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Telestroke capabilities may extend stroke expertise to hospitals without on-site stroke experts.

Telestroke Capabilities Increase Chances of Stroke Patients to Receive Reperfusion Treatment

Investigators at the Office of Inspector General identified trends in hospital billing and Medicare payments for stays at the highest severity level.

Hospitals Increasingly Billing for Inpatient Stays at Highest Severity Level

Speaking to a group of oncology providers, Dr. Kavita Patel, a former Obama administration official, predicted that issues affecting hospital revenue would be revisited under Biden. 

Patel Predicts 340B, Site of Service Reform to Be Ongoing Issues Under Biden

Dr. Sachin Jain and former HHS Secretary Kathleen Sebelius discussed the potential of the Center for Medicare and Medicaid Innovation during Academy Health's Datapalooza and National Health Policy Conference.

Sebelius, Jain Reflect on Power of Innovation Center to Change Healthcare

A group of authors, including experts with lead roles in the passage of the Affordable Care Act, offer advice on the next wave of reform.

A National Community Health Corps? An A-List of Experts Offers Healthcare Transformation Advice 

Medical debt is an enormous problem, as more than half of all U.S. adults have gone into debt because of medical or dental bills, according to the Kaiser Family Foundation.

In our latest episode of the “Data Book” podcast, we talked about medical debt with Ryne Natzke, the chief revenue officer of Sphere. Sphere is a technology company that works with health systems on patient billing systems.

Ryne discussed the difficulties for patients. And he says medical debt could be considered a social determinant of health.

“Medical debt is the largest overall contributor to personal debt,” Natzke says.

We also talked about the challenges for providers. Healthcare providers, which are facing tremendous financial pressures in the pandemic, also need to collect as much as possible from patients, Natzke adds.

“Hospitals don’t love having all this money sitting out there uncollected,” he says.

We talked about how health systems can sustain their operations without leaving their patients with catastrophic debt. He talks about the need for health systems to use technology to help determine which patients may be facing financial hardships due to their medical costs, and how to help them. 

But systems also need to give patients the human touch, and allow them to reach a person when they truly need assistance.

Reminder: You can subscribe to Data Book on Apple, Spotify, Google, iHeart Radio and virtually everywhere you get your podcasts.

In our latest episode, Ryne Natzke of Sphere talks about how providers need to take different approaches to ensure they are getting paid without leaving patients with heavy debt.

Data Book podcast: Medical debt and the impact on patients and providers 

In our latest episode of the Data Book podcast, Justin Norden talks about the emergence of ChatGPT and what it means for healthcare.

Norden is a physician who teaches about digital health at Stanford Medicine. He’s also a partner at GSR Ventures, an investment firm focusing on early stage digital health companies. In this conversation, he talks about how AI is going to eventually touch every part of the healthcare journey.

Growing up in a family of physicians, he graduated from Stanford University School of Medicine. He became fascinated with the idea of merging technology and healthcare. He helped start the Stanford Center for Digital Health.

As Norden says, “You can’t spend that long in Silicon Valley without starting a few companies of your own.” He was CEO and co-founder of Trustworthy AI, which was acquired by Waymo, Google’s self-driving vehicle company. He also worked on the healthcare team at Apple. He’s been at GSR Ventures for nearly four years.

ChatGPT could be the fastest-growing consumer technology project ever, Norden says.

When asked about ChatGPT’s implication for healthcare, Norden says, “That is the million, if not billion dollar question.”

Justin teaches about digital health at Stanford Medicine and is a partner at GSR Ventures. He talks about the potential of ChatGPT, the ethical questions, and how AI will transform the industry.

Data Book podcast: Justin Norden talks about ChatGPT and AI in healthcare

In this episode of the Data Book podcast, we talked with Ajay Khanna, the CEO of Tellius.

Tellius, a technology firm, operates an AI-driven decision intelligence platform. Khanna talks about machine learning and artificial intelligence, and its potential to help healthcare organizations gain new insights into their operations in areas ranging from hospital readmissions to supply chain challenges.

Khanna also talks about "decision intelligence," which he describes as bringing the what, why and how together. With AI, and decision intelligence, organizations can gain better insights into trends, such as why patients are choosing a certain medication.

