< + > AI's value is not yet clear in benefits administration, says VA

The Veterans Affairs Office of Information and Technology finds artificial intelligence-driven clinical documentation is helping to solve physician burnout, but the value for benefits administration is yet to be determined.

< + > HIMSSCast: Tips for smaller health systems starting out with AI

Where can smaller hospitals and health systems begin with artificial intelligence? Brent T. Hoard, a partner at Troutman Pepper and AI expert, says most likely with a vendor. He elaborates on this and much more advice.

< + > UCSF to build novel continuous AI monitoring platform

UCSF Health and the university's clinical informatics division plan to develop a real-time and automated artificial intelligence monitoring platform for clinical care.

< + > Indonesian state uni to pilot South Korean digital diabetes app and more briefs

Also, India is seeking Google's help in creating AI and digital tools for building its digital health infrastructure.

< + > SAP adds genAI through AWS to hasten digital modernization

The tech giants have expanded their strategic collaboration to bolster cloud-based enterprise lifecycle management with access to multiple LLMs and foundation models developers can use to build customized applications on in-house data.

< + > Crescent Regional Hospital is first to offer hologram patient visits

The Dallas-area hospital already uses a holographic video studio and will expand use by installing additional mini hologram displays at several locations throughout the facility and its associated clinics.

< + > Limited funding hinders uptake of RPM, DTx in Australia

The latest report from the Productivity Commission notes the "slow" uptake of remote care technologies despite wide availability.

< + > 2,000 telehealth kiosks to be deployed in rural Malaysia

The installation is expected to relieve overcrowding in rural health facilities.

< + > Epic leads new effort to democratize health AI validation

Healthcare organizations with fewer resources could use the new free and open source tools to validate any artificial intelligence model and monitor its ongoing performance. "This is your cookbook," says Corey Miller, Epic's VP of R&D.

< + > New workflow software boosts care experience at one psychiatric practice

The clinical analytics tool is improving engagement metrics at Tennessee-based Psychiatric Medical Care, helping report aggregate data to the board and The Joint Commission, informing performance evaluations – and offering something quantifiable to show patients and families.

< + > Beamtree inks $2M AI deal to enhance private Saudi hospital's clinical data

The Australian company is now taking jabs at Saudi's private health sector after cementing its presence in the kingdom's public health system.

< + > New Zealand coming up with national HIE standards

It will be patterned after the US Core Data for Interoperability standards.

< + > How a simple QR code can avoid 2,000 ED admissions

Gold Coast Health is helping keep patients with chronic diseases out of its busy ED.

< + > Prescription delivery via drone is coming to more cities

New partnerships with Mayo Clinic and Memorial Hermann Health Systems will bring Zipline's autonomous home delivery service to Houston, Jacksonville and Rochester, Minnesota.

< + > By outfitting police with telehealth iPads, mental health program saves government $62M

Officers in Oklahoma can contact mental health professionals from their vehicles, avoiding ER visits and other risks. In the counties served by the virtual care program, there has been a 93.1% reduction in hospitalizations for mental health crises.

< + > Why Australian clinicians aren't using My Health Record as much

The Productivity Commission has flagged the poor usability of the system despite substantial uptake from consumers and health professionals.

< + > House Health Subcommittee grills FDA leaders over med device missteps

Despite the highest agency user fees on record, and granted new authorities to reform and accelerate medical device and biologics approvals, representatives questioned delays in getting products to patients faster.

< + > MediSecure hack: No risk to eRx

Stolen data involved those e-prescriptions issued before the eRx transition late last year.

< + > Is Korea turning to AI to resolve ER crisis?

It has recently announced a $17 million project to develop a clinical decision support system for public emergency departments.

< + > Wellstar Health adds secure check-in through Epic

Integration with the Clear identity platform in electronic health records enables the Georgia health system to roll out streamlined patient registration and on-site check-in via 'selfies' at kiosks.

< + > The Cedars-Sinai AI story, from primary care to dataset training

The health system’s Cedars-Sinai Connect primary care application has been especially effective, says CIO Craig Kwiatkowski, who describes how he measures an app’s success and how his team is protecting against AI biases.

< + > CISA releases guidance for high-risk nonprofits

The guide, which encourages secure-by-design software development, is the latest in government efforts to shore up vulnerable organizations. It summarizes cybersecurity best practices and links to free support resources.

< + > AI-based risk scoring is driving surgical efficiency in Emirates Health Services

Using 14 key performance indicators (KPIs), decision-makers receive an overview of surgeon performance. This increased transparency aims to enhance the quality of care and identify potential areas for improvement.

< + > Budget 2024: $1B for critical digital systems in aged care

It will support major reforms in the sector, particularly the introduction of a new consolidated law.

< + > Cleveland Clinic names new CIO

Cleveland Clinic has named Sarah Hatchett as its new senior vice president and chief information officer.

< + > At-home, early warning heart failure wearable can save lives and money

By 2030, there is projected to be a shortage of 120,000 cardiologists in the U.S. Combined with the decline in hospital beds and rising cost of heart failure, healthcare organizations need to find a way to detect heart failure earlier and at lower cost.

< + > WEDI asks HHS to ensure info exchange capabilities after cyberattacks

As cyberattacks increase in scope and intensity, the Workgroup for Electronic Data Interchange is asking the U.S. Department of Health and Human Services and other federal agencies to do more to help health systems maintain operational continuity.

< + > Healthcare ChatGPT, Nurses in Pajamas, and Healthcare Costs – Fun Friday

Happy Friday everyone!  The good news if you’re reading this is that you made it through another week.  It’s almost time to kick off your weekend and have some fun.  That’s why we’re excited to share with you another edition of Fun Friday to get your weekend started off right.  Hopefully, you’ll enjoy a little laughter and maybe even learn something from the humor.  We have a great mix of cartoons today.

Friday cartoon..#Ottawa #Poilievre #cdnpoli #nlpoli #Alberta #Toronto #healthcare pic.twitter.com/r2GFck1Kmv

— John Meaney (@Meantoons) January 12, 2024

I always say. There are no easy solutions in healthcare. If there were, we would have done them long ago.

Today’s Cartoon / February 5, 2024 @ https://t.co/BeGTui6pAp via Glasbergen Cartoon Service. © Glasbergen#tirednurse #healthcare #copyrightedcartoons #wearpjstowork pic.twitter.com/AMrwAdwxaE

— Randy Glasbergen (@RGlasbergen) February 5, 2024

I think we may need to all take a lesson from nurses and wear something comfortable to work. I’m sure scrubs are really functional too, but comfort is key in any clothes and any environment. At least that’s my rule.

😜 #HealthCare Can Be A Scare 😲#comics #cartoon #lol #comedy #jokes #humor #hilarious #laughter #funny #fun #smile #laughing #lmao #haha pic.twitter.com/e2REHYQs6u

— Gregory Mancuso (@GregoryMancuso) May 30, 2023

This cartoon leaves me speechless.

Thanks for reading and being part of the Healthcare IT Today community. We hope you have an amazing weekend and look forward to seeing you next week with more great health IT content.

< + > ABOUT Healthcare Acquires Edgility, Advancing AI and Decisioning Across the Patient Journey

Acquisition Enhances Patient Velocity with a Next-Generation System-Wide Patient Flow Platform from Admission to Discharge by Delivering Real-Time Insights throughout the Patient Journey

ABOUT Healthcare (ABOUT), a leading provider of SaaS-based hospital operations solutions for admission management and post-acute placement, announced today that it has acquired Edgility, an AI and analytics platform company that monitors and manages operations in real time, resulting in optimized capacity, enhanced patient progression, and accelerated discharge velocity.

ABOUT’s acquisition of Edgility augments its care orchestration technology with new capabilities that create a next-generation system-wide patient flow model from admission to discharge by delivering “connective tissue” throughout the patient journey, helping healthcare organizations make better informed decisions about patient progression through predictive and prescriptive analytics. The new care orchestration solution provides greater visibility and optimization for increasing patient capacity through AI-driven decision support with elegant and intuitive visualizations, facilitating the transition of patients to the right facility at the right time. With the addition of Edgility into the ABOUT solution set, the company can further enable health systems to realize command center strategies and connect and improve the operational anchors of transfers, admit management, patient flow, daily huddles, discharges, hospital-at-home, and referral management to post-acute and behavioral health settings of care.

