Category: Editorial

Medical Imaging Needs More Speedy, Stable, and Secure Data Infrastructure to Produce Life-Saving Insights

By Josh Otten, director of IT and solutions engineering, Adventist Healthcare.

Artificial intelligence (AI) applications are making waves across industries. But in healthcare, we frequently find ourselves fighting against being left behind when it comes to new technology adoption. While the field inherently necessitates more caution when implementing emerging technologies into workflows that impact patient outcomes and human lives, AI is proving to be beneficial in offloading administrative, repetitive, and easily manageable tasks from an overburdened healthcare workforce.

When it comes to medical imaging, AI applications are accelerating time to diagnoses and improving accuracy by going much further than any human can. AI-driven insights and machine learning capabilities are able to mine hundreds of body scans in a matter of minutes for differences that the human eye can miss. With these new applications of AI in medical imaging, there is the potential for hospitals and health systems to detect problems earlier, track patients through their care journey more accurately, and offer more lifesaving treatment to patients at the time they need it.

The storage and retrieval of digital images is an integral component of any digital imaging system. A picture archiving and communication system (PACS) turns data into actionable insights by displaying, storing, and retrieving important imaging data used for the diagnosis and treatment of complex conditions. A PACS can also ensure long-term data retention and reduce physical storage needs, offering substantial cost savings, when they are running on the right system and platform that optimizes performance.

This means that seamless digital imaging processing systems are paramount to patient and provider success. When running on a platform or service that might slow down a PACS, providers are losing valuable time and patient outcomes may be impacted. Health systems are then left scrambling for something better, which in this case can mean the difference between life and death for patients with complex conditions.

The Golden Hour of Critical Care Is Impacted by Slow Operating Systems

Founded in 1907, Adventist Healthcare is one of the longest-serving healthcare systems in Maryland and delivers comprehensive care at over 50 locations across the Washington D.C. area. Adventist Healthcare delivers high-quality care across specialties but is primarily known for its expertise in cardiology, maternity, orthopedics, and mental health.

Like most health systems, we at Adventist have been trying to keep pace with the digitization of our industry and the fast-paced adoption of emerging tech, while remaining stable and scalable to meet organizational goals and patient needs. We were facing challenges that were delaying diagnoses, adding to physician workloads, and leaving patient information not as secure as it could be. Our life-saving services, including acute-care hospitals, primary care and imaging centers, home health services and more, could not be left up to chance– so we looked at strategic tech investments and partnerships to advance our operations and ensure that we are meeting the needs of patients and providers across the Maryland and D.C. region.

In an environment where every second matters, the underlying technology supporting critical healthcare systems must keep pace with growth. Our PACS and the storage needed to keep it operational and insightful directly influence our ability to save lives. For instance, when it comes to heart attack and stroke diagnoses and recovery, the ability to pull up prior patient images to make quick comparisons within the “golden hour” of an episode greatly increases the chance of patient recovery. When the storage behind our PACS began to experience performance issues, we had to look for solutions to leverage in order to gain speed, stability, and security, while cutting costs and complexity from our current data storage infrastructure to allow for better operations and room for business growth.

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Are Hochul’s Cybersecurity Regulations Enough For the Future of New York Healthcare?

Todd Moore

By Todd Moore, vice president of data security products, Thales.

On Nov, 13, 2023, New York Governor Kathy Hochul proposed a new set of cybersecurity rules for state hospitals. This includes a mandate that hospitals must develop their own programs and response plans and appoint chief information security officers (CISOs). The regulations are part of a statewide cyber strategy that Hochul launched in August to improve cyber resilience as attacks continue to rise.

The strategy is built on three central principles: Preparedness, Resilience, and Unification. It is also New York’s first roadmap to mitigate cyberthreats and attacks and has a long road ahead to combat the growing phishing and ransomware attacks across the state.

Are the regulations up to the task? Let’s take a look.

Preparedness

Tackling multiple cybersecurity threats in recent years may have weathered healthcare’s capacity for self-defense. But the industry is still more vulnerable than most. According to the Thales 2023 Healthcare and Life Sciences (HLS) Report, 71% of healthcare organizations have cited an increase in ransomware attacks this year, far higher compared to other industries at 49%. The higher frequency is mainly due to the vast personal data they store (medical records, PII, etc.) that present a goldmine for identity theft.

