The #HCBiz Show!

On this episode, we talk with Matt Hollingsworth, CEO of Carta Healthcare, about ChatGPT.  If you've been reading the headlines, and maybe even experimenting with Chat GPT yourself, but don't quite grasp what's going on, then this episode is for you. Mat gives a not-too-technical, high-level explanation of what's going on under the hood so that you have proper context for the discussion. Then, Matt outlines the potential benefits, and potential harms, of applying ChatGPT in healthcare. Finally, Matt shares his experience launching Carta Healthcare, including how he convinced VCs that software plus services could scale better than a pure SaaS offering in this space.  This is a good one. I'm honestly not sure in which part of this conversation I learned more.

Medicaid Transformation. 1115 waivers. Delivery System Reform Incentive Payment (DSRIP) programs. Expansion. Contraction. We’ve been at this for a long time. Why isn’t Medicaid transformed already? Well… it turns out that this is really difficult work. First off, there are complex political and ideological issues. Even if we all agree that we want the best healthcare for every American – a conceptually easy outcome to rally behind – we don’t all agree on what that looks like, how to get there, or how to pay for it. Second, it takes a long time for policy levers to play out in the real world. That makes it exceedingly difficult to measure the success of our programs, which further exacerbates the first issue. Add in a bunch of multi-billion-dollar entrenched institutions, technology hurdles, and social determinants of health, and you are still just scratching the surface of the many issues that need to be addressed and aligned to “succeed”. But all is not lost. We’ve learned a lot over the past 30-40 years, and we’ve made progress in many areas. There are approaches and mental models that have led to certain levels of success. And today’s guest has been participating in and observing many of them over the past few decades. Today we talk with Alan Weil, Editor-in-Chief of Health Affairs, the nation’s leading health policy journal.  Alan takes us through the history of Medicaid Transformation from the early 1980s on. We discuss the approaches taken, the thinking behind them, and the many factors that influenced their success. We explore the conflicts and hurdles, the friction and confounders, not to define a path forward, but to give the listener a more productive framing from which to build. This is admittedly a bit more of a philosophical discussion than what we usually have on this show. However, I feel we’ve taken a practical approach to the philosophical exploration and yielded actionable advice on how to adjust your frame. Please do let us know what you think!   For full show notes and links, visit: https://thehcbiz.com And of course, find everything from Health Affairs at: https://www.healthaffairs.org/

Cleveland Clinic recently announced that they would begin charging for certain patient-initiated messages. This flies in the face of everything the industry is talking about when it comes to patient engagement and value-based care. At the same time, it is quite unreasonable to think that a doctor should be available for questions at any time, for free. How can we protect the clinicians' time AND provide the patients with the care and attention they need?  And why are we moving away from value-based care? Craig Joseph, MD, Chief Medical Officer of Nordic Consulting Partners, and Matt Lambert, MD, Chief Medical Officer for Curation Health join Don Lee to share their take. Craig's article that led to this episode: To charge or not to charge For full show notes and links, visit https://thehcbiz.com

Don and Shahid discuss NCQA's Health Innovation Summit (November 2022) and FHIR Dev Days (June 2022). They explore these events as examples of how to interpret what you hear at conferences, in industry media, and even on podcasts like this.  The discussion covers a lot of ground including: What is NCQA? What is HEDIS? What does it mean to move from Electronic Clinical Quality measures (ECQM) to Digital Quality Measures (DQM)? Can FHIR really do all that!? Specified, but not implemented (this is important) Why is it hard to innovate and sell innovations in the quality measure space? How are health equity and social determinants of health factoring into quality measurement? It's a fun conversation, but... take it with a grain of salt.

On this episode, we talk with Ray Dogum, MS, MBA about the state of blockchain and web3 technology in healthcare. Ray is the producer and host of the Health Unchained podcast where he discusses blockchain developments in healthcare with industry experts. There was quite a hype cycle around blockchain in healthcare that has died, but there is still real development being done and plenty of opportunity to create value in the future. We’ll break down the pockets of success that are happening today and talk about where things could be headed in the future. For complete show notes and links visit: https://TheHCBiz.com

Some people tell doctors that anything more than a cup of coffee is a conflict of interest. What about executives? Is it ok to take them out to lunch? What about a trip to the Super Bowl? Is there a line? Where is it? On this episode, Don and Shahid discuss a recent LinkedIn discussion where a healthcare executive called shenanigans on himself and his colleagues for accepting gifts. The gift is a symptom... not the underlying issue.  Tune in to find out what the issue is and how to fix it. Plus, learn why Don hates RFPs and how we can do those better too.

There's no business case for doing the right thing in healthcare. Fortunately, being patient-first is the right thing to do and can be good for business too. Today we talk with Brian Sanderson, national healthcare management leader at Crowe LLP and author of the new book, The Patient-First Revolution.  In it, Brian provides a blueprint for hospitals to skyrocket net revenue by boosting patient experience (#HCBiz listeners can grab a free copy of the book here). Brian explains it's important to think about more than short-term financials. Yes... you need to operate efficiently and run a sound business… those are table stakes. The hospitals and health systems that take it to the next level will do so by playing the long game and being patient-first. This conversation continues our ongoing exploration of the Healthcare Delivery Organization Innovation Lifecycle Ontology (HDO-ILO). Brian helps us understand how to make the case for prioritizing patient-first practices and how to set and manage expectations within the organization. This, of course, is a critical early step for any healthcare innovation effort.  For full show notes and links, visit https://thehcbiz.com

It's easy to experiment with new tech and produce products that look and sound innovative. It's much harder to tie your innovation efforts to strategic objectives with measurable outcomes and then scale the solution across your organization. The former leads to "death by pilot". The latter makes a difference in people's lives. We need a more disciplined approach to innovation if we want to make a difference. In this episode (Ep. 201) we introduce the concept of the Healthcare Delivery Organization Innovation Lifecycle Ontology or HDO-ILO. That's a fancy way of saying that we are attempting to codify what we've learned over the past 200 episodes and through our decades of Health IT / Digital Health innovation experience. You can find the current draft here:  Healthcare Delivery Organization Innovation Lifecycle Ontology (HDO-ILO) Our goal is to help the industry move from a haphazard way of innovation to one that is more thoughtful, deliberate, targeted, measurable, and repeatable. And we need your help! There are several asks for the community throughout this episode. Please send us your ideas and experiences. We'll bring you on to share them with the #HCBiz community and we'll incorporate them (with credit) into the HDO-ILO. Let's innovate on purpose, and with purpose. Together... Find more at: https://thehcbiz.com/201-building-an-innovation-lifecycle-ontology/ Watch this episode on YouTube