Combining ABOUT with Edgility delivers a comprehensive suite of solutions driven by AI along with clinical expertise and best practices that automate and streamline the coordination of complex and interrelated tasks and processes, enabling healthcare providers to manage patient care more efficiently as well as reduce errors and delays. The new offering – a one-of-a-kind platform built for delivering health system command center and operational technology to the line-level, transfer centers, case management departments, and executive levels – will help health systems improve discharge and patient velocity, support operational and financial goals, and deliver optimal patient outcomes. With the only end-to-end care orchestration platform in the market, the new combined solution will uniquely enable health systems to achieve their strategic imperatives.

“Our acquisition of Edgility completes a powerful new end-to-end care orchestration solution that connects people, data, workflows, and systems to improve outcomes and enable better coordinated care,” said Jonathan Shoemaker, CEO at ABOUT. “Health systems can now derive deep situational awareness and decision support across the patient progression at the individual and system levels, removing friction points and natural delays, ultimately improving coordination at each step of the patient journey.”

The solution provides users with real-time situational awareness into discharge metrics to allow the movement and placement of patients more efficiently, connecting the intake and discharge processes and improving patient flow velocity. By using AI to forecast and predict discharge goals, the solution delivers discharge planning upon admission with discharge insights at the patient and system levels.

With real-time and actionable insights into patient progression throughout the hospital stay, the care orchestration solution delivers visibility that allows for early identification of discharge barriers and efficient management of discharge progression by surfacing insights that help identify friction and delays in moving patients to the appropriate care setting.

“We’re reshaping AI’s function in healthcare, surpassing mere information provision and auto-completion to dynamically deliver levers of actions. As a result of this acquisition, we now offer the only end-to-end platform tailored to guide the entire patient journey in the market,” said Balaji Ramadoss, President and CEO at Edgility. “Together, we’re poised to accelerate patient flow velocity without compromising quality care, driving health systems to reimagine an AI solution finely tuned to and for the frontline, where every decision is optimized to enhance care efficiency and quality.”

ABOUT’s acquisition of Edgility follows previous acquisitions of Acuity Link and Ensocare, further demonstrating the company’s focus on enabling health systems to enhance patient progression by moving and placing patients into, through, and out, more efficiently and substantially reducing the time it takes to get patients access to the care they need.

About ABOUT Healthcare

ABOUT offers a flexible, purpose-built solution that empowers hospitals and health systems to operate as one connected network of care. ABOUT enables easy access for clinicians to move patients into and out of the acute care setting — getting them to the next, best care setting faster and easier. Complemented by clinical experts and best practices, ABOUT provides health systems with the necessary controls and insights to grow with resilience, drive clinician effectiveness, and improve patient outcomes. For more information, visit abouthealthcare.com.

Originally announced April 19th, 2024

< + > E-scripts platform MediSecure hit by 'large-scale' ransomware

Hackers may have entered through one of its third-party vendors.

< + > Athenahealth launches customizable specialty EHRs

The IT developer says its latest update gives specialty providers, including women's health practices and urgent care centers, the ability to configure electronic health records to their specific needs, reducing administrative burdens. 

< + > Reactions to the Ascension Healthcare Ransomware Attack and Suggestions for Healthcare Organizations

It’s been a bad couple months for cybersecurity in healthcare.  Or maybe it will end up being a good thing.  I remember after the devestation of Hurricane Katrina, we all woke up to the need for better disaster recovery and business continuity.  While it’s amazing to consider two breaches and ransomware incidents the size of Change Healthcare and Ascension could happen so closely together, it’s very clear that healthcare is a target and we need to massively increase our investment in security to show we’ve learned from these experiences.

We reached out to our network of security experts to get their opinions and perpsectives on the Ascension ransomware attack and what healthcare should learn from it.  Here are a few of the responses we got from our community.

Mike Semel, President and Chief Security Officer of Semel Consulting

The Ascension health system data breach can’t be easily separated from the United Healthcare Change Health breach that recently caused a huge financial and medical impact across the healthcare sector and may have breached the personal information for a third of Americans. Because the Ascension breach is still being investigated, very little information has been released, but we know that ambulances are being diverted, putting lives at risk, and medical procedures are being delayed.

Both breaches are just symptoms of a weak regulatory system that has let healthcare providers and health plans get away with failing to adequately protect the personal data of millions of people.

Many think it is unfair to blame the victims but it is often justified. The US Senate heard the weak excuses of the United Healthcare CEO who admitted Change Healthcare had not secured its Citrix systems with multifactor authentication (MFA) even though they had a written policy to do so, and that they failed to notify data breach victims by the HIPAA and state data breach law deadlines.

The answer to this epidemic is to increase enforcement and make the penalties harsh enough to get executives, boards, and investors to care enough to adequately fund cybersecurity and be independently audited to ensure its policies are being followed.

The federal government paid healthcare providers to move from paper records to electronic health record systems. Now Congress needs to act by requiring the implementation of encryption, MFA, and vulnerability management (without exemptions) to protect all health and personal information with stiff enforcement and financial penalties. Executives should be required to attest to their organization’s cybersecurity implementation and be held responsible, as we are seeing in recent financial service and defense contractor regulations.

Legislation should be enacted that gives victims the right to sue even in the absence of demonstrated harm, since there is no way to tell if our personal data exfiltrated from a ransomware attack today will sit on the shelf for years before being weaponized. Cyber insurance should be prohibited from paying fines and lawsuit settlements or awards.

The U.S. Department of Health and Human Services (HHS) should follow what the U.S. Department of Defense is doing with its CMMC program that will require independent cybersecurity assessments of large and small defense contractors that work with sensitive information. The penalty will be disqualification from bidding on defense contracts without a certification. Health data should be protected by a similar assessment requirement for health plans and providers to receive federal funds.

The U.S. Department of Justice should step up enforcement of the False Claims Act against medical providers who accept Medicare and Medicaid payments but fail to implement a reasonable level of cybersecurity. The HHS Office for Civil Rights is no longer feared because of its inability or unwillingness to issue painful penalties against providers who know they can get away with saving money on cybersecurity – patients be damned.

Obviously, the weak regulations and lack of enforcement has enabled the success of hackers.

Ryan Witt, Vice President, Industry Solutions at Proofpoint, Inc.

Healthcare firms have long been targets for cyber criminals. They handle data like protected health information (PHI), intellectual property (IP), clinical trial data and payment card data, giving attackers many options to cash in, and healthcare is a critical infrastructure industry that can be hardest hit by ransomware attacks. The healthcare industry is more vulnerable because of the high-value nature of its data compared to data from other industries (PHI is thought to be worth 50x a credit card). Healthcare also stores a disproportionally large amount of data and often must keep that data often for long periods of time, increasing the size of the attack surface. The industry also has many third-party workers and a significant number of remote workers (both of whom often use employee-owned devices) which complicates the attack vector. Lastly, most healthcare IT expenditure over the last ten years has been focused on digitizing patient records, and investment in cybersecurity capability has lagged other industries. Threat actors know healthcare is a prime target for extortion and target them accordingly.

All organizations, including those in critical infrastructure industries such as healthcare, need to consider a three-pronged approach to protecting sensitive data: monitoring user behavior, looking at content accessed by users, and applying additional controls to the most highly targeted users—for example, those with privileged access. Healthcare has made significant strides in better protecting the industry, in part because hospital executives increasingly see cybersecurity as a core component of patient care. According to our 2023 Cyber Insecurity in Healthcare report, 54% of surveyed healthcare IT security practitioners said their organization suffered a ransomware attack, up from 41% in 2022.

It is encouraging to see investments being made to secure medical systems and equipment needed for patient care. But this approach is not enough in today’s digital world. Organizations must work together with their industry peers and embrace governmental support to build a stronger cybersecurity posture—and consequently, deliver the best patient care possible.

