Neri M. Cohen, MD, PhD, FACS, FCCP

I’ve been given advice that the fastest way to monetize HER Heard without charging the end user (woman) is trackers and selling data. Instead, I’d like to build something more trustworthy. I don’t want to be in a headline like this. If you are not paying, then you are the product (you/your data are being sold). There are newer ways to deindentify data or even to aggregate things women search for that can be of interest to various stakeholders. In theory that could be okay to sell, but in a post-Roe world with laws encouraging bounty hunting, I am vetting the choices ahead. I am all for moving fast, without breaking things.

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How can we build the right infrastructure to support remote patient monitoring (RPM) for all kinds of patients in all kinds of settings? Check out this new paper in NEJM Catalyst by recent medical school graduate, Nina Singh, MD on why and how to create the core capabilities within a health system , taking a different, more scalable approach -- "the focus is on building tools and workflows for practices that are interested in using RPM rather than on building centralized RPM programs for specific high-need populations." Practical tips include a #playbook for RPM and much more: "Exploratory features include a playbook detailing best practices for RPM use across NYULH, a device loaner program, direct Bluetooth pairing (as opposed to Bluetooth syncing and transmission of data through data aggregator pathways), systematic offboarding workflows for inactive or stable patients, and small centralized programs being developed among groups of practices with similar patient populations and needs (e.g., primary care faculty group practices managing hypertension). Super proud of Dr Singh's work during her year off with Nader Mherabi and others in informatics at NYULANGONEMEDICALCENTER. She's heading to University of California, San Francisco Department of Medicine to start her internship--what a star! Talmadge E. King, Jr. MD Robert Wachter Atul Butte https://lnkd.in/e-VpGie7

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This weekend #CMS issued a #Medicare Final Rule with new #PartD technical requirements. In addition to regulatory updates, this rule itself is a crucial reminder for #MA plans:  ✅ This FR codifies previous Proposed Rules which remained unfinalized. ✅ This FR reminds plans that unadjudicated #MedicareAdvantage #StarRatings proposals (including increase of #Improvement measure #HoldHarmless from 4 to 5 stars and removal of cutpoint guardrails from non-CAHPS measures) remain alive and can be finalized by CMS without additional rulemaking. From a technical perspective, among other things, this FR:   1️⃣ Requires Part D plans, prescribers and dispensers to to exclusively use NCPDP Formulary & Benefit standard for electronic transmission of formulary/benefits info (including ePA) by 1/1/2027. 2️⃣ Requires RTBTs to comply with RTBT standard v13 (adopted by ONC) by 1/1/2027. 3️⃣ Codifies many technical/technological details to align CMS and #ONC. If you’re not in the pharmacy space, why should you care? Here are 4 reasons: ⚠ This illustrates that pending high-impact #Stars changes can still be codified. ⚠ CMS admits this FR is needed because recently-codified RTBT requirements were created in absence of industry-wide standards, and as ONC catches up to policy needs, new regs will be established despite impact to providers, plans and vendors. ⚠ Last week’s restated Star Ratings to correct #Tukey errors may increase 2025 Medicare spending by up to $1 billion. CMS may seek methods by which to make that change budget neutral, which the proposals to remove guardrails and change the Improvement measure Hold Harmless provisions could achieve. ⚠ January's #Interoperability FR was complex and TL;DR for many, but it will trigger more #HHS Interagency alignment and regulatory adjustments sooner rather than later. Here are a few things insurors, providers and vendors outside of Part D should consider in response to this FR: ✔ How ready are you for January’s Interoperability FR? ✔ What gaps exist between your current status and looming Interoperability requirements? ✔ How might greater CMS/ONC alignment impact your organization? ✔ What strategic investments do you need to consider to ensure your readiness? With #PartDRedesign and the #IRA about to kickstart the most disruptive pharmacy changes since Part D launched in 2006, early adopters of these new requirements will lead the way in #CAHPS and #memberexperience. This is a great time for Stars teams to continue reminding executives that ambiguity and uncertainty is exactly what CMS wants! They want free markets to force us to strive as high as we're willing in order to reap #QBP rewards. Whether you are seeking corporate or personal leadership development and growth, our Reality-Based Improvement Institute has been designed to drive success amidst uncertainty. Reach out if you’d like to learn more. #WhatGotYouHereWontGetYouThere #LetsRoll ⭐ ⭐ ⭐ ⭐ ⭐

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In a recent report, only ~20% of healthcare executives claimed that they fully trust their data. At Fullsteam Health, we think that % is way too low. We're committed to reversing this trend with our automated data curation platform which was initially developed at Duke to address this very issue and allow for fast access to data that is needed and that has been cleaned, grouped, and continually monitored. https://lnkd.in/epWvPTDV

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How to improve healthcare by marrying value analysis with clinical outcomes to elevate patient care. Dr. Hudson Garrett, FACHDM, FAHVAP, FACHE, FSHEA, FNAP, FIDSA, Karen Niven and Anne Marie Orlando explore this intersection in there insightful upcoming article coming next week! #HealthDataManagement #ValueAnalysis #ClinicalOutcomes #EvidenceBased #HealthcareExcellence. 

