Benjamin Zaniello, MD MPH

There’s a category we believe is getting too little attention when it comes to AI in healthcare: AI Clinical Documentation Integrity (CDI) While AI ambient scribes and autonomous medical coding solutions have gotten most of the headlines, we’d argue AI CDI is equally impactful when it comes to quality care and accurate billing. For those not familiar, CDI ensures that clinical documentation accurately reflects the patient’s medical condition and the provided care. Historically, CDI was a manual slog, with dedicated CDI specialists, nurses, and physicians painstakingly reviewing patient charts to ensure documentation supported the care delivered. Today, AI is reshaping this landscape. While it’s still early days, we’re seeing three primary approaches to applying AI when it comes to CDI: 1️⃣ CDI + ambient scribing—an AI ambient scribe and AI CDI assistant operate simultaneously, generating comprehensive notes and surfacing codes for physicians to review at the point of care. (Example: Ambience Healthcare’s AutoCDI) 2️⃣ CDI via real-time diagnosis support—diagnoses are suggested at the point of care based on clinical data in the EHR, with auto-generated documentation and audit trails. (Example: Regard) 3️⃣ CDI via an AI-driven post-coding / pre-billing review—the entire patient record is ingested and analyzed against what is coded, surfacing suggestions for revenue and quality opportunities. (Example: SmarterDx) To date, AI in healthcare has focused primarily on administrative use cases. With the increasing adoption of AI CDI solutions, we’re now taking a step closer to clinical workflows. As clinicians get used to AI-suggested diagnoses in the CDI context, it will be interesting to see if this increases their comfort with AI playing a role in clinical care. Here's our working list of AI CDI vendors. Anyone else we should add? • Ambience Healthcare • Brellium • Iodine Software • Regard • Semantic Health • SmarterDx   

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Key trends and takeaways from HLTH 2024: 1. AI's Evolving Role: AI dominated discussions, with executives acknowledging its potential while also recognizing challenges in accuracy and clinician trust. There's a shift towards focusing on the practical applications of AI, with a call for partnerships to ensure reliable testing and implementation. 2. Infrastructure Focus: Beyond the glitzy AI tools, there's a growing emphasis on the "picks and shovels" needed for healthcare data accessibility, including infrastructure, compliance, and interoperability. Executives believe that improving data flow will facilitate the effective use of AI. 3. Middlemen Under Scrutiny: Pharmacy benefits managers (PBMs) faced criticism for their role in rising drug costs, with discussions highlighting misaligned incentives and the need for transparency in healthcare pricing. 4. Women's Health Spotlight: Women's health initiatives gained attention, particularly following government funding announcements and personal stories shared by advocates. However, investment in women's health remains minimal compared to overall healthcare funding. 5. Interest in Psychedelic Medicine: The potential of psychedelics for treating mental health conditions garnered significant interest, with discussions about funding and research moving forward, especially within the Veterans Affairs system. Executive Takeaways: Leaders from various sectors emphasized the importance of consumer-focused strategies, collaboration, and the need for responsible AI usage. There was a consensus on the critical role of addressing healthcare accessibility, improving patient experiences, and fostering innovations that genuinely enhance care delivery.

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I'll be honest, I'm a little reluctant to share our inaugural Threshold Health blog post. 😬 We don't highlight AI even once! Instead, we share some of the easiest ways healthcare orgs can immediately and rapidly level-up patient engagement. Front and center is the idea that there is no such thing as a silver bullet for engaging populations. Ultimately, the winning strategy (and the winningest at-risk organizations) are going to leverage modern platforms to rapidly learn about their populations and iterate, iterate, iterate. Luckily, with our platform, we're helping operators start with optimized templates and making iteration easy and rapid. And of course, AI is a means to that end. But it's not what we're highlighting to our partners. Check it out below, and keep an eye out for a couple more announcements this week! https://lnkd.in/gifpf3ce