On this episode, Don Lee and Shahid Shah celebrate 200 episodes of The #HCBiz Show! We discuss what we've done over the past 6 years and tell you where we're headed next. In a nutshell, we're going to work to codify what we've learned about innovation in healthcare over the past 200 episodes and in our decades of deploying digital health solutions.   We're steering the effort, but we need your help. There will be plenty of ways to get involved. Thanks for learning with us over the past 200 episodes. Here's to 200 more! Oh... and we're on YouTube now too if you prefer the visuals: The #HCBiz Show! - YouTube   Learn more at https://TheHCBiz.com

There’s no shortage of development when it comes to AI and ML in healthcare. The technology is already powerful and continues to advance. The challenge, as always, is getting things into the clinical workflow. And doing so at scale. Nuance has a plan to help innovators and health delivery organizations find alignment and get the right tools integrated into the clinical workflow quickly. Nuance started with ambient intelligence in the sensory realm. In computing, ambient intelligence (AmI) refers to electronic environments that are sensitive and responsive to the presence of people. Today, Nuance’s Dragon Ambient eXperience (DAX) can capture and code the natural conversation as it occurs between doctors and patients. Soon, ambient sensor tools will be able to see what’s going on in the exam room too. Building on the sensory tools, Nuance’s somatic ambient intelligence will allow AI to help doctors understand what’s happening inside the body too. And that starts with imaging. The Nuance Precision Imaging Network (PIN) is designed to integrate imaging insights into the broader healthcare ecosystem and facilitate the use of AI to inform precision diagnostics and therapeutics.  In short, Nuance is allowing innovators to deploy their models on top of existing infrastructure in healthcare delivery organizations across the country. And in doing so, they are making it much easier for healthcare delivery organizations to experiment with these models. A real win-win that could accelerate the integration of ambient intelligence into the clinical workflow. On this episode, we talk with Peter Durlach, Executive Vice President, and Chief Strategy Officer at Nuance, about the technology, the strategy, and the roadmap. Plus, we discuss the AI Collaborative Nuance launched with The Health Management Academy.   Full show notes and links: https://thehcbiz.com/199-ambient-intelligence-peter-durlach/

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: 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 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 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/

Healthcare orgs share large amounts of PHI with 3rd party vendors. They share it for analytics, rev cycle management, call center services, and more. It's a necessary part of the business. But you know what isn't necessary? Sharing everything!  There is a very disrespected requirement in HIPAA called minimum necessary. It means exactly what it says... you should share only that which is needed to do the job (typically under treatment, payment, or operations). In my experience, the default is to just send everything. It's lazy. It's wrong. It's risky. And it's completely unnecessary.  We recently spoke with Joan Ziegler, CEO, and Chris Hottinger, VP of Healthcare, at Sequent about their 3P Secure tokenization platform. It uses the technology behind your credit card chips to secure data in motion, rendering it worthless to the bad guys. It also provides healthcare organizations with a way to finally adhere to the minimum necessary requirement in HIPAA. On this episode, we discuss the value that tokenization brings to healthcare. We also explore Sequent's journey from FinTech to healthcare.  It's an instructive conversation about how to bring technology from other sectors into healthcare, and how to avoid walking into the buzzsaw that surprises many new entrants. This is the final of our 5 interviews recorded at ViVE 2022 in Miami. For full show notes and links: https://thehcbiz.com/188-tokenization-stop-sending-all-that-phi-sequent-vive-2022/

It's difficult for Digital Health startups to find alignment between their innovations and the complex business realities of healthcare. That is why this show exists. We discuss it in nearly every episode.  Today's guest has a novel approach to solving that alignment problem.  Alex Yarijanian and the team at CareNodes have decided to build their ideal customer. That's right. CareNodes is an MSO and accelerator of sorts. They find promising digital health innovations and then build a market for them. They'll start a medical practice, put their own clinicians in it, negotiate contracts with health plans, align it with NCQA certifications, and more. All of this is done to ensure that the digital health innovation has the ideal landing place, and is put in the best possible position to succeed. This one is unique. I'd love to hear your thoughts on it!   For full show notes and links: https://thehcbiz.com/187-build-your-own-customer-alex-yarijanian-vive-2022/

Virtual-First thinking and telehealth adoption exploded during the pandemic. Since necessity was the driver there is some expectation that demand and use will scale back as the pandemic wanes. Yet today's guest tells us that is not what's happening in the field. We spoke with Karsten Russell-Wood at ViVE 2022, and he's seeing the opposite . Not only is demand steady, but hospitals are evaluating all their workflows to see what else they can do with telemedicine.  Karsten serves as the Chief Marketing & Experience Officer for Equum Medical. Equum is a telehealth-enabled provider service delivery company. They provide much-needed clinical resources to hospitals and health systems all over the country via telehealth. Given the industry's struggles with staffing shortages and clinician burnout, Equum's services are in high demand. We discuss: - What's driving the continued demand for telehealth - How Equum is approaching the market - The importance of delivering a full solution to your customers and partnering with others to make it happen - The need to innovate in our business models, pricing, and partnerships just like we do with our products   For full show notes and links: https://thehcbiz.com/186-continued-expansion-of-virtual-first-healthcare-karsten-russell-wood--vive2022/

There's a difference between being "just another vendor", and being a true partner to your customers. Ed Marx has thrived on both sides of this equation, first as a health system executive and now as the Chief Digital Officer at Tech Mahindra / The HCI Group.  We sat down with Ed at ViVE 2022 to hear what he has learned about good vendor/health system partnerships. For full show notes and links: https://thehcbiz.com/185-how-to-be-a-good-partner-to-health-systems-ed-marx-vive-2022/

AvoMD is a no-code platform that allows users to create clinical decision support apps that integrate directly into their workflows. We caught up with Dr. Yair Saperstein, co-founder, and CEO to learn a bit about their platform and approach. Plus, we dig into the keys to gaining attention as an early-stage startup, being a good partner from the sales process onward, and the importance of answering questions. You’ll learn: Why most EHR alerts are ignored The 5 Rights of Clinical Decision Support (CDS) Why “No” can be a good thing in the early stages of a sale The importance of identifying your champion (and enabling them to do most of the selling for you). How to properly answer questions and address concerns during the sales process Plus, several more tactical nuggets that’ll help you close more deals. This episode is part of a series recorded at ViVE 2022 in Miami Beach, Florida, March 6-9, 2022. Visit https://TheHCBiz.com for full show notes and links.

