American Medical Association Archives - gettectonic.com
Value-Based Care Technologies
22Nov

Value-Based Care Technologies

Essential Technologies for Value-Based Care Success As healthcare providers increasingly adopt value-based care, they must invest in the right technologies and resources to succeed in this model, which incentivizes high-quality, cost-effective care. Value-Based Care Technologies tie reimbursement to care quality, making providers accountable for patient outcomes while providing resources to enhance care. As of 2021, nearly 60% of healthcare payments were already tied to value-based models, according to the Health Care Payment Learning and Action Network (HCP LAN). While partnerships can initiate value-based care, providers must invest in the right technology to fully achieve the intended outcomes. Health Information Exchange (HIE) A robust health information exchange (HIE) is fundamental to value-based care, as it enables providers and payers to access high-quality data seamlessly. HIE allows healthcare professionals to share patients’ medical information electronically across organizations, promoting care coordination by giving providers a comprehensive view of patient needs. For patients, HIE enables more informed involvement in their care by making their health data accessible across specialists, labs, and pharmacies. While joining an HIE may involve new technology investments and workflow adjustments, it ultimately enhances provider access to critical health data. Population Health Management Tools Population health management tools help providers assess health outcomes within groups rather than focusing on individuals alone. These tools aggregate and analyze data, allowing practices to identify high-risk patients and create targeted interventions. This not only enhances health outcomes but can also reduce costs by avoiding expensive treatments. Patient engagement tools, such as telehealth and remote patient monitoring, are essential in population health management, especially for monitoring high-risk patients when in-person care is not feasible. Digital surveys integrated within patient portals can provide insights into social determinants of health, adding a broader context to patient needs. Data Analytics Data analytics transform healthcare data into actionable insights across four types: descriptive, diagnostic, predictive, and prescriptive. Providers can use these analytics to reduce hospital readmissions, predict diseases, and identify chronic illnesses. Data integration and risk stratification capabilities are especially valuable in value-based care, enabling providers to track patient health outcomes effectively and prioritize high-risk cases. Artificial Intelligence & Machine Learning AI and machine learning support many data analytics functions, helping identify patient needs and easing administrative burdens. Given staffing shortages and burnout—reported by 63% of physicians in 2021, according to the American Medical Association (AMA)—AI can automate tasks like documentation, charting, and scheduling, allowing providers to focus more on patient care. Additionally, AI-driven automation in revenue cycle management tasks, such as billing and coding, can reduce the administrative workload associated with value-based care. Price Transparency Technology Price transparency empowers patients to seek cost-effective care, a core principle of value-based models. When providers comply with transparency regulations, patients can better understand their costs and make informed decisions. For providers, leveraging price transparency tools ensures compliance and facilitates partnerships with payers by enabling more effective negotiation, which supports the overall goals of value-based care. As healthcare continues shifting to value-based models, investing in these technologies is critical for providers aiming for long-term success. While these tools rdo equire substantial investment, they are essential for improving patient outcomes, optimizing care quality, and ensuring sustainability in value-based care. When evaluating and choosing healthcare technology tools, contact Tectonic for help. Like1 Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more The Salesforce Story In Marc Benioff’s own words How did salesforce.com grow from a start up in a rented apartment into the world’s Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Health Cloud Brings Healthcare Transformation Following swiftly after last week’s successful launch of Financial Services Cloud, Salesforce has announced the second installment in its series Read more

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November 22, 2024in AI Tools, Artificial Intelligence, Data, Life Sciences Cloud, Salesforce, Salesforce Development Services, Salesforce Foundations, Salesforce Health and Life Sciences Solutions, Salesforce Health Cloud, Salesforce Implementation Services, Salesforce Optimization, Technology
Impact of EHR Adoption
07Aug

