to the world’s best medical care”.

On this episode, we talk with Frank McGillen, CEO, and Peter Rasmussen, MD, Chief Clinical Officer of The Clinic by Cleveland Clinic to understand why one of the best known global brands in healthcare decided that a JV startup was the best way to bring this innovation to market quickly. We discuss:

The problem that needed to be solved
The benefits of the spin-off/startup approach
The benefits of partnering with vs. hiring a technology vendor
How they were able to get Cleveland Clinic physicians on board
The importance of unique business models in a competitive marketplace
How they are measuring the success of their second opinion service
How they are measuring the success of this innovation approach
Advice for organizations who are considering a startup/spin-off approach to innovation

About The Clinic by Cleveland Clinic The Clinic is a visionary joint venture that combines the unrivaled clinical expertise of Cleveland Clinic with Amwell’s industry-leading telehealth platform. Through innovative solutions like our Virtual Second Opinions, we enable easy, secure access to the highest quality medical expertise.

Patient-centric and deeply collaborative, we are passionate about realizing the global possibilities of digital health, providing advanced solutions that help tame the costs of care while enabling patients to achieve better outcomes and the greatest degrees of hope.

Learn more:

Web: https://theclinic.io/

LinkedIn: https://www.linkedin.com/company/digitalhealth1/

Anthem signs on with Cleveland Clinic’s, Amwell’s virtual second opinions service

Full show notes and links: https://thehcbiz.com/172-spin-offs-and-joint-ventures-with-the-clinic-by-cleveland-clinic

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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On this edition of #HCBiz Office Hours, Don and Shahid talk with Yuma Nambu, Chief Strategy Officer (CSO) at CROSS SYNC.

CROSS SYNC is a Japanese startup whose medical data analytics software, “iBSEN”, enables hospital ICU’s to automate the monitoring of patient vitals and motions continuously to assist healthcare professionals in identifying acute deterioration as early as possible.

The platform relies on multimodal AI capabilities that combine time-series vital analytics from physiological monitors and patients’ motion analytics from live video feeds including facial recognition and motion detection.

As CROSS SYNC looks to expand globally, and into the U.S. market in particular, what are the regulatory requirements for their software? Will they need FDA SAMD Clearance to deploy iBSEN in the U.S?

Don, Shahid, and Yuma discuss FDA/SAMD regulatory requirements in detail. Plus, they expand on the idea to explore the more important question all digital health startups face: How will you prove that your software works?

For more details and full show notes: https://thehcbiz.com/171-office-hours-does-my-software-need-fda-samd-clearance/

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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We spend a lot of time talking about how to align your startup’s vision with the realities of the business of healthcare. You can have the best idea in the world, but if you don’t properly validate your offering with customers, clearly and concisely explain the value it will bring them, close deals, and deliver on your promises then it will amount to nothing. Each of these steps is critical to your success. However, you can get many of them right and still fail. The best way to prevent this fate is by tying them all together with a financial plan that’s based on reality and considers the long-term goals for your startup.

Today we talk with Kristian Marquez, CFA, Managing Director for FinStrat Management, Inc. about how to properly manage your startup’s finances. The good news is that you don’t have to be perfect. Kristian tells us you should expect to get a lot of it wrong and have to clean it up along the way. That’s ok. His advice: go bare-bones in the beginning when it comes to finances, legal, and generally “papering your business”. That way, you can put all of your resources into ensuring you have a product that people will actually pay you for. That means more time talking with customers, managing your pipeline (and not lying to yourself about it), practicing selling, and cultivating the confidence to ask for the close.

Kristian walks you through this early-stage strategy, explains when it is time to bring in the experts, provides guidance on debt vs. equity funding, and even helps you prioritize your spending based on the type of company you want to build.

This episode pairs well with:

Episode 30: Why You Should Always Be Preparing to Sell Your Company with Dexter Braff

Episode 85: Lessons on Selling in Healthcare w/ Dom Cappuccilli

Kristian Marquez, CFA – Kristian serves as Managing Director for FinStrat Management, Inc.

FinStrat Management (“FSM”) is an outsourced financial department services firm providing fractional accounting, controller services and CFO services. Exclusively serving B2B SaaS companies, we provide fractional: Chief Financial Officer, controller and accounting services.

Web: https://finstratmgmt.com/

LinkedIn: https://www.linkedin.com/company/finstratmgmt/

Twitter: https://twitter.com/finstratmgmt

Please email info@finstratmgmt.com if you'd like a free consultation.

This episode is brought to you by:

The Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) gives behavioral health providers up to $250,000 to repay school loans in exchange for working full-time for six years at an approved site.

Apply now through July 22, 7:30 p.m. ET.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Just about every health system has an innovation program, but how do they know if it’s making a difference? That’s the question we set out to explore with the team from Houston Methodist Center for Innovation. On this episode we talk with:

Michelle Stansbury, Vice President of IT Innovation
Brad Shaink, Administrative Director of Digital Innovation
Josh Sol, Administrative Director of Ambulatory Innovation

They walk us through:

Innovation Expectations: How do you set expected goals, OKRs, KPIs, etc.?
Innovation Discovery: Where do you find solutions?
Innovation Evaluation: How do you evaluate solutions before you pilot them?
Innovation Pilots and Early Adoption: How do you pilot your solutions?
Innovation Procurement: RFPs, templates, etc.
Innovation Diffusion: Implementation, integration, etc.
Innovation Recognition: How do you recognize teams that are doing things well?
Innovation Failure: How do you know if an innovation has failed?
Exnovation: How do you know when it's time to stop doing something, or to turn off legacy solutions?

Key takeaways include:

Right-sizing your pilots: Start small and keep your efforts in line with what you are trying to accomplish.
Metrics can be qualitative or anecdotal, but they must exist and you must be honest with yourself about whether they are being met.
Honesty and trust are key to innovation success. If you aren’t giving honest feedback and holding one another accountable then everything falls apart.
Startups should focus on solving the customer's problem first and avoid pushing their own agenda. If you invest in the customer's needs first, you’ll get a chance to expand the vision later.
Make innovation a priority and develop innovation habits: The Houston Methodist team schedules “Monday Demos” each week to ensure they always have new ideas and solutions entering the pipeline. Sometimes they find a solution for a problem they didn’t even realize they had.

Links and Resources * Connect with Michelle Stansbury on LinkedIn * Connect with Brad Shaink on LinkedIn * Connect with Josh Sol on LinkedIn * Learn more: Houston Methodist Center for Innovation

Related Episodes:

Episode 149: How Health Systems Think with Neil Carpenter (Listener Favorite)
Episode 137: The Novation Dynamic: 3 Pillars for Healthcare Innovation Success with Michael Ackerman
Episode 133: Keeping Your Innovation Engine Humming During the COVID-19 Crisis w/ Karen Murphy, PhD, RN (Geisinger)

This episode is brought to you by:

Apply now through July 22, 7:30 p.m. ET.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Early in the pandemic, Amazon Web Services (AWS) launched the Diagnostic Development Initiative (DDI) to help organizations around the world accelerate diagnostics research and development. In the first phase of the initiative, AWS awarded $8 million in computing credits and technical support to 87 organizations in 17 countries. Some of the highlights include:

Stanford University School of Medicine’s smartwatch app that detects early signs of COVID-19
Ilumina’s identification of viral mutations through next-gen sequencing
Chan-Zuckerberg Biohub used Machine Learning to estimate the number of unreported COVID-19 Cases
University of British Columbia & Vancouver General Hospital applied machine learning to CT scans to identify indicators of COVIOD-19 and detect more severe progression of the disease. Then they open sourced the model.

Today we’re talking with Grace Kitzmiller, Principal Product Manager of AWS Disaster Response about the next round of DDI. AWS will distribute an additional $12 million in compute resources and technical support to organizations working in three areas:

Early disease detection
Prognosis
Public Health Genomics

And while AWS will continue to support COVID-19 projects, they will also consider projects focused on other infectious diseases.

The application is open now and runs through the end of the year. However, AWS is encouraging applicants to submit by July 31, 2021, for priority consideration.

In this interview we discuss:

The details of the AWS Diagnostic Development Initiative (DDI).
The problems AWS is trying to solve.
How AWS is measuring the success of the initiative.
The highlights and major outcomes from round 1.
How the program is being expanded for round 2.
How organizations can apply the compute, technical resources, and subject matter expertise made available through DDI.
Who should apply?
Plus, we do some brainstorming on possible solutions that could benefit from the program.

This is a great opportunity for organizations to accelerate their work in diagnostics and we encourage you to check it out.

Links and Resources * AWS Activate offers startups free tools, resources, and more to quickly get started on AWS * Registry of Open Data on AWS is a registry that exists to help people discover and share datasets that are available via AWS resources. * Synthea provides realistic health data at no cost. * Check out all our coverage in Infection Prevention and Control * Check out our sister podcast TIPS Deep Dive Interviews for discussions with the best minds in global health.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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A major driver of health disparities is that the system does not typically account for the differences in the culture, language, and experience of the patients it is charged to serve. Today we talk with Abner Mason, Founder, and CEO of ConsejoSano about the importance of customizing engagement to match the multicultural realities of your patients. Abner tells us that it’s not about translating, but “creating content based on culture; based on deeper factors than language”. And it’s effective. ConsejoSano is helping payers and providers get their patients into clinics and closing gaps in care. This of course leads to better outcomes, lower costs, and increased revenue for practices.

Key topics include:

What does it mean to create a more equitable and just healthcare system?
How has COVID shone the light on the problems in our system?
How do the Social Determinants of Health (SDOH) factor into health equity?
Is there a willingness for providers and health plans to invest in these solutions?
What did the original vision for ConsejoSano look like and how did healthcare’s challenging reimbursement models lead to a pivot?
How do you align patient engagement efforts with the multicultural reality of the U.S. population?
How does your solution fit into the business model of providers and payers?
What are the opportunities in Medicaid? Medicare Advantage?
How are value-based payment models driving this work?
What data is needed to support multicultural patient engagement?
What is Health Tech 4 Medicaid and how is it enabling innovation in Medicaid?
ConsejoSano’s podcast: Health Equity Now

Abner Mason, Founder and CEO, ConsejoSano Abner Mason is a healthcare technology leader who’s dedicated to creating a more just, equitable, and effective healthcare system. As the founder and CEO of ConsejoSano, a multicultural patient engagement company, he leads a team of diverse professionals who strive every day to improve outcomes and lower costs on behalf of health plans. He’s also the founder and chair of HealthTech 4 Medicaid, a nonprofit composed of innovative leaders working to radically change the pace of innovation to improve care quality and access. A federal and state government policy veteran with deep experience fighting the HIV/AIDS crisis, Abner knows how to tap people’s unique talents and innate sense of compassion to achieve big goals.

ConsejoSano ConsejoSano is a patient engagement platform that helps connect payers, providers and health systems with their multicultural Medicaid and Medicare patient populations. The company utilizes multi-channel engagement tools to reach patients in a culturally relevant way that increases engagement, lowers costs, and improves health outcomes. For more information, visit www.consejosano.com.

Connect with Abner on Twitter and LinkedIn
Check out ConsejoSano and connect with them on Twitter and LinkedIn
Watch the latest episodes of Health Equity Now, the show that’s dedicated to spotlighting and solving health disparities, here

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Price transparency and healthcare consumerism are top of mind for many operators and observers of the healthcare industry. On the surface, these topics sound great. Of course, we want to enable patients to be good consumers of healthcare. However, as we’ve seen so often on this show, aligning the obvious with the realities of the business of healthcare is no small feat. Today we’re talking with Dr. Steve Ambrose about healthcare costs, pricing, and consumerism. We discuss what these terms mean and why they are important. Then we dig into examples of companies that are already making an impact on these issues. We discuss:

Companies that are helping to lower healthcare prices like ONCOspark (24:22), GoodRX (41:05), Transcarent (48:42), Cedar (53:24), Green Imaging (55:23), and more.
What is going on in the retail space with the likes of Walmart, Target, Amazon and others (27:07).
And companies working to reduce administrative costs like Olive (1:04:00) and LeanTAAS (1:08:51).

This is an exciting space that is full of potholes and false promises. However, it is also a space where good companies are beginning to make progress. And that progress may offer us a glimpse into the future of healthcare.

Dr. Steve Ambrose Dr. Steve Ambrose is a healthcare strategist with 25 years in clinical, technology, patient engagement, and consumerism. He is selectively reviewing options to place his talents and passion into his next FT leadership role. Dr. Ambrose may be reached through contact information on his LinkedIn profile.

Links and Resources * Steve Ambrose on Drug Pricing and GoodRX: https://walktheridge.com/drug-pricing * Health Care Spending in the United States and Other High-Income Countries - this is the Ashish Jah study on healthcare prices and costs that Steve mentioned. * Walmart acquires telehealth provider MeMD, upping competition in telehealth space

Several recent #HCBiz episodes on AI/ML in healthcare administration:

Episode 162: What’s up with IBM Watson Health? A Discussion on the State of AI in Healthcare with Paddy Padmanabhan
Episode 159: A Practical Look at Machine Learning in Healthcare with Josh Miramant
Episode 147: Applying Conversational AI to Reduce Provider Burnout from HealthIMPACT Live’’

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Poor oral health has a direct link to high risk of chronic diseases like diabetes and heart disease. It contributes to depression, poor maternal health outcomes, and death. Research shows that it increased the risk associated with COVID-19.

Yet we treat oral health as being separate from “healthcare”. 65 million Americans lack dental coverage and even Medicare provides no oral health benefits to our seniors. Worse yet, this lack of coverage contributes to healthcare disparities as black adults are nearly seven times more likely to have an unmet dental need than white adults.

But where there are problems there are opportunities. Today we’re talking with Dr. Myechia Minter-Jordan, an MD, MBA, community health champion, and the President and CEO of the newly formed CareQuest Institute for Oral Health. Myechia shares with us how her role as the head of a Federally Qualified Health Center (FQHC) helped her see the gaps in our system and the extraordinary benefits of integrating oral health into primary care delivery. Better yet, those benefits extend far beyond a moral imperative. There is a clear business case for integrating oral health in a more holistic health delivery system. Myechia breaks it all down for us, plus much more including:

Why oral health has been treated separately from healthcare.
How oral health integration compares to behavioral health integration (which is already leading to improved outcomes and lower overall costs).
The many ways CareQuest Institute is moving the needle including grants, research, innovation, and social impact investing.
How entrepreneurs and startups can work with CareQuest Institute and why they will be launching the CareQuest Innovation Partners initiative to drive this.
The need for teledentistry.
The ways oral health and the COVID crisis have impacted one another.
How ACOs, Direct Contracting Entities, and other risk-bearing organizations can benefit from oral health integration.
The opportunity for dentists to rethink their own practice and begin to support primary care (and get reimbursed for it).
How to foster relationships between dentists and primary care providers.
Plus, we discuss The New Commonwealth Racial Equity and Social Justice Fund (NCF).

Myechia Minter-Jordan, MD, MBA Myechia Minter-Jordan, MD, MBA, serves as the president and CEO of the CareQuest Institute for Oral Health. A physician and business executive, Myechia leads a dynamic team of professional and clinical experts committed to building a future where every person can reach their full potential through excellent health.

Through Myechia’s leadership, CareQuest Institute operates as a catalyst for systems change, bringing forth ideas and solutions to create a more equitable, accessible, and integrated health system for everyone. CareQuest Institute collaborates with a wide range of partners to achieve its mission — to improve the oral health of all — through work in grantmaking, research, health improvement programs, policy and advocacy, and education, as well as leadership in dental benefits, care delivery, and innovation advancements.

Myechia also continues to shine a national spotlight on the importance of ending deep social inequity. In 2020, Myechia joined 18 other Black and Brown executives in Massachusetts as a founding leader of The New Commonwealth Racial Equity and Social Justice Fund (NCF) to provide philanthropic support to community groups and coalitions fighting systemic racism and racial inequity in the Commonwealth. Originally seeded with $20 million, the NCF aims to raise $100 million.

Before joining CareQuest Institute, Myechia served as chief medical officer and CEO of the Dimock Center, one of the largest community health centers in Massachusetts. During Myechia’s tenure, Dimock was recognized as a national model for comprehensive, integrated health and human services. As CEO, Myechia formed partnerships with world-class institutions to advance person-centered care, including Harvard Medical School, Beth Israel Deaconess Medical Center, and Partners HealthCare. Prior to Dimock, Myechia worked for Johns Hopkins Medicine as an attending physician and instructor of medicine.

Myechia also invests personal time in her community, serving on several boards and committees, including BlueShield of California, The Boston Foundation, Harvard School of Dental Medicine, Harvard Pilgrim Health Care, and the Isabella Stewart Gardner Museum. Previously, she held appointed positions for influential agencies, including the Massachusetts Health Planning Council Advisory Committee and the City of Boston Public Health Commission.

Myechia earned her doctor of medicine degree from Brown University School of Medicine and a master of business administration degree from the Johns Hopkins University Carey School of Business. She also received honorary doctorates from Northeastern University and Newbury College.

About CareQuest Institute for Oral Health CareQuest Institute for Oral Health is a national nonprofit championing a more equitable future where every person can reach their full potential through excellent health. We do this through our work in grantmaking, research, health improvement programs, policy and advocacy, and education as well as our leadership in dental benefits, care delivery, and innovation advancements. We collaborate with thought leaders, health care providers, patients, and local, state, and federal stakeholders to accelerate oral health care transformation and create a system designed for everyone. To learn more, visit carequest.org.

Twitter: @CareQuestInst
Instagram: carequestinstitute
LinkedIn: CareQuest Institute for Oral Health
Website: https://www.carequest.org/

Additional Resources and Links

Research Report: A Coming Surge in Oral Health Treatment Needs
- CareQuest Institute is set to release a series of reports in the coming months that provide in-depth analysis of the results of a comprehensive national survey aimed at understanding oral health equity in the US. They released their first report earlier in April that looks specifically at the impacts of the COVID-19 pandemic on our oral health and overall health systems.
- Key findings:
  - Roughly 6 million adult Americans have lost their dental insurance due to the pandemic
  - Nearly two-thirds of them have a symptom that is frequently linked to oral diseases, such as tooth decay and periodontal disease.
  - Many others have canceled or put off important preventive care in the last year – 28 million people have delayed care because of concerns ranging from cost and lacking insurance to risk of exposure to the virus.
  - The data also reinforces what became very clear early on in the pandemic: low-income individuals, those living in rural areas, and families and communities of color have been disproportionately impacted by this virus. In fact, 60% of Black respondents said they knew someone personally who has died from COVID-19. Across all demographic groups, the higher a respondent’s income level the less likely they were to know someone who has died from COVID-19.
Additional statistics on inequities in oral health care
- Poor oral health has a direct link to higher risks of chronic illnesses, including cardiovascular disease, diabetes, asthma, and more. It also leads to greater instances of depression and other mental health diseases.
- Over 65 million Americans lack access to dental coverage prior to the pandemic, four times the number of people who are medically uninsured.
- Americans in poverty are 2.5 times more likely to have an unmet dental need due to lack of insurance. Black adults are 68% more likely to have an unmet dental need than white adults.
- Nearly 4 in 10 Black and Latino adults reside in 14 states where Medicaid’s adult dental benefits cover no services or emergency-only care.
Press Release: New National Nonprofit Will Battle Inequity in Health Care

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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When it comes to billing codes there are many processes and solutions that focus on the backend. They support the coders and help ensure the codes are “bill ready”. However, as today’s guest points out, there are very few solutions that exist solely to help providers put those codes in the EHR accurately and efficiently in the first place.

Abboud Chaballout created Diagnoss to untether the clinician from a clunky EHR interface when it comes to coding. Chaballout describes it as a provider assistant that reads the free-text clinical narrative as they record it and uses AI to suggest the appropriate codes needed to paint an accurate picture of their patient’s health and the nature of the care they provided. Certainly, this will improve the accuracy of coding and allow for improvements in the overall coding workflow, but that really isn’t the goal. For Abboud, it’s far more important to give the providers some relief from clicking, pecking, and guessing in the EHR.

The EHR is one of many contributors to physician burnout, or as Abboud prefers to describe it, moral injury. Simply put, Abboud and Diagnoss are using AI in an attempt to improve providers’ lives. It’s their sole focus.

In addition to exploring Diagnoss’ goals and capabilities, we also get into the technical aspects of building this type of startup in healthcare. We discuss:

How to decide which EHRs to work with.
How to engage with those EHRs and get access to their API.
How much variance you see from EHR to EHR when it comes to integration and APIs.
How FHIR will impact the EHR integration process in the future.

This is a great discussion for anyone trying to do the hard things in healthcare, especially when they require tight integration with many EHRs.

Abboud Chaballout

Abboud Chaballout is the CEO and founder of Diagnoss, a digital health company on a mission to reduce the administrative burdens of medical providers on the front lines of our healthcare system by building seamless tech. At Diagnoss, he’s taking on medical coding with an AI-based coding assistant that “whispers over a doctor’s shoulders.” Find and connect with him on LinkedIn to talk AI, EHRs, and medical coding.

Connect with Abboud on LinkedIn
Follow Diagnoss on Twitter
Learn more at https://www.diagnoss.com/
Diagnoss Video: https://www.youtube.com/watch?v=6y3zFZ8yHPY

Diagnoss

Diagnoss supports providers in their most cumbersome EHR tasks so they can spend more quality time with patients. Today, Diagnoss's AI powered EHR assistant helps providers pick medical codes, more quickly and more accurately, saving them time while simultaneously enabling them to capture more revenue. By building the most robust real-time predictive system for clinical teams, Diagnoss transforms the experience of medical providers from one of frustration to one of inspiration.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

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95% of innovations that are brought to market fail to reach an adequate level of customer adoption or financial ROI. It sounds scary, but it doesn’t have to be this way. Today we’re talking with healthcare commercialization strategist and digital health advisor Dr. Roxie Mooney, about the steps innovators can take to dramatically increase their chances of being in the other 5%.

Why you need an early adopter strategy that focuses on the specifics needs, goals, and desires of the customers who are looking for something new and novel.
How to avoid pilot purgatory by negotiating future sales up-front and ensuring you can get value from the pilot along the way.
The risks of falling in love with your idea and skipping the all-important customer discovery and market validation step. And no, your mom is not a good source of feedback on your innovation.
The benefits of being strategic with your go-to-market timing (i.e., don’t rush to market; do rush to customer feedback).
How to co-create with your clients without building a product that works only for them.
When to convert your early-adopter messaging (i.e., new, never been done before, innovative, etc.) to mainstream messaging (i.e., social proof, trustworthy, reliable, ROI, etc.).

This is a rich conversation, and whether you’re a startup or innovating within your organization, it's full of things you should be thinking about right now!

Dr. Roxie Mooney, DBA Healthcare Commercialization Strategist and Digital Health Advisor Dr. Roxie Mooney helps health tech innovators uncover their most profitable and viable market strategies, from early adoption strategies to pivoting. She transformed 20 years of business practice, 7 years of researching over 500+ peer-reviewed articles, and 160+ interviews with health innovators into a repeatable method to go from an idea to full-scale adoption. She advises startups and emerging healthcare brands and has been involved in three successful exits.

She currently serves as the Healthcare Commercialization Strategist and Digital Health Advisor of Legacy DNA. She’s also the international best-selling author of How Health Innovators Maximize Market Success: Strategies to Launch and Commercialize Healthcare Innovations, as well as host of the podcast and video show “Health Innovators.”

In addition to her strategist role, Dr. Roxie is a sought out speaker and educator. She’s spoken at HIMSS and the Connected Health Conference, and currently serves as an Associate Professor of Marketing at the Jack Welch Management Institute and an Adjunct Professor of Gender Leadership and Coaching and Consulting at Palm Beach Atlantic University. She’s also a Board Member of One Purse, a nonprofit organization committed to restoring the lives and dreams of sex-trafficking survivors.

Dr. Roxie holds a DBA with a Marketing Specialization from Walden University, an MS degree in Organizational Leadership from Palm Beach Atlantic University, and a BA degree in Organizational Communications from Rollins College. She has carried out additional post-graduate studies on Disruptive Strategy under Clayton Christensen at Harvard Business School.

To learn more about Dr. Roxie’s personal and professional work, follow her on LinkedIn: www.linkedin.com/in/roxiemooney. Learn about her company Legacy DNA at www.legacy-dna.com.

Links and Resources More on selling/getting things done in Healthcare:

Episode 150: How to Turn the Growth Engine on in your Digital Health Startup with Bryan Loomis
Episode 149: How Health Systems Think with Neil Carpenter
Episode 148: Partnering with Payers w/ Andrew-Adrian Karlin of Highmark
Episode 103: Selling to Health Systems: Advice for Digital Health Startups (Part 1)
Episode 105: Selling to Health Systems: Advice for Digital Health Startups (Part 2)
Episode 85: Lessons on Selling in Healthcare w/ Dom Cappuccilli

Also mentioned on the show:

Clayton Christensen on what Disruptive Innovation really means.
Startup books by Steve Blank (and others he recommends)
VideoPeel.com – remotely capture video testimonials from your customers in seconds.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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IBM Watson Health came on the scene with swagger and promises. They were going to revolutionize healthcare! And now the unit may be for sale. We don't yet know what's really going on there, but the commentary surrounding this rumor provides some interesting points for discussion. What is the state of AI in healthcare? Is the industry ready for it? Will doctors use it? Is it going to kill us if it's not perfect? There's a lot to explore.

On this episode, Paddy Padmanabhan joins us to hash it all out. Paddy is the Founder and CEO at DAMO Consulting, Host of The Big Unlock podcast, and co-author of the new book Healthcare Digital Transformation: How Consumerism, Technology and Pandemic are Accelerating the Future with Edward Marx. We discuss what's working today (think administrative functions), and what may still be a ways off (think complex cancer diagnostics). Plus we get into the challenges of regulation, ethics, patient safety, messaging, and more.

About Paddy Padmanabhan Paddy Padmanabhan is the author of the best-selling book Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future. He is the founder and CEO of Damo Consulting, a digital transformation advisory firm that works with healthcare enterprises and digital health companies. He is the host of The Big Unlock, a widely subscribed podcast focusing on healthcare digital transformation. He is also the author of the book The Big Unlock: Harnessing Data and Growing Digital Health Businesses in a Value-Based Era.

About DAMO Consulting Damo Consulting provides digital transformation advisory services to enable healthcare organizations navigate the technology-enabled transition to telehealth and virtual care. We bring deep industry knowledge, market insights and technology skills to help develop and implement enterprise digital roadmaps. We work with healthcare IT and digital health firms to develop and execute market growth strategies.

Links:

Company Website: www.damoconsulting.net
Paddy Twitter: https://twitter.com/PaddyPadmanabha
Paddy LinkedIn: https://www.linkedin.com/in/paddypadmanabhan99
Paddy’s latest book on healthcare digital transformation: https://thebigunlock.com/healthcare-digital-transformation-book-by-paddy-padmanabhan-and-edward-w-marx/
Newsletter: https://www.damoconsulting.net/newsletter/
Assessing Digital Maturity: The DigiMTM Digital Maturity Model for Health Systems - Damo Consulting (White paper)
Selecting Technology Partners to Execute Digital Strategy - Damo Consulting (white paper)
Healthcare Digital transformation Podcast: https://thebigunlock.com/the-big-unlock-podcast/

More on AI and Machine Learning in Healthcare * Episode 159: A Practical Look at Machine Learning in Healthcare with Josh Miramant * Episode 147: Applying Conversational AI to Reduce Provider Burnout from HealthIMPACT Live * Episode 116: Enhancing Diagnostic Accuracy with Art Papier of VisualDx * Episode 91: Deep Medicine with Dr. Eric Topol * Episode 43: Demystifying Big Data and Machine Learning for Healthcare w/ Prashant Natarajan

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Healthcare Digital Transformation: How Consumerism, Technology and Pandemic are Accelerating the Future

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Picking a health plan can be the biggest crapshoot of anyone’s year. It’s confusing and tedious to compare the plan benefits, the provider directories are unreliable, and even if you can figure it out, there’s no way to know how much you’ll pay for a given service from one plan to the next. So, we cross our fingers, pick the one that seems like a fit, and hope for the best. Today’s guest is trying to change all of that. Akash Magoon is Co-founder and CTO at Nayya – a company that offers personalized enrollment guidance across all employee benefits. Today we talk about how Nayya uses claims and consumer data to help consumers pick the best health plan for their situation. Their goal is to “restack the odds for American families”. That’s something we can all get behind.

As a bonus to the startups out there, we talk about Nayya’s rapid growth over the past year. Pre-pandemic it was just Akash and his co-founder, Sina. Now a seed and series A round later, they have expanded to more than 30 employees and have customers in nearly every state. We talk about the key factors that enabled them to find their product-market-fit and show value to their customers.

On this episode you’ll learn:

How claims and consumer data can be used to help consumers make better decisions about health plans.
Why employers and health plans are interested in providing this service to their employees and members.
Why it's important to engage consumers throughout the year to help them get the most out of their plans for the least amount of money.
How the CMS Patient Data Access Rule creates new opportunities to empower healthcare consumers.
How to get feedback early and often when launching a new product, and other advice for finding your product-market-fit.

About Nayya At Nayya, we believe there is a better way to choose and use healthcare benefits. A more transparent, less confusing way where consumers feel more confident in their decisions. We focus on decision support and benefits engagement. It’s one of the most stressful and challenging situations consumers face – and we see that as an opportunity to do good. We’re excited to deliver a new experience to consumers – where they choose and use their benefits through our software, data and AI engine.

Learn more:

Web: https://www.nayya.com/
Nayya Series A Announcement
Nayya + Selerix Partnership
Nayya + Selerix Video

Get connected:

LinkedIn: https://www.linkedin.com/company/nayya
Twitter: https://twitter.com/Nayya_Inc
Facebook: https://www.facebook.com/WeAreNayya
Instagram: https://www.instagram.com/nayya_inc/

Links and Resources

Episode 153: How Will Patients Securely Connect 3rd Party Apps to Their Data Once Patient Access Rules Kick In? from Health Data Unbound
Episode 50: A Blueprint for the Next Generation Health Ecosystem | Dave Chase | The Health Rosetta
Episode 27: Health Benefits as a Strategic Opportunity | Chris Skisak | HBCH

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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What is the role of a doctor at a digital health startup? Why are they needed? What jobs will they do? How do you find one? And how can you tell if they will be a fit for your team?

If you’re a doctor considering this move, you may have similar questions in reverse. What will it be like to be a “digital doctor”? How can I find opportunities? What new skills will I need to develop? How can I tell if the digital health startup I’m looking at has a shot?

On this episode we talk with Sven Jungmann. He’s a medical doctor with additional degrees in Public Health, Public Policy, and entrepreneurship. He’s the Chief Medical Officer at FoundersLane in Berlin, Germany, where he advises digital health startups, and helps align other doctors with startups too. I can’t think of anyone more qualified to discuss this topic with!

You’ll learn:

Why many digital health startups really do need a doctor on their team.
What the transition is like when moving from practicing medicine to the startup world.
The drawbacks to doing this if you’re a doctor.
Six skills that make medical doctors indispensable for startups
What a non-clinical founder should do to bring themselves closer to the medical side.
That the problems in the U.S healthcare system are not unique when it comes to a lack of prevention and woefully inadequate data sharing.
Why Corporate Venture Building is a powerful way to drive innovation.

We also discuss Sven’s new book, FightBack NOW: Leveraging your assets to shape the new normal and his work at FoundersLane.

About Sven Jungmann Sven Jungmann is a medical doctor with additional degrees in Public Health (Master, LSHTM), Public Policy (Master, Oxford), and entrepreneurship (Postgraduate Diploma, Cambridge). He worked in hospitals for several years. Today, as Chief Medical Officer, he heads the Healthcare Vertical for FoundersLane and advises start-ups in the digital health sector. He’s co-author of FightBack Now.

Connect with Sven on:

LinkedIn
Instagram
Twitter

About FoundersLane FoundersLane is a Corporate Venture Builder that helps established organizations launch new digital offerings in the healthcare and sustainability space. FoundersLane is formed by serial full-stack entrepreneurs with experience in building tech companies from scratch to scale.

Learn more: https://founderslane.com

Newsletter: https://founderslane.com/insights

Links and Resources * Episode 149: How Health Systems Think with Neil Carpenter * Episode 103: Selling to Health Systems: Advice for Digital Health Startups (Part 1) * Episode 105: Selling to Health Systems: Advice for Digital Health Startups (Part 2) * Episode 85: Lessons on Selling in Healthcare w/ Dom Cappuccilli

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

FightBack NOW: Leveraging your assets to shape the new normal

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Machine Learning in healthcare (and Artificial Intelligence in the broader sense) is real and is being used today. The problem is, it’s difficult to sort out what’s real and what’s hype. Opinions on the matter range from “it’s all hype and BS” to “AI is revolutionizing healthcare and replacing doctors”. The truth, of course, lies somewhere in between. Today we talk with Josh Miramant, CEO and Founder of Blue Orange Digital, to help you sort this out. After listening you’ll have clarity on what Machine Learning is, an understanding of what’s possible in healthcare today, and a practical expectation of what’s coming next.

In this conversation we’ll:

Help you understand the terminology. What is Machine Learning? What is Artificial Intelligence? What is everyone talking about!?
Take the “magic” out of Machine Learning and help you understand at a basic level what’s happening here.
Layout the need for data quality and data fidelity (i.e., the usefulness of data for a purpose). Along with data acquisition, this is the first thing you’ll need to address.
Discuss practical applications of Machine Learning that are being used productively in healthcare right now. This is “Applied Machine Learning” and there are many solved problems that add value in healthcare administration, patient acquisition, costs, pricing models, etc.
Dig into the research and operational applications of machine learning. These include things like image detection, diagnosis, etc. like we discussed with Eric Topol (Episode 91). These applications are real and they’re improving, but they aren’t replacing doctors anytime soon.
Then we touch a bit on the theoretical. Things that are happening in the lab that are incredibly exciting but have a way to go before they have real-world applications.

About Josh Miramant Josh Miramant is the CEO and founder of Blue Orange Digital, a top-ranked data science and machine learning agency with offices in New York City and Washington DC.

Miramant is a popular speaker, futurist, and a strategic business & technology advisor to enterprise companies and startups. As an example of thought leadership, Miramant has been featured in IBM ThinkLeaders, Dell Technologies, Global Banking & Finance Review, the IoT Council of Europe, among others.

Connect with Miramant:

LinkedIn: @joshmiramant
Email: contact@blueorange.digital
Twitter: @jmiramant

About Blue Orange Digital Blue Orange Digital is recognized as a “Top AI Development and Consultant Agency,” by Clutch and YahooFinance, for innovations in predictive analytics, automation, and optimization with machine learning in NYC.

They help organizations optimize and automate their businesses, implement data-driven analytic techniques, and understand the implications of new technologies such as artificial intelligence, big data, and the Internet of Things.

Whether your goal is to optimize your supply chain, use existing data to decrease operating costs, or customize the patient experience with predictive modeling, Blue Orange Digital can help you meet your challenge.

Have a project in mind but need some help implementing it? Contact us, we’d love to discuss how we can work with you to co-develop your AI project.

For more on AI and technology trends, see Josh Miramant, CEO of Blue Orange Digital’s data-driven solutions for Supply Chain, Healthcare Document Automation, and more case studies at BlueOrange.Digital.

Connect with Blue Orange:

LinkedIn: @blueorangedigital
Email: contact@blueorange.digital
Twitter: @BlueOrangeData
Medium: @blueorangedigital

Links and Resources * Smartwatches can help detect COVID-19 days before symptoms appear

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Direct Contracting is a new model from the Center for Medicare & Medicaid Innovation (CMMI, or the CMS Innovation Center) aimed at reducing expenditures and preserving or enhancing quality of care for beneficiaries in Medicare fee-for-service (FFS). At a minimum, it’s an opportunity for providers to change the way they care for Medicare FFS patients. And if the Geographic Direct Contracting Model is launched (it’s currently under review by CMS), it will be a sea change in the 10 targeted “Geo” regions. Either way, it’s worth paying attention to.

We covered the Direct Contracting model and options at length in Episode 156 with Gail Zahtz. You should start there if Direct Contracting is new to you. During that conversation, Zahtz identified plenty of areas where the model could benefit doctors and their patients. However, she identified several grey areas that make it difficult for physicians to engage with potential DCEs as the application deadline rapidly approaches (April 1, 2021).

The timeline and lack of clarity make it difficult for a physician to evaluate the model and make a sound decision on how, or if to participate.

So, that’s our goal of this discussion. I talk with Dr. Krishnan Narasimhan, an academic family medicine physician and an Associate Professor in the Department of Community and Family Medicine at Howard University, about what Direct Contracting means to physicians.

What opportunities does Direct Contracting create for physicians?
What opportunities does Direct Contracting create for their patients?
How does Direct Contracting compare to other value-based payment programs?
How might Direct Contracting lead to deeper physician-payer alignment?
How does Direct Contracting enable physicians to truly address the Social Determinants of Health (SDOH)?
What questions should a physician ask a DCE to determine if they are a fit?
What should physicians’ do right now to determine if Direct Contracting is worth pursuing?
How can busy physicians fit this in with all their existing priorities during a pandemic?

Dr. Krishnan Narasimhan Krishnan Narasimhan M.D., is an academic family physician who has a proven record of driving health system and policy change.

Dr. Narasimhan has led grassroots coalitions to move the political and policy debate on health reform, expand access, and to increase primary care infrastructure. He has spoken at the U.S. Capitol, at universities, and with numerous stakeholders on health reform, health disparities, and physician workforce. He serves on the Boards of Doctors for America and the District of Columbia Academy of Family Physicians.

Dr. Narasimhan has a decade of experience in undergraduate and graduate medical education with a focus on curricular design, mentorship, and integrated care models. He has a record of consistently increasing primary care workforce capacity. His research on the Economic Impact of Family Physicians has been utilized extensively by the American Academy of Family Physicians.

Currently he serves as Associate Professor at Howard University, Director of the Family Medicine Clerkship, as Residency faculty, and takes care of underserved populations.

His training includes an M.D. from Jefferson Medical College, residency at University of Connecticut, Primary Care Health Policy Fellowship at Georgetown University, and a Certificate of Health Policy at the Georgetown Public Policy Institute.

Dr. Narasimhan is also an advisor to WiseCare, a startup applying to become a Direct Contracting Entity (DCE).

LinkedIn: https://www.linkedin.com/in/krishnanmd/

Links and Resources * Doctors for America - Doctors for America mobilizes doctors and medical students to be leaders in putting patients over politics on the pressing issues of the day to improve the health of our patients, communities, and nation. * District of Columbia Academy of Family Physicians: The District of Columbia Academy of Family Physicians (DCAFP) is a state chapter of the American Academy of Family Physicians. A membership organization for DC Family Physicians, the Academy advocates for Family Physicians and our patients, and conducts continuing medical education for Family Physicians. * Episode 156: Direct Contracting: It’s Coming Fast and Will Have a Big Impact on Medicare-fee-for-service w/ Gail Zahtz – you’ll find additional Direct Contracting resources there. * WiseCare

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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As of 2015 the Office of the National Coordinator for Health IT had awarded $548 million in grants to states to establish health information exchanges (HIE). I have no doubt hundreds of millions of dollars more have been invested in various ways since then. So, when faced with one of the most daunting healthcare data challenges of our time in the COVID-19 vaccine rollout, surely, we turned to the HIEs first. Right? Not so much, according to today’s guest.

Niam Yaraghi, assistant professor of Business Technology at Miami Herbert Business School at the University of Miami and a nonresident fellow at the Brookings Institution’s Center for Technology Innovation, recently explored the use of HIEs in vaccination efforts across the country. He tells us that “While the U.S. employed every possible resource to develop the vaccines, we are neglecting to use the best available information technologies to efficiently distribute them”.

In Yaraghi’s recent article, co-authored with Brookings Institution colleague Peter Levin, they share that none of the state vaccination plans they reviewed made any mention of using HIEs to support the effort. Further, they found no correlation between a state’s vaccination success and the existence of a robust HIE infrastructure in that state.

There are some efforts underway to change this, including ONC’s $20 million investment to help increase data sharing between health information exchanges (HIEs) and immunization information systems. Still, the question remains: why aren’t we using HIEs to their fullest potential to support the vaccine rollout? And why aren’t we turning to the HIEs first whenever we need to move clinical data in general? On this episode, we explore those questions plus:

Five ways that health information exchange can help with vaccination efforts.
How HIEs can change the conversation when it comes to revenue generation.
The opportunity for HIEs to add value and transform data into information through analytics.
How might HIEs play a role in reopening the economy?
Will HIEs play a role in patient-mediated exchange?
Why it’s time for the industry to rethink its views on HIE and make them their first stop for interop.
Plus, some novel API ideas for HIEs.

Niam Yaraghi Niam Yaraghi is an Assistant Professor of Business Technology at Miami Herbert Business School, and a non-resident Fellow in the Brookings Institution's Center for Technology Innovation.

Niam's research is focused on the economics of health information technologies. In particular, Niam studies the business models and policy structures that incentivize interoperability and sharing of health information among patients, providers, payers and regulators. Niam's research has appeared in leading business journals including MIS Quarterly, Information Systems Research, and Production and Operations Management, as well as top-tier health policy and informatics journals including Journal of American Medical Informatics Association, and Milbank Quarterly.

He regularly consults with various companies and platforms in the healthcare industry and is a sought-after expert and speaker on issues related to health information technology in media and at industry conferences.

Niam has a B.Sc in Industrial Engineering from the Isfahan University of Technology in Iran, and a M.Sc from the Royal Institute of Technology in Sweden. He received his Ph.D. in Management Science & Systems from the State University of New York at Buffalo.

Twitter: @niamyaraghi

HIE Links and Resources * The benefits of health information exchange platforms: Measuring the returns on a half a billion dollar investment * Five ways that health information exchange can help with vaccination efforts * Episode 140: Getting to Know eHealth Exchange – The Largest Health Information Network in the Country – Jay Nakashima * Episode 129: What you need to Know About TEFCA Right Now w/ Mariann Yeager * Episode 104: Why HIEs Will Lead the Way on Healthcare Quality Measurement w/ John D’Amore * The Regional HIE Should be Your First Stop for Interop * Plus 4 more #HCBiz Discussions with Niam Yaraghi

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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CMS Direct Contracting is coming fast, is very nuanced, and full of grey. In a nutshell, 50% of Medicare patients are in Medicare Advantage (i.e., value-based care) and 50% are still Medicare fee-for-service (FFS). Direct Contracting is CMS’ bold play to quickly move many of the remaining Medicare fee-for-service (FFS) patients into value-based care.

If you’re a doctor who takes care of Medicare fee-for-service (FFS) patients, then it is going to affect you whether you’re paying attention or not. That’s doubly true if you’re in one of the 10 “Geo” model regions (Atlanta, Dallas, Houston, Los Angeles, Miami, Orlando, Philadelphia, Phoenix, San Diego, Tampa). In those regions, 100% of non-Medicare Advantage beneficiaries will have to align with one of three to seven awarded Direct Contracting Entities (DCE). DCE applications are due April 1, 2021 and all beneficiaries will be re-aligned under this fully capitated plan beginning January 1, 2022. Ya… that fast.

“There will no longer be any fee for service for all of Medicare and all of dual eligibles, which is Medicaid and Medicare eligible, in up to 10 regions of our country starting the first of next year.” Gail Zahtz, Founder and CEO, WiseCare

Today we’re talking with Gail Zahtz, Founder and Chief Executive Officer at WiseCare, a startup applying to become a Direct Contracting Entity (DCE). Gail helps us to understand the urgency of the situation and walks us through the nuance of the model. And while she acknowledges the hurdles for providers and the risks CMS’ rapid timeline imposes, she also embraces the opportunity that Direct Contracting represents. As a cancer survivor, Gail understands firsthand the difficulty of navigating our healthcare system and she believes Direct Contracting offers a pathway to really make a difference in how care is delivered. It makes new services and care models possible, and it allows doctors to care for patients in the way they dreamed of when they got into medicine.

Direct Contracting / Direct Contracting Entity (DCE) Topics Covered

What is Direct Contracting and how does it differ from MSSP and Next Gen ACO models?
What are the timelines?
What are the different types of Direct Contracting Models?
How are beneficiaries aligned to DCEs?
Do patients have a choice in any of this?
How will patients’ benefits and/or costs change?
What will happen to doctors who ignore this and let the pieces fall where they may?
How do doctors interact with DCEs?
How does payment flow through the DCEs?
How can doctors find the DCEs in their area who they might partner with?
How should providers evaluate DCEs to determine if they are right for their patients and their business?
How does quality measurement work in Direct Contracting?
Will there be any changes to the model under the Biden Administration?

There’s a lot here, and still a lot of open questions on Direct Contracting. We’re going to do our best to unravel this for you in the coming weeks. Drop me a note at don@thehcbiz.com and let me know what questions you’d like us to cover.

Gail Zahtz

Founder and Chief Executive Officer, WiseCare Inc.

Gail Zahtz has spent her career focusing on the intersection of evidence-based healthcare and user-centric design to honor and empower the doctor-patient relationship. An entrepreneur since the 1990s when she took a health-in-the-workplace property to $100M valuation, she has served as an adviser to healthcare start-up funders, a thought leader and advisor to industry on designing for health outcomes, a consultant to health innovation startups, and the architect of value-base healthcare delivery for NY’s largest post-acute healthcare system. She has won numerous awards for her work at the intersection of health and design, including: Top 100 in Health Info Technology, Top 100 International Influencers in Health, and Top 50 Most Influential Health Leaders. As a survivor of late-stage cancer and domestic violence, Gail is dedicated to sharing her story of how to survive and thrive in the most challenging of circumstance to show young women everywhere a way forward.

Twitter: https://twitter.com/GailZahtz

LinkedIn: https://www.linkedin.com/in/gailzahtz/

About WiseCare

WiseCare is an Integrated Healthcare Collaboration Company, enabling doctors to deliver true wrap-around care to Medicare patients by leveraging the new value-based care models. WiseCare makes thriving within the new capitated models seamless for physician practices and alternate-level-of-care facilities. A partner, not just a payor, we offer the ready-made collaborations and working partnerships across the healthcare continuum that will be the key to success. And we’re expert in helping physicians keep, grow, and better care for their Medicare populations in this fast-changing environment. We lessen administrative burdens, improve financial stability, provide the data physicians need to make strategic care decisions, and deliver benefit enhancements that pay off for patient and caregiver, physician, and the practice. And our CareCoaches support patients and care plans between office visits, providing: condition and wellness education, targeted referrals to medical and social providers, and resolution of issues that stand between your patients and better outcomes.

That’s what we call Healthcare Made Well. To learn more about how WiseCare can partner with you, email us at info@wisecare.health.

Web: https://www.wisecare.health/
LinkedIn: https://www.linkedin.com/company/wisecare-health/

Links and Resources

Notice of DCEs Participating in the Implementation Period of the Direct Contracting Model, Global and Professional Options This is dated, and only covers the Global and Professional options, but is worth a look if you’re trying to figure out what’s happening in your area.
CMS Announcement: Geographic Direct Contracting Model (“Geo”)
CMS Direct Contracting Model Options
Industry Voices—CMMI chief: Direct Contracting Geographic Model a win for all stakeholders
ACOs press for halt to Geographic Direct Contracting model due to complexity concerns
ACOs Fear Direct Contracting Options Stray Too Far From Providers

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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The pandemic has exposed many weaknesses in our healthcare and public health systems, and our disjointed public health data infrastructure is certainly one of them. Like much of our healthcare data, public health data tends to be manually compiled, Excel-reliant, and lacking in critical detail needed to make good decisions. Today we talk with Prashant Natarajan, VP of Healthcare Life Sciences and Health Insurance at H2O.ai about reimagining the collection and use of public health data.

Public Health Data Topics Discussed

The current state of our public health data infrastructure (12:20)
Why data is the lifeblood of our society, and how it can help us make better public health decisions (22:36)
How the pandemic has exposed our weaknesses, and how the private sector can help (28:12)
The gaps in our public health data and opportunities for improvement (33:19)
Enable better decision-making with demographic and socioeconomic data (40:17)
The importance of sharing lessons from region to region and country to country (44:54)
Applications and use cases for Artificial Intelligence (AI) in public health data (52:01)
Converting data to narrative form and the importance of storytelling (1:02:22)

This was a fascinating conversation, and Prashant is always a lot of fun. I hope you enjoy it!

About Prashant Natarajan

Prashant Natarajan is VP of Healthcare Life Sciences and Health Insurance at H2O.ai

Award-winning global track record of building successful businesses with solutions and products. Conceptualizing, evangelizing & delivering lasting innovation and business transformation - across multiple geographies and organizations in

Healthcare
Life Sciences
Insurance (Health, Group, Annuities & Life)
Financial Services

Best-selling author of books that demystify data, analytics, AI-ML, and transformation for business leaders, domain experts, and non-technologists. Keynote speaker.

Twitter: @natarpr
LinkedIn: https://www.linkedin.com/in/natarpr/
Book: Demystifying Big Data and Machine Learning for Healthcare
Book: Multidisciplinary Approach to Head and Neck Cancer

About H2O.ai

H2O.ai is a leading AI technology company that enables organizations to rapidly build world-class AI models and applications. They continue to reimagine what is possible with artificial intelligence and deliver new platforms and technologies to put responsible AI into the hands of more users.

The company vision is to democratize AI by making it easier for individuals to build and access world-class and responsible AI. To achieve this vision, H2O.ai has created a culture of responsible and engaged makers: community, customers, partners, entrepreneurs, and their own “makers,” enabling them with the technology to “make.” H2O is a leading open-source data science and machine learning platform used by nearly half of the Fortune 500 and trusted by over 20,000 organizations and hundreds of thousands of data scientists around the world.

Links

Episode 43: Demystifying Big Data and Machine Learning for Healthcare w/ Prashant Natarajan
Episode 53: What exactly is Precision Medicine? | Prashant Natarajan | H2O.ai
Episode 126: Using Opportunity Zones to Drive Substantial Investment in SDOH w John Gorman
Episode 143: The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone w/ Dr. Vivian Lee
Episode 146: How Purpose-driven Interoperability and Data Quality Positioned Surescripts to Fill Communication Gaps During the Pandemic – Tom Skelton
Why Indonesia is vaccinating its working population first, not elderly
Survivorship Bias: See the In the Military section for an explanation and image of where the planes were shot
The Hero’s Journey – Joseph Campbell

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

Demystifying Big Data and Machine Learning for Healthcare (Himss Book)

Multidisciplinary Approach to Head and Neck Cancer, An Issue of Otolaryngologic Clinics of North America (The Clinics: Surgery Book 50)

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The pandemic has had a tremendous impact on the business of healthcare. With states canceling elective procedures and people deferring care for fear of being exposed to the virus, hospital and medical practice revenue is down. On the flip side, many health plans are sitting on a mountain of premiums that aren’t being spent because of this deferred care, possibly leading to rebates in some cases and a ton of uncertainty in pretty much all cases. One less obvious outcome of all of this may fall on Medicare Advantage plans in 2021, and it threatens to lower payments by 4-6% in 2021.

Medicare Advantage, of course, is the rapidly growing model that’ll cover more than 24 million Americans this year. According to a recent Avalere report, these plans may be looking at both a sicker population and reduced payments in 2021 because of this deferred utilization. Here to help us understand why, and to share some advice for how Medicare Advantage plans can weather the storm is Dr. Matt Lambert, a practicing ER clinician, and Chief Medical Officer at Curation Health. A few actions Dr. Lambert suggests are:

Focus on the long game and be patient. For example, don’t pay out more to shareholders and, instead, place revenue in short-term investments that they can access without penalty.
Prioritize virtual care/telemedicine enablement/reimbursement now and moving forward. This will enable more members to access care while avoiding in-person treatment risks.
Lead with interventions and the type of claim vs. volume of claims. MA plans will be best served to focus on capturing the key conditions that map specifically to chronic conditions as they drive the most improved outcomes, utilization and costs.

There’s a lot of nuance to this story and the way Medicare Advantage payments are calculated. Dr. Lambert breaks it all down for us. Enjoy!

Dr. Matt Lambert

Dr. Matt Lambert brings more than 20 years of experience as a clinician, CMIO, and change leader in value-based care, ensuring that patients receive more comprehensive care and that payers and providers better capture the value of their services. He is a practicing, board-certified emergency medicine provider who previously founded his own physician staffing company.

Dr. Lambert was one of the founding members of Clinovations. During his time there he served as part of the leadership team for several electronic health record implementations at the nation’s largest public health system in New York City, the University of Washington in Seattle, Johns Hopkins, Barnabas Health, Medstar, and Broward Health. He is also the author of two healthcare books: Unrest Insured and Close to Change: Perspectives on Change and Healthcare for a Doctor, a Town, and a Country.

mlambert@curationhealth.com

Curation Health

Curation Health was founded by a team of healthcare veterans and clinicians to help providers and health plans effectively navigate the transition from fee-for-service to value-based care. Their advanced clinical decision support platform for value-based care drives more accurate risk adjustment and improved quality program performance by curating relevant insights from disparate sources and delivering them in real time to clinicians and care teams. With Curation Health, clinicians enjoy a streamlined, comprehensive clinical documentation process that enables better clinical and financial outcomes while simultaneously reducing clinical administrative burdens on providers. Curation Health takes pride in combining the flexibility and speed of a startup with decades of leadership experience and know-how from roles in leading companies including Clinovations, Evolent Health, and The Advisory Board Company.

Web: curationhealthcare.com.
LinkedIn: https://www.linkedin.com/company/curationhealth/
Twitter: https://twitter.com/curationhealth
Case Study: https://curationhealthcare.com/a-case-study-on-curation-health-and-a-physician-group-in-the-midwest/

Links and Resources

Report: COVID-19 Pandemic May Reduce MA Risk Scores and Payments (Avalere)
Unrest Insured by Dr. Matt Lambert
Close to Change: Perspectives on Change and Healthcare for a Doctor, a Town, and a Country by DR. Matt Lambert
Episode #122: Headwinds Impacting the Shift to Value-Based Care with Kyle Swarts and Dr. Matt Lambert

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

Close to Change 2nd edition: Perspectives on Change and Healthcare for a doctor, a town, and a country

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The CMS Patient Access Rules are coming. And they’re easy to cheer for. We’re giving patients their data and that’s a huge win! We all love that!

But what we don’t love is when FraudulentHealthcareApp.com collects patient data and sells it to the highest bidder to support targeted marketing, or whatever other nefarious act they can come up with. Well, the health plans don’t get to pick and choose which apps they connect to. What if their member wants to use FraudulentHealthcareApp.com? What’s their recourse? How can they educate and protect their members?

On this episode, we’re sharing another of Shahid’s recent panels. This one from Health Data Unbound, and it’s like an #HCBiz super panel as we’ve had all 4 of the panelists on the show in the past. The panel asks the question: “How Will Patients Securely Connect 3rd Party Apps To Their Data Once Patient Access Rules Kick In?” And they will be kicking in on July 1st of this year (2021).

Shahid Shah is our moderator, and he’s talking with:

Andrew Adrian-Karlin, Director of Business Platform-Product, Highmark Health (Episode #148: Partnering with Payers)
Gunjan Siroya, Principal Partner & Sr. Vice President, Netspective (Episode #69: An Open Source Industry Platform for Provider Directory)
Ron Urwongse, Director of Strategy and Innovation, CAQH (Episode #13: Are We Asking Providers the Wrong Questions?)

They cover this core question and discuss the tools and frameworks health plans can use to protect their members and themselves.

And then, as he always does, Shahid asks the most important question. Is this going to make a difference for the patients/members? Will it help them pick a health plan? Will it help them find out if their doctor is covered? Their meds? Will it help them better understand how much things are going to cost them out of pocket? Because if not, what the hell is the point?

It’s easy to get caught up in the implementation, especially when you’re dealing with regulatory requirements. Question 1 is naturally… how do we meet the regs so we don’t have a problem? That, as Shahid puts it, is institution first thinking. The smart health plans… the member-centric health plans are asking, how are we going to use this to make things better for our members?

It’s a great discussion. You’re going to love it and I’m so happy we get to share it with you.

On that note, thank you to Satish Kavirajan, Managing Director at the Actionable Intelligence Network (AIN) for letting us share this with you!

Health Data Unbound

The Health Data Unbound Virtual Conference: Innovations in Health Data Sharing for the COVID-19 Era and Beyond, hosted by Actionable Intelligence Network, was held on November 10-12, 2020, and is now an on-demand event. While there have been many events on interoperability and data sharing, what’s unique here is the focus on the BUSINESS rationale for health data sharing. The conference focuses on the emergent need for interoperability of all kinds, implementation of appropriate sharing of patient information, high priority use cases, value propositions, and companies with enabling technologies, business models, and strategies.

Videos of all presentations from the Health Data Unbound Virtual Conference can be accessed by registering on the Summit website: https://ain.events/hdu/

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This podcast features the Selling to Health Plans panel discussion at the Digital Health Growth Summit, moderated by our very own Shahid Shah, with panelists Vijay Bhatt, Deputy CTO, Harvard Pilgrim Health Care, and Bill Friedman, Vice President of Sales, Zipari.

The panel covers some of the most important digital health technologies that health plans are interested in and how digital health startups can get health plan executives to buy the technologies they’re building. One of my favorite points is that you’ve got to de-risk the decision to buy:

Start small and build-up
Pilots are not bad when done right
Show the IT department that you won’t be a pain in their neck
Show the finance department a transparent roadmap of the true cost of ownership from implementation thru tangible ROI.

Some great advice for anyone trying to sell in healthcare.

This panel discussion complements several recent episodes:

Episode 145: How Payers Can Master Core Administrative Transactions and Deliver a World-class Experience to their Members and Providers w/ Steve Krupa
Episode 148: Partnering with Payers w/ Andrew-Adrian Karlin of Highmark
Episode 150: How to Turn the Growth Engine on in your Digital Health Startup with Bryan Loomis – one of the organizers of this event
Episode 151: Shifting Healthcare’s Culture Toward Openness and Experimentation with Red Hat’s Paul Jones where we talk about his experience as a buyer at a health plan and how that helps him in his new role as a seller.

We focus on selling a lot because you may have the best solution in the world, but nothing happens until someone sells something.

The Digital Health Growth Summit

The Digital Health Growth Summit, hosted by Actionable Intelligence Network and Viral Healthcare Founders, is an on-demand virtual event. The Summit was held on October 29-30, 2020.

This two-day Summit highlights the marketing, sales, and leadership capabilities and strategies that are necessary for digital health startups to grow and scale. Speakers include nationally recognized growth experts and executives from digital health companies, hospitals, health systems, health plans, investors and accelerators.

The Summit is designed to meet the information needs of marketing and sales leaders and other senior executives at digital health startups. The program would also be of interest to digital health accelerators, the investment community, consulting firms, and marketing and sales technology companies.

Videos of all presentations from the Digital Health Growth Summit can be accessed by registering on the Summit website: https://ain.events/dhgsummit/

Thank you to Satish Kavirajan, Managing Director at the Actionable Intelligence Network (AIN),and Bryan Loomis, Founder at Viral Healthcare Founders for allowing us to share this content with you

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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The business of healthcare is consensus-driven and permissions-based. As we’ve seen time and again on this show, this culture slows innovation, stretches sales cycles, and inspires institution-first thinking. Ultimately, it’s responsible for the high costs and lousy user-experiences we’re all trying to fix.

What if healthcare went from a culture of consensus and permission to one of openness and experimentation? That’s what we’re going to explore today.

Our guest, Paul Jones, “grew up” in a large health plan where he was the prospect and buyer of health IT systems and solutions. Now, as Red Hat’s Healthcare Strategist for the Northeast US, Paul is selling innovative healthcare solutions rooted in Open Source software back into the industry he cut his teeth in.

After making this move, Paul didn’t just find open-source software, but an open culture. Looking back on his days at the health plan, this is the first thing he would try to replicate if he went back. We’re going to find out why and explore the hurdles he might face in that endeavor.

In addition, we dig into everything Paul learned as a prospect and buyer of health IT systems, and how he’s using that to be a more effective partner as he sells back into the healthcare industry.

We round out the conversation with a real-world example of a Sepsis-detection system that has already saved 9,000 lives, a riff on why FHIR may still be the gamechanger the hype has promised, and of course, we get into data governance and data quality.

This is a wide-ranging conversation, and it's packed with insights. Enjoy!

Paul Jones Paul Jones is Red Hat’s Healthcare Strategist for the Northeast US. He and his teammates drive innovative healthcare solutions rooted in Open Source software. Prior to that Paul was VP, Card-to-Care at HM Health Solutions where he led the Clinical, Provider and Pharmacy Application Delivery domains focused on Value-Based Care and Care Management Solutions to multiple payers. Before that Paul Led Architecture at HM Health Solutions. Paul has had roles in both IT and Business.

“Open unlocks the world’s potential.”

Email: paul.Jones@redhat.com
LinkedIn: https://www.linkedin.com/in/paulejones/

Red Hat Red Hat is the world’s leading provider of open source solutions, using a community-powered approach to deliver reliable and high-performing Linux®, hybrid cloud, container, and Kubernetes technologies. This efficient, focused method outpaces traditional proprietary software development models and enables healthcare customers to customize solutions in areas such as data integration, clinical reasoning, and compliance automation. It’s why 100% of healthcare companies in the Global Fortune 500 rely on Red Hat.

Learn more at redhat.com/health

Related Episodes * Episode #148: Partnering with Payers – Andrew Adrian-Karlin * Episode #149: How Health Systems Think with Neil Carpenter * And since Paul briefly mentions the topic, check out our Provider Directory series.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Many digital health startups rely on sales prospecting to generate new leads. That works to a point but doesn’t scale because each deal takes a long time, and good healthcare salespeople are hard to find. Today we’re talking with Bryan Loomis, a Digital Health Growth expert and mentor, about how to design, build and execute a growth plan that generates leads in a more sustainable way.

We discuss:

Bryan’s PAGE Methodology (Purpose, Audience, Gospel, and Experimentation) for growth
The importance of generating marketing qualified leads instead of relying solely on sales prospecting
Why email opt-ins are a good indicator your plan is working
Useful tools to help you execute your growth strategy
The proper way to reach out to prospects on LinkedIn
How to use the assets you already have to generate content and “gifts” for your audience
You don’t need blind experimentation, but hypothesis-driven experimentation with measures and statistics.
And much more

Bryan Loomis

“I’m Bryan Loomis, digital health growth expert and mentor. I’ve mentored 25+ digital health companies, from ranging a founder with an idea to 200 million in ARR. My proven methodology helps digital health startups grow rapidly in an entrenched industry that’s set up for them to fail.

Grow your startup. Change the world.”

Learn more, check out the video series VHFcast, and sign up for Bryan’s Slack Community at: https://bryanloomis.com/

Connect with Bryan on LinkedIn

Related Episodes & Resources

Episode 136: Marketing in a Post-COVID World with Jared Johnson
Book: Traction: How Any Startup Can Achieve Explosive Customer Growth by Gabriel Weinberg and Justin Mares – This book breaks down the 19 channels that you can use to build your customer base and helps you identify the best ones for your business.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Traction: How Any Startup Can Achieve Explosive Customer Growth

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Get ready for a cold dose of reality. On this episode, we’re talking with Neil Carpenter, VP of Strategic Planning at Array Advisors and former health system Chief Strategy Officer, about how health systems think. This behind the scenes look at health system strategy, decision-making, and purchasing tells you much of what you need to know as a startup/vendor trying to sell into this market. You won’t like everything you learn, but it’ll give you a much more productive way to look at your product or service and how you fit into the cold-hard reality of health systems.

You’ll learn:

Health systems are permission oriented and consensus driven. What does that mean and how does it affect your sales strategy?
The difference between the big-name systems and their scrappy competitors down the road.
What is the role of a Chief Strategy Officer at a health system and how can you work with them to get your foot in the door?
Why health systems are so focused on what’s happening right now and struggle to look to the future.
That most decisions are driven by personal, and not organizational interests, and how that impacts your ability to make deals
How to avoid the common pitfall of focusing on your solution, and not taking the time to truly understand your buyer
Why it’s easier for health systems to buy from established players than small shops NOTE: We touched on this in Episode 148: Partnering with Payers too
Why health system executive compensation and performance expectations make innovation difficult
Why the “local monopoly” strategy is so common for health systems and why telemedicine is so threatening to that model
How to get to know health systems you’re trying to sell to
What are the two primary power centers within the health system and how to work with each of them?
Which solution spaces are overcrowded and should be avoided?
Which solution spaces are wide-open and ready for new solutions?
Why a good spreadsheet may be your most potent sales tool

This one is densely packed and full of fire. You may want to listen twice.

Neil Carpenter

Neil Carpenter is a health care strategy and innovation consultant– he advises clients from health systems (e.g., on the future of precision medicine, ambulatory planning) to the State of Maryland (e.g., COVID-19 planning). Neil’s thought leadership, where he is the VP of Strategic Planning at Array Advisors modeling the impact of COVID-19 on the US health care sector has been cited by the Wall Street Journal, the Washington Post and several industry publications (e.g., Health Leaders).

In his career, Neil has been a system leader and senior advisor to health system leaders and boards. Neil was the Chief Strategy Officer for LifeBridge Health, a $2billion+ integrated health care delivery system in Maryland with over 400 employed providers and assets across the entire continuum of care. In that role, Neil had wide-ranging responsivities, including helping lead the clinically integrated physician network which had one of the highest ACO savings in the country for several years, launched the first in the nation, offshore command center, the first bioincubator inside a community hospital in the country and new patient engagement technologies aimed at some of the most socio-economically patient populations in the country.

Neil also spent a decade at leading consulting firms. Neil’s clients included Kaiser Permanente, Sisters of Mercy Health System, Steward, UnityPoint, Trinity, Dana Farber, the Military Health System, Montefiore, and the University of Virginia among many others.

Prior to entering consulting after business school, Neil focused on global reengineering, financial analysis and process improvement at GE and American Express. Neil has a Master’s Degree in business from Georgetown University and a Bachelor’s in Business from the University of Massachusetts at Amherst. Neil has served on various state task forces related to Health System planning, taught at John’s Hopkins Carey School of Business and has been published papers on technology transformation in forums such as Digital Biomarkers and AMA Journal of Ethics.

