Experts say hospitals must plan for providing care after an attack

Cybersecurity and patient safety

Experts offer advice for hospitals on protecting systems and patients

Tips and tough love

Criminals know smaller systems are vulnerable to cyberattacks

Targeting small hospitals

Nasim Afsar, chief health officer of Oracle Health

Hospitals and health systems are paying more attention to 

, including the factors that affect the health of patients in their own neighborhoods.

Oracle Health is working with hospitals to reduce disparities in outcomes. Since completing 

the $28 billion acquisition of Cerner in June

healthcare is now the company’s primary focus

, Nasim Afsar, chief health officer of Oracle Health, discussed the organization’s work to identify the health needs in different neighborhoods. She also outlined how hospitals and health systems can improve health equity.

Why do zip codes play such an outsized role in a person’s health?

We all know that clinical factors aren’t the only influence on a person’s health and wellness. Where you live by country, by state, and even by neighborhood makes a profound difference. That’s why it’s important to bring social determinants of health into the EHR (electronic health records). Zip codes can tell us a lot about a person and are often indicative of the available resources in a community as well as people’s access to health clinics or to grocery stores with fresh, healthy fruits and vegetables. They also reflect income levels, with housing security and access to public transportation. These are all factors that play a critical role in an individual and community’s health and care.

How are we only recently seeing the role of one’s neighborhood as a key factor affecting health?

This is definitely not a new or recent phenomenon. For decades, public health experts, researchers and clinicians have seen the impact of zip codes on the health of individuals in communities across the globe.

However, over the past decade, as more medical records have been digitized and we are asking for and capturing more of these elements, we are able to have a better data-driven understanding and approach to the true impact of these indicators on health. Proactive relationships between health systems and communities help broaden healthcare and can be a game-changer. Data-driven insights should be integrated into the EHR to help providers identify those who might be at a health risk, food and housing insecurities and other factors.

How does Oracle Cerner’s Determinants of Health solutions help providers improve their health care and move closer to health equity?

Our job at Oracle Cerner is to create tools that enable clinicians to get back to what matters most – caring for patients. We have a real opportunity to not only raise awareness of but to also examine and identify how we can eliminate inequities today and into the future.

Rich data sets, dashboards and technologies such as Oracle Cerner’s data and insights platform can help providers access clinical, behavioral and social data about patients in one place, identify existing disparities and suggest community resources as part of a patient’s care plan.

Oracle Cerner’s Determinants of Health can help providers conduct community needs assessments to proactively address social risk factors. At the population level, you can see social risk factors like transportation barriers, food insecurity or housing instability all broken down by demographics. In June 2022, we added a new feature - the ability to zoom in to neighborhood groupings of 600 to 3,000 people to better understand and target social risk.

Why is this new capability so important? Consider Wyandotte County in Kansas – in the tool, you can see the entire county is coded red for being at high risk due to social factors such as lack of health insurance and a high prevalence of gaming and alcohol establishments. But that’s not the full story. The tool also shows that the eastern part of the county makes up most of this at-risk population. With this enhanced data, healthcare organizations can more accurately tailor and target their outreach and intervention programs.

What should hospitals and health systems be thinking about when it comes to “techquity”? 

Technology shouldn’t be something we think about – yet it should seamlessly connect to the most relevant data at the right time so clinicians can focus on the purpose of healing through compassionate connections with their patients. Technology and data insights are being used today to address health disparities, to prevent bias in care delivery and ultimately help improve overall outcomes in communities. Clinicians can look to understand how they can leverage a person’s social risk factors to provide proactive interventions that improve health and care. Many current systems are focused too much on reactive responses. Leveraging data enables us to be more proactive and prevent or minimize illnesses and diseases.

 solution helps organizations advance whole person care by identifying and intervening on social risk factors through action-oriented community analytics and social determinants of health capabilities embedded within care management workflows.

Can you offer a little more insight on how geospatial modeling identified patients at risk for diabetes and hypertension at an African American church in South Carolina?

