Category: Editorial

Harris Data Integrity Solutions Taps Julie Pursley as Director of Industry Relations 

Julie Pursley

Harris Data Integrity Solutions, the leading provider of best-in-class person data integrity services and software, announced today the appointment of Julie Pursley, MSHI, RHIA, CHDA, FAHIMA, as its director of industry relations.

In this role, which oversees all facets of sales activities, Pursley will focus on building team and client success and business operational efficiencies through a strong blend of management, strategic selling principles, industry presence, and thought leadership.

“Julie’s experience, reputation as a change agent in the evolving health information landscape, and her focus on ensuring the integrity, accuracy, and completeness of health data complements Harris Data Integrity Solutions’ commitment to providing innovative person matching and MPI management solutions and services,” says Rachel Podczervinski, MS, RHIA, senior vice president, Harris Data Integrity Solutions. “We are fortunate to have her as part of our team and are excited to see the results of her focus on leading and cultivating strategic initiatives and to promote thought leadership and best practices in health information management.”

A recognized health information professional with broad expertise in health data integrity, interoperability, and industry relations, Pursley’s health information career spans more than 30 years and a variety of roles and settings. Prior to joining Harris Data Integrity Solutions, she was senior director of knowledge practice with AHIMA, where she previously served as senior director and director of health information thought leadership. Her academic career includes her current position as an adjunct professor with Charter Oak State College. She also served as a trusted advisor, patient identification and matching optimization sales executive, health information leader for an integrated healthcare delivery system, and owner of a regional medical transcription service.

Pursley is a prolific author, educator, and renowned public speaker who has shared her insights and expertise to audiences in the US and abroad. She holds a Master of Science in Health Informatics and a Bachelor of Science in Health Information Administration from the University of Cincinnati.

About Harris Data Integrity Solutions

Harris Data Integrity Solutions delivers industry-leading data integrity services and software to reduce duplicate medical records and minimize the ongoing cost of maintaining quality patient data. Created by the integration of two data integrity powerhouses, Just Associates, Inc. and QuadraMed Corporation, Harris Data Integrity Solutions offers the unparalleled depth and breadth of industry expertise and the commitment to ongoing innovation necessary to meet the changing needs of patients and healthcare organizations. Designed to address the broad spectrum of challenges associated with person matching and data integrity, its suite of advanced technology solutions and services includes CuraMatch automated duplicate resolution, SmartIX Enterprise Master Patient Index (EMPI) and MPI Clean-up Services. For more information, visit www.harrisdataintegritysolutions.com.

How is Medicare Advantage Policy Forcing Changes in Payer Tech Stacks?

Don Rucker, MD

By Don Rucker, MD, chief strategy officer, 1up Health

Medicare Advantage is a capitated health plan and the government, which pays for the plan, needs massive amounts of performance data to ensure that plans do right by patients and don’t scrimp on care. With capitation’s pre-determined payment rates, there is an incentive to do less.

The main tool CMS has to monitor performance is the Star Ratings system (though there are lots of other regs to be sure with this as a goal). The data needed to optimize Star Ratings is what fuels the revenue cycle stack in MA plans. In 2025, health plans must

How do these MA payment policies force a rethink about data and technology?

Star Ratings measures of clinical and customer plan performance are reported, then scored and rolled up into overall scores by CMS.  These are used to set MA plan, bonuses, other payments and are also reported to patients when they are choosing a plan. This incents two large patterns of behavior – one is to get the underlying data to show performance and the other is to improve that performance. Historically, quality measurement has involved lots of manual steps and even today some data is based on chart pulls and having humans read EMR computer screens. The modern world, a decade of EMR incentives, and modern APIs provide starkly different options to get and improve plan performance data.

Are classic claims dataflows enough or will payers need rich clinical data to succeed?

Not surprisingly, most of the measures deal directly with clinical performance. Today much of Star Ratings scoring is based on claims data – increasingly the winners will use clinical data both to measure performance and to improve performance. It is important to understand the scores are relative – if a plan uses more clinical data and gets a better score that means the plans that don’t use clinical data are more likely to get a lower score. Economists describe this as a “zero-sum game.”