Nick Brigmon, Security Operations and Support Manager at Blumira

The recent cyberattack affecting hospitals across the US is a critical reminder for healthcare organizations to prioritize cybersecurity measures to safeguard their systems and patient data. But the road to implementing comprehensive cybersecurity measures can feel daunting, given cost and time investments and lack of cybersecurity expertise.

Healthcare organizations looking for guidance on where to start can consider taking the following four steps:

1. Update systems with the latest security patches and software versions to mitigate vulnerabilities. Implementing multi-factor authentication (MFA) and robust password policies can add an extra layer of security against unauthorized access.
2. Review the organization’s IT infrastructure to identify risks and vulnerabilities. This assessment should cover networks, systems, applications and data repositories. Consider partnering with a cybersecurity consultant to support this process, as they will be able to compare current security measures against industry standards and best practices.
3. Conduct cybersecurity training for employees. Doing so raises awareness about phishing scams and other common attack vectors.
4. Research and invest in advanced threat detection and response software. Prioritize a solution designed for your industry and ones that don’t require extensive cybersecurity expertise to manage. Look for a solution that provides real-time detection and automated response to contain threats faster, reducing the risk of ransomware infection across your network.

Dan Lohrmann, CISO at Presidio

The scale of the Ascension cyberattack is staggering, with 140 hospitals across 19 U.S. states impacted by the ransomware attack, including disruptions to services as well as access to electronic health records being cut off. Many stories about hospitals being unable to provide rapid care to patients experiencing medical emergencies and longs delays for others are simply heart-wrenching to hear.

Doctors and nurses needing to go back to pen and paper to have data to conduct medical procedures demonstrates that the operational resiliency strategies and /or business continuity plans (BCP) that were in place by Ascension were not satisfactory.

The American Hospital Association (AHA), The Federal Bureau of Investigation, Cybersecurity and Infrastructure Security Agency, Department of Health and Human Services, and Multi-State Information Sharing and Analysis Center released a joint cybersecurity advisory on May 10 to provide information on Black Basta, a ransomware variant whose actors have encrypted and stolen data from at least 12 out of 16 critical infrastructure sectors, including the health care and public health sector.

Some of the steps that healthcare organizations should be following to protect their data include:

1. Stay informed by monitoring updates from reliable sources like Health Information Sharing & Analysis Center (HISAC) at https://h-isac.org/ .
2. Maintain personal health records for accessibility during system downtime.
3. Prepare for emergencies by knowing alternative care facilities and routes.
4. Practice strong cybersecurity with unique passwords and two-factor authentication.
5. Be vigilant against phishing attempts and install antivirus protection and monitoring on all devices.
6. Have a tested, robust incident response plan that includes scenarios that have been recently used against health organizations.

Following the Ascension security incident, affected individuals should monitor any related medical accounts and change passwords – especially if directed by the health organization. To prepare for wide cyberattacks, everyone should consider enabling two-factor authentication, updating security software, beware of phishing, educate themselves on cybersecurity, back up data, report suspicious activity, and stay informed about developments and recommendations from authorities or affected organizations.

Al Yang, CEO and Co-founder at SafeBase

With the increase in data breaches and cybersecurity threats, businesses today are more security-focused and risk-averse than ever before. In the aftermath of the attack, it was confirmed that Ascension’s incident response plan included proper vendor notification processes. But the goal is to never have to get to that point.

It’s critical that we instill a more transparent ecosystem where organizations can seamlessly communicate their security and trust posture for more collectively secure partnerships. The attack on Ascension is the latest example that highlights the need for companies to have proper security protocols and systems in place as compromising the information of one company often means that many other companies were or are at risk, as well.

Bill Murphy, Director of Security & Compliance at LeanTaaS

One of the key vulnerabilities in healthcare systems is the human factor. Healthcare workers, from doctors and nurses to administrative staff, are often overwhelmed with critical patient care responsibilities and day-to-day operations. When they finally have a chance to check their emails, they are frequently multitasking or rushing between meetings and discussions with colleagues. This lack of focused attention makes healthcare workers susceptible to phishing attacks, which are a common entry point for cybercriminals to gain access to credentials and systems.  In cybersecurity, speed kills.  Cybercriminals also exploit our human desire to be helpful.  They target help desks through social engineering tactics. Help desk staff can inadvertently fall victim to carefully crafted pretexts and impersonation attempts, leading to the disclosure of sensitive information or the granting of unauthorized access.

One of hospital IT’s traditional concerns – hospital data stored in a vendor’s data center – can be a source of relief in a ransomware attack.  When a hospital’s Electronic Health Record (EHR) system is compromised or inaccessible, the vendor’s systems may contain the sole accessible records of upcoming patient appointments, procedures, and other critical healthcare activities. Vendors should be ready to assist with data extracts when a hospital comes calling and hospital IT should leverage these relationships.

David Stapleton, VP, Chief Information Security Officer (CISO) at ProcessUnity

The impact of the attack resulted in Ascension’s electronic health record (EHR) and MyChart systems being taken offline. This has caused cancellations and delays for some patients and emergency medical care has had to be redirected to other facilities. This underscores the direct and significant impact cyber attacks can have on human health and livelihoods. So often we think of corporations as the victims of cyber attacks, but this incident reminds us that there are tangible repercussions for real people.

Ascension’s proactive approach to cybersecurity is evident in their identification of “unusual activity” within their network, highlighting the importance of behavioral or heuristic-based anomaly monitoring. I appreciate the thoughtful, detailed, but user friendly update page that Ascension put in place. This is a good way to control messaging and provide information to potential victims and interested parties. It is also admirable that during the ongoing incident, Ascension has prioritized sharing threat information with organizations like CISA and H-ISAC, demonstrating their commitment to aiding other potential victims. While Ascension has not confirmed any compromised patient data, if Black Basta accessed their EHR, then we may be hearing about a massive breach of highly sensitive personal health data as the investigation progresses.

The threat actor behind the Ascension breach, Black Basta, is a Russia-backed ransomware-as-a-service group known for exploiting known vulnerabilities and executing spear phishing attacks to gain initial access into target systems. To combat such threats, organizations must prioritize patching systems, implementing strong multi-factor authentication (MFA) or passwordless authentication, and train their employees to identify and report phishing messages. Additionally, healthcare providers should receive regular disaster recovery training to revert to paper processes when electronic systems are unavailable, and it appears that Ascension was well prepared in this regard.

Sid Singh, CEO at Rectangle Health

It has been deeply distressing to witness the disruption of care operations and delivery, as these incidents harm patient trust, tarnish the practice’s reputation, result in significant financial losses, and burden staff with additional manual administrative tasks as they manage the fallout.

Recent incidents highlight how cyberattacks often stem from fundamental lapses in compliance protocols. It is imperative for healthcare organizations to remain vigilant in maintaining the latest cybersecurity measures and compliance policies. Equally crucial is the clear and comprehensive education of staff regarding these protocols to mitigate any confusion. Taking proactive steps will provide practices of all sizes with the strongest defense against malicious disruptions, safeguarding patients, data, and staff.

Christopher Budd, Director, Threat Research at Sophos

These continued cyber attacks against healthcare organizations have devastating implications for patients across the United States – but we can’t be surprised that it keeps happening. Healthcare organizations are major targets for cybercriminals precisely because adversaries know how important their operations are and how valuable their data is. According to Sophos’ recent State of Ransomware report, 67% of healthcare organizations surveyed globally were hit by ransomware in 2023.

Just two months ago, Change Healthcare was the victim, leaving its patients severely at risk and the company owing nearly $900 million. These attacks will keep annihilating businesses until we take steps as an industry to combat the problem, which is what many of us are discussing here at RSA Conference this week.

Gerasim Hovannisyan, CEO at EasyDMARC

The recent cyberattack on Ascension adds to a concerning pattern of breaches impacting significant US healthcare providers. It highlights the critical need for organizations to prioritize having a robust cyber incident response plan in place, especially those classified as critical infrastructure, like hospitals.

While the healthcare provider has taken swift action by alerting authorities, seeking expert cybersecurity assistance, and shutting down systems, the fallout will likely be substantial. Losses may range from operational disruptions to potential ransom payments and an irreversible erosion of customer trust, depending on the nature of any sensitive data that may have been accessed.