Roper St. Francis Healthcare, using geospatial mapping within Oracle Cerner technology, analyzed publicly available information and identified other institutions that patients frequent, such as churches. In collaboration with the Roper St. Francis Healthcare chief diversity and inclusion officer, the analytics team cross-referenced African American patients that had a high prevalence of diabetes and hypertension with the location of churches they attended. Working with the church, the chief diversity and inclusion officer provided literature, engaged church leaders and identified nurses who were members of the congregation to conduct screenings and outreach. This helped the system to step outside of the four walls and help ensure that community members received care in environments they trusted, ultimately impacting their health for the better.

Can you share more about the screening tool used to help the University of New Mexico Health Sciences Center spot the tie between social determinants and poor health outcomes in the diabetes population?

Within its Oracle Cerner platform, the University of New Mexico Health Sciences Center uses a screening tool to determine the correlation between adverse social determinants and poor health outcomes in populations with diabetes and other chronic conditions. The results led the organization to hire community health workers for its primary care clinics and its emergency room, to help make a more positive impact in vulnerable patient populations. Their Office of Community Health plays a vital role in advancing health and health equity, recognizing social determinants, such as housing, education, food, transportation, utilities, income and social inclusion, play a far greater role in health.

Where should hospitals or health systems start on health equity efforts?

Improving the health of populations without understanding the conditions in which they live is a difficult undertaking. Having accurate, localized community data within the EHR is crucial to addressing social risk factors and improving community health. This same data can also be used to advance health equity – a specific focus of many of our health systems here in the U.S.

What can smaller hospitals or health systems with more modest resources do to use data to address disparities?

Addressing inequities in healthcare is not easy, whether you’re a critical care hospital or a large integrated delivery system. And we have developed the Learning Health Network. Today a group of more than 100 health systems from 43 states, including small community hospitals and academic medical centers, share de-identified EHR data for the purpose of advancing clinical research. More than half of the health network members are small critical access hospitals who now have the chance to bring clinical studies to their rural communities. Healthcare is about people helping people – and the Learning Health Network is a very definition of that.

By design, diversity has become the Learning Health Network’s superpower. Clinical trials that run through the health network have three times the national average of Black and Hispanic participants. Take for example, Osmond General Hospital - a 20-bed critical access hospital in rural Nebraska. For the first time ever, they enrolled in their first clinical trial earlier this year for early detection of colorectal cancer. One of their patients who qualified for the study tested positive on her at home screening test. This prompted her to go in for a colonoscopy which confirmed a diagnosis of cancer. She is now undergoing treatment potentially years earlier into the disease.

This example brings to life the major benefit of the Learning Health Network – and how caregivers and patients are able to access leading therapeutics, diagnostics and medication sooner.

How do you ensure technology solutions to improve health equity don’t actually exacerbate disparities?

This is an area of increasing assessment and work for all of us in the healthcare industry. Data that’s entered into electronic health systems can reflect societal bias. Therefore, machine-learning algorithms that build off of data, can reflect and exacerbate disparities. To eliminate this, we have to take a proactive approach on multiple levels, including education at the delivery side to ensure we are bias-free in our documentation and data collection, and active monitoring and surveillance to ensure we are looking for and eliminating bias when identified in systems. This requires broad conversation and commitment from all of us.

How should hospitals and health systems work with the community in addressing health disparities?

Despite commitment across healthcare organizations to address health disparities, some have found it hard to detect and address inequities. An important step is to build relationships and infrastructure to support community engagement - something that historically hasn’t been considered. We haven’t always looked to what happens in clinics and hospitals without considering the full picture. However, what happens outside the doctor’s office and in daily life can influence decisions we make and opportunities we have. Robust, thriving relationships can help communities together understand how to identify gaps and address them to ensure better health and care for individuals, communities, and neighborhoods.

Articles

In an interview with Chief Healthcare Executive, the chief health officer of Oracle Health talks about the role of data in closing disparities. She also offers guidance for hospitals aiming to improve equity in care.