How can plans think about getting clinical data?

Obviously clinical data is captured and stored in EMRs. Certified EMRs are now required to have both patient access APIs as well as Bulk FHIR APIs. Bulk FHIR APIs allow the US Clinical Data for Interoperability (USCDI) to be obtained by the payer from the provider EMR in one swoop if the provider and the payer can reach a satisfactory agreement to share this data in their network contract.

Is getting clinical data enough?

No. It is not just about documenting today’s clinical performance. While that is a large step, the key differentiator will be doing something to improve that performance.

What does a modern digital strategy look like? 

A modern digital strategy, whether it is a merchant like Amazon, a service provider like a bank or airline, or a media company, relies on easy access to websites via smartphones and targeted outreach via messaging or email timed to optimize success. For payers that means thinking about what to “say” to patients and providers and how to “hear” from patient and provider feedback, device monitoring data, and clinical data. That is what APIs enable.

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The Healthcare Theme of 2025 Is Generative AI

Ben Beadle-Ryby

By Ben Beadle-Ryby, co-founder, AKASA.

As we approach 2025, healthcare and health IT are on the cusp of transformation, driven by advancements in generative AI (GenAI).

To understand where the industry is heading, we spoke with Ben Beadle-Ryby, senior vice president and co-founder of AKASA, a leader in GenAI solutions for the revenue cycle. Ben shared his insights into the evolving role of GenAI in healthcare, the challenges health systems face, and strategies for successful adoption of these technologies.

1. How is generative AI evolving in the revenue cycle, and where do you see it heading in 2025?

GenAI is no longer theoretical in healthcare; it’s delivering measurable outcomes, though it’s in its early days. In 2025, as the technology further matures, health system adoption will follow suit, with organizations embracing use cases like prior authorization and coding. Progressive organizations, such as Cleveland Clinic and Johns Hopkins, are already optimizing operations and revenue yield by leveraging GenAI to process and interpret clinical data more accurately and efficiently.

While GenAI holds promise across the entire healthcare ecosystem, starting with financial operations makes sense due to lower risks and faster ROI. By 2025, expect health systems to rely on GenAI to optimize revenue and achieve operational excellence.

2. How have perceptions of generative AI changed?

The release of ChatGPT in late 2022 revolutionized AI perceptions. What once seemed futuristic is now accessible and actionable.

Many health systems are now exploring this technology. AKASA sponsored a survey of health leaders with HFMA that showed that more than 70 percent of healthcare organizations are actively considering the use of GenAI, with nearly 60% of organizations eyeing it for the revenue cycle.

Initially, healthcare leaders approached generative AI with appropriate caution, wary of security and compliance risks. Best practice solutions that not only have a secure, HIPAA-compliant architecture but have also found a way to tailor and fine-tune large language models (LLMs) to a given hospital or health system provide a clear path to deploying GenAI that is safe, secure, and a value-add.

Generative AI isn’t just another buzzword or a flash in the pan. Unlike older technologies like RPA or early AI, GenAI tackles nuanced, complex tasks, augmenting human expertise. The time may soon come when we cannot imagine conducting business or performing healthcare without GenAI — just as today we cannot imagine working without personal computers or the internet.

In the short term, though, and across 2025, we anticipate widespread deployment and adoption of GenAI in the healthcare revenue cycle as leaders grasp its ROI potential and ability to drive nearly 100% revenue yield. It’s no longer a question of “if” but “how fast?”

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Unwrapping the Potential of Patient Feedback

Evan Steele

By Evan Steele, founder and CEO, rater8.

As the year comes to a close, patients are racing against the calendar, not just to complete their holiday shopping, but also to schedule end-of-year medical appointments.

For many, meeting their annual deductible or taking advantage of flexible holiday schedules makes December the perfect time to prioritize healthcare.

For medical practices, this seasonal rush presents more than just full waiting rooms; it’s an opportunity to strengthen their online presence and gather meaningful patient feedback to carry into the new year.

Post-Care Surveys vs. Online Reviews

While related, post-care surveys and online reviews serve distinct purposes in the patient feedback ecosystem. Post-care surveys help practices capture real-time insights to improve operations, while online reviews are a public reflection of patient experiences that boost reputation and visibility. When used together, they can drive impactful changes, offer benchmarking against competitors, and build trust with both current and prospective patients.

