There is no question that artificial intelligence (AI) has tremendous implications for the world of healthcare. The list of applications is long. From using machine learning to analyze medical images to facilitating patient communication through chatbots and even using predictive tools to identify high-risk patients, AI has the potential to enhance healthcare systems.
And that’s not to mention all the time AI can save on the backend by automating things like data entry and appointment scheduling, thereby granting healthcare professionals more time to focus on actually diagnosing and treating their patients.
Still, many in the industry have approached this new technology with trepidation. Potential violations of medical privacy laws are a perennial concern for healthcare organizations, and AI—with its seemingly opaque algorithms and its potential susceptibility to breach—can seem like more trouble than it’s worth on this front.
The reality is more complicated. Yes, generative AI does present a risk to healthcare organizations when handled without the proper precautions, as any technology does. In fact, nearly 60 percent of healthcare industry respondents to a recent survey conducted by Portal26 cited at least one GenAI-related security or misuse incident in the preceding six months. But with the right security mechanisms in place, the benefits of AI significantly outweigh the possible downsides.
The problem is that—as the same survey revealed—almost 30 percent of healthcare respondents said their employers lack any guidelines or policies at all surrounding AI usage. Building those guidelines—implementing AI as carefully, and cautiously, as possible—is essential to realizing the true possibility of this technology.
Secure full visibility into your AI systems
At the center of any concern around AI and medical privacy violations is protected health information (PHI). PHI encompasses any information relating to:
The past, present, or future physical or mental health/condition of an individual.
The provision of health care to that individual.
The individual’s payment history.
Feeding PHI into the large language models (LLMs) that are at the foundation of GenAI can pay massive dividends to healthcare organizations looking to optimize their day-to-day operations. But successfully achieving this objective, with a minimum of risk, requires taking an extremely proactive attitude towards precisely how this data is being used.
The key word here is “visibility.” If you are going to be feeding massive quantities of sensitive PHI into your systems, you need to ensure that you are aware of what it is, who is using it, and for what purpose. The need for this is especially acute given the rise of “shadow AI”—i.e., AI-related activities occurring out of sight of those tasked with overseeing it.
Unsurprisingly, 67% of healthcare industry respondents to the Portal26 survey are concerned about shadow AI at their companies. It is a problem that is growing daily—and one that can only be curtailed through increased visibility.
MDaudit announced today the release of Service Provider Workflow. This latest enhancement to its industry-leading billing compliance and revenue integrity platform supports billing when rendering providers differ from service providers, reducing audit risks related to the billing of split/shared services.
Under changes to its Evaluation and Management (E/M) guidelines, the Centers for Medicare and Medicaid Services (CMS) require split/shared services — which are performed jointly between a physician and a non-physician practitioner (NPP) in the same group and in a facility setting — to be reported by the clinician who performs the substantive portion of the patient visit.
To qualify for billing under the physician’s national provider identifier (NPI), which nets a higher rate than those billed by NPPs, the physician must have performed more than half of the provided care, as determined either by time spent or through evaluation of key components including history, examination, or medical decision-making.
“Service providers perform and document services under the supervision of the rendering provider. However, under current CMS E/M guidelines, the claim is no longer billed by the rendering provider unless they have performed a substantive portion of the care, which introduces a new layer of complexity and compliance risk into the billing process,” said Catherine Proctor senior product manager, MDaudit. “MDaudit’s new Service Provider Workflow functionality reduces that risk by allowing customers to include the service providers who aren’t on the claim as part of an organized audit.”
Users can efficiently organize line service providers into provider groups and audit both professional- and hospital-based service providers. It also features the flexibility to perform audits at the rendering, attending, or service provider level, organize audits at the line service provider level, and exclude cases from rendering/attending provider-organized audits when different line service providers are involved.
“The benefits of this new process are numerous, including a better root cause analysis for errors and the ability to provide feedback directly to documenting service providers while more easily targeting residents, ‘incident to’ providers, locum tenens, and split/shared services,” said Proctor. “Service Provider Workflow features were popular asks from the MDaudit community, and we are excited to deliver them to our clients to help further reduce their audit risk.”