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Healthcare technology is in trouble. After the relative boom time we experienced through during the pandemic, the fervor to innovate in health systems and payers seems to have dried up. While organizations continue to post stellar earnings, they also continue to lay off experienced health technology people en masse. Why? I think it's time for a bit of honest reflection. 70% of all enterprise healthcare technology projects fail. 17% of of all large scale IT projects go so badly that they threaten the very existence of the company itself. Bridging Business & IT, LLC For projects with a total price tag of over $1MM, that failure rate jumps to over 90%. And the ever prescient Clayton Christensen believed that the failure rate for all new product introductions is 95%. This is not new information. What is new is the most recent E&Y Pulse Survey that has health system CIOs believing that 7 in 10 of their healthcare IT projects have had no discernible #ROI. None. And this is for the projects that didn't fail. https://lnkd.in/gRgVt_Xs This is an existential crisis that health technology must face honestly and soberly. Lack of planning and poor communication are the core culprits. Clunky and outdated Waterfall project methodologies can be blamed for many of these failures. And frankly Agile disciples could use a bit more planning before they start iterating so they know what they're building. There are, however, some problem actors and business models that need to be called out. The historically biggest culprits, in my humble opinion, are large, institutional, enterprise software vendors and their server-based architectures. For decades they feasted on seven figure licensing deals, sometimes humble-bragging to potential implementation partners about 5:1 or 7:1 implementation cost to license cost ratios. Companies just went along with it, because no one gets fired for buying IBM, right? But the failures in this segment are legendary. And many have indeed been a key cause in the parent company failure. As for the ROI, there was a bright spot in the E&Y Pulse Survey. Despite not having established a demonstrable ROI, 96% of them still wanted to move forward with the projects, believed the investment was worth it. So the issue isn't necessarily that the projects aren't generating value, the issue is that the organizations (and their vendors) didn't do a good job up front validating agreed upon ROI metrics and measures. They don’t fully understand the value it is (or isn't) creating. This is our collective job to be better at this. So what can we do to reduce the failure rate and get health systems and payers back into investing in #innovation? #ROI #startups #valueengineering #goldenpath #LCNC #opensource

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Despite the "less conclusive quality and cost findings" shown by Hospital-at-home AHCAH programs for Medicare, participants in the program (both patients and clinicians) give it a thumbs-up. Big proponent of moving appropriate acute/post-acute care into the homes, however, a lot of these programs were not well executed and many were not appropriately resourced. It's not surprising that the overall data on quality and cost is underwhelming. Hopefully, the 2 yr extension (currently legislation due) should allow for this picture to become clearer. #HaH #AHCAH #Hospitalathome #Homehealth

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Eye Opening! As noted by Matthew Holt below, Doximity promotes itself as “The Professional Medical Network for Physicians” with a mission to “help clinicians be more productive so they can provide better care for their patients.” Sounds simple enough, a community built for doctors—a space where they can connect, share insights, and access tools to support their work. Their main source of revenue, subscriptions. Of course, you'd think the subscribers would be the doctors using this valuable platform and its tools, like video calls, hiring services, and various apps, platforms. But look a little deeper at their financials? Yuck. Doximity’s revenue doesn’t come from clinicians at all. The“subscriptions” (main source of revenue) are actually sold to pharmaceutical and other industry players that want access to docs and the powerful (and profitable) prescription pads they wield. These “Marketing Solutions” subscriptions allow advertisers to push tailored content directly into doctors' "news" feeds, with pricing set according to the type and number of doctors targeted. In effect, the platform sells access to doctors to those looking to drive up utilization of their products. Doximity’s real revenue engine (which is pretty amazing, see post below) lies in its advertisers. Life sciences companies and the highest bidders pay for the privilege of influencing what doctors see in their feeds—not just ads, but entire modules and news updates. What seems like a physician’s trusted source of industry news and updates is, in reality, a curated stream designed to serve business interests. This brings us to the key question: when doctors use Doximity as their “news feed” and source of the latest research, are we comfortable knowing their information stream is largely influenced by advertising dollars? When we scroll through platforms like Instagram or Facebook, we’re well aware of how advertising shapes our experience. Mention a skincare product in a text, and suddenly, your feed is filled with face cream ads. We know this, we accept it, and we view each ad with a healthy dose of skepticism. But are we okay with doctors facing the same experience? Are we comfortable with Doximity’s advertisers shaping the content doctors see, especially when they rely on this platform for up-to-date clinical research and product information? Let's hope our docs approach these tools with the same skepticism I do when I'm promised younger looking skin:). Jessica DaMassaPreston AlexanderDutch RojasPatient Rights Advocate Marilyn BartlettDave Chase, Health Rosetta-discovering archaeologistAnn LewandowskiJeffrey HoganDavid Contorno Stacey RichterLee Lewis Shawn GremmingerAndré WENCKER Renzo Luzzatti