Oracle Health’s Nasim Afsar discusses tech and equity in healthcare

Panelists at the HLTH Conference talked about improving health equity. From left, Eboné Carrington, managing director of Manatt Health; Amaka Eneanya, head of strategy and operations for Fresenius Medical Care; Bechara Choucair, senior vice president and chief health officer of Kaiser Permanente; Taylor Justice, co-founder and president of Unite Us; and Charlotte Owens, vice president and head of health equity and patient affairs at Takeda Pharmaceuticals.

Since the emergence of the COVID-19 pandemic, many healthcare leaders and experts have said the pandemic has vividly illustrated the inequities in health treatment and outcomes among disadvantaged groups.

Eboné Carrington, managing director of Manatt Health, said those disparities in healthcare among minority groups and those with lower incomes haven’t exactly been hidden. The fact that so many are genuinely surprised by health inequities indicates the conversation needs to move forward, she said.

“When no one is disadvantaged, then we’ll be on the way to health equity,” she said.

Carrington led a discussion on health equity with other healthcare leaders at a panel at the HLTH Conference in Las Vegas earlier this month. They talked about ways to close disparities in health outcomes.

CMS leader says health innovation must be available to everyone

Health systems need to think about the conditions of health and equity in the communities where their patients live, said Bechara Choucair, senior vice president and chief health officer of Kaiser Permanente.

Efforts to improve health equity must focus on the patient, Choucair said. Kaiser Permanente engaged in a text messaging campaign to gain a better understanding of the needs of its members. The organization eventually helped 100,000 people sign up for food assistance, Choucair said.

Kaiser Permanente has made some progress by “putting the patient’s voice at the center of the table,” Choucair said. That involves visiting individuals in their homes and asking them what they needed. It’s easy to sit in a conference room and try and come up with solutions, Choucair said, but organizations need to be reaching out and engaging with their communities for human-centered solutions.

Health systems say equity is a goal, but many aren’t budgeting for it

Charlotte Owens, vice president and head of health equity and patient affairs at Takeda Pharmaceuticals, said she had experience with health equity long before that phrase had become widely known.

“Most of what makes us healthy is outside of the healthcare system,” she said. “It’s about your personal ecosystem.”

“If that environment Isn’t healthy, you don’t have a good chance of being healthy,” Owens said.

Healthcare organizations looking to improve health in their communities need to partner with organizations and leaders in those neighborhoods, she said.

“If the problem sits in the community, the solution probably lies there, too,” Owens said.

Taylor Justice is co-founder and president of Unite Us, a technology company that connects health and social services providers. He said it’s important to do more than track how many people are being referred to social services. Ultimately, providers need to be sure people are getting the care they need.

“Put referrals to bed. Referral is only hallway there. The focus needs to be on the outcome,” Justice said.

It’s critical to examine the data to be sure interventions are successful, and to see where efforts are falling short.

“If we want to measure success, we need to be able to look at the good data, the bad data, and look at those gaps,” he added.

Amaka Eneanya, head of strategy and operations for Fresenius Medical Care, is leading a team working to address inequities in kidney disease.

Race is often misused in healthcare, she said. It’s useful to track race in efforts such as vaccination, to make sure that Black or Latino neighborhoods are gaining access to vaccines, she said.

But race is often used improperly in clinical algorithms and screening tools, potentially delaying some patients from getting treatment, she said. Race modifiers in algorithms used to measure kidney function have delayed Black patients from obtaining proper treatment, according to the Coalition to End Racism in Clinical Algorithms.

“Stopping with just race is lazy in your clinical algorithm,” Eneanya said. “You need to go beyond that.”

Justice also said that offering services to help individuals who have food and housing needs is actually more cost effective than having to treat more complex health conditions down the road. “Those services are usually far less expensive than a clinical intervention,” Justice said.

Addressing health equity involves coordinated effort of healthcare organizations, social services and government agencies working together, panelists said. “Health equity is really about a whole of government approach,” Carrington said.

“This isn’t on one sector to solve all of the problems,” Justice said. “This is all of us coming together.”