And he talks about the steps needed for healthcare organizations to move forward and embrace new technologies. "It's a culture change," Khanna says. But it's also about gaining greater ease with AI and other new technologies.

In the latest episode, Ajay Khanna explains how healthcare organizations can use artificial intelligence to gain new insights into their business. 

Data Book podcast: Ajay Khanna, Tellius CEO, talks about 'decision intelligence'

Kevin Olson certainly knows about multi-tasking in a crisis.

Olson is the chief information officer of Jupiter Medical Center, one of the top hospitals in south Florida. In this episode of the Data Book podcast, Olson discusses managing digital transformation amidst the COVID-19 pandemic.

“It’s been a unique challenge that I think we’ve never faced before,” Olson says.

He talked about the challenge of his role in the COVID-19 pandemic, while meeting the needs of caregivers taking care of patients and being agile to tackle important tasks.

Olson also discusses dealing with cyberattacks, a problem that has affected many hospitals. The medical center has worked with partners to fortify the medical center’s defenses.

“We’ve had an unprecedented amount of cyberattacks going on,” he says.

Olson stressed the importance of senior leadership and the board in changing the culture and getting everyone in the organization to take cybersecurity seriously.

And he talked about making it easier for consumers to engage with the healthcare system, and why patients of all ages are embracing technology.

Kevin Olson is the chief information officer of Jupiter Medical Center, one of south Florida's top hospitals. He talks about digital transformation, cybersecurity and helping patients. 

Data Book Podcast: Talking with Kevin Olson of Jupiter Medical Center

In this episode, we spoke with Gregg Church, the president of 4Medica, a healthcare technology company that works to give organizations a more complete view of patient records. 

He talked about the company’s work with hospitals, health systems, physicians and laboratories to exchange data and improve outcomes. 

“Our theme now is really health data quality, ensuring that we have the right information with the right patient at the right time,” he says.

Church says the challenge has been systems that are essentially silos, with data sitting in several different systems.

He also talked about how he sees the need for a nationwide patient ID, an idea which he acknowledges has its opponents. “I’m optimistic, but I still think it’s years away.”

Church also sees more promise that interoperability, the exchange of healthcare information between health systems, payers and patients. 

It has been talked about for many years, but Church said it is coming closer to reality. In a promising sign, hospitals are collaborating more often.

“Hospitals are starting to see they can’t hold their data hostage in their own silos,” he says. And he sees requirements for health plans to share data “is a tremendous opportunity for the country.”

Patient care will improve with the greater exchange of data, he says, and consumers are demanding it.

“Consumers are getting smarter,” Church says. “They want better access to their information.”

We talked about the company’s work with hospitals, the work towards interoperability, and why he’d like to see a nationwide patient ID.


Data Book Podcast: A conversation with Gregg Church of 4Medica 

It’s been a minute, but the Data Book podcast is back!

In this installment, we talked with Robbie Hughes, the founder and chief executive officer of Lumeon, a firm that works with healthcare organizations to automate processes to reduce the burden on staff and improve patient care. 

We discussed the challenges facing the healthcare industry, the need for higher quality patient engagement, staffing shortages and transforming health organizations.

Check out a very interesting conversation. And you can subscribe to the Data Book podcast on Apple Podcasts and Spotify.

The founder and CEO of Lumeon, he spoke with us about using automation to reduce the burden on staff and improve patient care.

The Data Book podcast returns: A conversation with Lumeon CEO Robbie Hughes 

On this episode of Healthy Bottom Line, we spoke with Mark Spinner, CEO of AccessOne, a patient financing solutions company that conducted a survey on the needs and concerns patients have regarding healthcare financing. We discussed some of the results from this survey as well as how hospitals and health systems can address the issues that were mentioned by patients. We also talked about the importance of having clear communication and price transparency between providers and patients.

To read more about AccessOne’s recent survey, click 

Mark Spinner, CEO of AccessOne, discusses some of the financing concerns that patients expressed in a recent AccessOne survey as well as some solutions that hospitals and health systems can implement to improve communication and price transparency.