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As promised here are my thoughts from Day 2 at the FDA's Digital Health Advisory Committee meeting on "Total Product Lifecycle Considerations for Generative-AI Enabled Devices." I have pretty much focused my thoughts on the talk and remarks presented by Dr. Keith J. Dreyer as he summarized it all very eloquently. He was truly inspiring! Here are my top 5 takeaways: 1️⃣ Continuous Clinical Validation is a Must: AI devices, especially in radiology, need ongoing validation to ensure they remain accurate and effective in real-world settings. 2️⃣ Regulating Generative AI for Patient Safety: There's a pressing need for clear regulations to guide the safe deployment of GenAI in healthcare, focusing on transparency and human oversight. 3️⃣ Expanding the FDA's Role: Keith emphasized that the FDA should look beyond manufacturers to include device users for better monitoring. As he put it, "We have to keep the data pristine to make sure these devices are working, independent of what the manufacturer makes." 4️⃣ Cost-Effective Monitoring Solutions: Recognizing that monitoring and validation can be costly, we need innovative solutions that make this feasible for all healthcare settings, big or small. 5️⃣ AI's Potential to Boost Efficiency: Generative AI could greatly enhance efficiency in radiology. Keith noted, "If there was a way to improve our efficiency through AI, and I think Gen AI has a way to be able to do that, then you're going to see availability, much broader availability of even specialists, to do more work and to work beyond the scope of what they can do today." I'm thrilled to be part of these vital conversations and can't wait to continue exploring how we can responsibly harness AI to transform healthcare! Here is the link to Dr. Keith J. Dreyer's talk: https://lnkd.in/gFisjcXW #GenerativeAI #AIinHealthcare #DigitalHealth FDA #PatientSafety #ClinicalValidation HOPPR American College of Radiology

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Here’s your recap of last week’s health IT news 🗞️ 👇 🤖 AI Clinician Assistant • Commure announced it will acquire Augmedix in a take-private deal. • Suki announced a partnership with Federally Qualified Health Centers and Community Health Centers, including Utah Navajo Health System, Inc., CenterPlace Health , and Access Health Louisiana. • OneHealth is partnering with healthPrecision / Medical Brain to support the former’s Modern Primary Care platform. 📈 Data & Analytics • Huma announced a $80M Series D that included pharma investors AstraZeneca and Leaps by Bayer, as well as the launch of its Huma Cloud Platform, a service that promises to help digital health products scale and launch their products more efficiently. • Intermountain Health partnered with NeuroFlow to better understand its Colorado patients’ behavioral health risks. 🔁 RCM • Medmetrix acquired HRSI - Healthcare Receivable Specialists Inc., accelerating development of its end-to-end solutions. • Thoughtful AI launched new “human-capable” AI agents for claims processing, patient eligibility verification, and payment posting and announced a $20M Series A. 📋 Patient Administration • XO Health Inc. is partnering with Kyruus Health to integrate its price transparency and directory tools. 💼 Provider and Practice Administration • West Tennessee Healthcare is implementing Qventus, Inc. 📱 Patient Support and Communications • Vizient, Inc has contracted with Mytonomy on behalf of its hospital and health system customers. • Tendo added FlyteHealth to its marketplace. • Epic offers a new integration with United Language Group allowing providers to dial-in an interpreter directly from the patient care workflow. ⚙️ Clinical Operations • Wolters Kluwer Health released an update to its UpToDate Pro software designed to support PCPs in prescribing, switching, and titrating antidepressant prescriptions. • Fullscript released two new studies demonstrating higher engagement and improved patient labs. 🍎 VBC • Guidehealth is now offering Story Health to its partner health systems. • Astrana Health is partnering with Elation Health to offer its EHR platform and billing technology to its customers. • Thyme Care closed a $95M series C, including healthcare funds such as CVS Health Ventures, Concord Health Partners, and more. 🧠 Food For Thought • A recent study found that Chat GPT-written patient portal messages were comparable in quality (and better on measures of empathy and communication style) to those drafted by healthcare professionals, according to PCP reviewers. We’re always interested to see physicians’ responses to GenAI solutions, as the tide turns toward greater acceptance of the technology. https://lnkd.in/gMX7ATX2 --- Want the latest healthcare tech news delivered to your inbox each week? Sign up here 📬 👉 https://lnkd.in/e2UJ3ckP

