By Dan Schulte, MBA, CHFP, senior vice president, provider operations, HGS.
Dan Schulte
As outbreaks of COVID-19 continue to crop up around the country, the ongoing public health crisis is just one facet of the situation; economic disruption is another grim reality, including for the healthcare industry itself. The American Hospital Association estimates COVID-19 will result in losses of $202.6 billion for the country’s hospitals and health systems due to factors such as the cancellation of nonemergency procedures; the high cost of treating a patient with COVID-19; and the millions of Americans who could become suddenly uninsured due to the economic implications of the virus.
Providers must improve cash flow to remain stable, which will require new revenue cycle management strategies supported by technology. Artificial intelligence (AI), machine learning (ML), and robotic process automation (RPA) together can provide an effective automation strategy that will help healthcare systems recover and retain more of their revenue — while boosting patient satisfaction — as they navigate this costly crisis.
Nine revenue cycle functions ripe for automation include:
Prior authorizations: With manual prior authorizations requiring an average of 21 minutes and as much as 45 minutes per transaction, the opportunity to drive cost savings through automation is significant. Because of well-defined business rules in this area and structured data that systems exchange in conducting prior authorizations, RPA can significantly improve this process: Implementing a “bot” that can perform the same tasks repetitively and without variation can help reduce error rates, so patients can get the authorization they need quickly, and lower the likelihood of claim denials.
Eligibility and benefit verification: While fully electronic transactions account for more than 84% of all eligibility and benefit verification transactions — a positive development — more can be done to reduce wasteful spending in this part of the revenue cycle. As the starting point for care delivery, this function represents a significant potential for improvement via intelligent automation. The focused manager will ensure that the EDI tools bring the right data across to the patient accounting system (timely, accurate and complete data), and will have the necessary add-ons to find the last 15% of data from screen scraping and outsourcing to a reliable service provider.
Since the start of the COVID-19 outbreak, the healthcare industry has had to adapt to closures, adopt automated processes and utilize telehealth more than ever before. Providers have been inundated with patient messages, phone calls and payments; in need of mobile-first solutions and custom workflows.
Relatient, a SaaS-based patient engagement company, helped University Physicians’ Association (UPA) to revamp its patient billing process for medical practices across East Tennessee, streamlining revenue cycle management (RCM) operations and extending a patient-friendly financial experience to patients and caregivers. The result was a 43% increase in patient payments with mobile-first billing.
Flexibility is key to meeting patient needs, and Relatient granted UPA the ability to extend self-service tools like mobile payments to the majority of patients who want this kind of access without neglecting those who still prefer to interact over a phone call. In addition to Relatient’s work with UPA, there are many other simple, practical ways to improve the patient experience.
The COVID-19 pandemic has indeed shed some light on the healthcare sector, especially in terms of how services are rendered. Even though remote care services have been around for a while, they have only now started gaining popularity.
These services continue to revolutionize the healthcare sector even beyond the pandemic, which is a welcome innovation. With the speed at which the world is moving, and with the changes that come with it, healthcare cannot remain the same since livelihoods depend on it. There is the need, however, for a more customer-centered approach when it comes to telehealth, that will be discussed in this article.
Why must telehealth focus on the customer experience?
There are a lot of benefits of telemedicine and telehealth in general, and there is evidence to prove it. It is cost-effective and speeds up the process of diagnosis, not to mention the convenience it brings. However, in conversations about the implementations, one of the things that are not at the top of the list is patient (or customer) satisfaction. This is surprising because when it comes to healthcare, patients need the reassurance of the results of the service they have paid for, and they need to reap all the benefits of the service and more.
What it means to create a patient-centered experience is to consider the patient’s satisfaction before other features, including how sophisticated the technology is, when evaluating the platforms. There are a few questions to answer in this regard. For example, how easy would patients find it to use the platform? Will they be eager to use it? Would the service be faster than when receiving care in person? And what is there any significant difference in the quality and outcomes of the service?
In creating a telehealth platform that answers these questions and many others for the benefits of the customer, there is an opportunity to reap certain benefits. For one, the financial incentive that comes from taking this initiative cannot be passed on. Facilities and organizations that go this route also get to gain new clients and hence more business.
Medial EarlySign’s mission is focused on finding extraordinary clinical insights inside billions of ordinary EHR databases. With more than 10 years of longitudinal data, Medial EarlySign’s data sets cover more than 20 million patient lives and 150 million patient years. They include geographically, ethnically, racially, and economically diverse populations with diverse health statuses.
Medial EarlySign has developed a secure HIPAA-compliant information architecture to protect patient data security. Additionally, internal procedures ensure high quality conduct of clinical studies in compliance with applicable international regulations and legal requirements. It works to safeguard the rights and well-being of participants, including privacy and confidentiality of their information, and the accuracy and completeness of the reported data.
What is the single-most innovative technology you are currently delivering to health systems or medical groups?
Medial EarlySign develops AI-based software solutions that help healthcare systems with the early detection and prevention of high-burden diseases, such as lower GI disorders, diabetes and related complications, COVID-19 and flu complications and more. It is the only company to successfully achieve peer-reviewed and clinically validated insights by leveraging routinely available medical information, such as blood test results and other EHR data, to assist in early prediction, prioritization and intervention for improved patient outcomes.
How is your product or service innovating the work being done in these organization to provide care or make systems run smoother?