Connected Care Technology

How Connected Care Technology Can Transform the Provider Experience Northwell Health is leveraging advanced connected care technologies, including AI, to alleviate administrative burdens and foster meaningful interactions between providers and patients. While healthcare technology has revolutionized traditional care delivery models, it has also inadvertently created barriers, increasing the administrative workload and distancing providers from their patients. Dr. Michael Oppenheim, Senior Vice President of Clinical Digital Solutions at Northwell Health, highlighted this challenge during the Connected Health 2024 virtual summit, using a poignant illustration published a decade ago in the Journal of the American Medical Association. The image portrays a physician focused on a computer with their back to a patient and family, emphasizing how technology can inadvertently shift attention away from patient care. Reimagining Technology to Enhance Provider-Patient Connections To prevent technology from undermining the patient-provider relationship, healthcare organizations must reduce the administrative burden and enhance connectivity between patients and care teams. Northwell Health exemplifies this approach by implementing innovative solutions aimed at improving access, efficiency, and communication. 1. Expanding Access Without Overloading Providers Connected healthcare technologies can dramatically improve patient access but may strain clinicians managing large patient panels. Dr. Oppenheim illustrated how physicians often need to review extensive patient histories for every interaction, consuming valuable time. Northwell Health addresses this challenge by employing mapping tools, propensity analyses, and matching algorithms to align patients with the most appropriate providers. By connecting patients to specialists who best meet their needs, providers can maximize their time and expertise while ensuring better patient outcomes. 2. Leveraging Generative AI for Chart Summarization Generative AI is proving transformative in managing the immense data volumes clinicians face. AI-driven tools help summarize patient records, extracting clinically relevant details tailored to the provider’s specialty. For instance, in a pilot at Northwell Health, AI successfully summarized complex hospitalizations, capturing the critical elements of care transitions. This “just right” approach ensures providers receive actionable insights without unnecessary data overload. Additionally, ambient listening tools are being used to document clinical consultations seamlessly. By automatically summarizing interactions into structured notes, physicians can focus entirely on their patients during visits, improving care quality while reducing after-hours charting. 3. Streamlining Team-Based Care Effective care delivery often involves a multidisciplinary team, including primary physicians, specialists, nurses, and social workers. Coordinating communication across these groups has historically been challenging. Northwell Health is addressing this issue by adopting EMR systems with integrated team chat functionalities, enabling real-time collaboration among care teams. These tools facilitate better care planning and communication, ensuring patients receive coordinated and consistent treatment. Dr. Oppenheim emphasized the importance of not only uniting clinicians in decision-making but also involving patients in discussions. By presenting clear, viable options, providers can enhance patient engagement and shared decision-making. The Path Forward: Balancing Technology with Provider Needs As healthcare continues its digital transformation, connected care technologies must prioritize clinician satisfaction alongside patient outcomes. Tools that simplify workflows, enhance communication, and reduce administrative burdens are crucial for fostering provider buy-in and ensuring the success of health IT initiatives. Northwell Health’s efforts demonstrate how thoughtfully implemented technologies can empower clinicians, strengthen patient relationships, and create a truly connected healthcare experience. Tectonic is here to help your facility plan. Content updated November 2024. Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Health Cloud Brings Healthcare Transformation Following swiftly after last week’s successful launch of Financial Services Cloud, Salesforce has announced the second installment in its series Read more Top Ten Reasons Why Tectonic Loves the Cloud The Cloud is Good for Everyone – Why Tectonic loves the cloud You don’t need to worry about tracking licenses. Read more

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August 7, 2024in Data, Generative AI, Life Sciences Cloud, Salesforce Health and Life Sciences Solutions, Technology
Standards in Healthcare Cybersecurity
27Jul

Standards in Healthcare Cybersecurity

The Change Healthcare cyberattack was a significant incident with widespread ramifications across the healthcare industry, with effects that are likely to persist for months or even longer. Standards in Healthcare Cybersecurity will change as a result. Since the ransomware attack on UnitedHealth Group’s (UHG) subsidiary, Change Healthcare, providers have faced financial and operational challenges due to disruptions in claims processing and other essential services. Change Healthcare, which processes 15 billion transactions annually and interacts with one in every three patient records in the U.S., is undergoing a complex and lengthy recovery process, with long-term implications for the industry. The attack was first reported on February 21st when Optum, another UHG subsidiary, alerted customers about the unavailability of some applications due to a cybersecurity issue. It was later confirmed that the BlackCat ransomware gang was responsible for the attack, which led to a $22 million ransom payment by UHG. The scale of the attack caused significant operational disruptions across the healthcare system, affecting entities ranging from large pharmacy chains to small, independently owned practices. In the weeks following the attack, UHG began restoring services, but the recovery process remains ongoing. UHG CEO Andrew Witty testified before Congress that the cybercriminals had gained access to Change Healthcare systems nine days before deploying the ransomware, using compromised credentials to access a Citrix portal without multi-factor authentication. The decision to pay the ransom was described as one of the hardest Witty has ever had to make. The incident has highlighted the vulnerabilities in healthcare cybersecurity, particularly for large organizations like UHG that handle vast amounts of sensitive data. It has also fueled the debate over whether ransomware payments should be made illegal, with arguments on both sides regarding the implications for victims and the broader cybersecurity landscape. The attack has prompted a strong response from industry groups and the federal government. The American Hospital Association (AHA) and the American Medical Association (AMA) have been vocal about the impact on providers, with the AHA calling it “the most significant and consequential cyberattack on the U.S. healthcare system in American history.” The federal government, through the Department of Health and Human Services (HHS), has provided guidance to Medicare providers and launched a formal investigation into the breach. As the healthcare industry continues to recover, the long-term impacts of the Change Healthcare cyberattack are expected to shape future cybersecurity strategies. The incident has underscored the importance of robust third-party risk management, the implementation of security measures like multi-factor authentication, and the potential need for more stringent regulatory standards in healthcare cybersecurity. The full extent of the breach, including the number of individuals affected, remains to be seen, but it is already clear that this event will have lasting repercussions for the industry. Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Health Cloud Brings Healthcare Transformation Following swiftly after last week’s successful launch of Financial Services Cloud, Salesforce has announced the second installment in its series Read more Top Ten Reasons Why Tectonic Loves the Cloud The Cloud is Good for Everyone – Why Tectonic loves the cloud You don’t need to worry about tracking licenses. Read more