Under Hochul’s proposal, preparedness will involve providing advice and guidance to ensure New Yorkers are empowered to take charge of their own cybersecurity. Healthcare facilities will have to develop their own cyber programs and incident response plans, with written policies, procedures, and regular risk and response assessment tests in place.

From a glance, these give facilities a good foundation on which to establish their cybersecurity strategies, particularly for the less tech-savvy ones. But while the regulations are a good starting point and may develop expansively, right now we’ve only gotten high-level objectives. There isn’t a clear direction for managing crucial resources in use, such as the cloud, which could undermine Hochul’s efforts to foster resilience and unification.

Resilience

We live in a multi-cloud reality. Nearly 90% of healthcare respondents deploy two or more cloud providers to better manage data. Over the past year, data security in the cloud has become increasingly complex (from 44% to 55%). Unfortunately, this makes cloud resources a leading target for attackers, particularly for healthcare (78%) over other industries (67%).

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Digital Technologies Provide Solution To American Healthcare Crisis

Harman Dhawan

By Harman Dhawan, founder and CEO, Bikham Healthcare.

The American healthcare system is under enormous strain; plagued by looming physician and nursing shortages that grow more dire every day and bogged down by inefficient and costly administrative processes that account for billions in wasteful spending every year. All this adds up to a healthcare system that is not only ineffectual but also extremely costly.

Healthcare budgets are rising exponentially while more and more pressure is placed upon healthcare workers who are increasingly understaffed and overburdened, leaving hospitals and providers unable to provide their patients with high-quality and accessible care. What has caused this precipitous fall in American healthcare, and how can this trend be reversed?

One of the largest obstacles that healthcare has been unable to overcome is its failure to adopt advancing technologies in its administrative processes. Doctors—already stretched thin—are forced to waste valuable time and resources navigating a tangled and disjointed web of health platforms in order to perform the simplest of administrative tasks.

License renewals and credentialing, processes that should take minutes with the assistance of digital technologies such as artificial intelligence, take months or more to execute. Providers must cross multiple platforms in order to manage, track, and monitor a host of different administrative processes, which cause onboarding delays, credentialing and privileging issues, siloed data management, and slower enrollment processes. This, in turn, reduces the efficiency and efficacy of services provided and increases the cost to both the provider and the patient.

Furthermore, these frustrating and tedious processes not only are responsible for delays that account for hundreds of thousands of dollars in lost monthly revenue, but they also take away from the limited amount of time a physician has to see patients and contribute to increased instances of physician burnout, which further depletes our ranks of healthcare professionals.

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A Not-So-Silent Battle: Tackling Nurse Burnout with Innovative Solutions

Brandy Sparkman-Beierle
Brandy Sparkman-Beierle

By Brandy Sparkman-Beierle, chief clinical officer, Homecare Homebase.

Healthcare is a fast-paced and demanding industry that has undergone profound challenges over the past few years, and its frontline employees are taking the brunt of the impact. Burnout among nurses is not new, but the pandemic significantly exacerbated it. While the world begins to see the light at the end of the COVID-19 tunnel, America’s nurses are still trying to catch their breath.

The intersection of rising patient volumes and staffing challenges has led to a significant drop in nursing satisfaction rates. This overextension puts healthcare professionals at risk of burnout, impacting their physical and mental well-being. A 2023 AMN Healthcare survey discovered that the satisfaction level among registered nurses has plummeted to 71%, reflecting the strain on care teams. The consequences of nurse burnout are far-reaching, affecting the individuals directly involved and the quality of care delivered to patients. To combat this growing epidemic, many hospital systems are left with the decision to deploy comprehensive technology solutions to fill the gaps and take some of the burden off the patient care teams’ shoulders.

The Need for Innovation

Addressing nurse burnout requires a proactive approach, and innovative solutions can be pivotal in transforming the landscape of patient care, whether in-patient or home-based. Organizations must prioritize the well-being of their nursing staff and seek tools that provide actionable insights into care team satisfaction. It is crucial to investigate solutions that assess the current state of nursing satisfaction and offer strategies to enhance their professional experience. Some tools that provide these essential benefits include:

Mobile Communication for Patient Care: As clinical outcomes become increasingly tied to revenue, home health, and hospice care require intricate documentation during every visit. Overlooking even a minor detail can significantly impact the level of care provided to your patients and expose an organization’s systems to noncompliance risks. Utilizing a mobile collaboration tool, nurses receive user-friendly prompts, reminders, and notifications and can efficiently record documentation during each visit, avoiding needing to catch up later. These systems also empower users to personalize assessment forms and pathways, reducing duplicate entries and ensuring agency and state compliance.