Sadly, this scenario is all too familiar, necessitating a proactive shift towards prevention. Healthcare institutions must invest in comprehensive cybersecurity solutions and staff training to proactively detect and thwart potential threats, safeguarding infrastructure resilience against future disruptive and potentially life-threatening attacks.

Given the healthcare sector’s attractiveness to cybercriminals due to its valuable data, the frequency of such attacks is likely to rise. As a result, it’s imperative to elevate cybersecurity as a priority and take concerted action to reverse this troubling trend.

Thanks to all the experts that shared their insights and perspectives with the community.  What do you think?  What are the lessons learned?  What actions should healthcare organizations be taking?  Let us know in the comments or on social media.

< + > Cutting Through the AI Hype: Deploying AI Now to Improve Patient Care

The following is a guest article by Bevey Miner, Executive Vice President, Healthcare Strategy and Policy at Consensus Cloud Solutions

Artificial intelligence (AI) is everywhere, and with so much hype around it, healthcare organizations are rightfully cautious about deploying AI solutions.

Although promising in its ability to transform healthcare through more efficient and accurate data capture and management, there is still much that we as an industry and society need to understand before scaling its use, especially when it comes to patient care. During a recent panel discussion at HIMSS24 in Orlando, Fla., March 11–15, three panelists representing different types of healthcare technology shared their perspectives on the role of AI in healthcare and provided a real-world look at how, in a controlled setting, AI can be deployed and monitored to handle the complexity of care delivery.

Today, AI is at the heart of many technologies, and a large subset of it deals primarily with software that can imitate human behavior through functions like pattern recognition, and natural language processing — which encompasses generative AI, one of the more popular applications of AI today — and machine learning, according to panelist Jeffrey Sullivan, Chief Technology Officer at Consensus Cloud Solutions.

Clinical and Administrative Uses of AI 

AI isn’t new to healthcare, but how we’re using it continues to evolve, according to another panelist, Madelaine Yue, Vice President of Solutions Delivery at Experis Health Solutions. For instance, we are capturing data in a more systematic way that can be used for machine learning in both clinical and administrative settings.

On the clinical side, this can include analyzing data from patients’ EHRs to provide decision support interventions, which is a term introduced by the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology in its recently released HTI-1 final rule to take into account how AI can inform clinical decisions. On the administrative side, AI can be used to automate manual processes, such as writing patient communications — which studies have found to be more empathetic than what clinicians draft — and consolidate information for “more efficient use of your human factor,” Yue said.

Population Health Insights and Patient-Centered Care

AI is also being used to gain insights about population health and provide more patient-centered holistic care, according to panelist Mason Ingram, Director of Payer Policy at Premier. For example, some providers are using ambient AI to record provider-patient interactions during exams or telehealth appointments, enabling them to capture more specific and discrete information, which helps drive proper outcomes. Meanwhile, predictive AI can help providers predict costs and figure out how to deploy scarce resources.

Tangential to its use in population health is AI’s application in the clinical trial space. Often delayed due to patient recruitment issues, Ingram shared that clinical trials are now leveraging AI to match the most appropriate patients for clinical studies.

One of Yue’s biggest concerns around the vast amount of data collected is whether human input is being used for AI outcomes to be actionable. Pointing to a study in which the diagnostic accuracy of AI was compared with that of human radiologists, Yue said the research found that AI caught more false positives, whereas humans detected more complex conditions that warranted immediate treatment. Although AI helped to maximize the efficiency of the radiologists, a human factor was still needed to detect the cases that needed more rapid intervention.

“With AI-augmented intelligence supporting human intervention, clinicians can use predictive analytics to see which patients are at a higher risk of being readmitted to the hospital or falling, and based on those patterns, make decisions regarding types of treatment and therapy,” Yue explained.

These insights are also helping provider organizations, especially critical access and rural hospitals that may lack adequate staffing, to remotely monitor patients, deploying proper interventions when they’re needed.

Reducing Provider Burnout with Turnkey Solutions

The question of whether and where AI will be used in healthcare has shifted since last year to conversations around how it’s being implemented, according to Sullivan.

He points to the real and practical benefits of AI as a tool to lessen the administrative workload of providers, allowing them to spend a higher percentage of their time doing high-impact clinical work with their patients.

On average, physicians spent 1.84 hours per day beyond work hours completing EHR documentation. That adds up to 9.2 hours spent each week on work outside of the workday.

“Your strategy on AI must be much more nuanced and involved now because it’s everywhere,” Sullivan said. “When you think about how you’re bringing AI into use in your daily work, it’s about helping you be more efficient, more effective, not about doing your work for you or displacing you.

“Understanding which areas would be most impacted by AI will help end users optimize the technology. For example, ambient listening to transcribe clinicians’ notes is one way AI offers users a clear return on investment.

“There are a lot of turnkey AI solutions that can unlock value for users, especially around administrative processes, according to Ingram. For example, AI can also play a role in formulating care plans for cases with ‘clear-cut clinical requirements’, such as appropriate use criteria for advanced diagnostic imaging.”

Some healthcare organizations are using intelligent data extraction, which combines AI software with natural language processing and tools like digital fax to gather shareable information more fully. These solutions pull information from unstructured documents like handwritten notes, PDFs, scans, and images, and send it to clinicians and staff directly within their workflows, speeding access to care and avoiding delays in treatment that could potentially impact outcomes.

Despite the abundance of low-hanging fruit for AI uses, Yue cautioned the healthcare industry to not be afraid of progression. “For example, some EHR companies are beginning to leverage generative AI to more easily craft communications that are more patient friendly,” she said.

The Need for AI Governance Amid Concerns 

It’s clear that AI is contributing to healthcare in meaningful ways. However, concerns abound around its use and the need for guidelines. Some of the primary concerns that panelists discussed involve the veracity of data used to train AI and whether that data introduces bias, as well as privacy and security issues.

Although the panelists expressed a need for greater clarity in what’s currently an “extremely nebulous regulatory environment,” they also cautioned that regulation, even if well-meaning, could have unintended consequences in what is a very nuanced and complex space.

“A really interesting policy/ethical question is, when is the greater good and the regulatory thing in tension with each other? How do we advance the greater good in a way that also preserves things like commercial interest or privacy rights?” Sullivan asked. “We must think about how to advance the state of healthcare in a way that’s both responsible and considers those limitations.”

< + > DrFirst Acquires Myndshft Technologies to Revolutionize Medication Management by Addressing Both Pharmacy and Medical Benefits

Pioneering Move Unites Medical and Pharmacy Benefits, Enhancing Access, Affordability, and Adherence for Specialty Medications and Procedures

Healthcare technology pioneer DrFirst today announced it has acquired substantially all assets of Myndshft Technologies, Inc., a leader of end-to-end real-time medical benefits and automated prior authorization (PA) software-as-a-service (SaaS). This strategic acquisition aims to improve the patient experience and expedite access to vital specialty medications, such as infusions and in-office injectables primarily covered by medical benefits. Combined with DrFirst’s platform and scale, the technology will also lighten the substantial administrative load on healthcare providers and their staff.

Founded in 2018, Myndshft is the only unified platform that streamlines prior authorization and related services for both medical and pharmacy benefits. This innovative technology uses AI, machine learning, and robotic process automation (RPA) to automate and streamline complex benefits, pricing, and PA processes across various payers and therapeutic classes into one seamless, intuitive workflow. The Myndshft platform also supports labs, imaging, and other procedures covered under medical benefits, which are often prerequisites for patients prescribed specialty medications.

Managing PAs is a significant burden on medical practices because of time-consuming manual processes and lack of integration with electronic health record (EHR) systems. These challenges lead to avoidable resubmissions and delays, frustrating healthcare providers and patients alike.

“This acquisition is a significant step forward in the industry, which has largely solved these issues for medications covered by pharmacy benefits but has yet to turn its focus to the complex, expensive, and often life-saving drugs covered by a patient’s medical benefit,” said G. Cameron Deemer, CEO at DrFirst. “The category of insurance benefit – pharmacy vs. medical – should not dictate a lower level of transparency or efficiency for prior authorizations. It’s unacceptable that the patients who most urgently need these life-saving therapies typically wait the longest to receive them. This acquisition will allow us to expedite patients’ access to these crucial treatments.”