Several experts discussed ways to close disparities among disadvantaged groups during a panel at the HLTH Conference. They stressed working with communities and measuring data to see if interventions are working.

Moving health equity from goals to reality

Insurers contend the No Surprises Act is living up to its billing by keeping consumers from being shocked by costly and unexpected medical bills.

Meanwhile, hospitals and doctors say key provisions of the law are unfairly benefitting insurers, and are hurting providers.

The No Surprises Act took effect at the beginning of the year and is designed to protect patients from receiving unexpected bills for out-of-network care.

The law has prevented more than nine million unexpected medical bills from reaching consumers this year, according to a report by AHIP and the Blue Cross Blue Shield Association released earlier this month.

Matt Eyles, AHIP president and CEO, said the report suggests the No Surprises Act is helping consumers in the way lawmakers envisioned.

“Thanks to the No Surprises Act, millions of Americans no longer face a complicated, confusing billing bureaucracy, being harassed by collection agencies, or even potential legal action,” Matt Eyles, AHIP president and CEO, said in a statement.

“The No Surprises Act has provided relief from the fear, stress, and frustration that comes with surprise medical bills, and we’ll continue to work with the Administration, Congress, and other health care stakeholders to protect patients from surprise medical bills for care they did not choose—or they didn’t even know they received in the first place,” he said.

David Merritt, senior vice president of policy and advocacy for the Blue Cross Blue Shield Association, said the law is succeeding in protecting patients.

“A health care emergency should not lead to a financial crisis. The No Surprises Act has now protected 9 million Americans from receiving costly surprise medical bills from care providers—a huge win for patients,” Merritt said in a statement.

Hospitals and physicians have said they support the spirit of the law in protecting consumers from unexpected bills. But they have repeatedly said the process to resolve billing disputes is problematic.

Hospitals, physicians and healthcare organizations say they remain concerned that the arbitration process is unfairly titled in favor of payers.

The Texas Medical Association has filed a lawsuit claiming the dispute resolution process gives commercial insurers an unfair advantage. The American Hospital Association and the American Medical Association have filed 

 in support of the Texas Medical Association suit.

Members of Congress have expressed concerns about the arbitration process, and those concerns cross party lines.

U.S. Rep. Richard Neal, D-Mass., and Kevin Brady, R-Texas, have written a 

 Nov. 18 to key members of the Biden administration expressing concerns over some facets of the legislation. Neal is the chairman of the House Ways and Means Committee and Brady is the ranking Republican.

The lawmakers noted that a federal court ruling found the dispute resolution process was flawed, but the administration’s revisions don’t solve the problem. "We are severely disappointed to find that the August 2022 final rule violates the No Surprises Act in the same ways as before," the lawmakers wrote.

In November 2021, a bipartisan group of 152 members of Congress wrote a letter outlining their problems with the arbitration process.

In the insurers’ report touting the success of the No Surprises Act, they also note that providers have submitted 275,000 claims to be resolved by arbitrators. The insurers said that’s 10 times as many claims as anticipated by the Biden administration.

Merritt said the high number of arbitration claims “clearly demonstrate that more needs to be done to ensure that they don’t abuse the system for their financial gain.”

Still, physicians and medical groups continue to challenge the arbitration process, and they are also troubled by some of the administrative hassles involved in the No Surprises Act.

The Medical Group Management Association said 

the demands of the No Surprises Act are adding to the administrative burdens practices are facing

Roughly four out five groups (82%) said they have seen greater administrative burdens from  requirements to provide good faith estimates for those without insurance or patients who are paying out of their own pocket, according to an MGMA survey. Nearly three quarters (74%) of participants said they don’t have the infrastructure to comply with new requirements that are taking effect next year.

Groups representing doctors and hospitals say they support the spirit of the law, but a process to resolve billing disputes is titled in favor of insurers. 

Insurers say No Surprises Act helps millions, hospitals say aspects remain flawed

Lee Barrett is executive director and CEO of the 

Electronic Healthcare Network Accreditation Commission (EHNAC)

 where he continues to work on key HIT industry initiatives that lay the foundation for health information technology.