Why Patient Feedback Matters During the Holidays

The end-of-year surge in patient engagement is the perfect time to prioritize both surveys and reviews. Here’s why:

  1. Patients are ready to engage: With healthcare top of mind, patients are more likely to provide meaningful feedback. Post-care surveys allow practices to gather input shortly after appointments, ensuring that responses are timely and relevant.
  2. Online reviews build momentum for the new year: A steady stream of patient reviews helps practices stand out online and reinforces trust with existing and prospective patients. Positive reviews improve a practice’s visibility and credibility online, creating a solid foundation for growth in the new year.
  3. Patient feedback drives meaningful change: While positive reviews enhance reputation, constructive criticism from surveys provides clear opportunities to refine operations, improve patient experience, and identify gaps in care delivery.

How to Boost Participation in Post-Care Surveys

Even in the hustle and bustle of the holiday season, you can inspire patients to participate in post-visit surveys with a few thoughtful strategies:

  1. Simplify the process: Send short surveys via text or email right after checkout with a direct link for easy access. A quick and seamless process is a win for busy patients.
  2. Communicate the value:  Be transparent about how their feedback helps improve care. When patients feel heard, they’re more likely to provide candid responses.
  3. Incentivize participation: Consider holiday-themed incentives, like a raffle entry or a personalized thank-you message, to encourage participation.

The Hidden Gift of Patient Feedback

It’s easy to focus on positive feedback: it feels good, boosts morale, and reinforces what you’re doing right. But the truth is, negative feedback can be just as valuable, if not more so. Honest criticism highlights areas where patients feel underserved and uncovers opportunities for meaningful improvement.

For instance, if several patients mention long wait times, it could be a sign to revisit scheduling processes or adjust staffing during peak hours. Or, perhaps feedback about confusing billing processes or difficulty reaching staff might indicate a need for better communication tools or additional training. These insights, while sometimes difficult to hear, are gifts in their own right, offering a clear path to better care. Moreover, gathering patient feedback and acting on it allows practices to benchmark themselves against competitors. By reviewing what other groups in your market are doing well or not so well, you can identify areas for improvement and differentiate yourself.

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Medical Devices are Attacked Every 20 Seconds: Here Is How to Protect Them

By Daniel Trivellato, vice president of healthcare and cyber risk solutions, Forescout.

A recent honeypot study revealed that every 20 seconds, somewhere in the world, a cybercriminal targets a medical imaging device. In the time it takes to check a patient’s vital signs, multiple attackers may be actively trying to breach the very systems designed to provide vital healthcare information and keep us alive.

While connected devices have become increasingly prevalent in healthcare, many healthcare organizations fail to adequately protect them. Recent research examining over 2 million devices across 45 healthcare organizations revealed that approximately half of all devices in healthcare networks are now Internet of Medical Things (IoMT), Internet of Things (IoT), operational technology (OT) or building automation devices. These are more than simply administrative systems, these devices play a direct role in influencing patient outcomes, including patient monitors, infusion pumps, and imaging systems.

Daniel Trivellato

Of the 306 medical device vendors observed, the research finds that medical devices are running on 110 different operating systems, making the complexity of securing these networks truly staggering.

While household names like Philips, GE Healthcare, and Baxter are major players in the space, these organizations only represent 40% of the vendor landscape. The remaining 60% is a fragmented maze of smaller providers, each with its own potential vulnerabilities.

Perhaps most alarming is the dramatic rise in exposed Digital Imaging and Communications in Medicine (DICOM) servers. Between August 2022 and May 2024, we’ve seen a 27.5% increase in exposed servers, with the majority of exposed devices located in the United States, India, Germany, Brazil, Iran, and China. Across all IoMT devices, our research uncovered 162 vulnerabilities, with half of the most critical flaws found in Windows-based systems.

Recent breaches have had real-world impact on both health systems and patients. In 2023, healthcare organizations experienced an average of 1.6 data breaches per day, with each incident affecting approximately 200,000 patients. This isn’t just about compromised data – it’s about real people whose private medical information is at stake.