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The Association of Healthcare Value Analysis Professionals (AHVAP) appreciates our ongoing collaboration with Health Data Management and Mitchell Josephson, FACHDM as we advance safety across the healthcare continuum. Check out our next article highlighting the utilization of evidence-based medicine in the evaluation of new products and technologies as part of the clinical value analysis process. #AHVAP #HDM #valueanalysis #clinicaloutcomes #valuebasedcare #EBM #EBP #evidencebasedcare

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Mandatory bundles in surgery are a bi-partisan objective, and (in)ability to optimize cost/quality will dramatically impact hospital P&L. Regular insights from granular data , and AI-based decision support are the only way to systemically reduce unwanted variability and be both profitable and high quality.

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Also don’t outsource your hospital’s core services to a GPO ran by foreign PE… I do find it so odd that Vizient’s own contracts couldn’t stand on their own so they had to create a aggregation group with Mayo Clinic called Capits. (https://lnkd.in/gpiVDKvn) Which by the way Mayo Clinic is being sued because not only does Mayo control pricing on supply chain contracts for Vizient, but guess who controls pricing on their self insured insurance plan. (https://lnkd.in/guvx5mqr) Oh and as of November of last year Mayo Clinic lead their state in adverse healthcare events. (https://lnkd.in/gXsPi2sw) Should I go on or have I made my point clear on why Oklahoma hospitals should not blindly follow Vizient, Captis, and the Mayo Clinic?

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🎙 Tune in to our Advancing Precision Oncology Podcast! 🎙 This 3-part series will explore how biomarkers and advanced testing capabilities are expanding patient access to precision oncology and improving health outcomes for cancer patients. Delve into the rapidly evolving landscape of biomarker testing, the benefits of integrating multi-data sources and the challenges and opportunities that lie ahead. 🔬💊 Listen to Part 1 with Dr. Gwyn Bebb and Wyatt Gotbetter: https://lnkd.in/eAuvzhFj #Podcast #Oncology #Biomarkers #NovelInsights

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Arlen Meyers, MD, MBA insights on #physician #innovation and #entrepreneurship are among the clearest and most impactful I’ve encountered. He lays out a sober assessment of the current state of physicians’ role in improving heathcare, challenges we encounter to leading transformation, as well as providing solution frameworks and education on these topics. Follow his LinkedIn posts here, dive deeper in his Substack, join the Society of Physician Entrepreneurs (SoPE), and check out his book, Digital Health Entrepreneurship. https://lnkd.in/geeAYKDq

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90% of startups fail. So why do healthcare initiatives at large corporations fail at about the same rate? Many of these were launched with great fanfare but announced closures a few short years lateer. A few reasons might be: 1. Mission but no strategy: it's not enough to have a mission to treat a specific population or group of employees, you have to be in it for the long haul with a strategy that will evolve over time. 2. Misunderstanding of healthcare complexity: many executives believe they understand the problem and use tools from other industries to solve healthcare issues. You can't always bring things that work in banking, finance, retail for example. 3. Execution: rarely does leadership hire people who have a track record of execution in healthcare. I'm talking about people who have been able to gut through the losses. This is probably the biggest misstep. You agree with these reasons? What would you add to these? #healthcare #failures https://lnkd.in/etzZywnK

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In #healthcare #interoperability news, The U.S. Department of Health and Human Services (HHS), through the Office of the National Coordinator for Health Information Technology (ONC) and its Recognized Coordinating Entity (RCE), The Sequoia Project, announced that the Trusted Exchange Framework and Common Agreement #TEFCA Version 2.0 (CA v2.0) has been released! "These enhancements and updates mark a huge step forward for TEFCA as it meets the promise of seamless nationwide exchange at scale." 🌐 What Is It? The U.S. Department of Health and Human Services (HHS) has released Common Agreement Version 2.0 (CA v2.0). This agreement sets the rules for securely sharing health information across different networks 🔑 Key Points: 🔸 TEFCA Exchange via FHIR: CA v2.0 now requires support for Fast Healthcare Interoperability Resources (FHIR). This means easier information exchange between health networks and better access to personal health data via apps. 🔸 Qualified Health Information Networks (QHINs): Seven designated QHINs can adopt and implement this new version. 🔸 Terms of Participation: Participants and Subparticipants must comply with specific requirements to join TEFCA. 🔸 Big Step Forward: CA v2.0 brings us closer to seamless nationwide health data exchange. 🚀 Why It Matters: This release enhances healthcare connectivity, making it easier for everyone to access and share vital health information. 🌟 Read more in this press release from ONC! 🔗 https://lnkd.in/eZPczt8e

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Great new insight from our Pivotal Analytics team. We spend a lot of time preaching about the value of localized data and this infographic is great way to see that in action - demand for Cardiology varies a LOT on a market-to-market basis. Utilizing claims data as an input allows us to tailor insight to a local population, something we see far too few people doing on a regular basis - I continue to be surprised how many strategy leaders rely on demand intel driven by national benchmarks.