Is there an upper limit on the cost of cybersecurity insurance? If the past few years is any indication, the answer is a firm “no.”

According to one study of insurers, the cost of cyber insurance 

 2021, and 82% expect premiums to continue to rise over the next two years. A proliferation of high-profile ransomware cases certainly plays a role, as does a lack of experiential data among insurance companies, a dearth of cybersecurity professionals, and the sheer number of access points that could be vulnerable to attack.

 by both cyberattacks and the cost of cyber insurance. 

For the 12th straight year, costs associated with a healthcare data breach rank the highest among industries — 

, a 42% increase since 2020. In comparison, the cost of a breach for a financial services company, the second most expensive industry, is 60% lower than in healthcare.

Hackers are somewhat shifting their focus toward smaller hospitals, specialty clinics, physician practices, and third-party vendors, which means that any healthcare facility could be vulnerable to attack.

The stakes are as high as the cost of cyber insurance, which points to the need for constant vigilance surrounding IT infrastructure, people, and processes. 

Accreditation and certification programs can help organizations to review and address any gaps, document processes, and to demonstrate to other providers, partners, and insurers that they take their cyber hygiene, including the privacy and security of healthcare data, seriously.

Insurance data shows that nearly one-half of all companies 

 in 2020, nearly double the percentage in 2016. However, premiums continue to rise while coverage limits are reduced in some industries, such as healthcare and education. 

Further, while homeowners frequently bundle auto, home, life insurance, and other coverages with one company to save money, cyber risk insurance often stands apart from other insurance types that a healthcare entity also needs.

Insurance companies have decades of experience-rated data to quote and underwrite policies based on a particular set of circumstances. 

An auto policy for a 16-year-old driving a red sports car in Los Angeles, for example, will cost considerably more than a policy for a 35-year-old man who drives a sedan in a rural area. When insurance companies know their cost basis, calculating rates is relatively straightforward to balance risk level with projected loss ratio.

In comparison, cyber risk policies are the Wild West of insurance — especially in healthcare, where the potential losses are particularly high. Healthcare data is prized by hackers because it contains sufficient information to create a fake identity in addition to credit card numbers and other protected information. 

Hospitals are connected to hundreds, if not thousands, of healthcare software systems, medical devices, third-party systems, health information exchanges (HIEs), community providers, and others that provide a broad attack surface. Even smaller hospitals, specialty clinics, and physician practices will have a significant number of data connections or “risk vectors.”

 have risen significantly. The reported percentage of breaches among specialty clinics jumped from 23% last year to 31% in 2022. 

Similarly, breaches in the health services and supplies category (pharmacies, medical supply companies, and provider alliances) rose from 10% of all breaches in the first half of 2021 to 14% in 2022, and physician group breaches have risen five-fold to account for 12% of all breaches.

Accreditation and certification reduce the number of audits

When shopping for cyber insurance, larger hospital systems report participating in large meetings with a dozen or more insurance carriers and underwriters, as hospital officials attempt to convince at least one carrier to offer them a policy. 

Insurance reps ask pointed questions about a system’s cybersecurity practices, while healthcare IT executives extol their security policies and practices, stressing increased maturity and ability to thwart cyberattacks.

Healthcare-industry standard accreditation and certification programs can eliminate much of this process between insurers and providers.

Tim Pletcher, executive director of the Michigan Health Information Network (MiHIN), is acutely aware of when cybersecurity insurance comes up for renewal and expresses confidence — thanks to accreditation from EHNAC and certification from HITRUST.

“While those (insurance) discounts have not yet actualized, I believe that will be possible down the road,” Pletcher says of third-party accreditation. “Our major health system participants do their own mini audits of our organization which create hundreds of hours of added work for us. We can take standard templates from EHNAC or HITRUST and have them cross-translate that into our own needs, relieving some of the burden off of our cybersecurity teams.”