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ICYMI: I wrote about HCA Healthcare's Q3 results. Here's a nifty one-pager for LinkedIn and what you missed in Hospitalogy: Volume + Utilization: • Another quarter of broad-based growth. OP surgeries down (from Medicaid/Uninsured), but revenue increased 5% (acuity & payor mix grew 7% to counteract the decline). HCA specifically called out cardiac procedures, rehab, and obstetrics in prepared remarks on the earnings call itself.   Medicare vs. MA: • Same-facility Medicare admissions grew 5.3%. Traditional Medicare was flat. MA admissionsgrew11%inQ3; HCA attributed 2% of this growth to the 2-Midnight Rule.   • Same-facility adjusted admissions declined 8.5% in Medicaid, increased ~4% in commercial, and increased 43% in exchange. Uninsured adjusted admissions increased +7.2%.   Revenue + Payor Mix: • 7.1% = Same-facility revenue growth. 7.9% overall revenue growth. ‘Modest’ benefit from Medicaid supplemental payment programs.   TOO MANY DENIALS: • Point of emphasis for all hospitals in 2024. HCA has seen ramp-up in payor denial activity but didn’t see a $$$ impact. Still, HCA observed a few large MA players driving the most denials. MA patients have higher LOS (around 10% higher) even adjusting for acuity. HCA blamed but is working with payors on this inefficient dynamic.   Expenses + Margin: • 0.9% increase in adj. EBITDA from improved labor (down 1.6% as a % of revenue) and contract labor (4.6% of total labor spend, down 18% over 2023). 2.5% - 3.5% wage increases for 2025. Supplies & other operating expenses squeezed revenues a bit. HCA sees opportunity with AI and other investments to improve admin functions. It recently announced an expanded partnership with Commure to deploy ambient AI system-wide.   Capital Allocation + CAPEX: • ~$1.2B in CAPEX in the quarter. ~$1.8B in share repurchases and ~$170M in dividends distributed. HCA plans to have added 600 IP beds and 100 new OP facilities by the end of 2024. $6B in capital projects under development. 2,600 sites of care by the end of 2024.   Outlook + Guidance: • HCA thinks elevated volume growth will continue at 3% - 4% while reimbursement will increase 2% - 3%, resulting in growth ‘near or slightly above’ long-term HCA targets in 2025. $50M or $0.15/share lost estimate from hurricanes in Q3. Exchange growth will moderate in 2025 to 8% - 10% vs. 30% in 2024 (commentary prior to election results).   My Take: • While we may have reached peak ‘hospital multiple’ HCA continues to benefit from a strong & stable operating environment entering 2025 in its markets: broad-based growth with ‘very few challenges.’ Expect HCA to continue to win IP market share over less efficient competitors as it drives toward having 13, and more like 17 to 20 access points per hospitals in its selected markets.

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I had the pleasure of contributing to this book, Digital Health, Telemedicine and Beyond. It has a broad list of topics including the basics of services, reimbursement, and regulations. I wrote the "Coding for Telehealth/CMS guidelines" chapter. I still don't believe this myself, but my most interesting and impactful work has been on reimbursement and regulation. Here I describe some of it based on the behemoth that is #CMS. Edited by Dipu Patel, DMSc, MPAS, ABAIM, PA-C as she describes it: "With a strong focus on case studies and patient outcomes, this title provides an overview of digital medicine, terms, concepts, and applications for the multidisciplinary clinical practitioner. Chapters provide a concise, yet comprehensive understanding of digital health, including telemedicine, mHealth, EHRs, and the benefits and challenges of each. The book gives insights on risks and benefits associated with storing and transmitting patient information via digital tools and educates clinicians in the correct questions to ask for advocacy regarding state laws, scope of practice, and medicolegal implications." I'm joined with a number of incredible authors. Link below to pick up a copy: Harvey | Amit | Susan | Sonia | Jeremy | Derek | Kathryn | Nathan | Tom | Lisa | Marty | John | Dr Stefan #ai #rpm #rtm #dtx #telehealth #telemedicine #digitalhealth #digitalmedicine #aiinmedicine #healthcare