Our population is aging. According to the Urban Institute: “The number of Americans ages 65 and older will more than double over the next 40 years, reaching 80 million in 2040. The number of adults ages 85 and older, the group most often needing help with basic personal care, will nearly quadruple between 2000 and 2040.” And the aging population continues to drive national healthcare spending. If we’re ever going to reign in our healthcare spending, then we will need to find ways to take better care of our aging population. According to the team from Blooming Health, medical care is only part of the solution. We need to connect people, especially those from underserved communities, with the resources that will help them thrive. That means addressing their food, housing, safety, and security needs. And it means finding ways to give them meaning and purpose. That’s where Blooming Health comes in. They exist to empower healthy aging in place. They help community-based organizations (CBOs) align older adults with the resources they need to thrive. Their technology is designed to meet the elderly where they are and strives to remove friction from the process at every step. On this episode, we explore what it takes to meet older adults where they are, speak to them in the language they prefer, and track results in a way that enables the health system to appropriately invest in their well-being. Learn more: https://gobloominghealth.com/ Contact: [email protected] For full show notes and links: https://thehcbiz.com/183-empowering-healthy-aging-in-place-with-blooming-health/

Whether you’re an administrator, clinician, or executive, if you’ve built a career in the healthcare industry then you have skills, knowledge, and connections that most digital health startups lack. On this episode, we talk with Dr. Alan Pitt, a physician, entrepreneur, and investor, about how to put your hard-earned healthcare industry expertise to work as a digital health advisor.   For full show notes and links: https://thehcbiz.com/182-how-healthcare-leaders-can-get-involved-with-startups-alan-pitt/

We tend to talk mostly with software startups about commercialization and sales. What do things look like for a startup selling a physical product? And a physical product that’s very relevant during the pandemic at that? That’s exactly what Jason Kang and the team at Kinnos are doing right now. Kinnos’ product, Highlight®, colors bleach, and bleach wipes bright blue, providing instant visual confirmation of coverage, then fades in minutes to remind users of contact time. Studies show using Highlight for Bleach Wipes for just a few weeks can improve cleaning scores by 70%. Given that we’re in the midst of a global pandemic, and cleaning and safety are top of mind, it would seem that this is Kinnos’ time to shine. And while that’s true, commercialization in healthcare is hard. We talk through what’s worked, and what’s not in terms of getting the attention of hospital buyers including a sample technique that yielded 70+ leads in a very short time. There are a lot of go-to-market lessons in Kinnos’ story and we extract them for you. All the while, giving you a bit of an education in infection prevention and a lead on a valuable new product that you can share with your colleagues. For full show notes and links: https://thehcbiz.com/181-commercializing-physical-products-in-healthcare-jason-kang-kinnos/

Have you ever had an idea that you just had to make real? No matter what it took… no matter what obstacles were in your way… no matter how many times people told you no… you just couldn’t stop until it existed? Well, this is one of those stories. It begins with an idea in 1988 and leads to the first-ever autonomous AI to be approved by the FDA for diagnosis without physician input. Dr. Michael Abramoff is a neuroscientist, a practicing physician, and holds a Ph.D. in Artificial Intelligence and Machine Learning. I know… slacker. In 1988, Michael was working on artificial intelligence during his residency and began to think a computer could diagnose diabetic retinopathy. Given the technology available at the time, this idea may have been a bit of a stretch. Still, Michael set out to prove it could be done. On this episode, we talk with Dr. Michael Abramov and Seth Rainford about the 30-year journey that led to the founding of Digital Diagnostics, and the first-ever FDA-approved Autonomous AI in healthcare. Plus, we explore the challenges they continue to work through as they commercialize their product. The journey itself is remarkable and each obstacle and resolution will be relevant to any digital health entrepreneur – especially those in AI and diagnostics. Of our 180 episodes, this is one of my favorite stories so far. It’s fascinating, entertaining, and incredibly useful. I hope you benefit from it as much as I did.   Dr. Michael Abramoff, MD, Ph.D. is the Founder and Executive Chairman of Digital Diagnostics Seth Rainford is the President and COO at Digital Diagnostics   For full show notes, links, and resources: https://thehcbiz.com/180-first-fda-approved-autonomous-ai-in-healthcare/

We talk about ML and AI quite a bit on this show. Our angle is always to avoid the hype and help you find the practical applications that you can put to work right now. Today’s episode is a great extension of this ongoing conversation. We talk with Dr. Taha Kass-Hout, Chief Medical Officer and Director, Machine Learning at Amazon Web Services about how they are trying to bring ML to the masses. We discuss: What’s needed to use machine learning at scale with cost efficiency, performance, and accountability. The challenges in analyzing healthcare’s largely unstructured data. The practicality of bringing AI/ML capabilities directly to the hospitals, health systems, medical offices, etc. How should CIOs and other buyers evaluate ML solutions? How can they tell what is real and what is hype? Detecting bias, drift in models, and drift in data in machine learning. Tooling for privacy, security, and compliance. The importance of owning and controlling your own data. The problems caused by bad training data ... For full show notes and links: https://thehcbiz.com/179-making-machine-learning-available-to-the-masses/

The No Surprises Act intends to prevent patients from getting burned with huge, unexpected bills for medical services. It is a needed law – medical bills are the #1 cause of bankruptcy in the U.S. And it’s certainly noble in its intentions. However, the healthcare machine works in unexpected and unintuitive ways. It has a way of moving surprises when we try to eliminate them. In this case, we may exchange surprise bills for new health access and health equity issues. And we will certainly create new surprises for the business. The law requires new and overhauled workflows, enhanced capabilities and technologies, and a solution to that pesky Provider Directory problem. Oh… did I mention it goes into effect on January 1, 2022? Giddy up! On this episode, I talk with Gail Zahtz, CEO at PropHealth, as part of our ongoing Value-based Payment in 2022 series about The No Surprises Act. We’ll explore: What is the No Surprises Act? Who is affected? (Spoiler: The entire healthcare industry… especially providers… and around 221 million Americans) What is required to happen? What workflows are needed to support this? What unintended consequences could play out? Why and how providers will be left holding the bag. What providers, and the entire industry in general, needs to do right now. How this fits into our conversation on VBP in 2022.   This may be about as negative as I’ve ever been on this show. I love the intent of the No Surprises Act, but I’m fearful for what’s going to happen because of it. If you can explain this in a way that makes it ok, please reach out.   For full show notes and links: https://thehcbiz.com/178-the-no-surprises-act-is-full-of-surprises-vbp-in-2022-with-gail-zahtz-part-4/