Healthy Bottom Line: The Critical Need for Better Communication, Price Transparency in Healthcare

On this episode of Healthy Bottom Line, Chief Executive Healthcare spoke with Erica Coletti, CEO of the Alliance for Better Health. We discussed some of the current problems associated with programs addressing social determinants of health (SDOH) and how the Alliance’s social Independent Practice Association (IPA) model can help tackle these issues. We’re also talked about the financial benefits hospitals and health systems can see when implementing policy changes that seek to improve SDOH programs.

Several problems exist with current programs that address social determinants of health (SDOH); however, a new social model aims to combat these issues and improve the programs’ effectiveness.

Healthy Bottom Line: The Trouble With SDOH Programs and the Secret to Improving Them 

On this week's episode of Data Book, Chief Healthcare Executive™ spoke Blair Childs, senior vice president of public affairs at Premier. We discussed potential for the Improving Seniors’ Timely Access to Care Act (

) to be signed into law and how it will improve access to care for patients by changing how prior authorizations are done. We also talked about how machine learning and artificial intelligence (AI) technologies can help health systems adjust if the bill is signed into law and how they can help automate prior authorizations.

Blair Childs, senior vice president of public affairs at Premier, explains how the Improving Seniors’ Timely Access to Care Act could revolutionize how prior authorizations are conducted and how machine learning technologies can help health systems adapt if it is signed into law.

Podcast: How AI and the Improving Seniors’ Timely Access to Care Act Can Revolutionize Prior Authorizations

Technology is everywhere in healthcare, and the list of ways that digital solutions can improve health outcomes and cut costs is endless: technology is used to improve consumer engagement, identify patients who are at risk of events like a heart attack, and increasingly to help different parts of the healthcare system to talk to each other.

But when technology falls short of its promise, it can add costs and burdens for those who use it. The best example might be the electronic health record.

Next-generation digital providers are helping to leverage technology to find the value long promised. Today, DataBook welcomes CitiusTech, a next-generation specialist provider that works with payers, providers, medical technology and life science markets.

In an interview recorded earlier this year, Chief Healthcare Executive Associate Editorial Director Mary Caffrey spoke with 2 leaders of Citius Tech about meeting healthcare challenges with digital solutions. Her guests are Sridhar Turaga, the senior vice president for Digital Innovation & Data Science, and Shyam Manoj Karunakaran, who is senior vice president and market head for Health Plans.

In June, after this interview was recorded, Citius Tech announced an acquisition of SDLC Partners of Pittsburgh, expanding its footprint in the payer solutions space.

In an interview recorded earlier this year, Chief Healthcare Executive Associate Editorial Director Mary Caffrey spoke with 2 leaders of Citius Tech about meeting healthcare challenges with digital solutions. 

Podcast: Using Digital Solutions to Address Technology Shortfalls with Citius Tech Senior VPs

The system based in Kansas City has seen low readmission and high patient satisfaction. Michael Nassif of Saint Luke’s talks about the program. 

Saint Luke’s Health System sees early success with hospital at home

The directors of home hospital programs say they offer new opportunities to improve patient care for all populations. 

Hospital at home and health equity: Aiming to close disparities

In the COVID-19 pandemic, the number of hospitals offering acute care at home has surged. Chief Healthcare Executive spoke with doctors and leaders around the country about their experiences.

Hospital at home: Why health systems are banking on this model | Special Report

Practices and patients can reap the benefits of in-office infusion. But it must be carefully managed, as infusion comes with substantial financial risk.

In-office infusion requires careful analysis, planning and execution for success | Luke Rubie

Franciscan Health hires a CEO for the central Indiana market, a New Jersey hospital names a new CEO, and others take new roles. 


Sutter Health appoints new chief digital officer, and more | MED MOVES

Doctors and leaders say hospital-at-home programs offer 

David Levine of Mass General Brigham talks about his system’s work to help patients who have challenges in their home environment. He’s the clinical director of research and development for Mass General Brigham’s “Healthcare at Home” program. Mass General Brigham has provided hospital-level care in patient’s homes for more than eight years.

“I think considerations for health equity are paramount in home hospital care,” he says. “And our program, and I know many programs across the country, have taken this very seriously and put in real service offerings to make sure that health equity is top of mind, and being sure that we're able to treat all sorts of patients at home.”

Mass General Brigham has helped patients get enrolled in programs offering assistance with housing needs. For patients in public housing with issues such as leaky windows or holes in the floor, the health system will push the landlord or superintendent to make necessary repairs.