The Myndshft platform provides eligibility and benefits verification for 95% of insured patients across the United States and instantly verifies prior authorization requirements for more than 600 payers and thousands of health plans. By automatically prescreening PA submissions for errors and omissions and providing a dashboard for monitoring the status of all PA requests, the platform significantly reduces manual effort by more than 70% and cuts claims rework by 90%.

“DrFirst’s acquisition of Myndshft is a strategic move towards solving the prior authorization problem for specialty medications,” commented industry analyst Seth Feder, Founder of OnTarget Advisors LLC and Expert Healthcare Adviser at Third Eye Advisory. “Specialty medications, often covered by medical rather than drug benefits, represent a crucial aspect of improving access to care while reducing the burden on physicians and back-office staff. The combined expertise of DrFirst’s scale and success in medication management with the AI-driven Myndshft platform sets the stage for delivering enhanced patient experiences and reducing healthcare costs, both of which are industry imperatives right now. DrFirst eliminates inefficiencies in medical prior authorization without disturbing existing clinical workflows – a smart move as it will win over healthcare providers and quickly deliver value.”

DrFirst’s integrated network – of 270 EHRs, nearly 500,000 healthcare providers, and nearly 100 million patients – has the technology, scale, and presence in electronic health record (EHR) workflows needed to quickly bring value and support to the U.S. healthcare market at scale.

“We were looking for the right partner with existing provider and patient workflows as well as expertise in integrating across the healthcare landscape to maximize the value of our innovative technology,” said Ron Wince, Founder and CEO at Myndshft. “We are excited to work within the DrFirst network to ease the administrative burden on healthcare providers and help patients access needed therapies and other services.”

The acquisition closed April 17, enabling DrFirst to bring “much-needed efficiency and time savings to an expanded client base,” said Drew Hunsinger, Vice President of Corporate Business Development at DrFirst. “This accelerates and amplifies our ability to support access, affordability, and adherence for patients taking specialty medications. We’re excited to leverage our extensive clinical and technical expertise to benefit a broader range of patients nationwide.”

About Myndshft

Myndshft software-as-a-service automates and simplifies time-consuming healthcare patient access tasks associated with prior authorization, eligibility and benefits verification, and patient financial responsibility, freeing providers and payers to concentrate more fully on patient care. Myndshft works with leading providers, payers, and health information exchanges. The platform provides HL7 FHIR standard API connectivity, the interoperability standard preferred by the U.S. Centers for Medicare & Medicaid Services and the National Coordinator for Health IT. Myndshft has also earned HITRUST Risk-based, 2-year (r2) Certified status validating adherence to regulations and industry-defined requirements for information security.

About DrFirst

Since 2000, healthcare IT pioneer DrFirst has empowered providers and patients to achieve better health through intelligent medication management. We improve healthcare efficiency and effectiveness by enhancing e-prescribing workflows, improving medication history, optimizing clinical data usability, and helping patients start and stay on therapy. In the last few years, DrFirst has won over 25 awards for excellence and innovation, including winning Gold in the prestigious Edison Awards in 2023, recognizing our game-changing use of clinical-grade AI to streamline time-consuming healthcare workflows and prevent medication errors. Our solutions are used by more than 350,000 prescribers, 71,000 pharmacies, 270 EHRs and health information systems, and over 2,000 hospitals in the U.S. and Canada. To learn more, visit DrFirst.com and follow us on Twitter and LinkedIn.

Originally announced April 18th, 2024

< + > This Week’s Health IT Jobs – May 15, 2024

It can be very overwhelming scrolling though job board after job board in search of a position that fits your wants and needs. Let us take that stress away by finding a mix of great health IT jobs for you! We hope you enjoy this look at some of the health IT jobs we saw healthcare organizations trying to fill this week.

Here’s a quick look at some of the health IT jobs we found:

• Server Systems Administrator – Epic
• Physician Specialist – Emergency Support – Cleveland Clinic
• IT Business Analyst (Hybrid) – US Pharmacopeia
• Manager, Health Information Management (HIM) – Jefferson Healthcare
• Principal Technical Program Manager – Oracle
• Integration Team Specialist (Senior Consultant MIS Lvl C) IT Governance and PMO – NYC Health + Hospitals
• Epic Associate IT Director-Digital and Technology Partners (Hybrid) – Mount Sinai Health System
• Oracle Technical Analyst (Remote) – Mayo Clinic School of Health Sciences
• IT Systems Support Specialist – Shifamed
• Epic Principal Trainer – Wellstar Health System
• Lead Healthcare IoMT Cybersecurity Specialist – Synergis
• Database Architect Epic EMR – Yale New Haven Health
• Network Administrator – Finys
• Clinical Implementation Specialist – Fresenius Kabi USA
• IT Support Specialist – University of Idaho – Another Source
• Computer Specialist (2 Positions Available) – University of Nebraska-Lincoln
• IT Product Manager, Consultant – Blue Shield of California
• Senior Communications Technology Engineer – Stanford Health Care
• Performance Support Designer I Technical Writer – Learning & Development – Elevance Health
• Healthcare Technology Management Director – iLocatum
• IT Project Manager – Group Health Cooperative of South Central Wisconsin

If none of these jobs fit your needs, be sure to check out our previous health IT job listings.

Do you have an open health IT position that you are looking to fill? Contact us here with a link to the open position and we’ll be happy to feature it in next week’s article at no charge!

*Note: These jobs are listed by Healthcare IT Today as a free service to the community. Healthcare IT Today does not endorse or vouch for the company or the job posting. We encourage anyone applying to these jobs to do their own due diligence.

< + > Fortis Healthcare gets AI boost for mental health vertical

Adayu Mindfulness will provide AI-powered self-assessment tools and 24/7 access to a virtual assistant.

< + > Achieving the perfect HIMSS DHI Score: A chat with Samsung Medical Center's digital lead

The hospital has recently achieved the maximum score of 400 for the HIMSS Digital Health Indicator.

< + > Vendor Notebook: AI tackles patient deterioration, obesity and stroke

Researchers compare machine learning models to traditional alerts for critically ill adults while a new real-world GLP-1 data trove incorporates unstructured data. Also, RapidAI earns another FDA clearance for rapid stroke imaging.

< + > Senators call for new VA oversight provisions in Oracle contract review

As part of its annual renegotiation of the agency's EHR modernization efforts, three senators are asking Veterans Affairs to add more opportunities to hold the vendor responsible for the quality and safety of its deployments.

< + > AHA, H-ISAC warn hospitals about Black Basta following Ascension cyberattack

Meanwhile, staff at the health system say they don't have patient orders and can't page doctors. As it works to restore clinical systems, Ascension says it's also working with law enforcement and sharing threat intelligence to help prevent similar attacks.

< + > HHS announces new funding opportunities for AI, behavioral health projects

New LEAP in Health IT money from ONC is meant to find and fund innovative new approaches to evaluating EHR data quality for machine learning models and driving IT adoption by behavioral health providers.

< + > Will the Change Healthcare Ransomware Attack Wake Up Healthcare? – Healthcare IT Today Podcast Episode 140

For the 140th episode of the Healthcare IT Today Podcast we are talking about the Change Healthcare ransomware attack. To kick this episode off, we share our insights on what has happened in the two months since the attack. Then we discuss whether or not we think this will be the inciting incident for healthcare organizations to wake up about their security. Next, we debate on whether or not this attack will have an impact on how healthcare organizations are approaching RCM. Lastly, we end this episode by sharing our thoughts on what we believe the long-term impact will be.

Here’s a preview of the topics and questions we discuss in this episode:

• We’re two months into the ransomware attack, what’s your take on what’s happened?
• Will this wake up healthcare organizations in regard to security?
• Will this impact how healthcare organizations are approaching RCM?
• What’s the long-term impact from this incident?

Now, without further ado, we’re excited to share with you the next episode of the Healthcare IT Today podcast.