The Centers for Medicare & Medicaid Services (CMS) released the 2022 Medicare Physician Fee Schedule and Quality Payment Program final rule on November 2, and there are big changes to physician payments. In particular, the Medicare conversion factor, which forms the basis for payments to clinicians, will be lowered by 3.7%. There’s nuance in calculating the payments, but you can sum this up as most doctors will take a pay cut in 2022. And since the final rule goes into effect on January 1, 2022, doctors will begin feeling the cuts in Q1 revenue. The rule is specific to Medicare, but there are plans to push similar changes in Medicaid and we all know commercial payers tend to follow CMS’ lead. We believe this change will have a ripple effect across the industry. On this episode, I talk with Gail Zahtz, CEO at PropHealth, as part of our ongoing Value-based Payment in 2022 series about what doctors can expect in terms of Medicare FFS payment come January 1, 2022. We discuss this as another example of CMS trying to make Fee-for-Service less “comfy” and expedite the move to value-based payment models. Gail helps us to understand what options exist and we lay out a framework for how to evaluate those options. This is a heavy episode, and there are no clear answers. However, there is a known direction and a viable path forward. We’ll try to get you moving in the right direction.   For full show notes and links: https://thehcbiz.com/177-doctors-just-took-a-pay-cut-vbp-in-2022-with-gail-zahtz-part-3/

We planned to discuss quality measures but shifted to address a very important piece of listener feedback after the preview and Episode 1. The comments came from a doctor in the audience and I know there are many more doctors and healthcare administrators who feel the same way. The feedback, in short, is that we’ve been hearing about the move to value for 10 years. We’ve invested in it through several evolutions and it still hasn’t come to fruition. The key is to rebuild trust between the government and those delivering the care- whether hospitals, payers, providers, or innovators. Otherwise, they won’t trust enough to act. Gail Zahtz, CEO of Prop Health, and I discuss this commentary in the context of this series. Thank you to the listener who provided this feedback. I hope this discussion is helpful. And to everyone else listening in, send us your thoughts, questions, and comments to [email protected]. <p styl

There’s a lot of unknowns as we head into 2022, but one thing is certain: Health Equity will be a major focus for CMS and CMMI. Gail Zahtz, CEO of PropHealth, tells us that “value-based payment models have failed to deliver on the promise of health equity” and that is a major reason why CMMI paused so many models earlier this year. When the next iteration of value-based payment arrives, you can bet that health equity will be front and center. And for that, we prepare. “Fee-for-service says you get paid to fix a broken arm. Value-based care says everybody's tripping on the sidewalk and breaking their arm – let’s fix the sidewalk. Health equity says we're going to fix the sidewalk everywhere.” Gail Zahtz, CEO, PropHealth This is the first episode in a 5-part series: Everything You Need to Know About Value-Based Payment Models to Prepare for 2022 with Gail Zahtz. On this episode, we take a deep dive into everything health equity to lay out what is known, what is unknown, and how you can build flexibility into your business operations and systems to ensure that you are ready for whatever comes next. Key topics include: Why have value-based payment models failed to deliver health equity? What is digital equity and why is it important? Why risk is not the solution on its own especially when you’re only changing the financial model for those you already serve. Risk scoring. Alignment! Alignment! Alignment! That is… patient, provider, and payer alignment. Serving health nomads. The importance (and lack) of race, ethnicity, and gender data. Health equity and value for the Native American community. The value of Federally Qualified Health Centers (FQHC) and how we can use them as a model to design Gail’s “Upside-down ACO”. How to design a community pilot that is effective and sustainable (i.e., good for the patients AND good for the business). How to design your data systems to support health equity initiatives. Quality measures are next in our 5-part series designed to get you ready for value-based payment in 2022. Subscribe and stay tuned! For full show notes: https://thehcbiz.com/175-health-equity-is-population-health-vbp-in-2022-gail-zahtz-part-1/

What is going on with Value-based payment models in healthcare? We’ve been talking about it for years and despite all the chatter and investment, uptake has been slow. Now, the CMS Innovation Center (CMMI) has put many of its models on hold including the Direct Contracting Geo model that we covered earlier this year. Does this mean we are moving away from value-based payment models? Absolutely not! In fact, things are going to start moving much more quickly towards value in 2022. The #HCBiz Show has partnered with Value-based Contracting expert, Gail Zahtz to bring you a 5-episode series that will tell you everything you need to know about value-based payment models to prepare for 2022. Get all the details here: https://thehcbiz.com/174-vbp-2022-series-preview-gail-zahtz/

We're less rational, less logical, and less deliberate than we like to believe. We have biases and regularly use heuristics, or mental shortcuts, to make our decisions. Most of the time we aren't even aware it's happening. Every actor in healthcare has these tendencies. Health systems have biases that influence doctors. Doctors have biases that influence patients. And of course, patients have biases too.  These compounding biases create challenges when presenting information, defining care pathways, or trying to help patients find their optimal path. On this episode, we talk with Talya Miron-Shatz, PhD, who is a leader in research at the intersection of medicine and behavioral economics, and the professor and founding director of the Center for Medical Decision-Making at Ono Academic College in Israel. Talya is the author of the new book Your Life Depends on It: What you can do to make better choices about your health. In it, Talya shines a light on the barriers we all face when making health and medical choices and provides actionable solutions for patients, doctors, and policymakers.  We'll explore these solutions to help you make better and more informed decisions for yourself and your family. And for you builders out there, we'll also share guidance on how to better present information, whether it be to doctors or administrators or to the patients themselves. For full show notes and links: https://thehcbiz.com/173-communicating-healthcare-to-humans-with-talya-miron-shatz