LinkedIn: https://www.linkedin.com/in/neil-carpenter-924a40/

Array Advisors

We understand that asking the right questions positively affects your Health System’s goals. Our purpose is to ask the questions that turn your goals into tangible realities. Array Advisors has the expertise to help position your organization for success in tomorrow’s uncertain market. As your trusted partners in Strategy Development, Organizational Transformation, and Building Informatics, we can help you solve strategic business problems and develop methods to improve efficiency and utilization. We approach each problem from a unique angle, providing a plan tailored to help you overcome your toughest challenges. Having dedicated our careers to healthcare innovation, our objective viewpoint and industry-wide knowledge provide you the decision support you need.

Website: https://array-advisors.com/
COVID-19 Resource Hub: https://info.array-architects.com/en-us/covid-19
Market Disruption Study: https://array-architects.com/press-release/array-models-healthcare-disruption-top-111-markets/

Links and Resources

Episode 103: Selling to Health Systems: Advice for Digital Health Startups (Part 1)
Episode 105: Selling to Health Systems: Advice for Digital Health Startups (Part 2)
Episode 85: Lessons on Selling in Healthcare w/ Dom Cappuccilli

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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For many healthcare startups and established vendors, partnering with payers is a crucial part of their business plan. And as we know, selling in healthcare is hard. It’s even harder when you don’t understand how these large corporations work. What do they want? How do they set priorities? How do they make purchasing decisions? How long does that process take? The list goes on, and if you’re strategizing without this knowledge you’re going to struggle. That’s where this episode comes in.

Today we’re talking with Andrew Adrian-Karlin, Director of Business Platform Product at Highmark Health. Andrew sheds some light on how payers decide what to do and who they decide to do it with. This episode will help you build an effective framework for preparing, approaching, and successfully partnering with payers.

You’ll Learn

What are “products” from a health insurance point of view?
What is the purpose of health insurance? Note: This is the same question we went deep on with Steve Krupa from HealthEdge on Episode 145. Steve’s answer is also worth a listen.
What are some things that payers are interested in from a “business processing” perspective?
How do payers set priorities?
What’s the typical timeline for bringing on a new vendor and what factors contribute to it?
What are the challenges, both internally and externally, that need to be managed when bringing on a new vendor?
What can/should vendors do to minimize these challenges and shorten the timeline?
How do external factors like the CMS Interoperability Rule or the COVID-19 pandemic impact your priorities? And a little bonus here: Why no one – not payer, not vendor, not lawmaker, and not even the regulator – fully understands new regulations and how that creates an early mover advantage.
What are the best ways to keep a pulse on what a health plan is trying to do so that you can partner with them? NOTE: For more tactics on this one, Jeff Byers gave us the journalists take on Episode 62.

Andrew Adrian-Karlin

Andrew Adrian-Karlin helps companies do new things by better applying technology. I’m proud to be transforming healthcare at Highmark Health.

As the Director of Business Platform- Product at Highmark Health, Andrew focuses on building cross-functional teams and leading Product Managers. He is accelerating speed to market for new products, reducing the cost to market, and delivering improved experiences to Highmark’s members.

Andrew has more than 10 years of experience in Information Technology. Prior work has included diverse areas like data analytics, cybersecurity, post-merger integration, and system development. He holds a BS in Accounting from Case Western Reserve University, an MBA from Carnegie Mellon University, and a number of professional certificates and certifications.

LinkedIn: https://www.linkedin.com/in/andrewadriankarlin/

Highmark Health

One of America’s leading health insurance organizations and an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. (the Health Plan) and its affiliated health plans (collectively, the Health Plans) work passionately to create a remarkable health experience for customers. Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of 5.6 million members in Pennsylvania, Delaware, and West Virginia.

As an industry, health care poses new challenges every day that require deep insights, constant innovation, and new solutions. The Health Plan business has boldly forged ahead with doing things differently, piloting new approaches, and breaking from the pack.

Web: https://www.highmarkhealth.org/

Links and Resources

Episode 145: How Payers Can Master Core Administrative Transactions and Deliver a World-class Experience to their Members and Providers w/ Steve Krupa
Episode 141: The State of Payer Data with Jordan Bazinsky
Episode 103: Selling to Health Systems: Advice for Digital Health Startups (Part 1)
Episode 105: Selling to Health Systems: Advice for Digital Health Startups (Part 2)
Episode 96: The CMS NPRM: Opportunities from the Payer Perspective
Episode 85: Lessons on Selling in Healthcare w/ Dom Cappuccilli

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

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There’s a lot of talk about addressing physician burnout, but little practical advice about what to do. The path to action lies first in understanding the many sources of burnout, and then separating them into those that we can impact, and those we cannot.

There’s a class of burnout factors that are intrinsic to being a physician. Simply put, it’s a hard job, and it's demanding in both a physical and mental sense. But this is part of what they signed up for, and due to their passion and sense of purpose (as we discussed at length with Dr. Vivian Lee on Episode 143), most physicians are willing and able to work through them. That’s good because there’s little we in the tech/entrepreneur community can do to help.

The problems arise with the other class of burnout factors – the extrinsic variety. As a society, we have in many ways changed our deal with doctors over the past 10+ years. Under the guise of healthcare transformation, we have piled on to the existing stressors with paperwork, regulations, quality measures, reimbursement cuts, and more. These are burdens that physicians didn’t sign up for, and they are not supported by the same passions we mentioned earlier. The additional layers may be necessary to support our healthcare transformation goals at a systemic level, but they don’t always translate into better care for individual patients, and often undermine the patient/physician relationship. To a physician, this administrative burden feels unnecessary at best, and directly in conflict with their mission at worst. If we really do need these things, and we should confirm that regularly, then we also need to provide the tools and support to make them happen.

And that brings us to the point of this episode. Today, we’re sharing a discussion from the HealthIMPACT Live Summer Forum (July 22-24, 2020). In it, our co-host Shahid Shah discusses how to apply conversational AI to reduce physician burnout with Peter Durlach, SVP of Strategy and New Business Development at Nuance. As the setup would indicate, Shahid and Peter discuss the sources of physician burnout and help us to better understand where we in the tech/entrepreneur community should be focusing our efforts if we want to make an impact. Their discussion covers:

The sources of physician burnout
The difference between intrinsic and extrinsic stressors and why we should focus on the latter
How good conversational AI, or dictation, can cut the administrative time by half
How ambient conversations, where the AI listens in to the conversation as it happens, can take it to the next level
Why we should also be working on nurse burnout
How we can help before, during, and after the patient visit
How the COVID-19 pandemic is accelerating decision making and innovation in healthcare (as discussed in Episode 137 - The Novation Dynamic: 3 Pillars for Healthcare Innovation Success with Michael Ackerman)
Specific advice for entrepreneurs looking to enter healthcare
The difference between health systems that get this right and those that spin their wheels

I’d like to thank our partners at Purpose Events for allowing us to share this content with you. They run the HealthIMPACT Live series, and our very own Shahid Shah is the HealthIMPACT Forum Chair. Shahid describes it as a “No BS and No PowerPoint” event that’s intended to be more of a conversation than a series of presentations. The goal is to get healthcare leaders together and facilitate a conversation amongst peers about the work they’re doing in the real world. Definitely fitting for a listener of this show.

Links and Resources * Purpose Events website * HealthIMPACT Live page * HealthIMPACT Live on YouTube * This interview on YouTube * Upcoming HealthIMPACT Live Events * Episode 144: HealthIMPACT Live Fall Forum Preview plus Tips on Running Virtual Events * Episode 90: Healthcare Is Not Quite Digitized w/ Bill DeStefanis of Nuance - how and why paper is still widely used in healthcare, how we can keep it secure, and how we can effectively integrate it into our digital workflows.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Many private organizations have stepped up to provide support as we deal with the pandemic. Surescripts, for their part, repurposed clinical direct messaging infrastructure to help health systems communicate critical information from the frontlines to federal agencies. It’s a great story of a private organization rapidly transitioning to fill a need.

What we’d like to explore, and what we think you will most benefit from hearing, is why Surescripts was in a position to do this in the first place. And ultimately, why co-host Shahid Shah calls them “THE interoperability story of our century”.

On this episode we explore:

Surescripts 19-year journey to build a national network that handles 19 Billion transactions per year
How good, purpose-driven work lead to success
Why getting the data flowing is the easy part, while data quality and workflow integration are the real problems
How purpose-driven data quality, which we often refer to as data fidelity at #HCBiz, guided the identification and prioritization of efforts and generated an alignment with partners to get stuff done.
The building blocks that resulted from the effort including a master patient index with 314 million patients, an accurate list of all prescribers in the U.S., an accurate list of all pharmacies in the U.S., clinical direct messaging, and more.
How those building blocks make the Surescripts network a “platform for innovation”, and for responding to emergencies like this pandemic
Whether or not we need a Surescripts-like network for other areas of healthcare like labs, imaging, etc.

There’s a lot you can take away from this. My hope is that at a minimum you walk away with a better understanding of your “data quality responsibility” and why use-case-driven interoperability is your best path forward.

About Tom Skelton

Tom is amazed by the changes he’s seen over the course of more than 30 years working in healthcare technology. Before joining Surescripts in 2014, he served as Chief Executive Officer of Foundation Radiology Group, a private equity-backed diagnostic imaging services firm that grew substantially under his leadership. His many other career accomplishments include serving as Chief Executive Officer for Misys Healthcare Systems and as a member of Elcomp Systems’ founding team.

LinkedIn: https://www.linkedin.com/in/skeltontom/

About Surescripts

Our purpose is to serve the nation with the single most trusted and capable health information network, built to increase patient safety, lower costs, and ensure quality care. Since 2001, Surescripts has led the movement to turn data into actionable intelligence, and convened the Surescripts Network Alliance™ to enhance prescribing, inform care decisions, and advance the healthcare industry.

Website: https://surescripts.com/
Twitter: https://twitter.com/surescripts
LinkedIn: https://www.linkedin.com/company/395901/?trk=tyah&trkInfo=tas%3Asures%2Cidx%3A2-1-6
Blog: https://surescripts.com/news-center/intelligence-in-action/
YouTube: https://www.youtube.com/channel/UCVJajqk__-rDozGAPMXB-TQ

Links and Resources

More from Surescripts:

Episode 130: Taking Friction Out of the Prescription Process with Surescripts Real-time Prescription Benefit – Andrew Mellin
Episode 71: Transforming the Prescription Decision Process Between Physicians and Patients w/ Tom Skelton
Episode 17: Going Deep on Provider Directory – Dave Marotz – Surescripts

My favorite book on interoperability and Data Quality:

Demystifying Big Data and Machine Learning for Healthcare (HIMSS Book) by Prashant Natarajan

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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It may seem cliché to say payers need to be more like Amazon, but the analogy provides fundamental, and surprisingly actionable insights for the health insurance industry.

Think about your experience with Amazon (or Google or Zappos, or any other organization that provides a phenomenal customer experience). Whether they're helping you find the right product, or streamlining the purchase, or dealing with a delivery problem, or a return, these organizations have made the transactions feel easy... frictionless... natural.

If you're a payer: Ask yourself, does your front-end member experience, or back-end provider experience even remotely resemble this?
If you're a member or provider: Does your experience with health insurance companies even remotely resemble this?

If we're being honest, approximately 100% of you are shaking your heads "No".

The reason that Amazon can provide an awesome consumer experience is because, through telemetry and analytics, they know exactly what's happening in their business in real-time. They know how much each decision costs them, and they know it on the spot. That enables automation. And that enables the end-user experience we're trying to emulate.

How is this relevant to payers?

Well... that's what this interview is all about. Steve Krupa, CEO of Health Edge, explains that the adequacy and data sharing capability of a payer's underlying transaction systems will be the rate-limiting factor when it comes to improving the member and provider experience.

And what could that experience look like?

First-pass payment accuracy that reduces the need for "claw-backs", saving health plans money and reducing a key source of provider abrasion
Point-of-Service Payments that provide members with transparent out-of-pockets costs and improve provider cashflows.
Automatic claims adjudication that works as-well-as, or better than the current workflow, and does it in real-time.

Additionally, Krupa very elegantly explains the transition of health insurance companies from underwriters of risk to managers of risk, and now increasingly, to participants in the delivery of care itself. We're always looking to expand our fundamental understanding of the business of healthcare. This section created some new and powerful connections for me, and I suspect it will for you too.

Steve Krupa, CEO, HealthEdge Software, Inc.

As the leader of HealthEdge, Steve has the unique opportunity to leverage the various aspects of his professional experience. He started out as a Mechanical Engineer and programmer for Johnson Controls, using software and digital interfaces to control large mechanical systems. Later, Steve became involved in the healthcare mergers and acquisitions business, where he worked on over $12BN of strategic acquisitions and recapitalizations, including the landmark acquisition of US Healthcare by Aetna. Prior to HealthEdge, spent 18 years as a healthcare venture capital partner at the Psilos Group. Today, Steve’s professional passion is for the people and customers of HealthEdge, and its vision to build its substantial and unique intellectual property into the most innovative solutions partner in the HCIT marketplace. Steve holds an M.B.A. with Distinction from the Wharton School of the University of Pennsylvania, where he graduated a Palmer Scholar; and a B.S. in Mechanical Engineering from the University of South Florida where he was elected to Tau Beta Pi.

About HealthEdge

HealthEdge provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect everyone in the healthcare delivery cycle. Its next-generation enterprise solution suite, HealthRules, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. An award-winning company, HealthEdge empowers health insurers to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy. For more information, visit www.healthedge.com.

LinkedIn. https://www.linkedin.com/company/healthedge/

Twitter. https://twitter.com/HealthEdge

Website. www.healthedge.com

Relevant Links and Resources

Episode #141 The State of Payer Data with Jordan Bazinsky of Cotiviti: Learn about the converging data management challenges that will change the payer industry forever, including clinical data integration and the CMS 2020 Final Rule.
Episode 104: Why HIEs Will Lead the Way on Healthcare Quality Measurement w/ John D’Amore
Episode 096: The CMS NPRM: Opportunities from the Payer Perspective
Episode 094: The Path to Healthcare Interoperability
Checkout #HCBiz's extensive coverage of the Provider Directory problem
Providence Digital Innovation Group: Publications, research and perspectives on issues that are reshaping health care through digital innovation

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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On this episode, we discuss the HealthIMPACT Fall Forum coming up September 30th – October 2nd, 2020. Shahid Shah, our co-host and the HealthIMPACT Forum Chair, tells us it’s a “No BS and No PowerPoint” event that’s intended to be more of a conversation than a series of presentations. The goal is to get healthcare leaders together and facilitate a conversation amongst peers about the work they’re doing in the real world.

We also talk about what it’s like to host a conference virtually and the techniques you can use to simulate the best parts of in-person conferences.

What you’ll learn at the HealthIMPACT Forum (from their website):

Building a sustainable innovation strategy in a post COVID world - lessons learned during rapid innovation deployment
Lessons learned from the rapid deployment of telemedicine technologiesin the diagnosis and treatment of COVID and non-COVID Patients
Digital Health’s role in addressing gaps in health equity and applications of SDoH to response and recovery
Tracking, testing, tracing, and treatment- Evaluating Digital Health’s role in supporting ongoing public health surveillance, driving interoperability, and addressing privacy concerns
Connected thermometers, wearables, and digital engagement tools for early control and treatment
VR and Chatbot applications to retain and boost capacity and ensure effective workflow resource planning volume management during and after a surge
Ensuring clinicians’ access to timely evidence-based information - dashboard and clinical information tools
Real-world evidence, and cross-sector collaboration - The coming together - lessons learned from singular focus

HealthIMPACT Live Fall Forum is open to providers, payers, pharma, and patients and closed to non-sponsoring vendors. Apply to attend here.

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On this episode we talk with Dr. Vivian Lee about her new book, The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone. Dr. Lee offers a fresh perspective that will strengthen your understanding of the issues facing America’s healthcare system. And while she acknowledges that our government must play a substantial role in driving systemic change, she points out how each of us as individuals, clinicians, payers, and employers all have a role to play. The book’s title suggests that we’re in for a long haul, and I agree. However, Dr. Lee offers concrete examples of driving change in the real world that can have an immediate impact on the work you’re doing today. In particular:

What it’s like to lead a multi-billion dollar health system into value-based care for the first time?
Why intrinsic motivators like purpose, autonomy, and mastery are more important than extrinsic motivators like compensation, and how to tap into them to motivate clinicians and drive change.
How to co-design change with clinicians (and patients).
How to implement patient satisfaction surveys that actually work.
How to develop measures that matter, and the surprising things that happen when you do.
How to track performance to the clinician-level, and the best way to share the data with them.
Creative ways to reinvest your savings.

I took a ton away from this conversation, and I’m sure you will too!

Dr. Vivian Lee

Vivian S. Lee, M.D., Ph.D., M.B.A,is President of Health Platforms at Verily Life Sciences, an Alphabet company whose mission is to apply digital solutions that enable people enjoy healthier lives. A passionate champion of improving health in the U.S. and worldwide, she works closely with Verily’s clinical and engineering teams to develop products and platforms that support the successful transformation of health systems to value and advance the co-production of health with patients, their caregivers, and communities. She also serves as a Senior Lecturer at Harvard Medical School and Massachusetts General Hospital, and a Senior Fellow at the Institute for Healthcare Improvement. In 2019, she was ranked #11 among the Most Influential People in Healthcare (Modern Healthcare).

She is the author of the acclaimed book, The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone (Norton, 2020).

Dr. Lee is theformer Dean, SVP and CEO University of Utah Health. As a leading healthcare executive, she is committed to the advancement of value-driven transformation in health care (NYT Corner Office, STAT). As CEO, Lee led University of Utah Health to recognition for its health care delivery system innovations (Algorithmsforinnovation.org) that enable higher quality at lower costs (JAMA & editorial, NYT) and with higher patient satisfaction (NYT, HBR, NEJM), as well as successful strategies of faculty development and mentorship. In 2016, University of Utah was ranked first among the nation’s university hospitals in quality and safety (Vizient). Dr. Lee also commercialized the University of Utah’s health plan as Chair of its Board, during which it grew five-fold and was successful in the individual exchange. As Dean, she led the significant expansion of the School of Medicine class size with increased state funding, and helped raise large philanthropic gifts.

Lee is an MR radiologist who developed novel methods for measuring kidney function and vascular disease with MRI. Funded by the NIH for 20 years, Dr. Lee was elected to National Academy of Medicine (formerly, the Institute of Medicine) in 2015, and in 2019, she received the International Society for Magnetic Resonance in Medicine’s highest award for scientific contributions and leadership, the Gold Medal. She served on the NIH Council of Councils advisory to the NIH Director and has authored over 200 peer-reviewed research publications. Presently she serves on the Defense Health Board, advisory to the Department of Defense for military medicine, the Board of Directors of the Commonwealth Fund and the Association of American Rhodes Scholars, the Membership Committee of the National Academy of Medicine, and on the Scientific Advisory Board of the Massachusetts General Hospital. She is also a director on the board of Zions Bancorporation, a publicly traded company.

Dr. Lee is a magna cum laude graduate of Harvard-Radcliffe Colleges, received a doctorate in medical engineering from Oxford University as a Rhodes Scholar, earned her M.D. with honors from Harvard Medical School, and was valedictorian of her Executive MBA program at NYU’s Stern School of Business.

https://vivianleemd.com/

Dr. Vivian Lee on Twitter

Dr. Vivian Lee on LinkedIn

The Long Fix

It may not be a quick fix, but this concrete action plan for reform can create a less costly and healthier system for all.

Beyond the outrageous expense, the quality of care varies wildly, and millions of Americans can’t get care when they need it. This is bad for patients, bad for doctors, and bad for business.

In The Long Fix, physician and health care CEO Vivian S. Lee, MD, cuts to the heart of the health care crisis. The problem with the way medicine is practiced, she explains, is not so much who’s paying, it’s what we are paying for. Insurers, employers, the government, and individuals pay for every procedure, prescription, and lab test, whether or not it makes us better—and that is both backward and dangerous.

Dr. Lee proposes turning the way we receive care completely inside out. When doctors, hospitals, and pharmaceutical companies are paid to keep people healthy, care improves and costs decrease. Lee shares inspiring examples of how this has been done, from physicians’ practices that prioritize preventative care, to hospitals that adapt lessons from manufacturing plants to make them safer, to health care organizations that share online how much care costs and how well each physician is caring for patients.

Using clear and compelling language, Dr. Lee paints a picture that is both realistic and optimistic. It may not be a quick fix, but her concrete action plan for reform—for employers and other payers, patients, clinicians, and policy makers—can reinvent health care, and create a less costly, more efficient, and healthier system for all.

Get it on Amazon

Links and Resources

Episode 139: Behavioral Economics Expert Explains How to Drive Massive Change with Minor Tweaks w/ Karen Horgan
Episode 098: Taking Aim at Phony Doctor Reviews w/ Ted Chan
Episode 079: HCAHPS and the Patient Safety vs. Patient Satisfaction Conundrum w/ Christine Greene and Maurits Hughes from HITS2018
Book: Drive: The Surprising Truth About What Motivates Us by Daniel Pink

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

The Long Fix: Solving America's Health Care Crisis with Strategies that Work for Everyone

Drive: The Surprising Truth About What Motivates Us

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Patient Centricity is a buzzword that’s easy to throw around, but difficult to realize. The notion itself is straightforward… build your product or service around the patient who it is intended to help. Talk with them. Incorporate their input. Understand their needs, desires, and goals. It’s so straight-forward that today’s guest tells us this is no “ah-ha” moment for healthcare, but more of an “ah-duh”.

Why do other industries do this organically, while healthcare talks about it as some enlightened idea? It’s because our healthcare system is dis-intermediated to the point where the patient no longer looks like the customer. And unfortunately, there is no business case for “doing the right thing” in healthcare. Even though our intentions are good, our end-game involves much more than an outstanding patient experience with the best possible outcome. Consequently, our thinking gets cloudy and our efforts get diluted.

Today we talk with Matthew Zachary, founder and CEO of Offscrip Media, about the shortcomings of healthcare’s so-called “Patient Centricity” movement. Matthew shares what he’s learned first-hand as a cancer patient and survivor, and through his advocacy work at Stupid Cancer, the nonprofit responsible for igniting a global movement advocating for AYA (adolescent young adult) cancer programs and support.

Patient centricity is table-stakes at this point, but you’ve got to be coming at it from the correct frame of mind. This interview will help you to think about it in a whole new way.

Matthew Zachary

Ten years after surviving brain cancer at age 21, concert pianist and composer Matthew Zachary created the first health podcast, founded Stupid Cancer, the nonprofit responsible for igniting a global movement advocating for AYA (adolescent young adult) cancer programs and support that brought dignity in the face of health adversity.

After stepping down as Stupid Cancer’s CEO in 2019, Matthew continues his legacy of building community, galvanizing the patient voice, and blowing up the status quo with OffScrip Media, the first digital health podcast network focused on patient advocacy, education, and empowerment.

LinkedIn: https://www.linkedin.com/in/matthewzachary/

Twitter: http://twitter.com/matthewzachary

Facebook: http://facebook.com/matthewzachary

Instagram: https://www.instagram.com/thematthewzachary

OffScrip Media

Today’s healthcare conversations are too polite. OffScrip Media’s here to fix that.

Created by Matthew Zachary, a 25-year brain cancer survivor, and the Founder of Stupid Cancer, OffScrip Media is the first podcasting network at the intersection of patient advocacy, education, and digital health. Our mission is to build community, end isolation, amplify voice, and improve quality of life for patients and caregivers.

Company: https://offscrip.com/

Links and Resources

Episode #114: Who’s Got the Patient’s Back? with Patient Advocate Grace Cordovano
Episode #93: Building a Social Network for Patients and Caregivers w/ Brian Loew of Inspire
The Mighty: a digital health community created to empower and connect people facing health challenges and disabilities.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Payers already face a formidable challenge when it comes to internal data management. After years of consolidation in the industry, many payers have a collection of legacy systems cobbled together to run their operations. This makes data management difficult for things like claims, provider directories, and member demographics. And those are just “the basics”.

Now, as quality measurement evolves and payers experiment in value-based payment, there’s an acute need for the integration of real-time clinical data to support operations and care management. Finally, there are the CMS and ONC final rules that create new requirements for payers to share data with members and other payers.

When you put it all together, payers have a monumental data management task in front of them.

Today we’re talking with Jordan Bazinsky, Executive Vice President and Chief Administrative Officer at Cotiviti. We discuss the current state of payer data, evolving clinical data needs, and the CMS and ONC final rules.

This episode lays the foundation for a new #HCBiz series around payer data that aims to chart a course through these challenges over the coming weeks. Stay tuned for more!

Jordan Bazinsky

As Executive Vice President and Chief Administrative Officer, Jordan is responsible for Cotiviti’s corporate strategy, marketing, retail, strategic alliances, legal, and compliance functions. In this capacity, he is entrusted with ensuring that Cotiviti’s vision aligns with our clients and the broader marketplace. He is committed to advancing our clients’ goals through solutions that empower their success in an evolving landscape.

Jordan has spent his career focused on technology and analytics, often applied towards developing sustainable business models for the delivery of healthcare in the U.S. He most recently served as Executive Vice President, Product and Strategy for the organization, and also previously served as Chief Operating Officer. Earlier in his career, Jordan held positions in strategy and new product development at The Advisory Board Company, a healthcare consulting and technology firm.

Cotiviti

Cotiviti is a leading solutions and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and network performance management programs.

Learn more: https://www.cotiviti.com/

Links and Resources

Cotiviti COVID-19 Outbreak Tracker

Whitepaper: Under pressure: How Medicaid plans can overcome the inevitable strain of COVID-19

Checkout #HCBiz’s extensive coverage of the Provider Directory problem

Episode 104: Why HIEs Will Lead the Way on Healthcare Quality Measurement w/ John D’Amore

Episode 096: The CMS NPRM: Opportunities from the Payer Perspective

Episode 094: The Path to Healthcare Interoperability

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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In a growing crowd of national health information networks, eHealth Exchange is one of the oldest and most connected in the U.S.. Notably, they are the primary way healthcare organizations connect with federal agencies such as the Social Security Administration (SSA), Department of Defense (DOD), and the Department of Veterans Affairs (VA). In addition, they're connected with 75% of all U.S. hospitals, more than 60 regional and state HIEs, more than 5,000 dialysis centers, and more.

Today we take a thorough look at eHealth Exchange with Executive Director, Jay Nakashima to find out what they do and to give you a sense of how they may fit into your clinical data strategy.

Topics include:

What does the eHealth Exchange do
Who participates
How eHealth Exchange connects federal agencies like the SSA, DOD, and VA
Why is the social security administration is such a large consumer of clinical data
The difference in outcomes when you're opt-in vs opt-out
How does eHealth Exchange compare with the other national networks
How does eHealth Exchange fit in with TEFCA
How the Surescripts Record Locator Service is used within the network
How is eHealth Exchange different than regional and state HIEs
Why they don't store any clinical information and the pluses/minuses for federated vs. non-federated exchanges
New support for electronic case reporting
Recent simplifications to their integrations and onboarding
The PULSE Connectivity model

Jay Nakashima

Over the past 25 years Jay Nakashima has designed and implemented EHRs, optimized clinical workflow, and spearheaded data exchange. Jay has worked for health IT vendors, providers, payers, and now leads the eHealth Exchange, the nation’s oldest and largest public-private health information network.

eHealth Exchange

Active in all 50 states, the eHealth Exchange is the largest query-based, health information network in the country. It is the principal network that connects federal agencies and non-federal organizations, allowing them to work together to improve patient care and public health.

Web: https://ehealthexchange.org/

Twitter: @ehealthExchange

Links and Related Episodes

What you need to Know About TEFCA Right Now w/ Mariann Yeager
Transforming the Prescription Decision Process Between Physicians and Patients w/ Surescripts CEO Tom Skelton
Interoperability 2.0 with Niko Skievaski
Why HIEs Will Lead the Way on Healthcare Quality Measurement w/ John D’Amore
The Path to Healthcare Interoperability
TEFCA, Interoperability, and an Industry’s Unreasonable Expectations
The Regional HIE Should be Your First Stop for Interop
ADVault: https://mydirectives.com/ make your end of life medical wishes known

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Everything you’re trying to accomplish comes down to one thing… getting people to do stuff. Behavioral economics, in its simplest terms, is the study of how and why people decide to do what they do (or don’t do). Whether you’re trying to sell, get users to adopt a new system or workflow, or make your staff feel comfortable coming back to work during a pandemic, understanding behavioral economics will greatly increase your chances of success.

Today we’re talking with Karen Horgan, CEO at VAL Health about how behavioral economics is being used in healthcare today, and how it should be used going forward to drive positive behavior change throughout the industry.

No matter what you’re working on, there’s something here for you. I can think of no better investment you can make in your self and your business than gaining a basic understanding of these concepts.

"Behavioral economics is the last mile to transform healthcare. As an industry, we have a behavioral deficit, not an informational deficit."

Karen Horgan, CEO, VAL Health

You’ll Learn

How behavioral economics is used to influence your decisions every day
How “changing the default” can drive dramatic behavior change overnight
Why things like scarcity, exclusivity, and social proof are such powerful influencers of human behavior
How one practice used behavioral economics to reduce no shows
Why losses are doubly as powerful as gains in driving behavior change
Why focus groups will often fail you
How to use behavioral economics to help employees feel safe at work
How to use behavioral economics to help patients feel safe going to appointments during the COVID-19 pandemic
The importance of creating and maintaining a feedback loop when trying to promote preventative measures
Using behavioral economics to influence up
The importance of using simple language (I’m looking at you… everyone in healthcare )
Why you should always make the right path the easy path

Today’s Guest: Karen Horgan

Karen co-founded VAL Health to apply behavioral economics to improve health and health care. A proven expert in developing high impact behavior change and engagement programs, Karen is commonly found presenting at leading industry conference and private speaking events including SXSW, HIMSS, the AHIP Institute, and the World Economic Forum. As the CEO, she has spearheaded the development of hundreds of behavior change programs that enable clients to overcome healthcare’s biggest challenges. Prior to starting VAL Health, Karen was Chief Marketing Officer at Keystone Strategy. Karen also previously led marketing and product management teams for early-stage technology companies and was a consultant with Bain and Company in Boston and Hong Kong. Karen holds an MBA from the Harvard Business School, a BA from the University of Pennsylvania, and a BS from the Wharton School of the University of Pennsylvania.

Connect with Karen on LinkedIn: https://www.linkedin.com/in/karen-sussman-horgan

VAL Health is the leading health-related behavioral economics consulting firm. We tackle the hardest problems in healthcare using proven behavioral economics science, pioneered by our academic co-founders and enhanced with our real-world experience. By meeting people where they are, we deliver sustained engagement and behavior change for clients, the leading payers, hospital systems and digital health companies.

Resources

Nudge: Improving Decisions About Health, Wealth, and Happiness
Influence: The Psychology of Persuasion, Revised Edition
Pre-Suasion: A Revolutionary Way to Influence and Persuade
VAL Health White Papers
The #HCBiz Show #66: Finding the Right Words w/ Stacey Richter – we discuss another relevant book on human behavior – Thinking Fast and Slow by Daniel Kahneman

And this is a great talk by Karen’s co-founder, David Asch. Worth checking out, especially for the graphs between the 9 and 10-minute marks: https://youtu.be/PI5V1-IFvlI

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Nudge: Improving Decisions About Health, Wealth, and Happiness

Influence: The Psychology of Persuasion, Revised Edition

Pre-Suasion: A Revolutionary Way to Influence and Persuade

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Public health vs. the economy is a dangerously false dichotomy. We can protect our people AND get back to work if we accept reality and embrace science. You already know you should wear a mask, wash your hands, and practice social distancing. As we begin to go back to work and spend time with our extended families and friends, Remote Patient Monitoring (RPM) tools present an additional layer of protection that could allow us to do so more responsibly, safely, and productively.

Remote Patient Monitoring (RPM) tools, like pulse oximeters, blood pressure cuffs, Bluetooth thermometers, and others often used in chronic disease management programs, can help you baseline your vitals, offer peace of mind, and alert you at the earliest possible moment when there might be a problem.

NOTE: We recorded this episode on June 15, 2020, right before the recent spike in COVID-19 cases in many states across the U.S. Things look quite different today, but these ideas and tools still apply. Be responsible. Wear a mask. Take care of yourself and your family. And in general, do your part to safely reopen our economy.

Watch this episode on Youtube: https://youtu.be/__iorUxYvPM

We'll be doing more video in the coming months. Get subscribed now so you never miss one.

You’ll Learn

Inexpensive tools that you can use at home to keep your family safe
The importance of baselining your vitals and monitoring for relative changes
What employers can do to keep their employees safe, and make them feel safe
Questions employees should be asking their employers before going back to work
How to do many medical tests in your home
The difference between telemedicine and tele–diagnostics
How to use the data you collect and how to share it with your doctor
How IoT manufacturers can get involved in healthcare right now
Opportunities for software vendors to support remote monitoring
How to assess the market and identify your opportunity

Resources

A Patient’s Home Resource Kit for COVID-19 by Robert Havasy, MS, Managing Director, Personal Connected Health Alliance, HIMSS
Episode #119: The State of Remote Patient Monitoring with Sam Liu of VivaLnk
Episode #3: Why Hand Hygiene Matters – Tamás Haidegger
HCBiz Blab Series #25: What’s Next for Chronic Care Management

Sponsor

This episode is sponsored by Formstack.

Formstack is a workplace productivity platform that simplifies healthcare data processes. Healthcare teams can transform piles of paperwork into automated workflows that are easy to administer and 100% HIPAA compliant. From appointment scheduling to insurance verification, Formstack makes it easy to breeze through administrative tasks, reduce security risks, and improve patient care and satisfaction. Learn more and try Formstack here.

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Michael Ackerman, director of the Master in Healthcare Innovation Program at The Ohio State University, believes that every innovation program must do three things in tandem:

Innovation – filling gaps where no solution currently exists, in a way that adds value
Renovation – quality improvement and process improvement
Exnovation – removing functions that no longer add value; also known as de-implementation

When practiced together, and ideally led by different teams within the organization, the 3 pillars of The Novation Dynamic help us overcome the notorious friction that has slowed healthcare innovation for too long.

You’ll Learn:

The 3 pillars of The Novation Dynamic and how to apply them in your organization
The 3 things that make innovation so hard in healthcare and how to address them
How to do evidenced-based innovation even though innovation is, by definition, void of evidence
Why we’re seeing so much innovation right now during the pandemic, and what we can learn from the experience to make sure we never slow back down.
How to create a culture of innovation (plus, a killer idea to make your end of year reviews meaningful at the same time).
Why no innovation should be deployed without a scheduled reevaluation date.
How to tap the tremendous potential of nurses to drive innovation

Today’s Guest:

Michael H. Ackerman, DNS, RN, FCCM, FNAP, FAANP, FAAP is director of the Master in Healthcare Innovation Program and professor of clinical nursing at the College of Nursing, The Ohio State University, in Columbus, Ohio.

LinkedIn: https://www.linkedin.com/in/michael-ackerman-dns/

Facebook Group: Stop the Silence in Healthcare

Resources:

The Novation Dynamic

Getting Rid of Stupid Stuff (NEJM)

The #HCBiz Show! #133: Keeping Your Innovation Engine Humming During the COVID-19 Crisis w/ Karen Murphy, PhD, RN

The #HCBiz Show! #7: Redefining Sepsis | Michael Ackerman

Sponsor:

This episode is sponsored by Formstack.

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The COVID-19 crisis has presented marketers with quite a challenge. Customers don't want to be sold to and no one wants to spend money. In fact, traditional marketing has been paused for fear of coming off as insensitive and out of touch. But that doesn't mean you stop. You just do it differently. The pandemic is driving marketers back to the fundamentals of relationship building and value creation. This is how you stay relevant during the crisis, and as we reopen the economy. On this episode, we talk with Jared Johnson of Shift.Health about how to get it done.

You'll learn:

How buyers priorities have changed over the past couple of months
The importance of "Show. Don't tell."
What to do when your buyers don't want to be sold to
How to understand your buyers needs when they don't want to hear from you
What to do when the top of the funnel is blocked and the middle of the funnel is slower than ever
How to create opportunities for your customers - and no, we don't mean the opportunity to buy your product
Why it's more important than ever to double-down on relationships
The right way to do email in a crisis
How to think like your customers and why that helps you add value
How to do your homework before a cold email or LinkedIn message
Understanding where you have the authority to speak
Why you should extend your marketing to include the experience your customers have when they consume your product or service

Today's guest:

Jared Johnson builds innovative healthcare brands through digital strategy and engaging content that turns heads. He is a digital branding consultant, rapping keynote speaker, prolific content creator, host of the Healthcare Rap Podcast, and author of Connect the Docs: Put Digital Health Into Practice. He is founder of the Shift.Health Content Network, the infotainment network of podcasts and video series that are shifting how healthcare is marketed and experienced. Onalytica listed him as a #DigitalHealth Top 100 Influencer, and his peers nominated him to the #HIT100 list of health IT social media influencers twice.

Healthcare Rap Podcast - http://healthcarerap.com/Jared's LinkedIn - https://www.linkedin.com/in/jaredjohnson/Jared's Twitter - https://twitter.com/jaredpianoShift.Health Content Network - https://shift.health/Shift podcasts - https://shift.health/podcasts/Shift video series - https://shift.health/videos/

Full show notes and links: https://thehcbiz.com/marketing-in-a-post-covid-world-with-jared-johnson

Sponsor:

This episode is sponsored by Formstack.

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The COVID-19 crisis and the resulting lock-downs across the world forced many organizations to go virtual in an instant. Some of them had sound Business Continuity (BC) and Disaster Recovery (DR) plans in place. And while they were still interrupted, they were able to move quickly and keep their people working. Others were caught off-guard and are now scrambling to make it all work.

In an industry like healthcare with reams of sensitive data and the regulations that go with it, this breakneck pace creates a ton of risk for organizations going remote. And the risks are exacerbated when they can’t provision hardware for everyone and they let their staff connect via their own devices.

On this episode, we talk with Jonathan Lieberman, CEO and Co-Founder at itopia. He tells us how virtual desktops can be deployed quickly and securely in the cloud, allowing your staff to access critical data and systems from anywhere on any device.

This approach has obvious benefits when you’re faced with the type of crisis we’re in right now, but it goes way beyond that. We’re really talking about sound Business Continuity (BC) and Disaster Recovery (DR) strategies. If you, as Jonathan puts it, “treat every employee like a remote worker”, then you’ll be ready for whatever comes next.

We cover a lot of strategy, along with the tactics to execute. Key topics include:

What’s special about remote workers and remote work environments
On-boarding and decommissioning users in a virtual environment.
Policies and procedures to ensure security, especially when employees are using their own devices
Special considerations for remote access to HIPAA-protected information
Rapidly re-deploying remote desktops infected by ransomware
Why all of this is really Business Continuity (BC) and Disaster Recovery (DR) planning
Why you should continue to treat every employee like a remote employee even after the crisis
Why there’s no way to create a secure desktop in a physical environment
What we can learn from the COVID-19 crisis about our ability to innovate quickly.
Why we should never go back to doing things exactly the way we did before.

Full show notes and links: https://thehcbiz.com/remote-work-environments-and-business-continuity/

This episode is sponsored by Formstack.

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We’ve talked a lot about the importance of addressing social determinants of health (SDOH) in healthcare, and why it may be the most critical factor when it comes to lowering costs and improving outcomes… especially for vulnerable communities. For me, there is zero doubt that this is what needs to happen. However, we’ve seen very few programs that have been successful, sustainable, and scalable. That’s a big problem, and when this happens, you risk losing the attention of key decision-makers that we need to drive these new approaches forward.

If we know the interventions work, but we haven’t been able to find financial alignment within the system… then perhaps we’re doing it wrong.

Today we’re talking with someone who’s made it work. Jill Feldstein is Chief Operating Officer at the Penn Center for Community Health Workers at Penn Medicine.

They help healthcare organizations across the country start or improve Community Health Worker (CHW) programs using the Center’s evidence-based IMPaCT model.

And they’re returning $2 for every $1 spent.

I first heard about the Penn Center for Community Health Workers at the recent NCQA Quality Talks event. Executive Director, Shreya Kangovi, pitched the idea of using federal funds to hire Community Health Workers as part of our COVID-19 response. It would help patients get the care they need. It would keep us safer as we re-open the economy. AND it would create new jobs! It’s effective. It’s efficient. I love this idea.

So today we’re going to learn about Community Health Workers, how health systems and payers can use the Penn Centers IMPaCT model to drive a 2:1 ROI, and why right now, in the face of the COVID epidemic, may be the best time to do it.

After you listen, I encourage you to consider signing The Penn Center for Community Health Workers letters to CMS and Congress. The letters outline the benefits of community health workers and explain how they can make a huge difference as we battle our way out of the COVID-19 crisis.

Learn more at: https://chw.upenn.edu/

Full show notes: https://thehcbiz.com/community-health-workers-to-combat-covid-19/

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Health Systems are being asked to make changes in 2 months that would have otherwise taken years. As some business lines come screeching to a halt, others have sped to a breakneck pace. Prioritizing problems to solve and finding novel solutions have never been more essential. Here today to teach us how innovation is done at Geisinger Health is Karen Murphy. Enjoy!

Highlights from the Episode

We define innovation at Geisinger as a fundamentally different approach to solving a problem that has quantifiable outcomes. So we only work on problems.

Pathway from nursing to government to innovation at Geisinger
The Solution-Oriented vs The Strategy-Oriented Innovation Team
What prioritization mistakes are hospitals and public health officials making during COVID-19?
Innovations in behavioral health and mental health for the healthcare workforce.
What have your frontline workers learned that can inform community reopening strategies?
How hospitals are tracking and factoring the quality of social distancing into their metrics.
Contact Tracing Technology and Techniques
Building your own Post-COVID Plan: What did you stop that you shouldn’t restart? What did you start that you should continue? And scenario planning.

Karen Murphy, PhD, RN Executive Vice President and Chief Innovation Officer, Founding Director, Steele Institute for Health Innovation, Geisinger

Dr. Murphy has worked to improve and transform healthcare delivery throughout her career in both the public and private sectors. Before joining Geisinger, she served as Pennsylvania’s secretary of health addressing the most significant health issues facing the state, including the opioid epidemic. Prior to her role as secretary, Dr. Murphy served as director of the State Innovation Models Initiative at the Centers for Medicare and Medicaid Services leading a $990 million CMS investment designed to accelerate health care innovation across the United States. She previously served as president and chief executive officer of the Moses Taylor Health Care System in Scranton, and as founder and chief executive officer of Physicians Health Alliance, Inc., an integrated medical group practice within Moses Taylor.

Dr. Murphy earned her doctor of philosophy in business administration from the Temple University Fox School of Business. She holds a master’s of business administration from Marywood University, a bachelor of science in liberal arts from the University of Scranton, and a diploma in nursing from the Scranton State Hospital School of Nursing. An author and national speaker on health policy and innovation, Dr. Murphy also serves as a clinical faculty member at Geisinger Commonwealth School of Medicine.

The Steele Institute for Health Innovation at Geisinger The healthcare industry across the country needs real solutions that drive transformation. Here at Geisinger, the Steele Institute for Health Innovation has forged a dynamic healthcare solutions team, headed by leaders across our enterprise, that is rapidly developing innovative solutions to change healthcare.

What drives us? An unshakable commitment to deliver better care to our patients, our members, our students, our Geisinger family and our communities.

Our purpose is simple, but powerful – to lead the nation in building solutions that improve:

Health
Patient experience
Care delivery
Affordability

Resources, Links and Related Episodes Geisinger Website

Steele Institute for Health Innovation

STAT Op-ed on Contact Tracing by Karen Murphy

The Geisinger Chapter of Reframing Healthcare by Zeev Neuwirth

Episode 126: Opportunity Zones w/ John Gorman

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In our ongoing series around the COVID-19 crisis, we plan each episode with the specific aim of delivering you, the listener, actionable items you can do right now. To ensure that during this crisis you can solidify and strengthen your business while continuing to serve your patients at the highest level, we're bringing you two of our favorite people in healthcare. Joining us today is David Goldhill, CEO of Sesame and Dr. Allison Edwards who runs a direct primary care facility, to talk about how you can adopt the right strategies for doctors to overcome this crisis.

Highlights

How a personal tragedy and a timely New Yorker article set David Goldhill on the path from being a top media exec to one of our leading voices in healthcare.
Why incentives and priorities are a huge motivation and focus of David's research.

What we saw was an opportunity to create something of an alternative health economy outside of third party reimbursement.

David Goldhill

The Direct Primary Care Marketplace: A guide for practices and patients.
The solution for high deductible patients you can't collect from.

We elected to not bill insurance in our clinic simply because we wanted to make sure that we were actually working for our patients as our customers.

Dr. Allison Edwards

Insurance made it difficult to treat patients: How helping under-served populations in an FQHC drove Dr. Edwards to DPC.
The DPC Speed Advantage: How Dr. Edwards was able to adapt and pivot without having to convince government or insurers, she just had to convince her patients.
The NEW Channels, Formats, and Expectations for the doctor-patient relationship.
An overview of the video platform, payment, and scheduling with Sesame.
What you can and can't do through Telemedince in Primary Care.
A rundown of the Virtual Check-in
Don’t let perfect be the enemy of good.

David Goldhill, President and Chief Executive Officer David Goldhill is the founder and CEO of Sesame, which operates an innovative direct pay marketplace for the full range of health care services. Sesame launched its service in Kansas City in 2019. Goldhill has been a leading voice of market-based health care reform since publication of “How American Health Care Killed My Father” as the cover story of the September 2009 issue of The Atlantic.

Goldhill is the author of “Catastrophic Care: Why Everything We Think We Know about Health Care is Wrong” (Knopf, January 2013) and of “The Real Costs of American Health Care” (Vintage 2016). He is co-editor of New York’s Next Health Care Revolution (Manhattan Institute, 2015). Goldhill is chair of the Board of Directors of the Leapfrog Group, an employer-sponsored organization dedicated to hospital safety and transparency.

In his business career, Goldhill was president and CEO of GSN, which operates a US cable television network seen in 80 million homes and one of the world’s largest digital games companies. He previously served as president and COO of Universal Television Group, the largest division of Universal Studios. In this capacity, he oversaw all operations at the company’s domestic and international cable television networks, cable and network television studios, first-run syndication business and worldwide television distribution.

Goldhill was also chairman and CEO of Independent Network Holdings, Ltd. (INTH), which created and operated the TV3 television network in Russia. Prior, Goldhill was the CFO of Act III Communications, a privately-owned holding company with interests in television stations, movie theaters, magazines, and film/television production. He has served as Director of Commerce Hub (CHUBA), Expedia (EXPE), eLong (LONG), and numerous private companies.

Goldhill graduated from Harvard University with a B.A. degree in history and holds a M.A. degree in history from New York University.

Sesame

Sesame is a marketplace for health services where customers pay upfront for care. Sesame connects patients and providers directly, making quality health care more accessible, affordable, and transparent. No surprise bills, no hidden costs. Just great doctors offering their services at fair, transparent prices.

Sesame offers an end-to-end HIPAA-compliant telemedicine solution with a key distinction. Sesame virtual appointment includes our direct-pay payment and billing functionality. At a moment of uncertain reimbursement policies around telemedicine – and with telemedicine appointments carrying fees meaningfully less than in-office visits, Sesame allows practices to recoup revenue with little administrative cost. Our platform is a fully HIPAA compliant, easy to use service that enables any licensed medical provider in the US - in any specialty - to immediately list their services using our convenient, self-onboarding tool. The platform also works with other video services, which allows physicians to utilize Sesame for its upfront payment functionality alongside an existing video conference solution. We’re offering the service free to all providers for the next three months as a way to introduce the concept of direct-pay services to a broader range of providers.

Patients can use Sesame to find the telemedicine care they need, with a wide range of specialties and providers—from general consultations, to dermatology, physical therapy and beyond, all available with clear, affordable pricing and a straightforward booking platform.

Links, Resources and Related Episodes Sesamecare.com

Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong

Catastrophic Care Book Review by Don Lee

DPCFrontier.com

Direct primary care alliance university

EHRs for DPC – Elation, Hint, Atlas (in the order they were mentioned)

Twitter @SesameCare @Dr_A_Edwards @David_Goldhill

Linkedin: Sesame David Goldhill Dr. Allison Edwards

More on Direct Primary Care (DPC) from The #HCBiz Show

Catastrophic Care: How American Health Care Killed My Father--and How We Can Fix It

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Many doctor’s offices have been closed for weeks and those that haven’t have seen massive cancellations. This episode is for healthcare providers and people working inside health offices. Today we’re going to share what we're seeing across the country in terms of closures, cancellations, and plans going forward. Joining us to help you formulate a plan, is Tashfeen Ekram, MD co-founder and chief medical officer of Luma Health.

Highlights from Serving Patients and Doing Business in Spite of COVID-19 * COVID-19 accelerating the patient first care model * How Luma Health makes communication easier * How CMS lifted the barriers to telehealth and remote monitoring

How can we continue to serve our patients in the way they want to be served, but at a distance?

Making sense of cancellation data from across the country
Clinic driven cancellations vs. patient driven cancellations
The fine art of Mass Messaging
Prioritizing patients with text message surveys
Reimbursement changes and new revenue centers

Before COVID-19 hit, everyone was thinking about telehealth. I think everyone will now have a telehealth game plan in place.

Convenience and patient experience will determine which changes are here to stay.

Tashfeen Ekram, MD, Co-Founder and Chief Medical Officer Tashfeen Ekram, MD, is the co-founder and chief medical officer of Luma Health. He is also a practicing radiologist at the Redwood Radiology Group, specializing in chest imaging. In his role as Chief Medical Officer, Dr. Ekram serves as a strategic customer contact to ensure the company’s patient relationship management system delivers optimal clinical workflows and meets the goals of Luma Health’s customers.

Luma Health

Luma Health was founded on the idea that healthcare should work better for all patients. Every single point along the care journey should be simple, seamless, and effective, from accessing care to achieving health goals. Luma Health empowers providers to make this a reality through its total patient engagement solution, designed to boost access, streamline patient-provider communications, and help providers grow their business.

Headquartered in San Francisco, Luma Health’s platform is modernizing communication by delivering smarter conversations that drive patient engagement and continuous care, empowering thousands of providers and more than 11 million patients across the United States today.

Links and Related Episodes Luma Health Website

The 5 stages of COVID-19

Get Luma Health solutions set up in 24h for free!

Luma Health Raises $16M

Dr. Ekram's email: tekram@lumahealth.io

Social Media:

Luma Health Facebook

Luma Health LinkedIn

Luma Health Twitter

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Surescripts is at the center of almost all prescriptions for medications in the US. In this era, when almost no other kind of prescriptions are being allowed, how is Surescripts thinking about digital prescriptions? How has Surescripts adapted to the new needs of patients and providers at the point of care with their real-time prescription benefit? Dr. Andrew Mellin, Chief Medical Information Officer at Surescripts joins us today to show us how the right technology changes physician prescribing behavior, saves patients money, and improves trust throughout the entire system, at the same time.

Highlights * How should providers, innovators, and developers think about digital prescriptions? * What effect will COVID-19 have on telemedicine and e-prescribing? * Challenges of practicing healthcare remotely. * Surescripts is exploring opportunities to work with The Sequoia Project on PULSE

If it's not in the workflow, the chance of it being used is extremely small.

The Toolset that Surescripts has for price transparency and real-time benefits checks.
How to change physician prescribing practices.
Getting information to the doctor at the point of care is the name of the game.
Behind the scenes on the network that flags prior authorizations and eliminates extra work.

Andrew Mellin MD, MBA, Chief Medical Information Officer Andrew Mellin, MD, MBA, is VP, Chief Medical Information Officer at Surescripts, where he helps the Surescripts Network Alliance improve the care experience for both providers and patients with a focus on technology and smart workflow solutions. Dr. Mellin has over 20 years of experience in health information technology, patient quality and safety, consumer health and EHR implementation and adoption. He is Board Certified in Internal Medicine and worked as a part-time hospitalist in St. Paul, MN for 15 years.

Surescripts Our purpose is to serve the nation with the single most trusted and capable health information network, built to increase patient safety, lower costs and ensure quality care. Since 2001, Surescripts has led the movement to turn data into actionable intelligence, and convened the Surescripts Network Alliance™ to enhance prescribing, inform care decisions and advance the healthcare industry.

Links and Resources * Andrew Mellin LinkedIn * Surescripts LinkedIn * Surescripts Twitter * Surescripts blog: ZIP Code v. Genetic Code: How Health Plans Can Use Technology to Address the Social Determinants of Health * Report: Prescription Price Transparency & The Patient Experience * Episode 71: Transforming the Prescription Decision Process Between Physicians and Patients w/ Tom Skelton

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A year after Draft 2 of TEFCA, what has happened and where are we now? The ONC awarded a cooperative agreement to The Sequoia Project to serve as the Recognized Coordinating Entity (RCE) to develop, update, implement, and maintain the Common Agreement and the QTF. On today's episode, Shahid Shah joins your host, Don Lee to talk with the CEO of The Sequoia Project, Mariann Yeager. If you are an HIE and you want to become a QHIN (or sell to one), this episode is for you.

Highlights from What you need to Know About TEFCA Right Now

TEFCA, Trusted Exchange Framework and Common Agreement, are the rules of the road and the specific technical requirements to enable health information networks to interconnect.

Sequoia has an HIE portfolio and is helping the ONC to implement TEFCA
What is a Qualified Health Information Network (QHIN)?
Minimum requirements for legal and privacy vs. technical implementation details for interoperability
What do product managers, developers, and customers need to know about TEFCA? Read the QTF!
The technology used for treatment based exchange is the easy part. TEFCA provides the trusted community to get over the privacy concerns.
Ms. Yeager breaks down the TEFCA Value Proposition.
What parts of TEFCA are descriptive vs. prescriptive?
Does the government or industry get to decide what it means to be "TEFCA compliant"?

Mariann Yeager Mariann Yeager, CEO has more than 20 years of experience in the health information technology field. She currently serves as CEO for The Sequoia Project, a non-profit solely focused on advancing secure, interoperable nationwide health data sharing in the US. She also leads the Recognized Coordinating Entity (RCE) effort, in close collaboration with the Office of the National Coordinator for Health IT to develop, implement, and maintain the Common Agreement component of the Trusted Exchange Framework and Common Agreement (TEFCA) and to operationalize the Qualified Health Information Network (QHIN) designation and monitoring process. The Sequoia Project also serves as a steward of independently governed health IT interoperability initiatives including the Patient Unified Lookup System for Emergencies (PULSE) and the RSNA Image Share Validation Program. Under her leadership, The Sequoia Project supported, the startup, growth and maturation of two highly successfully interoperability initiatives, the eHealth Exchange and Carequality, which now operate as independent non-profit organizations. Prior to her tenure at The Sequoia Project, she worked with the HHS Office of National Coordinator (ONC) for five years on nationwide health information network initiatives. She also led the launch and operation of the first ambulatory and inpatient EHR certification program in the US.

The Sequoia Project The Sequoia Project is a non-profit, 501c3, public-private collaborative chartered to advance implementation of secure, interoperable nationwide health information exchange. The Sequoia Project focuses on solving real-world interoperability challenges and brings together public and private stakeholders in forums like the Interoperability Matters cooperative to overcome barriers. Sequoia also supports multiple, independently governed interoperability initiatives, such as the Patient Unified Lookup Service for Emergencies (PULSE), a system used by disaster healthcare volunteers to treat individuals injured or displaced by disasters.

Links and Resources * www.sequoiaproject.org * Interoperability Matters * Patient Unified Lookup System for Emergencies (PULSE) * Qualified Health Information Network (Q-HIN) Technical Framework or QTF page 70, Appendix 3 * Recognized Coordinating Entity (RCE) * TEFCA Public Webinars

@sequoiaproject on Twitter

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There is an urgency to utilize social determinants in healthcare decision making, especially to meet the needs of underserved populations. Jvion launched its new COVID-19 Community Vulnerability Map, a free, publicly available tool that identifies populations — down to the census block level — that are likely to experience severe outcomes requiring hospitalization when they contract the virus. The map integrates the findings of the data analysis project that Jvion conducted last week, which analyzed a representative sample of 2 million patients to understand the social and clinical risk drivers that make populations more vulnerable to viral infections like COVID-19. Joining Don and Shahid on this episode is Chief Product Officer, Dr. John Showalter to talk about the deployment and use cases of the COVID-19 Community Vulnerability Map.

Highlights * COVID community vulnerability map – learn how limited datasets can be used to understand which communities are at risk of having high mortality and high hospitalizations. * Developed map on Azure and partnered with Microsoft to map the predictors. * This map is telling us where we should pay close attention when deploying resources. * The best maps for future planning and focusing on prevention.

Helping during the pandemic aligns with our values...our mission is to reduce preventable harm. We're committed to evolve this initiative and bring forward the best insights that we can.

About the surge prediction map
About the community risk map
Using socioeconomic status and behavioral health to understand clinical risk factors – AJMC article describing technique
What is Dirty COVID-19 data?
Trend analysis vs prescriptive planning
Jvion is joining the COVID-19 Healthcare Coalition
The mistakes of using advanced technologies: all data, no action.

A message from Shantanu Nigam, Jvion’s Founder

We are tremendously grateful for the thousands of healthcare workers on the frontlines of the battle against COVID. Their courage and rapid mobilization in the face of the greatest public health threat of our time has been incredibly inspiring. We are working around the clock to provide them with data-driven insights to help them protect the most vulnerable members of their communities.

Dr. John Showalter, Chief Product Officer Dr. John Showalter, MD is the Chief Product Officer at Jvion and a board certified internal medicine physician specializing in clinical informatics. He is passionate about quality improvement and the application of AI to improve patient outcomes, and is dedicated to ensuring the Jvion Machine drives value and improves lives.

Jvion Jvion enables healthcare organizations to prevent avoidable patient harm and lower costs through its AI-enabled prescriptive analytics solution. An industry first, the Jvion Machine goes beyond simple predictive analytics and machine learning to identify patients on a trajectory to becoming high risk and for whom intervention will likely be successful. Jvion determines the interventions that will more effectively reduce risk and enable clinical action. And it accelerates time to value by leveraging established patient-level intelligence to drive engagement across hospitals, populations, and patients.

Links, Resources and Related Episodes Jvion's COVID Community Vulnerability Map

Jvion Map Press Release

COVIDactNOW Surge Prediction Map

COVID-19 Healthcare Coalition

Dr. John Showalter and Jvion Contact: Dr. John Showalter

Jvion Twitter

Jvion LinkedIn

Jvion Main Website

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An #HCBiz Brief: Given the shortage of Personal Protective Equipment (PPE) in our hospitals due to COVID-19 and the elevated risks our medical professionals are facing every day, I wanted to share a tool I came across at an infection control conference last year that might help. This is a short PSA about an engineered control that prevents infective aerosols, sprays, and splash-back generated by suctioning. I hope you find it helpful.

https://prodaptivemedical.com/stal-shield/

And here's an interview I recorded with them at HITS 2018:

https://thehcbiz.com/ep77_prodaptivemedical_hits2018/

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The Opportunity Zones incentive is a new community investment tool to encourage long-term investments in low-income urban and rural communities nationwide. Nightingale is accelerating the health care industry’s ability to deploy underfunded SDOH benefits by leveraging the innovative financing mechanisms of Opportunity Zones, to catalyze a new marketplace of social service providers. Joining us today is the Founder of Nightingale Partners, John Gorman, to talk about one solution that is good for society, good for patients, and good for business.

Show Notes

I like to say, social determinants of health are just four fancy words for poverty.

We hacked a Republican billionaire tax shelter to try to improve healthcare for black and brown people in inner cities.

You can never get to compliant patients who are participating in population health activities unless their basic needs get met.

Breaking down silos to sign patients up for all available social services.
The Community Health Worker is the linchpin of any successful social determinant intervention.
Designing a management services organization to facilitate rent and utility subsidies for thousands of people.
Cultural competency and the "execution risk" for new interventions.
Case Study: Adult Daycare Centers in Puerto Rico

They're dropping $21 million on some big slick analytics package and I was like, " What is that actually going to do for you if you can't stand up an intervention the right way?" That's like putting the greatest scope in the world on a really rusty rifle. If you give me $21 million worth of social workers, I'll change the world.

John Gorman, Founder John is the Founder and former Executive Chairman of Gorman Health Group, at the time the industry’s leading consulting practice which spawned almost a dozen entrepreneurial ventures in government health programs. John’s work focuses on Medicare, Medicaid, and Affordable Care Act strategy, governance, and turnaround of distressed health plans. Prior to founding the firm, John served as Assistant to the Director of Health Care Financing Administration’s (HCFA, now CMS) Office of Managed Care, where he provided day-to-day management and served as the external liaison for the Medicare and Medicaid managed care programs. During the 1993 debate on national health care reform, John was chief lobbyist on health care financing issues for the National Association of Community Health Centers, an organization of federally-funded primary care clinics for the medically underserved. John’s career in Washington began as Press Secretary and Staff Director for U.S. Representative John Conyers, Jr. (D-MI), then Chairman of the Government Operations Committee. John serves on the Board of Directors of Henry Ford Health System’s Health Alliance Plan in his birthplace of Detroit, MI, and serves as a Senior Advisor to Premier, Inc., the hospital purchasing cooperative, on Medicare Advantage and Medicaid matters.

Nightingale Partners LLC Nightingale Partners LLC is a Qualified Opportunity Zone (OZ) fund and advisory firm that identifies, collaborates and invests in market-ready health care initiatives in OZs nationwide. NP focuses on designing evidence-based, targeted, non-clinical interventions addressing Social Determinants of Health (SDOH) for Medicaid and Medicare enrollees through creative partnerships with High-Net Worth Individuals, Institutional Investors, Government Agencies and Strategic Health Plans/Providers.

Resources, Links, and Related Episodes Nightingale Partners

https://www.linkedin.com/company/nightingale-partners-ll

https://www.nightingalepartners.org/

John Gorman

https://www.linkedin.com/in/john-gorman-098b265

https://twitter.com/johngorman18?lang=en

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Today’s episode is about how the Rural Risk-Free Solution helps rural hospitals and health systems take on risk faster to achieve value-based care. The methodology is a community / population health approach. By providing analytics on care metrics, nurse-led and team based care, and population health programs, you can improve outcomes for both communities and the hospitals. Today we have Lynn Barr here from Caravan Health to explain how it works.

Highlights from A Rural Risk-Free Solution * The rural challenges of moving from cost-based reimbursement to value-based care. * How consolidation is putting rural clinics at risk.

We thought we were very high quality, we were the best. We were leading the country. And guess what happened? We reported our quality results. And we were the worst in the country. It was the first time we knew. Nobody had been gathering our data!

The Rural ACO Turn Around Story
The payment incentive system that is working against us.
Build a support system around your doctors.

It doesn’t really take much time to fix this stuff. We beat the national averages by 2015. This isn’t rocket science. It’s just a bunch of work and it’s hard to change.

The ACO numbers game.
BONUS: How will the COVID-19 pandemic effect ACOs?

Lynn Barr, Founder and Executive Chairwoman of Caravan Health Lynn Barr is a recognized leader in the movement to transform and improve our nation’s healthcare systems. While working at a rural hospital as Chief Information Officer, Lynn organized the National Rural Accountable Care Consortium to overcome barriers for rural health providers so they could participate in innovative payment models under healthcare reform. In 2014 Caravan Health was formed to provide turn-key services to providers interested in population health programs in Practice Transformation Networks, Medicare and Commercial Accountable Care Organizations, MACRA, Comprehensive Primary Care, and other payment models.

As founder of Caravan Health, Ms. Barr has led the development and execution of nationwide programs that bring better care to patients and help health care providers achieve financial success. Caravan Health supports more than 13,000 primary care providers and 250 community hospitals making the transformation to value-based payments, with affordable, simple solutions that achieve outstanding results.

Ms. Barr is a popular speaker and a frequent collaborator with government and national organizations looking to improve our healthcare systems.

About Caravan Health Caravan Health was started by a forward-looking group of community hospital CEOs and physicians who recognized early on the many challenges they would face transforming to a value-based payment model. They were attracted to the emphasis on the patient and the focus on improving overall community health through operational improvements, staff development, community engagement, regional collaboration, and the effective utilization of useful information based on never-before-available data.

Caravan Health is now a national leader of successful accountable care and population health programs for community health systems. Caravan helps physicians and hospitals work together to create, operate and manage successful population health programs that improve patient care, clinician satisfaction and financial performance.

Links and Resources * Caravan Website: https://caravanhealth.com/ + About the Rura Risk-Free Solution for Rural ACO participants: https://caravanhealth.com/rural/ + Am I Rural? Webpage for providers to determine if they qualify as rural: https://caravanhealth.com/am-i-rural/ + See the Caravan Webinars page for more educational sessions and info https://caravanhealth.com/thought-leadership/webinars/ * Twitter: @CaravanHealth * Health Affairs: Payment Reform In Transition—Scaling ACOs For Success by Lynn Barr, Anna Loengard, LeeAnn Hastings and Tim Gronniger.

Check out my new podcast collaboration with The Infection Prevention Strategy (TIPS): https://deepdive.tips/

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Drugs are way too expensive. It has got to be from someone in the middle taking up all the money. Blame the pharmacy benefits managers! Right? Not so fast. If you're like me and have gotten derailed by complicated flow charts trying to understand PBMs in the past, this is the episode for you.

AJ Loiacono, CEO of Capital Rx, is a new PBM injecting some much-needed trust back into the system. By starting fresh and denouncing business as usual, AJ is giving control back to self-insured entities while looking after the community and specialty pharmacies that historically haven't had negotiating power. Don is joined by Shahid today and the tough questions are coming in hot! Enjoy!

Highlights * What do you mean by, "There are no drug prices in the US"? * The dangers of an inefficient market. * Does the PBM have an inherent conflict of interest?

If someone is being prescribed a $50,000 medication, my company makes $5. If someone's being prescribed a million dollar medication, my company makes $5. My competitor on a million dollar medication might make $200,000. That incentive is not aligned with both the patient care or the plan, and that's a problem. Personally, I think it should be completely against the law for any pharmacy benefit manager to be taking spread on drug and receiving payments from pharma industry.

The abandonment curve: When do groceries matter more than medications?
Capital RX is a clearinghouse, just like the New York Stock Exchange.

There's a price to everything. Words and definitions and things to fight about and exclusions and going through a hundred-page contract, that is an artfully constructed pitfall.

Proving value and building trust with EDI 835 and EDI 837.
Risk assessment and level-funded products.
An outcome-based rebate schedule.