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Risk adjustment ensures providers are paid fairly in capitated payment models, allowing them to deliver appropriate care to all patients. However, if done poorly, it can worsen health inequities by misallocating resources. In my work, I've seen the importance of accurately predicting future healthcare costs to ensure providers can care for healthier and sicker patients. Risk adjustment modifies payments based on patients' characteristics and health conditions. This method uses statistical models to assign risk scores, adjusting payments accordingly to reflect the expected cost of care. One challenge we face is inconsistent data and coding practices, which can affect the accuracy of these adjustments. Traditionally, risk adjustment focuses on factors like age and chronic conditions. However, incorporating social determinants of health—such as housing stability and food security—is essential for fair compensation. These factors impact health outcomes but are often excluded due to data standardization issues. To better support providers and reduce inequities, it’s crucial to design and implement risk adjustment models carefully, incorporating comprehensive data and considering social factors. This approach ensures we can continue to deliver high-quality care to all patients, regardless of their health needs. #Healthcare #Hospitals #doctors #hospitals #CommunityHealth

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🔔 Unleashing AI as a “Force Multiplier” in Healthcare AI isn’t just a tool—it’s a game-changer for healthcare providers striving to bridge the divide between mental and physical health. With NeuroFlow’s technology, healthcare professionals can identify behavioral health needs earlier and offer timely support like never before. 💡 How Does It Work? NeuroFlow’s platform leverages AI to enhance provider efficiency and patient care, helping ensure no one falls through the cracks. 📌 Highlights from our conversation with Christopher Molaro, CEO of NeuroFlow                   •  AI-Driven Efficiency: NeuroFlow’s AI acts as a “force multiplier” for healthcare providers, allowing them to extend their reach and impact in behavioral health.                   •   Risk Identification: AI technology analyzes a range of health data to proactively identify at-risk patients, supporting earlier intervention.                   •   Integration in Real Healthcare Settings: NeuroFlow’s work with veterans, insurers, and major health systems exemplifies the transformative power of AI in delivering holistic, value-based care. 🎧 Listen to the full episode for a deep dive into how AI is transforming whole-person healthcare! Website: https://lnkd.in/gg7sS-4f Spotify: https://lnkd.in/gz6x3em3 YouTube: https://lnkd.in/gYm-ARae Apple Podcast: https://lnkd.in/ggj4H3_X #AIinHealthcare #TheBusinessofAIinHealthcarePodcast #ChrisMolaro #AIinHealthcarePodcast

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Healthcare is highly suited for AI automation, with many opportunities to improve accessibility, affordability, and outcomes. AI can drive efficiencies across various functions, though it will inevitably reduce the need for some human roles. #higherorder #ai #automation #healthcare #healthtech

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If health systems master the art of delivering a world-class consumer experience in urgent care, they can replicate this success across their entire operation, becoming market leaders and thriving in the long term. This is the core thesis of what we do at UCP Merchant Medicine. For nine years, UCP Merchant Medicine has partnered with 68 healthcare operators, most of whom are health systems, to create internal capabilities that allow them to thrive in consumer experience excellence. This isn’t just about having a world-class urgent care platform, this is about owning the future and the capabilities to expand these experiences across the broader health system. As healthcare shifts towards a consumer-driven model, the need for health systems to adapt is more critical than ever. Patients now have unprecedented freedom to choose their care providers, with 45% researching providers and costs before choosing a health plan, and 44% before making an appointment, according to McKinsey’s consumer Health Insights Survey. These improvements are not just numbers; they're about real people getting better access to the care they need when they need it in a way that they will love. This is what we stand for at UCP Merchant Medicine. Join us as we continue to innovate and lead the way in making healthcare more responsive, efficient, and patient-centric. Together, we can transform the future of healthcare! #HealthcareInnovation #PatientCare #UrgentCare #HealthcareLeadership #UCPMerchantMedicine Intellivisit Solutions