When personal medical device data is stolen, patients can face serious personal risks, including identity theft, insurance fraud, and emotional distress. Many cybercriminals leverage stolen medical records to create sophisticated phishing schemes, impersonate patients to obtain prescription medications, or even blackmail individuals with sensitive health information. Patients may also experience emotional distress following a breach of personal information, feeling vulnerable knowing their most intimate health details have been exposed.

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Why’s Your Growth Game Stuck? Solutions for Health, Money & Tech Pros!

Today, where innovation and challenges collide daily, it can be hard to keep pace in industries that just won’t slow down. The healthcare, finance, and tech sectors feel these demands acutely.

Between patient loads, tech security threats, and funding crunches, professionals are balancing on a razor-thin edge. So, if your growth game feels stalled, you’re not alone! Let’s explore how a few strategic shifts can turbocharge your potential and make your operations more resilient than ever.

Are You Ready to Ride the Next Wave of Patient-Centric Care?

People today expect more from healthcare. Gone are the days when a quick consult would do the trick. Patients today want involvement, answers, and top-notch care on-demand. So, if your practice feels a bit behind, it’s time to rethink your approach.

Embracing a more patient-centered model is where the future lies. Think about virtual check-ins, real-time health data, or even AI-enhanced patient portals that empower patients while keeping them engaged. It’s about crafting an experience that feels less like an appointment and more like a personal health journey. Studies have shown that when patients feel more involved, they’re more likely to adhere to their health plans and experience better outcomes. For healthcare professionals, that’s a win-win.

A patient-centric approach also means thinking beyond individual visits. Regular check-ins, feedback surveys, and post-visit summaries can help build trust and loyalty. And in a time when patients can choose between thousands of providers, that loyalty can make a massive difference.

Is Your Tech Strategy Helping You Reduce Cyber Risks?

For finance and health pros, data security is non-negotiable. From patient records to financial details, these industries handle information that needs serious protection. But here’s the catch—security protocols are evolving rapidly, and hackers are even quicker to find new vulnerabilities. It’s a daily race to stay ahead.

So, what’s the key to keeping your data safe? First, a solid cybersecurity plan is a must. The old “it won’t happen to us” mindset has got to go. Regularly updating software, using multi-factor authentication, and educating your team on common threats are foundational steps. By proactively protecting your systems, you can reduce cyber risks and safeguard sensitive data.

Investing in advanced security tools might feel expensive initially, but think about the alternative. A single breach can lead to lawsuits, regulatory fines, and a massive hit to your reputation. In today’s tech-driven world, building robust security from day one is essential. Not only does it protect your clients, but it also shows you’re a trustworthy, reliable partner in their financial or health journey.

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How To Implement a Healthcare Cyber Resilience Plan

In healthcare, data breaches and cyber threats can disrupt patient care, compromise sensitive information, and even lead to financial losses.

A strong cyber resilience plan isn’t just about preventing attacks; it’s about preparing, responding, and recovering quickly if one occurs.

Here’s a step-by-step guide to building a cyber resilience plan tailored to the healthcare industry, ensuring your organization is well-prepared for cyber threats while maintaining patient trust.

1. Assess Your Current Cybersecurity Position

Begin by evaluating your cybersecurity strengths and weaknesses. Identify all digital assets linked to your network to uncover potential vulnerabilities. These include patient data systems and any third-party software, such as electronic health record (EHR) platforms. It’s also crucial to assess any digital health tools, like mobile apps or wearable tech integrations, that interact with patient data.

Once you’ve mapped out your assets, review defenses like firewalls, encryption, and system access policies to establish a baseline. This helps pinpoint gaps, providing a clearer picture of where to prioritize security improvements.

2. Set Clear Goals for Cyber Resilience

Define what “cyber resilience” means for your healthcare organization, focusing on maintaining essential services, protecting sensitive data, and reducing recovery time during an attack. These goals are critical in healthcare, where patient care depends on system availability.

Setting benchmarks, such as maximum allowable downtime or acceptable data loss, gives your team clear, measurable outcomes. This alignment ensures everyone understands the plan’s priorities and what success looks like.