There are many ways to innovate within an existing organization. However, it can be difficult to move as fast as you’d like within the constructs of an established business model and culture. For one, it’s difficult for your team to innovate on top of their “day job”. Second, it can be difficult to hire and incentivize the right people to drive the innovation within your existing constructs. These are the types of issues that the folks at Cleveland Clinic identified as reasons for not innovating fast enough in telemedicine. They decided that if they were going to pick up the pace, they were going to have to take a different approach. The Clinic is a joint venture between Cleveland Clinic and Amwell that connects patients with Cleveland Clinic physicians for online second opinions. Together they are using the latest telemedicine technology to, as CEO Frank McGillen put it, “unlock access to the world’s best medical care”. On this episode, we talk with Frank McGillen, CEO, and Peter Rasmussen, MD, Chief Clinical Officer of The Clinic by Cleveland Clinic to understand why one of the best known global brands in healthcare decided that a JV startup was the best way to bring this innovation to market quickly. We discuss: The problem that needed to be solved The benefits of the spin-off/startup approach The benefits of partnering with vs. hiring a technology vendor How they were able to get Cleveland Clinic physicians on board The importance of unique business models in a competitive marketplace How they are measuring the success of their second opinion service How they are measuring the success of this innovation approach Advice for organizations who are considering a startup/spin-off approach to innovation   About The Clinic by Cleveland Clinic The Clinic is a visionary joint venture that combines the unrivaled clinical expertise of Cleveland Clinic with Amwell’s industry-leading telehealth platform. Through innovative solutions like our Virtual Second Opinions, we enable easy, secure access to the highest quality medical expertise. Patient-centric and deeply collaborative, we are passionate about realizing the global possibilities of digital health, providing advanced solutions that help tame the costs of care while enabling patients to achieve better outcomes and the greatest degrees of hope.   Learn more: Web: https://theclinic.io/ LinkedIn: https://www.linkedin.com/company/digitalhealth1/ Anthem signs on with Cleveland Clinic’s, Amwell’s virtual second opinions service   Full show notes and links: <a

On this edition of #HCBiz Office Hours, Don and Shahid talk with Yuma Nambu, Chief Strategy Officer (CSO) at CROSS SYNC. CROSS SYNC is a Japanese startup whose medical data analytics software, “iBSEN”, enables hospital ICU’s to automate the monitoring of patient vitals and motions continuously to assist healthcare professionals in identifying acute deterioration as early as possible.  The platform relies on multimodal AI capabilities that combine time-series vital analytics from physiological monitors and patients’ motion analytics from live video feeds including facial recognition and motion detection.  As CROSS SYNC looks to expand globally, and into the U.S. market in particular, what are the regulatory requirements for their software? Will they need FDA SAMD Clearance to deploy iBSEN in the U.S? Don, Shahid, and Yuma discuss FDA/SAMD regulatory requirements in detail. Plus, they expand on the idea to explore the more important question all digital health startups face: How will you prove that your software works?  For more details and full show notes: https://thehcbiz.com/171-office-hours-does-my-software-need-fda-samd-clearance/   The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media.

We spend a lot of time talking about how to align your startup’s vision with the realities of the business of healthcare. You can have the best idea in the world, but if you don’t properly validate your offering with customers, clearly and concisely explain the value it will bring them, close deals, and deliver on your promises then it will amount to nothing. Each of these steps is critical to your success. However, you can get many of them right and still fail. The best way to prevent this fate is by tying them all together with a financial plan that’s based on reality and considers the long-term goals for your startup. Today we talk with Kristian Marquez, CFA, Managing Director for FinStrat Management, Inc. about how to properly manage your startup’s finances.  The good news is that you don’t have to be perfect. Kristian tells us you should expect to get a lot of it wrong and have to clean it up along the way. That’s ok. His advice: go bare-bones in the beginning when it comes to finances, legal, and generally “papering your business”. That way, you can put all of your resources into ensuring you have a product that people will actually pay you for. That means more time talking with customers, managing your pipeline (and not lying to yourself about it), practicing selling, and cultivating the confidence to ask for the close. Kristian walks you through this early-stage strategy, explains when it is time to bring in the experts, provides guidance on debt vs. equity funding, and even helps you prioritize your spending based on the type of company you want to build. This episode pairs well with: Episode 30: Why You Should Always Be Preparing to Sell Your Company with Dexter Braff Episode 85: Lessons on Selling in Healthcare w/ Dom Cappuccilli ---------- Kristian Marquez, CFA – Kristian serves as Managing Director for FinStrat Management, Inc. FinStrat Management (“FSM”) is an outsourced financial department services firm providing fractional accounting, controller services and CFO services. Exclusively serving B2B SaaS companies, we provide fractional: Chief Financial Officer, controller and accounting services. Web: https://finstratmgmt.com/ LinkedIn: https://www.linkedin.com/company/finstratmgmt/ Twitter: https://twitter.com/finstratmgmt Please email [email protected] if you'd like a free consultation. ---------- This episode is brought to you by: The Substance Use Disorder Treatment and Re

Just about every health system has an innovation program, but how do they know if it’s making a difference? That’s the question we set out to explore with the team from Houston Methodist Center for Innovation. On this episode we talk with:   Michelle Stansbury, Vice President of IT Innovation Brad Shaink, Administrative Director of Digital Innovation Josh Sol, Administrative Director of Ambulatory Innovation   They walk us through:   Innovation Expectations: How do you set expected goals, OKRs, KPIs, etc.? Innovation Discovery: Where do you find solutions? Innovation Evaluation: How do you evaluate solutions before you pilot them? Innovation Pilots and Early Adoption: How do you pilot your solutions? Innovation Procurement: RFPs, templates, etc. Innovation Diffusion: Implementation, integration, etc. Innovation Recognition: How do you recognize teams that are doing things well? Innovation Failure: How do you know if an innovation has failed? Exnovation: How do you know when it's time to stop doing something, or to turn off legacy solutions?   Key takeaways include:   Right-sizing your pilots: Start small and keep your efforts in line with what you are trying to accomplish. Metrics can be qualitative or anecdotal, but they must exist and you must be honest with yourself about whether they are being met. Honesty and trust are key to innovation success. If you aren’t giving honest feedback and holding one another accountable then everything falls apart. Startups should focus on solving the customer's problem first and avoid pushing their own agenda. If you invest in the customer's needs first, you’ll get a chance to expand the vision later. Make innovation a priority and develop innovation habits: The Houston Methodist team schedules “Monday Demos” each week to ensure they always have new ideas and solutions entering the pipeline. Sometimes they find a solution for a problem they didn’t even realize they had.   Links and Resources   Connect with Michelle Stansbury on LinkedIn Connect with Brad Shaink on LinkedIn Connect with Josh Sol on LinkedIn Learn more: Houston Methodist Center for Innovation   Related Episodes:   Episode 149: How Health Systems Think with Neil Carpenter (Listener Favorite) Episode 137: <a href= "https://thehcbiz.com/the-novation-dynamic-3-pillars-for-healthcare-