“We bring an element of a power dynamic with us, when there's a doctor or a nurse in somebody's home,” Levine says.

Levine and others say by treating patients in the home, clinicians can see other challenges such as food insecurity, or issues patients may be reluctant to discuss in the hospital.

“I think there's a real opportunity and responsibility to address some of the social determinants of health that we see when we're working closely with our patients in their homes," Levine said.

One of the nation's leading experts on home hospital programs talks about how they can help close health disparities.

David Levine talks about hospital at home and health equity

Across the country, more hospitals are offering acute care at home, and doctors leading those programs say they are impressed by how patients are responding.

They say they are seeing strong clinical outcomes, low readmission rates and high patient satisfaction. 

More than 270 hospitals in 37 states have been authorized to offer acute care at home. As part of our 

, Chief Healthcare Executive® talked to doctors leading programs about how they are helping patients. 

Clinicians and leaders say the programs require a great deal of planning and coordination to ensure patients are cared for safely. But doctors cite several advantages, including reduced risk of infection, better rest, and in some cases, reduced delirium and confusion because patients are in a familiar environment. 

As more health systems are offering acute care at home, doctors say they are seeing good results and high patient satisfaction.

Hospital at home: Leaders describe encouraging outcomes 

 says the future of healthcare isn’t going to be confined to the four walls of the hospital.

“Everyone agrees that part of the future of care is going to be care in the home. So we have to think about that future,” he says.

Current Health, a part of Best Buy Health, is a technology company which helps health systems provide healthcare at home, including hospital-at-home programs. Current Health is working with more than 20 health systems, including Geisinger, Mount Sinai and UMass.

 at the HLTH Conference in Las Vegas, McGhee talked about how healthcare systems need to think about providing home-based options along with inpatient care. And he offered keys to success for hospital-at-home programs.

A big one: Health systems need buy-in across the board, from the C-suite to clinicians, he says.

"It can't just be done as a side project," he says.

Health systems need to think about delivering care outside of the hospital. 

Current Health CEO Christopher McGhee: Keys to success in hospital-at-home

While telehealth is traditionally defined as between a patient and their provider, the use of telehealth to connect providers has been important and has allowed for better collaboration, said Heather Bonome, Pharm.D., director, pharmacy URAC.

So, there's a lot of different definitions to telehealth. A lot of times we think of telehealth as being a video chat between a patient and a provider. But telehealth can be defined as a patient of provider, a provider to patient or provider to provider. So, there's the whole concept of provider to provider, which is also really critical.

And there are a lot of different platforms that we've seen that enable providers to communicate that way and really collaborate at a whole different level. A lot of health system specialty pharmacies that already have a platform for that kind of interaction have really been able to embrace that and connect with the clinics that are prescribing it in a whole different way. And we've seen that increase pretty significantly.

While telehealth is traditionally defined as between a patient and their provider, the use of telehealth to connect providers has been important, said Heather Bonome, PharmD, director, pharmacy URAC.

Heather Bonome, Pharm.D.: Telehealth Has Improved Collaboration Between Providers

Craig Newman, the chief strategy officer at HealthChannels for ScribeAmerica, discusses how technology can be used to help reduce the amount of time and energy providers spend doing administrative tasks.

How can technology help reduce the administrative workload for doctors so that they can provide better care to patients?

Great question. I think everything is all about how do you make it easier for physicians to focus in on patient care? The last thing we want to do is actually create new sequential processes or new workflows that take the provider away from the patient.

And so, when I think about the model itself, and this is going to be different, again, based on the care environment that the providers working in — I'll just use an ambulatory clinic — I think about segmenting that work pre-visit, during the visit, and post-visit and looking at how we can offset some of that work with technology. For some, the technology is still not up to snuff to offload everything for that provider.

So, let me give you a prime example. So, let's talk about documentation of the physician itself and doing a clinical documentation. There's a whole notion of how do we leverage artificial intelligence (artificial intelligence) to actually drive value at the point of care to help with physician documentation. AI is incredibly effective when we talk about like radiology, or coding, or billing practices because there's tremendous data and very little variability.

