The #HCBiz Show!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Summit on Embedding Privacy in Digital Health

Register: https://ain.events/privacydigitalhealth/

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Targeted learning:

Health systems, clinicians, and network managers will learn:

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

Startups and entrepreneurs will learn:

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

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

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

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

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

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

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

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

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

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

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

We discuss:

- Has utilization and payment returned to pre-pandemic norms?

- Why are commercial carriers lagging behind Medicare and Medicaid in launching Advanced Alternative Payment Models?

- Will the shift to value and consumer-centric delivery methods like telemedicine diminish uncompensated care?

- Is it possible to be proactive and patient-centric in Fee-for-service?

- Are provider systems ready for AAPMs?

- Can employers band together to create enough demand for AAPMs in the under-65 commercial market?

- What were the arguments against the Direct Contracting Model?

- Did they have merit?

- What changes were made to Direct Contracting as part of the rebrand to ACO Reach?

- How does this dust-up over Direct Contracting confirm we are on a bi-partisan, unwavering march toward value and never going back?

- Why did Signify Health acquire Caravan Health?

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