Anthony J. Loiacono, CEO A.J is a successful Entrepreneur and CEO of Capital Rx. He has over 20 years of experience in pharmacy benefits, finance, and software development. As the CEO of Capital Rx, his mission is to change the way pharmacy benefits are priced and administered in the US

Capital Rx Capital Rx is redefining the way prescriptions are priced and administered in the U.S. Through its Clearinghouse ModelSM, Capital Rx unlocks the pharmacy supply chain and reduces prescription costs for employer groups. By establishing a competitive marketplace for drug pricing, Capital Rx focuses its resources on deploying actionable strategies that improve plan performance and patient outcomes. The company’s commitment to innovation, technology, and service is why Capital Rx is the fastest-growing pharmacy benefit manager in America.

Links and Related Episodes * National average drug acquisition cost * EDI 835 and EDI 837 * Website: https://www.cap-rx.com/ * Twitter: https://twitter.com/cap_rx?lang=en * Linkedin: https://www.linkedin.com/company/cap-rx/ * Aon Summit, 1/16/20 * Made in America, 1/19/20-1/21/2020 * PSG Summit, 1/21/20 * Episode 109: Driving Down Pharmacy Spending w/ David Henka

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The interoperability promise of a shared, longitudinal medical record has so far focused on connecting health systems to each other. With the growing investment and constant new entrants of SDOH solution vendors, a new wave of interoperability challenges are becoming apparent. How does your health app connect to an EHR? Will new anti-data blocking legislation help or hurt SDOH startups? In this wide-ranging conversation, Don Lee and Shahid Shah talk with Niko Skievaski, President and Co-Founder of Redox, about his team’s solution to interoperability and why health information exchanges (HIEs) are only part of the answer.

Highlights * One API to link them all. * FHIR is a language, not an API. * Redox helps you scale your integration infrastructure without scaling your team. * Interop with Epic: Then and Now. * B2B relationship building through Interface Analysts.

HIEs are designed to facilitate the movement of data to follow a patient, Redox shares data between health systems and their business associates.

The competing interests between Value-Based Care and Consumerism.
Where is the government investing in health tech?
2020 will be a big year for interoperability.
Implications of the Blue Button Breach.
Will the Cambridge Analytica problem come to Healthcare?
21st Century bugs need a 21st Century solution.

Niko Skievaski. President and Co-Founder As president and co-founder of Redox, Niko Skievaski leads his team in helping healthcare organizations fulfill the promise of digital health with an integration platform that securely and efficiently exchanges data. Prior to co-founding Redox in 2014, he worked at Epic, a multi-billion-dollar healthcare technology company. After Epic, he co-founded 100state, Wisconsin’s largest co-working community. He is also a board member at Prime Health, a Denver-based non-profit designed to accelerate the adoption of emerging healthcare technologies that address community and safety net needs. Niko has an MA degree in economics from Boston University and a BS degree in economics and international business from Arizona State University’s W.P. Carey School of Business. He lives in Boulder, Colorado with his collection of mountain bikes.

Redox Redox accelerates the development and distribution of healthcare software solutions with a full-service integration platform to securely and efficiently exchange healthcare data. With just one connection, data can be transmitted across a growing network of 600+ healthcare delivery organizations and 250+ independent software vendors. Members of the Redox Network exchange more than 7 million patient records per day, leveraging a single data standard compatible with more than 40 electronic health record systems. Redox exists to make healthcare data useful and every patient experience a little bit better.

Links, Resources, and Related Episodes LinkedIn: https://www.linkedin.com/in/skievaski/

Twitter: https://twitter.com/niko_ski

Website: https://www.redoxengine.com/

The Redox Podcast: https://www.redoxengine.com/blog/category/podcast/

Shahid Shah on The Redox Podcast

Trusted Exchange Framework and Common Agreement (TEFCA)

FHIR At Scale Taskforce (FAST) and the DaVinci Project

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Health systems have been working hard to lay the foundation for taking on a larger case mix of value-based contracts. 75% of health systems surveyed said they are ready to accept downside risk in the next two years, up from 42% in 2015. As health systems are discovering, value-based care reimbursement is more complicated and requires a new level of specificity in documentation. The question is, are health systems really ready to take on downside risk while continuing to manage FFS contracts?

Today we have Kyle Swarts, Chief Growth Officer, and Matt Lambert, MD, Chief Medical Officer from TrustHealthcare to help us answer that question. We discuss challenges and opportunities facing health systems as they embrace the shift to value. Enjoy!

Highlights from Headwinds Impacting the Shift to Value-Based Care * It's time for providers to take on risk. * Everyone has a population health department but fee-for-service is still driving your overall strategy. * The threshold for making the jump to VBP. * Why it's so difficult to get doctors on board with VBP.

"It's not how sick your patients are, it's how well you document how sick your patients are."

The risk of moving slowly to VBP.
The promise of 60 minute home visits with a physician finally has a reimbursement model.
Where we will see new consolidation in response to VBP.
The two big reasons specificity in documentation is key to successful downside risk contracts.
Reimagining EHR design to foster VBP.
AI success is all about physician adoption.

Kyle Swarts, Chief Revenue Officer Kyle is a growth-minded leader who has overseen sales, marketing, and business development at healthcare consulting, revenue cycle management and information technology companies for the past 12 years.

Matt Lambert, MD, Chief Medical Officer Matt brings over twenty years of experience as a clinician, CMIO, and change leader to value-based care, ensuring that patients receive more comprehensive care and that payers and providers better capture the value of their services.

TrustHealthcare

Founded in 2018 by a team of healthcare veterans and clinicians with private equity funding from Windrose Health Investors, TrustHealthcare’s mission is to empower healthcare provider organizations and health plans to successfully navigate from fee-for-service to value-based care. The TrustHealthcare platform seamlessly integrates with the electronic health record and leverages more than 500 proven clinical rules – while also connecting CDI specialists, clinicians, and coders in one simplified workflow. With TrustHealthcare, providers and health plans can rest assured that they are capturing the full value of patient care in real-time.

Links and Resources TrustHealthcare Website

TrustHealthcare Linkedin

Unrest Insured by Matt Lambert, MD

A Primer on HCC codes and Risk Adjustment

Related Episodes:

Top 10 Things to Ensure Success in a Value-based Healthcare World

Value-based Payment: Progress, Trends and Direction w/ Jason Helgerson

The Future of Value-Based Payment w/ François de Brantes of Remedy

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The quantification of how social determinants effect health has finally put enough pressure on healthcare organizations to force action. Finally discovering what social workers have known for years, the health sector is on the verge of providing a permanent revenue stream for Social Care Organizations who previously relied on grants and charitable donations. For your organization to develop health partnerships, Juliette Price from Helgerson Solutions Group says you need to answer three questions as clearly and completely as possible.

First, What problems are you trying to solve and how do you propose solving it? Second, Who is your target population? And Third, How do you measure your impact? Clarifying this value proposition is the only way to allow hospitals and health systems to calculate how much money you will actually save them and ultimately how many lives will be improved.

This is a wide ranging conversation and with lots of great takeaways. Enjoy!

Highlights from "A Playbook for Social Care Providers" * Cross sector learning networks - who already solved your problem? * Doctors are not trained to solve hunger and homelessness. Social referrals are not the same as medical referrals. * A common language to share your mental model of the system. * Hospitals are nonprofits. Applebee's is a community based organization. If you provide social care, honor yourself with the title: Social Care Organization.

"This is really the moment for social care providers to start understanding their value in this ecosystem... Define what you do, define the value you bring, and then ultimately bring that to a healthcare partner.

The huge opportunity for Social Care Organizations: It’s not just housing or employment or criminal justice, it’s everything.
This is about designing a better community.
If someone had figured it out, we would have replicated it by now.
The difference between charity and system change.
Philanthropy in a value based word.

"The age of big data has washed over us and we have been left drowning in data and starving for insight."

Juliette Price, Solutions Architect - Social Determinants of Health Juliette is working to bring health care and social sector partners together in new ways to deliver results for end users.

Juliette previously served as the director of The Albany Promise, a cross-sector, collective impact partnership of 100+ organizations in Albany, New York that focused on improving economic mobility for the city’s most vulnerable youth and families using shared vision, collective action, and rigorous continuous improvement. The partnership was widely recognized as leading the nation in the field of collective impact. Juliette was awarded the White House Champion of Change award in 2016 from the President Barack Obama Administration for her work in this field.

Previously, she worked for the Chancellor of the State University of New York, the nation’s largest, most comprehensive system of higher education, managing various aspects of the education pipeline and multiple initiatives related to teacher education, statewide education policy, and led the development and implementation of the New York State Master Teacher Program, a program which created a state-wide network of the highest-performing STEM teachers that are dedicated to sharing expertise with peers and attracting the brightest minds to a career in STEM. She staffed Governor Andrew M. Cuomo's New NY Education Reform Commission, which brought together nationally-recognized education, community, and business leaders to recommend reforms to the state's education system in order to improve performance in the classroom so that all of New York's students are fully prepared for their futures.

Helgerson Solutions Group Helgerson Solutions Group is an international consulting firm dedicated to finding solutions to today's most complex large-scale challenges in health care, social care, and education in communities around the world.

Links and Resources Addressing the Social Determinants of Health in a Value-Based Payment World: A Playbook for Social Care Providers

Juliette Price on Twitter

Helgerson Solutions Group on Twitter

Helgerson Solutions Group Website

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For long time listeners of this show, you know we’re in the business of helping entrepreneurs understand how to create use case alignment, how to get over the hump of defeating good marketers with a not so good solution, and how to get the right tools in the hands of people who need them. The hurdles involved with getting permission and building consensus around which new tech to bring in slows down diffusion and implementation of needed solutions.

Well today we’re looking at a new platform that gets targeted information to health system leaders who are driving meaningful change in their organization. On this episode, Don and Shahid speak with Amy Stevens, Executive Vice President of Provider Solutions and Avia Connect at Avia. In addition to the platform, Amy also gives us an update from earlier episode we did with David Smith, on the Medicaid Transformation Project and how the first couple behavioral health and community health projects are going. Enjoy!

Highlights from, “Designing an Innovator Network for Hospitals with Amy Stevens" * How do you run a better health system using digital solutions that let you scale? * Avia’s unique approach to helping health systems identifying the right tech. * The marketplace solution that levels the playing field between digital startups and incumbents. * What got you here, will get you there: using your network for vetting and implementing innovations. * Who is moving the fastest to digital? Why and How. * Why Avia isn’t a “digital PBM”. * Building relationships and understanding buyer intent. * Why aren’t best practices and successful programs rolled out in all 50 states? Why can’t you scale in Medicaid?

“We have buyers who you didn't think existed because you didn't think that people would invest in Medicaid.”

Finally, a collaboration that shifts the flow of dollars to where care is being provided.
Penn Medicine’s impact model – tackling a structural issue with real time joint problem solving.
A quick look at next years plans for new ways of building integrated care networks.
How Avia Connect connects payors and providers.
Using your network as an asset:

“Hear what the health systems are saying are their greatest pain points, where they've tried solutions and it hasn't been able to scale. And hearing not just one health system at a time is moving those entrepreneurs out of being stuck in ‘business development process’. As they hear need and concern, you bring them much earlier into the actual design and strategy process that will create real change.”

Call To Action: The best way for our members to learn more about your company is to claim your profile on AVIA Connect.

Amy Dirks Stevens, Executive Vice President Provider Solutions Amy has held significant leadership roles across the healthcare spectrum, including health systems, clinical integration organizations, ambulatory services, and physician practice management. She has been responsible for operations, strategy, and growth at local, regional, and enterprise levels for large, multi-national for-profit health systems with academic and quaternary centers, as well as community faith-based, non-profit systems. She was instrumental in receiving FTC-approval for one of the nation’s vanguard clinical integration organizations and later became its President, managing the MSO services and a network of over 50 healthcare entities, 6000 providers and 30 performance-based contracts with employers, commercial and government payers. Prior to healthcare, Ms. Stevens was a sought-after consultant in the energy and environmental sectors for contentious projects with high public visibility and business impact.

Amy Dirks Stevens LinkedIn

AVIA AVIA is the leading partner for digital health insights, strategic guidance, and consulting services. Members of the AVIA Innovator Network solve pressing challenges with digital solutions that deliver outsized financial and clinical results. AVIA provides strategic focus, unique market intelligence, and proven resources that accelerate digital transformation throughout healthcare.

Avia LinkedIn

Avia Twitter

Links, Resources and Related Episodes AviaHealthInnovation.com

The Medicaid Transformation Project (MTP)

AVIA Launches Partner Network to Expand Industry Access to Digital Insights

Join AVIA Connect

AVIA Raises $22 Million in New Funding

National Maternal and Infant Health Crisis Spurs 30 Health Systems to Take Action

Maternal Mortality in the United States Is on the Rise

Episodes 107 and 108: The Medicaid Transformation Project with David Smith Part 1 and Part 2

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The design solutions from the consumer wearable market are making this next generation of remote patient monitoring devices ready for mass adoption. With the solutions you’ll hear about today and CMS finally finding a method to pay for them, hospitals and patients will soon agree that remote monitoring could be the key to a more holistic healthcare solution.

With successful physician adoption strategies like the one we heard from Henry Ford Health System, more developers will be utilizing remote monitoring services from our guest today. In this episode, we talk with Sam Liu, Vice President at VivaLNK.

VivaLNK provides medical wearable sensors designed to monitor human vitals and biometrics. VivaLNK’s IoT sensor platform is quickly becoming the Amazon Cloud of remote healthcare sensors by making it very simple for healthcare developers to capture patient data for their own applications.

Whether you’re looking to implement your own remote monitoring program or you want to see how a great company is building a system around their solution, you’re going to get some great takeaways from this episode. Enjoy!

Highlights from “The State of Remote Patient Monitoring” * Building systems around your solution * Turning biometric sensors into APIs for easy application development. * Combining the two worlds of Consumer health vs medical care. * The quality of data needed for a step tracker vs. a fall prevention tool. * The current state and best practices of Remote Patient Monitoring. * Use case: Neutropenia after Chemotherapy. * Who pays for and benefits from remote patient monitoring? * Realtime trend spotting with wearables to relieve staffing pressure in post-acute care settings. * Remote monitoring as part of your infection prevention program. * Continu-omics, continuously captured data for advanced diagnostics and precision medicine * How to insulate your device company from privacy issues. * The behind the scenes algorithms for interpreting wearable sensors to collect accurate vitals. * Working with VivaLNK for your remote monitoring solution.

“Most people are kind of reactionary, but with the right implementation and devices, it comes so easy that patients will be more willing to get proactive about their health.”

Sam Liu, Vice President Sam Liu is the VP of Marketing at VivaLNK where he is responsible for marketing and business development for VivaLNK’s line of medical wearable sensor and IoHT products. Prior to VivaLNK, Sam has worked in executive positions at multiple startups in technologies including genomics, SaaS/cloud, mobile devices, enterprise software, and IoT sensors. His startup track record includes two IPOs and as many M&As. Sam has an MBA and a BS Computer Science.

VivaLNK VivaLNK is a provider of connected healthcare solutions for wellness, patient care, and telemedicine. The company’s portfolio includes wearable medical grade devices and data analytics applications that continuously monitor the health and well-being of individuals.

VivaLNK’s vision is to improve the quality and accessibility of healthcare worldwide by combining technology, data, and analytics into an integrated solution.

Links Resources and Related Episodes VivaLNK

Episode 80: How to Launch and Grow a Virtual Care Service w/ Henry Ford Health System and Vidyo

This episode was made possible by:

VBP Forward

VBP Forward is building a bridge between community-based organizations and healthcare delivery. VBP Forward: The Conference 2020 will be held in Albany, NY on April 28-30, 2020. Join us as we work to fully leverage the value of community-based organizations to realize healthcare’s loftiest goals AND ensure they are properly funded to continue and expand their efforts. https://www.vbpforward.com/

Unblock Health

Are you a leader in health information management who’s passionate about real-world interoperability, dedicated to making sure patients have access to their health information? Do you pride yourself on your organization’s HIPAA practices? Are you ready to level up and separate yourself even farther from the competition? Interoperability, autonomy, & transparency are the patient experience. Unblock Health is revolutionizing patient autonomy & consumerism as we know it. Patients are ready to use Unblock Health to hold our healthcare ecosystem accountable. Are you ready to meet them where they are? If so, head on over to unblock.health and click register.

For full show notes, images, and links: https://thehcbiz.com/119-sam-liu-vivalnk-remote-patient-monitoring

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Maternal mortality rates are steadily on the rise in the U.S. – the only developed nation where that’s true. The maternal mortality rate in 48 states and the District of Columbia increased by 26.6% between 2000 and 2014—from 18.8 to 23.8 per 100,000 live births. Hidden in those statistics is great racial disparity, where African American women are 3-4 times more likely to die in childbirth than white women.

The CDC recommends exclusive breastfeeding for about 6 months and cites benefits such as the reduced risk for Asthma, Obesity, Type 1 diabetes, and many more problems that the healthcare system is working earnestly to address.

According to DONA International, a Doula is “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible” and that “countless scientific trials examining doula care demonstrate remarkably improved physical and psychological outcomes for both mother and baby. Doulas have a positive impact on the well-being of the entire family.“

So, continuous support for women and children before, during, and after childbirth can support healthcare’s efforts in chronic disease prevention, health access, health equity, mental health, and more. And as usual, an ounce of prevention is worth a pound of care. Baby Cafés are sprouting up across the country and can provide these services to mothers and children to prevent problems for a fraction of what we’re spending in the healthcare system to address the problems later. And in doing so, they’re strengthening our communities and putting our children on a pathway to long-term health.

On today’s episode, we talk with Rev. Diann Holt from Durham’s Baby Café in downtown Buffalo. They provide mothers (and fathers!) with birth planning, breastfeeding education and doula services, plus hot meals twice per week, AT NO COST! Rev. Diann tells us all about the benefits of these services, and we explore how the healthcare system can support and benefit from community-based organizations like Durham’s Baby Café.

About Durham’s Baby Café Durham’s Baby Café is a 501c3 non-profit organization and social entrepreneurship founded in 2013 by Rev. Diann Holt.

https://www.durhamsbabycafe.com/

Durham’s Baby Café on Facebook

Rev. Diann Holt: (716) 427-0556

Licensed By Baby Cafe USA

Find a baby cafe near you: http://www.babycafeusa.org/your-nearest-baby-cafe/full-list.html

This episode was made possible by:

VBP Forward

Unblock Health

For full show notes, images and links: https://thehcbiz.com/118-rev-diann-holt-durhams-baby-cafe-sdoh/

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We’ve been talking about Social Determinants of Health for a couple of years now and I think we all got the basic concept: For the best health outcomes, we need to combine healthcare with social care.

”A doctor might prescribe to you the best care in the world, but if you can’t afford it or you can’t get to it because you don’t have a car, you might just not be able to follow those recommendations.”

Today we can happily say there are solutions that implement best practices for addressing SDOH in the doctor's office. The main questions now are how does it work and how does it integrate into my workflow? That’s exactly where we start today. LexisNexis Risk Solutions has built out an impressive suite of solutions to integrate SDOH best practices into your organization and here to tell Shahid and I about it is their Director of Market Planning, Erin Benson. In this episode, we go deep into a case study on medication adherence and have some needed conversations around data ethics. Enjoy!

Catch up with Shahid on the HLTH Conference.
How does a data collection company view SDOH?
How do you use SDOH to get better health outcomes and predict cost of care?
Is your credit score the same data as your SDOH?
Case study – Predicting and improving medication adherence from SDOH.
When to use doctors vs. social workers vs. CBO to talk to patients about addressing SDOH?
The power of having n data-driven healthcare organization.
The ethical use of SDOH.
The pathway from raw data to insights to health alerts.

“If you’re seeing that patient come in for the first time, we can give you a predictive score about how likely they are to adhere to their medications, even if we don’t have any clinical data.”

“We’ll tell them there’s a transportation issue and what that should do is trigger for the health care provider or pharmacist to have a conversation with the individual and say, “Are you going to be able to pick up this medication or would it be easier for you if we had it delivered to you?””

Erin Benson, Director of Market Planning Erin Benson is the director of market planning for LexisNexis Risk Solutions Health Care. Ms. Benson focuses on the development and execution of strategic planning for identity management and social determinants of health solutions. She came to LexisNexis from Deloitte Consulting. Ms. Benson earned both a Bachelor’s and Master’s degree in Human and Organizational Development from Vanderbilt University, and she holds an MBA in Strategy and Management from Duke University.

LexisNexis Risk Solutions is a leader in providing essential information that helps customers across all industries and government assess, predict and manage risk. Combining cutting-edge technology, unique data and advanced analytics, LexisNexis Risk Solutions provides products and services that address evolving client needs in the risk sector while upholding the highest standards of security and privacy. LexisNexis Risk Solutions is part of RELX Group plc, a world-leading provider of information solutions for professional customers across industries.

Our health care solutions combine proprietary analytics, science and technology with the industry’s leading sources of provider, member, claims and public records information to improve cost savings, health outcomes, data quality, compliance and exposure to fraud, waste and abuse.

For full show notes and links: http://thehcbiz.com/117-erin-benson-lexisnexis-risk-solutions-sdoh/

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It’s said that 10-20% of all medical diagnoses are wrong. That’s a bit scary, but it’s not surprising. Medical diagnostics is inherently complex, the medical literature is always expanding, and doctors, like all humans, grapple with availability bias – they diagnose diseases they know instead of diseases they don’t. Diagnostic accuracy is clearly a problem.

Today’s guest is Art Papier, MD. Art is the co-founder and CEO of VisualDx. According to Art, there are common diseases and rare diseases, and there are common presentations and rare presentations. The bulk of diagnostic errors are made on common diseases with rare presentations. The goal of VisualDx, a clinical decision support system, is to “augment the brain” of physicians and help them make better diagnoses at the point of care.

On this episode, you’ll learn:

The importance of being crystal clear on why you exist as a company. What problem are you trying to solve?
Why and how most diagnosis errors occur with common diseases.
Why physicians need a guidance system (and why that’s not Google).
Why diagnosis is NOT “big data”.
What’s the ETTO principle – Efficiency Thoroughness Trade-Off and how clinical decision support systems can help.
Why it’s so critical for startups and entrepreneurs to have doctors on their team.
Why Art favors pull technologies over push technologies when serving doctors. And the problems you have to overcome as a result of using them.
Why machine learning (ML) is a great way to augment the brain, but will likely never be the full solution.
How machine learning can be effectively applied to very good data (i.e. 20 years worth).
Why labeling and terminology are so critical to any successful machine learning application.
Why general artificial intelligence is a fool’s game and how to stand out with niche and nuance.
How VisualDx is sharing it’s 20 years of imaging with consumers and combining it with machine learning to help them better understand common skin conditions with Aysa.
How Apple CoreML allows Aysa to apply machine learning algorithms to consumer images without ever moving the picture off of the consumer’s device.

For full show notes and links: https://thehcbiz.com/116-art-papier-visualdx-diagnostic-accuracy/

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If we’ve established anything on The #HCBiz Show, we’ve established that healthcare is complex. And with a million priorities, each with its own complexity, it can be difficult to know if you’re doing any of it right. So, we do the best that we can with the knowledge, resources, and tools at our disposal, and put out the fires when they occur.

This, of course, can be very problematic when the work is more complex than it seems. And that is certainly the case when it comes to Environmental Services (EVS). We outlined the complexity of the issue at HITS 2018 with

The Environmental Services Optimization Playbook (ESOP) is a multi-disciplinary, cross-industry initiative to support reliable design (standardization of evidence-based practices) for environmental cleaning and disinfection in health care facilities in alignment with AHE Standards, to reduce the risk of HAI (healthcare-associated infection). As project lead Aaron Jett puts it, “it’s like bringing Coke and Pepsi together to talk about the best ways to make soda”.

On this episode, we get acquainted with the ESOP initiative and talk about how it will standardize around the 4 Ps: Patient, Product, Process, and Processing. And, in what might be our favorite part at the #HCBiz Show, the playbook will even provide guidance for explaining all of this to the various stakeholders within the health system. That’s huge!

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Environmental Services Optimization Playbook (ESOP) Primary Purpose: To support reliable design (standardization of evidence-based practices) for environmental cleaning and disinfection in health care facilities in alignment with AHE Standards, to reduce the risk of HAI (healthcare-associated infection).

For more information: https://www.zeroinfections.org/esop---evs-optimization-playbook.html

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This episode is sponsored by the Healthcare Infection Transmission System (HITS) Consortium. For the second year in a row, The #HCBiz Show had the honor and privilege of being a media partner for the annual HITS Conference. Last year we were in Nashville – check out the episodes we recorded there. This year, we attended HITS 2019 in Buffalo, NY.

Check out all our shows from HITS 2019.

Thank you to Christine Greene, Kelly Reynolds, Savannah Hatt, John LaRochelle, and Michael Diamond, along with the entire HITS Consortium for the work you’re doing to protect our families and our communities. The battle against healthcare-associated infections can only be won through collaboration, and from what I’ve seen in working with you all for the past few years, HITS is bringing the best ideas and brightest minds together to do just that.

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For full show notes and links: https://thehcbiz.com/esop-hits-2019/

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The healthcare system is not designed to serve patients. It may have started out that way, but it’s best we confront or current reality.

That’s not to say that the people working inside of this industry are bad. Not at all. Some of the best, most generous, and caring people I’ve ever met work in healthcare. Unfortunately, they, like the patients they serve, are merely inputs to a complex national healthcare system that’s evolved to serve itself and its ever-growing appetite for trillions of American dollars.

I don’t blame anyone for this. If you look at the history of how the system evolved, it makes a ton of sense that we’ve ended up here. And I’m encouraged by some of the emerging trends in the industry to pay for value, coordinate care and address the social determinants of health (SDOH). We'll get better, but it’ll take time.

In the meantime, what will I do if I or one of my loved ones gets sick? Like really, chronically sick where we need tight coordination across teams of caregivers from many organizations right now?

The fact that ONC and CMS are driving patient access to data someday won’t help me secure a second opinion today. The important, but glacially slow move to value-based payment won’t ensure my doctors collaborate over the next month. And the various star-ratings systems won’t help me pick the right doctor right now. No one will come to our rescue. We’ll need to figure it out on our own.

That’s where today’s guest comes in. Grace Cordovano is a board-certified patient advocate. Grace, and the growing army of patient advocates like her, are available to help you navigate the healthcare system “in a manner that’s conscious of your health literacy and culture”. Grace specializes in Oncology and her clients are newly diagnosed cancer patients. She becomes their care partner and works with them from the “point of diagnosis through survivorship or end-of-life care planning”. She takes the time to understand their challenges and goals and connects them to the “information and the tools that they need to make educated empowered decisions about treatment and their healthcare trajectory”.

That includes acquiring medical records, assessing which physicians may be best for second opinions, identifying which facilities host clinical trials, and much more. None of these are easy tasks, and to be successful, you’ll need a lot of time and expertise. Two things the average patient lacks.

Patient advocates are directly hired and paid for by patients. And while no one needs additional healthcare expenditures, this puts the patient advocate completely in the patient’s corner. They’re likely to become your most trusted ally along your care journey.

In this interview, Grace helps us to understand why patient advocates are needed, how they add value, and how much work and expertise is really necessary to do this job effectively. Topics include:

What is a board-certified patient advocate?
What made you decide to become a patient advocate?
Where can I find a patient advocate?
Which patients are most likely to benefit from this service?
Why aren’t health insurers and providers doing this already?
What exactly does a patient advocate do?
How do patient advocates interact with providers and insurers? And how are they received?
Do patient advocates ever experience resistance from the healthcare system?
Why is it so hard to acquire medical records? Do we really have a data blocking problem in healthcare?
Do we need a wall of shame for healthcare organizations who refuse to share data or those who make it difficult or slow?
What tools are absent from the market today that could help?
What is Unblock Health and what will you be discussing at the Connected Healthcare Conference on October 18th?

Full show notes and links: https://thehcbiz.com/patient-advocate-grace-cordovano/

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“Don’t find customers for your products, find products for your customers.”

Seth Godin

That’s one of my favorite quotes and it’s exactly what Proximity did when they looked across the 1,500 healthcare facilities they were already serving with wall-mounted workstations and medication storage carts. They saw a ton of high-touch surfaces that were not being cleaned regularly and that were likely contributing to the spread of healthcare-associated infections (HAI). This observation led them to launch their UV-CLEAN line of products that automate the sterilization of high-touch surfaces like keyboards in the hospital. It’s an automated disinfection device that uses UV-C energy to inactivate microorganisms at the genetic level by scrambling their cellular DNA (link below if you want to see what that looks like under a microscope).

On this episode, we talk with Steve Reinecke and Jeremy Goza of Proximity. They explain the risks these high-touch surfaces pose to hospital staff and patients and explain the mechanics behind that risk. It’s an interesting approach that stands to raise the baseline for disinfection, and reduce the spread of HAIs. All while nobody’s looking.

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Check out all our shows from HITS 2019.

Thank you to Christine Greene, Kelly Reynolds, Savanah Hatt, John LaRochelle, and Michael Diamond, along with the entire HITS Consortium for the work you’re doing to protect our families and our communities. The battle against healthcare-associated infections can only be won through collaboration, and from what I’ve seen in working with you all for the past few years, HITS is bringing the best ideas and brightest minds together to do just that.

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For full show notes and links (and to see a single-cell paramecium explode under UV-C light!): https://thehcbiz.com/proximity-hits-2019/

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The costs and human impact of healthcare-associated infections (HAI) are well known and have been well documented on this show. And as we’ve seen there are industry best practices and proven science to help us prevent and control HAIs. Yet, running an Environmental Services (EVS) unit at a hospital is no easy task. How do you pick the right people, and train and retain them? What products should you use? How should you use them? How will you stay on top of the constantly changing regulatory landscape? And how will you keep up with the evolving science, technology, and best practices to ensure you’re doing all you can to protect your patients?

On this episode, we talk with Brooke Hossfeld, Infection Prevention Specialist and Jeff Bennett, Director of Marketing about Sodexo Healthcare’s infection control protocol, Protecta. With Protecta, Sodexo Healthcare aims to address infection control at acute-care hospitals with a full-service model that covers staffing, training, product, procedure and best practice research, and outcomes measurement. Brooke and Jeff explain why this type of service is needed, tell us about the results so far, and share their insights on where the industry is headed next.

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Check out all our shows from HITS 2019.

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For full show notes and links: https://thehcbiz.com/sodexo-hits-2019/

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Usually, we know what we need to do. But doing it is hard and we struggle. This is true for individuals. It’s true for organizations. And it’s true in healthcare, especially when it comes to behavioral side of infection prevention.

Sanjay Saint, MD, MPH addressed these issues in the opening keynote for the HITS 2019 conference in Buffalo, NY. We caught up with him at the event to discuss:

What can we learn from the experiences of Ignaz Semmelweis?
How to address the adaptive/behavioral component of infection prevention
Addressing the culture and sub-culture so that we do the right thing every single time
The power of being present with your patients and how to use rituals to get you there
Understanding the significance of your interactions with the patient
Creating a culture of excellence that polices itself.

Sanjay Saint, MD, MPH, is the Chief of Medicine at the VA Ann Arbor Healthcare System and the George Dock Professor of Internal Medicine at the University of Michigan.

There’s a lot of wisdom in this short interview. Enjoy!

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For full show notes and links: https://thehcbiz.com/sanjay-saint-hits-2019/

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The evidence is clear. Addressing the social determinants of health can dramatically improve health outcomes and reduce spending in healthcare, social services, education, criminal justice, and more. The problem is that not all interventions can be isolated and measured, and the value is not always realized by the entity that pays the bill. This creates a tremendous amount of friction that prevents us from moving forward on initiatives that we all agree should happen. That’s where Pay for Success comes in:

Pay for Success (PFS) financing models are cross-sector partnerships in which funders pay upfront for a social service and then a government, healthcare, or other back-end payer repays the investment if, and only if, predetermined outcomes are met.

On this episode, we talk with Ruth Ann Norton, President & CEO of the Green & Healthy Homes Initiative (GHHI), about how they’re using Pay For Success to enable social innovation across the country. We discuss:

GHHI’s history and mission to break the link between unhealthy housing and unhealthy families
How to gather evidence that social interventions work
How to quantify that value in terms of outcomes and cashable savings
How to communicate that value to stakeholders
How to document and acknowledge that the one who pays for the intervention is not always the direct beneficiary of the improved outcomes or savings.
Why we need to avoid “penalizing innovation” through unintended consequences of our funding mechanisms
How Pay for Success (PFS) funding models work
How Pay for Success (PFS) funding differs from pay for performance

This is an important topic and conversation for anyone trying to drive meaningful change through social innovation. Give it a listen and let us know what you think on Twitter by tagging >@The_HCBiz.

For full show notes and links: https://thehcbiz.com/pay-for-success-in-social-innovation-ruth-ann-norton/

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Pharmacy Benefits Managers, better known as PBMs, are your classic middle-men. First, they buy medications from pharma manufacturers. Then they bundle those medications into formularies and sell that service to employers, plan sponsors and health plans. The problem is, there’s no transparency into how much PBMs pay for the drugs, and there’s a complex rebate system layered on top of that. With dug costs on the rise, it’s no wonder that many characterize PBMs as the bad guy, nor that the feds are taking aim at their business model.

Today’s guest tells us not to count on regulation to fix this. First of all, the pharmaceutical industry has strong ties to Washington and a very powerful lobby. That’s going to hold up any proposed regulation. Secondly, the regulations fail to address the underlying issues driving pharma costs today. But there is something we can do right now. David Henka, President and CEO at ActiveRADAR, tells us how they’re using reference pricing and therapeutic equivalents to enable a new interaction with the PBMs formulary. And he claims it can drive immediate and ongoing savings of more than 20 percent for employers, health plans and other plan sponsors.

David gives us a foundational overview of the issues at hand and offers up several suggestions for how we might move forward. Topics include:

What is a PBM?
Why were PBMs created in the first place?
Are PBMs the bad guy or a necessary component in the system?
What are PBM rebates and why do we keep hearing about them from the feds?
What is the fundamental issue with U.S. pharmaceutical pricing?
Is the U.S. really funding pharma R&D for the entire world?
What is reference pricing and how can it drive down pharma spending?
What are therapeutic equivalents? How do they differ from generics?
How has the market received the idea of reference pricing and therapeutic equivalents?

I’ve been meaning to cover pharma on the show for some time. This was a much needed first dive in, and Davide Henka delivered the goods to get us started.

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For full show notes and links: https://thehcbiz.com/driving-down-pharma-spending-w-david-henka/

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Missed part 1? Check it out here: The Medicaid Transformation Project with David Smith - Part 1.

The Medicaid Transformation Project (MTP) is a national effort to transform healthcare and address related social needs for the most vulnerable. Throughout this two-year mission, health systems will implement innovative solutions that address challenges like behavioral health and substance use disorder. MTP aims to create long-term systemic impact over the next 10 years with the goal of improving the health of 75 million Americans.

On this episode, we talk with David Smith, who is the Project Executive for the Medicaid Transformation Project. David tells us how Avia, in partnership with healthcare leaders and Andy Slavitt, is on a mission to change the health and care of the Medicaid population by leveraging digital solutions and innovative care models to more effectively and efficiently meet its needs.

The Medicaid Transformation Project with David Smith – Part 1 discussed the theory and approach to MTP. On this episode, we get practical and talk about what the MTP is doing in the market place, including:

Changing the role and the relationship that the ED has with the community.
How do you ensure that innovative models can be implemented in a sustainable way?
What are the 3 Horizons of healthcare innovation?
What’s been accomplished in MTP Phase 1?
What’s happening so far in MTP Phase 2 and why are you focused on Behavioral Health?
Why addressing Behavioral Health issues is so challenging.
How can health systems get involved?
How can startups/innovators/vendors find out what you’re looking for and submit their solutions for consideration?

For full show notes and links: https://thehcbiz.com/the-medicaid-transformation-project-with-david-smith---part-2/

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There’s a lot to get into here, including:

Who is Avia and why are they a good candidate to tackle this problem?
How did Andy Slavitt get involved?
Why does Medicaid need to be transformed in the first place?
Why do we need another Medicaid transformation effort on top of the DSRIP and other 1115 Medicaid Waivers in place across the country?
How do you balance incrementalism with big structural and systemic changes to drive innovation today?
What problems are you focusing on and how did you select them?
What is MTP’s framework for sourcing and evaluating innovations?
Is MTP focused more on clinical outcomes or business outcomes?
How will you prove you’ve been successful?

We cover all that and more, and that’s just part 1! Check out this amazing conversation with an inspiring healthcare leader and then come back for part 2 next week!

For full show notes and links: https://thehcbiz.com/medicaid-transformation-project-part-1/

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There are two types of innovation.

First, there’s innovation in the underlying technology, tools or components that can be used to do something. Let’s call it local innovation. This ussually starts as experimentation with new ways of doing things just to see if it’s possible… to see what happens. It does not start with a specific problem and can be completely fueled by curiosity and a sense of wonder. Local innovation is important because it creates new opportunities that didn’t exist before. However, it is not the type of innovation that leads to real change in the world and we can get into trouble when we pretend that it is.

Second, there’s innovation in the way we actually do our jobs. Let’s call this systems innovation. Systems innovation must start with a problem that needs to be solved. The problem, or current state, is clearly defined and the cost to the system is well known. The desired state is also well defined, and we at least have a plan for how we will measure and prove success. The real work, and therefore real systems innovation, occurs between the current and desired state. And that’s what we’re here to talk about today.

The reality is that there’s a lot of innovation just for the sake of innovation… it seems as if product development is outpacing an understanding of the actual needs.

Jeremiah Gray, EarthSafe Chemical Alternatives

Our guest is Jeremiah Gray, COO and founding partner of EarthSafe Chemical Alternatives. Jeremiah walks us through his framework for innovation with purpose and you’ll see that it requires systems thinking. The conversation yields an innovation continuum that looks something like this:

Clearly define the problem you are trying to solve. What is the current state? Why is it worth changing?
Clearly define the desired state. What should it look like? How will we measure and prove success?
What are the constants (i.e. things outside of our control, or things that we cannot change)?
What are the variables that we can change?
What is a solution that fits within the boundaries defined so far?
Who or what else is impacted by our approach?
Where are we finding, or creating points of friction that will hinder success?
How can we address those points of friction with our product, services, or through collaboration?
Have we created any new risks for our customers? How can we mitigate those?
Establish an ongoing and iterative approach for ensuring our customers continued success.

The big take away for me is this: Innovation with a purpose requires you to have a laser focus on your customer’s ultimate success. Your goal is not to build a product/service that CAN solve your customer’s problem, but to build it and deliver it in such a way that they actually succeed. That requires long-term, systems thinking.

Jeremiah explains ErthSafe’s approach to innovation by way of example. The launch of the EvaClean Infection Prevention System is a clinic in systems innovation and sets a high bar for taking responsibility for your work. If you’re innovating in healthcare, then there are lessons in here for you. Enjoy!

For full show notes: https://thehcbiz.com/innovation-with-purpose-jeremiah-gray-earthsafe/

This is a TIPS Deep Dive interview. Learn more about The Infection Prevention Strategy (TIPS) at http://infectiontips.org/

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Part 2 of 2 - What happens when you take an experienced digital health buyer and an experienced digital health seller and have an honest conversation about the process of bringing new innovations into a health system? You get lots of not-so-obvious, but tremendously valuable insight into how to cross the moats successful health systems have been forced to build to keep you out.

On this episode, Shahid and I discuss the key points from that interaction and tie them back to the principles we’re always talking about on The #HCBiz Show!

In part 2 we explore topics including:

Getting the right people in the room
Consultative selling
Having a clinician on your team (and how to find one if you haven’t already)
How to reach out to experts for help
The importance of having a documented integration plan and the Triple F (“flat-file fallback”)
Preparing for failure-based and success-based objections (i.e. you go out of business or you get bought)
Selling innovation to people who want hard proof and low risk.
The importance of knowing what you are trying to prove and having a plan to prove it.
Health Systems are not technology-averse, but they are risk-averse.

Selling into health systems is complicated, but it is possible to differentiate yourself from the flurry of innovators that are competing for their attention. With the proper perspective and a sound strategy, digital health startups can address the health systems unique needs and constraints to close deals. This conversation (along with the guidance in Part 1) will provide you with tools to get it done.

Check it out and let us know what’s worked for you by hitting us up on twitter: @The_HCBiz

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Links and Resources: Society of Physician Entrepreneurs (SOPE) – A global community of change makers and entrepreneurs transforming the future of healthcare

PubMed – PubMed comprises more than 29 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

NODE.Health (Network of Digital Evidence in Health) is the home for evidence based digital medicine that brings together a network of societies, organizations and innovators dedicated to digital transformation in health. NODE.Health builds and explores the knowledge base now required to lead global healthcare systems and industry into the value based era.

The Health Care Blog – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Perspectives on Working with Healthcare Systems for Digital Start Up Companies | Part 1 – This is the article that part 1 was based on.

Perspectives on Working with Healthcare Systems for Digital Start Up Companies | Part 2 – This is the article today’s episode was based on.

Let’s Get Real or Let’s Not Play: Transforming the Buyer/Seller Relationship
A tremendous book that’ll take you deeper on many of the concepts we discussed in this series.

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This episode is brought to you by Patchwise Labs. They’re a creative strategy firm focused on social innovations in health.

If you’re interested in the social determinants of health (SDOH), then you absolutely need to sign up for their newsletter, the Dispatch. It’s a weekly roundup and analysis that separates the signal from the noise in key topics across policy, business, and technology. Everything you need to know related to SDOH, in your inbox each week. I’ve been recommending the Dispatch to my clients and friends for months. They all love it and you will too.

And while you’re there… Listeners of The #HCBiz Show! can also use the code ‘HCBiz’ for a massive discount on Patchwise Labs’ 2018 Buyer’s Guide: Social Innovation Technology for Healthcare.

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For full show notes: https://thehcbiz.com/selling-to-health-systems-part-2/

Let's Get Real or Let's Not Play: Transforming the Buyer/Seller Relationship

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I've been saying it for years. The regional Health Information Exchange (HIE) should be your first stop for interop. That's especially true when it comes to quality measurement. Patients are going to get care in many settings and their data is going to be stored in many EHRs. According to today's guest, a sick Medicare patient may see 6-7 doctors in a given year! Proper quality measurement will require every hospital and every practice to proactively connect with one another AND solve the underlying data quality problems. FACT: It'll never happen.

I know what you're thinking. That's why we need to have interoperability in healthcare, right!? Well, as Thomas Edison said, "opportunity is missed by most people because it is dressed in overalls and looks like work." Healthcare interoperability has already been solved, but it requires a lot of hard work and we don't like that.

The good news is that there are strong HIEs operating across the country and they're in the business of doing that hard work for you. On today's episode, we talk with John D'Amore, President and Chief Strategy Officer at Diameter Health, about the role of HIEs in healthcare quality measurement. We discuss:

Why HIEs are the right place to start when it comes to quality measurement
Why it's important to think about quality measurement and clinical-decision support as 2-sides of the same coin
Why we'll never have ubiquitous interop between all providers and all EHRs
Why the ATM is a terrible analogy for healthcare interop
Why data quality is such an important and misunderstood part of our interop and quality measure issues
How the ONC and CMS NPRMs create opportunities and barriers for HIEs and quality measurement
How health plans are utilizing HIE data to support HEDIS-measurement and other workflows.
WHat NCQA is doing to support data aggregators and exchanges to enable the exchange of clinical data for measurement
Why you might want to check out the NCQA & HL7 Digital Quality Summit in Boston July 16-18.

Check out Episode 23: Quality Measures: Past, Present and Future w/ John D'Amore for a more general discussion on healthcare quality measurement history and trends.

For full show notes and links, visit: https://TheHCBiz.com

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What happens when you take an experienced digital health buyer and an experienced digital health seller and have an honest conversation about the process of bringing new innovations into a health system? You get lots of not-so-obvious, but tremendously valuable insight into how to cross the moats successful health systems have been forced to build to keep you out.

Co-host Shahid Shah recently published a post with Brian Van Winkle on The Healthcare Blog titled: Perspectives on Working with Healthcare Systems for Digital Start Up Companies | Part 1. Shahid, an experienced digital health innovator played the role of the seller. Brian Van Winkle, an expert on bringing new technology into hospitals, played the buyer. On this episode, Shahid and I discuss the key points from that interaction and tie them back to the principles we’re always talking about on The #HCBiz Show!

We explore topics including:

How health systems make decisions
How health systems contract
What it means when they say health systems are consensus-driven and permission-based
Why it’s critical to understand the budget process and procurement cycle
How to determine who should be involved in the process and who has the necessary authority
How volunteering can be a creative way to get on the inside
Using BANT to guide you (Budget. Authority. Need. Timing.)
How to balance the need to build a pipeline with the notoriously long sales cycles and the need to make sales now
Using OKRs, or Objectives and Key Results to prove your value.
Why there are 0 examples of software-only companies succeeding in healthcare. You’re a tech-enabled services company whether you like it or not.
Getting to No! It can be the best thing for you and your prospect and it’s valuable to get there quickly.
Looking at annual reports and SEC filings to find out what hospitals want to buy. (Jeff Byers talked about this on Episode 62 too)
Why and how to get on the RFP invitation lists.
And then why you probably shouldn’t reply to that RFP anyways!
The magic of “Always Be Valuable (ABV)”
Rule: If you don’t know your value then free is fine. If you know your value then free is a waste of time. Volunteering is for learning. Not selling.
Corollary: Even if they give you $0, it’s still not free for them. They are spending staff time and opportunity time on you.
Rule: If you’re asking them to do something for you before you’ve done something for them… stop!
There’s always a value exchange. There are other things you can ask them for besides money (i.e. Present at an event together. A shared study. A press release. Etc.)

Selling into health systems is complicated, but it is possible to differentiate yourself from the flurry of innovators that are competing for their attention. With the proper perspective and a sound strategy, digital health startups can address the health systems unique needs and constraints to close deals. This conversation (along with the technical guidance in Part 2 coming soon) will provide you with tools to get it done.

Check it out and let us know what’s worked for you by hitting us up on twitter: @The_HCBiz

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Links and Resources: NODE.Health (Network of Digital Evidence in Health) is the home for evidence based digital medicine that brings together a network of societies, organizations and innovators dedicated to digital transformation in health. NODE.Health builds and explores the knowledge base now required to lead global healthcare systems and industry into the value based era.

The Health Care Blog – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Perspectives on Working with Healthcare Systems for Digital Start Up Companies | Part 1 – This is the article today’s episode was based on.

Let’s Get Real or Let’s Not Play: Transforming the Buyer/Seller Relationship
A tremendous book that’ll take you deeper on many of the concepts we discussed today.

...

This episode is brought to you by Patchwise Labs. They’re a creative strategy firm focused on social innovations in health.

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For full show notes: https://thehcbiz.com/selling-to-health-systems-part-1/

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Legionella outbreaks, which can cause the deadly Legionnaires’ disease, are on the rise. In 2017, the U.S. Centers for Disease Control and Prevention (CDC) reported 7,500 Legionnaires’ disease cases. Within the general population, 10% of those affected will die. In a healthcare setting, the death rate jumps to 25%. And according to the CDC, 9 out of 10 Legionella outbreaks were preventable. Sound building water health plans in a hospital/healthcare setting are critical.

Think about that… we have an engineering problem that’s causing 7,500 people to get sick every year, and there’s a known solution that can prevent 90% of it. How would we respond if 7,500 people were injured in bridge collapses each year? It’d be all over the news and we’d demand a solution. Well, that’s what we have with water systems in hospitals and long-term care facilities. This is a big deal.

That’s why NSF International and the National Association of Environmental Health (NEHA) are partnering to host Legionella Conference 2019: “Building Water Systems: The Sustainability and Public Health Nexus” Sept. 11-13 in Los Angeles. There, scientific and public health experts will explore the complex relationship between water conservation and Legionella prevention in building water systems, including in a healthcare setting, where the disease is especially dangerous if contracted by those who are immune suppressed.

Joining today to discuss the importance of building water health in hospitals and healthcare settings are Chris Boyd of NSF International, a global public health organization based in Ann Arbor, Michigan, and Dr. Dave Dyjack, executive director of the National Environmental Health Association.

Chris led New York City’s response to the 2015 Legionnaires’ outbreak that hospitalized over 100 people and resulted in 16 deaths. He now leads the Building Water Health program for NSF International and works with healthcare facilities and municipalities across the U.S. and Canada, teaching and conducting training in an effort to prevent Legionella outbreaks.

Dr. Dyjack’s 30-year career includes expertise in environmental health, emergency preparedness and response, public health informatics, infectious disease, workforce development, governmental infrastructure, maternal and child health, health equity and chronic disease. A board-certified industrial hygienist, David also has a doctorate from the University of Michigan and a master’s from the University of Utah, both in public health. Prior to joining NEHA, he managed the National Association of County and City Health Officials’ grant and contract portfolio and 75 health professionals in support of 2,800 local health departments.

If you'd like to hear more about the history of Legionnaire's and additional perspective on this topic, check out: Episode 32: Legionella: A Manageable Risk for Health Systems | Dave Purkiss and Joseph Cotruvo | Legionella 2018

And don't forget to check out our extensive coverage of Infection Prevention and Control topics.

About Legionella Conference 2019:

NSF International and the National Environmental Health Association (NEHA) will host Legionella Conference 2019: “Building Water Systems: The Sustainability and Public Health Nexus” Sept. 11-13 in Los Angeles to explore the complex relationship between water conservation and microbial contamination prevention in building water systems.

International experts from government agencies, universities, hospitals and private laboratories in 11 countries are among the scheduled speakers. Organizations represented include the U.S. Environmental Protection Agency, the National Institute of Standards and Technology, Public Services and Procurement Canada, Network for Public Health Law and Association of State & Territorial Health Officials.

Water conservation efforts can sometimes have the unintended consequence of amplifying Legionella bacteria growth. The pathogen proliferates in poorly maintained water systems and can cause Legionnaires’ Disease, a serious and sometimes fatal flu-like illness that has increased more than five-fold between 2000 and 2017, according to the U.S. Centers for Disease and Prevention Control (CDC). Common sources of contaminated aerosols include cooling towers, low-flow fixtures, shower heads, HVAC systems, decorative spas and fountains.

International experts will address a wide range of topics related to building water health and water conservation, with topics including complex hospital water systems, cooling towers, proactive water quality monitoring, risk assessments, plumbing engineering, communication plans, greywater transfers for irrigation and culture change in water safety.

Visit host Legionella Conference 2019 for a full list of speakers and registration details.

I want to give a shout out and big thank you to Michael Diamond from TIPS for making this episode possible. You’ve heard Michael’s name before as we’ve worked with him a bunch over the past few years on our Infection Prevention and Control series, and our coverage of the HITS Consortium conference among other things.

TIPS, or the Infection Prevention Strategy, is a non-profit that makes the process of vetting new technologies, implementing successful programs and inspiring innovation more efficient, more accessible, more global and more collaborative. They believe that we shouldn’t have to wait years for promising innovations, ideas, and processes to be implemented and accepted. I agree. You can learn more about TIPS at infectiontips.org.

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Selecting digital health tools is tricky. There are thousands of innovators vying for your attention and dollars. They all promise to help you “get back to doing what you do best, caring for patients” (side note: I think that one has run its course – let’s move on marketers). But how can you be sure they’re selling something that will work for you?

That’s where Medigy comes in. It’s a decision support tool for selecting digital health tools. Our very own Shahid Shah is behind this one, and he’s created a platform that enables quantitative analysis of digital health tools to help you make objective purchasing decisions based on clearly defined objectives and key results, or OKRs. That’s fancy talk for: What does it do? Who is it for? How is it objectively measures and validated?

Shahid describes it as a kind of eternal digital health innovation challenge where innovators share they’re latest and greatest so that end-users and industry influencers can pick the winners. Medigy is a peer network that puts these evaluations in a structured format and maps it to existing classification systems of industry analysts like KLAS and Gartner. The idea is not to compete with those analysts, but to add another valuable input into the buying process that pairs with and complements their reports. What you end up with is a Yelp-like review page full of structured, quantifiable reviews with links to more information.

Medigy primarily serves buyers and influencers. Buyers get access to rich content about the digital health products they’re after. Influencers get a new place to build and engage with a community around their areas of expertise. However, the value to vendors and innovators (the supply-side) is pretty apparent. It’s a place for your product to be evaluated in a consistent and purposeful way. And it can be a great way to engage with your customers for feedback and requests.

On this episode, Shahid breaks down the current state of Medigy and explains his vision for the platform.

We also take a quick look at the recently announced Express Scripts digital health formulary for payers and patients.

For full show notes and links: https://thehcbiz.com/decision-support-for-selecting-digital-health-tools/

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A great way to align your vision with the realities of the business of healthcare is to test your ideas and assumptions at conferences. Unfortunately, many of these events peddle hype and highly curated sales pitches rather than actionable intelligence that’ll help you get things done (or get to the “No”, which may be even more important to you right now). Sure, you’ll get valuable networking done in most cases, but we want you to get the most bang for your buck (and time) so you can get back to innovating and giving us great stories to cover. That’s why we told you about the Expo.Health event last week. And this week we’re sharing another event that’ll be very much worth an innovator’s time: HealthImpact East in NYC on June 12 and 13, 2019.

Co-host Shahid Shah has been involved with this one since its start in 2011. If you’re a fan of The #HCBiz Show, then you know that Shahid gets to the point very effectively. As the on-stage facilitator, you can count on Shahid to drive the conversation towards real-talk right away and to ensure it won’t be all about the speakers on stage. HealthImpact is about discovery and enlightenment for everyone in the room.

On this episode, Shahid tells us why HealthImpact East is a “no BS and no PowerPoint” event, how they keep it that way, and what you, the innovator, can expect to take away.

Apply to attend here.

Mentioned on the show:

Perspectives on Working with Healthcare Systems for Digital Start Up Companies | Part 1by Shahid Shah and Brian Van Winkle
NODE.health

For full show notes visit us at: https://thehcbiz.com/healthimpact-east-nyc/

Also of note, this is episode #100! The #HCBiz Show has been a labor of love for the past three and a half years, and I can honestly say, it’s been one of the best things I’ve ever done for my education and growth. Thank you all for letting me learn with you over the years.

Here’s to 100 more!
– Don Lee

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There are 100s of healthcare and Health IT conferences every year. Most of them are visionary. That is, they focus on the future. On what might come.

Looking forward is important, and frankly, a lot of fun, but it’s not going to change the way you do business today. That’s why John Lynn created Expo.health, and he’s here to tell us what we can expect from the next installment happening in Boston from July 31 – August 2, 2019.

Expo.Health is an opportunity for everyone to collaborate together on solutions that they can do today rather than opining about what’s going to happen in five or ten years from now.

John Lynn, Founder of HealthcareScene.com and Expo.health

And when you’re focused on solutions for the near-term, it’s important to bring the whole team together. That’s why Expo.health is designed to serve the CIO and everyone that reports to them (especially the director level) at hospitals, health systems, large practice groups, and long-term care facilities (LTC).

John believes it’s important to serve the C-level to help them align tools and techniques with their vision. However, he says it’s equally important to serve the “doers” – the boots on the ground staff that will carry out that vision. Expo.health aims to bring the whole team together to talk about practical innovation from every perspective.

The five main themes for the conference will be:

Security and Privacy
Analytics
Communication and Patient Engagement
IT Dev Ops
Operational Alignment and Support

Learn more about Expo.health and get registered here: https://www.expo.health/

For full show notes: https://thehcbiz.com/expo-health-john-lynn/

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Fraudulent doctor reviews are a real problem. Ted Chan experienced it first hand while trying to help a loved one find a doctor online. In Ted’s words: “We found reviews that we thought were false or fake… so thought there was a opportunity to really represent the patient”.

And that’s exactly what Ted did when he launched CareDash in 2016. His goal was to create a healthcare provider directory and review site that was committed to transparency for both doctors and patients. Ted’s idea has resonated and CareDash has grown from 10,000 unique patients visits per month in March of 2018 to over 1,000,000 today.

On this episode, you’ll learn how CareDash identifies fraudulent doctor reviews and what they do about them. You’ll also learn how CareDash uses good SEO practices, online advertising, and quality content to drive their incredible growth.

This episode was recorded at the HITMC 2019 conference in Boston, MA.

Check out the full show notes and related content here: https://thehcbiz.com/preventing-fraudulent-doctor-reviews-ted-chan/

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Amazon has been a hot topic in healthcare for at least a year. And for good reason. With the acquisition of PillPak, the Haven initiative with JP Morgan and Berkshire Hathaway, Alexa HIPPA compliance, and the announcement that they’ll accept Health Spending Accounts (HSA), it’s clear that Amazon has big plans for healthcare.

When I was at the Healthcare IT and Marketing Conference (HITMC) in Boston last month, I got to talking about this with Jack Murtha and Tom Castles of Inside Digital Health and the Data Book podcast. To us it seemed like the industry was putting a lot of stock into everything Amazon was doing, or might do, and that many people see them as a potential savior for our dysfunctional healthcare system.

We didn’t question whether Amazon has the chops to shake things up in healthcare. Nor did we question the attention they’re getting. We did wonder if the high expectations of them were reasonable. We wondered if that optimism bordered on silver-bullet thinking. And most importantly, we wondered if that could actually slow healthcare innovation down.

So we decided to dig into that question in this collaborative podcast between Data Book and The #HCBiz Show!

Read the full show notes here: https://thehcbiz.com/amazon-in-healthcare-with-data-book/

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The CMS NPRM (Notice of Proposed Rule Making) is much more interesting than many of the past interop-related rules. That’s because it gets specific. It gets specific about technology by calling out FHIR APIs. It gets specific about use cases, such as patient access to data, payer to payer interoperability for administrative data, etc. And surprisingly, it gets specific about collaboration by suggesting that all health plans look at the Da Vinci project and consider implementing its use cases.

On this episode, Don Lee and Shahid Shah examine the CMS NPRM from the payer perspective. Our goal is to help you understand what opportunities exist within the rule, and we explore topics such as:

How health plans can benefit by making administrative data (i.e. claims) available to their members via 3rd-party app vendors. It can lower their long-term technology costs and improve their members’ perception of their service.
Why good health plans should be thrilled with the requirement to share administrative data with their competitors when their members leave (I know… very counter-intuitive)
The impact of payer-to-payer interoperability on prior-authorization
Why CMS promoted health plan participation in HL7’s Da Vinci Project in the NPRM preamble
How ONC’s FHIR at Scale Taskforce (FAST) complements the Da Vinci project

There are a lot of opportunities here, and with little industry push back so far, we have a pretty good sense of where things are headed in the next 3-5 years. It’s the perfect opportunity for smart health plan executives to get a jump on their competition, and for entrepreneurs looking to support the new requirements with 3rd party apps and other services. Let’s dig in!

Be sure to check out our opening episode on the CMS and ONC NPRMs: The Path to Healthcare Interoperability

For full show notes, visit: https://thehcbiz.com/cms-nprm-payer-perspective/

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On this episode, we discuss the power of online communities like
#HCLDR, a new push for healthcare interoperability in Canada called Access 2022, and much more. Our guest is Colin Hung, CMO and editor at HealthcareScene.com, and founder of #HCLDR.

Online Communities: #HCLDR is a weekly tweet chat (Tuesday’s at 8:30 PM EST) that has been going strong for 7 years. It attracts an international audience of 150-200 people who generate 1,500-3,000 tweets and up to 12 million impressions.

This community, plus others like #HITsm were a huge influence on my path in healthcare and Health IT. In fact, The #HCBiz Show! started as the #HCBiz tweet chat. These communities provide a surprisingly effective way to network and learn new ideas, and they lead long term relationships. Ultimately, they took me to Toronto for this interview.

Canada has national healthcare… and still struggles with interoperability!?!? That’s right! Interoperability is not magically “fixed” in a single payer system. Canada, just like pretty much everyone else in the world, struggles to get healthcare data where it needs to be. I won’t get into that here, but you can hear all about why interop is challenging on last week’s episode – The Path to Healthcare Interoperability – or read about it here.

This is why Canada Health Infoway (Infoway) launched the ACCESS 2022 movement. Infoway helps to improve the health of Canadians by working with partners to accelerate the development, adoption and effective use of digital health solutions across Canada.

And Access 2022 provided the backdrop for this #HCBiz interview. I drove up to Toronto on the day Colin was being filmed to help raise awareness for the Access 2022 movement. You can see the product of that in the video below – and you can even see this podcast being recorded around 1:33. I know… meta.

https://youtu.be/BxIlHrhPwvQ

HITMC and Health IT Expo: Colin and I also discuss the Healthcare and IT Marketing Conference or HITMC (happening right now in Boston!) and the Health IT Expo (July 31-Aug 2 also in Boston).

I’ll be headed to Boston for my first HITMC shortly after hitting publish on this post. Hit me up if you’re there!

And I highly recommend you check out the HealthIT Expo coming up on July 31-August 2. It’s a practical conference that aims to send you home with actionable information – much like I always say on this show, things you can take home and put to work on Monday. Check out all of our coverage from last year’s Health IT Expo here.

About Colin Hung: Colin Hung is an award-winning marketing executive with more than a decade of healthcare and Health IT experience. He co-founded one of the most popular healthcare chats on Twitter, #HCLDR and he has been recognized as one of the “Top 50 Healthcare IT Influencers”. He is an active member of #TheWalkingGallery, #pinksocks, #HealthITChicks and #HITMC.

Colin writes and blogs frequently. His work has been featured in a number of publications including the Journal of the American College of Radiology and HospitalEMRandEHR.com. Colin holds an Engineering degree from the University of Waterloo. He is currently helping to build the HITMC Community and organize the new HealthIT Expo. His Twitter handle is: @Colin_Hung.

Colin is the CMO and editor at HealthcareScene.com

See the full show notes here:

https://thehcbiz.com/hcldr-access2022-colin-hung/

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There's a lot happening on the healthcare interoperability front:

HIMSS has released a new definition for interoperability
The CMS proposed rule is stacked with interesting use cases and is highly focused on making data available to patients.
The ONC proposed rule attempts to address data blocking.
Both proposed rules promote FHIR APIs.
Emergency Triage, Treat and Transport (ET3) Model provides a business context for interoperability with a focus on outcomes.

Don and Shahid discuss each of these and pull out the actionable threads. This conversation sets up the next several episodes where we'll identify the opportunities that are being created and share ideas on how you can capitalize on them.

See full show notes and links here: https://thehcbiz.com/the-path-to-interoperability/

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On this episode, we talk with Brian Loew, founder and CEO at Inspire. They've built a social network for patients and caregivers that provides a safe place for them to share their stories and learn from people like them. And it empowers patients to raise their hands and volunteer to participate in research that could advance treatments for their disease.

It definitely fits the #HCBiz template for a solid healthcare business: Good for patients. Good for society. Good for the business of healthcare. Listen in to find out how it works, how trust is built and maintained, and how it is all sustained.

Check out the full show notes and links here: https://thehcbiz.com/social-network-for-patients-and-caregivers/

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The transition to value-based healthcare is official. It’s happening. The only question now is how painful the road will be, and how effective we’ll be in improving outcomes and controlling costs.

The fate of your healthcare organization will largely be determined by how you decide to proceed. Will you embrace value-based healthcare and enter into it on your own terms? Or will you sit back and wait, and ultimately be forced into it?

On this episode, we hear from Jason Helgerson, founder of Helgerson Solutions Group and former Medicaid Director for the State of New York. Jason shares with us his top 10 list of things you can do (should do? must do?) to ensure success in a value-based healthcare world. Unsurprisingly, sitting by and waiting for it to pass, didn’t make the cut.

This keynote address was recorded at the VBP Forward conference held in Buffalo, NY on February 20 & 21, 2019. Jason goes into great detail on each of the 10 items and provides examples for how they work in the field.

Give it a listen and let us know which one you feel is most important and why by tweeting @The_HCBiz

Check out the full show notes plus more links and pictures here: https://thehcbiz.com/top-10-steps-value-based-healthcare/

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The way we practice medicine today is broken. We prioritize the business and treat the patient as nothing more than a cog in our great machine. According to today’s guest, ” we have an emotional breakdown, with disenchanted patients largely disconnected from burned-out, depressed doctors.” Dr. Eric Topol calls this epidemic “shallow medicine”. It’s driven by runaway healthcare costs and an insatiable drive for increased efficiency and profits, and unfortunately, is largely the way we deliver healthcare today. Because of this, Topol says, “patients exist in a world of insufficient data, insufficient time, insufficient context, and insufficient presence.”

But, Dr. Topol is optimistic. He believes that Artificial Intelligence (AI), while still finding its place in medicine, and still mostly unproven in real-world clinical situations, can create the space we need to change course.

In his new book, Deep Medicine, Dr. Topol makes an optimistic, but realistic argument for how artificial intelligence can make healthcare human again. He tells us that it’s early, and this is definitely a race with no finish line, but we’ve seen great progress so far and there’s plenty of evidence that the tools will have a profound impact on every part of healthcare. Dr. Topol believes that we will get there, and that AI will create new efficiencies and workflows that can be used to either make things really good, or really bad. He tells us that “the increased efficiency and workflow could either be used to squeeze clinicians more, or the gift of time could be turned back to patients – to use the future to bring back the past.”

On this episode, Dr. Topol explains his thesis and we explore the potential paths from where we are now, to where we might go. Dr. Topol makes a compelling case for breaking that inertia and putting the priority back on the patient.

For full show notes, link and bios, visit https://thehcbiz.com/deep-medicine-eric-topol/

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We've effectively digitized medical record via EHRs, but the healthcare industry still relies heavily on paper for many of its workflows and supporting documents. On this episode, we talk with Bill DeStefanis, Director of Product Strategy at Nuance about how and why paper is still widely used in healthcare, how we can keep it secure, and how we can effectively integrate it into our digital workflows.

About Bill DeStefanis: As Nuance’s Director of Product Strategy, Bill brings more than 20 years of experience in the software industry to the position. He is responsible for defining Nuance Imaging product strategy and vision. During his time at Nuance Bill has lead product management teams designing solutions that automate document workflows. Before joining Nuance, Bill was held various product management positions in companies developing voice recognition and natural language processing applications. He holds an MBA from Suffolk University.

About Nuance: We are reinventing the relationship between people and technology. At Nuance, we believe in the power of intelligent systems, and quite specifically what that power can do for you. Our innovations in voice, natural language understanding, reasoning and systems integration come together to create more human technology.