EarlySign’s proprietary machine learning-based solutions analyze the dozens of “hidden” factors residing in electronic health records, including routine laboratory tests results, demographics, medications and diagnostic codes, to accurately predict who is at highest risk of having or developing specific life-threatening conditions, creating opportunities for early intervention strategies and more effective prioritization of resources. Medial EarlySign’s AI-based software models are already being used by global healthcare systems to help detect and prevent high-burden diseases.
Using EarlySign solutions, providers have begun leveraging data and delivering personalized, preventative interventions that has helped shift the conversation of the medical community from sick care to health care.
What is the primary need fulfilled by the product or service?
With the move to value-based care, health players need to be more effective and able to reach out to individuals with rising risk trajectories. Medial EarlySign enables this with a practical approach and focused solutions that allow short deployment times and demonstrate clear value, while the use of routinely available data can address large global populations.
Having your child suffer from childbirth is among the most gut-wrenching things that a mother has to deal with. There are many mothers who feel guilty about the hardships that their child has to go through. Birth traumas like brachial plexus injuries can have long-term effects. Thankfully, the healthcare industry is now receptive to advancements in diagnostics, therapies, and overall management of such cases. In this post, we’ll look at the current diagnostic practices and advanced treatment options available for brachial plexus injuries.
Current Diagnostic Modalities
Some of the currently used diagnostic modalities for damaged brachial plexus include:
Diffusion-Weighted Magnetic Resonance Neurography
In the past, most doctors would use standard magnetic resonance imaging (MRI) to localize the injury, specifically near the damaged nerve roots. However, without a 3-D image of the nerve sheaths, it was difficult to fully visualize the extent of the injuries and the adjacent structures.
Diagnostic modalities have evolved to include diffusion-weighted magnetic resonance neurography that allows doctors and surgeons to see the structures more accurately with 3-D images. Due to this, medical professionals can now make a proper assessment of how to approach treatment.
The government is determined to see that all healthcare institutions use electronic health records (EHRs) and electronic medical records (EMRs). Their features, after all, streamline the healthcare process. Many physicians and healthcare professionals, however, remain reluctant to implement these records, overwhelmed by the complex system.
Although inefficient systems can make physicians a “slave” to their EMR/EHR, the software increases workflow efficiency and preserves critical medical information when implemented properly.
EHR and EMR implementation is a costly affair. The software, hardware, implementation assistance, support, training, and ongoing fees consume a large chunk of your planned capital investment.
According to government reports, the minimum cost of purchasing and installing an EHR/EMR system is $15,000, while the maximum is $70,000 (depending on the provider). Unplanned expenses may also add to the total cost of implementation. Finding financial resources for EHR and EMR is a major hurdle, especially for smaller practices.
The software cost is one of the reasons that discourage healthcare institutions from investing in EMR and EHR. Still, the benefits significantly outweigh the implementation expense; getting an EHR/EMR system is more cost-effective in the long term.
When the pandemic first hit the world, everyone was distressed, and many businesses began to fail. However, people have started to accept the new normal that comes along work from home and social distancing. The new world order has paved the way for different opportunities for people.
In simple terms, telemedicine provides treatment to a patient while maintaining distance. Multiple modes of communication can be employed, including via text, video or audio call, and so on. You can refer to the given article for more details regarding the future of telemedicine startups after COVID-19.
Increasing demands for telemedicine
From hospitals to small clinics, all of them are brimming with people suffering from coronavirus. There is no place to take more patients as they have exceeded their current limits.
Moreover, people are trying to avoid such places. They prefer to receive treatment through telemedicine. Furthermore, a lot of health care providers have lost their lives trying to cure and help people. So, investing in telemedicine can save millions of lives in the near future.
To start this off, we would first of all look into the definition of stem cells.
What Are Stem Cells?
Stem cells are undifferentiated biological cells that can differentiate into distinct specialized cells and divide to produce more stem cells through the process of mitosis.
They are mostly found in multicellular organisms, and in humans, they can be divided into two broad classes:
Adult stem cells – They are multipotent stem cells, this means that they can differentiate into a range of other cell types. These adult stem cells can be found in a few locations in the body such as bone marrow, adipose tissue or gonads. Also, they are gotten from the umbilical cord of newborn babies, or their placental matter.
Embryonic stem cells – These cells are derived from an embryo at a point between fertilization and implantation. At this stage, any of the cells can differentiate to form any tissue in the body. From a medical point of view, the use of embryonic stem cells is still questionable in terms of their safety for the adult body. Ethical restrictions on the use of unborn children’s tissues are also a factor in preventing treatment using embryonic stem cells.
Functions of Stem Cells
The functions of stem cells are numerous judging from their ability to repair other cells and differentiate into new cells.
In adults, stem cells along with progenitor cells act mainly as repair systems for the body. Their main function is the repairing and replenishing of adult body tissues.
In developing embryos, stem cells have the ability to differentiate into all the specialized cells. They could differentiate into endoderm, mesoderm or ectoderm. Stem cells, in general, also function to maintain a normal overturning of regenerative tissues such as blood, skin or intestinal tissue.
How Are Stem Cells Being Used in the Medical Field
Ever wondered what we can do with stem cells and cell cultures? Well, the answer to that question is given below.
Based on their potency and potential for self-renewal, stem cells can be used to treat a number of diseases. The benefits of stem cell uses today ranges from things like wound healing and teeth repair to managing and curing post-stroke, eye diseases, neurological disorders and other conditions that were initially thought to be incurable.
The functions aren’t limited to that, because advances in stem cell research are developing ways to correct a lot of genetic and mutational abnormalities. This could lead to a lot of stem research breakthroughs.
Now, you have been given a broader view of stem cells and their potential, let us dive into the meat of the matter.