Early in the pandemic, Amazon Web Services (AWS) launched the Diagnostic Development Initiative (DDI) to help organizations around the world accelerate diagnostics research and development. In the first phase of the initiative, AWS awarded $8 million in computing credits and technical support to 87 organizations in 17 countries. Some of the highlights include:   Stanford University School of Medicine’s smartwatch app that detects early signs of COVID-19 Ilumina’s identification of viral mutations through next-gen sequencing Chan-Zuckerberg Biohub used Machine Learning to estimate the number of unreported COVID-19 Cases University of British Columbia & Vancouver General Hospital applied machine learning to CT scans to identify indicators of COVIOD-19 and detect more severe progression of the disease. Then they open sourced the model.   Today we’re talking with Grace Kitzmiller, Principal Product Manager of AWS Disaster Response about the next round of DDI. AWS will distribute an additional $12 million in compute resources and technical support to organizations working in three areas:   Early disease detection Prognosis Public Health Genomics   And while AWS will continue to support COVID-19 projects, they will also consider projects focused on other infectious diseases. The application is open now and runs through the end of the year. However, AWS is encouraging applicants to submit by July 31, 2021, for priority consideration.   In this interview we discuss:   The details of the AWS Diagnostic Development Initiative (DDI). The problems AWS is trying to solve. How AWS is measuring the success of the initiative. The highlights and major outcomes from round 1. How the program is being expanded for round 2. How organizations can apply the compute, technical resources, and subject matter expertise made available through DDI. Who should apply? Plus, we do some brainstorming on possible solutions that could benefit from the pr

A major driver of health disparities is that the system does not typically account for the differences in the culture, language, and experience of the patients it is charged to serve. Today we talk with Abner Mason, Founder, and CEO of ConsejoSano about the importance of customizing engagement to match the multicultural realities of your patients. Abner tells us that it’s not about translating, but “creating content based on culture; based on deeper factors than language”. And it’s effective. ConsejoSano is helping payers and providers get their patients into clinics and closing gaps in care. This of course leads to better outcomes, lower costs, and increased revenue for practices.   Key topics include:   What does it mean to create a more equitable and just healthcare system? How has COVID shone the light on the problems in our system? How do the Social Determinants of Health (SDOH) factor into health equity? Is there a willingness for providers and health plans to invest in these solutions? What did the original vision for ConsejoSano look like and how did healthcare’s challenging reimbursement models lead to a pivot? How do you align patient engagement efforts with the multicultural reality of the U.S. population? How does your solution fit into the business model of providers and payers? What are the opportunities in Medicaid? Medicare Advantage? How are value-based payment models driving this work? What data is needed to support multicultural patient engagement? What is Health Tech 4 Medicaid and how is it enabling innovation in Medicaid? ConsejoSano’s podcast: Health Equity Now     Abner Mason, Founder and CEO, ConsejoSano   Abner Mason is a healthcare technology leader who’s dedicated to creating a more just, equitable, and effective healthcare system. As the founder and CEO of ConsejoSano, a multicultural patient engagement company, he leads a team of diverse professionals who strive every day to improve outcomes and lower costs on behalf of health plans. He’s also the founder and chair of HealthTech 4 Medicaid, a nonprofit composed of innovative leaders working to radically change the pace of innovation to improve care quality and access. A federal and state government policy veteran with deep experience fighting the HIV/AIDS crisis, Abner knows how to tap people’s unique talents and innate sense of compassion to achieve big goals.   ConsejoSano   ConsejoSano is a patient engagement platform that helps connect payers, providers and health systems with their multicultural Medicaid and Medicare patient populations. The company utilizes multi-channel engagement tools to reach patients in a cultural

Price transparency and healthcare consumerism are top of mind for many operators and observers of the healthcare industry. On the surface, these topics sound great. Of course, we want to enable patients to be good consumers of healthcare. However, as we’ve seen so often on this show, aligning the obvious with the realities of the business of healthcare is no small feat. Today we’re talking with Dr. Steve Ambrose about healthcare costs, pricing, and consumerism. We discuss what these terms mean and why they are important. Then we dig into examples of companies that are already making an impact on these issues. We discuss:   Companies that are helping to lower healthcare prices like ONCOspark (24:22), GoodRX (41:05), Transcarent (48:42), Cedar (53:24), Green Imaging (55:23), and more. What is going on in the retail space with the likes of Walmart, Target, Amazon and others (27:07). And companies working to reduce administrative costs like Olive (1:04:00) and LeanTAAS (1:08:51).   This is an exciting space that is full of potholes and false promises. However, it is also a space where good companies are beginning to make progress. And that progress may offer us a glimpse into the future of healthcare.   Dr. Steve Ambrose Dr. Steve Ambrose is a healthcare strategist with 25 years in clinical, technology, patient engagement, and consumerism. He is selectively reviewing options to place his talents and passion into his next FT leadership role. Dr. Ambrose may be reached through contact information on his LinkedIn profile.   Links and Resources   Steve Ambrose on Drug Pricing and GoodRX: https://walktheridge.com/drug-pricing Health Care Spending in the United States and Other High-Income Countries - this is the Ashish Jah study on healthcare prices and costs that Steve mentioned. Walmart acquires telehealth provider MeMD, upping competition in telehealth space   Several recent #HCBiz episodes on AI/ML in healthcare administration:   Episode 162: What’s up with IBM Watson Health? A Discussion on the State of AI in Healthcare with Paddy P

Poor oral health has a direct link to high risk of chronic diseases like diabetes and heart disease. It contributes to depression, poor maternal health outcomes, and death. Research shows that it increased the risk associated with COVID-19. Yet we treat oral health as being separate from “healthcare”. 65 million Americans lack dental coverage and even Medicare provides no oral health benefits to our seniors.  Worse yet, this lack of coverage contributes to healthcare disparities as black adults are nearly seven times more likely to have an unmet dental need than white adults. But where there are problems there are opportunities. Today we’re talking with Dr. Myechia Minter-Jordan, an MD, MBA, community health champion, and the President and CEO of the newly formed CareQuest Institute for Oral Health. Myechia shares with us how her role as the head of a Federally Qualified Health Center (FQHC) helped her see the gaps in our system and the extraordinary benefits of integrating oral health into primary care delivery. Better yet, those benefits extend far beyond a moral imperative. There is a clear business case for integrating oral health in a more holistic health delivery system. Myechia breaks it all down for us, plus much more including:   Why oral health has been treated separately from healthcare. How oral health integration compares to behavioral health integration (which is already leading to improved outcomes and lower overall costs). The many ways CareQuest Institute is moving the needle including grants, research, innovation, and social impact investing. How entrepreneurs and startups can work with CareQuest Institute and why they will be launching the CareQuest Innovation Partners initiative to drive this. The need for teledentistry. The ways oral health and the COVID crisis have impacted one another. How ACOs, Direct Contracting Entities, and other risk-bearing organizations can benefit from oral health integration. The opportunity for dentists to rethink their own practice and begin to support primary care (and get reimbursed for it). How to foster relationships between dentists and primary care providers. Plus, we discuss The New Commonwealth Racial Equity and Social Justice Fund (NCF).     Myechia Minter-Jordan, MD, MBA Myechia Minter-Jordan, MD, MBA, serves as the president and CEO of the CareQuest Institute for Oral Health. A physician and business executive, Myechia leads a dynamic team of professional and clinical experts committed to building a future where every person can reach their full potential through excellent health. Through Myechia’s leadership, CareQuest Institute operates as a catalyst for systems change, bringin