Used by 90% of hospitals and 10,000 healthcare organizations worldwide, our AI‑powered solutions capture 300 million patient stories each year. We help unburden clinicians, radiologists and care teams with efficient new ways to capture clinical information, applying real-time intelligence for better decision making across the continuum of care.

NOTE: Nuance Document Imaging is now a part of Kofax

https://www.nuance.com

Join our Community! Trying to drive change within your healthcare organization? Launching a new product? Having trouble getting decision makers attention and buy-in?

We'll help you understand the whole picture so that you can align your innovation with the things decision makers care about. And then we'll help you execute It's not easy, but it's possible and we'll help you get there. Sign up here and we'll keep you up to date on healthcare industry news with podcasts, blog posts, conference announcements and more. No fluff. No hype. Just the valuable (and often not-so-obvious) information you need to get things done.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

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On this episode, we talk with Jason Helgerson, founder of Helgerson Solutions Group and Former Medicaid Director for New York and Wisconsin. Jason shares his perspective on Value-based payment progress and direction tells us who needs to get involved and how, and we discuss how to measure success. That is, how will we know if value-based payment has been adequately deployed, and more importantly, how will we know if it's working?

This episode is sponsored by VBP Forward: VBP Forward will host its inaugural conference February 20-21, 2019 in Buffalo, NY at the Hyatt Regency Buffalo. The conference will bring together over 200 professionals who serve Medicaid and Medicare special needs or complex populations or have an interest in that value chain. Participants will gain insight into the next generation of value-based payment and will be provided with a roadmap for their path towards effective value payment for special needs populations. In addition to clinical providers, VBP Forward will have a track and focus on guiding community-based organizations down the right path for the collection of social determinants of health and how they can become not only an integral part of care delivery but also the revenue cycle associated with that delivery.

2:09 Engaging providers who feel left behind by the Value-Based Payments conversations.

3:18 In New York, 80% of all reimbursement for Medicaid must be under VBP contract by 2020.

5:36 Community Based Organizations are treating the same issues health systems are struggling with. What do CBOs and Health systems need to learn about each other to create new sustainable business models?

9:10 Breaking down the language barriers.

12:49 What has made early pioneers successful?

Green and Healthy Homes Initiative
God’s Love We Deliver

15:11 How do CBOs explain to plans and health systems what the expected ROI will be? "Walk before you run."

18:07 Begin the dialog with payors early. You can see this as an opportunity or a threat, but the train has left the station.

21:40 When taking on risk, you’re responsible for more than you were in a FFS model. This necessitates partnerships with CBOs. If you wait, you’re going to have to take what’s left.

22:45 What’s happening outside NY? Examples nationally and abroad. England and NHS

28:15 What about Medicare and commercial payors?

31:15 Measuring success in a VBP future. What does success look like for the state, for CBOs, for doctors, and for patients?

“I think at some point in the not too distant future, we will look back on how we treat people who are sick and with flu-like symptoms almost as bloodletting. Requiring them to leave their homes and go to a clinic to be treated when the technology exists to do bloodwork and other tests in the home; with new telehealth tools to be able to almost do a complete exam on those individuals without them having to leave the comfort of their home, which is in the best interest of the patient and the public's health, those models are not possible in the traditional FFS system. They are much more possible in a value-based world."

"Consumers having more choices will be the real power of Value-Based Payments."

37:00 How close are we to knowing which clinical outcomes to measure? HEDIS measures taken from claims data measure process and not the true outcome. Patient-reported outcomes are needed to say if patients are getting high-quality services. Beyond healthcare measures, how do we measure the health and wellbeing of a community?

42:00 Helgerson Solutions – What do you do and who do you do it for?

About Jason Helgerson Jason Helgerson is an entrepreneur, investor, consultant and social change agent. After more than 20 years of public service he has embraced the “gig economy” and launched a multifaceted private sector career. Helgerson Solutions Group LLC (HSG) is focused on helping companies, providers, payers and governments make the move to value in health care. Jason also advises Private Equity firms and Venture Capital funds that share his commitment to value-based health care. Jason also works around the world as a Senior Advisor to a global management consulting firm.

Before his move to the private sector, Jason was a nationally recognized leader in public sector health care. Most recently he was New York’s Medicaid Director, a role he held for over seven years. New York’s Medicaid program provides vital health care services to over 6.6 million New Yorkers and has an annual budget in excess of $68 billion. Jason also served as the Executive Director for New York’s Medicaid Redesign Team, nationally recognized as a 2015 Innovation in American Government Finalist by the Harvard Kennedy School of Government. In this capacity he directed Governor Cuomo’s effort to fundamentally reshape the state’s Medicaid program in order to both lower costs and improve health care quality. In 2015, Jason was also recognized as a Public Official of the Year by Governing Magazine.

Twitter: @policywonk1

About Helgerson Solutions Group HSG was founded to make the world a better place. Its founder, Jason Helgerson, has made that his mission his entire professional life. He has been a positive and successful change agent in every position he has held. Most recently he was New York’s Medicaid Director. In that role he led the state’s historic Medicaid redesign efforts which not only bent the cost curve but improved outcomes for Medicaid members.

A 2018 Commonwealth Fund study found New York to be the most improved state in the nation relative to its overall health system performance and suggested that further improvement was likely thanks to reforms launched by Jason and his team.

Prior to moving to New York, Jason was Wisconsin’s Medicaid Director. In this role he led the effort to expand access to health care to virtually all state residents. He also helped lead a major cost-cutting exercise that brought down spending without taking benefits away from a single Medicaid member. Prior to his Medicaid work, Jason held a series of positions in state and local government leading efforts to reform education, child care, public finance and, of course, health care.

https://www.helgersonsolutions.com

Related and/or Mentioned on the Show: DSRIP and VBP reform

Green and Healthy Homes Initiative

God's Love We Deliver

Adam Boehler and CMMI

MVP Healthcare

Join our Community! Trying to drive change within your healthcare organization? Launching a new product? Having trouble getting decision makers attention and buy-in?

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

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What's the difference between value-based care and value-based payment? How can we attribute outcomes and cost savings to specific innovations in care delivery? Does anyone really know what they're doing? What do the patients think? Who needs to be at the table to figure this all out?

On this episode, guest-host Janae Sharp asks Don Lee and Shahid Shah about the VBP Forward Conference happening in Buffalo on February 20th and 21st. And we try to break down what's really happening in the move from Fee For Service to Value-based healthcare.

See full show notes at https://thehcbiz.com/ep88-value-based-experiment/

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Mergers and acquisitions activity in healthcare ranked third behind energy and media entertainment in terms of total deal volume in the first half of 2018. And from what we can tell, things didn't slow down after that. Of course, you have the big deals like CVS-Aetna, Cigna-Express Scripts, and Amazon-Berkshire Hathaway-JP Morgan. And the much-hyped entrance from tech giants like Apple. But we're also seeing a ton of consolidation in specialty practices, software companies and more. The rise of value-based payment is certainly a factor, but the market is complicated and there are many, less obvious factors at play.

On this episode, Amanda Hansen, Vice-President of Strategy and Business Development for AdvancedMD breaks down the M&A activity and industry trends to help us understand what's happening, and why.

For more information about this episode, and full show notes, visit: https://thehcbiz.com/ep87-healthcare-consolidation-amanda-hansen

...

This episode is sponsored by VBP Forward:

VBP Forward will host its inaugural conference February 20-21, 2019 in Buffalo, NY. The conference will bring together over 200 professionals who serve Medicaid and Medicare special needs or complex populations or have an interest in that value chain.

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On this episode, we talk with François de Brantes, Senior Vice President of Commercial Business Development at Remedy, about the future of value-based payment. François shares with us the importance of transparency, measurement, and responsibility and tells us why payment reform is such an effective lever to drive change. You'll hear about models that have been successful, how employers are driving change, and what you can expect from the next generation of value-based payment. In addition, François shares his insights on how we can account for the social determinants of health (SDOH) in our program design. This section led to a significant "aha" moment for me and underscores the importance of incorporating community-based organizations (CBOs) more tightly with our traditional healthcare delivery system.

View full post and show notes on the web

François de Brantes will be a keynote speaker at the inaugural VBP Forward Conference in Buffalo, NY on February 20th and 21st, 2019.

This episode is sponsored by VBP Forward:

VBP Forward will host its inaugural conference February 20-21, 2019 in Buffalo, NY at the Hyatt Regency Buffalo. The conference will bring together over 200 professionals who serve Medicaid and Medicare special needs or complex populations or have an interest in that value chain. Participants will gain insight into the next generation of value-based payment and will be provided with a roadmap for their path towards effective value payment for special needs populations. In addition to clinical providers, VBP Forward will have a track and focus on guiding community-based organizations down the right path for the collection of social determinants of health and how they can become not only an integral part of care delivery but also the revenue cycle associated with that delivery.

About François de Brantes:

François de Brantes serves as Senior Vice President of Commercial Business Development at Remedy Partners. He leads customer development of the Medicare Advantage, Self-Insured Employer, and Commercial Payer markets. He has spent close to two decades working to transform the U.S. healthcare system by improving incentives for providers and consumers in order to encourage value-based decisions.

Prior to joining Remedy Partners, he served as Vice President of Altarum, a national nonprofit. From 2006 to 2016, he was Executive Director of the Health Care Incentives Improvement Institute (HCI3), a not-for-profit company that designed programs to motivate physicians and hospitals to improve the quality and affordability of healthcare delivery. The organization, which merged with Altarum in December 2017, was responsible for the Bridges to Excellence® (BTE) and PROMETHEUS Payment® programs, which compensate and reward clinicians that focus on episodes of care and performance measures.

Prior to HCI3, François was Chief Operating Officer of the eHealth Initiative (eHI), which promotes adoption of health information technology in the U.S. He led the development of eHI’s HIE Value and Sustainability Model, a method to value services offered by Health Information Exchanges. Early in his career working in General Electric’s corporate health care department, he was involved in many strategic programs that created, connected and supported Active Consumers, and defined market mechanisms to reward providers for better performance.

François holds a master’s degree in Economics and Finance from the University of Paris IX-Dauphine and a master’s degree in Business Administration from the Tuck School of Business Administration at Dartmouth College.

Twitter

About Remedy:

Remedy operates the nation’s largest bundled payment network. Remedy is not only an operator of bundled payment programs, but actively manages and assumes financial risk with providers that are contracted for at-risk bundles. Remedy works hand in hand with the payer and the providers to deliver bankable savings by implementing double-sided risk programs.

We believe that it’s only by sharing financial risk that bundled payment operators can truly become partners with the payer and the providers in the transformation of the delivery system and achieve better quality and cost outcomes. All of the bundled payment programs that Remedy has participated in and implements are risk-based.

https://www.remedypartners.com/

Related and/or Mentioned on the Show:

Quality of Healthcare in America Report

Join our Community!

Trying to drive change within your healthcare organization? Launching a new product? Having trouble getting decision makers attention and buy-in?

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Selling is hard. Whether you're selling an idea, service or product, you've got to get to the core of the issue quickly or you'll lose your audience. And the challenge is notoriously exacerbated by the risky, regulated and complex healthcare system you're selling into. That's why we're talking with Dom Cappuccilli from The Clean Sell. Dom's a storyteller turned sales guy who's been successful in both inside / direct sales and enterprise sales. Dom shares some of his most important lessons from the journey like:

How to avoid common sales mistakes like over-reliance on your deck
Why no-one cares about your solution and how to get to the core of their problem with needs alignment
How to use relevance hooks to earn the right to share more
Why you should always reach out to 5 or more people at a large organization (and no... they won't get mad at you)

There's much more too. At the end of the day, Dom shows us that these aren't lame sales tricks to get what you want. No. They're tried and true methods in human communication and relationships and you neglect them at your own peril.

This one was a lot of fun. Check it out!

P.S. Dom shared an awesome quote from one of his colleagues that's worth pondering:

"People don't buy from you because they love your product. They buy from you because they believe you understand their problems". - Dom's unidentified sales trainer :)

Timestamps:

2:03 – Dom tells us how he went from being a writer to getting recruited by ZocDoc, to helping companies build scalable sales efforts.

8:00 – Storytelling as a tactic for Aligning Value! This is it, people! We always talk about it and it's finally here. This how you get buy-in from multiple stakeholders with multiple problems.

10:00 – Inside sales vs. Enterprise sales: With inside sales, you get about 12x as many chances to practice selling a month. This constant feedback is what you need to become an expert salesperson. Dom shares a story you HAVE to hear.

13:52 Dom's got both inside and enterprise sales experience at ZocDoc. The only people who survived got really good at pattern recognition.

18:12 – The same mistakes keep being made by enterprise sales people: Too much reliance on their deck.

19:51 – Enterprise sales is changing. A lot of times it’s not that they don’t think your solution is good enough it’s that they can’t agree internally on what the problem is. “You need to know the players but if you pitch what they each get out of it, often what they get out of it is in conflict with each other. What you need to do is help them build consensus that each of their pain points are a result of a problem that you can help them solve. “

21:43 – The end-user is usually your foot in the door. You need to give them the tools to sell to everyone else. Facilitate consensus on the problem then consensus on the solution. A good pitch and getting people excited is just the beginning. Navigating enterprise sales is a project management function.

25:46 – Are you experiencing the pain points we can solve for you? What are those pain points costing you? Here is why these pain points are happening to you. If you sell different problems causing the pain point to different people in sales cycle there’s no shared common insight that allows people to buy in an enterprise sale.

30:23 – Whoever you're selling to has 500 problems they have to solve every day. The one problem that I solve, I see 500 times a year and I can offer help in that problem because I know why that problem is happening to them. Just be valuable.

34:22 – Tools and tactics for inside sales. When trying to get attention, the key is relevance. What is the most relevant piece of information that you have on that person?

37:22 - Tools and tactic for enterprise sales. The principles are the same. Don’t just reach out to one person. Whoever it’s relevant for will respond. The relevance hooks are always different but I always reach out to at least 5 people. Follow up is huge. The second email has double the response rate of initial email.

About Dom Cappuccilli Dom Cappuccilli has helped hundreds of entrepreneurs to not only tell a better sales story, but also built many of their sales efforts from the ground up. He combines the power of a trained storyteller with the real world experience of an elite salesperson. In fact, he became an elite salesperson because he was a trained storyteller.

After 10 years as a reporter, author and screenwriter, Dom found his calling when he rewrote the sales story of a fast-growing healthcare company and doubled their revenue in six months. From there, he quickly rose to be a sales leader at unicorn startup ZocDoc - currently valued at $1.8B - before going to Arches Technology where he created and sold an entirely new healthcare technology product to health systems.

During his time in the startup and small business world, Dom met many founders and was amazed that almost all of them were succeeding in spite of their sales effort and strategy, not because of it. The Clean Sell was born soon thereafter and in time since its founding has helped hundreds of entrepreneurs to not only tell a better sales story, but also built many of their sales efforts, processes and teams from the ground

LinkedIn Dom Cappuccilli Dom@TheCleanSell.com About The Clean Sell We help founders & CEOs turn their subject matter expertise into a structured, scalable and simple sales process that fuels their growth.

The Clean Sell is a B2B sales consultancy helping everyone from startups to Fortune 500 companies to create a structured, scalable and simple sales effort in line with best practices. Throughout a company’s lifecycle, there are key inflection points where a lack of sales knowledge and process can sabotage a business that should be thriving. We fill these gaps for our clients.

No matter what stage you’re in, we have the right solution for you.

www.TheCleanSell.com

Facebook TheCleanSell

Twitter TheCleanSell

Related and/or Mentioned on the Show Whitepaper: The 7-Step Pitch

The Clean Sell Blog

Join our Community! Trying to drive change within your healthcare organization? Launching a new product? Having trouble getting decision makers attention and buy-in?

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This episode is part of our in-depth coverage of the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN that took place September 18-20th.

...

On this episode, we wrap-up our coverage of the HITS 2018 conference. We talk with HITS board members Dr. Kelly Reynolds and Savannah Hatt about what we learned at the 2018 conference, what's next for the HITS Consortium, how you can get involved, and what to expect from the HITS 2019 conference in Buffalo, NY.

Show notes:

2:32 A great time in Nashville

3:33 Summary of the insights you missed at HITS 2018

4:58 How clean is clean enough?

6:47 A Bundled Systems approach: Designing for Clean.

7:55 After measuring how healthcare facilities are achieving reductions in hospital-acquired infections (HAI), HITS has assigned quantitative values to infection prevention investments called Clean Credits. As you layer different interventions into your system, Clean Credits will quantify what your expected ROI should be.

11:55 A Systems Approach VS a Systematic Approach Standard Operating Procedures are important, but culture holds it all together.

14:40 EVS is a protector of ROI but not always given enough resources. Make sure that the staff knows how important their role is.

16:41 How can we design the ideal treatment room? Seamless walls. Sealed entryways. We need to connect healthcare architects and designers with infections prevention. The best time is during renovations but awareness is poor.

21:30 Bringing the C-Suite to the table. Nothing moves without the right decision makers. To become a priority you need to paint a very clear picture.

22:59 There were lots of discussions about the practical side of implementation. Lots of Infection Preventionists (IPs) in attendance this year at Workgroup meetings. Many discussions centered around workflow and concluded with a solution to empower EVS technicians and arming the C Suite with research.

25:20 You Need To Be Here! These conversations happen nowhere else.

Dry biofilms. Seeing what's left behind.
More applications for tracking pathogens, tracking mutations and antibiotic resistance.
What can be present that we can’t culture?
Spores on wheels. How many environments does a food cart travel into?
HVAC simulation model of containment and control.
Waterborne pathogens like Legionella.
Training programs at the conference.

31:27 The 8 Workgroups from 2017 presented on their ongoing research. Looking forward to 2019, Workgroups are encouraged to collaborate with each other for more interconnected systems solutions. THIS IS THE BEST TIME TO JOIN A WORKGROUP!!!

34:04 Plans for HITS Consortium 2019: Outreach beyond hospitals. Sponsors for research in the form of financial support, lab space, and scientific advisors for our Workgroups.

36:26 We’ve all be a patient before. We can all get behind infection prevention. Anyone who is interested can attend foundation dinners and other events. Help us get the research and its implementation.

37:50 When and where is 2019 – Aug 6-8 in Buffalo! We're expecting a big Canadian attendance for companies looking to do business internationally.

Call to Action

Come to the Conference
Participate in Workgroups
Volunteer!!!
Donate financially
Sponsor through other support

About Dr. Kelly A. Reynolds Kelly A. Reynolds, MSPH, PhD
Associate Professor
University of Arizona
Tucson, AZ

Dr. Reynolds is an Associate Professor in Environmental Health Sciences at the University of Arizona’s College of Public Health, and Director of the Environment, Exposure Science and Risk Assessment Center. She has over 29 years of experience as an environmental microbiologist and directing a research program related to infectious disease transmission, quantitative risk assessment, and public health policy and education. The relationship of fomite, hand and air contamination and pathogen survival characteristics relative to human health outcomes has been a common theme in Dr. Reynolds’ research. During the course of her academic career, she has served as a principal investigator on numerous projects and published over 350 journal articles, book chapters and professional reports. Recent and related projects involved the risk of MRSA transmission via hospital personnel scrubs, evaluation of an infection control intervention for first responders, development of infectious waste disposal protocols, tracking environmental microbiomes in long-term care facilities and testing methods for decontamination of soft surfaces in healthcare environments. As co-founder of the HITS Consortium, Dr. Reynolds brings her expertise in integrating academic research teams with medical personnel, clinical diagnostic laboratories, patients, industries and other stakeholders for a multidisciplinary approach toward research, communication and management efforts in infection prevention.

University of Arizona's College of Public Health

Environment, Exposure Science and Risk Assessment Center at the University of Arizona

About Savannah Hatt, MPH Project manager for the Applied Research Center at NSF International
HITS Board Member

Savannah Hatt is a Project Manager in the area of sanitation and contamination control for the Applied Research Center at NSF International. Joining the team in March of 2016, Ms. Hatt is primarily responsible for managing client projects and for supporting development of new service offerings for the healthcare industry. She also acts as the conference coordinator for the Healthcare Infection Transmission Systems (HITS) annual conference, which was first held in 2017. Ms. Hatt holds a Bachelor of Science in biochemistry and a Master’s of Public Health in epidemiology, and her graduate research focused on reducing healthcare-associated infections.

NSF International

About Healthcare Infection Transmission Systems (HITS) The Healthcare Infections Transmission System (HITS) Consortium looks to promote public health by reducing healthcare-associated infections through the integration of best infection prevention practices. HITS will focus on the major pathogen transmission systems in the healthcare setting specifically; surfaces, person to person, water and air. Join us for this one-of-a-kind, multimodal event where researchers and experts from across disciplines will work toward identifying research gaps and applying data-driven methods in the field. Meet, greet and share ideas with the individuals and organizations who are growing and sustaining the industry, as we explore creative and innovative solutions to this global problem.

Learn more: Web: http://www.hitsconsortium.org

For questions or to join their mailing list, email: info@hitsconsortium.org

Twitter: @HITSConsortium

HITS Consortium on LinkedIn

Related and/or Mentioned on the Show HITS 2018: A Catalyst for Change in Infection Control - Conference preview with Dr. Christine Greene and Dr. Kelly Reynolds

Why Healthcare Needs a Systems Approach with Jason “The Germ Guy” Tetro from HITS 2018

Bringing Science to the Art of Hospital Cleaning w/ Michael Rochon from HITS2018

Preventing HAIs at the Source w/ Al Wickheim and Laura Barker of Prodaptive Medical Innovations from HITS 2018

Clean Air and Patient Satisfaction w/ Samantha Kitchen of Radic8 Ltd from HITS2018

HCAHPS and the Patient Safety vs. Patient Satisfaction Conundrum w/ Christine Greene and Maurits Hughes from HITS2018

Join our Community! Trying to drive change within your healthcare organization? Launching a new product? Having trouble getting decision makers attention and buy-in?

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This is a crossover episode with David Shifrin from The Future of Health Podcast and Health:Further. We cover three main topics that have been coming up a lot on our podcasts:

Care Transitions * Anytime a patient is moved from one care delivery location to another you need to have contextualized data exchange. * If care coordinators don’t have the right data, how could the patient? * How can technology help educate patients and increase discharge instruction adherence? * Telehealth for post-discharge follow-ups. Use telehealth for increased touchpoints and a better doctor-patient relationship. * Bruce Greenstein former HHS CTO, says we must address high utilizers. When you fix big spenders, you free up money for innovation.

Clinical Decision Support * How do you help providers be more effective at their job? * A reliable, unbiased assistant to help evaluate data more quickly. Examples: ILÚM Health Solutions, VisualDX. * Still skepticism around layering another CDS platform on top of an already problematic EHR platform. How do you design something that will fit into the business and the culture? The message is: this is a new way to deliver YOUR care. * Binary Fountain – Analytics to find the most effective doctors. * Align physicians with one another to encourage sharing of best practices but you need a solid culture to be able to have honest conversations. Dr. Jeff Thompson at Gundersen Health focused on their mission to foster their culture.

Business Realities, Culture, and the New Patient Journey * Carrie Liken from Yext (appearing on bo/th podcasts) says the availability of data changes the way patients expect care delivery. The patient's digital expectations are set by Google and Amazon. * Focus on your employees having the tools they need to do their job. * Dig to find the incremental improvements. There are no silver bullets.

About David Shifrin I am a scientist, writer, and connector. I love data, but I know that it doesn't always speak for itself. Often, the difference between success and failure is a good narrative surrounding that data. My job is to create that narrative.

At Health:Further, I produce, edit and curate content focused on healthcare innovation, working to build a community of people who share the goal of making healthcare accessible, affordable and sustainable.

At Filament Life Science Communications, I help life science and healthcare companies create the marketing content they need to display their leadership and grow their audience.

I also like three-item lists, with or without the Oxford comma.

LinkedIn David Shifrin

About Health:Further Health:Further is an open community focused on the future of health. We are driven to pursue two difficult ideals: that health is a human right, and that health must be supported affordably and sustainably. We are providers, payers, politicians and practitioners. We are investors, innovators, artists and activists. We are all patients, and together, we will create the ideal future of health.

Twitter Health:Further

LinkedIn Health:Further

Facebook Health:Further

https://www.healthfurther.com/

About The Future of Health Podcast This podcast is where we come to hear from entrepreneurs, startup founders, healthcare executives, service providers, healthcare educators, and patient advocates to figure out what we can do to build a healthier society and use technology to care for real people.

The Future of Health Podcast

Join our Community! Trying to drive change within your healthcare organization? Launching a new product? Having trouble getting decision makers attention and buy-in?

We'll help you understand the whole picture so that you can align your innovation with the things decision makers care about. And then we'll help you execute. It's not easy, but it's possible and we'll help you get there. Sign up here and we'll keep you up to date on healthcare industry news with podcasts, blog posts, conference announcements and more. No fluff. No hype. Just the valuable (and often not-so-obvious) information you need to get things done.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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The social determinants of health (SDOH) are a hot topic in the healthcare industry. And rightly so:

"Social, economic, and environmental issues have been shown to influence the length and quality of life by 50%, according to community health research. In comparison, only 20% is tied to the clinical care provided to community residents."

Virginia Gurley, Sr. Vice President and Chief Medical Officer at AxisPoint Health

But SDOH is not a new concept - it's just modern terminology for something called Social Epidemiology. What's new, is the ability to apply SDOH data to expand existing predictive models of risk stratification. By identifying the patients that are at the highest risk both clinically and socially, you can help care coordinators get much more tactical and concrete about supporting the individual.

On this episode, Dr. Virginia Gurley, Sr. Vice President and Chief Medical Officer at AxisPoint Health joins us to explain how to put SDOH data to work.

Read the full post here:

http://thehcbiz.com/ep82-sdoh-virginia-gurley/ ‎

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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If you're a medical practice, 4 major industry waves are rocking your boat. New demands bring new opportunities for fast practices that can quickly get physician alignment around a strategy that will maintain physician autonomy and increase reimbursement. Equally as important, the patient expectation has changed. They demand convenience and flexibility and want to interact with their care in new and innovative ways. Physicians can accept this, or ignore it at their own peril.

I'm fortunate to be joined today by Ken Comée, CEO of Carecloud who will shed some light on these 4 waves:

Migration to a modern, cloud-based infrastructure
Practice consolidation
Value-based care
Consumerism and the new patient expectation

We break down what the 4 waves are, what they mean for practices and how practices can capitalize on the change. Enjoy!

0:56 What does CareCloud do and who do you do it for?

2:40 The smartphone has changed everything. What do doctors need to do to modernize?

4:00 Who are your customers? How has that changed as your company has grown? How has consolidation in the Health IT marketplace affected you?

6:08 The 1st Wave is a migration to a modern and cloud-based environment. It creates efficiencies and is needed for an interconnected, interoperable future.

9:30 The 2nd Wave is acceleration towards consolidation and rollups of physicians. You need IT infrastructure to rollup brick and mortar medical practices.

12:58 Hospitals need to re-evaluate what they are offering to compete with outpatient surgery centers.

14:33 The 3rd Wave is Value-Based Care. VBC means physicians are required to be more active in terms of outcomes. You must engage with patients earlier, more regularly, and over a longer period of time. Independent medical practices will be able to thrive if they can build an active and loyal patient base.

16:23 What do you see with people trying to prepare for a VBC future while still living in a Fee For Service now? Outcomes of medical care need to be thought of as if the consumer has options and can go somewhere else. They can. Attract. Serve. Retain.

20:00 What is the patient's experience with your practice from the first second they know you exist? Must have a holistic approach to end to end experience. Cloud infrastructure lets physicians thrive.

22:31 The 4th Wave is patient expectations and consumerism. Average out of pocket expense is going up and your patient experience could make or break you. I mean, Clipboards? Really?

25:50 Patients need to find info with as little friction as possible. Put your hours and prices on the web. Provide as much decision-making information as possible to prevent the patient from having to call and ask a question.

28:55 What do the 4 Waves mean for the practice listening? Every practice has different pain points. The Cloud can solve those pains and set you up for future growth.

31:22 What does all of this mean for CareCloud? Their platform is an all-in-one solution that can generate data that allows you to provide better care and proactive care for your patients.

33:55 What are the big tech giants up to? What are they going to do that impacts midmarket practices trying to stay independent? Amazon is going after the consumer experience. Their biggest impact is on facilitating the expectation of ease and simplicity for patients. Physicians need to be aligned with that. Amazon is doing it with their employees to show that it can be done.

36:29 Opening their own clinics? Amazon/Apple. Smart players are sometimes not the one that goes in first. They’re watching innovative companies like Forward and OneMedical to see how they do and whether they should build or buy.

38:11 To use CareCloud, do you have to use both front and back office software? We’re flexible. It's very easy for pieces to integrate with your current system. We ask, “How do we get you on the path to a cloud-based infrastructure with the least disruption so we can ensure success."

43:00 What is your biggest opportunity as a company coming from the 4 Waves? Interoperability. Carecloud is FHIR API certified. Going deep in cloud infrastructure means we can partner with Amazon and apply machine learning so practice systems get smarter.

45:02 Where can you find us? If you’re a partner and want to integrate with our platform we have a robust partner program where you can download our APIs and work with them in real time. Our service and training side of the business is looking to expand.

46:19 What's your partnership model for apps on your system? Open system. Nothing but. We can’t build everything. We integrate with care coordination, pop health, telemedicine, service or product side as extensions to our platform. Contact us for a discussion then apply.

...

About Ken Comée Ken Comée is CEO of CareCloud, the cloud-based software and services platform focusing exclusively on supporting high-growth medical groups. Ken joined CareCloud as CEO in 2015 after serving on the company’s Board of Directors while an Executive-in-Residence at Norwest Venture Partners. Ken brings to CareCloud a track record of building high performing organizations and helping early-stage companies reach their full potential and value.

Ken is a seasoned technology industry executive who has had a successful track record leading growth companies to achieve high-value strategic exists. Prior to joining CareCloud, Ken led several technology companies spanning the software, big data and analytics spectrum. Among these companies was Cast Iron Systems, a platform for integrating cloud-based applications from SaaS providers with on-premise applications. Ken managed Cast Iron’s turnaround, successfully positioning the company for its sale to IBM, which bought the company to serve as a foundational element of its cloud strategy. As CEO of PowerReviews, which provided technology and tools for retailers and e-commerce companies to host product reviews on their websites, Ken orchestrated the company’s acquisition to its largest competitor, Bazaarvoice.

In addition to his roles as CEO, Ken has served as an executive advisor and on the board of directors for several new ventures, including BeyondCore, which was acquired by Salesforce.com, and Simpplr, a social intranet company focused on improving employee engagement.

Ken’s role as an advisor reflects his personal mission to help shape the next generation of CEOs. In addition to mentoring up and coming entrepreneurs, Ken also is committed to supporting philanthropies and non-for-profits that are making a meaningful difference in promoting health and quality of life. He most recently participated in the “Real Men Wear Pink of Miami” campaign to support the American Cancer Society.

Ken earned his MBA from the London Business School and a BSc from Santa Clara University. A recent transplant from Silicon Valley to Miami, Ken enjoys spending his free time on the water and exploring South Florida.

...

About CareCloud CareCloud is the leading provider of cloud-based revenue cycle management, practice management (PM), electronic health record (EHR), patient experience management (PXM), and telemedicine solutions for high-growth medical groups. CareCloud helps clients increase profitability, streamline workflow and improve patient care nationwide. The company currently manages more than $4.2 billion in annualized accounts receivable on its integrated clinical and financial platform. To learn more about CareCloud, visit www.carecloud.com.

Links:

Twitter: @CareCloud

LinkedIn: https://www.linkedin.com/company/carecloud/

Facebook: https://www.facebook.com/carecloud/

Website: carecloud.com

...

Related and/or Mentioned on the Show The New Patient Journey and its Impact on Healthcare Marketing | Carrie Liken | Yext

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Virtual Care. Telehealth. Telemedicine. Whatever you call it, there are very real benefits to patients and health systems when you do Virtual Care right. But there are many obstacles too. On this episode, we talk with Courtney Stevens, Director of Virtual Care at Henry Ford Health System and Brian Young, Director of Healthcare Solutions Marketing at Vidyo about how to develop a Virtual Care strategy, gain buy-in from clinicians and patients, deliver service and measure success along the way. They provide a comprehensive overview of the process from start to finish with actionable advice about what to do at each step of the journey.

Highlights from "How to Launch and Grow a Virtual Care Service" 1:36 Henry Ford Health System is celebrating 100 years of helping patients!

3:00 Vidyo specializes in digital enablement. They manage a portfolio of capabilities that allow doctors to deliver care digitally.

4:15 Is it Telehealth or Telemedicine? Neither. It's Virtual Care.

9:58 What does virtual care mean at Henry Ford Health System and how has it impacted care?

14:45 Internal messaging is huge for getting staff through training and the inevitable hurdles.

16:08 Be the Myth Buster. Pay attention because the myths keep changing at each phase of the adoption curve even within the organization.

18:53 Valid concerns were raised that helped us improve our final product. Plan, do, check, ask cycles of learning are in our DNA!

20:40 Barriers to adoption are all about shifting mindset. "Personalized healthcare without borders." You need someone who can lead the charge.

27:15 Admin vs Clinician concerns. Battling the misconception of cost. Pay close attention to the impact on staffs workflow. Everyone needs to get involved and get trained.

29:55 Store and Forward Messaging Visits are kind of like an email. Patients can initiate care from home by entering information into a questionnaire. The provider will review it and gets back to you.

32:25 What’s the use case for video? It starts with remote specialist access from hospital to rural communities. Stroke care is huge.

34:14 You need a regulatory strategy. How is reimbursement? Telehealth in Michigan has a parody of coverage law but no parody of pay so payors can reimburse visits at a different rate. So far, 38 other states have telehealth parody laws. We get into the details here.

38:52 The difference in reimbursement between in-person and telehealth is that you only get paid for the professional portion of the code, not the facility portion of the code. The clinic to clinic model is more widely accepted across government and commercial payers.

42:00 In 2020, all ACOs will be able to include 'home' as the originating site. Employers see it as a way to keep costs down.

43:20 There are so many great use cases where reimbursement doesn't even matter. So even for organizations that are skeptical of the reimbursement models should investigate ways to improve access, post-ops, care plan adherence, reducing no-shows, and more. Don't let reimbursement be your only factor.

44.37 Vidyo's tech. What are you doing for Henry Ford Health? How do you integrate? What does the patient see?

50:00 What is the feedback from patients?

52:46 How do you measure ROI? I think this is the most metrics we've ever had listed by a guest on this show. Get ready to write this down.

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Courtney Stevens, MsEM: Director, Virtual Care at the Henry Ford Health System

Courtney Stevens has been with the HFHS for over 10 years. She started at HFHS in Process Improvement as a management engineer, where she has applied her industrial engineering and project management skills to various projects to aid in health system integration and alignment. She transitioned to Customer Engagement where she helped to improve the customer experience through project management, data/root cause analysis, training, and process improvement initiatives. Courtney was integral in the development and deployment of various system-wide (over 24,000 team members) trainings, as well as a standard system approach to leadership rounding. As of 2016 Courtney accepted a leadership role in Virtual Care developing the strategy and standards for telehealth expansion throughout Henry Ford Health System’s continuum of care. These applications, including remote monitoring, E-Visits, Clinic to Clinic telemedicine appointments/consults, MyChart Post Op Follow-Ups, and MyChart Mobile Video Visits, produced over 100 virtual visits/consults in 2015, over 3200 visits/consults in 2016, and over 4700 visits/consults in 2017, saving patients almost 67,000 miles or 86 days of travel and providers over 11,000 miles or over 50 clinic days of travel.

Courtney has a Bachelor of Science in Industrial Engineering from Western Michigan University and Masters of Science in Engineering Management from Wayne State University. She also has 4 years of experience as a Senior Product Engineer at TRW Automotive Occupant Safety Systems in their driver side airbag and steering wheel division.

Email: cstevens2@hfhs.org

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About Brian Young: Brian Young currently works for Vidyo, Inc. as the Director of Healthcare Solutions Marketing. Brian is responsible for driving Vidyo’s go-to-market strategy within the healthcare marketplace. As an expert in product strategy and strategic marketing Brian has spent the last 20 years helping healthcare providers, payers and patients use innovative technologies to become more interconnected, and to tell their stories. Brian currently resides in Chattanooga, TN with his wife and three children.

...

About Henry Ford Health System: Henry Ford Health System is a Michigan not-for-profit corporation governed by a 17-member Board of Trustees. Our advisory and affiliate boards comprising more than 100 Trustee volunteer leaders provide vital links to the communities we serve. Wright Lassiter III is the president and chief executive officer.

As one of the nation’s leading comprehensive, integrated health systems, we provide health insurance and health care delivery, including acute, specialty, primary and preventive care services backed by excellence in research and education. Founded in 1915 by auto pioneer Henry Ford, we are committed to improving the health and well-being of a diverse community.

https://www.henryford.com/

https://www.henryford.com/services/virtual-care

...

About Vidyo: Our vision is to connect the world by video-enabling any application or idea. Vidyo delivers the highest quality cloud video conferencing service, on-premises solutions and platform-as-a-service for market leaders and innovative upstarts. Vidyo is used by nearly 400 health systems representing over 4500 hospitals.

Vidyo web site

Vidyo Healthcare

2nd Annual Vidyo Healthcare Summit, December 3-5, 2018, Scottsdale, AZ

Making Telehealth Work for You, The Ultimate Guide whitepaper

2018 Trends in Telemedicine - Complimentary eBook

Vidyo APIs allow you to rapidly embed real-time group video chat into your app

...

Related and/or Mentioned on the Show: CMS telehealth fact sheet (PDF)

American Telemedicine Association

National Telehealth Resource Center

Center for Connected Health Policy

Podcast: HIMSS18: Nathaniel Lacktman | Asynchronous Telemedicine | Foley & Lardner LLP

...

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You'll get one email from me each week detailing:

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This episode is part of our in-depth coverage of the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN that took place September 18-20th. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures a patient's satisfaction with the quality of their care during their stay at the hospital. It measures things like staff communication and attentiveness, discharge information, food service, and the hospital environment. These are important measures and every hospital should strive for excellence in each of them (we talked about this in our last episode). However, and as is often the case in healthcare, the HCAHPS survey can have unintended consequences.

Typically, the Environmental Services Department (EVS) is given responsibility for the hospital environment portion of the score. And this too makes sense. They're the ones cleaning the rooms, emptying the trash, and ensuring that the patient has a comfortable environment to heal in. However, the most important responsibility for EVS is to ensure the environment is safe and HCAHPS does nothing to measure that. There is no measure that grades the EVS staff on how well they prevent the spread of pathogens through the hospital. This becomes a problem when pressures mount to improve HCAHPS scores. It creates an environment where EVS staff are forced to focus on the perception issues, and with shrinking staff sizes, it often comes at the expense of doing their most important work.

On this episode, we talk with Christine Greene, MPH, Ph.D., Principal Research Investigator at NSF International and President of HITS and Maurits Hughes, Director of Logistics and Support Services at Michigan Medicine about how to deal with the patient satisfaction vs. patient safety conundrum. It's a challenge that requires proper education for staff and leadership about the importance of EVS' role in the hospital and the alignment of EVS and other critical teams like Infection Control. It also requires a new attitude towards EVS staff. They aren't just custodians or housekeepers... they are Infection Prevention Technicians. We can do a lot for patients by elevating the stature of and support for the EVS team.

HCAHPS and the Patient Safety vs. Patient Satisfaction Conundrum: 1:46 Measuring Environmental Services (EVS) with HCAHPS: What sounds good on paper doesn’t always work in practice.

2:40 The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures a patient's satisfaction with the quality of their care during their stay at the hospital. The problem with tying patient perception of cleanliness to reimbursement is that it creates the conundrum of patient satisfaction vs patient safety. Contamination removal does not increase patient satisfaction.

4:55 Environmental Services (EVS) at Michigan Health are closely aligned with Infection Prevention (IP). In the 30 minutes a day EVS is in a patient room, staff must make the room look clean, remove the clutter of medical supplies, ensure trash doesn't get too full, all while trying to stay as quiet as possible to improve HCAHPS scores.

6:20 HCAHPS has nothing to do with patient safety. It sounds good on paper but doesn’t really measure if the patient is actually safe.

7:30 EVS must partner with IP and use tools to help them measure if the staff is cleaning to necessary levels. Cut-backs on staff and resources mean each staff member is being expected to do more in a given day. The culture of cleaning excellence is compromised by not respecting the folks who do the cleaning. If these frontline employees are, "the tip of the spear against pathogens" how do we make sure they’re treated, compensated, trained and supplied like it?

10:20 Remind employees that they are Infection Prevention Technicians (as opposed to custodians or housekeepers) and their role is to prevent the spread of infections and save lives. All services are hospital services.

12:22 The industry has not made investments in training for EVS. Getting the lab and IP staff to help educate the C-Suite would be huge.

13:20 How do you quantify the value that EVS brings to the organization? Michigan Health uses ATP testing, microbial swab testing, gel marking and special procedures in ED and other high priority areas to track EVS effectiveness. We share the results with leadership.

14:45 A "Bundled" approach to accountability. EVS, IP, and nursing staff are all responsible for taking action if a patient has an infection. Tests that determine if a surface has been wiped vs. decontaminated can help you better prioritize which processes need improvement.

17:30 A Quality Assurance program that uses the latest technology can help validate who infection control committees should focus on.

19:30 How do you get people to see EVS as a protector of ROI and prioritize cleaning at the level needed?

22:50 HCAHPS doesn’t align with the goals of infection prevention and that's a huge disservice to patient safety. It leads to EVS focusing on the perception of cleanliness and quiet first, and safety second. The smell of the chemicals might be bad but we’re not cleaning a fast-food restaurant, we’re cleaning to save lives. To improve HCAHPS scores we need adequate levels of staff, training of staff, access to facilities and a team approach to preparing patients for a safe environment.

25:00 This issue won’t manifest itself immediately and requires a long-term strategic prioritization or eventually it will prevent you from doing other things you’re trying to accomplish.

On the HITS Consortium and HITS Conference:

“I think change will occur by getting more EVS and IP leaders involved in this sort of initiative but it is going to require us to change the paradigm and change the model of how EVS is perceived and managed throughout the healthcare facilities.” - Maurits Hughes

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This episode was recorded on site at the HITS 2018 conference in Nashville, TN. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.

Thank you to HITS, Christine Greene of NSF International, Kelly Reynolds of the University of Arizona and Michael Diamond of The Infection Prevention Strategy for working with us on this conference coverage. It was a great event, in a great city, attended by true heroes of Infection Prevention and Control from all over the world.

Be sure to check out the next HITS conference in August 2019 in Buffalo, NY!

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About The HITS 2018 Conference: The HITS 2018 Conference was held on September 18-20th in Nashville, TN. HITS 2018 offers a unique forum for the exchange of knowledge and experience in the prevention of healthcare-associated infections and promoting “hospital health”. The 2018 HITS “Catalyst for Change” Conference is a working conference, bringing together research scientists, industry and healthcare professionals for an interdisciplinary and dynamic approach. We work together to understand and prevent the transmission of pathogens throughout the hospital facility through a collaborative effort that includes engaging in applied research. The conference is accredited as a provider for continuing education units (CEUs) through National Environmental Health Association (NEHA) and National Board of Public Health Examiners (NBPHE). Join us for this one-of-a-kind, multimodal event where researchers and experts from across disciplines will work toward identifying research gaps and applying data-driven methods in the field. Meet, greet and share ideas with the individuals and organizations who are growing and sustaining the industry as we explore creative and innovative solutions to this global problem. The full 2018 schedule can be found at https://hitsconsortium.org/2018-nashville/2018-schedule/

The HITS organizing committee has assembled world experts and key opinion leaders to share their knowledge and expertise. We host a research poster session to hear from those in healthcare about the research being conducted in their facilities. We also incorporate workshop breakout sessions each day in order to provide a unique forum through which everyone can interact and be innovative as we work to identify potential solutions to key barriers and develop an agenda for change moving forward into the next year. After the conference, members have the opportunity to become involved in one of the many research workgroups conducting research around pathogen transmission in healthcare.

Check out highlights from the HITS 2017 conference: https://hitsconsortium.org/2017-hits-highlight-reel/

For media inquiries: https://hitsconsortium.org/media/

For more information, please visit the HITS Consortium website: https://hitsconsortium.org/ or email us: info@HITSconsortium.org

Checkout our conference preview episode: HITS 2018 A Catalyst for Change in Infection Control - Episode 67 w/ Dr. Christine Greene and Dr. Kelly Reynolds.

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About Christine Greene, MPH, PhD: Principal Research Investigator at NSF International

Dr. Greene is the Principal Research Investigator for the Sanitation and Contamination Control unit of the Applied Research Center at NSF International. She has over 10 years of experience in epidemiological and laboratory research. She holds a Ph.D. in Environmental Health Sciences and an MPH in Hospital and Molecular Epidemiology from the University of Michigan, Ann Arbor. Her academic research focus has been on healthcare pathogen transmission, pathogen environmental survival, hand hygiene, disinfection and biofilms which has led to multiple publications. At NSF International, Dr. Greene has been making strides to improve public health in the areas of infectious disease prevention and control in clinical, dental and community settings. Her work serves to improve the accuracy of environmental mediated infectious disease transmission modeling, strengthens current guidelines to control healthcare-associated infections and provides new insights that will stimulate innovative approaches to reduce the risk of biofilm-related infections, pathogen transmission and curtail the environmental persistence and transmission of infectious agents. Dr. Greene is a member of the NSF International 444 Joint Committee Standard – Prevention of Injury and Disease Associated with Building Water Systems and serves on the ISO TC 304 working group 3 as the project leader for the healthcare hand hygiene performance and compliance standard. She serves as a board member for The Infection Prevention Strategy. Dr. Greene is a co-founder of the Healthcare Infection Transmission Systems (HITS) Consortium – an organization that strives to break down silos in healthcare using a cross-disciplinary, systems approach to addressing the pressing issues around infection control.

Email at cgreene@nsf.org

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About Maurits Hughes: Maurits Hughes is the Director of Logistics and Support Services at Michigan Medicine. He's a dedicated executive with over 20 years of management experience in clinical and non-clinical environments.

Maurits Hughes on LinkedIn

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About the Healthcare Infection Transmission Systems (HITS) Consortium: The Healthcare Infection Transmission System Consortium is a not-for-profit organization serving the field of infection control and prevention. HITS takes a holistic perspective to targeting healthcare associated infections by including multiple disciplines in the conversation, including infection prevention, environmental services, construction and renovation, facilities management and engineering along with research scientists and industry experts. HITS focuses on the major avenues for pathogen transmission in hospitals: hands, surfaces, water and air. HITS provides the necessary, cross-disciplinary platform to share knowledge and engage in research regarding the prevention of healthcare-associated infections and promotion of overall hospital health.

@HITSConsortium on Twitter

HITS Consortium on LinkedIn

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Related and/or Mentioned on the Show: The Patient Hot Zone w/ Darrel Hicks

Check out all the #HCBiz Show! Infection Prevention and Control coverage.

...

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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Content or ideas that I've found valuable in the past week.
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Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime.

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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There are plenty of reasons to be concerned with air quality in the hospital environment. The obvious ones are related to patient safety, but as we move toward a more consumer-directed healthcare system and as CMS continues to incentivize a positive patient experience through HCAHPS surveys (Hospital Consumer Assessment of Healthcare Providers and Systems) and other programs, it's important to address patient perception too.

On this episode, we're talking clean air and patient satisfaction with Samantha Kitchen, Director at Radic8 Ltd. Sammy explains how a well-placed air quality system can eliminate air contaminants, alleviate foul smells that leave a bad impression, and give patients peace of mind.

A few highlights from our conversation with Radic8: * After becoming the gold standard for air sterilization in Canada, Radic8 is ready to bring us new tech from the UK that can reduce airborne viruses by 99.9999%. * The primary challenge is still about educating hospitals. The message: you can control what you touch but can’t control what you breathe. * Radic8 is wall-mounted, circulating sterilized air within the room. This allows you to maintain air quality standards with no need to heat, cool or treat the air, bringing HVAC costs down. * Radic8 helps with HCAHPS and patient satisfaction scores. The reduction in strange smells is huge for helping patients feel like they’re in a clean environment. * Home units are available too. With Hextio, Radic8 used the same hospital virus-killing technology and shrunk it into a compact, 12-inch unit that provides a direct flow of clean air to your child, workplace, or in a hotel. It’s great to have large units in the hospital but people need this everywhere. * Radic8.com looking for partners in the US

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This episode was recorded on site at the HITS 2018 conference in Nashville, TN. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.

Be sure to check out the next HITS conference in August 2019 in Buffalo, NY!

...

Check out highlights from the HITS 2017 conference: https://hitsconsortium.org/2017-hits-highlight-reel/

For media inquiries: https://hitsconsortium.org/media/

For more information, please visit the HITS Consortium website: https://hitsconsortium.org/ or email us: info@HITSconsortium.org

Checkout our conference preview episode: HITS 2018 A Catalyst for Change in Infection Control - Episode 67 w/ Dr. Christine Greene and Dr. Kelly Reynolds.

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About Samantha Kitchen: Experienced Company Director with a demonstrated history of working in the environmental services industry. Strong business development professional skilled in Customer Service, Strategic Planning, Business Development, Marketing Strategy, and Public Speaking.

Samantha Kitchen on LinkedIn

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About Radic8: Radic8 is an independent air purification company based in the UK. With a strong belief that everybody has the right to clean air, Radic8 are passionate about innovating and distributing the very best technology in their field.

The Infection Prevention Strategy named Radic8's Viruskiller Technology as one of its Top Innovations of the Year: 2018.

Radic8 Website

Hextio

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Related and/or Mentioned on the Show: Check out all the #HCBiz Show! Infection Prevention and Control coverage.

...

Subscribe to Weekly Updates: If you like what we're doing here, then please consider signing up for our weekly newsletter.

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Benjamin Franklin told us that “an ounce of prevention is worth a pound of cure”. Healthcare-associated infections (HAI) cost U.S. hospitals as much as $45 Billion per year. We've covered many of the ways you can combat HAIs and we just spoke with Michael Rochon (also at HITS 2018) about how to improve our hospital cleaning procedures. Proper hospital cleaning and disinfection certainly satisfies the Franklin axiom, but what if we step back further. How did the contaminants get on the hospital surfaces in the first place? What if we could prevent some of that? Well, that's exactly what today's guests are doing. Many common healthcare procedures create sprays and splashes that spread contaminants to walls, ceilings, floors, and the clinicians' protective gear (Personal Protection Equipment or PPE). If you can prevent that spread in the first place, then cleaning becomes quicker and easier, PPEs last longer and you've really begun to take a stand against the spread of HAIs.

On this episode, Al Wickheim and Laura Barker from Prodaptive Medical Innovations join us to explain how the STAL Shield & Stand, an engineered safety control, can provide much more than an ounce of protection against the spread of HAIs.

Highlights from our interview:

Prodaptive Medical Innovations, President Al Wickheim, Operations Executive Laura Barker
Prodaptive Medical Innovations' foundation is based on the concept of providing innovative and simple improvements to existing technology. We try to make good, better.
The STAL Shield & Stand is a dome-shaped device the size of a wallet that breaks the chain of infection transmission at the first link. This stops splashes, mists and aerosol sprays during medical procedures from getting onto healthcare workers, patients, and the environment. Cleaning out wounds, oral suction, suction catheters, incision and drainage procedures, wound irrigation, and medication installations can all benefit.
A common reaction to this device is: "Well, duh!" The suction catheter is 100 years old. Doctors say, "Why didn’t I think of this?" Square and stand. All in one. Perforated diaphragm. Seals around a variety of instruments.
This protects the worker and their PPE (personal protective equipment, anything covering their skin). The healthcare worker takes less contaminate away from the work site and that results in less self-inoculation.
Feedback has been good but there has been a big resistance to change. It's an additional procedure and executives with budget restrictions say their hands are tied. It's hard to see the downstream results of reduced CMS fines but you can see reduced cleaning time and faster room turnaround time immediately!
The research with Dr. Sattar for irrigation catheters found 99.5% reduction in environmental contamination and 95% contaminate capture at the site. This enhances the effectiveness of the PPE meaning less cleaning supplies, less water needed, less harsh detergents that will extend the life of your equipment, and less laundry.
What do you think of the HITS conference? It's a revolutionary wave of innovation to address a global problem and we’re loving being a part of it.
What does the future hold? Our immediate goal is to expand our worldwide presence. This should be a global product and we have future products coming soon.

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This episode was recorded on site at the HITS 2018 conference in Nashville, TN. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.

Be sure to check out the next HITS conference in August 2019 in Buffalo, NY!

...

Check out highlights from the HITS 2017 conference: https://hitsconsortium.org/2017-hits-highlight-reel/

For media inquiries: https://hitsconsortium.org/media/

For more information, please visit the HITS Consortium website: https://hitsconsortium.org/ or email us: info@HITSconsortium.org

Checkout our conference preview episode: HITS 2018 A Catalyst for Change in Infection Control - Episode 67 w/ Dr. Christine Greene and Dr. Kelly Reynolds.

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About Al Wickheim: Al Wickheim is one of the founders, innovators, and the CEO of Prodaptive Medical. He grew up near Sooke, B.C. doing a variety of shipyard duties for his Dad. Everything from wreck salvage diving off the rugged Westcoast of Vancouver Island to pile-driving and running a modest machine shop. Al spent a fair bit of time “underground’ as a spelunker on the Island in his youth – sometimes forcing him into new and unexplored passages and territory.

Starting with the local fire department as a volunteer for a couple of years Al next worked for BC Ambulance for 30 years, the last 18 as an Advanced Life Support Paramedic. He has been involved in several major projects for BCAS including managing the EMS outfitting for the B.C. Summer Games in 1986 and overseeing the preparation of 36 ambulances for the Commonwealth Games of ’88. He was involved in the development and teaching of the recent H1N1 and Infectious Disease Control program for the employer and was a Level 11 CBRNE Tech. He worked for a Kenn Borek Air, a well established operation in Iqaluit and did numerous Med-evac tour on Baffin Island in Canada’s far north, to as far as Thule, Greenland. Al is always seeking improvements and refinements, tireless to the end.

As an ERU Tech with the Canadian Red Cross Al was in Nepal in 2015 and currently is the Community Coordinator for the JdF Emergency Program in Otter Point. Al’s background of innovation and self-sufficiency has taken him through various ventures of construction, hazardous tree topping and falling, bull-dozer and excavator operations. Al and his family live on their farm in the rainforest of southern Vancouver Island where he does wilderness and big tree tours to remote regions of the Island. At home, he works on managing the adventures established and coming up with new projects at a fairly constant rate. He enjoys astronomy and, well, work.

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About Prodaptive Medical Innovations: Prodaptive Medical develops and markets solutions to problems and shortcomings in clinical medical equipment. The partnership of two well seasoned emergency care providers with overlapping areas of expertise has resulted in the development of Prodaptive’s first product to market, the STAL Shield and Stand.

In 2009 Al Wickheim took an idea from concept to product addressing an obvious need to the biohazard concerns inherent in the use of the Yankauer suction device. SARS had struck a deadly blow in Toronto a few years before and H1N1 loomed.

While initially designed as a shielding device, it was apparent that the STAL served numerous other functions as well such as a stand. As an adjunct to half a dozen medical instruments used in Aerosol Generating Procedures – AGP’s, the STAL Shield’s versatility and effectiveness makes it the preferred choice when it comes to at-source medical bio-hazard blockade and confinement.

Other products are on the drawing boards and with input from practitioners, patients and manufacturing specialists Prodaptive Medical sees growth ahead where the status quo is no longer good enough.

At Prodaptive ‘Making good better‘, is what we do.

The STAL Shield & Stand was recognized as one of InfectionControl.tips Top Innovations of the Year: 2017

Prodaptive Medical is part of the TIPS Sudden Science program, which provides support and resources to advance their innovation into the market.

www.prodaptivemedical.com

The STAL Shield & Stand

Prodaptive Medical on Facebook

Prodaptive Medical on LinkedIn

Breaking the Chain at the First Link - A critical evaluation and research paper on the STAL Shield & Stand's effectiveness on InfectionControl.Tips.

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About the Healthcare Infection Transmission Systems (HITS) Consortium The Healthcare Infection Transmission System Consortium is a not-for-profit organization serving the field of infection control and prevention. HITS takes a holistic perspective to targeting healthcare associated infections by including multiple disciplines in the conversation, including infection prevention, environmental services, construction and renovation, facilities management and engineering along with research scientists and industry experts. HITS focuses on the major avenues for pathogen transmission in hospitals: hands, surfaces, water and air. HITS provides the necessary, cross-disciplinary platform to share knowledge and engage in research regarding the prevention of healthcare-associated infections and promotion of overall hospital health.

@HITSConsortium on Twitter

HITS Consortium on LinkedIn

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Related and/or Mentioned on the Show: Dr. Sattar Episode on understanding the spread of infectious agents in the environment.

Check out all of the #HCBiz Show! Infection Prevention and Control coverage.

...

Subscribe to Weekly Updates: If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime.

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

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...

Hospital cleaning is one of the most important activities in Infection Prevention and Control. However, chemical cleaners that aim to kill all of the microbes aren't always as effective as you might think. At least not by themselves. And they have some serious side-effects too. Today's guest is Michael Rochon, a pioneer chemical formulator and President of Process Cleaning Solutions Ltd. Michael explains why physical cleaning followed by disinfecting may be the best approach. It allows us to reduce the microbes to a safe level while lessening the side-effects of harsh chemicals on the hospital environment. Plus, and this is really fascinating, it reduces the spread of microbes that become immune to the chemicals. Just like overuse of antibiotics leads to antibiotic-resistance, over-use of harsh chemicals can lead to chemical resistant microbes. Once you bring in the potential savings from extending the life of hospital surfaces, Michael makes a strong scientific and business case for limiting the use of harsh chemicals in hospital cleaning.

Bringing Science to the Art of Hospital Cleaning Highlights from our conversation:

HITS 2018 is about finding better paths forward for stopping the spread of infections. PCS is a company dedicated to cleaning in a scientific manner to reduce environmental contaminants to a safe level.
The terrible moment that inspired a campaign to find a safer way to clean.
The research in physical wiping techniques that is changing how we clean hospitals and enabling the leap from sporicides to healthier alternatives.
Chemical cleaner residues that are toxic promote more resistance to cleaners AND antibiotics.
PCS will be publishing research that shows organic acid cleaners, with no synthetic chemicals, and microfiber cloth physical wiping techniques can reduce contaminants to safe levels with 325x less toxicity to aquatic and microbial life.
Reducing microbes to safe levels is key.
Infection prevention is a continuous event. What’s the appropriate target for manageable levels? More chemicals mean more mutations leading to more pathogens. It's a cycle you can’t win. We must fix the problem with science!
The new goals are to give health centers and schools the ability to test and verify that they are at safe levels. Practical microbial testing in the field gives everyone a way to evaluate their methods.
We need to get people to understand the implications of their cleaning methods and use the right tool at the right time.
The easiest win for your organization is to separate cleaning from disinfecting. These are two separate jobs. The physical removal of contamination on surfaces makes the disinfectant afterward more effective. This will be very effective at reducing the need for harsh chemicals in your organization.
Harsh chemicals do damage to equipment, create more porous surfaces for microbes to cling to. The associated costs of these cleaning products are starting to show up.
PCS is based out of Canada. Their organic acid cleaners are very successful with hospitals in Canada, now we want to have even more success with less chemistry needed with a goal of lower than 95%. Disinfectants are also approved and available in all 50 U.S. states and Mexico.
In addition to working with HITS 2018 and Michael Diamond, Michael Rochon is also part of The Infection Prevention Strategy (TIPS). In Rochon's advisory role, he is helping TIPS to pioneer new technologies and evaluates the latest science and discoveries.

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This episode was recorded on site at the HITS 2018 conference in Nashville, TN. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.

Be sure to check out the next HITS conference in August 2019 in Buffalo, NY!

...

About The HITS 2018 Conference The HITS 2018 Conference was held on September 18-20th in Nashville, TN. HITS 2018 offers a unique forum for the exchange of knowledge and experience in the prevention of healthcare-associated infections and promoting “hospital health”. The 2018 HITS “Catalyst for Change” Conference is a working conference, bringing together research scientists, industry and healthcare professionals for an interdisciplinary and dynamic approach. We work together to understand and prevent the transmission of pathogens throughout the hospital facility through a collaborative effort that includes engaging in applied research. The conference is accredited as a provider for continuing education units (CEUs) through National Environmental Health Association (NEHA) and National Board of Public Health Examiners (NBPHE). Join us for this one-of-a-kind, multimodal event where researchers and experts from across disciplines will work toward identifying research gaps and applying data-driven methods in the field. Meet, greet and share ideas with the individuals and organizations who are growing and sustaining the industry as we explore creative and innovative solutions to this global problem. The full 2018 schedule can be found at https://hitsconsortium.org/2018-nashville/2018-schedule/

Check out highlights from the HITS 2017 conference: https://hitsconsortium.org/2017-hits-highlight-reel/

For media inquiries: https://hitsconsortium.org/media/

For more information, please visit the HITS Consortium website: https://hitsconsortium.org/ or email us: info@HITSconsortium.org

Checkout our conference preview episode: HITS 2018 A Catalyst for Change in Infection Control - Episode 67 w/ Dr. Christine Greene and Dr. Kelly Reynolds.

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About Michael Rochon Michael Rochon is a pioneer chemical formulator with a successful track record in developing low-odor and zero-V.O.C.-emission cleaning products. Michael’s ground breaking work in the field of new technology cleaning formulations has led to many patents including United States Patent 6,346,279 B1 Hydrogen Peroxide Disinfectant with Increased Activity. For the past forty years, Michael has worked in the cleaning supply and contract maintenance industry.

Michael’s insight and vision led him to develop new technology cleaning formulations presently used in many hospitals. With foresight, he recognized the need for safer and healthier cleaning product formulations for the general public, and especially for the chemically hypersensitive individuals. Michael’s efforts in bringing to market low-odor cleaning products garnered him endorsements from several environmental organizations. Michael has also pioneered new technology cleaning formulations for disinfection and sanitization markets. Michael is President of Process Cleaning Solutions, Peterborough, Ontario, Canada. Process Cleaning Solutions is a Canadian company devoted to cleaning in such a way as to protect public health, protect the most sensitive, protect the environment and prevent the spread of antibiotic resistant bacteria.

Michael is currently developing cleaning processes that physically remove bacteria and bacterial spores to the same level as disinfectants are required to kill or inactivate for registration as disinfectants. These processes are used with PCS products registered with the United States EPA and Health Canada as disinfectants, allowing institutions to shift the focus to better cleaning of health care facilities in a safer , more effective and sustainable manner.

As with Michael’s discovery of synergy between hydrogen peroxide, anionic surfactants and inorganic acids he has now discovered a synergy between PCS stabilized sodium hypochlorite’s and controlled moisture cleaning with micro fiber cloths.

This synergy allows for effective, safer and sustainable cleaning to protect public health including hospital isolation daily and discharge cleaning without the need to supplement cleaning with additional protocols like UV disinfection.

Michael also is committed to assisting Health care facilities validate cleaning process with onsite microbial testing. Cleaning to a scientifically validated standard.

Michael has presented at numerous conferences including: International Policy Forum, Environmental and Professional Hygiene, Toward the Prevention of Drug Resistant Infections, International Society of Microbial Resistance and Office of International Medical Policy School of Public Policy, George Mason University, 11th World Congress on Environmental Health Vancouver, Sept 2010.

Michael is an Advisory Board member at The Infection Prevention Strategy (TIPS).

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About Process Cleaning Solutions Process Cleaning Solutions Ltd. is a new Canadian company devoted to cleaning in such a way as to:

• Protect Public Health
• Protect The Most Sensitive Among Us
• Protect The Environment
• Prevent The Spread Of Antibiotic Resistant Bacteria

PCS has cleaning processes for hospitals, long term care, hospitality, professional service providers, day care and schools. Following a proven cleaning process provides confidence you are cleaning to protect public health. PCS provides all of the components and procedures to achieve consistent excellent results.

The PCS definition of cleaning to protect public health is as follows:

"Removal of organic surface contamination to very low levels not visually apparent, validated by scientific measurements with ATP monitoring or microbial testing." In its marketing of Process Cleaning Solutions and cleaning processes, PCS is committed to working with all stakeholders to develop practical solutions to removing the most problematic contaminants from environmental surfaces to reducing the risk environmental surfaces pose in transferring disease causing pathogens.

Find more information about Process Cleaning Solutions and tons of additional education at: ProcessCleaningSolutions.com

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@HITSConsortium on Twitter

HITS Consortium on LinkedIn

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Related and/or Mentioned on the Show Dr. Sattar Episode on understanding the spread of infectious agents in the environment.

The Infection Prevention Strategy (TIPS)

The Infection Prevention Strategy is a registered non-profit. We have created a model of information sharing that makes the process of vetting new technologies, implementing successful programs and inspiring innovation more efficient, more accessible, more global and more collaborative. Our global teams are driven by the firm belief that we should not have to wait years for promising innovations, ideas and processes to be implemented and accepted.

Around the world, our teams develop trials and conduct pilot studies to aid in the discovery of successful research to market technological advancements.

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

Check out all of the #HCBiz Show! Infection Prevention and Control coverage.

...

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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Content or ideas that I've found valuable in the past week.
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Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime.

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Adapted from Jason "The Germ Guy" Tetro's Opening Keynote at HITS 2018 Have you ever written the perfect checklist? You left no stone unturned and accounted for every possible step that needed to occur. You trained your staff. Everyone was understood and was on board. But you still failed.

Today’s guest would tell you that you failed because you took a systematic approach when you really needed a systems approach.

A systematic approach takes all the facts into consideration and manifests itself as guidelines, a checklist or standard operating procedure (SOP). It’s based in science and best practice. On paper, it makes all the sense in the world.

A systems approach considers much more. How does your guideline fit in with the culture of those that will carry it out? Forget whether or not they’ll believe it. The question is, will they follow it? A systems approach requires empathy. It works because it shows people that there’s a place for them, and they’re culture, within the systematics and steps they need to carry out.

This may sound hokey to you. You may shout: “I’m not going to pander to peoples’ feelings! I have a business to run!” But you do so at your own peril. You can write your guidelines, checklists and standard operating procedures until you’re blue in the face. But if people won’t follow them, then you’ve wasted your time. This, as we like to say on the show, is called confronting reality.