MiHIN’s network consists of thousands of care providers exchanging information including health systems, hospitals, care providers, behavioral health clinics, FQHCs, PIHPs, health plans/payers, pharmacies, post-acute care, and hospices, so Pletcher has a unique view of the healthcare IT landscape in Michigan. 

From that perspective, he expects to see groups of providers pool their cybersecurity resources and self-insure to combat increasing premiums and ever-higher attestation standards. He posits that it’s also possible that a cybersecurity company could offer cyber services to healthcare providers while insuring them against losses.

“There’s enough of a market for self-insurance and cybersecurity services that if somebody came along and bundled those two together, it could be a really powerful combination,” Pletcher says.

Adequate coverage starts with standard practices

An endpoint protection solution or a multi-factor authentication solution won’t create the confidence in a provider’s IT network that insurance companies need to make solid, data-based pricing, underwriting, and coverage decisions.

In 2021, the cyber insurance industry’s loss ratio was 73%, up from 52% in 2019, pointing to turbulence in the industry. At the same time, 75% of respondents to a global survey reported experiencing 

 in the past year. In even more troubling news, just 3% of respondents categorized their cyber hygiene as excellent.

Another survey showed that 14% of North American companies have cyber insurance coverage that exceeds $600,000, 

 for potentially millions in unreimbursed costs in the event of a breach or cyberattack. It’s no wonder, then, that 20% of companies in the U.S. and across Europe went out of business following a cyber incident.

Requiring some type of industry accreditation/certification framework that meets the Public Law 116-321 of “recognized security practices” would help providers recognize and adopt standard minimum privacy and security protocols while giving insurance companies better insight into security practices.

However, not all third-party assurance mechanisms are actual certifications or accreditations as some entities hold them out to be (i.e., SOC 2 is not a certification), and those that are true certifications/accreditations are not created equal.

Having assurances that are independently validated and further issued by a third-party certification or accreditation body enforces additional levels of quality assurance within the process, adding to a higher level of reliability for the organization seeking a level of trust.

Cyber insurers and underwriters have explicitly indicated that cybersecurity assurance reports that are not independently validated and are not further credentialed by an independent certification or accreditation body are not looked at as providing higher levels of comfort relative to an organization’s good security and cyber program hygiene and maturity.

The article was written by Lee Barrett, executive director and CEO, EHNAC, the Electronic Health Network Accreditation Commission, and includes contributions by Michael Parisi, vice president of adoption, HITRUST.

Accreditation and certification programs can help organizations address gaps and demonstrate to other providers, partners, and insurers that they are serious about protecting healthcare data.

As cyberattacks and insurance costs grow, time is right for accreditation | Viewpoint

Brian Smith, president of Bon Secours Mercy Health, said Tuesday that he will retire Dec. 31.

Smith has spent more than three decades with the health system. He’s credited with playing a key role in the integration of Bon Secours and Mercy Health.

“When I started as a wages and benefits manager in 1990, I had no idea that Mercy Health – and later Bon Secours Mercy Health – would be my professional home for 32 years,” Smith said in a statement. “Serving this ministry and the millions of patients who come through our doors each year has been my pleasure and a true calling, and I am honored to have been a part of such a dynamic and innovative health system.”

Smith spent 22 years at St. Rita’s Medical Center in Lima before moving to a system-wide role in 2012.

Bon Secours Mercy Health CEO John Starcher described Smith as a “dedicated servant leader.”

“Many of our most successful initiatives are evidence of Brian’s continued operational focus and intellectual curiosity,” Starcher said in a statement. “When I think about the millions of patients we serve, the advancements we’ve made in technology and the emphasis Brian has placed on better care processes that improve the patient experience, I know it is Brian’s strong leadership that has enabled our teams to work at the top of their license.”

Bon Secours operates 48 hospitals and is one of the five largest Catholic health systems in America.

ECU Health hires first chief nursing executive

Trish Baise has been hired as the first chief nursing executive of ECU Health in North Carolina.

Baise will join ECU Health on Jan. 1, 2023. In her new role, she will advance nursing care, education and research throughout the system. She joins ECU Health after serving as vice president and chief nurse executive at Atrium Health-Cabarrus.