We publish a new Healthcare IT Today podcast every ~2 weeks. Thanks to our friends at Healthcare Now Radio, you’ll be able to listen to the latest episodes of Healthcare IT Today on their radio station for the first two weeks. Then, we’ll be publishing each episode as a podcast and YouTube video here after it finishes on the radio.

You can also subscribe to the Healthcare IT Today podcast on any of the following platforms:

• Apple Podcasts
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Thanks for listening to Healthcare IT Today and if you enjoy the content we’re sharing, please rate the podcast on your favorite podcasting platform.

Along with the popular podcasting platforms above, you can Subscribe to Healthcare IT Today on YouTube.  Plus, all of the audio and video versions will be made available to stream on HealthcareITToday.com.

If you work in Healthcare IT, we’d love to hear where you agree and/or disagree with the perspectives we shared. Feel free to share your thoughts and perspectives in the comments of this post, in the YouTube comments, with @Colin_Hung or @techguy on Twitter, or privately on our Contact Us page. Let us know what you think of the podcast and if you have any ideas for future episodes.

Thanks so much for listening!

Listen to Our Latest Episodes:

< + > HTI-1 Final Rule: Implications for Healthcare Providers – Focus on DSI and Algorithmic Transparency

The following is a guest article by Nitin Kunte, Sr. Director at NTT DATA

On February 8, 2024, the Office of the National Coordinator for Health Information Technology (ONC) published the Health Data, Technology, and Interoperability (HTI-1) Final Rule in the Federal Register, which took effect on March 11, 2024. This comprehensive regulation introduces vital updates to the certification program, promotes algorithm transparency, and establishes critical standards for information sharing among healthcare providers.

The HTI-1 Final Rule has significant implications for all providers who use electronic health records to administer and deliver patient care. This especially relates to how they can use Predictive Decision Support Interventions (DSIs) to improve patient care.

We could dive into and provide insights into the five points mentioned above but we’ll start with the details of the HTI-1 Final Rule, specifically focusing on Decision Support Intervention (DSI) and Algorithmic Transparency. 

HTI-1 Final Rule Synopsis

1. The New Regulatory Approach – “Edition-less” Certification Criteria: discontinue the year-themed editions and establish a single set of certification criteria
2. Certification Standards and Functionality Updates: new and revised standards and certification criteria
3. Emphasis on Decision Support Interventions (DSI) and Algorithmic Transparency: revises existing CDS certification criteria, simplifies and streamlines requirements, and narrows the scope of impacted predictive DSI
4. Insights Condition and Maintenance of Certification Requirements (EHR Reporting Program): provide details on what needs to be reported when (frequency) by whom and how they will be measured. It also provides a reporting timeline 
5. Information Blocking: provides detailed definitions and exceptions

Emphasizing Algorithmic Transparency and the Role of Predictive DSIs

Predictive DSIs are technologies that intend to support decision-making based on algorithms or models that derive relationships from training or sample data and then are used to produce an output or outputs related to, but not limited to, prediction, classification, recommendations, evaluation, or analysis.

The HTI-1 Final Rule particularly focuses on enhancing algorithmic transparency for predictive DSIs defined broadly, encompassing technologies from simple algorithms to advanced machine learning models.

For healthcare providers, the HTI-1 Final Rule mandates access to a new realm of detailed source attribute information for both evidence-based and predictive DSIs. This requirement is crucial for ensuring that healthcare providers can make informed decisions based on transparent and updated information regarding the DSIs they deploy. 

Key Dates and Implementation Timelines

March 11, 2024: The HTI-1 Final Rule takes effect, initiating the transition phase for health IT developers and healthcare providers.

December 31, 2024: Deadline for health IT developers to update their technologies in compliance with the new HTI-1 regulations, specifically regarding the DSI certification criterion and the maintenance of certification requirements as detailed in §170.315(b)(11) and its subparts.

Non-compliance with predictive DSI requirements may result in penalties or loss of certification. Providers not using certified EHR may face downward payment adjustments to their Medicare reimbursements in the affected payment year. 

Predictive DSI: A Closer Look

Predictive DSIs, as defined by the ONC, encompass a broad range of techniques, from simple risk calculators to advanced machine learning models using AI. The finalized configuration nexus, maintenance of certification requirements, and certification criteria outlined in the rule, provide a structured framework for the deployment of these interventions. Importantly, the regulation stresses the need for DSIs to be evidence-based, actively enhancing clinical decision-making processes.

The Goals of New Rules

1. Improve Transparency with respect to how a Predictive DSI is designed, developed, trained, evaluated, and should be used
2. Enhance Trustworthiness through transparency on how certified health IT developers manage potential risks and govern predictive DSIs that are supplied by the health IT developer as part of its Health IT Module
3. Foster an Information Ecosystem necessary to help healthcare organizations and users of these tools better determine whether their Predictive DSIs are fair, appropriate, valid, effective, and safe (FAVES)
4. Advance Health Equity by Design by addressing bias and health disparities, potentially propagated by predictive DSIs, to expand the use of these technologies in safer, more appropriate, and more equitable ways for patients and individuals

Stress on Transparency and Equity

The HTI-1 Final Rule sets clear expectations for health IT modules regarding DSI selection, feedback mechanisms, and source attribute requirements. For example, health IT modules certified to the DSI criterion must enable users of such applications to select, activate, and provide feedback on both evidence-based and predictive DSIs. This inclusivity ensures that healthcare providers can harness the power of predictive analytics while being grounded in evidence-based practices.

The rule also mandates detailed source attribute categories for Predictive DSIs, covering intervention details, development insights, and fairness assessment processes.

Recommendations: To Ensure Compliance by Dec 31st, 2024

Here are our recommendations to healthcare providers to maintain compliance with Decision Support Interventions (DSI) and Algorithmic Transparency under the HTI-1 Final Rule:

1. Audit & Assess Existing DSIs: Conduct a thorough audit of currently utilized Decision Support Interventions. Identify whether they are evidence-based or predictive and assess their compliance with the new rule.
2. Enhance Feedback Loops and Transparency: Establish mechanisms for collecting and analyzing feedback on DSIs. These loops should enable modifications to DSIs based on real-world performance and user feedback, ensuring there are no biases, continuous improvement, and compliance. Ensure that detailed source attribute information for both evidence-based and predictive DSIs is accessible. This includes development details, purpose, intended use, and any limitations or biases addressed.
3. Update Risk Management Plan: Revise and update Intervention Risk Management (IRM) practices in line with the HTI-1 requirements. Focus on algorithmic transparency, fairness, safety, and privacy considerations for each Predictive DSI.
4. Communication and Training: Maintain regular communication and develop comprehensive training programs for medical and technical staff. Focus on understanding the functionalities, limitations, and appropriate uses of DSIs within clinical workflows.
5. Engage with Health IT Developers: Collaborate closely with certified health IT developers to ensure that the DSIs integrated into your systems meet HTI-1 Final Rule standards. Discuss any necessary updates or modifications to maintain compliance.
6. Governance and Monitoring: Set up a governance model to monitor compliance.

Conclusion: Key Takeaways for Healthcare Providers

In a sector facing financial challenges, investing in certified health IT and predictive DSIs is vital. The initial investment in updating technology and training staff is notable. Yet, the benefits in decision-making, patient care, and the avoidance of medical errors are significant. Providers that adopt can offer unique, evidence-based treatments. Compliance with HTI-1 is expected to lead to both improvements in the efficacy of care as well as patient experience.

Following the HTI-1 Final Rule can also protect against penalties from information blocking and non-compliance. This makes the investment in new technology and processes worthwhile. Moreover, using transparent and validated predictive DSIs can lead to more accurate and fair patient care.

Healthcare providers should prepare for these new regulations to take full effect by December 31, 2024. These regulations will affect operational efficiency, financial health, and market position.

About Nitin Kunte

Nitin Kunte is a Sr. Director at NTT DATA, a leading provider of IT and business services with extensive healthcare experience spanning over 50 years. Nitin is the practice lead for NTT’s healthcare technology consulting practice. With his deep expertise in healthcare industry, he has helped healthcare clients with areas such as Integration and Interoperability, predictive AI, developing value propositions that support IT investment and reshaping IT organizations and capabilities to meet their strategic goals. Connect with him on LinkedIn.