On this episode, we’re talking with Jason Tetro. He’s the microbiologist, author and thought leader better known as The Germ Guy! We recorded this episode live at the Healthcare Infection Transmission System Consortium (HITS) 2018 conference in Nashville, TN where Jason was the opening keynote. In his talk there, Jason explained to us why a systematic approach often falls short in the real world, and why an empathic systems approach may be better suited to help you get your job done.

This conversation fits the premise of The #HCBiz Show! as well as any we’ve done to date. Jason’s common sense approach to confronting reality in the healthcare system takes us down interesting paths including the patient workflow (yup… they have one), blockchain, gamification, and even Eminem’s song, Lose Yourself. This is good stuff. I promise you’ll gain a brand new perspective on a thing or two.

Here are some highlights:

0:50 The Germ Guy’s journey from the lab to the TV.

3:37 Fixing the public’s dysfunctional relationship with microbes.

7:44 Keynote – Systematic vs Systems approach to infection control. The Systematic approach is following the guidance documents and standard operating procedures. The Systems approach takes a universal perspective on how to achieve a goal and, through a multifactorial approach, uses current systems to achieve that goal. It all comes down to empathy.

13:39 Empathy is when the system shows you that there is a place for you and your culture. If it’s right on paper but wrong in the real world, you need to confront the reality you’re dealing with and allow the workforce to participate the way they need to.

15:05 Innovation, culture, empowerment. When you forget about those 3 things you’re taking away your own capacity to make a difference. Don’t just follow rules and regulations if you know there is more that could be done. This must be a democratized system that hears all 20 different components to good infection control.

19:48 Quality measures are too distanced from the patient. There is too much bureaucracy in the way to remember the actual purpose of your actions.

20:55 Blockchain could be the potential link between systems and systematic approaches. What if human activities could be viewed as transactions in real time? You can find a way to develop transactional steps between SOPs to see the most common mistakes and fix the system.

24:20 Tokens and gamification of healthcare. The token can be used as proof of actions or accomplishments that can be used for checkpoints or rewards.

27:15 Physician workflow and the patient journey. What can we do within an existing workflow? How do we collect data while doctors are doing normal tasks without interrupting? Include the patient in providing info that will make doctor’s jobs easier.

29:18 Examples of infection prevention and the simple but effective parking idea to make visitors wash their hands.

31:20 Robust checklists can shut off your creativity and problem-solving skills but we know they can be helpful. Where is the line? Checklists work until the parameters around checklist have changed.

This episode was recorded on site at the HITS 2018 conference in Nashville, TN. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.

Be sure to checkout the next HITS conference in August 2019 in Buffalo, NY!

Check out highlights from the HITS 2017 conference: https://hitsconsortium.org/2017-hits-highlight-reel/

For media inquiries: https://hitsconsortium.org/media/

For more information, please visit the HITS Consortium website: https://hitsconsortium.org/ or email us: info@HITSconsortium.org

Checkout our conference preview episode: HITS 2018 A Catalyst for Change in Infection Control - Episode 67 w/ Dr. Christine Greene and Dr. Kelly Reynolds.

@HITSConsortium on Twitter

HITS Consortium on LinkedIn

This episode was recorded on site at the HITS 2018 conference in Nashville, TN. Look for more #HCBiz conference coverage from HITS 2018 coming soon!

About Jason Tetro Jason Tetro is a visiting scientist at the University of Guelph and has over 25 years of experience in health-related microbiology and immunology. He has worked in numerous fields including bloodborne, food and water pathogens; environmental microbiology; disinfection and antisepsis; and emerging pathogens. In the public, he is better known as The Germ Guy. He regularly writes for The Huffington Post Canada and is a regular with media outlets worldwide. He has written two books, The Germ Code, which was shortlisted as Science Book of The Year (2014) and The Germ Files, which spent several weeks on the national bestseller list. Jason is an advisory board member of InfectionControl.tips.

@JATetro on Twitter

www.JasonTetro.com

thegermguy@gmail.com

The Germ Code

The Germ Files: The Surprising Ways Microbes Can Improve Your Health and Life (and How to Protect Yourself from the Bad Ones)

Related and/or Mentioned on the Show: Closing the loop: Larry King's real name is Lawrence Harvey Zeiger.

Check out all of the #HCBiz Show! Infection Prevention and Control coverage.

Subscribe to Weekly Updates: If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime.

---

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

The Germ Code: How to Stop Worrying and Love the Microbes

The Germ Files: The Surprising Ways Microbes Can Improve Your Health and Life (and How to Protect Yourself from the Bad Ones)

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When it comes to healthcare conferences, it's easy to get stuck in an echo chamber. Too often it's the same ideas about the same topics from the same people. That's why I found last year's Quality Talks event so refreshing. NCQA brought together a varied set of speakers and topics that were guaranteed to offer a fresh perspective to anyone who attended - they certainly did for me. Plus, as a 1-day event, it was easy to get in and get out without disrupting my entire week, and the deep, TED-style talks were a welcome break from the typical stream of panel discussions.

Since I enjoyed it so much last year, I decided to give you this short episode to preview the 2018 event. My guest is Andy Reynolds, Assistant VP of Marketing and Communications at NCQA and the master of ceremonies at Quality Talks. Andy tells us about Quality Talks 2018, the tracks and speakers and explains what NCQA is trying to accomplish with the event.

Quality Talks 2018 takes place on October 22, 2018, in Washington, DC. Learn more about the event and register here: http://www.qualitytalks.org/

About Quality Talks Quality Talks 2018 takes place on October 22, 2018, in Washington, DC.

From the Quality Talks Event page:

This isn’t your ordinary health care discussion. Quality Talks is a series of stirring, succinct talks by current and emerging health care leaders with ideas about how we can collaboratively improve American health care. In addition to the dynamic and thought-provoking speakers, the event features interactive dialogue among all attendees about advancing the health care system and improving patient care.

Quality Talks began in 2015 as part of NCQA’s 25th Anniversary and grew so successfully that NCQA made it an annual event. In 2016, this sold-out event was held at a larger venue which enabled us to reach an even wider audience. We hope to continue in 2018 with thought-provoking speakers and continuing the Quality Talks health care discussion.

The Goal
NCQA wants to look ahead through the eyes of tomorrow’s leaders, who are inspiring the future of American health care. The Quality Talks are meant to inspire action to tackle the real and pressing problems in our health care system, and to dismantle barriers to a better future.

The Format
Far from a conventional conference, this event follows a “TED”-style format. That means the talks are shorter, compelling, memorable and novel in nature. Expect to leave this event hearing something you haven’t heard before.

Learn more about the conference and register here: http://www.qualitytalks.org/

About Andy Reynolds and NCQA Andy Reynolds is the Assistant VP of Marketing and Communications at NCQA and the master of ceremonies at Quality Talks.

NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s Web site (ncqa.org) contains information to help consumers, employers and others make more informed health care choices.

twitter: @NCQA

Related and/or Mentioned on the Show Quality Talks 2017 | Andy Reynolds | NCQA - last year's preview episode with Andy Reynolds

Digital Quality Measures 2.0 | Rick Moore | NCQA - a conversation on the future of quality measurement with NCQA's CIO Rick Moore.

Practical Innovation at the Health IT Expo | John Lynn - Andy discussed the importance of bringing the patient perspective on stage and I mentioned that the Health IT Expo had a patient as the opening keynote at their inaugural event.

LIFE AS A HEALTHCARE CIO - Speaker John Halamka's blog

Venture Valkyrie - Speaker Lisa Suennen's blog

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

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The patient journey has changed drastically in the past 5 years and it's having an outsized impact on healthcare marketing. You know about the "Google-effect", but did you know that 83% of patients are not going to the hospital website to research doctors and services? And now with Alexa, Apple Car Play and Android auto, voice-first is adding a brand new wrinkle. In short, there are many ways for your patients to find you and if you aren't managing the digital landscape, then you're missing out. Proper branding across channels makes it easier to be discovered and signals to your patients that your company is trustworthy.

On this episode, me and Shahid Shah are joined by one of healthcare's leading experts on the patient journey, Carrie Liken. Carrie is the Head of Industry for Healthcare at Yext, and she helps us sort it all out.

The New Patient Journey and its Impact on Healthcare Marketing 1:51 How has the patient journey changed in the last five years? What sort of impact is it having on healthcare marketing?

2:22 What is Yext?

5:08 Have you checked your address on Google Maps to see if patients are being taken to the right place?

8:00 "Everyone comes to our website. Google doesn’t matter." Sorry, wrong answer.

9:40 Technology has changed the patient journey forcing doctors to be more digitally engaged. What is the new patient journey?

13:45 Hospital executives: You must accept that patients are finding information about you and your doctors via external resources that may be outside of your direct control.

15:55 Google search has made small local hospitals the biggest competitor for big city hospitals. People don't want to travel for healthcare and rural hospitals who have optimized across search and media channels are taking market share.

20:58 The new rules of re-targeting in healthcare. 83% of people don’t go to hospital websites. How do you find your audience?

26:11 What else will hospitals and clinics benefit from if they already have a lot of patients?

31:50 What’s going on with voice search? Most common question: “Where is my doctor located?”

35:18 When it comes to voice search, Carrie says go FOND (First Organic, Next Direct).

37:55 Patients still can't search to see if their doctor is in-network.

42:30 What is it about branding that will suffer if external data is wrong?

45:41 Benefits of managing your "provider directory" well will help with tons of internal processes. Find more #HCBiz coverage here Provider Directory.

46:45 Where should health clinics start? First, talk to patients and collect data. Next is go internal and find where your data lives today. Third, launch and iterate. You can’t stop a patient from searching (and potentially finding bad data) so just start now.

51:17 If you are spending money on your website but not the organic discovery of your website, you’re doing it wrong. You’re only serious if you know how much money you’re spending on organic vs direct. Here are the most important KPIs you should be tracking.

About Carrie Liken Carrie Liken joined Yext as the company’s first Head of Industry for Healthcare. In her role, Liken leads all healthcare-related activities, including product and partnership development. Over the last fifteen years, Liken has gained experience in the government, legal, nonprofit, and for-profit sectors, focusing on healthcare and health policy.

For 8.5 years, she worked for Google, where she worked with healthcare organizations of all sizes to better understand the patient journey, digital’s impact on patient and customer acquisition, and how to drive increased revenue and sales through digital means.

Find Carrie Liken on LinkedIn

About Yext Yext is the leading Digital Knowledge Management (DKM) platform. Yext’s mission is to give organizations control over their brand experiences across the digital universe of maps, apps, search engines, voice assistants and other intelligent services that drive provider discovery, patient decision and action. Today, hundreds of healthcare organizations -- including brands like Vanderbilt Health, Steward Health and OhioHealth -- use the Yext Knowledge Engine™ to manage their digital knowledge in order to boost brand engagement, drive patient acquisition and increase system revenue.

Healthcare Industry Page at Yext.com

Follow Yext on Twitter

Follow Yext on LinkedIn

Follow Yext on Facebook

Related and/or Mentioned on the Show * The Evolving Patient Experience - white paper / report * All of the #HCBiz Provider Directory coverage * The #HCBiz Show! Episode 63: Internet Marketing for Healthcare Practices | Garrett Smith | InboundMD

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Robotic surgery is a loaded term. Just reading the words can bring Hollywood-inspired images of fully autonomous robot doctors to mind. But that's not what's happening in the industry today. The "robots" are merely tools used by doctors, just like a stethoscope or a scalpel. And they have some interesting use cases and value propositions to health systems. For example, they can act as a great equalizer by helping young surgeons perform subtle movements that would otherwise take them years to perfect. But there's a flip side. Studies like this one from Stanford question the value of robotic tools that yield similar results and raise costs. There's truth to that, but as always, there's nuance and the headlines don't always mean what suggest. Imagine that.

On this episode, Shahid Shah and I are joined by Dr. Roger Smith, Chief Technology Officer for Florida Hospital's Nicholson Center for Surgical Advancement. Dr. Smith took a break from profiling surgical robots in his Robot Of The Day series to help us better understand how robotics are impacting surgery.

This is one of the more fascinating conversations we've had on the show, and it takes us out of our comfort zone. I hope you enjoy it!

Robotic Surgery: Business Cases, Benefits and Myths 2:25 What is robotic surgery? What can it do and what can’t it do?

4:40 Why are so many people afraid of this? Are hospitals not explaining this properly or are patients justified in being afraid?

7:00 What does the evidence say about robotic surgery outcomes? What’s the advantage that robots bring to surgical procedures? It’s all about the rate of improvement.

11:18 A brief history of robotic surgery and the need for updated terminology that segments the variety of robotic devices.

16:16 Assisted procedures vs autonomous robotics.

19:00 What happens to the patient when a robot malfunctions?

22:17 As we look forward to new robots, does the FDA effectively regulate the industry? Are there things the FDA is missing? Surgeons and device makers have different opinions.

27:57 Check out the Software As a Medical Device (SAMD) pre-certification process. The FDA is asking the robotics industry how they would like to be regulated! Submit your answers! Take this opportunity to help them ease your burden.

31:27 What is creating demand on health purchaser side? The 3 big benefits for hospitals

37:20 Cost is a hurdle to adoption. Without robot surgery CPT codes, hospitals get reimbursed the same with or without robots.

41:23 What other benefits do hospitals receive?

45:50 Which surgeries don’t need robots?

48:50 Where are the opportunities for innovation in robotic surgery? Who are the big players in robotic surgery?

About Dr. Roger Smith Dr. Roger Smith is the Chief Technology Officer for Florida Hospital's Nicholson Center for Surgical Advancement. He was previously the CTO for U.S. Army Simulation, Training and Instrumentation and a Research Scientist at Texas A&M University. He is also Graduate Faculty at University of Central Florida and President of Simulation First where he provides keynote event presentations and scientific lectures.

Roger Smith Linkedin

Robot Of The Day on LinkedIn

About The Nicholson Center For over a decade, the Florida Hospital Nicholson Center has trained more than 50,000 physicians from around the globe on leading-edge clinical and surgical techniques. Utilizing state-of-the-art surgical suites, and labs, plus advanced medical simulation robotics and learning centers, medical professionals can acquire and advance their skills in a highly collaborative surgical learning environment. Take advantage of the technology-enhanced operating techniques that are becoming the mainstay of tomorrow’s healthcare by training with the Florida Hospital Nicholson Center. We are one of the largest and most experienced medical learning and simulation incubation centers of its kind in the country dedicated to advancing next-generation clinical knowledge. Year after year, our hands-on training techniques have proven to provide key skills needed to advance your medical development and grow your practice.

Florida Hospital Institute for Surgical Advancement

The Nicholson Center White Papers

Related and/or Mentioned on the Show Useful website by a heroic anonymous surgeon http://surgrob.blogspot.com/

The da Vinci Surgical System - when most people think about robotic surgery, according to today's guest, this is the one they're thinking of.

New Studies Look At Cost And Benefits Of Robotic Surgery - University of Stanford researchers conducted a multiyear analysis and study with 24,000 patients with kidney cancer who needed laparoscopic surgery to remove a patient’s kidney indicated that the two approaches had comparable patient outcomes and hospital stays. Researchers analyzed data from 416 hospitals across the country from 2003 to 2015 for the study.

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Unanticipated high out-of-pocket prescription costs negatively impact patient safety and may lead to increased healthcare spending later. According to the Truven Health Analytics-NPR Health Poll for Prescription Drugs (June 2017), the most cited reason by respondents who did not fill their prescription was cost (67%).

Prior-authorization is another hurdle, and when it's required, according to today's guest, medication adherence drops precipitously.

In general, medication treatment failures due to a variety of issues, including medication non-adherence and friction from prior-authorization are a big problem in U.S. healthcare. Patients don't get the care they need and it costs the healthcare system an estimated $500-672 Billion each year (Note: It's often said that medication non-adherence costs $300 Billion - and I referenced that number on the show, but that's a bit hazy as this article explains).

The bottom line is this: administrative functions, high drugs prices, and increased out of pocket expenses for patients are creating friction between Americans and the care we need.

On this episode, Shahid Shah and I sit down with Surescripts CEO Tom Skelton, to discuss their Real-time Prescription Benefits and Electronic Prior Authorization services. When used together, they bring patient-specific medication prices and alternatives into the conversation between doctors and patients and reduce the friction between patients and the care they need.

We also talk about the many ways in which Surescripts has been a model for an industry seeking "interoperability". Their use-case driven approach is very instructive.

Some of the highlights:

1:24 Today we're talking about Medication Non-adherence and how it relates to the rising cost of prescription drugs.

3:09 Surescripts is a massive connector who digitized the medication management process and provides medication reconciliation at the point of care to provide patients with radical transparency for shared decision making.

6:14 One way we're fighting non-adherence is to eliminate friction.

10:00 The two things Shahid wants you to learn from Surescripts' example:

If you care about interoperability, you can make it happen.
Tie interoperability to a specific use case.

12;34 Physicians with inside knowledge of insurance still get burned by surprise costs when there is no transparency at the point of care. We need to start having discussions with providers about expenses.

14:50 Prior authorization causes a drop in adherence. A $10 increase in cost at the pharmacy has a significant impact on adherence. Physicians want instant answers to a patient's financial options.

18:29 The steps necessary to make data available to the patient:

Is the data available?
Can it be connected to the EHR?
Has the EHR presented the info at the time of care?
Is the physician using the info to start a conversation?

The answers to criteria 3 and 4 are the pressing issues of the day.

22:30 The biggest threat to question 4 is uncompensated care. Doing more work for no pay is not a tech problem, it’s a business problem.

26:30 When medication reconciliation was taking extra time, it helped the patient so insurance companies paid doctors for their time with the coordination of care code. There should be another code for financial discussions to drive medication adherence!

28:20 With the many other use cases of the data Surescripts collects, how do your partners gain consent from patients to use their data?

32:10 The Surescripts Network Alliance is rallying for access and connectivity.

35:25 A look at what else Surescripts is doing beyond prescriptions: National Record Locator and Exchange Service, Medical History consolidation, Insights for population health, extracting value from interoperability for care management.

38:08 Interoperability is use case specific. If you speak generally it seems insurmountable. You get alignment behind the use case. Physician price transparency happened quickly because people wanted it but there is a cost to raising the adoption curve.

42:15 National Patient Identifier is not the biggest hindrance to interoperability. Don’t look for the reason why it can't be done. Just solve the problem. Surescripts has been a catalyst for interoperability by focusing on the use case.

45:27 How do e-prior auths come into play with price transparency? Feedback in real time to see if you need prior auth for prescriptions. We make it more convenient for the patient so they don't have to make two trips to the pharmacy.

About Tom Skelton Chief Executive Officer, Surescripts

Tom is amazed by the changes he’s seen over the course of more than 30 years working in healthcare technology. Before joining Surescripts in 2014, he served as Chief Executive Officer of Foundation Radiology Group, a private equity-backed diagnostic imaging services firm that grew substantially under his leadership. His many other career accomplishments include serving as Chief Executive Officer for Misys Healthcare Systems and as a member of Elcomp Systems’ founding team.

LinkedIn: https://www.linkedin.com/in/skeltontom/

About Surescripts Our purpose is to serve the nation with the single most trusted and capable health information network, built to increase patient safety, lower costs, and ensure quality care. Since 2001, Surescripts has led the movement to turn data into actionable intelligence, and convened the Surescripts Network Alliance™ to enhance prescribing, inform care decisions, and advance the healthcare industry.

Website: https://surescripts.com/

Twitter: https://twitter.com/surescripts

LinkedIn: https://www.linkedin.com/company/395901/?trk=tyah&trkInfo=tas%3Asures%2Cidx%3A2-1-6

Blog: https://surescripts.com/news-center/intelligence-in-action/

YouTube: https://www.youtube.com/channel/UCVJajqk__-rDozGAPMXB-TQ

Related and/or Mentioned on the Show 2017 National Progress Report

Network Alliance video

How Surescripts is Accelerating Interoperability

Solutions by Surescripts:

Enhance Prescribing - Collectively Enabling Safer and More Affordable Prescriptions

Inform Care Decision - Arming Healthcare Professionals with Actionable Patient Intelligence

Advance Healthcare - Convening, Informing, and Advocating for the Healthcare Industry

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You'll get one email from me each week detailing:

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We've talked extensively about the problem with provider directories. It's a fundamental issue in healthcare administration and many of our processes are built on top of it. I've called it healthcare's ultimate death by paper cut. Now, we're starting to see new solutions in the market. Last week we looked at an open-source industry solution. This week we're looking at the statewide effort in California.

California's Senate Bill 137 (SB-137), the "toothiest" provider directory law to date, set the stage for a state-wide collaboration that would have been otherwise difficult to attain. Today I'm joined by Jon McBride, CTO at Integrated Healthcare Associates and Rajan Shah, VP of Business Development at Gaine Healthcare to learn more about California's Provider Directory Utility and find out what happens when you get the entire healthcare industry rowing in the same direction to solve a well defined problem.

3:25 The Integrated Healthcare Association convenes diverse stakeholders to solve industry-wide inefficiencies in a non-competitive environment to find common ground solutions.

4:45 What is the California Provider Directory Utility (PDU) and how does it affect me?

7:13 How does Gaine Healthcare's data management solutions work with Availity and Integrated Healthcare Association (IHA)?

9:13 The plumbing of the data points, finding relevant data sources, and going to where the data already is.

11:44 Big launch or small pilots? How does IHA plan to take on such a big project?

14:35 How tough are the regulatory hurdles? Is California working with you or against you?

17:12 What are the key metrics to demonstrate that you’re making progress?

19:10 Were there any difficult or surprising issues in bringing stakeholders together? What was your approach to solving a common problem without doing the same old thing that got us here in the first place?

22:15 Now that regulators are serious about enforcing this law, everyone is rowing the same direction. This is collaboration like we've never had before. We're building an industry utility that everyone will benefit from.

25:35 The money set aside to be used for this project was from the merger of Blue Shield and Care First. What’s the plan to keep it funded as a utility in the long run?

27:55 An overview of the solution. What is the PDU? Architecture, components and points of interaction.

31:50 The integration model. Are you really going to go to every provider in the state 1-by-1? Do you have the staff for such a large operation?

34:00 How do you deal with over 300 large provider organizations, more than 50 different managed care plans and thousands of mom and pop practice with widely different EHRs and not a lot of technical support?

36:30 What are you doing that helps you manage mass integration with smaller staff? How do you scale high touch? The tech platform plays critical role. We do all the integration. Health plans and providers don't have to change their process and won't need additional staff.

43:01 The power of effective regulation.

44:41 Soft launch. What is it? The 3 phases are data integration, day to day operations, and attestation.

51:00 This was the right time to get the problem solved. We have 40M people waiting on us and the benefits of fixing this problem will be huge!

The PDU is in soft launch through the end of 2018 and will be available to providers and health plans across California in early 2019.

Check out this CMA webinar about the PDU

About Jon McBride, MBA, Chief Technology Officer at Integrated Healthcare Association (IHA) Mr. McBride is a business-focused technology executive who has spent the last 25+ years working in technology endeavors, startups and innovative healthcare teams. Mr. McBride currently leads and builds mission critical systems as IHA's PDU CTO and as founder/CTO of Sunfish Health.

Mr. McBride previously founded Sunfish Health and Afoundria - and currently serves on both Boards; and served as startup CTO and CIO of Availity, building a technology platform that, at the time, grew to over 2 billion annual healthcare transactions and averaged more than US$1 billion per day in electronic healthcare claim submissions. Previously technology executive and software developer at several companies and ventures, including Lockheed/NASA, St. Jude Children's Research Hospital and Johns Hopkins.

Jon McBride on Twitter

Rajan Shah, VP of Business Development at Gaine Healthcare Mr. Shah currently serves as the Vice President of business development at Gaine Healthcare. His primary focus is centered around healthcare organizations, both payer and provider alike, looking to expand upon master data principles and healthcare interoperability. In the past, Mr. Shah has served as an Information Technology Director over clinical applications and innovation within a payer/provider delivery system focusing on electronic medical record solutions as well as health information exchanges. As a part of that, he focused heavily on analytic solutions that helped manage the health plan's population base.

Raj Shah on Twitter

http://www.gainesolutions.com/hc

About Integrated Healthcare Association Integrated Healthcare Association (IHA) is a nonprofit organization that convenes diverse stakeholders, including physician organizations, hospitals and health systems, health plans, purchasers and consumers committed to high-value integrated care that improves quality and affordability for patients across California and the nation.

With the support of industry leaders across California, IHA is leading the development and roll-out of a statewide Provider Directory Utility (PDU) to simplify the provider data management process, reduce administrative work, and make it easier for healthcare providers and health plans to meet requirements.

The California Provider Directory Utility Website

IHA website

IHA Twitter

IHA Linkedin

Upcoming events with IHA

Related and/or Mentioned on the Show How to Tap Existing Processes for Provider Data | Martin Dunn | Gaine Healthcare

A Provider-side Approach to Provider Directories plus SB-137 | Bill Barcellona (CAPG)

Provider Data: What is Known and What is Assumed? | Mark Martin | Availity

See all of The #HCBiz Show's extensive coverage of the Provider Directory problem

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We've talked extensively about the problem with provider directories. It's a fundamental issue in healthcare administration and many of our processes are built on top of it. I've called it healthcare's ultimate death by paper cut. Today we're going to talk about solutions. On this episode, I talk with Gunjan Siroya, Principal Partner at Netspective, about RosterSource. It's an open source industry platform that enables physician roster data exchange across systems and organizations, securely and in real-time.

0:00 Setting the stage for today's discussion on Provider Directories.

3:14 What is RosterSource? RosterSource enables you to communicate securely without additional burden to the provider or practice.

6:19 How do you send data from provider to payer without extra work? RosterSource created a platform for exchanging real time physician demographics through a centralized hub that can be accessed by whoever the provider allows.

8:37 Each practice or health system has a Node. This Node is software with a collector agent, extraction agent, aggregation agent, harmonization agent, and an access agent. Provider maintains complete control of their data.

11:30 Now, if everyone gets a node, everyone can communicate. Here is how the software works.

16:57 Aggregation is within that health system. There are many departments that require this data and each need different elements of the data within their own unique context.

19:38 Different health systems will have their data pulled in an EHR specific way. The harvesting agent is the only thing different in each Node. The software will send it to the node which then sends cleaned data to the database. The database sends contextualized data to whoever the provider has given access.

20:57 When your health system is Excel spreadsheet based, you’re very reactive to fixing data entry errors and you're not going to correct the mistake unless a bill bounces or a patient complains. With RosterSource, you're alerted earlier and accuracy improves. Care coordination and care management will be much simpler.

27:03 What happens to this data when it arrives in the database? Distributed network approach. Version control. When update is complete, everyone gets access to it.

31:05 There's no central repository. It's more like a subscription model for updates. Only exchanged between partners. Blockchain concepts without being blockchain. This scalable architecture means you'll never have to reconfigure your data or change your software.

37:51 What makes sure data is as clean as it could be without guessing what context is needed? Providers can set rules and give feedback for which data goes where and can use algorithms to flag records or guess which option is best.

43:30 How do you pull data with appropriate context? System or provider can pick and, based on workflows, can decide what to do. Can also integrate with other data sources to figure it out.

46:12 The level of detail can help payers more confidently direct and navigate patients.

50:45 Can utilize algorithms to customize how we decide who to trust for our data sources and even get records certified by providers as being correct.

54:33 This is a tool set that enables organizations to trade data, track data, and tweak algorithms over time. Managers can use this data for additional analysis.

55:53 RosterSource is an open source solution, with a membership based organization to drive feature development. All are invited. Individual contributors who want to share or integrate code, you can find us at RosterSource.github.io to find open source code, download software and configure software. Release date set for late August or early September.

About Gunjan Siroya Principal Partner at Netspective, Gunjan has 20+ years of experience as global business executive who blends innovative business development, technology, business operations, partner management, marketing and product management strategies to generate revenue and profit growth. Gunjan has helped build collaborative relationships, organizational capability, managed P&L and optimized bottom-line and has deep knowledge of technology services business applying multiple delivery models like Cloud / SaaS, Outsourced and staffing. Most recently, Gunjan was P&L head of Consumer Electronics vertical at HCL Technologies, a $4.5 B global organization, where he led the establishment of the Consumer Electronics business unit. Prior to that, Gunjan has led I.T., Engineering, Infrastructure and Business Process Outsourcing business units across Medical Devices, Payer and Healthcare, Retail, Financial Services and other industries. Gunjan has also ventured into entrepreneurship, leading product development and management of e-Commerce and online solution based business. Gunjan has an Engineering Degree in Digital Electronics.

Gunjan Siroya on LinkedIn

@gsiroya on Twitter

About RosterSource RosterSource as an Open source industry platform, enables physician roster data exchange across systems and organizations, architected to provide universal secure integration capability in real-time.

Healthcare Provider roster changes are difficult to capture and harder to share by a physician practice. Roster updates are done on EHR/EMR, RCM, HR system or maintained in a spreadsheet, but are not integrated with a physician practice website or with supported Health Insurance Plans. This lack of automation adds cost, reduces productivity and can lead to revenue loss or an unsatisfactory patient experience. Healthcare Insurance Plans are on the hook for CMS penalties, forcing manual cross checks for regular physician roster updates. Today’s approaches are inadequate, as they are error prone and add significant cost overhead to Plans and Providers.

RosterSource Platform solves this problem by bringing real-time provider roster data from various internal physician practice systems securely to authorized and practice approved RosterSource users on the RosterSource network. These users can be other peer physician practices or plans that individual providers have contracted with, for healthcare services. The history of all the roster changes including RosterSource address duplication, merger and conflict resolution of the physicians' roster is maintained.

Learn more about RosterSource at their website

RosterSource on GitHub

@RosterSource on Twitter

--- Related and/or Mentioned on the Show Explore our extensive coverage of Provider Directories

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$11.1 Billion. That's how much, according to the 217 CAQH Index, the healthcare industry could save by transitioning to fully electronic administrative transactions. The transactions are for things like claim submission, eligibility and benefit verification, pre-authorization, etc. These are clearly defined standards and many of them are widely adopted. This is real interoperability in healthcare and it's in place today. Yet, not everyone is participating. Why is that? How can we expand adoption and realize the tremendous value that's available for the taking? And what can we learn from this process to help us achieve real interoperability in other areas of healthcare?

My guests today Dr. Kristine Burnaska, Director of Research and Measurement at CAQH and Reid Kiser, Lead Researcher of the 2017 CAQH Index tell us how the CAQH Index measures the cost of administrative transactions in healthcare and gives us a detailed look into the industry's progress. More importantly, they help us to understand the tremendous opportunity we have in front of us.

NOTE: This is also the topic for the #HITsm chat on Friday, August 17th at 12 EST that I'm co-hosting with CAQH: The Cost Savings Opportunities on the Business Side of Healthcare – #HITsm Chat Topic

0:00 This is real interoperability in healthcare. Why isn't everyone on board?

2:13 Background on CAQH – Nonprofit alliance of health plans that acts as the convener, collaborator and catalyst for streamlining the business of healthcare.

5:34 The CAQH Index – The best measure of efficiency in the cost of administrative transactions between doctors and health plans.

10:11 The CAQH Index has informed operations staff how their facility measures up to the competition and makes the business case for administrative technology investments.

14:35 What did the 2017 report say? What are the types of transactions being tracked?

The 13 metrics: Claim Submission, Eligibility and Benefit Verification, Claim Status Inquiry, Claim Payment, Remittance Advice, Prior Authorization, Referral Certification, Coordination of Benefits Claim, Claim Attachment, Prior Auth Attachment, Enrollment and Disenrollment, Premium Payment, and Acknowledgements.

18:30 Electronic vs Manual Transactions.

22:20 What are Partially Electronic Transactions? An introduction to portals.

25:25 The 2017 Report: Why is claims submission 95% electronic?

30:04 The 2017 Report: What have prior authorizations not improved since 2008?

33:21 The dollar savings opportunity for improving prior authorization is $11.1B, $9.5B from provider side, and it's still growing. What are the numbers really telling us?

37:51 Why have high deductible health plans increased the number of manual transactions? Are we still going in the right direction?

39:05 Why certain organizations are adopting and some aren’t, who’s doing well, and what we learn from best practices.

42:55 Portals and Passover – why is this metric different than all other metrics? The increase in portal use is driving increase in manual transaction rates. Are portals a bridge or barrier to full automation?

48:13 Where does the report focus on in 2018? New topics include: Portal use, value based payments, vendor fees, and call inquires.

Like all CAQH initiatives, the CAQH Index is the result of an industry-wide collaborative effort. Health plans covering more than half of the commercially insured U.S. population and a wide range of healthcare providers contribute data on how many of the studied transactions they conducted throughout the year and how they conducted them. They are joined by vendors and other business partners in offering insights about dynamic market conditions driving decisions about use of administrative transactions. Government agencies and policymakers often contribute data and insight to the Index as well.

Advance the Effort. Health plans and healthcare providers can advance the effort by contributing data. For the 2018 CAQH Index, more data is needed to more completely benchmark the transactions currently tracked and to reveal insights about the evolving use of administrative transactions.
Every Contribution Adds Value. Every data contribution enriches the overall quality of the Index dataset. With richer data, CAQH can deliver increasingly useful insights, more precise measures of progress, and more accurate estimates of cost savings. All health plans and providers, regardless of adoption status, are encouraged to participate.
Receive a Customized Benchmark Report. Health plans and healthcare providers that contribute data receive customized benchmark reports. CAQH prepares and delivers a detailed analysis of organizational performance alongside national results to each data contributor.

About Kristine Burnaska, Ph.D. Director, Research and Measurement, CAQH Kristine Burnaska, Ph.D. is Director, Research and Measurement, at CAQH, a non-profit alliance of health plans and related associations working together to achieve the shared goal of streamlining the business of healthcare. Kristine manages CAQH Explorations and in that capacity is the lead researcher for the annual CAQH Index, which tracks the healthcare industry transition from manual to electronic business transactions and the related cost savings. Before joining CAQH in 2018, Kristine was the Director of Operations at the Health Care Cost Institute, where she focused on understanding and guaranteeing smooth daily operations of its price transparency initiative. She previously served the Health Industry Distributors Association as Director of Research and Market Intelligence and Abt SRBI as Director of Analytics / Consumer Insights. Kristine holds a Ph.D. in statistics and research methods from the University of Illinois at Urbana-Champaign.

Reid Kiser, MS Lead Researcher, 2017 CAQH Index Reid Kiser was the lead researcher for the 2017 CAQH Index in his former capacity as Interim Director of CAQH Explorations, the research arm of CAQH, a nonprofit alliance of health plans and related associations. An independent consultant with Kiser Healthcare Solutions, Reid is a former employee of CAQH. He managed the transition of the U.S. Healthcare Efficiency Index, the predecessor to the CAQH Index, to CAQH in 2012. Prior to his role at CAQH, Reid served in several capacities involving quality measurement and improvement for health plans and providers. He was an executive lead for Inovalon’s HEDIS Advantage™ and served as UnitedHealthGroup’s National Director of Clinical Excellence. He also served in a variety of capacities at NCQA. He holds a Master of Science in evaluative clinical sciences from Dartmouth.

About CAQH and The CAQH Index CAQH is a non-profit alliance of health plans and related associations working together to achieve the shared goal of streamlining the business of healthcare. The CAQH Index is the industry source for tracking health plan and provider adoption of electronic administrative transactions. It also estimates the industry cost savings opportunity, an amount that should decline as adoption and efficiency grows.

The CAQH Index is the authority on:

Claims-related administrative costs for medical and dental providers and health
plans.
Time consumed by providers.
Savings potential from conversion to fully electronic administrative transactions.
Trends in use of fully electronic (HIPAA), online portal, phone, fax, mail and
interactive voice response (IVR) transactions.

Related and/or Mentioned on the Show All resources below are complimentary and available at the CAQH website.

About the CAQH Index

The 2017 CAQH Index Report

Participate in the CAQH Index!

Follow and engage with CAQH on:
Twitter @CAQH
LinkedIn CAQH
Email at Explorations@CAQH.org

CAQH Soultions collaborates for shared utilities.

COB Smart helps coordinate your benefits.

CAQH Proview AKA the Universal Provider Datasource uses an intuitive, profile-based design, for providers to easily enter and maintain their information for submission to selected insurance organizations.

ENROLLHUB helps payers send providers electronic payments.

Sanctionstrack for automated sanctions monitoring.

CAQH Core drives the creation and adoption of healthcare operating rules that support standards, accelerate interoperability, and align administrative and clinical activities among providers, payers and consumers.

Use the Savings Calculator to estimate potential organizational savings by transitioning to electronic administrative transactions!

In addition, CAQH invites those who share its passion for reducing the cost, time and frustration associated with the business of healthcare to stay informed about this and other work at CAQH by signing up for its email newsletter.

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Controlling the transmission of infections isn't one person's job and it can't be measured with a few key performance indicators. It's breaking down barriers to allow for collaboration between all interested parties. And that's exactly what's being done at the Healthcare Infection Transmission System (HITS) Conference this September 18-20th in Nashville, TN.

Today I'm joined by Dr. Christine Greene, Principal Research Investigator for the Sanitation and Contamination Control unit of the Applied Research Center at NSF International and Dr. Kelly Reynolds, Professor and Chair of the Community, Environment and Policy Department at the College of Public Health, and Director of the Environment, Exposure Science and Risk Assessment Center at the University of Arizona. We discuss the challenges and opportunities in infection control and prevention as well as get a sneak peek of what's to come at this year's HITS Conference. Enjoy!

NOTE: Find extensive coverage from The #HCBiz Show! on Infection Prevention and Control

0:00 Aligning infection prevention and control with business reality.

3:13 Introducing Dr. Christine Greene and Dr. Kelly Reynolds

3:51 Background: How does HITS use their understanding of what impacts the survival and movement of microorganisms to reduce infection rates?

6:15 What’s the ROI for getting infections under control in your business?

9:22 The 2017 HITS conference worked with attendees to find key focus areas in infection control. How did people work together and what did the groups find?

12:20 Sentiment analysis, word clouds, and attendee feedback helped design this year's working groups, which include:

Air Transmission
Hospital Construction and Design
Hand Hygiene
New Innovation Adaption
Risk Assessment
Surface Transmission: Floors
Surface Transmission: Genomics
Water Transmission

15:20 Each of the 8 groups continues to work towards progress throughout the year.

16:26 How clean should a hospital be? The math to find quantitative cleaning goals.

18:46 All work groups will be presenting at fall conference. You can find updates on the HITS Consortium website and newsletter and InfectionControl.tips. Next step is research funding.

21:35 Do you want to reduce healthcare acquired infections? Product companies, monitoring companies, private practices and hospitals now have a way to help! Engage with HITS and get involved!

24:30 What’s new for 2018? Expanding HITS networking platform, exhibit hall, new products, talking with industry leaders and academics, poster sessions, lightning talks and more!

28:52 Infection prevention, EVS, facilities management, scientists, and industry suppliers will all benefit from attending! HITS is still accepting sponsors!

32:00 Who are this year's speakers? More than 20 experts from around the world!

38:29 Our sponsors are internationally recognized for their commitment, leadership, and passion for controlling and preventing infections world-wide. When we all come together, we become the catalyst for change.

This September step forward and join the HITS Consortium. Choose to make a difference in your field. Be part of the Catalyst for Change! HITS 2018 Conference

About Christine Greene, MPH, PhD Principal Research Investigator at NSF International

Dr. Greene is the Principal Research Investigator for the Sanitation and Contamination Control unit of the Applied Research Center at NSF International. She has over 10 years of experience in epidemiological and laboratory research. She holds a Ph.D. in Environmental Health Sciences and an MPH in Hospital and Molecular Epidemiology from the University of Michigan, Ann Arbor. Her academic research focus has been on healthcare pathogen transmission, pathogen environmental survival, hand hygiene, disinfection and biofilms which has led to multiple publications. At NSF International, Dr. Greene has been making strides to improve public health in the areas of infectious disease prevention and control in clinical, dental and community settings. Her work serves to improve the accuracy of environmental mediated infectious disease transmission modelling, strengthens current guidelines to control healthcare-associated infections and provides new insights that will stimulate innovative approaches to reduce the risk of biofilm-related infections, pathogen transmission and curtail the environmental persistence and transmission of infectious agents. Dr. Greene is a member of the NSF International 444 Joint Committee Standard – Prevention of Injury and Disease Associated with Building Water Systems and serves on the ISO TC 304 working group 3 as the project leader for the healthcare hand hygiene performance and compliance standard. She serves as a board member for The Infection Prevention Strategy. Dr. Greene is a co-founder of the Healthcare Infection Transmission Systems (HITS) Consortium – an organization that strives to break down silos in healthcare using a cross-disciplinary, systems approach to addressing the pressing issues around infection control.

About Kelly A. Reynolds, PhD Associate Professor at the University of Arizona

Dr. Reynolds is a Professor and Chair of the Community, Environment and Policy Department at the College of Public Health, and Director of the Environment, Exposure Science and Risk Assessment Center at the University of Arizona. She has over 30 years of experience in academia- specializing in tracking pathogen movement in healthcare environments and evolving predictive risk assessment models for determining pathogen spread, human exposure potentials, adverse health impacts and intervention efficacy. Dr. Reynolds has served as a principal investigator on numerous projects and published over 375 journal articles, book chapters and professional reports. In the last year, her work was featured in over 50 popular media outlets, including the Wall Street Journal, BuzzFeed and the Huffington Post. Most recently she co-founded the HITS (Healthcare Infection Transmission Systems) Consortium, utilizing her expertise in integrating academic research teams with medical personnel, clinical diagnostic laboratories, patients, industries and other stakeholders for a multidisciplinary approach toward research, communication and management efforts in infection prevention.

Additional information: https://publichealth.arizona.edu/directory/kelly-reynolds

About The Healthcare Infection Transmission Systems (HITS) Consortium The Healthcare Infection Transmission System Consortium is a not-for-profit organization serving the field of infection control and prevention. HITS takes a holistic perspective to targeting healthcare associated infections by including multiple disciplines in the conversation, including infection prevention, environmental services, construction and renovation, facilities management and engineering along with research scientists and industry experts. HITS focuses on the major avenues for pathogen transmission in hospitals: hands, surfaces, water and air. HITS provides the necessary, cross-disciplinary platform to share knowledge and engage in research regarding the prevention of healthcare-associated infections and promotion of overall hospital health.

About The HITS 2018 Conference The HITS 2018 Conference will be held on September 18-20th in Nashville, TN. HITS 2018 offers a unique forum for the exchange of knowledge and experience in the prevention of healthcare-associated infections and promoting “hospital health”. The 2018 HITS “Catalyst for Change” Conference is a working conference, bringing together research scientists, industry and healthcare professionals for an interdisciplinary and dynamic approach. We work together to understand and prevent the transmission of pathogens throughout the hospital facility through a collaborative effort that includes engaging in applied research. The conference is accredited as a provider for continuing education units (CEUs) through National Environmental Health Association (NEHA) and National Board of Public Health Examiners (NBPHE). Join us for this one-of-a-kind, multimodal event where researchers and experts from across disciplines will work toward identifying research gaps and applying data-driven methods in the field. Meet, greet and share ideas with the individuals and organizations who are growing and sustaining the industry as we explore creative and innovative solutions to this global problem. The full 2018 schedule can be found at https://hitsconsortium.org/2018-nashville/2018-schedule/

Check out highlights from the HITS 2017 conference: https://hitsconsortium.org/2017-hits-highlight-reel/

For media inquiries: https://hitsconsortium.org/media/

For more information, please visit the HITS Consortium website: https://hitsconsortium.org/ or email us: info@HITSconsortium.org

Related and/or Mentioned on the Show More on Infection Prevention and Control from The #HCBiz Show!

Using Barrier Technology to Stop the Spread of Infectious Disease – Rik Heller

Why Hand Hygiene Matters – Tamás Haidegger

Shining a Light on C. diff – Christian John Lillis

Lessons on Infection Control and Healthcare Sales from the Man with the High-Tech Pillow | David Woolfson

Redefining Sepsis | Michael Ackerman

Understanding Infectious Agents in the Environment | Dr. Syed Sattar and Bahram Zargar

The Patient Hot Zone | Darrel Hicks

Legionella: A Manageable Risk for Health Systems | Dave Purkiss and Joseph Cotruvo | Legionella 2018

HITS 2017 Conference Preview with Dr Christine Greene and Dr. Kelly Reynolds

Sepsis Episode with Mike Ackerman

Lesson on Infection Control with David Wolfson

Infection Prevention and Control with Niall Wallace and Michael Diamond

HIMSS18: Dr. Lucas Schulz | UW Health & ILÚM Health Solutions – We chat with Dr. Lucas Schulz, infectious disease and critical care pharmacist at University of Wisconsin Health. Luke is also an adviser to ILÚM Health Solutions – An infectious disease (ID) platform and real-time information service. We cover antimicrobial stewardship, clinical decision support & more.

The Infection Prevention Strategy (TIPS) – The Infection Prevention Strategy is a registered non-profit. We have created a model of information sharing that makes the process of vetting new technologies, implementing successful programs and inspiring innovation more efficient, more accessible, more global and more collaborative. Our global teams are driven by the firm belief that we should not have to wait years for promising innovations, ideas and processes to be implemented and accepted. Around the world, our teams develop trials and conduct pilot studies to aid in the discovery of successful research to market technological advancements.

InfectionControl.tips – The www.IC.tips journal is a Pan-Access, worldwide collective that extends globally and touches locally. We are a 100% volunteer-based organization. We do not accept advertising or influence. The articles and contributions on our journal are from volunteers, edited for accuracy and free of influence from special interest. We do not pay our authors. Our ISSN is 2369-7342. Our journal utilizes all the same depositories as other journals (ResearchGate, Google Scholar). However, unlike other journals the IC.tips platform is consistently marketed to over 500 groups in social media. We are the world’s largest global health platform for infection prevention and control. Our motto is: Free to Publish. Free to Access. Accessible Scientific Services.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
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How do you get everyone to stick to the strategy? With doctors, CEOs, and Congress all trying to move healthcare forward, where is the progress? This week's discussion dives deep into the components of making change happen. From shared understanding to aligned incentives, Stacey Richter from the Relentless Health Value Podcast and I explain why change is so hard and how to get everyone working towards a common goal.

0:43 Everything in the industry is viewed very differently by different parties. There are different, sometimes conflicting incentives for each party. When you understand their motivations, you start to understand why certain moves make sense.

2:57 If you don’t have a language you can’t have conversation.

4:43 Organizations are realizing they need to work together. If you can’t talk about shared priorities it’s really difficult to collaborate.

6:49 Transparency is becoming more known as consumers start to have access to pooled information. The cascade to transparency has started.

12:05 You’re not going to stop healthcare costs from going up for a very long time but that doesn’t mean that good things aren’t happening on the ground floor.

13:40 Once you pay for something, it becomes a priority. The linchpin is how fast can we get the economic incentives in place?

16:11 A few of the many reasons interoperability is a low priority for small practices.

18:06 Are you willing to help your competition if it’s what’s best for the patient?

19:29 How do you create environments where it’s safe to share patient information? HINT: If everyone does it, there's no competitive advantage.

25:20 "For every complex problem there is an answer that is clear, simple, and wrong." - H. L. Mencken

28:10 Is your bonus is tied to something that is counter to company goals?

30:20 Dr. Anne Beal said that her generation was defined by the haves and the have nots, now it’s the knows and the don’t knows. Knowing that info exists and having the tools to go out and find it are different but equally important.

32:37 Enabling doctors to do their jobs and a discussion on the need for evidence based clinical decision support.

40:14 It’s not technology, it’s good technology. If you don’t like a certain technology, have to awareness and patience to understand that it's probably not good technology.

42:23 C-suite strategy vs Short-term incentives

45:22 Create a culture where people follow the principles of the organization and feel safe to make mistakes.

48:02 Critical thinking is difficult and with a million priorities that are all fighting for attention we’re distracted and don’t have time to do the right thing. If we’re unable to find the space and time to put the patient at the center it’s all just words.

51:39 What an organization does is the result of a thousand tiny decisions. Put your foot down if you see someone making a decision against the best interest of the patient.

53:23 What feedback do you get? How do you see if what you’re doing is working?

Listen to the interview:

About Stacey Richter Co-President, Principal at Aventria® Health Group

Stacey has 20+ years as a health care strategist and innovator specializing in niche market engagement, raising above-brand performance, and HIT-integrated programs. She is the host of Relentless Health Value, a weekly interview podcast for leaders at payers, providers, employers, life sciences, health tech, and patient advocacy organizations.

About Relentless Health Value Podcast Relentless Health Value is a weekly interview podcast hosted by Stacey Richter since 2014. A dynamic health care entrepreneur and innovator, Stacey has spent more than 20 years mentoring clients and colleagues in the shared pursuit of health care value. Subscribe to the podcast and spend an hour with us every Thursday.

Relentless Health Value is the show that connects you with other health care leaders trying to achieve the triple aim of improving population health and patient experience, while managing costs effectively. Our mission is to help transform health care by breaking down silos and connecting disconnected parts of our industry. The first step toward collaboration is simply knowing what others are working on and wrestling to overcome.

Relentless Health Value is for business leaders working in payer and provider organizations, as well as for pharma, medical device, patient advocacy, and other health care businesses. It’s an ideal resource for health industry innovators and entrepreneurs or aspiring entrepreneurs who strive to improve health care every day. “No outcome, no income,” is the mantra we live by daily.

We all know the health care business is not, and has never been, an easy business. The barrier to entry is often high, the cost of doing business, equally high. Success is often a frustrating tangle of regulations, litigation risks, perverse incentives, and technology requirements.

However, those of us not daunted by the challenge can thrive in these times of great change. The Affordable Care Act has reset incentives ─ value over volume. Health care value has become more than an intellectual talking point. It is now a business imperative. We’re in an era of evolution and disruption. And while change breeds pain, it also is the genie of great opportunity.

Let’s get inspired. Let’s talk to health care leaders and innovators who are making waves in our industry and who can inspire us. Let’s hear from the boisterous and from those who are quietly achieving greatness. Let’s support those who can turn disjointed health care services into value-based systems. Finally, let’s join health care builders and disrupters who share our goals to reorder the health care universe.

Everyone working in the health care industry has a story to tell.

Related and/or Mentioned on the Show Relentless Health Value

On Twitter @RelentlesHealth

Stacey.Richter@AventriaHealth.com

QCHealth

Aventria Health

Dr. Anne Beal on RHV

Alex Jung on RHV

Joe Murad on RHV

Dave Chase on TheHCBiz

Thinking Fast and Slow

Word to the Wise: Think of 3 answers to a problem before you make a decision. This will buffer against knee jerk reactions.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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What a patient does at home during the time between doctor visits has the largest effect on the outcome of their care. The instructions doctors and nurses give patients at the point of care varies greatly and give health systems an opportunity. Stacey Richter, Co-President of Aventria Health Group and host of The Relentless Health Value podcast joins me to talk about her new company QCHealth and how patient education can have a huge affect on quality metrics.

2:04 Are we defining patient education?

4:02 What is outcome guided engagement?- care plan is series of outcomes, how do we get people to remember what we’re saying, sometimes they don’t remember appointments either.

7:30 What does evidence based medicine say are engagement opportunities along the patient pathway?

9:40 What needs to happen during that moment in time? Does the patient know the WHY behind their treatment plan?

13:20 Patient education is currently everywhere. It’s a commodity. But education needs to be medically accurate, culturally competent, the right language, ect. How do we reduce variability of care?

15:55 If patient education materials are from an association, often times it’s very disease specific and not patient or context appropriate. How do you treat a newly diagnosed patient vs some patient who has had the disease for years?

18:25 Nurses EHR skills to find the appropriate patient education is essential to get patient the info they need at the point of care.

21:07 The missing piece is patient education that facilitates movement through care plan and empowers the patient to be an advocate of their own care.

23:17 What strategies are there to address the patients that might not be willing or able to engage with their care plan.

25:30 Do docs and nurses think of this as high value care?

29:15 What QCHealth is focused on is ensuring the patient education is understanding the Why so that they can better contribute to their care.

35:22 Avoid unnecessary tests that may find conditions that would have otherwise not needed treatment.

37:57 Aventria is focusing on the shared priorities between different players in the healthcare marketplace.

42:19 We use feedback loops and gather context that helps us get your providers to be more engaged with patient education.

45:55 Getting the right information available at the right time for the practitioner to give it to that patient.

47:26 The missing link to engagement and what’s most important but always overlooked is the taxonomy in the care plan that gets you not just any information but the right information.

About Stacey Richter Co-President, Principal at Aventria® Health Group

About Aventria® Health Group Aventria® Health Group, LLC, is the parent company of Franklyn Healthcom, LLC; Pinnacle Health Communications, LLC; and QCHealth, LLC. The combination of these entities has created one of the largest, most experienced and innovative customer acquisition and engagement agencies serving large employers, pharmaceutical, medical device, and other health care clients. Providing a full continuum of services from access strategies to EHR-integrated pull-through, Aventria® represents an unmatched combination of expertise and creative/technological innovation.

Aventria® Health Group’s mission statement is “Making a difference in patient care by helping patients, providers, and payers collaborate on shared priorities.” For more information, visit aventriahealth.com.

About QCHealth™ QCHealth™ is a mission-driven organization dedicated to improving patient outcomes through patient education that is provider-friendly to use. The organization developed a uniquely simple technology to facilitate Outcomes Guided Engagements™ at key points within evidence-based care plans. With no business associate agreement or data exchange required, nurses and physicians can effectively counsel patients and encourage shared decision making. Patients are empowered, and providers are supported.

For more information, visit qc-health.org.

Related and/or Mentioned on the Show QCHealth

Aventria Health

Relentless Health Value

Stacey.Richter@AventriaHealth.com

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
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Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Patients are buying health insurance based on misleading information. Incomplete or incorrect provider directories can obstruct patients from accessing care. Additionally, the healthcare industry is building its administrative workflows on top of this bad provider data, creating all types of inefficiency. Today on the podcast I'm joined by Dara Price-Olsen and Tammy Weaver to discuss the LexisNexis and AMA collaboration on Provider Directories. We hear a story early on showing how easy it is to be fooled into purchasing a restrictive or needlessly expensive plan. We also get into the details on how claims data can give us new insights to help fix this problem.

Check-out our extensive coverage of the problem with and attempts to fix the Provider Directory issue.

2:02 Background of the provider directory issue: patient access and administrative burden.

4:50 Consumers are having coverage issues making it hard to shop for healthcare due to incorrect info.

6:44 The patient perspective. Inaccurate and misleading options could have real consequences.

10:36 When consumers need answers and neither doctors or health insurers can help, how do you handle this?

12:40 A 2016 audit found 45% of directory information was deficient enough to effect access to care. In 2017, 52% was deficient.

15:44 Why is the problem getting worse if there is so much focus and effort trying to fix it?

17:15 What are the issues that CMS found? 2.4% of providers need to update their information each month. That's 28% a year. You can’t just assume all 28% are going to call and update you.

21:45 What is Roster Inflation? How does this relate to Data Fidelity?

25:50 CMS enforcement actions are coming! Be able to demonstrate how you’re working on this problem.

28:43 Health plans should be using all the data available to them to solve this problem. Look at claims data to validate or flag what providers are telling them.

30:00 The AMA - LexisNexis Collaboration

33:10 Instead of driving outreach that costs money and increases administrative burden, use that data you already have.

34:50 Insights derived by claims data.

39:04 Who is customer and who will benefit from the collaboration?

42:42 VerifyHCP will streamline keeping your directory up-to-date.

47:47 Start with the low hanging fruit and become more and more automated over time.

49:10 The Frictionless System

About Dara Price-Olsen Dara Price-Olsen is the Senior Director of Product Management & Market Planning at LexisNexis. Dara is putting her 28 years of experience to use in developing a collaboration with the AMA to improve the dismal state of doctor directories. Dara received her BS in Computer Engineering from Iowa State University.

https://www.linkedin.com/in/dara-price-olsen-01b7911/

About Lexis Nexis LexisNexis® Risk Solutions provides customers with solutions and decision tools that combine public and industry speciﬁc content with advanced technology and analytics to assist them in evaluating and predicting risk and enhancing operational efﬁciency.

We use the power of data and advanced analytics to help our customers make better, timelier decisions. Our innovative solutions enable organizations to manage risks like identity theft, fraud, money laundering and terrorism, and prevent ﬁnancial crimes, and insurance and government beneﬁt scams. We help those without traditional credit histories obtain access to funds, assist agencies to ﬁnd uncollected revenue, and research ways to improve business outcomes for healthcare companies. We also work with law enforcement to solve crimes.

By bringing clarity to information, we ultimately help make communities safer, insurance rates more accurate, commerce more transparent, business decisions easier and processes more efﬁcient.

LexisNexis® Risk Solutions and its sister company LexisNexis® Legal & Professional are part of RELX Group, a global provider of information and analytics for professional and business customers across industries. The group serves customers in more than 180 countries and has offices in about 40 countries. It employs approximately 30,000 people of whom half are in North America.

https://risk.lexisnexis.com/

https://www.twitter.com/lexisnexisrisk

https://www.linkedin.com/company/lexisnexis/

https://www.facebook.com/LexisNexisRisk

About Tammy Weaver Tammy Weaver is the Director of Database Products Portfolio at the American Medical Association. Tammy is a results-oriented professional with robust product management, marketing and client relationship management experience. Tammy is adept at analyzing market trends, developing and executing business strategies. Demonstrated ability to generate new business, and manage and expand existing customer bases within competitive industries.

https://www.linkedin.com/in/tammy-weaver-a347b26/

About American Medical Association The American Medical Association is the powerful ally and unifying voice for America’s physicians, the patients they serve, and the promise of a healthier nation. The AMA attacks the dysfunction in health care by removing obstacles and burdens that interfere with patient care. It reimagines medical education, training, and lifelong learning for the digital age to help physicians grow at every stage of their careers, and it improves the health of the nation by confronting the increasing chronic disease burden. For more information, visit ama-assn.org.

https://www.facebook.com/AmericanMedicalAssociation

https://www.twitter.com/AmerMedicanAssn

https://www.linkedin.com/company/american-medical-association

Related and/or Mentioned on the Show White Papers:

Keeping directories up-to-date with VerifyHCPc

Unlock the Potential in the Claims Data You Already Have

Total Directory Resolution

Provider data accuracy with ProviderPoint

LinkedIn Articles:

Three Quick Ways to Test the Real Accuracy of Provider Data

The Doc is not in: The #1 problem with provider directories.

Webinar recording on YouTube:

Total Provider Directory Resolution | LexisNexis Risk Solutions

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Even the best doctors in the world can have their patients stolen away by savvy online marketing. Practices are doing their patients a disservice by not doing everything they can to prevent that from happening. In this episode, I sit down with Garrett Smith, CEO of InboundMD and author of Book Now! Internet Marketing for Healthcare Practices, to discuss how everyone from large practices to solo docs can improve their online marketing. Garrett lays out an easy-to-use checklist to rev your marketing engine from 0-60 in as little as 1 hour a week. Get ready to take notes. Your future patients will be glad you did.

1:00 How InboundMD provides an all in 1 marketing solution for healthcare practices.

3:27 Even if your patients search specifically for you, they’re going to see other docs right next to you. You STILL have to stand out. Two scenarios...

8:23 The patient decision-making process is not happening on your page. There are lots of online nooks and crannies. You must have a large internet presence.

10:11 If I have nothing, where do I start? How much of a difference does an online presence make?

12:50 Many docs don’t have a positive view of sales and marketing but if you’re the best option then the marketing that you do is helping your patients not fall victim to substandard care.

15:10 The Must Have List

18:27 If you’re not accepting new patients, does this still apply to me? Yes!

21:20 Signing up for new marketing services is not a 90 day sprint.

23:25 The provider who is planning on selling their practice, what should they do?

28:50 What size practices and what kinds of doctors should be marketing?

31:30 Where can practice manager go to get 360 view of internet marketing for their practice? This is the accessible and comprehensive guide. Get informed!

34:06 Doctors are overwhelmed, how can they maximize their time? Don’t go into it blind.

37:48 Start with personnel. Who is going to own the marketing in the practice? Second, what patients do you want to come into the practice?

42:47 A World-class Healthcare Website

44:40 Search Engine Optimization

47:33 Ratings and reviews will always benefit you.

49:14 The rundown and recap of low hanging fruit you must address for a good foundation.

53:40 Every provider is a subject matter expert. Enlist a guide to help you become a writer.

55:20 Mistakes are expensive. You need to know what to look for when hiring a marketing vendor.

About Garrett Smith Garrett Smith is an author, entrepreneur, and marketer. He is the Founder of InboundMD, a digital marketing service for healthcare practices that allows them to acquire patients, protect their practice's professional reputation, and engage patients with social content campaigns, all without having to be a marketing expert. Over the past decade, Garrett has successfully directed the internet marketing efforts for independent health practices, hospitals, and pharmaceutical companies across the US helping them to increase new patients, bolster their reputation, and establish themselves as leaders in their field. Follow him on Twitter @garrettsmith and @inboundmd.

About InboundMD InboundMD is an all-in-one marketing solution for private healthcare practices. InboundMD automates internet marketing for providers with an innovative software platform and creative services that allow healthcare practices to acquire desired patient cases, centrally manage their professional reputation and engage with patients through social content campaigns without having to be a marketing expert. For more information about InboundMD, please visit www.InboundMD.com.

About Book Now! Internet Marketing for Healthcare Practices The internet has changed the patient-doctor landscape forever. Searching for health-related information is currently the third most popular online activity, and more than half of adults in the United States use the internet as their first source for answers to their medical questions. Patients have access to more data, more statistics, more tools...and more choices than ever before.

Bombarded with information (or worse, misinformation) and overwhelmed with options, standing out to patients requires the modern medical practitioner to break free from the old way of thinking that said, “Practice great medicine and the business will take care of itself.” To thrive in the age of the internet, you must practice both great medicine and great marketing.

In Book Now! Internet Marketing for Healthcare Practices, Garrett Smith gives you a step-by-step roadmap to practicing great marketing and getting the most out of your online presence. After reading, you will know:

How to turn your practice website into patient appointment generating machine
How to ensure your practice has great visibility for related healthcare searches on Google
How to clean up your medical listings and inconsistent practice data on internet directories and maps
How to create a prolific online reputation, drive positive patient reviews, and respond to negatives
How to improve patient engagement through blogging and social media

“Few can bring the experience and insights into internet marketing that Garrett does. With patients heading online to find care now more than ever, he shows you exactly how to take advantage of the opportunities available to grow your personal brand, and practice, online.” - Dr. Michael A. Gott, Orthopedic Surgeon, Westchester Sport and Spine

"This is the definitive guide to internet marketing that health care marketers have been seeking for years. Garrett has saved you the trouble of Googling each topic one at a time; everything is here for you!" - Jared Johnson, Keynote Speaker, Manager of Marketing Technology, Phoenix Children's Hospital

Related and/or Mentioned on the Show Buy the book on Amazon at Book Now! Internet Marketing for Healthcare Practices

Visit the book website at HealthcareMarketingBook.com

Get the help you need for your practice at InboundMD or call at 800-818-7199

Follow Garrett on Twitter @garrettsmith

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Book Now! Internet Marketing for Healthcare Practices

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Having a great product is not always enough to be news worthy. It is much easier to get noticed at a conference when you know what journalists are looking for. On this episode, Shahid and I get a behind the scenes look at how to hack healthcare news. Jeff Byers, Associate Editor at Healthcare Dive, tells us how he spots trends, how to pick which conferences to attend and shares dozens of tips for how to get your company's story placed above the fold.

1:25 How you can reach out to get PR before a conference.

2:47 The journalist's conference to-do list: Writing, networking, industry knowledge gain, promotion, source building, assignments, interviewing individuals.

5:47 Categories of story topics for HIMSS vs HLTH

7:51 Does Healthcare Dive try to set the agenda for what everyone should be talking about or do you do more reporting on and explaining what is already out there?

11:10 Deciding which topics to write about is the biggest struggle. Do you write what you as the writer care about or what your audience cares about?

13:13 How to get a journalist to write about you: Know what they write about and know their audience. Pro-tip: Jeff's big on hospital trends.

14:44 How Healthcare Dive determines what trends are happening in healthcare.

17:00 Best resources for trend analysis.

18:50 Scheduling and preparing for meetings at conferences.

20:47 Get personal with your reporters. Ask them why they care about what they care about. Leads to unobvious answers. These are people. Build real relationships.

24:00 When starting a relationship with a reporter, don't make it transactional. Meetings don’t have to always lead to a story. Get on the radar.

26:40 Become a source, not a story. Being valuable will get you quoted more frequently.

29:22 Tips for reaching out to journalists and the nuances of following up.

33:47 Discussing details around current trends. Comparing HIMSS and HLTH. And the endless search for Hard News.

42:23 Everyone makes product announcements at conferences. Here's how you can get yours picked up.

43:37 What is Healthcare Dive working on now?

About Jeff Byers Jeff Byers is a healthcare journalist based out of Washington, DC. He is currently the Associate Editor for Healthcare Dive and covers hospital and digital health trends. He received his MPA from James Madison University and his BA in English from Virginia Commonwealth University.

Cheese & Crackers > Cake.

Follow Jeff on Twitter: http://twitter.com/jeffpbyers

About Healthcare Dive Our mission is to provide busy professionals like you with a bird's-eye-view of the healthcare industry in 60 seconds.

We cover industry news and provide original analysis. Throughout the day, our editorial team analyzes the top news stories and publishes in-depth feature articles. You can also use our site to check out industry events, jobs, and more.

Signup for Healthcare Dive's newsletter: https://www.healthcaredive.com/signup/

Check out Healthcare Dive's HLTH Coverage: https://www.healthcaredive.com/news/hlth-2018-what-happened-23andme-athenahealth-walmart/523190/ https://www.healthcaredive.com/news/geisinger-to-provide-free-dna-sequencing-for-patients/522915/ https://www.healthcaredive.com/news/andy-slavitt-town-hall-ventures/523118/ https://www.healthcaredive.com/news/change-healthcare-adobe-microsoft/523123/

Related and/or Mentioned on the Show Med Tech Dive (Coming Soon)

Biopharma Dive

Things Jeff is interested in: SDOH, smart cities, hospital consolidation, vertical integration, consumerism.

Contact Jeff if you're a provider or digital company with an interesting take on data ethics in healthcare. How do you view data in the post Cambridge Analytica era?