Brian Floyd, chief operating officer of ECU Health said nursing is at the heart of the organization.

“The creation of the CNE position and the appointment of Dr. Baise to lead in this role allows our organization to innovate and collaborate to further build a nursing culture that helps recruit and retain talented nurses and care givers who are dedicated to serving our region,” Floyd said in a statement.

Baise brings more than 30 years of healthcare experience to the role.

“I am honored to have the opportunity to pioneer the Chief Nursing Executive position at ECU Health,” Baise said in a statement. “ECU Health is a recognized leader in rural health care and the organization’s mission aligns with my professional values of providing high-quality care to communities in rural environments.

“I am constantly inspired by the difference nurses make in the lives of those they care for, and I look forward to working alongside the great nurses that live the ECU Health mission every day,” she said.

HCA Gulf Coast appoints new vice president

Holly Elliott has been named the vice president of women’s and children’s services of HCA Healthcare’s Gulf Coast Division.

Elliott will take the new role beginning Jan. 1. She is currently serving as HCA Healthcare’s corporate vice prescient of women’s and children’s services.

Amy Casseri, senior vice president of physician relations, women’s and children’s services and imaging at HCA Healthcare, touted Elliott’s accomplishments.

“Holly has been instrumental in leading the corporate women’s and children’s strategic agenda,”  Casseri said in a statement. “Among many of her successes, Holly initiated HCA Healthcare’s first company-wide OB/GYN Physician Townhall focused on initiatives to improve maternal and neonatal outcomes. Additionally, she coordinated the completion of our 2022 NICU cohort workshops and the consolidation of our NICU cohort 3-year strategic plan.”

Elliott will focus on developing women’s and children’s growth initiatives and coordinate best practices across the HCA Gulf Coast Division’s hospitals and women’s centers.

“Holly’s previous division experience driving high-priority initiatives and recruiting high-quality clinicians is invaluable,” Mike Lance, chief development officer at HCA Healthcare Gulf Coast Division, said in a statement. “Holly will be a tremendous asset to our development team yet again.”

Head of Pa. hospital trade group plans to retire

Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania, plans to step down next year.

Carter announced last week that he plans to retire by June 30, 2023. He has led the organization since 2012.

"Together with a truly remarkable team of dedicated professionals, we have strengthened health care in Pennsylvania by making it more accessible, affordable, and higher quality,” Carter said in a news release.

“From successfully advocating early in my tenure for Medicaid expansion, to relentlessly improving quality and safety, HAP and its members have been vigorous champions for achieving the vision of a healthy Pennsylvania.”

Carter formerly served as the president of the Ohio Children’s Hospital Association, and he also led the Visiting Nurse Associations of America.

The hospital association’s board of directors is undertaking a national search to find Carter’s successor. Carter plans to stay on board until his replacement is named and plans to assist in the transition, the association said.

Orlando Health elevates leader to hospital president

Maggie Bonko has been named the new president of Orlando Health Horizon West Hospital.

Bonko will start in her new role on December 1. She has been serving as assistant vice president and chief operating officer of Orlando Health South Seminole Hospital for the past five years.

She joined Orlando Health in 2005 as a recruiter and one year later was promoted to the role of manager of recruitment. She became director of human resources in 2010 for both Orlando Health Dr. Phillips and Orlando Health-Health Central Hospital. She later served as administrator of allied health and operational support for both Orlando Health South Seminole and Orlando Health Dr. P. Phillips Hospital.

“Orlando Health Horizon West Hospital is in the heart of a rapidly growing community. Maggie has the right experience and drive to match that growth inside the hospital by providing additional services and programs that will benefit our patients,” Philip Koovakada, senior vice president Orlando Health South Central region and president, Orlando Health–Health Central Hospital, said in a statement.

ECU Health hires its first chief nursing executive, HCA Gulf Coast appoints a new vice president, and the head of Pennsylvania's hospital association is retiring.