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🌟 Announcing the Launch of Healthyr® Horizon! 🌟 I am beyond excited to share the monumental news of the launch of Healthyr® Horizon, our groundbreaking interoperable digital care delivery platform. This isn't just a technological advancement; it's a testament to our unwavering commitment to transforming healthcare and delivering superior care to patients everywhere. In the realm of digital health, we face significant challenges. Many solutions only address fragments of the problem, leading to little to no engagement because they fail to see the bigger picture. At Healthyr, we understood from the beginning that to truly transform healthcare, we had to tackle the entire problem. And that’s exactly what we have set out to do. Healthyr Horizon: Transforming Healthcare Healthyr Horizon is more than just a care delivery platform. It embodies our vision to revolutionize healthcare delivery by enabling longitudinal, evidence-based care pathways targeted to specific disease states. Our platform ensures seamless, real-time data integration and communication across various healthcare systems, providing unparalleled care coordination and patient engagement. With Healthyr Horizon, physicians now have the tools necessary to scale preventative care outside of their clinic doors, bridge diagnosis gaps, and elevate care quality. Healthyr Horizon: The Pillars of Our Vision Access to Care: We believe that everyone should have easy access to high-quality healthcare. Health equity isn't just a problem for some—it’s a challenge for us all. Care Coordination: Effective healthcare requires seamless coordination among providers. Our platform ensures that every piece of patient information is shared and acted upon in real-time, facilitating comprehensive care. Experience of Care: Patients deserve seamless, personalized care that feels connected and attentive. We aim to elevate the experience of care for both patients and providers. Interoperability: True interoperability is key to efficient healthcare delivery. Healthyr Horizon integrates with over 90 EMRs and HIEs ensuring data flows seamlessly across different systems, preserving the integrity and continuity of patient information. At Healthyr, we are not just addressing fragments of the problem; we are tackling the entire challenge of transforming healthcare. Our mission is to redefine healthcare delivery, creating a space where patients and providers engage meaningfully, where care is coordinated seamlessly, and where access is equitable and expansive. Together, we are not just navigating the future of healthcare; we are pioneering it. I am incredibly proud of what we have accomplished and excited for what the future holds. Thank you to the entire Healthyr team for your dedication and passion. Welcome to the Dawn of a New Era in Healthcare! Exclusive Sneak Peek Here:  https://lnkd.in/ewSsTYtu #HealthcareInnovation #DigitalHealth #HealthyrHorizon #Interoperability #PatientCare

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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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One key reason why healthcare technologies like AI, telemedicine, and software haven't structurally lowered costs or broadened access for the entire system after decades of experimentation (excluding pure financial engineering of payer contracts) is the limited reimagining of care delivery itself, with asynchronous telemedicine as a notable exception. In the same way that digitizing physical paper failed to exploit the capabilities of a new computing medium for word processing, hosting physician-patient conversations over video does not transform the actual delivery of care. In telemedicine, many of the inputs (e.g., clinician time) and therefore cost structures of in-person care persist, which is why we often see fee-for-service telemedicine companies struggle to achieve economies of scale (i.e., growing revenues non-linearly while growing costs linearly). Until we deconstruct the components of a medical appointment – from intake and triage, to chart review, history gathering, physical examination, diagnosis, treatment, and follow-up – we will continue to be underwhelmed by the disconnect between the transformative potential of these technologies and real-world patient/system impact. I’m optimistic that the emergence of reliable and performant medical AI agents will urge us to perform this deconstruction and redesign the fundamental building blocks of a “medical appointment.”

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Bigger isn't always better in healthcare. Just look at the graphic below. Some of the largest health systems in the country are underperforming. They've entered (or operate in) bad markets, hold bloated cost structures, and struggle to hold leverage against payors. As it turns out, and as I'm often reminded, market performance matters. It doesn't matter that you're just big and can absorb a vast swath of overhead. As a health system, the way you throw your weight around in markets is more important than ever. This is the key concept of density and having the right assets in the right markets. CVS, HCA, Tenet, and others all have mentioned the importance of market density in 2024. Density - and being dense in attractive markets - is primarily what separates -3.9% from 10%+ operating margins. I should have paid attention in physics!! PS: if you like graphics and analysis like this, subscribe to my newsletter Hospitalogy here with 34k+ others: https://lnkd.in/gniNmHvz

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It is so much fun to think about redesigning the primary care workforce, and push and beyond to thinking about how we TRAIN the whole care team (starting at the medical school, nursing school, NP/PA school level) Paulius Mui, MD Minoo D'Cruz, MD #PrimaryCare #XPC #TeamBasedCare

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