Catastrophic Care

Measure What Matters

Neil Versel

Conferences Mentioned

HIMSS, HLTH, Health IT Expo, Health 2.0, JP Morgan, Healthcare of Tomorrow, Health Datapalooza

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Measure What Matters: How Google, Bono, and the Gates Foundation Rock the World with OKRs

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Software that supports EMR needs to change and evolve at the same pace as medicine. Getting clinicians on the front lines the tools they need to make decisions is a team effort. On this episode, Shahid and I sit down with Dr. Betty Rabinowitz to talk about her new position as CMO at NextGen and how her team plans to improve the lives of those who practice medicine and those they care for.

1:16 Dr. Betty's journey from primary care to startup to Nextgen CMO.

4:40 How the physician perspective can improve the EMR implementation.

6:25 Should physicians be building software, advising the product team, or treating patients? Which physicians fit best into these roles?

9:03 The 3 tiers of tech-savvy clinicians. How do we ensure all voices are heard?

11:04 One of the main roles of a CMO in a software company is as a skilled guide who can filter the signal from the noise.

13:45 The most important focus for any med tech company: What’s best for the patient?

14:15 Analyzing evidence from usability tests. Selling ideas vs solving real problems.

17:10 Managing clinicians’ expectations of EMR.

19:24 Putting value-based population health into a fee-for-service EMR. Is being too early bad for business?

21:16 Fitting the EMR to the workflow doesn’t work when the industry doesn’t have a population health workflow. Is tech in the drivers seat for creating a pop health workflow?

24:40 We still don’t know how the patient wants to engage with their health.

27:00 Self-pay is driving new needs of transparency, shared decision making, patient choice. EMR needs to be actively involved and build into core offering rather than add-ons.

30:37 Pre-patients are the hardest patients.

32:50 What is it that EMR vendors are actually managing? Are they managing the person and their health or just the person’s health record? How do we give physicians visibility of everyone they will eventually be responsible for?

35:00 The number 1 question you need to ask your pop health vendor.

37:50 Are physicians ready to see behind the marketing curtain?

40:02 Insurance, whether it is commercial or government, has the best opportunity to build patient relationships and reach out with non-disease centered interactions.

42:27 Preassigned primary care physicians can start patient engagement early.

About Dr. Betty Rabinowitz Dr. Betty Rabinowitz was appointed as the NextGen Healthcare chief medical officer on April 19, 2018. She brings to this position more than 25 years of extensive clinical experience and expansive knowledge of population health and value-based practice transformation. In her role, Betty is tasked with helping NextGen Healthcare promote and improve our solutions in support of our clients’ provider performance, clinical outcomes, patient satisfaction, and financial efficiency.

Betty joined the NextGen Healthcare family in August 2017 as one of the founders and the former chief executive officer of EagleDream Health, the cloud-based analytics and population health management solutions we now know as NextGen® Population Health, which drives meaningful insights across clinical, financial, and administrative data to optimize ambulatory practice performance.

Born in Johannesburg, South Africa, Dr. Rabinowitz graduated from Ben-Gurion University Medical School in Israel, where she also completed a residency in Internal Medicine. She came to the United States in 1990 for a fellowship in Medicine and Psychiatry at the University of Rochester School of Medicine, where she became a professor of clinical medicine. In addition, Dr. Rabinowitz served as a medical director at the University of Rochester Center for Primary Care, overseeing clinical operations and population health management for a network of 28 practices and 130 primary care physicians.

About NextGen Through comprehensive soulutions degiend for healthcare providers, NextGen Healthcare is on a relentless quest to improve the lives of those who practice medicine and those they care for.

 We provide tailored healthcare solutions to fit the needs of ambulatory practices, as they strive to reach the quadruple aim while navigating the journey of value-based care. The result? Healthier patients and happier providers.

Main website: https://www.nextgen.com/

Leadership page: https://www.nextgen.com/about-us/leadership

Twitter: @NextGen

Facebook: https://www.facebook.com/NextGenHealthcare/

LinkedIn: https://www.linkedin.com/company/nextgen-healthcare-information-systems

Related and/or Mentioned on the Show NextGen Mobile

NextGen Connect Integration Engine

Dr. Jim Rickards formerly of Oregon State Health Dept

Mirth

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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In the rush to implement EHR and meaningful use, did we forget about interoperability? Congress thinks there should be more to show for the billions of dollars already spent on EHR. Now, they've asked the Office of the National Coordinator (ONC) to give guidance for the future. On this episode, Shahid and I sit down with Niam Yaraghi to discuss what TEFCA is and what it means for interoperability and the business of healthcare.

The problem with all this is that no one can clearly articulate what interoperability (or data blocking for that matter) is. In reality, healthcare has already solved interoperability about as well as any other industry. If you show me two parties who want to exchange data, and are willing and able to fund the effort, then I'll show you interoperability.

Further, there are robust regional Health Information Exchanges (HIE) throughout the U.S. And as I have said many times before, the regional HIE is the only near-term option to solving for interoperability in a way that resembles what everyone seems to be looking for.

TEFCA, in many ways, assumes these things aren't already working. And because of that it may actually impede efforts that are already on the path to success.

Summary:

1:20 What is TEFCA (Trust Exchange Framework and Common Agreement) and where did it come from? History lesson and overview.

5:40 Reaction to TEFCA may be based on your political tendencies.

7:37 There is an unreasonable expectation that the problem should have been solved even though no one can clearly articulate what interoperability means

9:15 Data integration happens because of BUSINESS interoperability between 1 or more workflows across organizations.

11:15 There is no business model in healthcare for businesses to do the right thing, so we have to create it.

13:05 The economic effects of not charging for sharing data.

16:17 Interoperability causes fears of patient leakage. It only works if groups come together with a common interest.

19:28 New York is an example of a healthy HIE market. Here is how TEFCA might change that.

21:55 HIEs are currently working best in markets that have a certain level of trust.

25:55 The best business models for TEFCA. Since the vast majority of healthcare is local, what are the costs and benefits of a regional vs national exchange?

30:45 Unreasonable expectations doomed TEFCA. Cut healthcare some slack.

33:08 Who pays your bills? If your patients are mostly Medicare, get ready to share your data. If you remember what happened after HIPAA, you know you need to hurry.

36:00 What should small and medium size businesses do about TEFCA?

40:28 What would Medicare for All mean for TEFCA? What if patients continue to pay a larger percentage? What if nothing changes? No matter what you’re going to need to share your data.

43:55 Do we even need a national network?

46:46 When we align priorities and incentives you’re going to be more profitable and no one will need to tell you to do the right thing.

49:40 The ONC should pick a small use case to show the industry how it’s done. Don't try to solve this all at once.

About Niam Yaraghi Niam Yaraghi s an assistant professor of Operations and Information Management at the University of Connecticut's School of Business and a non-resident fellow in the Brookings Institution's Center for Technology Innovation. His research is focused on the economics of health information technologies. In particular, Niam studies the business models and policy structures that incentivize transparency, interoperability and sharing of health information among patients, providers, payers and regulators. He empirically examines the subsequent impact of such efforts on cost and quality of care. Niam’s ongoing research topics include health information exchange platforms, patient privacy, and healthcare evaluation and rating systems.

He has a B.Sc in Industrial Engineering from the Isfahan University of Technology in Iran, and a M.Sc from the Royal Institute of Technology in Sweden. He received his Ph.D. in Management Science & Systems from the State University of New York at Buffalo.

Niamyaraghi.com

@niamyaraghi

Niam's call to action for the listener:

The state of privacy in healthcare is bad, but not as bad as you think! Federal privacy protection rules have helped with protecting privacy of many patients, yet the costs of implementing and complying with such rules are still unclear. We should realize that given the digitization of our lives, the borders around our private information are slowly fading away, and our individual responsibility and awareness about what we share with whom is our best bet in protecting our privacy. ~Niam Yaraghi

Related and/or Mentioned on the Show Our last episode with Niam Yaraghi

Drivers of information disclosure on health information exchange platforms: insights from an exploratory empirical study

An empirical analysis of the financial benefits of health information exchange in emergency departments

Network Effects in Health Information Exchange Growth

The benefits of health information exchange platforms: Measuring the returns on a half a billion dollar investment

A Sustainable Business Model for Health Information Exchange Platforms: The Solution to Interoperability in Health Care IT

Surescripts

Previous Episode Discussion Data Fidelity

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Electronic health records were built to help organize notes but only recently have developers begun to tap their true potential. Providers can now be aided at the time of service with actionable healthcare intelligence to support a variety of initiatives. From decision support to adverse event prediction, Adam Klass gives us a glimpse of how VigiLanz is improving care and saving doctors time.

This episode was recorded at the Health IT Expo. You can find more of our coverage of the conference here.

:30 Introduction to Adam Klass and VigiLanz – How we automate manual data collection.

1:09 What data VigiLanz helps collect and how do they use it?

3:11 Who does this help most?

4:24 The 3 Pillar Services – Infection Prevention, Pharmacy best practices, Antimicrobial Stewardship.

6:31 What’s coming next: Predictive intelligence and time of service alerts in your EHR.

8:43 What do administrators need to know? Your EHR was not built to help reinforce best practices.

10:04 How do you work with my EHR?

10:54 About Dynamic Safety Surveillance and the new web portal coming this summer.

11:46 Why vendors should come to the Health IT Expo.

About Adam Klass Adam Klass is the Chief Technology Officer at VigiLanz, a clinical surveillance platform that performs meaningful data analysis across the entire hospital. Adam has been with VigiLanz since its inception in 2001 and is one of the company’s founding members. He has expertise in designing, building and supporting large-scale data driven applications and is responsible for driving the technological vision of the company. Prior to joining VigiLanz, Adam held technical positions with DaVinci Software, Software Architects, and Red Sky Technologies. He holds a B.A. in political science from the University of Kansas, as well as an M.A. in Public Administration from the University of Illinois at Chicago.

https://www.linkedin.com/in/adam-klass-49450a5/

About VigiLanz VigiLanz is a privately held, rapidly growing provider of SaaS healthcare intelligence and predictive analytics. The firm is focused on aggregating disparate EHR transactional workflow and documentation data across health systems to identify real-time clinical issues that avoid or minimize harm, optimize clinical outcomes and support preventive care along the entire health system continuum. VigiLanz supports a large and growing community of hospital CMOs, CMIOs, CIOs, quality teams, infectious disease and control specialists, pharmacists, and other clinicians dedicated to real-time inpatient and outpatient care. VigiLanz is shaping the emerging era of real-time health care by delivering enterprise intelligence technology and services that improve clinical outcomes, patient care and operational effectiveness.

VigiLanz Infection Prevention

Dynamic Safety Surveillance

https://vigilanzcorp.com/

https://www.linkedin.com/company/vigilanz-corporation/

Twitter: @vigilanzcorp

Related and/or Mentioned on the Show Check out our extensive coverage of Infection Prevention and Control (IPAC).

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Music by StudioEtar

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How much money would your business lose every second your database is down? How long would it take to get it back up and running? Would you be able to answer these questions on your own? Probably not. That's why Jeff Garbus started Soaring Eagle Database Consulting. In this episode, Jeff takes us on a fast-paced journey through the ultimate data management insurance process and shares some of the most common issues CIOs get blind-sided by. Don't lose focus and get your pens out because you will be talking about this with your team first thing tomorrow.

This episode was recorded at the Health IT Expo. You can find more of our coverage of the conference here.

0:33 "I'm a database geek." - Intro to performance, tuning and scalability.

2:33 CIO’s call me and say, "Give me a check-up!"

3:10 What you don’t know about your data can hurt you! Top 2 things CIOs need to be thinking about right now, so it doesn't burn you in the future. Is your data retrievable? Data corruption used to be a bug or a bad entry but now it’s a hardware error and needs to be cleaned sooner than later.

5:09 Have your team build tools to find corruption in the database. Do it before you age out your backups. How much data are you prepared to lose is the answer to how often you should do a maintenance check.

7:35 Test your backups! Tell your team you lost a file and see what happens. If they can’t do it, it’s a problem. How to automate this process.

8:57 What to do if your data system just failed.

9:36 All about disaster recovery. How long does it take to restore a database? Is it time to get faster hardware? What's the business impact of being down?

10:47 Make sure application servers have backups too. They must be able to be brought back from off site. Here is your insurance plan.

12:00 The percentage of companies that close after a data failure is 65%!

12:20 Moving to the cloud only gives you data infrastructure. It provides no index rebuilds, no data management. What do you do without just shifting the problem downstream?

14:00 24/7 operational support can stop your DBAs from getting overwhelmed and reduce turnover.

17:00 How he wrote 20 books in 30 years! Details about his latest book Mining New Gold: Managing Your Business Data

About Jeff Garbus Jeff Garbus is the Co-Founder and CEO of Soaring Eagle Database Consulting. Jeff is responsible for the technical direction, vision, image, and long-term growth of the company.

Thirty-plus years ago when Jeff consulted around the country on complex database problems, he observed a need for software to track his client’s database performance from anywhere in the world. Thus, Soaring Eagle was born.

Since then, Jeff has grown Soaring Eagle Database Consulting into a multi-million dollar firm. An expert in MS SQL Servers and SAP ASE (formerly Sybase) SQL Servers, Jeff has written 20 books to date on these subjects in order to help businesses overcome their database issues.

Jeff holds a Bachelor of Science in Computer Science from Rensselaer Polytechnic Institute. When he’s not consulting on IT issues, Jeff enjoys playing poker and tennis, traveling with his wife, and spending time with his kids and grandkids.

SQL Server blog: http://mssqlperformance.blogspot.com/

Webinar rebroadcasts: http://www.youtube.com/user/soaringeagledba

About Soaring Eagle Database Consulting As a leader, you expect long hours at the office. They’re a hazard of the job. You are all too familiar with with the apologetic phone calls with the kids, telling sweet little Suzy you’ll be at her next dance recital, or promising Billy you’ll make his next soccer game.

Thirty years ago, our founder, Jeff Garbus, was a senior database consultant traveling the country helping exciting companies and interesting people solve their most complex database issues. He loved that the work he did allowed his clients to stop making those dreaded phone calls on account of database problems. What he didn’t love, was making the same phone calls himself.

One day it dawned on him. If he could develop software to track his client’s database performance from anywhere in the world, he could keep doing the work he loved without missing out on the little league games and school performances.

And so, Soaring Eagle Database Consulting ® was born. Jeff hired a team of expert developers and created a proprietary remote database reporting system called Flight. Today, Jeff and his team of DBA gurus still spend time traveling the world to help companies architect and implement database solutions, but now with the software and systems in place, his clients aren’t the only ones spending time enjoying the moments that matter most.

Our services include;

Database performance & tuning
Database design and scalability planning
Emergency problem solving
Migrations & Upgrades
Corrupt data restoration
Database Mentoring and guidance
Database Training & Education
Application Development
Contract and Permanent Staffing

Our managed services include;

Oversight db - Remote database administration Service 7x24x365!
rpm - Remote Performance Management

Soaringeagle.guru

https://www.youtube.com/user/SoaringEagleDBA

https://www.facebook.com/SoaringEagleDBA/

https://www.linkedin.com/company/soaring-eagle-consulting-inc-/

https://twitter.com/SoaringEagleDBA

https://plus.google.com/+SoaringEaglebiz

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Thinking about the endless paperwork, long wait times, and confusing bills at the doctor's can make even healthy people feel like their luck ran out. Just because it's not concierge medicine doesn't mean it can't be concierge service! In this episode Vishal Agarwal, Co-Founder and COO of CareCognitics, shares with us how his years in the casino industry have taught him to give patients the VIP treatment and make the doctor's office feel more welcoming.

0:51 What does CareCognitics do?

1:33 What can the casino industry’s loyalty program teach healthcare? A master class in the logistics of customer service. What does the casino do when it’s not your lucky day?

5:45 We know chronic conditions need to be managed. Why not give them the concierge service?

8:33 Loyalty programs, like healthcare, work best with the right incentives.

9:48 Which incentives do patients prefer and which incentives should doctors use?

11:40 How CareCognitics enables customer service that drives patient engagement.

14:40 Creating value for the patient: You’re competing with everything else they could spend their money on.

16:10 Members become proactive with a better doctor patient relationship.

16:52 Road to launch and success stories.

17:50 Coordination of care requires physician engagement. Which physicians will make the changes necessary to provide superior care?

About Vishal Agarwal Vishal is the Co-Founder & COO of CareCognitics. Prior to CareCognitics, Vishal was the Co-Founder & CTO of BeyondCurious an Innovation Consultancy. Vishal is a seasoned technology evangelist who brings over 20 years of experience in solving complex challenges and creating solutions that have transformed businesses. Vishal is a Silicon valley native and holds a Bachelors degree in Electronics Engineering from University of Mumbai.

https://www.linkedin.com/in/agarwalvishal/
https://twitter.com/vagarwal1

About CareCognitics We focus on patient relationships not just population health compliance. Sirona is our personal virtual health assistant that helps providers and Medicare beneficiaries better manage chronic care. Sirona not only helps foster a deep relationship with patients but also offers dependable chronic care management (CCM) while keeping costs low. Plus, Sirona is augmented by our experienced staff of medical assistants that are available 24x7 to drive Medicare compliance and provide the best quality of care!

https://www.carecognitics.com/
https://twitter.com/CareCognitics
https://www.linkedin.com/company/carecognitics/

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Leading healthcare providers are always looking for new ways to help their patients and bend the cost curve. New technology companies are always looking for early adopters to try their products. You'd think it'd be easier to match them up, but if you've been on either side of that equation then you know how hard it actually is. On this episode Vice President of Innovation at UCHealth, Julie Reisetter takes us through how her team finds the right partnerships for her health system. We also hear from existing UCHealth partners Borna Safabakhsh, CEO of AgileMD and Cole Sandau, CCO of Health Scholars on the innovative work they're doing and what it's like to partner with a health system.

This episode was recorded at the Health IT Expo. You can find more of our coverage of the conference here.

Julie Reisetter – VP of innovation at UC Health 0:00 Introduction to UCHealth

2:00 Origins of UCHealth and big problems they were trying to solve: Wayfinder into hospital, EMR user experience, VR for training

5:58 Running an innovative company

8:10 How UCHealth finds digital partners

10:30 Goals and milestones for partnerships with tech companies

www.uchealth.org

Borna Safabakhsh - CEO of AgileMD 14:00 Introduction to AgileMD. What is a Clinical Decision Support engine?

15:25 How does CDS integrate into your EMR system?

16:45 Roadmap to partnering with UC Health

18:55 Important differences between early customers for a Health Care IT company

20:21 Quality control for CDS and feedback loops to customize algorithms

22:22 What medium to large companies can gain from managing practice variation

www.agileMD.com

Cole Sandau, Chief Commercial Officer at Health Scholars 23:55 Introduction to Health Scholars. Clinical education and medical simulation: a true blended learning experience in virtual reality.

25:23 What kinds of simulations can doctors use to practice in? Fire in the OR!

28:10 The study published on this scenario had 250% improvement after VR training.

28:40 The ROI of simulating a “Never Event”.

32:28 The visceral experience of a VR. A richer education you'll never get from a textbook.

35:00 Why abstract concepts and non-repeatable events are best explained in VR.

37:40 How did you partner with UC Health?

39:35 Goals for partnerships and what the future holds.

www.healthscholars.com

About our Guests Julie Reisetter – VP of Innovation at UCHealth In 2016, Julie was selected as the University of Colorado Health’s first Vice President for Innovation where she oversees the activities of UCHealth’s CARE (Care Advancement through Research and Entrepreneurship) Innovation Center.

The CARE Innovation Center at UCHealth offers a comprehensive suite of resources and services designed to revolutionize healthcare with leading industry and startup partners. By combining the intellectual assets of the University of Colorado faculty and the clinical laboratory at UCHealth, the CARE Innovation Center is focused on developing, testing, implementing, and spinning out the next generation of digital technology and decision support science. The CARE Innovation Center team includes physician informaticists, engineers and data scientists working with clinicians who have unparalleled expertise in clinical care delivery, process improvement, implementation science, clinical informatics, and predictive analytics. A world-class team at the forefront of improving the way healthcare is being delivered.

Prior to joining UCHealth, Julie served as Banner Health’s first Chief Nursing Officer, Telehealth Services, within the Innovation division. In addition, she's had the opportunity to speak widely on a national level, including ACHE, HMA Executive Forum, NAHC, HealthLeaders Media and HIMSS and has served in a variety of advisory positions, including the AAMI Foundation National Coalition for Alarm Management and the National Coalition to Promote the Safe Use of Complex Healthcare Technology.

https://twitter.com/JulieReisetter

https://www.linkedin.com/in/julie-reisetter-19252a24/

Borna Safabakhsh - CEO of Agile MD Borna Safabakhsh is a software engineer and healthcare entrepreneur in Silicon Valley, and the cofounder and CEO of AgileMD, a digital health startup reinventing how physicians interact with clinical data and tools at the bedside. AgileMD’s clinical tools are used at over 300 hospitals by 50,000 healthcare providers to deliver high-quality care. While getting his MBA from Chicago Booth, Safabakhsh was recognized as "Most Promising Entrepreneur" by the University of Chicago and "50 for the Future" by the Illinois Technology Foundation. [Source: https://research.chicagobooth.edu/home/magazine/winter-2016/conversations/in-good-health]

https://www.linkedin.com/in/bornas/

https://www.agilemd.com/

Cole Sandau, Chief Commercial Officer at Health Scholars Cole Sandau recognized the need to advance immersive education and clinical training effectiveness. As Chief Commercial Officer, Cole is furthering Health Scholars’ vision is to develop the industry’s most effective and comprehensive enterprise platform to manage and orchestrate clinical education, disseminate best practices and enable cross-disciplinary collaboration – ensuring customers can deliver the very best patient care.

As the founder of Optera, Cole is the managing director, providing direction and vision to the company. Cole has extensive experience in market strategy and customer insight, including 20 years of practical, hands-on experience in developing and executing core marketing and sales programs.

Cole is a recognized industry leader in the design and execution of integrated marketing, value selling and go-to-market programs. He has pioneered the use of customer experience models as a business management framework and adapting experience models to multi-tier distribution models. Prior to founding the Optera Group in 2005, Cole played key market strategy and development roles within leading technology companies, including StorageTek, Sun Microsystems, Qwest Communications and SpectraLink.

Cole has degrees from the School of Management at Purdue University and attended the executive program at the University of Chicago Graduate School of Business.

https://www.linkedin.com/in/colesandau/

https://twitter.com/ColeSandau/

http://www.healthscholars.com/

http://opteragroup.com/

About Guest Companies UCHealth UCHealth is a nationally recognized, nonprofit network of 10 acute care hospitals and more than 150 clinics throughout Colorado, southern Wyoming and western Nebraska. With University of Colorado Hospital as its academic anchor, UCHealth is uniquely able to provide advanced treatments and innovative clinical trials, ensuring excellent care and outcomes for more than 1.4 million unique patients each year. UCHealth’s mission is to improve the lives of people in Colorado and beyond, and in fiscal year 2017, UCHealth spent $647 million on financial assistance, subsidized care and other areas to directly benefit patients and the communities it serves.

U.S. News & World Report has named University of Colorado Hospital to its Best Hospitals Honor Roll, a list of the top 20 facilities among almost 5,000 hospitals across the nation. The American Nurses Credentialing Center has awarded Poudre Valley Hospital, Medical Center of the Rockies and University of Colorado Hospital with multiple Magnet designations, representing the highest quality nursing. With a constant focus on quality and safety, including minimizing patient falls, hospital acquired infections, readmissions and other risks, UCHealth hospitals rank among the top 10 percent of facilities nationwide according to Vizient (previously called University HealthSystem Consortium).

The UCHealth Medical Group directly employs about 700 providers, and our partners at the University of Colorado School of Medicine employ an additional 2,800 providers. Thousands more physicians and advanced practice providers are affiliated with UCHealth and have privileges to practice at our community hospitals.

https://www.uchealth.org/
https://www.uchealth.org/about/innovation/

Agile MD At AgileMD, we are building the most advanced real-time predictive analytics and clinical algorithms platform for hospitals. Our cloud-based engine supports and empowers the medical decisions of thousands of physicians across hospitals and clinics around the country, so that every patient receives the highest quality and value of care based on the latest medical knowledge and data.

AgileMD is headquartered in San Francisco, California.

We are backed by Y-Combinator and Rock Health. AgileMD is funded with seed capital, awards earned by winning the Chicago Booth New Venture Challenge and the Chicago Biotech Consortium Competition, as well as strong revenue from our hospital customers.

https://www.agilemd.com/

Health Scholars Health Scholars was created in 2017, spun out of OSF Healthcare and their mission to bring healthcare led innovations to market. Health Scholars is headquartered in Denver, Colorado and has clinical and support operations embedded in the world-class Jump Trading Simulation and Education Center on the OSF Campus in Peoria, Illinois.

Health Scholars was founded by healthcare professionals who recognized the need to advance immersive education and clinical training effectiveness. Health Scholars’ vision is to develop the industry’s most effective and comprehensive enterprise platform to manage and orchestrate clinical education, disseminate best practices and enable cross-disciplinary collaboration – ensuring our customers can deliver the very best patient care.

http://www.healthscholars.com/

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You'll get one email from me each week detailing:

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Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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It is the Healthcare IT Entrepreneurs’ Dilemma. In order to become a Unicorn, you either have to survive or take a long detour around the Valley of Death, that strange netherworld where the value of your company can actually drop once you become marginally profitable. As counter intuitive as that may seem, it is strangely logical once you realize that valuation – especially in technologically innovative sectors – is rooted far more in “behavioral economics” than rigorous math. On this episode, Dexter Braff explains the phases of value a health IT company can anticipate and the challenges – and opportunities – it may face as it moves through them.

This episode was recorded at the Health IT Expo and is based on a breakout session by the same title that Dexter Braff led there. The description rove is adapted from the conference program.

Show Notes:

1:40 Who is Dexter Braff and the Braff Group

2:07 Stages of a company: Concept, Maybe Baby, There’s a there there, Breakout, Top of the World Ma!

6:10 Valley of death – Occurs between stages 3 and 4. Early investors get antsy, employees aren’t cohesive, management gets worried, it takes a lot of work to educate the consumer.

7:35 How to get the best valuation for the third stage company.

9:57 Unicorns have "unreal" valuations.

12:10 Why Unicorns don’t happen in healthcare.

14:38 How to find buyers who think you’re worth 10x revenue.

17:34 It takes a few offers to know what you’d ideally like to see happen.

19:49 Is it wrong to take advantage of a high valuation?

20:45 Adoption rates of Health IT and why valuation is hard.

22:07 Consumer driven healthcare is not a near term breakthrough.

22:47 M&A for Minicorns!

24:30 Decision making in uncertainty.

25:50 How fee for outcomes changed the opportunities for Health IT.

You can hear more from Dexter on three recent and very popular episodes:

Episode 28: How to Analyze the Health IT Market
Episode 30: Why You Should Always Be Preparing to Sell Your Company
Episode 40: Dexter Braff at HIMSS18

About Dexter Braff Dexter W. Braff is President of The Braff Group, one of the nation’s leading health care merger and acquisition advisory firms (source: Thomson Reuters). Since its founding in 1998, the firm has completed more than 300 health care deals.

With 30 years of experience representing health care service companies, Dexter is recognized as the industry expert in health care M&A. He has written and contributed to feature articles that have appeared in numerous health care industry publications and has written a chapter in the Handbook of Business Valuation published by John Wiley & Sons. He is frequently interviewed on various topics regarding health care mergers and acquisitions by news outlets including Bloomberg News, CNBC, USA Today, The Huffington Post, The Palm Beach Times, and numerous health care sector journals. Additionally, the firm is the publisher of marketWATCH, a quarterly review of mergers and acquisitions activity in six industry segments: Behavioral Health Care, Health Care Information Technology, Home Health and Hospice, Pharmacy Services, Urgent Care, and Home Medical Equipment.

Dexter has presented seminars, webinars, moderated discussion panels, and has been the keynote speaker on various issues regarding health care mergers and acquisitions and finance at conferences across the country including Art of the Deal, the Remington Think Tank, Health Care Capital Investors Conference, HME News Business Summit, HHFMA Financial Managers Conference, Treatment Center Investment and Valuation, Foundations: Moments of Change, Behavioral Health Care: Buying, Selling and Valuing, National Association for Home Care, National Home Infusion Association Conference, Homecare 100, Long Term Care 100, Medtrade, Urgent Care Association of America, and many more. He was recently inducted into The Home Care and Hospice Financial Managers Association Hall of Fame as “deal-maker extraordinaire.”

Dexter holds an MBA from the University of Pittsburgh, a Master of Science from the University of Oregon, a Bachelors of Arts from Cornell University, and received the Vincent W. Lanfear Award for academic achievement.

About The Braff Group The Braff Group is a leading mergers and acquisitions advisory firm specializing exclusively in health care services including behavioral health care, home health care, hospice, pharmacy services (home infusion, specialty Rx, institutional Rx), urgent care, health care information technology, health care staffing, home medical equipment, and ancillary health care services.

Unlike many brokers and investment sectors that work many sides of the negotiating table which can create conflicts of interest, we provide sell-side only transaction advisory services including representation, divestiture strategy, debt and equity recapitalizations, and valuation.

Since the firm’s inception in 1998, we have closed more than 300 transactions, more than any other mergers and acquisitions advisory firm covering these sectors.

In the Land of Unicorns, How do you Value a Health Care IT Company? Check out the article here!

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
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Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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When the promises of workplace wellness programs and population health analysis don't live up to expectations, lack of trust can stifle growth for the entire sector. Linda Riddell tells us how to bypass savvy marketing to help employers and health systems evaluate if vendors' claims match reality. Care Innovations' Validation Institute is rescuing outcome measurements by rigorously checking the math and methods before giving their stamp of integrity.

Show Notes:

1:35 – What is the Value Institute? – Review of outcome measures

5:50 – Meaningful outcome measures – Simple questions with big predictions

7:12 – The holistic approach to measuring the health of a population and how third parties work with employers.

9:50 – Direct vs. indirect measures of health in a population: challenges and expectations for employers

10:45 – Data protection, 3rd party vendors, neutral middle man, confidentiality

13:10 – Validation Institute origin story

14:45 – First customers and impact in the payer marketplace

17:07 – Helping data shine over marketing

18:03 – Breaking through the “conventional wisdom”, understanding clinical guidelines vs wellness guidelines

19:24 – Backing up health screens and fitbit challenges with real data: Accreditation vs. Validation

22:44 – Biggest opportunities in validating health claims – Standard Bearer: Morning Star, “Show me the CarFax”

24:10 – Employers need to watch out for intuitive and easy to track measurements with no objective, scientific validity

26:46 – Opportunities for health systems – financial risk contracting forces health systems to be more diligent and weary (‘measure sensitive’) than employers, should be doing their own analysis about what works, 3rd party can give feedback towards “getting to no” and alternative measures that would be more effective

29:25 – Health Value Awards

31:17 – Most exciting new idea – Integrated Musculoskeletal Care, link of overview of contestants

33:11 – World Healthcare Congress

About Linda Riddell Linda K. Riddell, MS is a Population Health Scientist and Independent Validator for the Validation Institute. Ms. Riddell has 30 years’ experience in health care, public and private health insurance, and health policy. Her company specializes in measuring outcomes for health and wellness programs, such as coaching, behavior incentives, and novel interventions. Clients range from state governments to private insurers to start-up technology companies. She is Strategic Initiatives Manager for Care Innovations Validation Institute, which peer reviews outcome measures for member companies. She has a master’s degree in health policy and management from the Edmund Muskie School of Public Service.

Linda's call to action to listeners:

Ask your vendor if their program has been validated by the Validation Institute. If the answer is yes, you know their promises are real; if not, send them to the Institute to get reviewed.

LinkedIn: https://www.linkedin.com/in/linda-riddell-557b2a13/

About The Validation Institute Helping people choose health and wellness programs that deliver measurable, positive results is the goal of the Validation Institute. The Institute's Trusted Community members have had their outcomes independently reviewed and validated. Our team of population health experts and bio-statisticians are a resource for program vendors who want to compete on the basis of outcomes and for purchasers who want effective programs.

Find more about the Validation Institute here: https://www.validationinstitute.com/

About The Critical Outcomes Report Analysis (CORA) Certification Consultants, brokers and others can get certified by the Validation Institute by studying the certification course curriculum and passing the final exam (Wellness that Works). The course awards four credit hours for health insurance brokers; credits for HRCI certification are underway.

This course will help you to understand population health metrics, and give you the tools to assess the validity of ROI promises and outcomes measures.

As the healthcare industry evolves so that the achievement of cost savings replaces the appearance of cost savings as the key outcome, individuals who understand the difference will be highly valued in the marketplace.

Certification course graduates have the option to join the Validation Institute's Trusted Community of Certified Professionals. This comes with a listing on our website and use of the Certification Logo. For more information, click here.

Find more about their certification course here: https://www.validationinstitute.com/validation-certification/

Find a certified professional here: https://www.validationinstitute.com/certified-professionals/

Related A Blueprint for the Next Generation Health Ecosystem | Dave Chase | The Health Rosetta

We talk with Dave Chase about Health Rosetta principles, plus their work with the Validation Institute on the Health Value Awards.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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The promise of AI-driven precision medicine creates confusion around what problems can be solved with data. After a lengthy career as an expert consultant helping industry leaders hone the scope of their big data projects, solutions designer Prashant Natarajan focuses our attention to what precision medicine can do by first defining what it actually is (and isn't). Prashant discusses the definition of precision medicine as he defined in Multidisciplinary Approach to Head and Neck Cancer, and gives the CIO advice on how to prepare their team and tool sets to put it into practice.

Show Notes:

3:25 Details on Prashant's current work, "Demystifying AI for the Enterprise"

4:13 What is Precision Medicine?

5:43 Important concepts in Precision Medicine.

11:20 Why Social Determinants of Health matter more than you think.

13:40 What is NOT Precision Medicine?

16:50 How Precision Medicine effects the healthcare analytics team.

21:25 What data does Precision Medicine use to develop the individualized risk profile?

24:00 Execution of feeding data into your models.

25:45 A list of data sources you should be collecting.

28:25 The goals of big data management and tools for health IT to accomplish them.

32:20 Training and skills for the CIO’s team.

35:00 All levels of providers will be affected and they will all need training too.

40:30 Practical applications for new machine learning trends and advances in Precision Medicine.

42:20 The best way to get feedback and how to know if interventions are working (i.e. feedback loops).

47:30 Prashant Natarajan’s new role at H2O.ai

51:10 Health AI uses and industry segments.

About Prashant Natarajan Prashant Natarajan is Senior Director & Product Maker at H2O.ai where he is responsible for AI solutions for industry verticals: health, life sciences, & government. He is passionate about helping healthcare organizations maximize their technology investments to improve personal wellness, care access & affordability, clinician satisfaction, and health policy. Prior to joining the H2O.ai team, Prashant contributed to award-winning roles as a product manager, domain specialist, and expert consultant at Oracle, McKesson, Siemens (now Cerner), Healthways, and eCredit.com.

His current areas of focus are health insurance, drug discovery & safety, precision medicine, population health, and opioid crisis. He is a recognized executive leader, industry/domain expert, and hands-on solutions designer. Prashant received his master's degree in technical communications & linguistics from Auburn University. He has an undergraduate degree in Chemical Engineering from Manipal University.

Prashant is a best-selling author and contributor to books on business intelligence, big data analytics, applied machine learning, and head & neck cancer. He is currently writing “Demystifying AI for the Enterprise” (2018), which separates reality from hype using validated use cases and best practices across multiple industry verticals.

Prashant is Industry Advisor for the California Initiative to Advance Precision Medicine (CIAPM) project at San Francisco VA. He is on the Board of Advisors at Council for Affordable Health Coverage, Washington DC. He enjoys teaching Applied Deep/Machine Learning & Artificial Intelligence as Co-Faculty Instructor at Stanford University, Palo Alto. Prashant also serves on Rutgers University's Big Data Advisory Board. He lives in Livermore, CA, with his wife, Vishnu; 6-year old, Shivani, baby Neel, and his Australian Cattle Dog, Simba.

LinkedIn: https://www.linkedin.com/in/natarpr/

Twitter: @natarpr

And checkout our last show with Prashant as well: HIMSS18: Prashant Natarajan | Demystifying Big Data and Machine Learning for Healthcare

About H2O.ai From their about page:

H2O.ai is the leader in AI with its visionary open source platform, H2O. Its mission is to democratize AI for all. H2O.ai is transforming the use of AI within all software with its category-creating visionary open source machine learning movement. More than 12,600 companies use open-source H2O in mission-critical use cases for Finance, Insurance, Healthcare, Retail, Telco, Sales, and Marketing. H2O.ai recently launched Driverless AI that uses AI to do AI in order to provide an easier, faster and cheaper means of implementing data science.

Learn more: https://www.h2o.ai/

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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The promise of an AI-lead precision medicine breakthrough casts confusion on what problems data can solve. After a lengthy career as an expert consultant helping industry leaders hone the scope of their big data projects, Solutions Designer Prashant Natarajan focuses our attention to what Precision Medicine can do by first defining what Precision Medicine actually is. Prashant discusses his contributions to a major textbook and walks the CIO through how to train your team and the tools that set them up for success.

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On this episode, we welcome back two long-time friends of the show to talk privacy, security and HIPAA. David Harlow and Niam Yaraghi join me and Shahid for a wide-ranging discussion that includes:

Niam's recent report: How HIPAA omnibus rules effectively reduced the number of data breaches among health care providers’ business associates
Europe's General Data Protection Regulation (GDPR) and how it applies to the U.S. healthcare system.
The difference between a systems approach and a data approach to security and privacy
How privacy might be seen as a facet of patient safety and how that could change the approach
Breaking down myths about the value of stolen health data (and some ways it can be valuable to organized crime)
Dealing with privacy when the business model is to share (i.e. the Facebook scandal)
How can we expect privacy when we are the product?
What can we / should we expect from companies like Facebook when it comes to privacy?
What is the privacy paradox?
Will more regulations help or hurt privacy?
What's the FTC's role in all of this? Plus the LabMD saga.
What's a digital health startup to do? All 4 panelists give advice to startups on how to deal with security and privacy. Hint: bake it in from scratch. It's not as hard, or expensive as you think.

About David Harlow DAVID HARLOW is Principal of The Harlow Group LLC, a health care law and consulting firm based in the Hub of the Universe, Boston, MA. His thirty years’ experience in the public and private sectors affords him a unique perspective on legal, policy and business issues facing the health care community. David is adept at assisting clients in developing new paradigms for their business organizations, relationships and processes so as to maximize the realization of organizational goals in a highly regulated environment, in realms ranging from health data privacy and security to digital health strategy to physician-hospital relationships to facilities development to the avoidance of fraud and abuse. He's been called "an expert on HIPAA and other health-related law issues [who] knows more than virtually anyone on those topics.” (Forbes.com.) His award-winning blog, HealthBlawg, is highly regarded in both the legal and health policy blogging worlds. David is a charter member of the external Advisory Board of the Mayo Clinic Social Media Network and has served as the Public Policy Chair of the Society for Participatory Medicine, on the Health Law Section Council of the Massachusetts Bar Association and on the Advisory Board of FierceHealthIT. He speaks regularly before health care and legal industry groups on business, policy and legal matters. You should follow him on Twitter.

http://davidharlow.me

http://healthblawg.com

@healthblawg

Niamyaraghi.com

@niamyaraghi

Niam's call to action for the listener:

The state of privacy in healthcare is bad, but not as bad as you think! Federal privacy protection rules have helped with protecting privacy of many patients, yet the costs of implementing and complying with such rules are still unclear. We should realize that given the digitization of our lives, the borders around our private information are slowly fading away, and our individual responsibility and awareness about what we share with whom is our best bet in protecting our privacy. ~Niam Yaraghi

Related * Why You Should Always Be Preparing to Sell Your Company (i.e. build a company that's worth owning) | Dexter Braff | The Braff Group - Dexter's take on how to build a valuable company is very relevant to today's discussion. As Niam said: look at security and privacy as a builder of trust. It's a business value, not a business expense. * Sharing Consumer Health Information: Look Before You Leap - This is David's post on the FTC complaint investigation that effectively put LabMD out of business. It's an ongoing story with all kinds of lessons for digital health companies dealing with consumer data. * Grindr breach reveals inadequacy of digital age privacy regulations - Niam breaks down the recent Grindr breach. This is an interesting use case too because it's a breach born in good intentions for the users. Good intentions do not shield you from privacy obligations and rules. * A New Story for Healthcare Security and Compliance w/ Niam Yaraghi - and #HCBiz video interview * Can CPC+ align Physicians, Payers and HealthIT? w/ David Harlow - and #HCBiz video interview * Trumpcare: Innovation, Speculation and What's Next w/ Niam Yaraghi - and #HCBiz video interview

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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We've always asked a lot of our doctors. Now we're asking them drive value based care. The question is, are we giving them the right tools and the right information to succeed?

On this episode we talk with GT LaBorde, CEO of IllumiCare. They've built a platform that empowers clinicians with real-time cost and iatrogenic risk data – at the point of care. Here are some of the key topics we discuss:

What's missing from our current healthcare economy and what problems does that cause?
Why has this problem persisted and what needs to be done about it?
Should doctors consider the cost of care?
What information should we give doctors at the point of care to help them make the best decisions for their patients?
How can doctors stay up-to-date on how much medications cost when they're changing all the time?
How much variation do you see in costs between similar doctors in different hospitals? In the same hospitals?
Is there any link between cost and quality in healthcare?
How do you effectively deliver additional information to providers at the point of care without disrupting their workflow?
How do you incorporate an effective feedback loop in your platform so that doctors can tell us what's helping and what's slowing them down?
Healthcare costs aren't just financial. There's a human cost too.
What is iatragenic risk and how do you reduce it?
How can we track and consider the cumulative effect of healthcare on a given patient?
How can you "do no harm" if you don't track and review the accumulation of potentially harmful things we've already done (i.e. radiation exposure from imaging over time)?
How does IllumiCare enable providers to drive value based care?
How does IllumiCare fit into and support a hospital business model?
What incentives are coming into play to limit payment in the outpatient setting?

About GT LaBorde GT LaBorde is CEO of IllumiCare, bringing nearly 20 years of experience in information technology to drive sales, recruiting and growth efforts for the company. He is a graduate of Louisiana State University, where he completed his law degree and practiced as an attorney before co-founding his first medical technology company, MedMined. GT is passionate about helping healthcare technology startups grow, currently serving as a consultant for Eastside Partners, a growth-equity investment firm in the Southeast. He is also a member of the Board of Directors for Hygia Health Services, a single-use medical device reprocessor that reduces healthcare costs and landfill waste for its client hospitals.

LinkedIn: https://www.linkedin.com/in/gtlaborde/

You can hear more form GT LaBorde on this episode of The Future of Healthcare podcast.

About IllumiCare IllumiCare was founded in 2014 in Birmingham, Ala., by a visionary physician and a team of hospital IT experts to help clinicians become better stewards of healthcare spending, creating an efficiency mindset in the healthcare system. With deep experience in the clinical, financial and technical aspects of hospital operations, IllumiCare created the Smart Ribbon, which combines actionable clinical and financial intelligence in a platform that has a very light technical footprint and does not disrupt a physician’s workflow. Today, IllumiCare’s Smart Ribbon is deployed in 9 U.S. health systems, 32 hospitals total.

Here are two studies that showcase real-world results of the Smart Ribbon listeners can check out:

http://www.illumicare.com/hospital-wide-deployment-at-a-community-hospital/
http://www.illumicare.com/large-hospital-study/

Listeners can schedule a demo of the Smart Ribbon at www.IllumiCare.com.

LinkedIn: https://www.linkedin.com/company/illumicare-inc-/

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If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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We're celebrating our 50th episode by interviewing one of my favorite healthcare thinkers, Dave Chase. Dave shares his vision for the next generation health ecosystem, and talks about the many ways the Health Rosetta is driving that change, including their involvement in the upcoming Health Value Awards. We cover a lot of ground, including:

Why we need to rethink business models that have been in place since World War II
Why you should never automate a broken process
Aligning what's right for the business of healthcare with what's right for the patient
How healthcare leaders can learn from what happened to the newspaper industry
What are the major push backs against the Health Rosetta concepts and are they being relaxed?
Why the employer healthcare market is the key to scaling fixes in the healthcare system
Why the health plan industry's worst nightmare is employers realizing they are actually the insurance company
How do we get employers to demand innovation in healthcare?
Why is selling into hospitals deadly for startups?
Why he tells CEOs they're running a healthcare business whether they like it or not.
How employers are unwittingly the biggest enabler of the opioid crisis
What are the Health Value Awards?
What's different about how the categories are being judged?

Dave's generated loads of great content on all of this. I highly recommend you checkout his work by clicking the links throughout.

Dave's ask to listeners: Download his book at www.healthrosetta.org/friends for free. Once you’ve read it, whether you like it or not, please write a review on Amazon.

About the Health Value Awards The Health Value Awards are a joint effort of the World Congress, The Health Rosetta Institute and The Validation Institute with the goal of shining a bright light on health care organizations, purchasers and individuals that consistently deliver significant value, relative to their peers, within health care niches and that promote essential price and outcomes transparency. On April 29th, the winners will be announced at the World Health Care Congress conference in Washington DC.

About Dave Chase and Health Rosetta Dave Chase is the Health Rosetta co-founder focused on the problem that healthcare has become an extractive industry taking resources from what drives 80% of outcomes (education, economic opportunity, public health, healthy behaviors, public safety, clean air and clean water). Recognizing we didn't get better lighting in homes and cities by optimizing oil lamp technology, the Health Rosetta is an open source blueprint for the next generation health ecosystem.

The LEED-like Health Rosetta Institute is focused on replacing the extractive sick care system. Health Rosetta Media highlights the collateral damage from the Extractive Era of healthcare and the tremendous successes & opportunities with Health Rosetta-type health plans.

The "CEO's Guide to Restoring the American Dream: How to deliver world class healthcare to your employees at half the cost" became a Kindle #1 best seller.

Chase is working on his next book -- "The Opioid Crisis Wake-up Call" -- outlining how the opioid crisis isn't an anomaly. Rather, it's a logical (& tragic) byproduct of a catastrophically dysfunctional healthcare system.

Health Rosetta replicates health economies that rebuild hope and community by massively replicating already-proven approaches that deliver Quadruple Aim success -- a much better care team experience leading to an improved patient experience which naturally leads to better outcomes and lower costs in high performing models.

Chase's TEDx talk "Healthcare Stole the American Dream - Here’s How We Take it Back" sums up healthcare's devastation of the middle class & redemption coming via a bottom-up movement. Chase has reached 750,000 people through his writing & speaking.

Chase was the Co-founder of Avado, acquired by & integrated into WebMD/Medscape (the most widely used healthcare professional site). Chase founded Microsoft's $2B, 28,000 partner healthcare ecosystem.

Chase is a father of two student athletes, husband & oxygen-fueled mountain athlete. He was a former PAC-12 800 Meter competitor.

Connect with Dave and learn more:

Twitter: @ChaseDave

LinkedIn: https://www.linkedin.com/in/chasedave/

Download the book at www.healthrosetta.org/friends for free. Once you’ve read it, whether you like it or not, please write a review on Amazon.

Learn more at Health Rosetta

Related * Health Benefits as a Strategic Opportunity | Chris Skisak | HBCH * Unbreaking Healthcare: The Big Heist Film Project * Making the Move to Direct Primary Care

Mentioned on the Show * Report: Global Digital Health VC Funding Hits Record $2.5B in Q1 2018 * Not your usual hospital ad: 'If our beds are filled, it means we've failed' * FDA permits marketing of artificial intelligence-based device to detect certain diabetes-related eye problems * Telemedicine Regulations with Nathaniel Lacktman * Amazon, Berkshire Hathaway, JP Morgan Healthcare Partnership

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You'll get one email from me each week detailing:

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On today's episode we're talking with Janae Sharp. Janae is a physician suicide survivor and the founder of the Sharp Index. The Sharp Index has a mission to reduce physician suicide and provide meaningful tools to improve provider quality of life.

The epidemic of physician suicide is costing us lives. Not only the lives of physicians themselves, but also patient lives. If we do not care for the caretakers, how many more lives will we lose to medical error? The cost of physician suicide has carried a heavy toll on me and especially my children. It is our hope that the system will improve, and that the physician community can have better support. Technology can enable the human connection necessary to combat the loneliness of burnout and grief at the loss of our doctors.

Janae Sharp, CEO, Sharp Index

Janae is on a mission to help physicians directly and to help healthcare organizations support their clinicians. We talk about:

Janae's story and why she decided to launch the Sharp Index.
How the Sharp Index works.
Why is there such a stigma around burnout, anxiety and mental health within medicine?
Why is it difficult to identify and address physician burnout?
Who is the Sharp Index for and how can they engage with it?
Why good mental health is great for business.
How putting providers first can actually improve the patient experience.
What's next for the Sharp Index?
How you can get involved
How you can help out

Good mental health is great for business.

Janae Sharp, CEO, Sharp Index

The Sharp Index is a not-for-profit startup aiming to solve a problem that impacts all of us. We're never going to transform healthcare, or improve patient experience without taking care of our caregivers. If you'd like to get involved, the Sharp Index has an opening on its board. Please contact Janae for details. If you'd like to contribute to this noble and worthy cause, then consider donating. Just click the Donate button on the Sharp Index home page.

Learn more about the Sharp Index:

Twitter

https://sharpindex.org/

And share your own story at https://www.mdsuicide.com/

About Janae Sharp

Janae Sharp is a physician suicide loss survivor and the Founder and CEO of Mdsuicide.com and the Sharp Index, a nonprofit dedicated to better physician mental health. She loves to match-make to solve problems. Her main work involves healthcare data and analytics marketing to improve healthcare outcomes for the under-served. Janae has learned to code in python, and enjoys making communication easier in tech production, but her true passion is in matchmaking companies to create elegant health IT systems and improve health. She has worked with interoperability and social determinants of health and is an expert on patient and physician engagement. Janae has three children, enjoys learning new things, hiking, triathlon, and quilting.

Find her on Twitter at @CoherenceMed or on LinkedIn.

You can also find some of her great writing here.

Mentioned on the Show

Stellicare - A turn-key, cloud based, HIPAA compliant software for clinicians to use with patients to decrease symptoms of depression, anxiety and other patient-centered topics like sleep and substance abuse.

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We're big fans of practicality at The #HCBiz Show! Don't get me wrong... we love disruptive innovation and cutting age tech as much as anyone, but we love getting things done RIGHT NOW a lot more.

We're glad there are smart folks out there building the tools that'll change the game in 10-20 years, but our job is to give you the information you need to get things done when you go to work on Monday. That's why you'll see us touch just lightly on the cutting edge, and then dig incredibly deep on the here and now.

So, it should come as no surprise to you that we're excited about today's guest and topic. On this episode, we talk with John Lynn, founder of Healthcare Scene and the brand new Health IT Expo happening May 30 – June 1, 2018 in New Orleans. The Health IT Expo is a conference that's focused on practical innovations that you can implement today as opposed to moonshot ideas that may affect you 10 years from now. That's beautiful. Isn't it?

John's a great interview and we cover a bunch, including:

What is the Health IT Expo?
What is practical innovation?
Why is it so hard to spread practical innovations across the healthcare industry?
How does practical innovation create space for a disruptive and break-through future?
What are you doing differently for vendors at the Health IT Expo?
How do you plan to facilitate collaboration among all the attendees and the vendors?
What is the "No BS Principle"?
What are you doing to ensure attendees get actionable takeaways and not just insights?
What does it mean to "go beyond the EHR"?
Why are health systems suddenly talking about ERP systems?
How can we keep the conversation practical, while still addressing the cutting edge tech that may someday drive disruptive innovation?

About John Lynn John Lynn is the Founder of Healthcare Scene. Healthcare Scene is a unique healthcare IT network which consists of 10 EHR and Healthcare IT blogs containing over 11,000 articles published over 11 years. Of those articles, John has written over 5500 of the articles himself.

These EMR & Healthcare IT related articles have been viewed over 18 million times and John has over 80k social media followers & 53k email subscribers who follow him as a thought leader in the EHR & Healthcare IT space.

John also led Healthcare Scene’s acquisition of the leading Health IT Job board, Healthcare IT Central. This included the acquisition of Healthcare IT Today, a unique career resource for healthcare IT professionals.

In 2014, John launched the first of its kind Healthcare IT Marketing and PR Conference (HITMC). Through John’s leadership, this conference has become the premiere venue for health IT marketing and PR professionals to learn and network with their peers. Plus, out of this conference, John has organized a strong community of marketing and PR professionals who are working to improve healthcare.

John has given keynote speeches and taught workshops across the country and around the world. John has spoken at the Healthcare Information and Management Systems Society (HIMSS) Annual conference 6 times and at conferences like CES (Consumer Electronics Show), SXSW, and CTIA – The Wireless Association along with keynote speeches at EHR user conferences include Modernizing Medicine’s EMA Nation and the gMed Summit to name a few of his speaking engagements. John has also taught multiple EHR workshops in Dubai with attendees from throughout the Middle East and Asia.

John co-founded Influential Networks and Physia and is currently a formal advisor to three healthcare IT companies. John was previously an advisor to docBeat which was acquired by Vocera.

John has 4 children and a beautiful wife that keep him grounded and remind him of what’s important in life. John loves to play competitive ultimate frisbee and dance. His love of dance is reflected in his Reality TV blog network which covers shows such as Dancing with the Stars, So You Think You Can Dance, and America’s Got Talent.

John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy and @ehrandhit and LinkedIn.

If you’d like to have John Lynn be a keynote speaker at your conference, please reach out to him with details and budget here.

You can hear more from John on this great episode of the Relentless Health Value podcast.

About Health IT Expo The Health IT Expo is a community of healthcare IT professionals focused on sharing, collaboration, and support. This event is focused on practical innovations that you can implement today as opposed to moonshot ideas that may affect you 10 years from now.

The five main themes for the conference will be:

Security and Privacy
Analytics
Communication and Patient Engagement
IT Dev Ops
Operational Alignment and Support

The conference is happening May 30 – June 1, 2018 in New Orleans.

Learn more at https://www.expo.health/ and register here.

Special Offer - Free Registration: If you're from a provider organization (hospital, health system, ambulatory practice, etc.), you can use the "HCBiz" promotional code for 100% off your registration. But hurry, the offer is only good for the first 10 people that use the code in the next 30 days.

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You'll get one email from me each week detailing:

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This interview is part of our HIMSS18 coverage and was recorded live on the showroom floor.

On this episode I talk with Nathaniel Lacktman, Health Care Partner and Chair of Telemedicine Industry Team and Digital Health Group at Foley & Lardner. He's also one of the nation's leading voices on telemedicine laws and business models.

Nate gives us a quick primer on why startups and entrepreneurs shouldn't put legal issues on the back-burner, especially when it comes to fraud and abuse. He tells us how we can avoid big problems down the road by coming up with a business model that establishes legally acceptable ways to grow and that takes the laws of all 50 states into consideration. This portion of the conversation echoed the advice Dexter Braff gave us a few episodes back about how to build a company that others want to invest in.

Nate also makes predictions about where the telemedicine market is headed. He's very excited about asynchronous telemedicine and makes a compelling case for how it can improve the patient experience and create new opportunities for doctors to work the way they want to. Nate knows that asynchronous telemedicine isn't the best approach in many healthcare situations, but it works really well in others and should be embraced there. For example, many protocol-based, decision-tree primary care activities are great candidates for an asynchronous approach.

Nate opened my eyes to a whole new world of possibility in telemedicine with this asynchronous approach. Give it a listen and let me know what you think!

~ Don

About Nathaniel Lacktman

Nathaniel (Nate) Lacktman is a partner and health care lawyer with Foley & Lardner LLP. He is the chair of the firm’s Telemedicine Industry Team and co-chair of the firm’s Digital Health Work Group. He advises health care providers and technology companies on business arrangements, compliance, and corporate matters, with particular attention to telehealth, digital health, and health innovation. His approach to practicing law emphasizes strategic counseling, creative business modeling, and fresh approaches to realize clients' ambitious and innovative goals.

Mr. Lacktman is regularly requested to speak on telemedicine nationwide by a variety of organizations. In addition, his skills are recognized by Chambers USA: America’s Leading Business Lawyers, where Mr. Lacktman has been listed as a notable practitioner from 2013 – 2017.

Mr. Lacktman chairs the Telehealth Work Group of the American Health Lawyers Association. He serves on the Executive Committee of the American Telemedicine Association's Business & Finance SIG. He is a chief legal counsel to the Telehealth Association of Florida and a Certified Compliance & Ethics Professional (CCEP).

Learn more:

Blog: https://www.healthcarelawtoday.com/

Profile: https://www.foley.com/Nathaniel-M-Lacktman/

Twitter: https://twitter.com/Lacktman

You can also hear from Nate on this interview with our friends at RED HOT Healthcare.

About Foley & Lardner LLP

From https://www.foley.com/about-us/

Foley & Lardner LLP looks beyond the law to focus on the constantly evolving demands facing our clients and their industries. With over 1,100 lawyers in 24 offices across the United States, Mexico, Europe, and Asia, Foley approaches client service by first understanding our clients’ priorities, objectives, and challenges. We work hard to understand our clients’ issues and forge long-term relationships with them to help achieve successful outcomes and solve their legal issues through practical business advice and cutting-edge legal insight. Our clients view us as trusted business advisors because we understand that great legal service is only valuable if it is relevant, practical and beneficial to their businesses.

On April 1, 2018, Foley combined with Gardere, Wynne & Sewell LLP. Foley & Lardner LLP operates as “Foley Gardere” in Austin, Dallas, Denver, and Houston, and as “Foley Gardere Arena” in Mexico City through its subsidiary, Gardere, Arena y Asociados, S.C.

You can find the rest of our HIMSS '18 Interviews here.

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You'll get one email from me each week detailing:

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This interview is part of our HIMSS18 coverage and was recorded live in the exhibit hall.

On this episode we talk with Stuart Goldberg, MD, Chief Scientific Officer at Cota. Dr. Goldberg tells us all about Cota's physician-led journey to organize and classify real-world evidence about every type of cancer. This effort led to something they call the Cota Nodal Address (CNA), and it's enabling health systems to get very specific about the types of patients they're treating, the costs associated with them, and the outcomes being achieved. This apples-to-apples comparison allows Cota to identify variation and address it in ways that are beneficial to the provider, payer and patient. It enables a concept Dr. Goldberg calls "Precision Payment", which in turn enables proper bundled payment design, and precision medicine.

And Cota is not only physician led, but the payers are on board too. Literally. Horizon Blue Cross Blue Shield lead their Series A funding round. Plus, they just closed a $40 Million Series C funding round in February. Cota is clearly a company to watch.

This was one of the most intriguing conversations I had at HIMSS '18 and one that I'll be exploring some more. I'm very excited to share it with you...

~ Don Lee

About Cota

Cota is a healthcare data and analytics company that enables providers, payers and life science companies involved in diagnosing and treating complex diseases to optimize the outcomes of individual patients and lower the overall cost of the patient population served. It is powered by the patented Cota Nodal Address™ (CNA) system, a unique digital classification methodology built by leading physicians and data scientists. The CNA is the first and only system that precisely categorizes patient factors, their diseases and intended therapies, enabling precision medicine at scale.

Cota's technology enriches medical records to create research-grade data and joins it with a suite of analysis, visualization and management tools. This enables providers, payers and life science companies to analyze, report on and research outcomes, costs, treatments and quality at any granularity and stage of the patient journey. The result is a constantly improving system that merges technology and medicine to improve the lives of patients everywhere. For more information, go to www.cotahealthcare.com

About Stuart Goldberg, MD

Stuart Goldberg, MD is Chief Scientific Officer at Cota, Inc. and Associate Clinical Professor of Medicine at Rutgers: The New Jersey Medical School. He also maintains an active clinical practice in the Division of Leukemia at the John Theurer Cancer Center. Dr. Goldberg obtained his medical degree at the Milton Hershey Medical Center of Pennsylvania State University. After completing internal medical residency and hematology-oncology fellowships at George Washington University Medical Center, he served as a BMT fellow at the Mayo Clinic and Associate Director of the BMT Program at Temple University. Dr. Goldberg’s clinical research has focused on new treatment strategies for patients with chronic myelogenous leukemia and myelodysplastic syndromes.

Recognizing the wealth of information contained in electronic health record data, he and his partners at JTCC founded Cota, a data and analytics company that seeks to optimize patient outcomes while reducing population healthcare costs. In the field of “big data” analysis he has used databases to redefine the incidence and complications related with myelodysplastic syndromes (published in JCO and Transfusion) and has reviewed observational databases (including SIMPLICITY) to foster adherence with evidence based CML monitoring guidelines (published in JOP, CRMO and CLML). Most recently he has used the Cota database to explore rates and implications of EGFR mutational testing among community oncologists (published in Clin Lung), patterns of care in T-cell lymphoma (published in CLML), end-of-life care decisions (published in Palliative Med) and cost-effectiveness of genomic profiling in lower risk breast cancer (published in AJMC). This research earned him the 2015 David King Clinical Scientist Award from the Association of Community Cancer Centers (ACCC). He is listed as a Castle Connolly Top Doctor for Medical Oncology in the NY Metro and NJ areas.

You can find the rest of our HIMSS '18 Interviews here.

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You'll get one email from me each week detailing:

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode we talk with Jay Holley, Head of Partnerships at Uber Health. As a founding member of the Uber Health team, Jay works to ensure that Uber can provide reliable, HIPAA-compliant transportation solutions striving to ensure that transportation is not a barrier to healthcare.

Uber Health partners with healthcare organizations to provide reliable transportation for patients. The dashboard allows healthcare professionals to order rides for patients going to and from the care they need. Jay and I discuss:

How it works
How HIPAA plays in
Servicing patients without smart phones
Who benefits and how
Jay's thoughts on a recent study that suggested ride sharing services didn't reduce no shows

Learn more at https://www.uberhealth.com/ and click the green Get Started button to enroll and start scheduling rides.

You can find the rest of our HIMSS18 Interviews here.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode we talk with Travis Moore, SVP of Market Solutions at Kyruus and Matt Gove, Chief Consumer Officer at Piedmont Healthcare, about provider data and patient access. We discuss how to address provider data inconsistencies across systems so that you can enable a better patient experience. Topics include:

Self-scheduling and why your patients are ready for it
Call-center scheduling
Doctor-to-doctor referrals and in-office scheduling
Why at Piedmont Quick Care Retail Clinics in Walgreens more than 50% of the volume is booked online.

The big take away for me is that patients are ready for online scheduling and they want to be seen on their own terms. This is evident in Piedmont's high online booking rates, a preference to have a scheduled time even at walk-in retail clinics and in how millennials seem to be embracing asynchronous telemedicine options.

About Travis Moore, SVP of Market Solutions at Kyruus

Travis Moore is Senior Vice President of Market Solutions at Kyruus, where he is responsible for working with existing, and future clients, to provide them with insight into how the Kyruus platform can be used to improve patient access. Prior to joining Kyruus, Travis was with Influence Health for 12 years – starting his career as a Sales Account Executive, then transitioning into the Director of Sales role, and later becoming the VP of their Sales / Product Specialty team. Additionally at Influence Health, Travis was VP of Product Management and Strategy before eventually focusing on the clinical aspects of the business as the SVP of Clinical Solutions and Sales. Prior to Influence Health, Travis was responsible for Product Management over the patient education and nursing solutions at Truven. Travis started his career in healthcare as a Pediatric Nurse on the Neurotrauma and Orthopedic unit at Children's Hospital in Denver, CO. Travis has his Bachelor's degree in Nursing from University of Wisconsin-Milwaukee and MBA from University of Phoenix-Denver.

Twitter: https://twitter.com/tmoore634RN

LinkedIn: https://www.linkedin.com/in/travis-moore-mba-rn-4651b11/

About Matt Gove, Chief Consumer Officer at Piedmont Healthcare

Matt Gove is Chief Consumer Officer for Atlanta-based Piedmont Healthcare, where he oversees marketing, communications, patient experience, community benefit and government relations for the seven-hospital system. As Piedmont’s Chief Consumer Officer, Matt shapes the system’s approach to healthcare consumerism, working closely with physician practices, hospitals and outpatient services to provide a better understanding of Piedmont’s customers, how to better meet the consumer’s needs around access and experience, and how the system can best use emerging technologies to engage consumers. Under Matt’s leadership, the Piedmont team has won more than three dozen local and national marketing awards since 2013, and he has been individually recognized as AMA/Atlanta Corporate Marketer of the Year and American Business Awards Marketing Executive of the Year.

Twitter: https://twitter.com/gove

LinkedIn: https://www.linkedin.com/in/mattgove3/

About Kyruus

Kyruus delivers proven provider search and scheduling solutions that help hospitals and health systems match patients with the providers best suited to care for them. The ProviderMatch suite of solutions—for consumers, access centers, and referral networks—enables a consistent patient experience across multiple points of access, while aligning provider supply with patient demand. The company’s proprietary provider data management platform forms the foundation of its solutions, powering them with accurate data by coupling data processing with administrative applications. To find out why a Better Match Means Better Care, please visit www.kyruus.com.

You can find the rest of our HIMSS18 Interviews here.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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On this episode, we chat with Prashant Natarajan, an innovation and product leader, best-selling author on Big Data, Analytics, Machine Learning and AI, and, if I do say so myself, an all-around swell guy! Prashant takes a very pragmatic approach to demystifying big data, ML and AI and shows us that it all starts with the data. He introduces us to the concept of data fidelity, which is the appropriateness of data for a purpose. That concept is so important to grasp. It allows us to get started where we are, drive towards value over time and enables us to get value from innovative tools like machine learning an AI.

We don't spend all our time in the data weeds. Prashant also tells us how we can operationalize big data, machine learning and artificial intelligence and align it with the current and future needs of healthcare. It can support us in our fee-for-service and value-based contracts. It enables consumerism and patient engagement. It can help employer groups drive change. In short, with data fidelity, big data/ML/AI become more than headlines and begin to drive real value in healthcare.

This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

About Prashant Natarajan Prashant is an innovation and product leader and a consultant with an award-winning track record of conceptualizing & delivering innovative solutions. He is a best-selling author on topics in big data, analytics, machine learning, AI and precision medicine. He is also a Senior Fellow at HeathITnow.

LinkedIn: https://www.linkedin.com/in/natarpr/

Twitter: @natarpr

About Demystifying Big Data and Machine Learning for Healthcare I find this book's practical approach to enabling big data and machine learning through proper data management to be very refreshing. It lays out many of the data quality and analytics concepts that it took me 15+ years to learn the hard way. I strongly recommend this book to anyone working on data and analytics problems in healthcare.