Bon Secours Mercy Health president is stepping down, and more | MED MOVES 

Derek Streat is founder, CEO and chairman of DexCare, a data-driven intelligence company focused on healthcare access.

Consumers today are experts in online shopping. 

Whether you’re buying clothes, electronics, furniture, or nearly anything else, online stores allow you to sort items and apply filters to find the exact products you’re looking for, delivered exactly when you need them. The site may even recommend items it thinks you’ll like based on purchase history or other criteria. Once you find what you want, you can add it to your cart and check out with just a few clicks.

If online shopping can be this streamlined and simple, yet personalized to individual preferences, why can’t finding care be? By improving e-commerce capabilities in healthcare, it can.

The last time you tried to schedule a doctor’s appointment, what was your experience like?

Most likely, it wasn’t as simple as the last time you tried to buy a new shirt online. 

Maybe you had to visit multiple different sites before you found the correct one for scheduling, or you were directed to call the office and were inevitably placed on a long hold. You may have even found a provider you wanted to see, only to find out they didn’t have any appointments available.

This is the current state of appointment scheduling, and it’s incredibly frustrating. To simplify this process and optimize care access, health systems need to merchandise care – making care options, providers, and appointment times more easily discoverable, just like your favorite online retailer. 

Merchandising is the next frontier of healthcare, and health systems need to reach it in order to compete with growing threats in the industry.

Utilizing the same technology as online retailers, care discovery will be as easy as browsing your favorite store, and appointment scheduling will look like a digital storefront.

The patient can begin their journey by making a search on either a search engine or a website, including the health system’s digital front door. If searching on Google, for example, the e-commerce technology will route patients and drive traffic to the health system’s booking site. 

The platform then automatically filters search results based on the patient’s input of intent and need and displays real-time availability for the care options best suited to their needs. The interface also shows additional information such as the providers’ specialties – just like you’d be able to see the details of a product you’re considering buying. Providers that aren’t a good fit or are unavailable aren’t shown at all, so patients don’t waste their time pursuing options that aren’t relevant.

With all this information personalized for the individual, patients can feel confident that they’re finding the best possible care option for them. Once the patient has identified the best provider, location, and time, they can book the appointment in just a few clicks. The whole process is so intuitive that, ideally, the care finds the patient instead of the patient having to find the care.

Internal research found that 80% of patients who begin the process of booking an appointment drop off before they complete it – missing out on critical and potentially life-saving care. By simplifying the process, health systems can greatly reduce this alarming number and ensure that all patients get the care they need.

Why health system executives should embrace e-commerce

Merchandising healthcare may seem controversial. You might worry that taking an e-commerce approach will make the experience more impersonal and transactional, but this is not the case.

Merchandising can make care more accessible and custom-tailored by allowing patients to find exactly what they want and need. Healthcare is undergoing a massive transformation, and patients now expect to find and receive care with ease and convenience. Merchandising is the best path to delivering these experiences that will result in the highest patient satisfaction.

Health systems will also see immense benefit from merchandising. Turning care discovery into a storefront will enable systems to better capture, convert, and retain patients, which will drive greater revenue down the road. One health system that implemented improved e-commerce saw a 121% conversion lift, 39% increase in bookings, and 30% more net new patients while also significantly lowering the cost of delivering care.

Our current appointment scheduling platforms aren’t enough anymore. It’s time for health systems to get on board with the model of e-commerce that online retailers have seen so much success with.

Merchandising is nothing to be afraid of – it’s just about getting things to consumers more intelligently and effectively – and both health systems and patients stand to benefit from this.

Just as Americans are shopping online for the holidays, patients should be able to have the same convenience in finding the care that they need. 

Online shopping for healthcare? Why health systems should merchandise care | Derek Streat

Abhishek Jacob is vice president of Edifecs

Fred Guthrie is associate vice president of Edifecs

Amid an uncertain economy, providers, payers, and patients alike will be turning their attention to value-based care models to cut costs and improve health outcomes.

Health plans possess the back-end technology powering value-based models and the patient information that will empower more equitable care.