Think about your primary care office. You've got different voices, different templates, different processes, different people coming in and out, maybe different caregivers, a ton of variability that exists for providers today. Technology alone — AI and machine learning models — can't solve the problem. And so, I think what we're seeing happen in the market, and what we've done with our product line Speke, is actually blend front-end technology that creates a seamless workflow for the provider. Imagine being able to walk into a room, hit a single button, and it could capture the entire conversation between a patient provider. No periods, no stop phrases, no clicking around in the EMR (electronic medical record), no nothing. And then, you leave the room, you hit stop, you can verbalize something after the fact, move on to your next patient, and never be tethered to the computer. And then, within moments to 24 hours, that note is structured in the EMR.

How did that happen? Well, we take that smart technology optimization process — sort of audio preprocessing, and speaker segmentation and machine learning — we route it to back-end labor to do QA (quality assurance) and CDI (computer design and integration) and then offload the clerical task from the doctor, doing that work behind the scenes a little bit asynchronously. Just by doing that little step, you can free up time. And getting back to that what we talked about previously around time driven activity-based cost, you've got to create time for the physician and offload those clerical tests.

We're seeing the same thing to providers, pre- and post-visit who were using technologies like chatbots or robotic process automation technologies, that can help make sure that we automate as many processes as possible. But then, we still need to make sure that there's human glue involved, who can help them with support strategies like doing comprehensive chart prep, helping tee up where there are care gaps to close, helping them with their specificity, acuity, documentation, or even making sure their charts are completed, efficient, and on time so the bills get out, so they don't have outstanding charts and their DSOs [daily sales outstanding] don't get screwed up throughout the course of the week or month.

So, I think it's a balance of technology and labor working in concert together. It's not an and/or [situation]; it's a both.

Craig Newman: How Technology Can Reduce Administrative Burden for Physicians

Craig Newman, the chief strategy officer at HealthChannels for ScribeAmerica, discusses the amount of time that physicians, nurses, and scribes spend on administrative work and how the pandemic has exacerbated the need for things to change.

How much of a physician’s day is spent doing administrative work and how does this time allocation impact the quality of care that patients receive?

As you know, there's about a million active physicians throughout the country working across the care continuum. And that may range depending on which care environment they're in—emergency medicine, the inpatient setting, urgent care, or the clinic-based environment. Or sometimes we think about home care. On average, most physicians are spending, just to give you a sense of the average clinic day—I'm just going to talk about the outpatient clinic—so if you're in clinical practice, you're spending between 9 minutes a clinic hour and 20 minutes of clinic hour, clicking, typing, or moving things around in the EMR [electronic medical records], navigating and working below license.

If you're in the inpatient setting, that may net out to about 3 hours of working below license. So, in a 12-hour shift, imagine 25% of the time we're paying our highest-cost FTEs (full time employees) to do remedial duties. And there's actually a study that came out in 2014, called time driven activity-based cost. And the idea behind this was how do we shift towards value and reduce costs models and think about, not just cost in terms of clinical cost, but also how we think about total costs from a labor spend perspective. And this gets to your point of how much time physicians spend below license.

Imagine they came up with an equation around capacity of a resource cost. And so, essentially, let's say if you make a quarter million dollars a year to $2 a minute. A nurse practitioner, if it's $100,000 a year, it's $1, a minute. A scribe or virtual scribe is the lowest cost, you'd see is like 35 cents a minute. So, on a minute-by-minute basis, you can begin to see and they've tested this up at Boston Children's Hospital, how much cost is going and time is being spent by a physician working below license, and how we can offset that information to a lower-cost resource, whether that's labor or technology, or a bit of both to drive value and improve care delivery models.

It was actually early on how we started thinking about the quadruple aim and really moving towards care-based models that drive high value, clinical care, reduce the cost of care and improve patient satisfaction all at the same time and getting doctors done by dinner. So, that was a long-winded way to say they are spending way too much time on clerical duties, and much less time than they should be on engaging with their patients, whether that's during the encounter or following up with them after the fact.