< + > RFX Solutions Closes on $9 Million in Series A Funding to Revolutionize Healthcare Compliance through SaaS Technology

In a move towards transforming healthcare compliance, RFX Solutions, a trailblazer in SaaS compliance software for healthcare facilities, is proud to announce a $9 million Series A funding round led by Arthur Ventures. This investment underscores the confidence in RFX Solutions’ mission to streamline and enhance compliance processes in healthcare settings.

RFX Solutions is partnering with Arthur Ventures for this pivotal phase of growth due to the firm’s deep expertise in partnering with growing B2B SaaS companies.

Amanda Penrod, PhD, Co-Founder and CEO at RFX Solutions, expressed her enthusiasm for this new chapter, “We are thrilled to partner with Arthur Ventures, a firm that truly understands the SaaS landscape and shares our vision for a more efficient and error-free compliance process in healthcare. This investment is not just a financial milestone but a testament to the hard work and dedication of our team. It propels us forward in our mission to eliminate the cumbersome and error-prone manual management of compliance data and documents in healthcare facilities.”

“RFX Solutions’ platform is a game-changer for Ambulatory Surgery Centers (ASC), providing a comprehensive solution to the mounting challenges ASCs face,” said Patrick Meenan, General Partner at Arthur Ventures. “Remaining compliant with government regulations and operating efficiently shouldn’t have to be overwhelming. With RFX Solutions, ASCs can remain compliant, significantly streamline operations, and focus on what matters most-delivering high-quality patient care. We’re thrilled to partner with RFX Solutions as they continue to grow and transform ASC operations.”

The Series A funding will be instrumental in accelerating RFX Solutions’ software development, enhancing the product roadmap and bolstering sales enablement efforts. By focusing on regulatory compliance, RFX Solutions addresses a critical pain point in the healthcare industry – the manual handling of compliance data and regulatory documents. This traditional approach is fraught with inefficiencies, risk and potential for errors, which can result in non-compliance, document mismanagement, and considerable time spent preparing for audits and surveys.

With RFX Solutions’ innovative approach, healthcare facilities can look forward to a future where compliance is streamlined, risks are minimized, and the focus can return to patient care. The investment by Arthur Ventures marks a pivotal step in RFX Solutions’ journey to redefine healthcare compliance through cutting-edge technology.

About RFX Solutions

RFX Solutions is a leading provider of SaaS compliance software, designed to simplify and improve the compliance processes within healthcare facilities. With a focus on innovation and customer-centric solutions, RFX is committed to helping healthcare facilities meet regulatory requirements efficiently and effectively.

About Arthur Ventures

Arthur Ventures is a Minneapolis-based early growth capital firm that leads investments in B2B software companies. Since 2013, they have partnered with 50+ companies across the United States and Canada. Arthur Ventures manages $1.1 billion and is actively investing out of its $300 million fifth fund. For more information, visit arthurventures.com.

Originally announced April 16th, 2024

< + > Bonus Features – May 12, 2024 – 79% of healthcare CIOs plan to implement generative AI by 2026, 47% of healthcare data is underutilized in decision-making, plus 28 more stories

Welcome to the weekly edition of Healthcare IT Today Bonus Features. This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job.

News

• Ascension was the latest provider to get hit by a cyberattack. The organization said clinical operations were disrupted, with EHR access down and several hospitals on diversion for emergency services.
• In happier news: Rock Health named its annual Top 50 in Digital Health – shout out to friend of Healthcare IT Today Grace Vinton for recognition as a Storyteller – and this year’s MedTech Breakthrough Awards are out.

Studies

• Nearly 80% of healthcare CIOs expect to adopt generative AI by 2026, according to a survey from Vena. To date, 40% of organizations surveyed have already implemented AI models.
• An Experian Health survey found 55% of providers but just 28% of patients said patient access and service are improving. The top challenge for patients, cited by 27% of those surveyed, is seeing a doctor quickly.
• Research from Arcadia and HIMSS found 47% of healthcare data is underutilized when making clinical and business decisions. This is despite 95% of leaders saying data and analysis can help clinicians improve productivity.
• A Solera Health survey found nearly 60% of women live with tolerable discomfort, while many women are reluctant to bring up “embarrassing, mild or sporadic symptoms” with their gynecologist.
• A Surescripts study found e-prescriptions filed by pharmacists increased 47% from 2019 to 2022, compared to just 4% for PCPs.

Partnerships

• Colorado-based HIE entities Contexture and Quality Health Network announced their affiliation.
• FHIR integration tool HealthConnect now integrated with athenahealth, having previously integrated with Epic and Oracle Health (Cerner).
• TruBridge has integrated Multiview ERP into its EHR.
• Data from glucose RPM devices from Senseonics is now integrated with Rimidi‘s chronic disease management platform.
• Electronic Caregiver and Cognitive Systems are partnering to distribute discrete sensor technology to seniors who wish to age in place.

Product and Company News

• Following go-live at Chicago’s Captain James A. Lovell Federal Health Care Center, Oracle EHR is now at operational at all Department of Defense garrison facilities worldwide.
• eClinicalWorks introduced Sunoh.ai for dental clinics and announced Nevada-based FQHC Community Health Alliance as an early adopter.
• Hinge Health launched Hinge Health Global, which will help enables multinational employers provide personalized digital musculoskeletal care.
• Community care technology company WellSky released WellSky Value-Based Insights for Hospice.
• Together by Renee updated Find My Meds to enable the transfer of prescriptions to pharmacies where drugs are available, ensuring continuity of access.
• CentralReach launched CR ClaimCheckAI to automate claims submission for care for autism and intellectual and developmental disabilities.
• symplr updated symplr Workforce to enable users to nominate nurses for DAISY Award recognition.
• An evaluation of TimelyCare found users experienced clinically significant changes to depression and anxiety symptoms by their third visit with a counselor or psychiatrist.
• RapidAI received FDA 510(k) clearance for AngioFlow, its module for detecting rapid changes to blood flow in the brain.
• Robotics company MMI completed its first microsurgical procedures in the United States at Penn Medicine, using small robots to reconnect blood vessels.
• The Erdős Institute validated Veda’s provider directory as exceeding 90% accuracy.

Sales

• Baptist Health is expanding its use of Caregility telehealth devices to more than 700 bedsides system-wide.
• Florida-based Pasco County Corrections selected NaphCare to administer care to inmates and provide technology support.
• NHS National Services Scotland implemented Rhapsody Enterprise Master Person Index.

People

• The American Telemedicine Association named Dr. Sree Chaguturu as Chair of the Board of Directors; he’s Executive Vice President and Chief Medical Officer at CVS Health.
• Ambient AI documentation vendor DeepScribe appointed Dr. Dean Dalili as Chief Medical Officer.
• Cybersecurity vendor Anatomy IT appointed Varun Gulati as Senior Vice President of Operations.
• Clinical trial accelerator Lindus Health appointed Dr. Tim Garnett to its Advisory Board.

If you have news that you’d like us to consider for a future edition of Healthcare IT Today Bonus Features, please submit them on this page. Please include any relevant links and let us know if news is under embargo. Note that submissions received after the close of business on Thursday may not be included in Bonus Features until the following week.

Happy Mother’s Day, everyone!

< + > Attendees report in on 'next chapter in virtual care' at ATA conference

Four telehealth experts discuss the roles of AI, collaboration, hybrid care, regulation and more as presented at this week's American Telemedicine Association annual conference.

< + > The benefits of home-based, tech-enabled care for depression

Universal Brain Founder and CEO Dr. Kazu Okuda, a psychiatrist, discusses precision psychiatry and the technology that facilitates this form of treatment in the home.

< + > New collaboration platform removes barriers to nurse-led care

For nurse practitioners and physician assistants in states with restrictive practice rules, it matches them with other clinicians, automates licensing compliance and provides EHR-agnostic chart sharing and HIPAA-compliant chat.

< + > New EU assessment framework for digital health on the horizon?

A harmonised European Health Technology Assessment Regulation (HTAR) is set to come into force in 2025, but the mandatory application of the regulation does not cover digital health technologies. The EDiHTA Project aims to address that.