Education and Training: Boosting retention efforts by developing programs that train, provide ongoing education, and touch base with nurses throughout their first year and beyond is crucial to enhancing the nurse experience and reducing burnout. Leveraging an end-to-end collaboration solution ensures agencies and healthcare systems have the tools and knowledge to run successful training programs. Some ways to bring these programs to life include:

The Role of Clinician Scorecards

One of the most essential things a platform can do for its users is make it a priority to listen to caregivers and act on those insights consistently. This is where tools like clinician scorecards become paramount. These tools work as a comprehensive means to evaluate and improve the well-being of nurses and field clinicians by going beyond traditional metrics and delving into the intricacies of nursing satisfaction levels.

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Unlocking Optimized HCC Documentation and Coding

Profile photo of Eric McGuire
Eric McGuire

By Eric McGuire, senior vice president, Medical Coding and CDI Service Lines and Corporate Strategy, AGS Health.

Traditional fee-for-service reimbursements are falling by the wayside as healthcare continues its transition toward value-based reimbursement models. This is evidenced by data from the Health Care Payment & Learning Action Network (LAN), which shows more than half of healthcare payments in 2022 were made under value-based care models. Additionally, nearly 75% of health plan leaders surveyed by LAN believe value-based care model activity will continue to rise.

Integral to this transition – which requires providers to better manage patient costs based on a clear, concise, and comprehensive picture of patients’ health and medical conditions – are Hierarchical Condition Category (HCC) codes. Used by the Centers for Medicare and Medicaid Services (CMS) and commercial payers to forecast medical costs for patients with more complex healthcare needs, the HCC risk adjustment model measures relative risk due to health status to determine reimbursement levels. The more complex the patient’s medical needs, the higher the provider’s payment.

In fact, HCCs are the preferred method of risk adjustment for the Medicare population, which includes nearly 60 million people on both Part A and Part B, CMS reports. As such, accurate HCC management is critical for appropriate reimbursement of the care provided to Medicare patients and beneficiaries.

Accuracy is Key

The highly complex HCC model includes approximately 10,000 diagnosis codes that map to HCC codes and 189 different HCC categories with 87 CMS-HCCs, each of which represents diagnoses with similar clinical complexity and expected annual costs of care. Any error can significantly impact reimbursements, which under HCC is determined by mapping a patient’s diagnoses to these codes to create a Risk Adjustment Factor (RAF) score.

The RAF score represents the estimated cost of caring for that patient based on their disease burden and demographic information. It is then multiplied by a base rate to set the provider’s per-member-per-month (PMPM) reimbursement amount. The sicker the patient, the higher the RAF score and, subsequently, the provider’s reimbursement.

Each year, CMS publishes a list of diagnosis codes and corresponding HCC category. Hierarchies (or ‘Families’ of categories) are listed among related condition categories, which set values based on the severity of illnesses. Improperly documenting HCC codes, or failing to document the highest appropriate specificity, results in lower reimbursement rates. For example, HCC 19 (diabetes with no complications) might pay an $894.40 premium bonus compared to a bonus of $1,273.60 for diabetes with ESRD, which requires two HCC codes mapping to 18 and 136.

Conversely, properly documenting HCCs at the highest appropriate specificity can boost reimbursements. For example, if CMS has set a $1,000 PMPM for a patient with an RAF of 2.234 who has diabetes with complications reimbursement would be just $673 per month if the condition is not coded. However, if the case was properly coded as E11.9 Type 2 diabetes mellitus without complications under HCC19 Diabetes without complications, the RAF increases to 2.366, resulting in reimbursement of $1,062 per month. If properly coded as E11.41 Type 2 diabetes mellitus w/diabetic mononeuropathy under HCC18 Diabetes w/ chronic complications, the RAF increases to 2.513 for a reimbursement of $1,312.5.

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The Future of Alcohol Rehab: AI’s Role In Addiction Treatment

Everywhere you turn around, artificial intelligence is the topic of the hour. Indeed, the new program is taking over the world by a storm, and it has grown into the drug recovery field too. The many alcohol rehab center across the US have started using AI systems in literally every part of their treatment process.

The AI has made it easy for them to identify addiction, provide proper treatments for recovery, and even take preventive measures to combat relapse in patients. If you are addicted to alcohol, and you seek a meaningful way to come out of addiction, then you are in for a fun time ahead, for AI is in the picture now. 