Any doctor’s dream is to open a medical practice and to have patients line up the next day. Unfortunately, it’s a lot more difficult than this. A quick online search for marketing tips gives you hundreds of suggestions, but most don’t factor in the fact that the medical field is a unique industry. Patients don’t leave their houses to seek medical services from just any doctor, as building trust is a process. Here are tips you can use to market your medical practice.
Target the right audience
What conditions are you treating? Are you a consultant, a gynecologist, a pediatrician, or an obstetrician? If you are a pediatrician, you should market your business to mothers and fathers with newborns and toddlers. Your marketing message should be specific on services offered and expressed in a language that exudes professionalism and inspires trust. The information should drop the veil from the first word, leaving no room for second guesses.
Build a website
By now, you must have heard of Internet marketing, which entails establishing a presence on various Internet platforms. A website acts as an online version of your physical clinic. It contains all the necessary information on your practice, such as qualifications, licenses, recommendations, and services offered. It should also feature a blog showcasing success stories and free medical advice that links to your business.
Network with other local businesses and professionals
Networking with local businesses is a great way to cross-promote your businesses. For instance, your medical practice can partner with a local personal injury lawyer like this Motorcycle Accident Lawyer in Duluth, GA, for the benefit of both of your businesses. They can refer injury victims to your hospital and vice versa. Networking and collaboration opportunities allow you to build a valuable pool of resources for your medical practice that you can leverage. Cross-promotional strategies you can consider include:
Healthcare has a vibrant startup and innovation ecosystem, but that doesn’t mean everyone shares the perks that come with technological developments. Historically, payors have often been ahead of the game in adopting and benefiting from new tech, forcing providers to play catch up.
But artificial intelligence (AI) is changing the game. A persistent trend I’ve witnessed is the steady rise of providers prioritizing technology – especially AI – to inform strategic priorities and address chronic headwinds such as staff shortages, increasing cost pressures, and slow reimbursement times, to name a few.
As healthcare leaders catch on to the enormous potential of AI to combat thorny issues, AI will take center stage next year, reshape the larger healthcare ecosystem, and begin to even the playing field between payor and provider.
As the end of the year approaches, here’s how I see this playing out in 2024:
Autonomous medical coding will be widespread — if not the norm.
The latest health IT report from Bain & Company and KLAS Research highlights the increasing importance of software and technology. Per the report, 70% of providers think AI will have a more significant impact on their organizations this year vs. last year, and an impressive 56% of those surveyed view software and technology as one of their top three strategic priorities, with revenue cycle management (RCM) coming in at a resounding first place. With many health systems focused on reducing administrative burdens for clinicians and a continued shortage of medical coders, autonomous coding adoption will surge.
Large language models (LLMs) like ChatGPT won’t work as advertised.
There’s plenty of commotion about the capabilities of language models, but they will likely disappoint when functioning as the core of autonomous coding engines. However, they will be enormously valuable in solving smaller pieces and edge cases, pushing coding automation rates to 100% for all the high-volume outpatient specialties.
The non-emergency medical transportation (NEMT) industry plays a crucial role in the lives of individuals with special medical needs. They often rely on NEMT providers to ensure that they arrive at medical appointments on time. Therefore, any delays or scheduling issues can lead to anxiety and frustration, as well as incur additional costs for the patient.
Aside from meeting patients’ transportation needs, NEMT providers must adhere to safety standards and regulations if they want to ensure their business’s long-term sustainability. Additionally, healthcare facilities and insurance companies are more likely to choose providers with a track record of dependable service.
That said, if you’re in the NEMT business, efficiency and reliability are paramount. This is why it’s important to constantly seek ways to improve your services for your company to thrive in the competitive market. Read on to learn some practical tips on how you can improve your existing NEMT services.
Implement Advanced Scheduling Software
As mentioned previously, NEMT providers need to be prompt when transporting patients to and from their medical appointments. That’s why implementing an advanced NEMT scheduling software is a good way to help revolutionize the efficiency of your operations.
This software automates the assignment of trips, optimizes routes, and adjusts schedules in real-time. It does this by taking into account factors like traffic, patient preferences, and vehicle availability. This ensures that passengers are picked up and dropped off as efficiently as possible.
By Dr. Benjamin Barlow, chief medical officer, Experity.
As we evaluate the healthcare landscape following the COVID-19 pandemic, particularly the urgent care (UC) industry, facilities have undergone significant transformation. Patient behaviors and economic factors have converged to reshape the way people perceive healthcare.