Again, I think they're it's a multiprong issue. There are challenges, obviously with flow, but physicians get behind because they have to spend so much time with clerical responsibilities that could be offset to a resource like a scribe or a virtual support model or digital assistant. That could be much more effective and if they were able to offload that work, they could actually not just run a much more efficient practice or have an efficient flow but, alternatively, they could potentially see more patients, which would improve the amount of time it would take a patient to get in the door. That's a huge problem we have in healthcare today is the wait times it takes for new patients to get in to see physicians, especially specific specialists where there may be shortages, and that problem is only getting worse for so many organizations across the country. So, those clerical components, we really need to take a hard and fast look at. That's why our company, we serve 3500 hospitals and health systems and over 2000 medical groups, this is exactly the focus. How do we reduce clerical burden from physicians and their care team to improve flow, reduce cost models, and drive value to patients?

How has the pandemic impacted administrative workload for physicians?

I'd say it's only increased. Again, this is a this is a big topic, right? So, hard to cover in a short interview today. But I'd tell you that, physicians, first of all, they're people just like everybody else. And you got to remember they've got family members, they've got other folks. So, they need to protect their time as well and have a work/life balance. The problem is, there's more work being put on them. When we moved forward in the pandemic, obviously, we had a hybrid delivery system. And what I mean by that is we moved from just having in person care to telehealth visits as well.

Well, that's not just a change for them. That's a change for their office staff, as well as for the patients, which means there's more steps that went into the process to make sure that we connected that provider with that patient. That's added burden right off the top. So, I'd say that's problem number one, because if a patient doesn't show up, or maybe a patient's 10 minutes late for that telehealth visit. Well, that backs up everything else throughout the course of the day and there's cascading problems.

But then there's another challenge that we have, which is labor shortages. I've worked with a number of health systems who ranged from having a 10% shortage of medical assistants, to a 30 to 40% shortage of medical assistants. Medical assistants, there weren't enough to go around pre-pandemic. Now, we're competing with, let's say even if we're paying a pretty good salary, they can go down the street to Dunkin Donuts, make $5 an hour more and get a signing bonus, it's a huge challenge. Or maybe they have they're providing home care or childcare for their kids. And so, we're seeing that shift. So, if there aren't medical assistants who can actually help support the provider with flow, or even do some of those additional ancillary duties, it's a huge challenge that backs up the clinician or adds to their day, which means they're spending more time at night on the weekends trying to play catch up with some of those remedial duties like documentation. 

That's actually one of the reasons we have an arm of our company, ScribeAmerica, where we've actually leveraged the scribe as a care team assistant, whether in person or virtually, to actually help with some of those ancillary tests. So, it doesn't bog down the clinician, the care team. So, chart preps, documentation, pending orders, helping organize their time after the event like a personal assistant can really help drive and improve care delivery models and make life a little bit easier for the physician because at the end of the day, again, they're human. They're they're impacted by COVID-19 as well and so are their families and you want them done by dinner feeling refreshed because the last thing we need is to accelerate the burnout curve when we're already facing physician shortages.

Craig Newman Highlights How Administrative Work Impacts Physicians' Ability to Provide Quality Healthcare

Neil Evans, M.D., is an internist and the chief officer of connected care at Veterans Health Administration (VHA), the largest integrated healthcare system in the U.S. VHA provides care at 1,255 healthcare facilities, including 170 medical centers and 1,074 outpatient sites, and serves 9 million enrolled Veterans each year.

had the opportunity to speak to Evans about VHA's use of health technology, big data, wait times, and dealing with mental health and substance abuse issues.

A VHA expert discusses how the health system leverages data and technology.

Neil Evans, M.D., Says VHA's "Present and Future Are Bright"

The Trump administration’s price transparency rule requires hospitals to disclose what they could charge for basic items and services. The rule took place at the beginning of 2021 after getting approval from a U.S. appellate court.

ADVI, a pharma and healthcare consulting firm, released a report about hospitals’ early compliance with the price transparency rule. Caitlin Sheetz, head of analytics and director at ADVI, recently broke down the findings of the report to 

, as well as how the rule might affect pricing at hospitals and competition.

ADVI searched on the websites of 20 of the largest U.S. hospitals based on bed size to find available price transparency data. The organization downloaded all the available files and looked through any of the online pricing tools to determine what information hospitals were disclosing. Once compiled, ADVI tried to make comparisons for pricing for various institutions and made notes about the formatting of the published data and how comprehensive the data were compared to the requirements of the mandate.

An ADVI expert details the firm's report about hospitals' early compliance with the price transparency rule.

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