< + > Revenue Integrity in 2024: Reducing Leakage Points in a Complicated Cycle

The following is a guest article by Tanya Sanderson, RN, BSN, MBA, MHA, CLNC, CHFP, Senior Director of Revenue Integrity at Xsolis

The concept of “revenue integrity” hasn’t really changed over the years, but the roles, responsibilities, and oversight have become far more complex and difficult to gain industry consensus around. What began as several defined systems of controls by which hospitals guarded against revenue loss, revenue integrity has seemingly turned into more narrowly focused controls in many organizations, leaving critical gaps in what once was a more holistic approach to fiscal oversight.

In short, revenue integrity simply means ensuring providers are paid appropriately for all services provided and in an efficient and compliant manner to prevent revenue leakage and compliance risk. That’s easier said than done.

An increasingly complicated payer-provider landscape and rising staff shortages are magnifying the disconnects between clinical and administrative metrics, technologies, and processes. These challenges are further compounded by technology and digital transformations, system consolidations, and organizational restructuring across many hospitals and health systems – exposing more possibilities for revenue loss than ever before.

Let’s take a closer look at what revenue integrity looks like in 2024, how the challenges have evolved, and the best practices stakeholders can implement in today’s environment.

The Changing Landscape for Revenue Integrity

How has revenue integrity changed over the years? First, the evolution of technology and the ability to solve for some of the various challenges that previously existed has completely revolutionized the charge capture process.

As an example, I often refer back to the early days in my career as a young ER nurse, where charge capture meant an index card in the patient’s chart that our business office would remind us to use to capture supplies and medications used during a patient’s visit. There were many times I would arrive home after a grueling or intense twelve-hour shift to find those ‘yellow stickers’ meant to capture charges stuck to my scrubs or the bottom of my shoe. In an emergency department setting where life and death are on the line and more patients are waiting with potentially life-threatening issues, those little yellow stickers getting on the patient’s chart were not the priority. Not much has changed over the last thirty years in some respects as the clinical needs of the patient must always come first. But in a cloud-based digital world, that would amount to a band-aid on a gaping wound with no easy way to reconcile or find potential lost charges.

Now hospitals have sophisticated supply chain and pharmacy systems that can automatically assign a charge to a patient’s account when supplies or medications are used during a patient’s encounter. This eliminates the need for those manual processes of keying in charges or validating what was used or given from documentation found in the patient’s chart prior to billing. While these advancements have eased the burdens of supply chain and charge capture processes, they still leave gaps as it relates to documentation that supports the charges billed and medical rationale for each amount, procedure, or level of service.

As technology has transformed processes, the acceleration of digital transformation and health system consolidations and restructuring has disrupted existing safeguards, exposing additional risk and gaps in revenue integrity. According to one study, about 1,500 hospitals were targeted as part of a completed merger or acquisition from 2010-19, and most of these deals (55%) involved hospitals or health systems in different commuting zones.

According to another study, about one in eight rural hospitals merged with an out-of-market hospital or health system from 2010-18. That activity has begun to increase again in the past few years as post-pandemic financial challenges have necessitated organizations with poor financial performance seek more financially stable partners, creating more organizational and market restructuring.

So how do organizations safeguard their revenue amidst the disruptions of today?

Being Aware

If a hospital or health system is unaware of where it is losing revenue – either at the front, middle, or back end of the process – it’s difficult to control against that loss in the future.

The traditional three-part revenue cycle is still a useful roadmap for identifying potential points of revenue leakage and where safeguards are needed:

1. Front End: This starts with the patient intake process: obtaining accurate insurance and demographic information, getting authorization from the payer, and confirming it meets the payer’s medical policy to ensure their care is covered. Resolving unknowns with the provider or patient prior to service helps ensure appropriate reimbursement for care, while also reducing patient dissatisfaction and reimbursement delays.

2. Middle: Mid-revenue cycle is where patient care takes place, and the risk of revenue leakage is highly reliant on clinical administrative processes and documentation. Particular emphasis is given to capturing and documenting what was done during the patient’s care (i.e. treatments, medications, procedures, etc.) and why (patient acuity, severity, risk of adverse outcome, uncontrolled pain, etc.) to support compliant coding and billing practices as well as appropriate reimbursement. In today’s digital, drop down, electronic health record, that requires intentionality, education, and assistive technology.

3. Back End: Back end revenue cycle processes are typically considered any of the administrative processes that occur after the patient is discharged. This typically includes any of the technical or administrative processes to finalize charges, coding, and claim submission, as well as any transactions between patient, payer and provider that take place after discharge. This is when the bill goes out, when claims are processed, and claim-related denials are issued. Ensuring your teams have automated and intuitive workflows, objective data to identify opportunities for improvement, and clear and consistent lines of communication to both clinical and revenue cycle areas is critical to improving performance and outcomes.

One of the largest drivers of revenue leakage and financial strain outlined earlier stems from denied reimbursement from insurance claims. Creating sound processes throughout the revenue cycle and leveraging objective data to ensure all stakeholders are aware of the opportunities, risk, and financial impact, improves collaboration and reduces gaps. When 35% of hospitals report losses greater than $50 million due to exhausted insurance appeals, the need to address revenue integrity externally must be mentioned as well.

One approach hospitals can take is creating open lines of communication with their payers, and leveraging objective data to solve for subjectivity in complex and inconsistent payer policies.  Much like the collaboration objective data can create internally, an intentional and objective approach can create better alignment with your payers.

We can also tackle this challenge as an industry. The Hospital Financial Management Association Executive Revenue Integrity Council, a national consortium of representatives from both the payers’ and providers’ side of the aisle, held its first meeting in February. To fix the problems that need fixing, both sides need to come together to discuss their shared challenges, find common areas of concern, and learn what each side can do to help each other determine the most feasible paths to solutions.

Discussions in this kick-off meeting highlighted the challenges already outlined above as topics, inconsistent areas of oversight, and objectives identified by the group were as vast and broad as the revenue cycle process itself. One topic resonated above all: the need to reduce revenue leakage from increased denials and rework, which requires closing gaps in each area of the revenue cycle (both clinical and financial) and creating better collaboration and alignment with payers.

As this new consortium of providers and payers works together, or as hospitals and their payer partners work collaboratively, more opportunities for alignment and automation can be realized. The more revenue cycle functions can be automated, objective, and streamlined, the more burdens can be relieved from hospitals’ limited resources. That’s easier said than done, of course, but finding ways to put the dollars back where they’re supposed to be — into patient care — requires innovative solutions and deserves more focus than ever.

Automated Solutions

Everyone knows that AI and automation are hot topics these days, but how can AI and automation help solve these challenges?

Empowering teams with data-driven insights to fix systemic challenges is the goal, but getting those teams on the same page presents complications. Some processes are more easily automated than others, and as previously highlighted, this requires a shared framework between clinical and financial administrative processes where competing priorities and viewpoints often collide. Creating a shared framework and objective approach that relieves clinician burden, and improves coordination and collaboration with revenue cycle stakeholders, can expand the possibilities of successful automated processes.

As these teams work together to automate workflows and leverage AI to identify potential revenue leakage or risk, the three-part revenue cycle (front end, middle, back end) becomes a more integrated and efficient system. As AI and automation then close the gaps between clinical and administrative revenue cycle requirements and functions with an objective approach, hospitals and health systems can achieve revenue integrity as a consistent organizational framework, as opposed to siloed functions that leave gaps, risk, and leakage unnoticed.

About Tanya Sanderson

Tanya Sanderson RN, BSN, MBA, MHA, CLNC, CHFP, is the Senior Director of Revenue Integrity with Xsolis, the AI-driven health technology company with a human-centered approach. Tanya’s healthcare career spans 30 years including clinical nursing, legal and regulatory consulting, and healthcare revenue cycle leadership.  For more than a decade, Tanya has built, led and transformed multiple revenue integrity, denial management, and audit and appeal departments and created processes to improve denial mitigation, recovery, and compliance in multiple settings ranging from 12-hospital centralized business offices to enterprise oversight in $14+ billion integrated health systems.