When it comes to billing codes there are many processes and solutions that focus on the backend. They support the coders and help ensure the codes are “bill ready”. However, as today’s guest points out, there are very few solutions that exist solely to help providers put those codes in the EHR accurately and efficiently in the first place. Abboud Chaballout created Diagnoss to untether the clinician from a clunky EHR interface when it comes to coding. Chaballout describes it as a provider assistant that reads the free-text clinical narrative as they record it and uses AI to suggest the appropriate codes needed to paint an accurate picture of their patient’s health and the nature of the care they provided. Certainly, this will improve the accuracy of coding and allow for improvements in the overall coding workflow, but that really isn’t the goal. For Abboud, it’s far more important to give the providers some relief from clicking, pecking, and guessing in the EHR. The EHR is one of many contributors to physician burnout, or as Abboud prefers to describe it, moral injury. Simply put, Abboud and Diagnoss are using AI in an attempt to improve providers’ lives. It’s their sole focus. In addition to exploring Diagnoss’ goals and capabilities, we also get into the technical aspects of building this type of startup in healthcare. We discuss:   How to decide which EHRs to work with. How to engage with those EHRs and get access to their API. How much variance you see from EHR to EHR when it comes to integration and APIs. How FHIR will impact the EHR integration process in the future.   This is a great discussion for anyone trying to do the hard things in healthcare, especially when they require tight integration with many EHRs.   Abboud Chaballout Abboud Chaballout is the CEO and founder of Diagnoss, a digital health company on a mission to reduce the administrative burdens of medical providers on the front lines of our healthcare system by building seamless tech. At Diagnoss, he’s taking on medical coding with an AI-based coding assistant that “whispers over a doctor’s shoulders.” Find and connect with him on LinkedIn to talk AI, EHRs, and medical coding.      Connect with Abboud on LinkedIn Follow Diagnoss on Twitter Learn more at https://www.diagnoss.com/ Diagnoss Video: https://www.youtube.com/watch?v=6y3zFZ8yHPY    Diagnoss Diagnoss supports providers in their most cumbersome EHR tasks

95% of innovations that are brought to market fail to reach an adequate level of customer adoption or financial ROI. It sounds scary, but it doesn’t have to be this way. Today we’re talking with healthcare commercialization strategist and digital health advisor Dr. Roxie Mooney, about the steps innovators can take to dramatically increase their chances of being in the other 5%.   Why you need an early adopter strategy that focuses on the specifics needs, goals, and desires of the customers who are looking for something new and novel. How to avoid pilot purgatory by negotiating future sales up-front and ensuring you can get value from the pilot along the way. The risks of falling in love with your idea and skipping the all-important customer discovery and market validation step. And no, your mom is not a good source of feedback on your innovation. The benefits of being strategic with your go-to-market timing (i.e., don’t rush to market; do rush to customer feedback). How to co-create with your clients without building a product that works only for them. When to convert your early-adopter messaging (i.e., new, never been done before, innovative, etc.) to mainstream messaging (i.e., social proof, trustworthy, reliable, ROI, etc.). This is a rich conversation, and whether you’re a startup or innovating within your organization, it's full of things you should be thinking about right now!   Dr. Roxie Mooney, DBA Healthcare Commercialization Strategist and Digital Health Advisor   Dr. Roxie Mooney helps health tech innovators uncover their most profitable and viable market strategies, from early adoption strategies to pivoting. She transformed 20 years of business practice, 7 years of researching over 500+ peer-reviewed articles, and 160+ interviews with health innovators into a repeatable method to go from an idea to full-scale adoption. She advises startups and emerging healthcare brands and has been involved in three successful exits. She currently serves as the Healthcare Commercialization Strategist and Digital Health Advisor of Legacy DNA. She’s also the international best-selling author of How Health Innovators Maximize Market Success: Strategies to Launch and Commercialize Healthcare Innovations, as well as host of the podcast and video show “Health Innovators.” In addition to her strategist role, Dr. Roxie is a sought out speaker and educator. She’s spoken at HIMSS and the Connected Health Conference, and currently serves as an Associate Professor of Marketing at the Jack Welch Management Institute and an Adjunct Professor of Gender Leadership and Coaching and Consulting at Palm Beach Atlantic University. She’s also a Board Member of One Purse, a nonprofit organization committed to r

IBM Watson Health came on the scene with swagger and promises. They were going to revolutionize healthcare! And now the unit may be for sale. We don't yet know what's really going on there, but the commentary surrounding this rumor provides some interesting points for discussion. What is the state of AI in healthcare? Is the industry ready for it? Will doctors use it? Is it going to kill us if it's not perfect? There's a lot to explore.  On this episode, Paddy Padmanabhan joins us to hash it all out. Paddy is the Founder and CEO at DAMO Consulting, Host of The Big Unlock podcast, and co-author of the new book Healthcare Digital Transformation: How Consumerism, Technology and Pandemic are Accelerating the Future with Edward Marx. We discuss what's working today (think administrative functions), and what may still be a ways off (think complex cancer diagnostics). Plus we get into the challenges of regulation, ethics, patient safety, messaging, and more.    About Paddy Padmanabhan Paddy Padmanabhan is the author of the best-selling book Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future. He is the founder and CEO of Damo Consulting, a digital transformation advisory firm that works with healthcare enterprises and digital health companies. He is the host of The Big Unlock, a widely subscribed podcast focusing on healthcare digital transformation. He is also the author of the book The Big Unlock: Harnessing Data and Growing Digital Health Businesses in a Value-Based Era.   About DAMO Consulting Damo Consulting provides digital transformation advisory services to enable healthcare organizations navigate the technology-enabled transition to telehealth and virtual care. We bring deep industry knowledge, market insights and technology skills to help develop and implement enterprise digital roadmaps. We work with healthcare IT and digital health firms to develop and execute market growth strategies. Links: Company Website: www.damoconsulting.net   Paddy Twitter: https://twitter.com/PaddyPadmanabha Paddy LinkedIn: https://www.linkedin.com/in/paddypadmanabhan99 Paddy’s latest book on healthcare digital transformation: https://thebigunlock.com/healthcare-digital-transformation-book-by-paddy-padmanabhan-and-edward-w-marx/ Newsletter: <a href= "https://www.damocon