3. Implement Cloud Security

Cloud technology is essential in healthcare for storing and sharing patient data, but it brings unique risks. Strengthening cloud security involves using multi-factor authentication (MFA) for system access and encrypting all data stored or transferred in the cloud.

Choose cloud providers who comply with healthcare regulations and conduct regular audits to ensure ongoing security. With robust healthcare cloud security measures, you protect patient data and enhance recovery options if a cyber incident occurs.

4. Develop Incident Response and Recovery Protocols

An effective resilience plan includes detailed incident response and recovery protocols. Your response plan should outline immediate steps for a breach, such as identifying the threat, containing it, and notifying affected parties under the Health Insurance Portability and Accountability Act (HIPAA) guidelines.

Disaster recovery protocols focus on restoring systems and retrieving data quickly, minimizing operational disruption. Automated backup tools help reduce downtime, and regular testing ensures readiness for real-world incidents.

5. Train Your Staff in Cybersecurity Awareness

Employee mistakes are a frequent cause of security incidents, often due to actions like clicking unsecured links, sharing passwords, or ignoring security alerts. Regular training equips your team to identify phishing emails, avoid unauthorized software downloads, and report unfamiliar devices connected to hospital equipment.

Additionally, encourage proactive security habits, such as locking screens when away, securing personal devices used for work, and updating passwords regularly. Hands-on activities, like unauthorized access scenarios or fake login prompts, help employees practice responses effectively. A culture of cybersecurity awareness empowers staff to safeguard data, fortifying your defense against potential breaches.

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Digital Health Adoption is Surging, But So Is Consumer Distrust

Dara St. Louis

By Dara St. Louis, executive vice president and a founding partner, Reach3 Insights

Many of us know exactly how many steps we’ve taken today. A quick glance at our phone or other fitness tracker makes quantifying certain aspects of our health a literal no-brainer. But while digital health is integrating snugly into everyday life for many Americans, there’s a catch: For every digital health evangelist, a similar number of Americans don’t trust big tech to use their health data responsibly.

In a study of 1,012 Americans 18 and older, we uncovered a tension between growing adoption and lingering trust issues that poses a unique challenge for companies in the healthcare tech space. Companies that can strike the right balance between innovation and trust could win over both sides of the trust spectrum, especially among younger, tech-savvier generations.

Digital Health Adoption Continues to Surge

Our latest digital health research suggests Americans are ready and willing to use technology to help them manage their health needs. Our latest digital health research reveals significant growth in the adoption of health-related technology among Americans:

— 66% of Americans now use health-related devices (up from 18% in 2021).
— 72% of Americans are using health-related apps, a sharp increase from 55% in 2021.
Fitness wearables and health apps have become mainstream, especially among younger generations:
— 29% of Gen Z and 23% of Millennials are particularly drawn to holistic wearables.
These users aren’t just downloading apps—they’re using them regularly. In fact:
— 88% of users actively engage with their health and wellness apps, especially for tracking: Fitness, nutrition, sleep, and mental health.

Mental health app usage is particularly notable among younger users, as 26% of Gen Z and 31% of Millennials use mental health apps. Many Americans say they’re open to AI playing a role in their health as well:

— 53% of respondents have positive or very positive feelings about AI in health and wellness.
— 17% specifically seek out applications that use AI.
— Over two-thirds might be interested in AI for digital health, especially for: Fitness, diagnosis, and screening applications.

The average American seems excited for digital health integration on the part of healthcare tech providers. There’s just one issue.

Americans Don’t Trust Big Tech with Their Health Data

The convenience is appealing, but when it comes to handing over sensitive health data, many are hitting pause. We saw this skepticism crop up several times in our research: The tech is promising, but Americans’ relationship with Big Tech is a stumbling block.

Fifty-seven percent of Americans believe tech companies could bring down the cost of healthcare, but 53% say they would never trust these companies with their personal health data. Over time, Americans have developed more reservations about Big Tech’s involvement in healthcare, with 44% expressing concerns in 2024 (up from 28% in 2022). Data privacy remains a key issue, as 49% of consumers are afraid it may be misused by the companies.

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