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July 27, 2024in Salesforce Health and Life Sciences Solutions, Salesforce Health Cloud, Salesforce Optimization
AI Potential to Improve Prior Authorizations
17May

AI Potential to Improve Prior Authorizations

AI’s Potential to Reduce Provider Burdens in the Prior Authorization Process Artificial intelligence (AI) has the potential to significantly ease the documentation and substantiation burdens providers face during the prior authorization process. Prior authorization, a critical step where health plans approve or deny coverage for services or prescriptions before they’re administered, is a key cost-control mechanism in the U.S. healthcare system. While it helps payers avoid unnecessary spending, the process poses significant challenges, especially for healthcare providers tasked with gathering and submitting documentation. AI Potential to Improve Prior Authorizations examined. Historically, prior authorization has been a major regulatory challenge for providers, surpassing other issues such as electronic health record (EHR) interoperability and compliance with the No Surprises Act. Despite its cumbersome nature, prior authorization isn’t likely to be eliminated, as it plays a crucial role in balancing healthcare affordability and access to quality care. AI Potential to Improve Prior Authorizations The transactional nature of many prior authorization tasks makes them ripe for automation. Increasingly, stakeholders are turning to AI and other technology-driven solutions to streamline the process, making it less burdensome for providers. How AI Can Streamline Prior Authorization AI has already been applied to various aspects of healthcare, from automating hospital discharges to alleviating the administrative burdens of nurses. When applied to prior authorization, AI can speed up the approval process for both providers and payers, reducing delays in patient care and lowering administrative costs. Health insurance companies are already beginning to leverage AI to expedite prior authorization and claims decisions. However, concerns are growing over whether the use of AI in these areas complies with state and federal regulations. For example, a 2023 AMA Annual Meeting resolution cited an investigation revealing that Cigna doctors denied over 300,000 claims in two months, spending an average of just 1.2 seconds per case using AI. UnitedHealthcare has also employed AI to make “fast, efficient, and streamlined coverage decisions,” raising questions about whether these decisions adhere to regulatory standards for fairness and accuracy. AMA’s Call for Oversight on AI in Prior Authorization Recognizing the risks, the American Medical Association (AMA) has called for increased regulatory oversight of AI in prior authorization. Specifically, the AMA advocates for: AI could potentially reduce the time-consuming, manual tasks associated with prior authorization. However, as AMA Trustee Dr. Marilyn Heine cautioned, “AI is not a silver bullet.” The increasing reliance on AI for prior authorization must not add to the already overwhelming volume of requirements that burden physicians and hinder patient care. Nor can it increase the threat of cyberattacks. Fixing Prior Authorization: AMA’s Role Addressing the challenges of prior authorization is a key part of the AMA’s Recovery Plan for America’s Physicians. The organization is committed to reducing the overuse of prior authorization and improving the fairness of existing processes, ensuring that the use of AI in healthcare supports—not hinders—patient care. To that end, the AMA continues to research the costs and impacts of prior authorization on healthcare providers and patients. To learn more about the proper use of AI in medicine and the AMA’s efforts to reform prior authorization, visit the AMA’s resources on healthcare AI. Content updated September 2024. Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Health Cloud Brings Healthcare Transformation Following swiftly after last week’s successful launch of Financial Services Cloud, Salesforce has announced the second installment in its series Read more Top Ten Reasons Why Tectonic Loves the Cloud The Cloud is Good for Everyone – Why Tectonic loves the cloud You don’t need to worry about tracking licenses. Read more

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May 17, 2023in Artificial Intelligence, Salesforce Health and Life Sciences Solutions, Salesforce Implementation Services, Technology

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