For urgent care, access to the use of reliable, accurate data is critical to inform intelligent decision-making and clinic success throughout dynamic market conditions and changing consumer preferences.
Part of this adaption centers around redefining expectations and benchmarks to measure success by leveraging data-driven insights to ensure that UC clinics continue meeting the evolving needs of their patient population.
Changing Patient Behaviors
In 2019, urgent care clinics were a familiar and reliable part of the healthcare ecosystem. Patients sought their services for minor injuries, illnesses, and a range of non-life-threatening conditions. During the pandemic, patients visited for COVID-related issues like testing, vaccinations, and respiratory care, but were hesitant to visit medical facilities for non-COVID conditions in fear of contracting diseases.
Now, UC clinics are vastly different as patient sentiment has again changed. This transformation can be attributed to shifts in patient behavior and the economic impact of healthcare decisions. Additionally, the end of the public health emergency (PHE) has stripped millions of Americans of their Medicaid coverage, further amplifying the issue of healthcare access, and adding to the uncertainty surrounding patient healthcare coverage.
According to a 2022 Gallup report, 38% of Americans delayed seeking medical care due to cost implications, marking a 12% increase from the previous year. This reflects the growing concerns surrounding healthcare affordability, having a profound impact on when and where patients seek medical attention. Rising deductibles, changes in insurance coverage, and the economic conditions following the pandemic have led individuals to reconsider their healthcare choices, often delaying care until conditions worsen and requiring costly emergency room (ER) visits.
The worsening of these cases is often preventable if patients seek care when they first notice symptoms, and UCs can help fill this gap as an alternative to an ER visit. With robust education through marketing initiatives, the value of a practice and the services it can provide throughout the community will ensure patients have the information needed to make educated decisions about their healthcare.
Oftentimes, medical facilities need to focus on preventing overstock and out-of-stock supplies needed to get their work done or when needed to provide their patients with the best care. But like any other business, sometimes, those much-needed items such as tools, supplies, or even something such as a medical file are temporarily misplaced and become lost until someone just by chance finds it again.
This clearly destroys productivity for everyone involved; you’re missing much-needed items, you’re missing information and issues that need to be solved have to be placed on the back burner until something is found again or needs to be reordered. There’s no room for these productivity killers in the workplace, especially in the healthcare sector, where a patient’s health is at risk. Plus, there’s potential for financial loss and compliance issues, too. So, what steps could a health business take to prevent losing medical supplies, tools, files, or anything else? Where? Here’s what you need to know.
You Have to Start By Implementing a Robust Inventory Management System
When it comes to any business, whether it’s in the healthcare industry or not, you’ll have to focus all on this first. Essentially, the foundation of preventing medical supply loss is a well-organized inventory management tool system. So, it’s best to go ahead and implement an electronic inventory tracking system that allows you to monitor stock levels, track usage, and set reorder points for critical supplies. Plus, you’ll also want to regularly update and reconcile your inventory to ensure accuracy.
Oftentimes, medical facilities need to focus on preventing overstock and out-of-stock supplies needed to get their work done or when needed to provide their patients with the best care. But like any other business, sometimes, those much-needed items such as tools, supplies, or even something such as a medical file are temporarily misplaced and become lost until someone just by chance finds it again.
This clearly destroys productivity for everyone involved; you’re missing much-needed items, you’re missing information and issues that need to be solved have to be placed on the back burner until something is found again or needs to be reordered. There’s no room for these productivity killers in the workplace, especially in the healthcare sector, where a patient’s health is at risk. Plus, there’s potential for financial loss and compliance issues, too. So, what steps could a health business take to prevent losing medical supplies, tools, files, or anything else? Where? Here’s what you need to know.
You Have to Start By Implementing a Robust Inventory Management System
When it comes to any business, whether it’s in the healthcare industry or not, you’ll have to focus all on this first. Essentially, the foundation of preventing medical supply loss is a well-organized inventory management tool system. So, it’s best to go ahead and implement an electronic inventory tracking system that allows you to monitor stock levels, track usage, and set reorder points for critical supplies. Plus, you’ll also want to regularly update and reconcile your inventory to ensure accuracy.
MDaudit 