AI is Revolutionizing Every Field

You might have come across artificial intelligence through apps like ChatGPT, or Lensa, and OpenAI. These are applications that use a program code at their base. They are loaded with algorithms that use a set of variables to predict the outcome of a certain event. For example, the Lensa AI uses keywords to generate new images and art using already existing pictures and art pieces. The idea is to use the existing information to generate new information we desire.

This same idea is taken up for medical purposes too. In medicine, AI is very helpful in identifying symptoms of diseases, and suggesting various treatments and medication early on before the symptoms get serious and cause pain for the patients. 

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Escalating Cybersecurity Crisis Grips Healthcare Sector: Ransomware Attacks Surge Across Industry Leaders

In the throes of an ever-intensifying cybersecurity crisis, the healthcare sector is under siege, grappling with the fallout from a wave of ransomware attacks. Among the prominent victims are Ardent Health Services and Norton Healthcare, two pillars of the industry facing sophisticated cyber threats. These incidents, and many others, coupled with a new study led by MIT professor Stuart Madnick, paint a bleak picture of the industry’s vulnerability to cyber adversaries.

Ardent Health Services, a health system overseeing 30 hospitals and more than 200 care sites across six states, was the victim of a significant ransomware attack in late November, necessitating the diversion of emergency room patients and rescheduling non-urgent procedures. The fallout has prompted Ardent to take its network offline, suspend user access to critical IT applications, and launch an effort with cybersecurity partners to restore normal operations rapidly.

Usman Choudhary, chief product and technology officer at VIPRE Security Group, said the pervasive greed among ransomware groups and calls for unity within the security community underscores the critical need for accessible and affordable cybersecurity solutions. Even advanced technical protections are futile if hindered by prohibitive costs or complexity, Choudhary said.

Norton Healthcare, another healthcare provider managing eight hospitals across Kentucky and Indiana, suffered a significant data breach impacting up to 2.5 million individuals throughout 2023. The breach took place between May 7 and 9, 2023, exposing personal and protected health information of patients and employees.

This incident at Norton Healthcare amplifies the broader concerns outlined in Stuart Madnick’s report, funded by Apple, showing that ransomware attacks during the first nine months of 2023 surpassed the total from all of 2022. Ransomware attacks impacted more than 360 million people through August of this year.

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Tackling Top Healthcare CIO Operational Challenges and Technology Advancement Opportunities  

Sheri Stoltenberg

By Sheri Stoltenberg, founder and CEO, Stoltenberg Consulting, Inc.

The expansion of artificial intelligence in healthcare has garnered significant industry hype over the past year, as health IT executives recognize its potential to transform healthcare delivery — and its efficiency. According to the recent Health IT Industry Outlook Survey, which highlights healthcare CIO strategic goals and pain points, 32% of hospital CIOs recognize AI and machine learning as the top health IT priority for the next year.

While not a new concept, the advancement of machine learning algorithms has accelerated generative AI’s potential to solve health system challenges, like provider shortages and clinical burnout. This has created a sense of urgency amongst healthcare organizations to rapidly implement and expand these technologies. However, IT departments — struggling with their own workforce challenges — bear heavy operational burden if resource and support strategies aren’t in place to shoulder these evolving tools and their growing user expectations.

Before expanding AI initiatives, hospitals and health systems must address operational barriers and process inefficiencies. Finding the proper balance between workforce optimization and automation is key in developing a successful IT support framework.

Securing qualified IT resources amid staffing shortages

Despite compounding IT team workload, talent strain remains a top obstacle for hospital and health system CIOs this year, with 44% of survey respondents highlighting “retaining and budgeting for qualified IT resources” as the greatest operational challenge.

To secure resources and strengthen support processes, IT executives must first evaluate their current support models, gauging their capacity to withstand project load, user experience needs, and budgetary pressures. Having identified support gaps, leaders can then consider workforce optimization initiatives — improving retention strategies, seeking staffing partnerships, or utilizing blended support frameworks — to ease talent strain.

Survey results also revealed that most healthcare CIOs (36%) deemed “flexible IT staffing support to ramp up or down with project demands” as the No. 1 area in which they desired stronger support. By moving beyond conventional staffing approaches, hospitals can develop adaptable IT programs, better equipped to support advancing consumer expectations, compete with new market entrants, and maintain new care models.

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