Description

Healthcare transformation requires us to continually look at new and better ways to manage insights – both within and outside the organization today. Increasingly, the ability to glean and operationalize new insights efficiently as a byproduct of an organization’s day-to-day operations is becoming vital to hospitals and health systems ability to survive and prosper. One of the long-standing challenges in healthcare informatics has been the ability to deal with the sheer variety and volume of disparate healthcare data and the increasing need to derive veracity and value out of it.

Demystifying Big Data and Machine Learning for Healthcare investigates how healthcare organizations can leverage this tapestry of big data to discover new business value, use cases, and knowledge as well as how big data can be woven into pre-existing business intelligence and analytics efforts. This book focuses on teaching you how to:

Develop skills needed to identify and demolish big-data myths
Become an expert in separating hype from reality
Understand the V’s that matter in healthcare and why
Harmonize the 4 C’s across little and big data
Choose data fidelity over data quality
Learn how to apply the NRF Framework
Master applied machine learning for healthcare
Conduct a guided tour of learning algorithms
Recognize and be prepared for the future of artificial intelligence in healthcare via best practices, feedback loops, and contextually intelligent agents (CIAs)

The variety of data in healthcare spans multiple business workflows, formats (structured, un-, and semi-structured), integration at point of care/need, and integration with existing knowledge. In order to deal with these realities, the authors propose new approaches to creating a knowledge-driven learning organization-based on new and existing strategies, methods and technologies. This book will address the long-standing challenges in healthcare informatics and provide pragmatic recommendations on how to deal with them.

Find it on:

Amazon: Demystifying Big Data and Machine Learning for Healthcare (Himss Book)

CRC Press

http://bigdatacxo.com/

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You'll get one email from me each week detailing:

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode, we chat with Sean Cassidy, Chief Product Officer at SA Ignite. We discuss MACRA, MIPS , and QPP strategy for providers and practices, changes to the MIPS program under the new federal budget, and the importance of establishing a culture of quality now, regardless of where MIPS is headed.

Spoiler alert... you're going to be in value-based programs one way or another.

About Sean Cassidy

Sean is an experienced health IT leader with a passion for incubating and growing data and analytics focused software businesses. Prior to joining SA Ignite, he led the development and growth of Charlotte based Premier’s enterprise analytics and ZirMed’s value based care businesses. As Senior Vice President and General Manager of Initiate System’s healthcare business, Sean was a member of the management team that successfully sold Initiate to IBM in 2010. After beginning his career at Andersen Consulting, he also held executive positions at a number of enterprise software and e-commerce companies. Sean leads SA Ignite’s strategy, product management, research & development and IT operations functions.

LinkedIn: https://www.linkedin.com/in/sean-cassidy-5b6791/

About SA Ignite

From their web site: https://www.saignite.com/

SA Ignite simplifies the management of complex value-based programs, helping healthcare organizations boost both their reimbursement and reputation. In today’s healthcare environment, SA Ignite’s advanced solutions give customers a competitive edge.

SA Ignite combines innovative, cloud-based software with in-depth regulatory knowledge. Our experts are frequently found meeting with healthcare organizations to understand ongoing business challenges, examining regulations to understand how they impact clinicians, and speaking at industry conferences and webinars to share critical information and insight.

You can find the rest of our HIMSS18 Interviews here.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
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On this episode, we chat with Dr. Lucas Schulz (@LucasTSchulz), infectious disease and critical care pharmacist at University of Wisconsin Health. Luke is also an adviser to ILÚM Health Solutions - an infectious disease (ID) platform and real-time information service that supports patient management decisions, quality programs, and better outcomes through:

Clinical collaboration and ongoing quality consulting
Program level insight
Point-of-care clinical decision support

Luke helps us to understand:

What it means to be an infectious disease and critical care pharmacist
How to establish an Antimicrobial Stewardship program and which health system teams/departments are involved
How a platform like ILÚM helps you move from anecdotal to evidenced-based medicine
How to deliver high quality care and simultaneously deal with the business and financial pressures of running a health system

This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

About Dr. Lucas Schulz

Dr. Lucas Schulz is the infectious diseases clinical coordinator and PGY2 Infectious Diseases residency program director at University of Wisconsin Health. Following graduation from the University of Wisconsin - School of Pharmacy, he completed PGY1 and PGY2 critical care residencies at the University of Wisconsin Hospitals and Clinics. In his current role, he is responsible for all anti-infective use across the UW Health enterprise leading the antimicrobial stewardship program at UW Health and is involved with all institutional committees pertaining to infectious diseases. He has served as PGY2 Infectious Diseases Residency Program Director for 7 years

His patient care, research, and teaching activities focus on antimicrobial stewardship, PK/PD optimization, hospital-acquired infections, and clinical decision support development. 32 peer-reviewed publications on infectious diseases topics. Currently serves on the Wisconsin Department of Health Antimicrobial Steering Committee, a panel member for the National Comprehensive Cancer Network guideline on prevention and treatment of cancer-related infections, and the programming committee for the Society of Infectious Diseases Pharmacists 2017 Annual Meeting. Active member of the Vizient Antimicrobial Stewardship Taskforce and Research Committee.

https://www.uwhealth.org/

https://www.uwhealth.org/antimicrobial-stewardship/

@LucasTSchulz

About ILÚM Health Solutions

ILÚM Health Solutions was created by Merck HSS and shares the vision to improve health and well-being. ILÚM is a specialized service focused on the unique challenges of infectious disease with the goal of supporting improved patient and hospital outcomes. Their technology-enabled solution helps leverage HIT assets to maximize the impact of quality programs.

ILÚM Health Solutions aims to help hospitals and healthcare institutions:

Efficiently target patients and accelerate time to interventions to make improved empiric treatment decisions
Efficiently and consistently track performance, prescribing, and patient outcomes
Enhance timely communication and clinical collaboration within workflow

https://www.ilumhealthsolutions.com/blog/

@ilumhealth

You can find the rest of our HIMSS18 Interviews here.

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode we catch up with Dexter Braff of The Braff Group. Dexter shares advice for Health IT entrepreneurs on how to stay focused while big players keep making big announcements. And there have been plenty of big announcements:

Apple Health Records
Amazon, JP Morgan Chase, Berkshire Hathaway Partner to disrupt healthcare
Uber and Lyft want to take you to the doctor
The Whitehouse has a new plan for interoperability
Apple is launching its own medical clinics

Dexter tells entrepreneurs to pay attention, stay focused and don't panic, plus a lot more good advice.

You can hear more from Dexter on two recent and very popular episodes:

Episode 28: How to Analyze the Health IT Market
Episode 30: Why You Should Always Be Preparing to Sell Your Company

And, checkout the rest of our HIMSS18 Interviews here.

Since the firm’s inception in 1998, we have closed more than 300 transactions, more than any other mergers and acquisitions advisory firm covering these sectors.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode, we chat with Miki Kapoor, President of Tea Leaves Health. We discuss:

How consumer engagement is driving health system strategy
The challenge of balancing fee for service and value-based revenue streams as the system continues to transform
The importance of establishing a direct and continuous feedback loop with your patients.

Checkout the rest of our HIMSS18 Interviews here.

About Miki Kapoor

With two decades of experience exclusively in healthcare – operations, finance, strategy and policy – Miki Kapoor has a notably broad perspective on the U.S. healthcare system.

Most recently, Mr. Kapoor was the President of Everyday Health, a publicly-traded company that was acquired in a $465 million transaction in 2016. As part of aggressively scaling Everyday Health while moving the company toward utilizing vast amounts of consumer and medical data for effective patient and physician communication, Mr. Kapoor acquired Tea Leaves Health for Everyday Health in 2015. Today, Mr. Kapoor serves as Chief Executive Officer of Tea Leaves Health.

Mr. Kapoor’s experience also includes serving as Head of the Global Payer & Provider Division as well as Global Head of Strategy for IMS Health, having joined as part of the $5 billion take-private of IMS Health. That transaction later resulted in the IPO of the company in 2014, in what is considered one of the most successful and largest turnarounds in healthcare private equity history. He has served as Senior Expert for McKinsey & Company and Executive Vice President, Health Systems and Health Finance for the Clinton Foundation while living in Africa and India. He started his career with almost a decade on Wall Street as an investment banker focused on payers and providers, healthcare information technology, and healthcare services.

Miki Kapoor attended graduate school at Yale University, where he received both an MBA in Finance and an MPH in Health Policy. He is a graduate of Washington University in Saint Louis, where he received a bachelor’s degree in biological sciences. He is a Fulbright Fellow, formerly a visiting professor at two universities, and sits on the boards of several healthcare organizations. He is passionate about public and private healthcare and believes there are substantial and achievable improvements that can be made to change the quality, access, and cost equations for patients.

About Tea Leaves Health

Tea Leaves Health, a Welltok company, transforms the way healthcare executives manage their business through a platform that provides the total information awareness and business intelligence needed to achieve strategic growth, effective physician engagement strategies and increased revenue. Tea Leaves Health combines a deep understanding of healthcare business development with the technical savvy to deliver strategic success for healthcare organizations of any size. The proprietary Patientology™, Physicianology™ and Decisionology™ software tools easily transform internal and external data into immediately actionable information for multiple leadership levels. While working with clients to develop measurable and successful growth initiatives, Tea Leaves Health strives to provide the best software, strategic consultation and support in the industry.

Tea Leaves Health joined the Welltok family in 2017. Welltok is the leading consumer health enterprise Software as a Service company that enables population health managers to target and connect consumers to personalized health improvement resources, helping individuals achieve and sustain their optimal health.

Today, Tea Leaves Health is one of the largest strategic growth vendors and works with over 500 hospitals including 8 of the top 20 hospitals in the country.

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode we chat with Matt Fisher (@Matt_R_Fisher), Healthcare Corporate Regulatory lawyer, host of Healthcare de Jure and HIMSS 18 Social Media Ambassador.

You can find all of our HIMSS '18 Interviews here.

About the Healthcare de Jure

Tune in as we serve up the hottest healthcare issues of the day, all from a legal point of view. From public policies and Federal initiatives to privacy and security, join host Matt R. Fisher as he and his guests discuss a smorgasbord of topics, giving hospitals, physicians, vendors and patients a seat at the table. Matt’s virtual conversations can be listened to on demand or heard on air. So don’t miss a minute of what’s on the menu.

About HEALTHCARENOWRADIO.COM

HealthcareNOWradio.com is an Internet radio station operated and produced as part of Answers Media Network. The station offers interviews, commentary, discussions and speeches from industry leaders in healthcare and health information technology.

Subscribe to Weekly Updates

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You'll get one email from me each week detailing:

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode we chat with Brian Mack, Manager, Marketing and Communications at Great Lakes Health Connect and HIMSS 18 Social Media Ambassador.

You can find all of our HIMSS '18 Interviews here.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
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Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode, we chat with Mr. Workflow, Chuck Webster (@wareFLO). If you're at HIMSS then Chuck needs no introduction. He's the one that 3D printed that glitter tiara on your head :)

For everyone else, Chuck is THE workflow expert and has been evangelizing the value of workflow and business process management in healthcare for a long, long time. He's also a social media innovator who's always testing out new stuff like blab, periscope (he put me up on a 360 live cam while I was working on this post in the HIMSS press room), and now VR.

Chuck is 1 of 20 HIMSS 18 Social Media Ambassadors.

Check out Chuck's work at the Healthcare Business Process Management blog. And be sure to follow him on twitter at @wareFLO.

HIMSS '18 Coverage

Checkout the rest of our HIMSS18 Interviews here.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode, we're talking with Kelly Thompson, CEO of the Strategic Health Information Exchange Collaborative (SHIEC) and Dan Chavez, Executive Director at San Diego Health Connect.

About the Strategic Health Information Collaborative (SHIEC)

SHIEC is a national collaborative representing health information exchanges (HIEs). The organization already represents 60 HIEs, and these HIEs collectively cover more than 200 million people across the U.S., well over half of the American population.

http://strategichie.com/

@SHIEClive

About Kelly Thompson

As SHIEC CEO, Kelly Hoover Thompson is responsible for working collaboratively with SHIEC’s members and board of directors to develop and actively advance an organizational strategy that ensures SHIEC’s success. Her goal is to elevate the awareness, stature, and perception of HIEs on the national healthcare landscape.

Before joining SHIEC, Thompson was Deputy Secretary at the Pennsylvania Department of Health. While there, she created a new long-term care partnership in care delivery and oversight. Under her leadership, the eHealth Partnership achieved statewide connectivity, offering electronic health information exchange in every county of the Commonwealth. She also co-founded and led the Commonwealth’s Privacy and Security Practice Group.

Prior to this, Thompson was a senior advocate of policy and regulatory matters for the Hospital & Health System Association of Pennsylvania. In that role, she advised providers on health policy, regulatory and legislative matters. She established the Annual Organ & Tissue Donation Hospital Campaign and was a primary drafter of the Commonwealth’s deemed status legislation, aimed at ensuring timely standards for health care facility oversight.

Thompson serves on the board of the YWCA of Greater Harrisburg. She holds an appointment to the Lower Swatara Township Civil Service Commission.

About San Diego Health Connect

San Diego Health Connect securely connects hospitals, health systems, patients, private health information exchanges (HIEs) and other healthcare stakeholders—so that they can share important health information. As a not-for-profit organization, our sole purpose is to serve every member of the community and improve healthcare for everyone.

About Dan Chavez

Daniel J. Chavez joined San Diego Beacon HIE as Executive Director in March 2013 with more than 30 years of health care information technology experience. He has an extensive track record of cultivating startups, business development and product marketing. Previously, he served as Vice President of Marketing and Business Development for Independa, a San Diego-based innovator that provides solutions to help the elderly remain independent. In his previous positions, Chavez was Executive Vice President at Payformance Corporation, Senior Vice President and General Manager of the medical division of Immersion Corporation, and Senior Vice President at Availity. His prior experience includes IBM, GTE, SAIC, Stellcom Technologies and CSC. He holds a BA from San Jose State University and an MBA from Stanford University.

And checkout the rest of our HIMSS18 Interviews here.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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This interview is part of our HIMSS18 coverage. We'll be talking with thought leaders and vendors all week at the annual Health Information Management Society conference in Las Vegas.

On this episode, we're talking with Dr. Betty Rabinowitz, Senior Vice President of Solutions Analytics at NextGen Healthcare.

Dr. Betty Rabinowitz is one of the founders and the former CEO of EagleDream Health, the software analytics solutions company acquired by NextGen Healthcare in August, 2017. EagleDream Health comprises cloud-based analytics and population health management solutions that drive meaningful insights across clinical, financial, and administrative data to optimize ambulatory practice performance.

Quality Systems, Inc., known to its clients as NextGen Healthcare, provides a range of software, services, and analytics solutions to medical and dental group practices. The company’s portfolio delivers foundational capabilities to empower physician success, enrich the patient care experience, and enable the transition to value-based healthcare.

Learn more about Dr. Betty and NextGen:

https://www.nextgen.com/
https://www.linkedin.com/company/nextgen-healthcare-information-systems/
https://twitter.com/NextGen
https://www.nextgen.com/insights

You can checkout the rest of our HIMSS18 Interviews here.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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I'm at HIMSS '18 in Las Vegas. I'll be here all week and will do my best to bring you along with me. Here's the plan:

I'll post a new show each day at HIMSS recapping what I experienced/learned the day before. Make sure you're subscribed at your favorite podcast source so you don't miss them. Most popular:

http://bit.ly/HCBiz-iTunes
http://bit.ly/HCBiz-GooglePlay
http://bit.ly/HCBiz-Stitcher
http://bit.ly/HCBiz-Spotify

I'll grab impromptu interviews at the various events, in the hallways, at the meetups and happy hours and include them in #1. If you're around and you want to participate just let me know.
I'll be recording shorter than normal spots with vendors and thought leaders throughout the week and releasing those as 10-15 minute #HCBiz Bytes from HIMSS18 in the days and weeks after the conference.

I'll be covering/attending:

Power Press Party (Sunday)
HIMSS/SHIEC INTEROPERABILITY & HIE SYMPOSIUM: FACILITATING PERSON-CENTERED INTEROPERABLE HIE TO MANAGE COMPLEX POPULATIONS (Monday)
NHIT Collaborative Leadership Conference: Leveraging Health IT to Address Health Disparities (Tue/Wed)
NODE Health Innovation Roundtable (Wed)
New Media Meetup (Wed)

Plus I have a ton of vendor interviews lined up throughout.

It's gonna be a fun week! As you can see, my schedule is pretty packed, but let me know if there's something else you think I should cover.

Most importantly, I'd love to meet you. If you'll be there you can track me down at one of the events listed above or ping me on twitter (@dflee30).

And I will be tweeting throughout from @dflee30 and @The_HCBiz.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.

Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Today we're talking about a widespread issue that's extremely important to the business of healthcare, and probably not on your radar: Legionella. And more specifically Legionellosis, which is the most significant waterborne disease in the U.S.

Legionellosis accounts for thousands of hospital admissions and many deaths. It has a 10% mortality rate for those infected and that rate goes up as high as 25% in a healthcare setting.

The good news is, it's controllable. In fact, it's largely an engineering problem that has known, low-tech controls.

Related: Checkout our entire Infection Prevention and Control series

Given the prevalence of the issue, the high mortality rate and increased risk in healthcare settings (especially in LTC), CMS now says that Hospitals must develop water management policies to prevent Legionnaires' disease. They're calling for hospitals to do a risk assessment, implement a water management program and specify testing protocols. The approach sounds like it would be in line with that of a good HIPAA or cyber-security program. That is, you must build a culture of control and manage the issue for the long haul.

On this episode, Dave Purkiss and Joseph Cotruvo tell you what Legionella is, how it can be controlled and why health systems should prioritize the issue. Most importantly, they'll tell you about the standards, tools and approaches that'll help you implement a sound water management program, keep your patients safe, and avoid a non-compliance citation from CMS.

Dave and Joe also tell us about the Legionella 2018 conference coming up May 9-11, 2018 in Baltimore, MD (they are co-chairs). The conference will bring together many of the experts working in this space to give you a 360 degree look at what the problem is, why it's important and what you can and should do about it today.

On this episode you'll learn:

What is Legionella?
Why was it largely unknown prior to 1976?
Why does Legionellosis have such a high mortality rate?
Can we control the issue and prevent outbreaks?
What is the CDC doing to track outbreaks and promote the appropriate measures to control it?
How much of a problem is Legionella for U.S. Hospitals?
Are Hospital leaders aware of the issue?
Why are Long-Term Care (LTC) facilities at a greater risk?
Are healthcare leaders aware of the tools that exist to properly manage water systems and control Legionella?
When did CMS begin to regulate the issue?
How does CMS validate that the health systems are properly managing their water systems?
Why should a healthcare organization prioritize this issue?
What advice would you give a health system leader for getting started with a water management program?
How can health systems use tools like the NSF 444 standard and ASHRAE 188 to guide them?
Is there a potential for a CMS audit and are there any financial penalties involved?
The Legionella 2018 conference: Who's it for? What you'll learn? What are the goals of the conference?
How does a good water systems control program relate to a HIPAA program or a cyber security program?

About Dave Purkiss Dave Purkiss was recently appointed to the position of Vice President, Global Water Division at NSF International.

In his new role, Purkiss leads NSF International’s global water programs, including certification programs that help ensure the quality and safety of products used in municipal water treatment, water distribution, residential drinking water treatment, plumbing, pools and spas, and wastewater treatment.

Reporting directly to NSF International’s President and CEO, Purkiss is responsible for strategy development, innovation, growth of water programs and teams, and alignment with NSF International’s mission, strategy and goals. He leads a global team with locations in the United States, Canada, Belgium, China, India, Japan, Korea, Thailand and the United Kingdom.

Most recently, Purkiss served as interim Director of NSF International’s Global Water Division and General Manager of the Plumbing Products Program. During his 30 years at NSF International, he has worked in all areas of water treatment and distribution. His previous leadership roles include General Manager of Municipal Water Products, General Manager of Drinking Water Additives and Managing Director of NSF International’s UK Water team, formerly known as NSF-WRc. He began his career at NSF International working as an hourly employee in the engineering laboratory.

During his time at NSF International, Purkiss has worked on several major initiatives in the water industry, including assisting in the development of NSF/ANSI 223: Conformity Assessment Requirements for Certification Bodies that Certify Products Pursuant to NSF/ANSI 60: Drinking Water Treatment Chemicals – Health Effects. This standard establishes minimum requirements for certification organizations that evaluate and certify products to NSF/ANSI 60. He also played a key role in the launch and development of NSF International’s water products testing service in the UK to provide independent testing and certification services to Europe’s water product industries.

Purkiss is a member of the American Water Works Association (AWWA) and has chaired both the AWWA Polyelectrolytes and the AWWA Utility Quality Management Committees. He holds a bachelor’s degree in biochemistry from Michigan State University.

About Joseph Cotruvo Joseph is Board Certified in Environmental Science, and president of Joseph Cotruvo and Associates, LLC, Water, Environment and Public Health Consultants.

He was the first Director of USEPA’s Drinking Water Standards Division that produced the first regulation of TTHMs in drinking water as well as many existing drinking water standards, and initiated USEPA's Drinking Water Health Advisory Program.

He has participated in the World Health Organization Drinking Water Guidelines development process for over 20 years. WHO work includes producing monographs on Health Aspects of Plumbing, Pathogenic Mycobacteria, Heterotrophic Plate Counts, Calcium and Magnesium in Drinking Water, Waterborne Zoonoses, Health and Environmental Aspects of Desalination Technology, and Potable Water Reuse Guidelines.

His work also includes drinking water quality and risk evaluations, water treatment technology, direct and indirect potable water reuse, and international and national regulatory assessments. He has initiated and managed toxicological research on bromate, water system decontamination, and studies on trihalomethanes. He served as chair of the Water Quality Committee of the Board of Directors of the Washington DC Water and Sewer Authority. He received a PhD in Physical Organic Chemistry from The Ohio State University.

About NSF International NSF International is an independent, global organization that writes standards, and tests and certifies products for the water, food, health sciences, and consumer goods industries to minimize adverse health effects and protect the environment. Founded in 1944, NSF is committed to protecting human health and safety worldwide. With operations in more than 170 countries, NSF International is a Pan American Health Organization/World Health Organization (WHO) Collaborating Center on Food Safety, Water Quality and Indoor Environment.

NSF International's Global Water programs provide risk assessments, testing, inspection and certification services for the water industry from source to tap. NSF led the development of the American National Standards for all materials and products that treat or come in contact with drinking water to help protect public health and the environment and minimize adverse health effects. In 1990, the U.S. EPA replaced its own drinking water product advisory program with these NSF standards.

Mentioned on the podcast InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

National Science Foundation

CDC

EPA

American Water Works Association

Related Check out our series on Infection Prevention and Control (IPAC):

Infection Prevention and Control with Niall Wallace and Michael Diamond

Using Barrier Technology to Stop the Spread of Infectious Disease with Rik Heller

Why Hand Hygiene Matters with Tamás Haidegger

Shining a Light on C. diff with Christian John Lillis

Lessons on Infection Control and Healthcare Sales from the Man with the High-Tech Pillow with David Woolfson

Redefining Sepsis with Michael Ackerman

Understanding Infectious Agents in the Environment with Dr. Syed Sattar and Bahram Zargar

The Patient Hot Zone | Darrel Hicks

HITS Conference Preview w/ Dr. Christine Greene and Dr. Kelly Reynolds

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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There were two huge Digital Health stories in the past few weeks.

Apple Health Records First we were introduced to Apple Health Records. This new feature will allow consumers to download their health records from participating providers directly to their iPhone. Some industry observers see it as a huge step forward in the liberation of our health data and the transformation of the healthcare industry. Others see it as little more than a publicity stunt that'll ultimately end up in history's innovation waste basket next to Google Health.

Amazon, Berkshire Hathaway and JP Morgan Just a few days later we were told that Amazon, Berkshire Hathaway and JP Morgan had teamed up and plan to disrupt healthcare. Once again, we split ourselves into two groups. The first group sees this as a promising sign that American businesses are finally stepping up and taking responsibility for the devastating growth in healthcare spending. They hope these titans can figure it out and set the course for the rest of the nation. The second camp says this move is intended to drive down healthcare costs for these 3 companies and stands little chance of impacting anyone else.

The Apple Health Records deliverable is simple and clear: move data from participating health systems to iPhones via SMART on FHIR for view-only use.

The Amazon, Berkshire, JP plan is almost completely unknown - they've simply said their working together to make healthcare work better.

The question is, will either of them matter in the long run?

On this episode, we break both stories down and talk about what they're promising, what they're not and what we can expect in the coming years. Key questions and topics include:

Apple Health Records * Should we doubt that big tech companies can have a positive impact in healthcare just because a few have tried and failed? * What are Apple Health Records really intended for and why? * Will Apple Health records matter to the future of healthcare? * What's different today than when Google Health and Microsoft Health Vault launched 10 years ago? * What's the difference in general between Apple Health records and past Personal Health Record (PHR) plays? * Does the fact that Apple Health Records will use industry standards like SMART on FHIR, CCD, CDA, etc. make it any more likely to succeed? What does that selection mean for the industry? * Now that Apple has created a platform that enables patients to aggregate their own data, will anyone care? That is, will they create enough demand (from app developers) for the supply of personally aggregated data? * Personally aggregated healthcare data without apps to make it useful is like having a whole bunch of map data with no GPS. * Is there any relation between Apple Health Record's goals and the goals of the recently released ONC Trusted Exchange Framework and Common Agreement (TEFCA)? * Does Apple Health Records "HIE of 1" enable or support population health in any way?

Amazon, Berkshire Hathaway and JP Morgan * What do we think this deal means? Will these organizations simply work as a Group Purchasing Organization (GPO)? If so, how will it be better than all the existing GPOs? * Or will it be something new altogether? * How might this partnership influence changes in the healthcare market beyond just these 3 companies?

What do you think? Let us know in the comments below or drop us a line twitter.

~ Don Lee

Related Unbreaking Healthcare: The Big Heist Film Project (#hcbiz 29) and

Replay: The #hcbiz Show! Ep. 29: The Big Heist Film Project w/ Dave Chase

Hear the story behind Health Rosetta Institute, The Big Heist film project and the CEO's Guide to Restoring the American Dream book.

Health Benefits as a Strategic Opportunity | Chris Skisak | HBCH

Learn why employers may be the only ones who can improve healthcare costs and quality in the near-term. By improving the way they buy benefits, they can gain a strategic business advantage, improve their employees lives and potentially prevent healthcare from bankrupting itself.

Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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CEO's Guide to Restoring the American Dream: How to Deliver World Class Healthcare to Your Employees at Half the Cost

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You've heard of "Always Be Closing", right? Well today we'll tell you why you should at least "Always Be Preparing" (to Close).

Every entrepreneur can and should learn the ways of the M&A market and use that knowledge to inform the way they build their company. That's true if you hope to exit someday because it'll drive decisions that make your company more valuable later. And it's true if you plan on staying in your business for the long haul. Investors have battle-tested methods for determining what's valuable and what's risky. As the current and future investor in your company, you should be applying those tests and addressing the results along the way.

On this episode, we're once again talking with Dexter Braff, President of The Braff Group, one of the nation’s leading health care merger and acquisition advisory firms. We dig into Dexter's process for evaluating companies and find out how he determines if they'll demand attention on the open market. Dexter shares valuable insights on the valuation process and breaks down the 3 major components that contribute to it. He also gets into the psychology of deal making and offers up plenty of practical advice that any entrepreneur can put into action right away. This one's full of gems and I know you're going to enjoy it.

What you'll learn:

When should startups begin thinking about and positioning themselves for acquisition?
How can a company be more valuable when losing money than when they're turning a profit?
What are the "Behavioral Determinants of Value"?
How do you evaluate a company to determine if it will generate legitimate interest from the M&A/Private Equity market?
Should you market your company to a broad audience of investors, or keep it focused?
What's the most important thing for entrepreneurs to study/stay informed on and why?
What are the major factors that determine a company's valuation?
What's something every entrepreneur should be doing regardless of company stage and size?
What's the most common misconception that you see in entrepreneurs when it comes to selling their company?
What advice would you give an entrepreneur for giving a good elevator speech to an investor?

And if you dig this, be sure to check out Part 1 with Dexter for a macro view of the Health IT market.

Thanks for listening!

Don Lee

Since the firm’s inception in 1998, we have closed more than 300 transactions, more than any other mergers and acquisitions advisory firm covering these sectors.

Related How to Analyze the Health IT Market | Dexter Braff | The Braff Group | Part 1

Learn how to analyze the Health IT market and categorize it according to how it's likely to consolidate. This will help you to understand where the market is headed so that you can best position your product or service and gain traction. For startups, new products, and industry innovators.

JPM18, WinterTech, Startup Bundles & More

Hear about what went down at the JP Morgan Healthcare Conference (#JPM18) and Health 2.0 WinterTech. You'll learn about the trends in healthcare investment, delivery and innovation and how you can position yourself for success in the coming years. Plus, a new concept: Startup Bundles.

Accelerating Digital Health for Social Good | Christian Seale | Startupbootcamp Miami

On this episode Christian talks about sub-categories within the market that can be drawn by community and cultural lines. A very interesting supplement to Dexter Braff's analysis.

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On this episode we recap the 36th Annual J.P. Morgan Healthcare conference (#JPM18), the Health 2.0 WinterTech event and talk about the "festival" that J.P. Morgan Week becomes in San Francisco. We cover the trends and topics coming out of the festival and use them as a jumping off point to discuss the next wave of digital health investment and innovation.

What you'll learn:

What is the J.P. Morgan Healthcare conference?
What is the Health 2.0 WinterTech Event?
Who attends these events and how do you get value from them?
How you can take part in the festival even if you're not invited to the main show.
The trends and topics coming out of the festival and what they mean for Health Systems, Investors, Innovators and Startups
Who are the "Strategics"? What are they investing in? And why are they starting to invest in earlier rounds?
What are the major Health System strategies and why are they still so "muddled"?
How and why you should develop pipelines for product development and innovation
Why we should start to consolidate startups earlier and bundle them into more comprehensive offerings in support of broader strategic initiatives
How an accelerator might organize around a very specific, outcomes-driven investment thesis and use the "startup bundle" model to create very comprehensive (and fund-able) companies.

The 36th Annual J.P. Morgan Healthcare Conference Held January 8-11, 2018 - San Francisco

This is the premier gathering of healthcare investors in the U.S. This year more than 400 companies from startups to very large healthcare delivery systems presented to more than 8,000 attendees to share their vision and strategies for the coming years. The idea is to telegraph to investors what's coming (if you're an innovator), and what you'll want to buy (if you're a large health system). One observer said it "provides an incredibly efficient snapshot of the strategies for large healthcare delivery systems".

The event is invite-only, but there are plenty of opportunities to get involved in the various events and meetups happening around town. A prime example of that is the Health 2.0 WinterTech event.

Learn more about #JPM18

The 4th Annual Health 2.0 WinterTech Event Held January 10, 2018

A much smaller and more targeted event that is billed as "the place for insider insights on investing trends in health care technology". Less than a year after being acquired by HIMSS, it's great to hear that this event is still, as Shahid put it, "very much a Matthew (Holt) and Indu (Subaiya) Health 2.0 event". That means startups get the spotlight. Matthew and Indu love to put them on stage and let them tell the investors what they're up to.

Learn more about Health 2.0's WinterTech

...

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To be understood, seek first to understand.

It applies in life, and it applies when you're trying to gain traction with an innovative product, solution, or workflow in the Health IT market. Why? Because there are too many draws on your customers' attention. If you want them to take the time to understand you, then you'd better position yourself where they already are, or will soon be looking. In short, get to know your market.

On this episode, we're talking with Dexter Braff, President of The Braff Group, one of the nation’s leading health care merger and acquisition advisory firms. Dexter walks us through the analysis his team performed on the Health IT market and shares with us key insights they uncovered along the way. They studied 300-400 transactions, identified patterns of consolidation, and used their findings to re-categorize the entire Health IT market. You'll benefit from understanding the process they went through, and you'll get to take a few shortcuts via the insights he shares.

What you'll learn:

How to survey the Health IT market landscape and organize it into understandable categories
How to use your market analysis to predict where market consolidation is likely to occur
Which Health IT Market categories are experiencing the most consolidation and M&A activity. Interestingly, more than 40% of the transactions The Braff Group examined came from a single category.
Predictions on which categories will move next
A breakdown of the forces expected to drive the next round of consolidation
Different approaches to enable "Collaborative Reimbursement" across provider disciplines (i.e. Bundled payments and other innovative reimbursement programs)
Why we should be mindful of the potential value in Social Determinants of Health (SDOH) data.
The differences between cutting edge and bleeding edge and the importance of timing.

And if you enjoy this one, be on the lookout for Part 2 with Dexter Braff where he offers practical advice on how companies can best position themselves for future raises and acquisitions.

~ Don Lee

About Dexter Braff: Dexter W. Braff is President of The Braff Group, one of the nation’s leading health care merger and acquisition advisory firms (source: Thomson Reuters). Since its founding in 1998, the firm has completed more than 300 health care deals.

About The Braff Group: The Braff Group is a leading mergers and acquisitions advisory firm specializing exclusively in health care services including behavioral health care, home health care, hospice, pharmacy services (home infusion, specialty Rx, institutional Rx), urgent care, health care information technology, health care staffing, home medical equipment, and ancillary health care services.

Since the firm’s inception in 1998, we have closed more than 300 transactions, more than any other mergers and acquisitions advisory firm covering these sectors.

Mentioned on the podcast: Dexter mentioned a chart that shows his team's analysis of the Health IT Market categories. You can find it here under Market Data - M&A Environment for HIT.

Related: Accelerating Digital Health for Social Good | Christian Seale | Startupbootcamp Miami On this episode Christian talks about sub-categories within the market that can be drawn by community and cultural lines. A very interesting supplement to Dexter Braff's analysis.

Subscribe to Weekly Updates: If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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Read this on the web

Have you ever wondered why your employer buys your health insurance for you? They don't get involved in car insurance, home owners, etc. Why healthcare? To understand that, you have to go all the way back to World War II.

When the federal government froze wages during WWII, employers needed a way to compete for employees. As it turned out, benefits weren't included in this freeze and became a great way to attract talent. And then, as often happens, inertia took over and we just kept doing it that way. For a while, that wasn't such a big deal, but then healthcare costs began to explode. And it happened so quickly that before we realized it, companies like Starbucks were spending more on health benefits than on coffee beans. Healthcare is now one of the top P&L items for every business in the U.S. Unfortunately, most C-suites aren't looking at it as a strategic opportunity. Instead, they task ill-equipped benefits managers with trying to find the best "deal" and just "hope it doesn't go up too much this year".

Today's guest is trying to change all of that. Chris Skisak is the Executive Director of the Houston Business Coalition on Health (HBCH). Chris and his team at HBCH are determined to make all employers aware of the strategic opportunity that health benefits represent and help them execute on that opportunity.

What you'll learn:

What is HBCH? (1:36)
What was the catalyst for employers coming together to try and collaborate on controlling healthcare costs and outcomes? (2:50)
The history of healthcare purchasing and how we've gotten to where we are today (6:30)
Do employers worry about investing in their employees' health only to have them leave? (12:30)
Do employers have access to useful quality and outcomes data? Can they get their own claims? (16:30)
What types of employers are good candidates for this approach - that is, who is best positioned to take advantage of the strategic opportunity in health benefits purchasing? (19:00)
How do you get the C-suite involved? (21:00)
What is a Chief Health Strategy Officer and why do you think most employers need one? (21:00)
What is the Walmart Centers of Excellence program and how does it serve as a model for employers to make better health benefits decisions? (23:45)
Using collective influence and tools like Choosing Wisely and LeapFrog to drive change (30:30)
Tell us about some of HBCH's current initiatives aimed at improving quality of care and saving money for employers and their staff. (35.40)
What's the one thing that every employer should be doing right now? (43:00)

Of all the cost-savings and quality programs that I work on and study, the employer-centric approach is the most encouraging. Employers have a unique combination of pain, opportunity and spending power that should give them the sustained motivation to do this. They may be the only ones who can move the needle in a meaningful way in the near-term. I'm excited to see what happens in the next few years.

~ Don Lee

About Chris Skisak Chris became Director in August of 2014. Prior to HBCH, he was President and Founder of Corporate Health Management Solutions, an organizational health and productivity management company providing consulting and software to employers and their health management partners to demonstrate the value of an integrated health management strategy. Dr. Skisak had previously worked 25 years with Houston Fortune 50 energy companies in a variety of health management positions. He is originally from Chicago and attended the University of Illinois. He received his B.S. from the University of Houston and his M.S. and Ph.D. from the University of Texas School of Public Health.

About HBCH - Houston Business Coalition on Health The Houston Business Coalition on Health (HBCH) is an employer-centric organization that allows for the sharing of evidence-based strategies and practices, while using its collective influence to assist employers effectively and efficiently deliver the spectrum of its health benefits investments. Employer-centric implies that the value of healthcare and benefits delivery is viewed from the focal lens of the employer. HBCH is able to discuss and impact employer health in a unique environment that brings together employers, health plans, hospital systems, physicians, benefits consultants and other health services providers. All healthcare is local, so much of HBCH’s effort is oriented towards local improvement. However, HBCH works with national organizations to assist employers achieve improvement in other cities where its employer members may have a presence.

http://houstonbch.org/

Keynote Speaker: Elisabeth Rosenthal, author of An American Sickness: How Healthcare Became Big Business and How You Can Take It Back (which is a pretty good book - I listened on Audible and the reader was good at 1.25 speed).

Houston Business Coalition on Health on LinkedIn

Houston Business Coalition on Health on Twitter

Mentioned on the podcast The National Alliance of Healthcare Purchaser Coalitions - HBCH is a member

NORC Study - Employer Perspectives on the Health Insurance Market: A Survey of Businesses in the United States: Research Highlights - Research shows that many employers in the United States that offer health insurance to employees are unfamiliar with objective metrics of health plan quality information, and most consider costs both to their organization and their employees as important factors when selecting plans. Chris told us that only 7% of employers consider objective measures of health when choosing a plan and that is why we need eValue8.

eValue8 - eValue8™ was created by business coalitions and employers like Marriott and General Motors to measure and evaluate health plan performance. eValue8™ asks health plans probing questions about how they manage critical processes that control costs, reduce and eliminate waste, ensure patient safety, close gaps in care and improve health and health care.

Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care by Marty Makary - another great book to checkout (again, I did this on Audible at 1.25x). This came up in the context of how we all need help in selecting the right surgeon. Warning... this one is a bit startling.

National Diabetes Prevention Program a CDC program that Chris tells us has been shown to prevent many pre-diabetics from becoming diabetic, saving employers big money and improving the lives of their staff.

Related If you're into all of this then you should be following Dave Chase. He wrote a book called
CEO's Guide to Restoring the American Dream, is working on a movie about this called The Big Heist and founded the Health Rosetta Institute to develop and disseminate a blueprint for high-performance health benefits.

He was also a guest on our video podcast to discuss the movie project:
Replay: The #hcbiz Show! Ep. 29: The Big Heist Film Project w/ Dave Chase

Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care

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People like to say things like "If you've seen one healthcare system, then you've seen one healthcare system" or "every community is different". That may be true on some level, but these are really just excuses to keep doing things the same old way. In fact, most communities are exactly the same when it comes to the most important issues facing the U.S. healthcare system.

If you pick any random community across the country and examine their healthcare delivery system, you'll find that:

Traditional healthcare delivery accounts for only 10-20% of health outcomes. Social Determinants of Health (SDOH) drive the rest.
Healthcare costs are growing in an unsustainable manner
There's heavy competition between the players in the community and limited collaboration
Governments, companies and individuals are struggling to pay for it all

On this episode, Jim Rickards MD, MBA tells us the story of how Yamhill County, Oregon is addressing these issues through their Community Care Organization (CCO). Made possible by Oregon's 1115 Medicaid Waiver, the CCO is a community governed health plan that brings competing hospitals, providers, dentists, community leaders, patients and their families to the table. The CCO, as Jim puts it, "gave the community permission to work together". And they have. Whether it be allowing patients to choose Naturopaths as PCPs, tapping latent community resources to launch a paramedicine program, or the creative approach to engaging highschoolers through "Teen Swag Night", Yamhill County has shown that there are ways to move the needle on some of our most pressing healthcare issues. It just takes a change in perspective.

This all comes from Jim's new book, Our Health Plan: Community Governed Healthcare That Works. It's very well written and accessible even if you're not an expert in healthcare delivery or the business of healthcare in general. I highly recommend it to anyone trying to drive collaboration in their community, or just generally looking for a new approach to addressing the Social Determinants of Health (SDOH).

"The CCO gave the community permission to work together" -Jim Rickards MD, MBA

Here's a breakdown of the topics we discuss:

What is a Community Care Organization? (1:00)
What was the catalyst for Medicaid reform in Oregon?
What are the 3 ways to reduce healthcare spending? (12:15)
What was your strategy for getting competitors to collaborate? (16:30)
How is the health plan funded? (27:30)
Can you give some examples of community collaboration that drove meaningful changes? (32:30)
Quality Measurement: How do you (and CMS) ensure that you're doing a good job for the community and the patients? (37:30)
How did you pick your clinical quality measures? (42:40)
Are the providers on board with the quality measures? (44:00)
Tell us how the CCO helps the doctors meet their quality measures, as opposed to just measuring them. (46:25)
What is "Teen Swag Night" and how does it help you close gaps in care? (47:00)
Do you think the program has been successful? (51:00)
Do the providers and others stakeholders in your community think the program has been successful? (52:15)
What things might a critic point to as still needing work? (53:00)
This was a 5 year program and has been extended by CMS. When did things click for you? When did you start to feel like you were making an impact? (55:00)
Tell us about the Teledermatology program. (57:30)

Give it a listen and then give yourselves permission to work together.

~ Don Lee

About Jim Rickards MD, MBA Jim Rickards MD, MBA is the senior medical director at Moda Health in Portland, Oregon and author of Our Health Plan. He was a pioneer in developing the Coordinated Care Model for the state of Oregon as a new way to deliver healthcare services to its nearly 1.1 million Medicaid members.

Previously, Dr. Rickards was the Chief Medical Officer of the Oregon Health Authority, where he provided clinical and policy leadership in managing Oregon's Medicaid population.

He received his B.S. from Indiana University Bloomington, MBA from Oregon Health and Science University, M.D. from Indiana University School of Medicine, and completed residency and fellowship training in radiology in Chicago at Cook County Hospital and Rush University Hospital, respectively.

Dr. Rickards currently resides in Mcminnville, Oregon.

Learn more: jimrickardsmd.com

Related If you're into innovation you might also like:

Accelerating Digital Health for Social Good | Christian Seale | Startupbootcamp Miami

Replay: Medicaid Open IT with Open Health News

Bringing Direct Primary Care to Medicaid

Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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On this episode, Rick Moore, CIO at NCQA, joins us for a discussion about what's next for digital quality measurement. Rick likes to call this Digital Quality Measures 2.0 and you can see it coming to life in NCQA's eMeasure Certification (eMC) program. The program aims to take burden away from health plans and auditors by establishing a process for generating standard supplemental data for HEDIS measures. This will enable software vendors, providers, HIEs and others to more effectively and efficiently provide needed clinical data without all the manual chart pulls (you can see the certified vendors here).

Additionally, the eMeasure test process is now approved as the only alternative to the Project Cypress toolset in the ONC Health IT Certification Program.

Rick sees great opportunity ahead for a few reasons:

The community is more engaged (vendors, providers, payers)
The government has backed off (a bit) on mandating specifically how things will be done
There are more options available to providers

These factors, coupled with the rise of promising new specifications like Clinical Quality Language (CQL) and FHIR, might put us in a position to move away from performance-based measures of providers and towards holistic, patient-centered measures; away from manual data entry and toward clinical data that is automatically collected as a by-product of the physician workflow. At the same time, he is realistic and offers several cautions:

We can't wait for CQL and FHIR. Let's move forward with what we've got now and upgrade along the way.
We can't just toss out process measures and go strictly outcomes measures. We need both.
We can't mandate interoperabillity as the basis for all measures right away

We address these issues and so much more, including:

What is the National Committee for Quality Assurance or NCQA? (0:55)
What's NCQA's role in monitoring quality in healthcare? (2:08)
What's the difference between process measures and outcomes measures? What about Patient Reported Outcomes Measures (PROMs) vs. institutionally focused outcomes measures? (4:35)
How does NCQA decide what's worth measuring especially when you consider the high levels of administrative burden and burnout on the physicians? (10:00)
The unintended consequences of value-based payment (13:00)
What if we decided that from this point forward we would only have measures that could be collected digitally? (15:30)
Structured vs. unstructured data (20:00)
Manually entered and properly coded vs. automatically captured data points (23:45)
What if we decided that from this point forward we won't collect measures unless we have interoperabillity? Would we get interoperabillity more quickly? (25:30)
Why aren't we using all the digital info that is already available? Think manual chart pulls instead of data extracts or queries against Health Information Exchanges (HIE)? 27:30
Do you agree with the following statement? Some health systems will make the investment needed to satisfy quality measure requirements without a major burden on providers and that will give them a competitive advantage because doctors will choose to work there (33:00)
What is the Electronic Measure Certification (eMC) program? (39:00)
Does the eMC program serve as a vehicle for HIEs and other community aggregators to get in the HEDIS measurement flow by providing standard supplemental data to the health plans? (49:00)
What advice would you give doctors who want to have more of a say in the quality measure specifications going forward? (51:25)
Where can listeners learn more about you, NCQA and the eMC program? (51:25)

There's a lot here. I hope you enjoy it!

~ Don Lee

Mentioned on the podcast Re-imagining Quality Measurement by Shahid Shah (presented at The Digital Quality Summit)

The Digital Quality Summit | Held November 1-2, 2017, Washington, DC

HL7 and NCQA partnered to host the Digital Quality Summit - gathering the best and brightest in health care and technology to demonstrate methods for eliminating measurement burdens and bridging the digital gap.

Health Impact Mid West | Held November 16, 2017, Chicago, IL

The 5th Annual HealthIMPACT Mdiwest, developed in partnership with NODE Health where the brightest minds in clinical health technology move beyond the digital medicine hype and forge a path from innovation to implementation to digital transformation using evidence as our guide.

About Rick Moore, PhD As NCQA’s Chief Information Officer, Rick Moore is responsible for the vision and strategic direction of the Information Services, Information Technology and Information Products. He also works closely with NCQA’s stakeholder partners and represents NCQA on leading several national health information technology initiatives and panels including the Office of National Coordinator Standards and Interoperability Workgroup, and the Health Information Management and Systems Society (HIMSS) Quality and Patient Safety Committee.

Prior to joining NCQA in 2008, he was the Director of Health Informatics at the National Association of Children’s Hospitals where he led the development of information services and products for over 200 member hospitals. He has also served the Office of the Secretary of Health Affairs at the Department of Defense where he led the development of Electronic Health Record (EHR) systems and was awarded the Information Technology Officer of the Year of the Joint Medical Information Systems Office in 2004.

From 2001 to 2003, he was competitively selected by the U.S. Air Force Medical Service to attend the University of Alabama at Birmingham where he studied Health Informatics. In 2002, he was selected as a recipient of the HIMSS Foundation Richard P. Covert National Scholarship Award. Previously, he has served as the Director of Medical Readiness at Langley Hospital and was recognized as the Medical Readiness Officer of the Year for the command. He has also served as the Director of Managed Care for Moody Community Hospital and was selected in 1996 as the Air Force Medical Service’s Managed Care/Patient Administrator of the Year.He holds a Doctorate degree in Health Related Sciences from Virginia Commonwealth University, a graduate degree in Health Informatics from the University of Alabama at Birmingham, as well as a graduate degree in Management from Troy State University, and a Bachelor Degree in Industrial Technology from Southern Illinois University. He is a certified health care executive and Fellow in the American College of Healthcare Executives (FACHE), a Fellow of the Health Information Management and Systems Society (FHIMSS), a certified Professional in Health Information and Management Systems (CPHIMS), a Certified Information Security Manager (CISM), and a certified

Project Management Professional (PMP) Email: moore@ncqa.org Blog: http://blog.ncqa.org/author/rick-moore/

About NCQA NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s Web site (ncqa.org) contains information to help consumers, employers and others make more informed health care choices.

Twitter: @NCQA

Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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They say that civilization advances by extending the number of important things we can do without thinking about them. To me, that's the promise of technology and it's particularly true when it comes to artificial intelligence and machine learning. Still, not everyone sees it that way. Some worry that they'll be replaced. Others take offense to the fact that they're seen as replaceable. But just like the rise of ATMs led to an INCREASE in the number of bank tellers, we'll see AI drive unpredictable, and generally positive change in the healthcare industry. Some will be displaced, but if they're open to it they'll be in a position to take on new and even more valuable roles that we can't even imagine today.

Side note: AI may just help us deal with the projected doctor shortage.

I know what you're thinking: That's big talk from an industry that recently gave you the EMR. That's fair, but there is a way to do this right. And that's what we're going to talk about today.

Today's guests are Shahid Shah (usually co-host, but today I'm calling him a guest) and Dr. Chesley Richards, CDC Deputy Director for Public Health Scientific Services. Together we'll discuss the rapid pace of technological change in healthcare and what that means for doctors, vendors and patients. We'll show you how AI will complement and enhance the capabilities of today's clinicians and allow them to focus on keeping us healthy. We'll show you how technology, when its properly deployed and used, can be incredibly effective. And perhaps, most importantly, we'll tell you why listening is the starting point and potentially the most important thing you can do to ensure this all goes well.

An overview of The Health IT Leadership Summit w/ Jody Braner and an introduction to today's podcast guests (0:00 - 10:20)
Given all the advances in technology such as Artificial Intelligence, Machine Learning, Predictive Analytics, Precision Medicine, etc. will doctors have jobs in 10 years? (11:10)
Similarly, what will HealthIT vendors be working on in 10 years? (20:30)
Looking at vaccines as technology, and applying that technology intelligently and in a way that was designed to work in specific communities and regions allowed us to eradicate diseases like Smallpox (29:38)
How can tech vendors realign themselves to support the goal of cures instead of focusing on disease management and administration? (32:00)
What hurdles do we have to get over so that collectively we're getting back to our focus on cures over just treatment? (35:15)
Why does population health matter? (38:00)
Let's discuss the dangers of technology and how it can adversely impact the delivery of care when it's not properly deployed and used. (41:00)
We often think of technology as a way to digitize and automate what I do today. Why don't we take the opportunity to ask what we can do better? What can we stop doing altogether? (43:00)
How can we power all of this in new ways with data? (47:35)
How can the CDC and other organizations open up more data for public experimentation? (52:00)
What new workforce needs or changes will emerge in healthcare in the coming years? (56:00)
We can use data to cut down on the time from idea thru randomized trial to approval of new drugs - today that might take up to 17 years!!!! (1:01:35)

This is a very engaging and insightful conversation, and one I know will make you think about a few things differently. I can honestly say that I loved listening to the final product and I believe you will too. Enjoy!

~ Don Lee

About Chesley Richards and CDC Chesley Richards M.D., M.P.H., F.A.C.P. is Centers for Disease Control and Prevention (CDC) Deputy Director for Public Health Scientific Services as well as Director, Office of Public Health Scientific Services.

In these two roles, Dr. Richards is a key advisor to the CDC Director and oversees the National Center for Health Statistics (NCHS) and the Center for Surveillance, Epidemiology, and Laboratory Services (CSELS) with activities that include the MMWR, Vital Signs publications, the Epidemic Intelligence Service and other scientific training programs, the Guide to Community Preventive Services, and a broad range of cross cutting epidemiology, public health surveillance, and laboratory services.

Dr. Richards earned his M.D. from the Medical University of South Carolina, an M.P.H. in Health Policy and Administration from University of North Carolina at Chapel Hill and is a graduate of the Epidemic Intelligence Service (EIS) at CDC, the Cancer Control Education Fellowship at UNC Lineberger Cancer Center and the Program on Clinical Effectiveness at Harvard School of Public Health. He completed Internal Medicine (Medical College of Georgia), Geriatric Medicine (Emory University) and General Preventive Medicine and Public Health (UNC Chapel Hill).

Learn more: https://www.cdc.gov

About The 8th Annual Health IT Leadership Summit Created in 2010 by the Georgia Department of Economic Development, the Metro Atlanta Chamber and the Technology Association of Georgia’s Health Society, the Health IT Leadership Summit brings together leaders from across the healthcare continuum to discuss how the industry can drive innovation to enable better healthcare delivery at lower costs to more people.

November 7, 2017 - Atlanta, GA

“Join industry thought leaders as we explore and collaborate on the importance of connectivity and working together for the advancement of healthcare delivery. Hear how health IT is formalizing analytics, encouraging patient engagement and implementing value-based care. What is working? What is not working? Learn about success stories and road blocks. This event is also an opportunity for your voice to be heard, as each session includes audience question and answer sessions. You will hear from security professionals, providers, innovative companies and other leading professionals. We also have a few exciting demonstrations to share. I look forward to seeing you!”

Jodie Braner, 2017 HIT Summit Chair

Learn more and register: https://healthitleadershipsummit.com/

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On this episode, we talk with John D'Amore. John is Founder, President and Chief Strategy Officer at Diameter Health and has been working on Quality Measures in healthcare since the early 2000s. Yup, pre-EMR quality measures!

John takes us on a fascinating journey from paper based quality measurement (see RHQDAPU... at least we've streamlined our acronyms!) to the dawn of electronic measurement. via the Electronic Medical Record (EMR). He explains why the single-EMR approach made sense in the hospital, but how the industry was hurt when it decided to apply that approach in the ambulatory setting. Finally, John describes the future state where quality measures are calculated from a longitudinal patient record that encompasses all the care a patient has received. This, of course, calls for a trusted central authority to do the aggregation, data remediation and reporting. Perhaps, an HIE?

It's a complex story and John delivers it well. We dig through all that and so much more, including:

What are Quality Measures and why do we need them? (1:23)
John D'Amore's background and the founding of Diameter Health (5:30)
What has been the historic approach to quality measurement in healthcare? (8:00)
Should we limit quality measures in the short-term to only those that can be understood by patients? (13:00)
How do we pick the measures? What do we care about? (17:30)
What might a quality program look-like in a "digital-native" world? (21:10)
How can we move from a retrospective, tell me what happened world, to one where clinicians and administrators get the data when there's still time to impact outcomes? (25:48)
We talk about the difference between clinical and claims data, and explore why the clinical data is not flowing. (30:30)
John gives an example of an HIE that's achieved great success in Quality Reporting (Indian Health Information Exchange) and we explore why they've been successful (33:00)
Will providers start to realize that a robust HIE can help them improve quality scores and potentially increase revenue? (36:15)
Why is Data Quality such a linchpin issue when it comes to quality measures? (38:15)
How does data fidelity, or fitness for purpose, differ when looking at a single chart vs. longitudinal data sources form many systems? (42:50)
John and Shahid are both speaking at the Digital Quality Summit. We discuss their talks and goals for the event. (45:45)

We'll be continuing the Quality Measurement series over the next month or two. I hope you enjoy the setup episode as much as I did!

~ Don Lee

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Quality...

What does that mean in healthcare? How can it be measured? Is it the same for everyone? Who gets to decide?

These are just a few of the incredibly difficult questions that the healthcare industry is grappling with as we enter the age of value-based care. The decisions we make about quality in the coming years will have significant and lasting impact on the future of our industry. This is a conversation that's very much worth having.

On this episode, we bring you another conference preview. Our intention is to help you find unique learning and networking opportunities that complement the normal programming on The #HCBiz Show! With our Quality Measure series just around the corner, this one is a particularly good match.

The National Committee for Quality Assurance (NCQA) is bringing Quality Talks to Washington D.C. on October 16th, 2017. This 1-day event is designed to address some of the most difficult questions around healthcare quality. NCQA will bring us 10 speakers across the following tracks:

The Future's Not What You Think: In this contrarian track, the speakers will caution us that the headlines may not be the trend lines.
Evidence, Ethics and Values: This track takes on the difficult task of defining, measuring and valuing care.
Beside and Beyond Big Data: This track dives in to cognitive computing, open data and innovation.

Our guest is Andy Reynolds, Assistant VP of Marketing and Communications at NCQA. Andy tells us about the tracks and speakers and explains what NCQA is trying to accomplish with the event. It's an interesting conversation that covers a range of topics including innovation, hype, end-of-life care, vulnerable populations and much more.

I hope you enjoy it. And if you do attend, please track me down and say hi!

Learn more about the conference and register here: http://www.qualitytalks.org/

~ Don Lee

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About Andy Reynolds and NCQA Andy Reynolds, Assistant VP of Marketing and Communications at NCQA.

twitter: @NCQA

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The healthcare industry has lots of problems, lots of money and is in a constant state of change. With those characteristics, it's no wonder startups are throwing their hats in the ring in increasing numbers. The theory is that they'll take some technology or process that's just killin' it in every other sector, apply it in healthcare and profit. The reality they find is quite different. Even with a great product, the notoriously long sales cycles, counter-intuitive financial incentives and policy-driven Health IT strategies converge to deliver a very strong message... you need help.

On this episode, we talk with Drew Ramsey, a partner at Valor Partners and the head of their healthcare division. Drew specializes in placing executives and sales leaders in startups and venture-backed firms that are bringing Health IT products to market. As you'll hear, Drew's success measure is not just placement, but long-term success. That means that he and the team at Valor are very picky about who they work with. Drew shares with us how they vet their prospective clients to increase the odds of success and from that we can extract some key insights into when startups are ready to grow, expand marketing teams, scale sales teams, etc.

This is a fascinating conversation that made me think about several things in a new light. Here's a few of the key topics:

What characteristics are most important for a Health IT leader? How important is empathy? (5:30)
What characteristics seem to be asked for most by Health IT startups? (7:45)
What aren't companies asking for, but should be? (9:40)
How do you align comp plans with the level of talent you're after? (14:00)
Do leaders tend to come from the same sector as the startup, or might they jump from provider to payer, or long-term care to telemedicine, etc.? (18:53)
When should startups bring on executive leadership? (21:45)
What skills are needed to deal with healthcare's notoriously long sales cycles? (25:00)
Why is it important that startups be able to articulate where they are as a company and what they expect of a new leader? (26:15)
What are some examples of unreasonable expectations a startup might have when searching for new leaders? (27:10)
What are some tricks and tips for realigning those expectations? (29:00)
In your experience, do startups properly prepare markets before bringing on sales teams? (33:15)
How can a startup tell if they are ready to build a sales team? (35:30)
When should a startup expand their marketing team? (38:15)
Tell us more about Valor Partners and where our listeners can learn more. (42:00)

If you're building a HealthIT startup, I promise you'll find something valuable here. Let me know what you think!

BTW... if you're into Health IT startups then you may also enjoy our conversation with Christian Seale of Startupbootcamp in Miami.

~ Don Lee

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Prefer to read it? Transcription coming soon!

About Valor Partners Founded in 2002, Valor Partners is a true search firm - our clients are software and technology companies ranging from the innovative startup to the established market leader -who rely on us to find and attract talent that is hidden; the candidates that are too difficult and time consuming to find or recruit without us. We have over 15 years of dedicated technology search expertise focused on building leadership, sales, and marketing teams for our clients; it's all we do. However, we don't view our service as simply providing candidates to our clients; our true value is in the deep insight we can share: about the candidate, the search strategy, the market, about how we can succeed together.

http://www.valorpartners.com/

@Valor_HealthIT

@ValorPartners

About Drew Ramsey A Partner at Valor since January of 2014, Drew specializes in Executive-level, retained and engaged Healthcare search and has personally completed over 200 searches. Having joined Valor Partners in early 2010 as a Project Coordinator, Drew rapidly ascended the ranks to Account Executive and Director, before becoming a Partner. He established the Healthcare Technology and Services vertical at Valor and currently manages the Practice, leading Business Development efforts, Client Acquisition and Recruiting.

Drew’s team has been a catalyst for dozens of Healthcare vendors these past years, building world-class Sales, Marketing and Delivery teams to achieve a desired outcome. An already lengthy list of client growth patterns and successful acquisitions continues to grow.

In his spare time, you can find Drew outdoors on Roanoke’s local “Greenway” trail with his wife, Laura, and their two dogs; Charlie, a Foxhound, and Stella, a Cocker Spaniel. You may also find him in Venice, Paris, Iceland or any of the upcoming international destinations on the list.

Drew is a Virginia Tech Hokie and bleeds his Alma Mater’s colors of Chicago maroon and burnt orange.

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The entire healthcare industry went digital in a very short time. We've barely got our arms around the mountains of data created every day in our transactional systems (i.e. EMR, Scheduling, RCM, etc.). Now the genomic, patient-generated and device-generated data is starting to flow. Take all that, mix it up with some HIPAA, a few parts ransomware, an uncompromising need for on demand data and reliability, the almost-dogmatic refusal to ever let go of a single piece of information, and the rapidly expanding need for new insights, and you'll start to get a glimpse of the state of healthcare data today.

Enterprises must find a way to reap the benefits of all this "big data" without getting paralyzed in the complexities of managing it. Today's guest believes that data storage is ripe for innovation and that a hybrid cloud approach may be the best path forward. A hybrid solution combines the speed, reliability and comfort of an on-premises infrastructure with the scalability and convenience of the cloud.

Lazarus Vekiarides is the co-founder and CTO of ClearSky Data. Laz gives us a run-down on the state of data storage in healthcare today and offers insights on where things are headed. We touch on topics including capacity utilization, the difference between hot and cold data, how little of your data is accessed on a regular basis and how you can use that knowledge to your advantage. We cover all that and much more, including:

An introduction to ClearSky Data (5:15)
What do you wish people would stop doing with their data? (10:00)
What's the alternative to making lots of copies of your data? (13:00)
How do you identify and measure your most accessed and least accessed data? What can you do with that info? (15:30)
What healthcare data use cases do you support? (18:13)
How has the world of data storage changed in the last 10 years and what does a good data storage strategy look like today? (21:45)
Are you starting to see organizations ditch on-prem and go all in on the cloud? (24:00)
Have software engineering capabilities caught up with the new realities of the cloud? (26:15)
Besides latency, what other issues should we consider when evaluating our cloud strategy? (29:00)
Is the software-side ready to support the hybrid model of edge computing w/ public cloud backing? (33:30)
What's going to happen to all the legacy systems? Do they go away? Get migrated to the cloud? Something else? (36:00)
Can you compare and contrast the perceived costs of on-prem vs. cloud with the actual costs? (38:15)
Is backup and Disaster Recovery a good place for enterprises to start thinking about going hybrid? (43:50)
Where can listeners learn more? (45:15)

This is a must listen for anyone responsible for IT infrastructure in Healthcare. I hope you enjoy it!

Don Lee

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About Lazarus Vekiarides and ClearSky Data Laz is the co-founder and CTO of ClearSky Data.

ClearSky Data’s global storage network simplifies the entire data lifecycle and delivers enterprise storage as a fully managed service. IT is now liberated from the treadmill of managing primary, backup and disaster recovery storage infrastructure, and empowered to access all data as if it were local, with on-demand scaling and agility. ClearSky delivers data where it’s needed, enterprise-ready and fully optimized to eliminate the cost and data center footprint of traditional storage solutions.

Learn more: https://www.clearskydata.com/

Checkout their weekly free webinars here: https://www.clearskydata.com/resources/webinars

Follow them on twitter:

@lazvek

@ClearSkyData

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The most important thing we do on The #HCBiz Show! is confront reality. We don't complain about how things are, or how they ought to be. We know that's a dead-end. Instead, we examine our current situation and identify our obstacles. Then we come up with practical ideas for how to work through, under, around, or with those obstacles. That's the only reasonable approach for an innovator.

Dealing with obstacles to Infection Control The Healthcare Infection Transmission Systems (HITS) conference (and the consortium behind it) gives us a wonderful example of this #HCBiz philosophy in action. The HITS consortium knows that the science and technology exist to make significant strides in Infection Prevention and Control (IPAC) and Healthcare Associated Infection (HAI) reduction. They also know that, while the benefits of the solutions seem obvious to many, it's not a slam-dunk to get health systems to adopt them in meaningful and sustainable ways. There are many reasons for this, and as usual, it all starts with communication and culture. That's why the HITS consortium aims to bring experts from many disciplines together for this conference to address these issues collaboratively. The consortium's goal, as steering committee member Dr. Christine Greene put it, is to promote "the how and why in support of culturally relevant and contextually anchored quality improvement initiatives". If you're a fan of The #HCBiz Show!, it'll come as no surprise to you that we love that idea.

A scientific analysis of culture and communication The events keynote speaker is Myles Leslie, Ph.D. Myles is a Healthcare Sociologist and Institutional Ethnographer. Ethnography, which is a new concept for me, is basically a scientific way to understand a day in the life. The following excerpt from his speaker bio will give you a pretty good idea at what HITS is trying to accomplish here:

As part of this work, he has engaged the full spectrum of health system stakeholders, including policy makers, healthcare administrators, clinical specialists, clinical support staff, and patients and families. Dr. Leslie uses ethnography and its allied qualitative methods to identify and break down communication barriers and cultural silos between these stakeholders. His expertise is in surfacing communications issues and cultural interactions that can remain buried in the normal flow of clinical or policy work and in quantitative studies. By addressing questions of how and why that purely quantitative designs are often ill-equipped to answer, Dr. Leslie’s research enables the development of culturally-relevant, contextually-anchored QI interventions.

Yes, please. I think healthcare innovation would benefit from a healthy dose of Ethnography across the board.

What you'll learn from the show So, we're bringing you a preview of the HITS conference for several reasons:

To dig deeper into the HITS consortium's approach to innovation, which aligns so well with the core philosophy of #HCBiz.
To explore the conferences ties to our IPAC series. I received quite an education doing that series and now see IPAC as a critical element in the future of our healthcare system.
To bring our listeners information on a small (~100 attendees), lesser-known conference that offers an opportunity for real connection and learning. We plan to bring you more of these in the coming months.

You don't have to be in the IPAC space to get value from this conversation. Anyone innovating in healthcare should give our guests, Dr. Christine Greene and Dr. Kelly Reynolds a listen. Their thoughtful approach to innovation with a healthy respect for communication, culture, value, and proof is both instructive and refreshing.