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Information Systems Research (ISR) has recently published a new article to the Articles in Advance page:   Article Title "How Hospitals Differentiate Health Information Technology Portfolios for Clinical Care Efficiency: Insights from the HITECH Act"   Authors Jessica Pye (deceased), Arizona State University Arun Rai, Georgia State University John Qi Dong, National Technological University, Singapore   Problem definition We examine how hospitals differentiate their HIT portfolios in response to cost inefficiencies in clinical care processes and HIT policy uncertainty.   Relevance Adapting HIT portfolios to address cost-based shortfalls and policy uncertainty is crucial in shaping service delivery and impacting care costs, making it a key concern for policymakers and hospital decision-makers. Theoretical foundations We combine behavioral theory and institutional theory to explain how hospitals differentiate their HIT portfolios through idiosyncratic learning in response to cost-based performance shortfalls and shifting isomorphic pressures from changes in HIT policy uncertainty.   Methodology We constructed a panel dataset of 11,316 hospital-year observations from 3,319 U.S. hospitals over 2007–2014 to investigate how hospitals’ HIT search differentiation is influenced by cost-based performance shortfalls and policy uncertainty during the phases of the HITECH Act, from conceptualization to enactment to enforcement.   Results Our research provides a key insight: Moderate policy uncertainty, particularly during the HITECH Act's phases, significantly shapes hospitals' search for novel HIT solutions to address performance shortfalls. Hospitals enhance their search differentiation when uncertainty decreases from conceptualization to enactment but reduce it as uncertainty diminishes from enactment to enforcement.   Contributions Our findings surface the utility of combining the behavioral theory of the firm with institutional theory to explain the interdependence among a hospital’s cost-based performance shortfalls, HIT policy uncertainty, and HIT search differentiation. They show how hospital managers and policymakers can reorient their strategies to leverage the interdependencies among these elements, thereby encouraging the pursuit of innovative HIT systems over widespread imitation, to effectively address cost-based performance shortfalls in hospitals.   Short quote Unlocking Healthcare Innovation: hospitals excel in deploying new technologies through peer benchmarking and navigating moderate regulatory uncertainty. Dive into our research to see the transformative impact of this benchmarking strategy combined with moderate policy uncertainty!"   #HealthcareInnovation #HITECHAct #PolicyImpact   Keywords search differentiation, health information technology, performance shortfalls, policy uncertainty, behavioral theory of the firm, institutional theory   Link to article: https://lnkd.in/djh84uad

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And why? With the EPIC vs Particle Health debate, the business-side of the situation is just being pushed even more towards the front. TEFCA participation is voluntary. Regional HIE participation is voluntary. Even Care Everywhere is voluntary for EPIC-using systems. You know what is mandatory? Patient access. Why are we depending on competing businesses to make it work? The patient has the most at stake and has the most interest in information flowing and getting the best outcome. Give them the power to participate. The framework is already there. IYKYK, but that's what we do at Primary Record and that's why we do it.

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What are some of the best examples of how AI is helping tackle and improve patient care? How is AI impacting patients in real time? These were some of the questions we tackled in a wide-ranging panel discussion at the recent Fortune Brainstorm Health conference. I came away inspired by the knowledge that we are actively deploying the technology in a multitude of ways, and as it evolves, its impact will only continue to grow. In a discussion moderated by Fortune’s senior writer Erika Fry, several of us shared insights into how it’s being utilized for precision care in women’s health, to assist clinicians with patient note-taking, in medical devices that deliver therapeutics, in assessing mental health, and in Carrum’s case, how it enables rigorous provider quality evaluations and in identifying patients at risk for chronic health issues even before they’re aware of it. # My take is that we can harness AI for virtually every component of patient care, but the human element is still key for the critical context we need to make decisions, and this is where care concierges who pull all the pieces together and steer the patients matter the most. AI has the potential to dramatically enhance the care concierge team's performance and help them serve patients more effectively. # Second, the challenge with healthcare claims data is that it’s not a clean set like it is in other industries like financial services. So cleaning up claims data is a project in itself. With patients facing critical health issues, weaving data into the mix needs to be done with care so it truly enhances the patient experience. We use AI to predict which members in a given population are on a path to an acute care event in the near future. This is where I see it truly making a difference - until now, health care has been sick care. But with sophisticated data analysis, we can upend that so health care is preventative care. Plus, data we currently generate from handling thousands of patients going through surgery and cancer care also informs all the potential ways to help future patients avoid pitfalls and navigate their care better. #fortunehealth #patientcentricai #patientexperience

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Most viewed in the last 7 days from JAMA Health Forum: This JAMA Forum discusses 3 types of assets (financial, physical, and social) that unlock access to resources and shape population health. https://ja.ma/3UA1Bhi

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Last Friday, we chatted with Carrie Liken and Christian J. Ward to discuss #AI and how its innovations are impacting #healthcare. Carrie explained the importance of recognizing that #providerdata is actually "#inventory." Understanding the intricacies of these data -- especially in the patient journey -- will be key for organizations taking a leap forward in combining quality patient care with cutting-edge AI #technology. Listen to the entire podcast here: https://okt.to/nzuYEW #HealthTechnology #ArtificialIntelligence #HealthcareMarketing #GEO #SEO

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