Picking a health plan can be the biggest crapshoot of anyone’s year. It’s confusing and tedious to compare the plan benefits, the provider directories are unreliable, and even if you can figure it out, there’s no way to know how much you’ll pay for a given service from one plan to the next. So, we cross our fingers, pick the one that seems like a fit, and hope for the best. Today’s guest is trying to change all of that. Akash Magoon is Co-founder and CTO at Nayya – a company that offers personalized enrollment guidance across all employee benefits. Today we talk about how Nayya uses claims and consumer data to help consumers pick the best health plan for their situation. Their goal is to “restack the odds for American families”. That’s something we can all get behind. As a bonus to the startups out there, we talk about Nayya’s rapid growth over the past year. Pre-pandemic it was just Akash and his co-founder, Sina. Now a seed and series A round later, they have expanded to more than 30 employees and have customers in nearly every state. We talk about the key factors that enabled them to find their product-market-fit and show value to their customers.   On this episode you’ll learn:   How claims and consumer data can be used to help consumers make better decisions about health plans. Why employers and health plans are interested in providing this service to their employees and members. Why it's important to engage consumers throughout the year to help them get the most out of their plans for the least amount of money. How the CMS Patient Data Access Rule creates new opportunities to empower healthcare consumers. How to get feedback early and often when launching a new product, and other advice for finding your product-market-fit.   About Nayya At Nayya, we believe there is a better way to choose and use healthcare benefits. A more transparent, less confusing way where consumers feel more confident in their decisions. We focus on decision support and benefits engagement. It’s one of the most stressful and challenging situations consumers face – and we see that as an opportunity to do good. We’re excited to deliver a new experience to consumers – where they choose and use their benefits through our software, data and AI engine.   Learn more: Web: https://www.nayya.com/ Nayya Series A Announcement <a href= "https://www.prnewswire.com/news-releases

What is the role of a doctor at a digital health startup? Why are they needed? What jobs will they do? How do you find one? And how can you tell if they will be a fit for your team? If you’re a doctor considering this move, you may have similar questions in reverse. What will it be like to be a “digital doctor”? How can I find opportunities? What new skills will I need to develop? How can I tell if the digital health startup I’m looking at has a shot? On this episode we talk with Sven Jungmann. He’s a medical doctor with additional degrees in Public Health, Public Policy, and entrepreneurship. He’s the Chief Medical Officer at FoundersLane in Berlin, Germany, where he advises digital health startups, and helps align other doctors with startups too. I can’t think of anyone more qualified to discuss this topic with!   You’ll learn:   Why many digital health startups really do need a doctor on their team. What the transition is like when moving from practicing medicine to the startup world. The drawbacks to doing this if you’re a doctor. Six skills that make medical doctors indispensable for startups What a non-clinical founder should do to bring themselves closer to the medical side. That the problems in the U.S healthcare system are not unique when it comes to a lack of prevention and woefully inadequate data sharing. Why Corporate Venture Building is a powerful way to drive innovation.   We also discuss Sven’s new book, FightBack NOW: Leveraging your assets to shape the new normal and his work at FoundersLane.   About Sven Jungmann   Sven Jungmann is a medical doctor with additional degrees in Public Health (Master, LSHTM), Public Policy (Master, Oxford), and entrepreneurship (Postgraduate Diploma, Cambridge). He worked in hospitals for several years. Today, as Chief Medical Officer, he heads the Healthcare Vertical for FoundersLane and advises start-ups in the digital health sector. He’s co-author of FightBack Now. Connect with Sven on:  LinkedIn Instagram Twitter   About FoundersLane   FoundersLane is a Corporate Venture Builder that helps established organizations launch new digital offerings in the healthcare and sustainability space. FoundersLane is formed by serial full-stack entrepreneurs with experience in building tech companies from scratch to scale. Learn

Machine Learning in healthcare (and Artificial Intelligence in the broader sense) is real and is being used today. The problem is, it’s difficult to sort out what’s real and what’s hype. Opinions on the matter range from “it’s all hype and BS” to “AI is revolutionizing healthcare and replacing doctors”. The truth, of course, lies somewhere in between. Today we talk with Josh Miramant, CEO and Founder of Blue Orange Digital, to help you sort this out. After listening you’ll have clarity on what Machine Learning is, an understanding of what’s possible in healthcare today, and a practical expectation of what’s coming next.   In this conversation we’ll:   Help you understand the terminology. What is Machine Learning? What is Artificial Intelligence? What is everyone talking about!? Take the “magic” out of Machine Learning and help you understand at a basic level what’s happening here. Layout the need for data quality and data fidelity (i.e., the usefulness of data for a purpose). Along with data acquisition, this is the first thing you’ll need to address. Discuss practical applications of Machine Learning that are being used productively in healthcare right now. This is “Applied Machine Learning” and there are many solved problems that add value in healthcare administration, patient acquisition, costs, pricing models, etc. Dig into the research and operational applications of machine learning. These include things like image detection, diagnosis, etc. like we discussed with Eric Topol (Episode 91). These applications are real and they’re improving, but they aren’t replacing doctors anytime soon. Then we touch a bit on the theoretical. Things that are happening in the lab that are incredibly exciting but have a way to go before they have real-world applications.   About Josh Miramant Josh Miramant is the CEO and founder of Blue Orange Digital, a top-ranked data science and machine learning agency with offices in New York City and Washington DC. Miramant is a popular speaker, futurist, and a strategic business & technology advisor to enterprise companies and startups. As an example of thought leadership, Miramant has been featured in IBM ThinkLeaders, Dell Technologies, Global Banking & Finance Review, the IoT Council of Europe, among others.   Connect with Miramant:   LinkedIn: @joshmiramant Email: [email protected] Twitter: @jmiramant   About Blue Orange Digital Blue Orange Digital is recognized as a <a href= "https://