Here are a few highlights from our conversation:

What is the HITS Consortium? (3:00)
What is the HITS conference? (4:10)
What made you decide that a conference was needed? (6:00)
How can we help innovators isolate, quantify and effectively communicate the value they bring to the table? (9:00)
Who should attend the conference? (19:45)
Who are the most important people to get the HITS message in front of? (21:00)
If you could get a message in front of every healthcare CEO in America, what would you tell them? (23:15) If you only listen to 2 minutes of this show, start here. Both of their answers are spot on!
Where can people learn more? (25:00)

I hope you enjoy it!

~ Don Lee

Check it out on:

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Prefer to read it? Ok, but you'll have to wait a bit. Transcription coming soon!

About Dr. Christine Greene Christine Greene, MPH, Ph.D.
Principal Investigator for Sanitation and Contamination Control
NSF International, Applied Research Center
Ann Arbor, MI

Dr. Christine Greene has over 9 years of experience in epidemiological and laboratory research. She holds a Ph.D. in Environmental Health Sciences and an MPH in Hospital and Molecular Epidemiology from the University of Michigan, Ann Arbor. Her academic research focus has been on healthcare pathogen transmission, pathogen environmental survival, and biofilms which has led to multiple publications. At NSF International, Dr. Greene has been making strides to improve public health in the areas of infectious disease prevention and control in clinical and dental settings. Her research focus in on healthcare pathogen transmission, pathogen environmental survival, disinfection, hand hygiene and biofilms. Her work serves to improve the accuracy of environmental mediated infectious disease transmission modeling, strengthens current guidelines to control healthcare-associated infections and provides new insights that will stimulate innovative approaches to reduce the risk of biofilm-related infections, pathogen transmission and curtail the environmental persistence and transmission of infectious agents. Dr. Greene also co-founded the Healthcare Infection Transmission Systems (HITS) Consortium – an organization that strives to break down silos in healthcare using a cross-disciplinary, systems approach to addressing the pressing issues around infection control.

About Dr. Kelly A. Reynolds Kelly A. Reynolds, MSPH, PhD
Associate Professor
University of Arizona
Tucson, AZ

How is HITS different? This year’s conference theme is Catalyst for Change. Fittingly, HITS will take a holistic perspective to targeting healthcare associated infections. The conference looks to focus on “hospital health.” By including multiple disciplines in the conversation, HITS looks to remove silos and encourage a systems approach, aligning with infection prevention.

Who Should Attend? Hospital management and Administrators
Healthcare facilities and Environmental Services managers
Research Scientists and Industry experts
All those with backgrounds in:

Building water health
Environmental microbiology
Environmental transmission
Epidemiology
Ethnography
Infection prevention
Healthcare Environmental Services (EVS)
Healthcare Facilities Management
Hand hygiene

Learn more: Web: http://www.hitsconsortium.org

Speakers: http://www.hitsconsortium.org/speakers.php

For questions or to join their mailing list, email: hits@nsf.org

Twitter: @HITSConsortium

Collaborative Partners: NSF International

University of Arizona

Sedexo

InfectionControl.tips

The Ohio State University

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About the Infection Prevention and Control Series If you liked this episode then you should also check out our 8-Part Series on Infection Prevention and Control (IPAC). We’d like to thank our partners InfectionControl.tips and the Center of Excellence for Infection Prevention and Control (COE IPAC) for their support and guidance with that series.

About InfectionControl.tips

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

About Center of Excellence for Infection Prevention and Control (COE IPAC)

Center of Excellence for Infection Prevention and Control (COE IPAC) is a collaborative effort to accelerate and support new solutions that hold the promise of significantly advancing infection prevention and control. On a quarterly basis, the Center of Excellence will evaluate at least 3 international innovations – giving them access to independent testing, publication as well as a US commercialization site

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Healthcare is the most intermediated business in the history of the world. There's always someone, and usually several someones, in between the clinician and the patient. Similarly, while most of us working on the business of healthcare will enthusiastically agree that we do this for the patients, we spend very little time talking about them. Of course, I'm not referring to the "front-lines" of healthcare delivery (i.e. doctors, nurses, etc.) or even their immediate support team at the hospitals and clinics. I'm talking about those of us who are working in the background to enable "healthcare transformation". While we try to fix provider directories, calculate quality measures and otherwise streamline the business of healthcare, we're regularly focused on the complex, technical details of those problems. The concept of the patient is usually abstracted. Even when we talk about things like "covered lives", we tend not to discuss them as actual people; as our grandparents or brothers or children.

That's not wrong, per se. We all need to focus on our part of the mission and trust that our "team" is giving us the right problems to solve. However, we may be selling ourselves short. It can be incredibly powerful to remind ourselves from time to time that we are, in fact, ultimately working for the patients. It's the "commander's intent" behind what we're doing and should guide us as we make 100s of seemingly unrelated micro-decisions throughout our day. The expanded perspective helps us to re-center our "why" and keeps us moving productively towards a healthcare system that works for all of us (i.e. patients, providers, health plans, administrators, entrepreneurs, government, etc.).

That's why we talked to Tam Ma, Legal and Policy Director at Health Access California. Tam explains why provider directory accuracy is so important from the patient's perspective and why her organization was vocal in the crafting of California's SB-137 legislation. In doing so, she helped me realize that we're aiming way too low with our solutions in this space. We're still struggling with the basics:

Where does the doctor work?
How do I contact them?
Are they accepting new patients?
Will they accept my plan, or will I get nailed with dramatically higher out-of-network charges?
Etc.

We've demonstrated the reasons why these seemingly simple questions are so difficult to answer throughout this series. It's hard, but we shouldn't expect any pats on the back when we're done. Instead, we should expect a resounding "It's about time" from the patients. That's because we're still playing catch-up with their most basic expectations. I should know who's in a plan before I buy it. They should be able to tell me the doctor's correct phone number. By looking at this patient perspective, we can start to see why this isn't enough. It's a step on the path, but we need to aim higher so we can start to deliver real value and truly address the convenience and access issues that patients face. When a patient can reliably search for a dermatologist who participates in Medicaid, is accepting new patients, offers Saturday appointments and has an office (that they actually work at) on the 15 bus line, then we'll have arrived.

Tam and I break down these ideas and much more including:

What is Health Access California?
Why did you get involved in SB-137?
Where do provider directories fall short?
Who's responsible for provider directory accuracy? Who should be held accountable?
SB-137 has provisions that allow health plans to take action against non-compliant providers (i.e. de-listing). Are these viable options in the face of network adequacy regulations and other tangential pressures?
Beyond having accurate information, how can we improve provider directories for the patients?
What customer-facing tools can we adopt from other industries like retail?

Bonus: Tam tells us about new regulations in California that protect patients against unexpected out-of-network bills.

I hope this episode broadens your horizons on what a proper provider directory should look like. It did for me.

Enjoy!

Don Lee

Check it out on:

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Prefer to read it? Grab the full transcription PDF here!

About Tam Ma Tam M. Ma is Legal and Policy Director at Health Access California, where she represents the interests of health care consumers in the Legislature and before administrative and regulatory entities. Tam started her career as a California Senate Fellow and was previously senior staff to Senators Mark Leno and Sheila Kuehl, where she advised the Senators on policy and state budget issues relating to health and human services, consumer protection, housing, judiciary, and women's issues. She also advocated for the rights of low-income tenants when she was a trial attorney with Legal Services of Northern California's Sargent Shriver Civil Counsel Act project.

Tam was honored by the California Partnership to End Domestic Violence and the California Coalition Against Sexual Assault for her work to strengthen protections for survivors of these crimes. She sits on the board of the Women's Foundation of California and has served as a trainer and mentor for the foundation's award-winning Women's Policy Institute since its inception in 2003. Tam also serves on the board of the Asian/Pacific Bar Association of Sacramento and is Past President of My Sister's House, a domestic violence shelter serving women throughout the Central Valley. Tam received her B.A. and J.D. from the University of California, Berkeley.

About Health Access California Health Access California is the statewide health care consumer advocacy coalition, advocating for quality, affordable health care for all Californians.

As a coalition organization representing consumer groups, communities of color, immigrants, people with disabilities, children, seniors, women, people of faith, and organized labor. Health Access seeks to connect grassroots organizing to policy work, on-the-ground mobilization with savvy Sacramento strategy. Coalition member organizations can count on Health Access for timely analysis and tools so that whatever time and effort they have for health advocacy is spent in the most effective way possible.

http://www.health-access.org/

@healthaccess

Mentioned on the Show Secret Shoppers Find Access To Providers And Network Accuracy Lacking For Those In Marketplace And Commercial Plans (Health Affairs)

DMHC Fines Blue Shield and Anthem for Provider Directory Inaccuracies

About the Provider Directory Podcast Series This episode is part of our ongoing Provider Directory series that aims to dissect the issue from all perspectives, including provider, payer, patient, and regulator. Our goal is to help facilitate an expanded national conversation that drives us towards an open, collaborative industry solution.

Check out all our Provider Directory posts and episodes here!

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You'll get one email from me each week detailing:

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How do you eat an elephant? One bite at a time.

That may be the best advice I can give the healthcare industry at this point.

On this episode, we talk with Dave Marotz, Director of Directory Services at Surescripts to break down the Provider Directory concept into its component parts... "capability style".

We go deep on the technical and architectural hurdles that need to be overcome to progress Provider Directory. You'll learn about:

The various standards-based approaches that have been/are being attempted.
New wrinkles on provider context and how we may need to know what the truth was about them at a certain point in time (i.e. rights to dispense a prescription).
What should be shared? Who should own the "shared data"?
Why it's hard to get something as simple as proper provider names.
Strategies for identity proofing and identity resolution.
Decomposing the conceptual master provider directory into its component parts
The various industry and commercial approaches to provider directory solutions.
The wisdom of working prototypes over ideas for standards or approaches.
How Surescripts evolved, why they're so interested in Provider Directory and why they're so supportive of collaborative solutions.

Dave is a technical wizard when it comes to provider directory data and networks. Get ready for a mental workout!

~Don Lee

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Prefer to read it? I don't believe you, but I'll still let you download the PDF here!

About Dave Marotz Dave Marotz is Director of Product Innovation at Surescripts, responsible for provider directory services which enable e-prescribing and the electronic exchange of clinical information. He joined Surescripts in 2010 to lead the network expansion for E-Prescribing of Controlled Substances (EPCS) and supported EHR and Pharmacy during development and adoption of the technology (e.g., DEA IFR Part 1311 compliance, and Identity Proofing/Two Factor Authentication requirements). Prior to joining Surescripts Dave spent seven years with Accenture’s Health and Life Sciences group leading delivery projects under FDA and CE regulations and involving cross-industry information exchange utilizing Health Level 7 v2 messaging and v3 modeling. Dave earned his undergraduate degree in Economics from St. Olaf College. In 2015, he received his MBA from Yale School of Management, focused on Leadership in Healthcare.

Contact: Dave.Marotz@surescripts.com

About Surescripts Surescripts purpose is to serve the nation with the single most trusted and capable health information network. Since 2001, Surescripts has led the movement to turn health data into actionable intelligence to increase patient safety, lower costs, and ensure quality care. Visit us at Surescripts.com and follow us at twitter.com/Surescripts.

Check out all our Provider Directory posts and episodes here!

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This week's guest is Martin Dunn, CEO of Gaine Healthcare. Martin frames up the current state of provider data and directory issues quite well with this quote:

"It doesn't matter how much you regulate the docs, It doesn't matter how much you've threatened the docs. It doesn't matter how much you incent the docs to pull this information together for you. If you ask questions that are difficult to answer, difficult to understand, impossible to keep up with because the doctors and the physicians and the provider organizations just don't have the systems in order to give you that information, you're not going to get it."

Sticks Won't Fix Provider Data So, we can't just beat the doctors into submission (pun intended)? What about SB-137? That law has "teeth" to hold the providers accountable. Not so fast, says Dunn. The first provision is that payers can withhold payments for providers who don't respond in a timely manner with quality data (Bill Barcellona called this "the Hammer Provision" in episode PD-02). That's nice, but it's probably not a good way to do business nor to build collaborative relationships between providers and health plans. The other provision is that health plans can delist providers with out-of-date data. But, as Dunn points out, then you've got health plans breaking their own network adequacy. It's kind of like cutting off your nose to spite your face.

Using Operationally Validated Provider Data Our position at The #HCBiz Show! has always been that this provider data exists, but it's all over the place and hard to find. More importantly, you have to find it and capture it without adding new work to the providers' plate. Anyone selling into healthcare knows new work is a non-starter.

So, what can we do? Martin offers us a bit of genius on the matter: "Use the existing, trusted relationships". He points out that the providers have already self-selected the people they trust to keep track of their most important data. They've outsourced their credentialing to one vendor, their billing to another, and so on. Once you've identified the provider data you need, grab the provider's list of vendors and find out who's the source of truth for each element. The process dictates where the information is stored. According to Martin, we should:

"Connect into existing business processes; existing trusted relationships. Get back to their system so that we can gather that new information. When we find a conflict we can report it out to the people, who in their normal course of business, would want to resolve that conflict. We didn't find the conflict and add it to someone else's "to-do list". We've used the network to identify things that these organizations want to do anyway."

I like to refer to this as "Operationally Verified Provider Data". If you can identify a source, where the data absolutely, positively has to be correct in order for them to do their work, then you've found your source of truth. Will it always work? No. Of course not, but you're playing the odds that the billing vendor has the most operational opportunity to find and fix problems with... billing data. That sounds like a good bet to me.

On this episode... I discuss these key topics in more detail and so much more with Martin Dunn, CEO of Gaine Healthcare, including:

Why data quality should be defined as fitness for purpose (and therefore the importance of understanding your purpose).
Why you should only trust the contract signatory to interpret the facts.
How to use a practices vendor list to build a strategy for provider data collection.
The challenge of tracking and balancing provider Full Time Equivalency (FTE) in support of provider directories and network accuracy (a new wrinkle that hadn't yet been discussed in our series).
What the future holds for the healthcare industry as it pertains to provider directory and the many efforts and collaborations that are underway to address it.
How Gaine Health uses its Sanator product to address these issues. Martin walks us through a few scenarios and use-cases.

This episode turns out to be a key part of our series. I promise you'll learn something new.

Enjoy!

~Don Lee

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Download the full transcription as a PDF.

About Martin Dunn Mr. Martin Dunn is an expert in the field of data management. He has founded several successful companies, on three continents focused on making information actionable for large corporations.

Martin was the co-founder and CEO of Gaine Solutions, the first company to offer Master Data Management Software as a Service (SaaS) with clients across multiple industries. Martin is presently the CEO of Gaine Healthcare which is focused on addressing the critical unmet needs of healthcare delivery organizations.

Previously, Martin was the co-founder and CEO of Delos Technology, the world’s first Enterprise MDM Software provider. Delos merged with Siperian in 2003 before selling to Informatica in what remains, the largest ever acquisition by Informatica.

About Gaine Healthcare Gaine Healthcare enables interoperability between disparate systems allowing clinical, administrative and analytic systems to exchange information relating to patients, health plan members, health care providers and facilities without the need for complex integration code.

For more information go to www.gainehealthcare.com/about

Gaine created the Sanator Provider Registry, a collaborative platform that enables provider organizations and health plans to exchange provider information in an efficient process that reduces administrative overhead for both parties. Sanator eliminates unnecessary outreach by phone and fax to medical offices and gives providers a trusted platform to collect and distribute information to health plans.

For more information go to www.provider-registry.com

Check out all our Provider Directory posts and episodes here!

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Friedrich Nietzsche argued that there are no facts, only interpretations. It seems that this idea holds true for provider data too. Today's guest is Andrew Kobylinski, Head of Platform at BetterDoctor. Andrew tells us that the provider directory issue is first and foremost a data quality issue. At the heart of data quality, he says, is metadata that explains where the information came from, what it means, when it was updated, and more. This metadata is the interpretation and without it, your facts are pretty much useless. According to Andrew, "collecting the data is one-half of the problem. It's actually the easier half. The other half of the problem is taking the data that you've collected and sharing it with all the stakeholders that need it in the format they can actually consume and trust".

Andrew admits that there's a fair amount of complexity in the context (i.e. interpretation) of provider data and that it does make for an interesting challenge. However, he thinks the healthcare industry uses this complexity as an excuse for bad user interface design. With better user-interface design, many of the context issues go away.

Another key idea from Andrew is that there's a consumer aspect to all of this. He's not talking about the patient, but rather the provider as a consumer. That is, many providers are paying to have their information kept up-to-date and propagated to sites like Yelp, Yext, and others. That, coupled with Andrew's real world experience in working with doctors, suggests that they do want this data to be correct and they want people to have access to it. So, we have the need, the desire, and the resources. It's time to give doctors the tools they need to get the job done.

Andrew, co-host Shahid Shah and I discuss all of this and so much more. Here are some highlights:

Why we should approach provider directory as a data quality problem (3:05)
How did BetterDoctor get into the provider directory space? (4:20)
How BetterDoctor's involvement in the AHIP Provider Directory Pilot solidified their pivot (8:25)
How to know what the right data is and why it's important to share the metadata in support of quality and context (10:12)
How the industry uses complexity as an excuse for bad user interface design (13:40)
BetterDoctor's approach to collecting high-quality data (15:52)
What's the provider's incentive to respond to information requests and keep their data up-to-date? (21:30)
The often overlooked consumer aspect of this issue is that many providers pay to have their information updated and syndicated to sites like Yelp, Yext and more. They want it to be correct and they want everyone to have it (24:04)
Why many innovation labs and coding camps are making use of BetterDoctor's API (26:03)
Should we incorporate credentialing into the provider directory issue right now? (28:30)
New innovation models like CPC+ and regulations like MACRA may require accurate provider network data as a pre-requisite for getting paid. Do these programs finally give us the incentives we need to solve this problem? (34:30)
What do you say to providers who look at the BetterDoctor form as more work or another distraction? (38:13)
BetterDoctor just closed an $11M investment round. What's next? (47:07)

As usual, I had a lot of fun with this one and learned a ton. I hope you enjoy it!

Don Lee

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Download the full transcription here

About Andrew Kobylinski and BetterDoctor As Head of Platform, Andrew leads BetterDoctor's data and API business. Andrew has over ten years experience creating new products and bringing them to market at healthcare startups. Creating a solution to inaccurate provider data is his latest passion.

BetterDoctor delivers accurate provider directory data to ensure health plans, health systems, provider groups, and doctors are regulation-compliant and can provide patients with the care they’re looking for.

Learn more on the web: http://betterdoctor.com/

Developers: http://betterdoctor.com/developers/

Email: hello@betterdoctor.com

Twitter: @BetterDoctor

Check out all our Provider Directory posts and episodes here!

Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

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Life can be hard for entrepreneur's in healthcare. Sure, we've seen an increase in Digital Health investment over the past few years, but it remains exceedingly difficult for new companies to prove their value, align with complex reimbursement models and get that first customer. That's where Digital Health Accelerators like Startupbootcamp Miami come in. They're in the business of aligning startups with specific customer needs, and in doing so, can help founders make big leaps in a short amount of time.

This episode's guest is Christian Seale. He's the founder and Managing Director at Startupbootcamp in Miami, which focuses on Digital Health. More specifically, they focus on Digital Health Startups that can make healthcare more equitable, efficient and accessible. We'll talk with Christian about how you can build valuable companies that are fun and profitable, AND deliver a ton of social good.

This is a fun interview with an interesting back-story. We cover a lot of ground including:

How do Digital Health Accelerators enable innovation? (1:10)
A very different experience with healthcare in Colombia vs. one in NYC (4:43)
How Medicaid and other underserved communities are a big opportunity for startups and investors. (6:00)
Why Startupbootcamp chose Miami and Digital Health (11:18)
Why accelerator focus is so important (14:30)
Why healthcare should be focused on the needs of the Latin American community (17:20)
What it means to make healthcare more equitable, efficient and accessible (19:50)
Why certain communities are ignored and why that's a big opportunity (23:00)
How the biggest pain points for providers are often these overlooked communities (25:35)
Get commercial traction first and let the investment money come to you (27:00)
How to tell if someone is teachable/acceleratable (28:40)
What's in it for the founders who join Startupbootcamp Miami (31:00)
How did Startupbootcamp Miami get the health systems on board? (32:45)
What can a founder do to maximize their experience from a digital health accelerator? (36:00)
How can mission-driven startups stay focused on their big why as they continue to scale? (39:27)
How can founders apply to join Startupbootcamp Miami? (41:55)

I hope you enjoy it!

Don Lee

Prefer to read it? Transcription coming soon!

About Christian Seale Christian Seale is an entrepreneur and early stage investor committed to transforming healthcare and eradicating healthcare disparities. He has built Miami's first digital health innovation program and fund as an initial step towards his vision to make the city a globally recognized hub for healthcare innovation.

Christian’s efforts are supported by the Knight Foundation, Miami Children’s Hospital, University of Miami Health System, Univision and private investors. To date, eleven investments have been made in companies from across the US, Latin America and Israel.

Before his work in Miami, Christian was a founding member of Equitable Origin, the world’s first certification for responsible energy production which was featured in the award-winning PBS documentary Oil & Water. He is a Founding Member of NextGen Venture Partners in Boston and previously worked for consumer-only VC firm Maveron, Goldman Sachs and Teach for America. Christian is a World Economic Forum Global Shaper and a Fulbright Scholar. He is an active contributor to Univision and TechCrunch.

Christian earned his MBA from Harvard Business School and graduated Phi Beta Kappa and magna cum laude from Brown University.

About Startupbootcamp Miami Startupbootcamp is a global family of industry-focused innovation programs with 20 programs globally and a mentor network across 30 countries.
In Miami, Startupbootcamp has partnered with the Knight Foundation, Miami Children's Hospital, University of Miami Health System, Univision and private healthcare investors for its innovation program and seed fund focused on transforming healthcare from Miami. To date, the Miami program has invested in ten companies from across the US, Latin America, and Israel.

For more, visit: http://www.startupbootcamp.org/accelerator/digital-health-miami/

Office Hour Dates: https://www.f6s.com/sbcdigitalhealthmiamifasttrack/connect

Email: Digitalhealth@startupbootcamp.org

Twitter: @SBCHealth

Mentioned on the Show It’s Time The Tech Industry Paid Attention To The Healthcare Needs Of The Hispanic Community

RockHealth

StartupHealth

Best in Class Care

Stryker's MAKO Surgical Acquisition

Magic Leap

CVS Caremark takes aim at Hispanic, specialty pharmacy market with Navarro deal

Hoy Health

ConsejoSano

Keep Living

TruClinic

DreamIt

BabyScripts

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On this episode, the fourth in our ongoing Provider Directory Series, we continue to unravel the "why" behind provider directory inaccuracies. One major theme that's emerged is that we have a context gap between health plans and providers. That is, even when we're asking the right people at the right time, we might be asking the wrong questions.

Our guest, Ron Urwongse, a Senior Product Manager at CAQH, explains how adding a level of specificity to our questions can yield dramatically different results. For example, if you ask a provider if they work at an office, they may say yes even if there's only a slight chance they ever will (i.e. to cover for a colleague). The tendency, Ron explains, is that providers play defense - they don't want to have a claim denied if they ever do submit one from that office.

By adding some specificity to our questions, we could cut down on the confusion. How often do you work at this office? Or, do you accept new patients at this office? Are bound to yield more accurate results. These follow-on questions help the providers to understand what they are truly being asked. We can add even more context by making sure they know how the information is going to be used. Where do you bill from so that our billing department can process your claims properly? Where should our provider directory list you as accepting new patients?

Ron and I discuss this context issue and so much more, including:

What is provider data? (2:00)
Besides demographics, what else do we need to know about providers? (4:00)
In addition to patients, who else is affected by bad provider data? (5:30)
We're spending billions of dollars managing provider directories. Why are they still broken? (8:15)
Is it fair to place accountability on the providers and put pressure on them to resolve this issue? (10:57)
What are the proposed penalties from CMS for Medicare Advantage plans whose directories fall out-of-date? (11:50)
Has anyone been fined yet? (12:10)
Do health plans do a good job of sharing provider information across departments within their own organization? (12:10)
Why can't I just go to NPPES? Why aren't the doctors keeping their data updated? (15:00)
Why do providers (and their groups) report that they work at locations that they don't work at? (17:37)
Why do providers feel that their data submissions fall into a black hole once submitted? (20:00)
The typical 5 -doctor practice has 12 contracts and each of them requires 140 data points. That's 8,400 data points for a relatively small practice. (21:20)
Are the regulators being reasonable in their demands? (23:30)
How does contracting and reporting at the group-level cause problems for provider directories? (25:30)
Is there any reluctance to share because of security/privacy/competitive concerns? (29:15)
How does the expansion of the care team make this problem more complex? (31:40)
What's happening on the solution side? (33:15)
How can we foster safe collaboration among industry competitors? (34:10)
A call to reduce provider burden, while simultaneously raising their accountability. (35:00)
What is the minimum necessary data set for provider directories? (38:30)
What is CAQH doing to solve the problem of bad provider data/inaccurate provider directories? (37:00)

I hope you enjoy it!

Don Lee

About Ron Urwongse and CAQH Ron Urwongse is a Senior Product Manager at CAQH. Ron guides the cross-functional team responsible for CAQH ProView. Previously, he led product development and operations at Tyrula LLC, focusing on risk adjustment and quality improvement solutions in managed care. At Vecna Technologies, Ron served as a product manager. He also led the development of a billing solution for the Massachusetts Commonwealth Connector, the first state health insurance exchange website. Ron received his MBA from the MIT Sloan School of Management, Master’s Degree in Information Systems Management from Carnegie Mellon University, and B.S. degree in Information Systems from Carnegie Mellon University.

CAQH, a nonprofit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients, and health plans.

COB Smart® quickly and accurately directs coordination of benefits processes.
EnrollHub® reduces costly paper checks with enrollment for electronic payments and electronic remittance advice.
CAQH ProView® eases the burden of provider data collection, maintenance, and distribution.
SanctionsTrack® delivers comprehensive, multi-state information on healthcare provider licensure disciplinary actions.
DirectAssure® helps health plans increase the accuracy of provider directories.
CAQH CORE® maximizes business efficiency and savings by developing and implementing federally mandated operating rules.
CAQH Index® benchmarks progress and helps optimize operations by tracking industry adoption of electronic administrative transactions.

Learn more:

CAQH Home: https://www.caqh.org/

Provider Data Action Alliance: http://CAQHProviderData.org

Provider Data Tools from CAQH: http://ProviderDataManagement.org

Defining Provider Data Whitepaper: https://www.caqh.org/about/defining-provider-data-white-paper

Twitter: @CAQH

Mentioned on the Show JAMA: The Accuracy of Dermatology Network Physician Directories Posted by Medicare Advantage Health Plans in an Era of Narrow Networks

Health Affairs: Secret Shoppers Find Access To Providers And Network Accuracy Lacking For Those In Marketplace And Commercial Plans

CMS Online Provider Directory Review Report

Check out all our Provider Directory posts and episodes here!

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There are two kinds of Provider Data Explicit provider data comes directly from the providers, their groups or even their IT systems (i.e. EMR, RCM, etc). Since this data is coming from the source, it's assumed to be up-to-date and accurate. However, as we learned in episode 11 (PD-02) there are subtleties and complexities to consider. For example, there are scenarios where it's best to go straight to the provider and others where you must talk to the group instead. You see, there are contractual complexities that change the context of the information. The context of the data is as important as the data itself.

Implicit provider data comes from secondary activities that involve the provider. For example, we can use claims data to make certain assumptions. You should be able to look at claims data and see what facilities they work in. If they submit a claim for a procedure done at facility X, then they should be listed at facility X on our provider directory. Right? Riiiiight???? Not so fast! That provider was covering for her colleague who was away at a medical conference and may never work in that office again. She certainly won't be accepting any new patients there. If you add her to that location in your directory and later CMS tries to verify she works there... DING! That'll be $25K. Thank you. Come again! I'm being a bit dramatic to make my point, but once again, we need context.

On this episode (part 3 in our ongoing provider directory series), Mark Martin, Director, Payer and Vendor Portfolio at Availity, tells us about the gap between what is known (explicit provider data) and what is assumed (implicit provider data) and the difficulty that lies between. It's a fascinating discussion that addresses this gap, and so much more. I hope you enjoy it!

Don Lee

Prefer to read it? Transcription coming soon!

About Mark Martin and Availity Mark Martin (@HIT_MMartin) is Director, Payer and Vendor Portfolio at Availity.

As an industry-leading, HITRUST-certified health care information technology company, Availity serves an extensive network of health plans, providers, and technology partners nationwide through a suite of dynamic products built on a powerful, intelligent platform. Availity integrates and manages the clinical, administrative, and financial data needed to fuel real-time coordination between providers, health plans, and patients in a growing value-based care environment. Facilitating over 8 million transactions daily, Availity's ability to provide accurate, timely, and relevant information is vital to the financial success of its clients. For more information, including an online demonstration, please visit www.availity.com.

Mentioned on the Show Lessons Learned from AHIP’s Provider Directory Pilot Programs - Summary blog post

Provider Directory Pilot Program Overview and FAQ - w/ link to Full White Paper

5 Reasons Accurate Directory Information Helps Providers by Mark Martin

Inaccurate provider directories create barriers to care by Mark Martin, Dianne Wagner

Check out all our Provider Directory posts and episodes here!

Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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The national provider directory discussion is clearly focused on the patients and health plans. It focuses on the patients because they're the consumer of this information and without it, they can't make educated decisions when buying health insurance. The conversation focuses on health plans because they're the ones being held accountable for making the information available to consumers. To effectively address this issue, we also need to take a good hard look at things from the providers' point-of-view. That's what this episode is all about.

We'll talk with Bill Barcellona, Sr. VP for Government Affairs at CAPG, which is a national association that represents physician organizations who practice capitated, coordinated care. Bill does an excellent job of sharing the providers point-of-view on the provider directory issue and shows us how provider groups can take the lead on cleaning things up. Bill also tells us about California's SB-137 and explains how it's putting pressure on both health plans and provider groups. It's a fascinating discussion that will expand your understanding of this increasingly complex issue. You'll learn:

What is SB-137? (1:20)
Where do all the provider directory errors come from? (3:19)
Who's responsible for provider directory accuracy? Who's accountable? (5:00)
What does SB-137 call for specifically? (7:45)
How have providers responded to the accountability placed on them by SB-137? (11:00)
What is the SB-137 timeline (12:45)?
Why can't health plans pull accurate provider demographics from the claims? (13:25)
Why is it beneficial to address this problem on the provider side? (17:30)
How else are providers impacted by this problem? (19:30)
When should the health plan go directly to the provider for info? When should they go to the group? Why is there a distinction? (20:40)
How can inaccurate provider directories lead to FTC/anti-trust scrutiny? 24:50
How is CAPG working with Gaine Solutions (Sanator) to help providers address the issue? (26:45)
What is the California Provider Directory Collaborative? (30:30)
Can a California-based solution scale nationally, or are California's problems unique? (33:00)
What are the risks associated with a state-wide or nation-wide solution? (34:27)
How SB-137 and other rules have killed the idea that narrow network details are proprietary information (37:15)
Defining a public API for master and metadata needed to share information about contracts, networks, products, and providers nationwide.

Or, listen right here:

Prefer to read it? Transcription coming soon!

About Bill Barcellona Bill Barcellona serves as the Senior Vice President for Government Affairs for CAPG, overseeing state and federal legislative and regulatory activities for the association in Sacramento and Washington, DC. Bill is the former Deputy Director for Plan-Provider Relations for the Department of Managed Health Care in Sacramento. In that capacity, he oversaw health plan operational issues and handled policy matters for the DMHC. Bill has a Masters in Healthcare Administration from the University of Southern California and serves as an adjunct faculty member at USC and also holds a B.A. in political science and a J.D. He enjoys teaching and lecturing across the country on health care management, operations and policy matters. He has practiced law for 28 years in California and prior to his service at the DMHC he spent 16 years at two major law firms in Newport Beach and Sacramento, primarily as a civil litigator. His current legal experience includes general health law matters with an emphasis in Knox-Keene Act and managed care issues.

Bill is a former Judge Pro Tem in the El Dorado County Superior Court and served as an appointed member of the California State Bar Association Insurance Law Committee. He was previously awarded the 2009 Alumnus of the Year by the USC Health Services Administration Alumni Association, and a 2-year term as a board member of the Health and Human Services Privacy and Security Advisory Board. He lives in Folsom, a small town in the foothills of the California Gold Rush. He has been active in the community for over 20 years, serving as a Planning Commissioner for the City of Folsom, chairing bond measure campaigns to build new schools, serving as an officer of the Folsom Economic Development Corporation and in the past as a Director of the Folsom Chamber of Commerce. Bill currently serves as a member of the USC Price School Health Advisory Board.

About CAPG CAPG is the leading association in the country representing physician organizations practicing capitated, coordinated care. Their membership currently comprises close to 300 multispecialty medical groups and independent practice associations (IPAs) across 42 states, the District of Columbia, and Puerto Rico.

Learn more:

http://www.capg.org

@CAPGVoice

Register now for the CAPG Annual Conference 2017 - June 22-24 in San Diego, CA - CAPG's Annual Conference attracts national industry leaders from top medical groups, independent practice associations, hospitals, health plans, and government who come together to learn about the latest and greatest in capitated, coordinated healthcare.

Also mentioned on the show:

California Provider Directory Collaborative - The California Provider Directory Collaborative Community of Practice is an online forum dedicated to supporting a statewide dialogue on critical provider data and directory issues and to inform regulators as they implement SB 137. Please contact us at ProviderDirectory@manatt.com if you have any questions or would like to learn more.

CAPG White Paper: Provider Directories - Driving Accurate Lists for Consumers

Sanator Provider Registry by Gaine Solutions

SB-137 California's SB-137, which took effect on July 1, 2017, is one of the most aggressive pieces of legislation addressing the provider directory issue at the state level. It also became the first legislation that holds providers directly accountable for reviewing and updating their records with the health plan. If providers fail to share updates in a timely manner then health plans can remove them from the directory, withhold full or partial payments for up to 1-month (the so-called "hammer provision"), or even terminate their contract. This bill has real teeth and it's gotten people's attention.

Check out all our Provider Directory posts and episodes here!

Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

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In 2016 we saw new provider directory regulations from CMS and several states, including the particularly "toothy" SB-137 in California. The new rules are intended to hold health plans accountable for any inaccurate and/or incomplete information in their provider directories. The national conversation is focused intently on the consumer side. That is, bad information makes it difficult for patients to make educated decisions when they select plans and can lead to access issues down the road.

The consumer issues are real, but only scratch the surface of the overall provider data problems we face.

Health plans and provider groups struggle to keep each other up-to-date making communication more difficult and less efficient.
Even departments within the same organization have trouble staying in sync and that leads to all types of problems in our day-to-day operations.
Government and regulatory bodies are hindered in their efforts to ensure appropriate access and coverage in our health plans.

When you put this all together you'll begin to see why I call provider directories the ultimate death by paper cut in healthcare. This is not as simple as it sounds.

Kicking-off the Provider Directory Series Over the next 6-8 weeks The #HCBiz Show! will be focused on the provider directory problem. We'll talk with experts who are dealing with this issue from all sides to understand what the issue is, why it exists today, and how we can fix it.

For background, you can check out our video conversation and the accompanying post from last year. You may also enjoy our breakdown of CMS' first review of provider directory accuracy.

On this episode, co-hosts Don Lee and Shahid Shah give an overview of the issues and talk about the upcoming series. You'll hear:

Lessons learned from our Infection Prevention and Control Series (1:05)
The difference between being Accountable and Responsible and how that can predict a solution's success or failure very early on (2:42)
What is the Provider Directory issue? (9:15)
Why narrow networks require accuracy and adequacy (11:30)
Why half of the nation's health plans would be fined if CMS implemented them today (14:00)
How inaccurate provider directories impact patients (15:00)
How the fines are making someone accountable for the first time (18:00)
Why it's hard to keep just 15-20 basic pieces of information up-to-date (19:00)
How the need for health plans to let patients understand their narrow networks conflicts with their desire to keep their competitors in the dark (21:20)
How the bad data affects health plans internal day-to-day operations (22:20)
What can we learn from the internet's Domain Name System (DNS) (25:50)
Who is responsible vs. who is accountable (26:40)
How are provider groups and health systems impacted by bad provider data (27:25)
How organizations like the AHIP Innovation Lab can help bring industry leaders together on problems like this (28:40)
Why it's important to apply accountability at the right "height" within an organization (30:24)
How a federated solution might work at the national level (34:00)
How to enable collaboration in a competitive market (38:20)
Why it makes sense that the accountability is being placed on the health plans today (40:25)

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The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

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Darrel Hicks is internationally recognized as one of the subject matter experts in infection prevention and control as it relates to cleaning. He has written and published numerous articles in professional and healthcare related journals as part of his commitment to providing a cleaner, safer and healthier indoor environment.

Darrel has a specific interest in soft surfaces and what he calls "The Patient Hot Zone". That is the hospital bed and the 36" around it. There are high-touch surfaces here that can be difficult to clean and require some imposition on the patient (i.e. cleaning their bed rails while they're in the bed).

Today we'll learn about:

The Patient Hot Zone
Cleaning soft surfaces
How proper cleaning can improve patient satisfaction scores (I.e. HCAHPS)
The new CMS / Joint Commission requirements for patient mattresses – which came into effect January 1, 2017 – provide a new challenge to healthcare accreditation and safety/quality programs.
How 1 well-trained housekeeper can prevent more infections than a room full of doctors.
Why it's important to raise the stature of the housekeeping staff in the hospital - not the first time we've heard this.
How proper cleaning and treatment of soft surfaces can save hospitals large sums of money.

Subscribe on iTunes

About Darrel Hicks Darrel Hicks is the author of “Infection Prevention for Dummies”, a 43-page, pocket-size book that is focused on keeping the hospital’s environment healthy.

He began his career in the management of housekeeping services in 1981 and recently retired as Director of Environmental services at a 500-bed, award-winning hospital in the United States.

Darrel is nationally recognized as one of the subject matter experts in infection prevention and control as it relates to cleaning. He has written and published numerous articles in professional and healthcare related journals as part of his commitment to providing a cleaner, safer and healthier indoor environment.

Web: http://darrelhicks.com/

You can order a copy of Infection Prevention for Dummies on the site!

Also mentioned on the show:

Colleen Sweeney, RN conducted a survey on patient fears about the hospital.

Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

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About the Infection Prevention and Control Series This episode is part of The #HCBiz Show’s Infection Prevention and Control (IPAC) series. We’d like to thank our partners InfectionControl.tips and the Center of Excellence for Infection Prevention and Control (COE IPAC) for their support and guidance with the series.

About InfectionControl.tips

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

About Center of Excellence for Infection Prevention and Control (COE IPAC)

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Soundtrack credit: Acid Lounge by FoolBoyMedia

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What happens to an infectious agent once it leaves the human body? Well, it ends up in our cars, airplanes, food, water and soil. If we know how that contagion behaves "in the wild", then we'll be able to kill it, filter it, or otherwise prevent it from proliferating, and potentially improve the lives of millions of people in the process. This is the study of Environmental Microbiology and it's a topic that today's guest has spent more than 30 years trying to understand.

Dr. Syed Sattar is Professor Emeritus of Microbiology at the Faculty of Medicine, University of Ottawa. He is also a co-founder and Chief Scientific Officer at CREM CO. He's a world-renowned expert who regularly advises national and international agencies like the World Health Organization (WHO), and private-sector companies.

We're also joined by Bahram Zargar, CEO of CREM CO. This is a company built on top of Dr. Sattar's extensive body of work that aims to speed the assessment, development, and promotion of innovative and sustainable strategies for environmental control of harmful microbes for a safer tomorrow. It blends engineering with environmental microbiology to enable a whole new level of scientific rigor.

You'll learn:

What happens to infectious agents once they leave the body?
What can we do with that knowledge?
How air travel and the international food market have eliminated borders in the battle against infectious disease.
How engineering can support Infection Prevention and Control (IPAC) by enabling scientific rigor and validation.
How this science can be used to develop new barrier technologies.
What is lacking in today's IPAC efforts and where does it need to go?
How disinfectants can lead to their own form of resistance (i.e. bugs resistant to cleaning) and may even contribute to antibiotic resistance.
What's the biggest challenge in matching IPAC innovations with potential buyers in the healthcare system?
Why we need to enable our "foot soldiers" (i.e. the cleaning staff and environmental services teams at hospitals) with proper training and tools to win this war.
Why it's important for innovators and manufacturers to be more scientifically responsible (i.e. don't chase the bug of the month).
Why government needs to increase funding for research and development in IPAC.
Why it's so important to stand on the shoulders of the IPAC greats that came before us and build on their work.

A few key points that I'd like to highlight:

There's very little money set aside by governments for research and development in IPAC. If there's no money, then the best researchers aren't motivated to go after these issues and innovation is starved. We've seen that recently in the U.S with the constant attack on the Prevention and Public Health Fund.
We rely on our cleaning staff and Environmental Services (EVS) teams to do a very important job in the hospital, but we don't treat that position with much respect. "If our soldiers are not well trained and ill-equipped for battle, then how do we expect to win the war against the spread of infection?"
In a world of increasing antibiotic-resistance and anti-microbial resistance, we must focus on prevention in IPAC.

Subscribe on iTunes Sign-up for our weekly newsletter!

About CREM CO CREM Co is a contract and R&D laboratory uniquely positioned to provide value to the infection prevention and control (IPAC) industry as well as those working in health-related environmental microbiology and molecular biology.

CREM Co has the expertise for handling all major classes of pathogens in water, food, air, municipal wastes as well as on animate and inanimate surfaces. It can assess disinfectants and antiseptics using internationally accepted test protocols. Its state-of-the-art aerobiology facilities are designed to study airborne microbes and decontamination of indoor air.

Building on the rich history of the Centre for Research on Environmental Microbiology, CREM Co will continue to focus on the assessment, development, and promotion of innovative and sustainable strategies for environmental control of harmful microbes for a safer tomorrow.

http://www.cremco.ca/

CREM CO on LinkedIn

CANADIAN RESEARCHERS TEST INDOOR AIR DECONTAMINATION APPLIANCES FOR CARS

Indoor air as a vehicle for human pathogens: Introduction, objectives, and expectation of outcome

And this is a post about the event in Buffalo that we mentioned: Using Chemical Microbicides to Interrupt the Environmental Spread of Pathogens

Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.
The question of the week.

Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime.

About InfectionControl.tips

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

About Center of Excellence for Infection Prevention and Control (COE IPAC)

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Soundtrack credit: Acid Lounge by FoolBoyMedia

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Sepsis is not an infection. Rather, it's your bodies overwhelming reaction to an infection and can lead to some serious health issues. In fact, sepsis is the #1 cause of death for patients in hospitals.

Sepsis definitions and protocols have been around for some time, but have been undergoing major changes. Additionally, sepsis is under scrutiny from CMS at the federal level and is subject to public reporting in many states. All of this, plus the importance of quickly diagnosing and treating the condition puts clinicians in a difficult spot. Many times they'll find themselves treating to the protocol, even when their clinical instincts suggest something else.

In that regard, sepsis proves to be a very instructive topic in our never-ending quest to unravel the business of healthcare.

On this episode, we'll talk with Michael Ackerman who's an Acute Care Nurse Practitioner and an Associate Director and Professor at Niagara University School of Nursing. Michael is an expert on the topic who speaks on it across the country. He'll help us understand what we're up against and why it's so complicated from both a clinical and administrative standpoint. We discuss:

What is sepsis?
How is sepsis diagnosed?
Why it's so important to diagnose and treat quickly.
Why protocols and definitions continue to change.
How new definitions of sepsis seem to be at odds with public reporting.
How this impacts the clinicians and their ability to treat.
How public reporting and media impact the approach.
How proper identification and treatment impact healthcare costs.
Why we need to focus on quality, but can't ignore the patient experience, the costs of care or the value that you bring to that care.
What it all means to the patient and how we can protect ourselves.
Why hospital administrators need to take the long-view.
How a Sepsis-team can drive tremendous value to the hospital.
The importance of incorporating new technology.

Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter.

You'll get one email from me each week detailing:

New podcast episodes and blog posts.
Content or ideas that I've found valuable in the past week.
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Michael Ackerman’s Background: Michael (Mike) Ackerman has held just about every role nurse could; from Candy Striper to Senior Director. His entire career has been in the critical care arena from staff nurse, nurse manager, clinical nurse specialist, nurse practitioner and most recently senior director of nursing. He has over 50 publications as well as several funded studies.

In addition, he has held leadership roles in academia. Mike has a passion for critical care nursing. This is evident in his much sought after presentations on a variety of critical care topics. He also has a passion for the “Crucial Conversations” program which he has implemented in two of his recent institutions. This implementation has been a catalyst in much of Mike’s work in the area of culture change.

Mike is a skilled clinician, avid researcher, motivational speaker and caring leader. Leading from the bedside has been a consistent theme in Mike’s career.

Check out Mike's facebook group: Stop the Silence in Healthcare and learn more about him here: www.ackermanhealthcareconsulting.com

Michael will be speaking at The National Teaching Institute & Critical Care Exposition in Houston from May 22-25.

Mentioned on the Show Mike mentioned a book on the episode called Take this Book to the Hospital With You. It's a consumer guide to surviving your hospital stay. I've never read that one, but I'm currently reading The Patient Survival Guide: 8 simple solutions to prevent hospital and healthcare-associated infections by a friend of the show Dr. Maryanne McGuckin and Toni L. Goldfarb.

Doctor Turns Up Possible Treatment For Deadly Sepsis - Dr. Paul Marik uses Vitamin C to treat Sepsis cases with great success.

Sepsis Alliance - On a mission to save lives and reduce suffering by raising awareness of Sepsis as a medical emergency.

About InfectionControl.tips

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

About Center of Excellence for Infection Prevention and Control (COE IPAC)

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Soundtrack credit: Acid Lounge by FoolBoyMedia

Take This Book to the Hospital With You: A Consumer Guide to Surviving Your Hospital Stay Rev Upd edition by Inlander, Charles B.; Weiner, Ed published by Peoples Medical Society Paperback

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There are two things I can say for sure. First, healthcare-associated infections (HAI) cause a lot of suffering and cost a lot of money. Second, it's really hard to sell into healthcare, even when you have an innovative product that attacks a well-known problem in a common-sense way. On this episode, we get to dive into both of those things.

Infection Control and Environmental Surfaces Over the past decade, substantial scientific evidence has accumulated indicating that contamination of environmental surfaces in hospital rooms plays an important role in the transmission of several key HAIs. Environmental surfaces contribute to cross-transmission of pathogens. These surfaces include both nonporous (hard) surfaces and soft surfaces such as bed linens, gown, mattress, etc. The more a patient comes into contact with a surface, the more important it is to keep it clean. Well, what happens if you can't keep your pillows clean? Many standard issue hospital pillows allow pathogens to enter through sewn seams, vents, and non-barrier covers. Then patients put their heads on them. It's an issue that seems to have a common-sense call-to-action, much like hand-hygiene. But as we've seen, common sense and good products ae not all you need to penetrate the healthcare market.

Selling into the Hospital Innovators and entrepreneurs who want to make it in the healthcare business should absolutely focus their efforts on delivering products and services that help patients. That is, after all, the whole point of what we're doing. But if your sales strategy relies on what you've deemed to be "common sense" and "good for the patient" and nothing else, then you're likely to fail.

When David Woolfson and his team at Gabriel Scientific started winning awards for their hermetically sealed pillow with a filter, they thought they had short-circuited the healthcare sales cycle. As we'll hear, it drove some VC attention but did little to open doors at the health systems. David's story is instructive in many ways, but it delivers a truth that many in the startup community won't want to hear: it's going to be a grind and there are no short-cuts.

Episode 006 (part 5 of 8 in our IPAC series): On this episode, we talk with David Woolfson to learn:

How soft surfaces like pillows and mattresses contribute to the spread of infection in hospitals.
How outbreaks close hospital rooms and impact revenue
How working in infection prevention often makes you feel like Cassandra (in Greek mythology she had the power of prophecy but was cursed so that no one would ever believe her).
How to isolate your value, show direct economic impact and get on your buyer's priority list.
The importance of understanding the purchasing systems of your prospects and adjusting your approach to match it.
The importance of understanding your buyer and their personal needs as much as the hospital's needs.
What the heck "Stars and Stripes selling" means.
How to get the experts talking about your product and leveraging that to open doors (even just a crack)
Who is the hardest person in the hospital to convince
How to keep yourself safe and healthy at home, at the hotel, and the hospital.
And most importantly, how an Irishman can be an asset on St. Patrick's day and get you free pints!

I hope you enjoy it!

~ Don Lee

About David Woolfson and Gabriel Scientific David Woolfson is CEO of Gabriel Scientific in Dublin, Ireland.

Gabriel Scientific is a life sciences company dedicated to the design and manufacture of barrier property bedding for the hospital, hotel, and home. Gabriel Scientific products are CE marked medical devices, used by Infection Control and Tissue Viability Departments to combat medical bedding contamination.

SleepAngel products with PneumaPure Filter Technology are scientifically proven to block hospital pathogens and reduce the risk of patient cross-infection.

SleepAngel home bedding is scientifically proven to block germs and allergens that can trigger asthma and allergic reaction.

Learn more:

http://www.sleepangel-medical.com/

https://www.youtube.com/user/PneumaPure

https://www.facebook.com/SleepAngel.Social

@SleepAngelTweet

Gabriel Scientific on LinkedIn

About InfectionControl.tips

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

About Center of Excellence for Infection Prevention and Control (COE IPAC)

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Soundtrack credit: Acid Lounge by FoolBoyMedia

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Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), often called C. difficile or C. diff impacts 453,000 people every year. And with 29,000 associated deaths, it takes more lives than AIDS and drunk-driving combined. Yet, most people have never even heard of it. That's a big problem because you can't protect yourself from a threat when you don't even know it exists.

The impact on the business of healthcare is significant too. A study published in the American Journal of Infection Control found that C. diff-associated diarrhea (CDAD) increases hospital costs by 40% per case (an average of $7,285 ) and puts those infected at high risk for longer hospital stays and readmissions. Some even believe those numbers are likely underestimated.

C. diff presents us with an interesting problem at the cross-section of Infection Prevention and Control (IPAC). It's an environmental bacterium that's found pretty much everywhere and is difficult to kill, but it's usually held in check by the good bacteria in our bodies. The problem usually occurs when a patient is in a weakened state from some other healthcare intervention. That may be an antibiotic treatment for another healthcare-associated infection or chemotherapy, etc. With our bodies in a weakened state and our good bacteria depleted by antibiotics, we become susceptible to C. diff. So, it's important that we execute on all the other IPAC practices like proper hand hygiene and surface cleaning in the hospital so that, as our guest puts it, we can disrupt the chain of events that allow to C. diff to proliferate.

Episode 005 (part 4 of our IPAC series): On this episode, we're joined by the co-founder and Executive Director of the Peggy Lillis Foundation (PLF), Christian John Lillis. Like so many people who've dedicated their lives to driving change in the healthcare industry, Christian has a very powerful "why". He lost his mother to a clostridium difficile (C. diff) infection in April 2010. After struggling with the fact that he lost his mother to a disease he never heard of, and later finding out that it impacts so many people, Christian, along with his brother Liam, founded PLF and are building a nationwide C. diff awareness movement by educating the public, empowering advocates and shaping policy.

Christian gives us a deep and personal take on his family's experience with C. Diff and the work that the Peggy Lillis Foundation is doing to help. We discuss:

What is clostridium difficile (C. diff)?
Is C. diff a Healthcare-Associated Infection (HAI) or something else?
How important are hand hygiene and environmental cleaning in preventing the spread of C. diff?
Why haven't more people heard of C. diff?
Why is it so hard to measure the true impact of C. diff on our health system? How do we fix that?
Why do only some states require reporting on outbreaks? How does that affect the business of healthcare? How does it affect the patients?
What is the Prevention and Public Health Fund? Why is it under fire and what is the impact to the CDC, states and beyond?
What is the financial impact of C. diff?

Christian's story is powerful and it's full of wisdom that can help patients, families, and providers. In our quest to unravel the business of healthcare, it's important to understand the people we serve and how our work impacts their lives. This is a crash course and I hope it touches you as it did me. Enjoy.

~Don Lee

About Christian John Lillis Christian John Lillis is executive director of The Peggy Lillis Foundation (PLF), which he co-founded with his brother, Liam, following the death of their mother from a clostridium difficile (C. diff) infection in April 2010. PLF is building a nationwide C. diff awareness movement by educating the public, empowering advocates and shaping policy.

He was previously managing director of prospect strategy & research at Teach For America. With more than 15 years’ experience as a frontline fundraiser and behind-the-scenes strategist for healthcare, LGBT rights, and education organizations, he led prospect identification and research programs that increased resource development both nationally and regionally.

Prior to joining Teach For American in November 2009, Christian served in a variety of roles for a diverse group of nonprofits, including as Director of Development for In The Life Media, Director of Major Gifts for the National LGBTQ Task Force, and Associate Director of Development Research for NYU Langone Medical Center. Throughout his career, Christian has been a frequent speaker at conferences including the Mid-Atlantic Researchers Conference and Creating Change: The National Conference on LGBT Equality. He was also a contributor to Prospect Research: A Primer for Growing Nonprofits by Cecilia Hogan.

Christian is an adviser to the Patient Voice Institute and Gulf Coast C. diff Collaborative, as well as a member of Consumers Union Safe Patient Project and Chicago Area Patient-Centered Outcomes Research Network.

He is a former member of the board of directors of the Center for Lesbian and Gay Studies at the City University of New York and the Association of Professional Researchers for Advancement (APRA) of Greater New York.

Christian began his fundraising career at Lambda Legal Defense & Education Fund.

He holds a B.A. in Political Theory from Brooklyn College, where he served as a term as President of the Lesbian, Gay, Bisexual and Transgender Alliance and won The Donald G. Whiteside Poetry Award his senior year.

Christian is a native of Brooklyn, New York. He currently lives in Park Slope with his husband, Chris Young, and their rescued “beagle baby”, April. His hobbies include Tae Kwon Do (he is a black belt), Zumba, reading comic books and JD Robb’s “In Death” series, and poetry writing.

About the Peggy Lillis Foundation Mission: The Peggy Lillis Foundation is building a nationwide clostridium difficile awareness movement by educating the public, empowering advocates, and shaping policy.

Vision: We envision a world where C. diff is rare, treatable and survivable.

https://peggyfoundation.org/

2017 C. diff Summit & National Strategy Meeting

Facebook: https://www.facebook.com/PeggyFoundation/

Twitter: @PeggyFund

Mentioned on the show:

The Uncounted: The deadly epidemic America is ignoring. A Reuters report.

Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong: One of my favorite books on healthcare. Be prepared to be jarred and probably angry, but more aware of what's going on in the business of healthcare. Also, a good listen on Audible at 1.25 speed.

Patient Mortality During Unannounced Accreditation Surveys at US Hospitals

About InfectionControl.tips

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

About Center of Excellence for Infection Prevention and Control (COE IPAC)

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Soundtrack credit: Acid Lounge by FoolBoyMedia

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Hand hygiene is the number one line of defense when it comes to controlling the spread of healthcare-associated infections (HAI) and infectious disease. Since we know that antibiotic and antimicrobial resistance is on the rise, and few new antibiotics are being developed, it becomes exceedingly important that we prevent people from acquiring these infections in the first place.

Checkout our extensive coverage of the Infection Prevention and Control (IPAC) space

We know that hand-washing is effective when done right, and we know that when monitored, we do it right. In fact, right after we recorded this podcast the Jama Network showed us that patient mortality decreased during unannounced accreditation surveys at US Hospitals. The point is that you can expect what you inspect.

Episode 004 (part 3 of our IPAC series): On this episode, we get into the details with Tamás Haidegger and discuss:

Why hand hygiene is so important
How the struggle to get it right goes back to the 1800s
The complex human psychology that we need to address to solve this problem
The astonishing number of people who fail hand-washing tests even when they know they're being monitored
Engineering solutions that can help keep us objective
How hand-hygiene can save the U.S. healthcare system $9 Billion next year

This conversation is way more fun than you think it's going to be and very informative. I hope you enjoy!

Don Lee

About Tamás Haidegger Tamás Haidegger received his M.Sc. degrees from the Budapest University of Technology and Economics (BME) in Electrical Engineering and Biomedical Engineering in 2006 and 2008, respectively. His Ph.D. thesis (2011) was based on a neurosurgical robot he helped develop when he was a visiting scholar at the Johns Hopkins University. His main field of research is control/teleoperation of surgical robots, image-guided therapy, and supportive medical technologies.

Currently, he is an associate professor at the Óbuda University, serving as the deputy director of the Antal Bejczy Center for Intelligent Robotic. Besides, he is a research area manager at the Austrian Center for Medical Innovation and Technology (ACMIT), working on minimally invasive surgical simulation and training, medical robotics and usability/workflow assessment through ontologies.

Tamás is the co-founder and CEO of a university spin-off—HandInScan—focusing on objective hand hygiene control in the medical environment. They are working together with Semmelweis University, the University Hospital Geneva and the World Health Organization POPS group.

About HandInScan HandInScan Zrt. is a health-tech company focusing on the unmet and critical need of reducing healthcare-associated infections (HAIs) that causes more than 250,000 unnecessary deaths in the developed world and 1.4 million cases a day worldwide.

HandInScan was formed in 2012 as a spin-off of the Budapest University of Technology and Economics (BME). As a spinoff project, HandInScan was incubated at Demola from 2013. Original founders were private individuals from the engineering development team, aiming to create a device to objectively control hand hygiene performance of medical staff. The innovation and the technology transfer received numerous international awards. After the initial successful validation with early prototypes of the Hand-in-Scan device, the application domains were significantly extended to target clean manufacturing sites, the food industry and high-end tourism. The founders’ core team skill set included biomedical engineering, infection prevention and control, electrical engineering, computer science, finance, marketing and project management. The company exclusively licensed the relevant patent from BME, entitled “Method and apparatus for hand disinfection quality control (HU P1000523)”.

HandInScan has a key partnership agreement with its regional development partner, the Austrian Center for Medical Innovation and Technology (ACMIT), and continued working together with researchers at BME.

http://www.handinscan.com

Twitter: @HandInScan

Facebook: https://www.facebook.com/handinscan

Tamás also mentioned the World Health Organization's Hand Hygiene day on May 5th, 2017. Learn more here.

About InfectionControl.tips

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

About Center of Excellence for Infection Prevention and Control (COE IPAC)

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Soundtrack credit: Acid Lounge by FoolBoyMedia

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Rik Heller is a serial entrepreneur and founder of Wello. A self-confessed technology and healthcare geek, Rik has also been called the Grandfather of Active RFID and holds many patents in this area that are licensed globally. With a background in math and electrical engineering, he has been working in healthcare since 1989.

In 1999 Rik Heller founded FreshLoc and became a pioneer of environmental monitoring for compliance and reporting in the healthcare industry. Freshloc is a remote temperature monitoring technology for hospitals, pharmacies, laboratories, and other healthcare entities to help comply with temperature related safety regulations.

More recently, Rik has pursued interests in infection prevention and control, founding Wello. There he has developed, among other high-tech digital solutions, a hands-free, self-service fever screening, identification and notification platform that is focused on controlling entry of potentially contagious persons to very high-risk patient areas. Rik calls this a "barrier technology" and believes that in the battle against Healthcare-Associated Infections (HAI) it's critical that we "separate the match from the fuse".

Episode 003 (part 2 of our IPAC series): We cover a lot of ground on this episode, including:

How infections spread
Why it's only partly a healthcare solution that we need to seek
The role of humidity in mitigating or amplifying a contagion
Why we must dispell the myth that asymptomatic people are the problem
How 10% of the sick are "super-spreaders" and how we can identify them
Why you should stay home when you're sick and why your employer should make you
Where the CDC gets it wrong
Why good hair days are bad health days

Subscribe on iTunes You can learn more about Rik here:

LinkecIn: https://www.linkedin.com/in/rikheller/

Twitter: @rikheller

Wello: https://welloinc.com/

Wello on Twitter: @Wello_Inc

This episode is part of The #HCBiz Show's Infection Prevention and Control (IPAC) series. We'd like to thank our partners InfectionControl.tips and the Center of Excellence for Infection Prevention and Control (COE IPAC) for their support and guidance with the series.

About InfectionControl.tips

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

About Center of Excellence for Infection Prevention and Control (COE IPAC)

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Soundtrack credit: Acid Lounge by FoolBoyMedia

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The #HCBiz Show first address the topic of Healthcare Associated Infections (HAI) in July 2016 when we asked Infonaut founder Niall Wallace the question: Why are we losing the battle to hospital-acquired infections? From that post/interview:

Hospital Acquired Infections (HAI) are a big deal in US healthcare:

They cost U.S. hospitals as much as $45 Billion per year.
On any given day, approximately one in 25 U S patients has at least one infection contracted during the course of their hospital care
In 2011, there were an estimated 722,000 HAIs in U.S. hospitals and 75,000 of the patients died.

This issue impacts everyone who enters a healthcare setting whether they be patients, clinicians, administrators or guests (and anyone that comes into contact with them after that). It drives tremendous spending and resource usage. Improving infection prevention and control would easily check all the boxes of the triple aim (better patient experience, better population health, and lower costs). And yet, it's incredibly difficult to make progress. The incentive systems don't always support it, it's hard to prove things work and it's even harder to measure true return on investment (ROI) for making things not happen. In other words, HAIs and IPAC are the perfect #HCBiz topic.

On this episode, we're kicking off an 8-episode deep dive on Healthcare-Associated Infections (HAI) and Infection Prevention and Control (IPAC). We'll explain what the issue is, why it's important, why it exists and what innovative companies and practitioners are (or can/should be) doing about it.

Our guests: Niall Wallace is Co-founder at the Center of Excellence for Infection Prevention and Control and the CEO of Infonaut, a Hospital infection surveillance company.

Michael Diamond is Co-founder and Executive Director of The Infection Prevention Strategy, which runs the PAN-Access journal InfectionControl.tips and Co-founder at the Center of Excellence for Infection Prevention and Control.

Niall and Michael do a great job of framing up the issue for our industry deep-dive and discuss issues such as:

Why HAIs and IPAC are a global problem
How superbugs and antibiotic resistance will ultimately take more lives than cancer and are no less than a threat to the human race (BTW... Bill Gates agrees)
Who's impacted and how
Why it's so hard to innovate and drive change in IPAC
What InfectionPrevention.tips is doing about it
What the Center of Excellence for Infection Prevention and Control (COE IPAC) is doing about it
And so much more...

I learned a ton recording this episode and series. I hope you do too!

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About InfectionControl.tips

InfectionControl.tips is a Pan-Access journal that extends globally and touches locally. www.IC.tips is: Free to Publish. Free to Access and provides Accessible Scientific Services.

About Center of Excellence for Infection Prevention and Control (COE IPAC)

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Soundtrack credit: Acid Lounge by FoolBoyMedia

View Details

Co-hosts Don Lee (@dflee30) and Shahid Shah (@ShaidNShah) introduce the podcast and tell you what to expect in 2017.

The premise behind #HCBiz is that we can't "just innovate". Sure, you may have a great idea, an all-star team and execute flawlessly, but if you don't understand the complex dynamics of the healthcare business you'll never get traction. It'll seem that the system is broken and the people inside of it are irrational. You'll swear that it just doesn't make any sense at all. Well, we're here to tell you that it always makes sense. There just happens to be a dozen or more counter-intuitive, conflicting incentives that are driving the behavior that confuses you. Our job is to help you identify those incentives, break them apart into smaller, more manageable chunks and devise a plan to work with them, around them, and possibly even use them to your advantage. It's like one big innovation serenity prayer and it applies to anyone who's trying to drive change in healthcare from startups to industry insiders.

Our goal is to educate and empower the doers out there and to help them get the best tools and processes in the hands of the people who need them.

#HCBiz History We launched The Business of Healthcare Tweetchat on this premise in February 2016 and added live video shortly after that. We ran 35"shows" in our first year that usually consisted of a tweet chat followed by the live video. We built a great community and I've developed some incredible relationships as a result. We covered topics ranging from MACRA to Direct Primary Care to Interop and everything in-between. Some of the highlights:

MACRA Help and Resources from CMS w/ Aisling McDonough
The Big Heist Film Project w/ Dave Chase
The Problem w/ Provider Directories w/ Shahid Shah
Taking Patient Generated Health Data Mainstream w/ Validic, PCHA and Frost & Sullivan
What happens when you let patients design the clinic? w/ Dr. Justin Smith

There were too many great guests to name. You can see all the videos here and read all the corresponding blog posts and summaries here. I'm so grateful for the wonderful guests that shared with us in 2016.

Introducing the #HCBiz Show! as a Podcast Now we're launching The #HCBiz Show! as a traditional audio podcast available on iTunes (and all the other typical podcast channels). There are a lot of reasons for this. First and foremost, we like to experiment and want to see what we can do with this medium. I myself am a huge fan of podcasts and audio books and I consume anywhere from 10-20 hrs worth each week while driving, doing household chores, etc. It's been an incredible tool for me, and now I want to give back by producing great content that helps others get through traffic and laundry :)

Our approach to the podcast will be to go deep. Instead of one-off episodes like we did in 2016, we're going to deliver 6-8 episode deep-dives over a period of 1-2 months. These "min-series" will break apart a particular topic and attack it from every angle. When we're done, we hope that our listeners will have a strong grasp of the issue and be in a position to apply what they've learned in the real-world. Here's a look at what we're planning:

April: Infection Prevention and Control
May: Provider Directories
June: Digital Health Startup Crash Course
July: How to Run an Innovation Lab

Episodes will be delivered weekly (Wednesday's at noon EST) and will run in the 30-60 minute range.

We're really excited to continue this journey with you. Please subscribe to the podcast here and let us know what you think by rating it on iTunes and leaving your comments. Your ratings/comments go a long way to help us reach new audiences and your help is greatly appreciated.

I hope you enjoy the show!

Don Lee

Episode 001: Don Lee and Shahid Shah explain the premise behind the show and important principles such as:

Disintermediate! Disintermediate! Disintermediate!
Create space for innovation by freeing up resources and cash
Using What, Why and How to set your path.
Innovation is about eliminating things as much as it is about adding things.
Just because it works for Amazon, Uber or Facebook doesn't mean it will work for healthcare.
Introducing our first deep-dive. The #HCBiz Infection Prevention and Control (IPAC) Series

Check out all of our podcasts, videos and blog posts here.

The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

Soundtrack credit: Acid Lounge by FoolBoyMedia

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