Anshuman Sharma

📢 Exciting news for healthcare professionals! 🏥✨ I've just come across a fascinating article that delves into the world of healthcare standards and their impact on interoperability. 🌐 If you're interested in gaining insights into FHIR and how it compares to existing standards, this is a must-read! 📚 The article highlights some thought-provoking points, shedding light on the emergence of FHIR and its potential to revolutionize healthcare data exchange. It provides a comprehensive analysis of FHIR's key features and advantages, while exploring the challenges faced by other existing standards. I highly recommend giving it a read as it offers a fresh perspective on the future of healthcare interoperability. 🚀💡 Let's engage in a meaningful discussion on this topic by sharing your thoughts and experiences with healthcare standards. 🗣️✍️ I look forward to hearing what you have to say about this fascinating article! #HealthcareStandards #FHIR #Interoperability https://lnkd.in/e6GZbrpZ

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📢 The 2025 final Medicare Physician Fee Schedule dropped yesterday and there are two really significant changes impacting health tech. (1) CMS finalized coverage for digital therapeutics for mental health. This is the first time there is codified coverage for software-only digital therapies (that have gone through a 510(K) or De Novo pathway). The CPT Editorial Panel also expanded the definition of RTM codes starting in 2025. Together, these changes open the door to coverage and payment for digital therapeutics (though uptake will still be an uphill battle without much stronger clinical evidence). (2) CMS finalized coverage of advanced primary care management codes. These codes can be used instead of CCM, TCM, PCM, eConsult and eVisit codes, and shifts focus for providers and tech-enabled services companies from tracking time to developing capabilities that underpin advanced primary care. Providers will be able to bill for these services once per Medicare beneficiary per month so long as the practice has in place the capabilities to provide advanced primary care. Also some good news related to some operational telehealth flexibilities but we still need congress to act before the end of the year to extend the most important flexibilities (originating site and geographic restrictions). Manatt Health will have a more full summary in the coming days.

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CEP CORE Back Tool: An intuitive decision tree incorporating yellow and red flag screens. Despite being 8 years old, this tool is still relevant due to its structured approach and adherence to best practices. It offers a glimpse into what a clinical decision tree could look like if traditional care delivery is to maintain a viable clinical presence in the future. The tool presents simple, visual data for basic clinical risk analysis and provides foundational guidance for clinical care. By establishing baseline parameters for the clinical community, it paves the way for more optimized processes. Instruments like this, especially in a digitized format, are essential for reducing uncertainty and standardizing the MSK delivery process. This helps MSK professionals establish a core single source of truth, fostering a stronger professional identity. https://cep.health

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🔍 The Epic EHR Wonderland: A Tale of High Hopes and Lingering Dissatisfaction Since the rollout of Epic EHR, funded by the HITECH Act of 2009, healthcare providers have faced mixed experiences. A 2022 study from Finland and Denmark revealed that 32% of users were dissatisfied with Epic, citing poor usability despite improved technical performance. Strikingly, only a small fraction of physicians (4.7%) and nurses (7.3%) found accessing patient information easy, with even fewer agreeing that it improved patient care. Meanwhile, a 2019 US study showed that while modern EHRs enhanced certain process measures, they made no significant impact on patient outcomes. Worse, the emotional toll on healthcare workers is substantial. A 2020 study found that physicians working after hours on EHR tasks were 4.8 to 12.5 times more likely to experience emotional exhaustion. As we continue to navigate the balance between technology and care, it’s critical to re-examine whether systems like Epic are truly serving healthcare providers and patients. #HealthcareIT #EpicEHR #PhysicianBurnout #HealthcareInnovation #DigitalHealth

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Are we making progress in healthcare #interoperability? 🏥💻 The latest KLAS Research Arch Collaborative report offers some sobering insights. Based on feedback from over 500,000 clinicians, this comprehensive study sheds light on the current state of health information exchange. Despite government mandates for #EHR interoperability dating back to 2004, clinicians' data integration needs are still unmet. ⛔ Key findings from the #report: 👉 Only 44% of respondents agree their EHR provides expected integration with outside organizations 👉 47% of clinicians can't quickly find important patient information from external sources 👉 Another 47% report having to sift through duplicated data The study, which included responses from over 33,000 #clinicians about their experience with external patient data, underscores the ongoing need for improved interoperability solutions. ⭐ Physicians report interoperability as their top fix request, citing difficulties in accessing and leveraging external patient data within their EHR systems. However, it's not all bad news ☀️ The report identifies 17 organizations where 70% or more of clinicians agree that external integration meets their needs. From these success stories, KLAS compiled five key steps to enhance health data interoperability 1️⃣ Commit to sharing data through governance, resource allocation, and strategic planning 2️⃣ Collaborate closely with core sharing partners 3️⃣ Focus on key health measures for shared populations 4️⃣ Elevate end-user EHR awareness and proficiency through targeted training 5️⃣ Involve EHR vendors to optimize data-sharing settings and standardization One exciting finding is the impact of training on perceived interoperability success. The report found that 72% of clinicians who received sufficient training on accessing outside data reported satisfactory EHR integration, compared to only 26% of those who felt undertrained. 💪 Want to learn more about interoperability in healthcare and how our AI solutions can help address these challenges? Read the newest article on our blog: “What is healthcare interoperability and why does it matter?” Link to the article and KLAS report in comments 👇👇

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🔥 Fireside chat highlights from the Best Practice Show 🔥 Throwback to the Best Practice Show when Dr Satya Raghuvanshi, VP of Clinical at Accurx, and Dr Devin Gray discussed the topic: "How to Harness Data for Total Triage." Here’s some key messages from that session: 🧑🏾‍💻 Data is unique to each practice. The Accurx dashboard provides qualitative feedback, which can be used to tailor each practice's service. 🗣️ Keeping patients and staff updated through transparent communication is crucial so everyone understands any changes and how they benefit. 🤝 Addressing patient concerns about new care access methods is critical. 🔍 Ensuring accessibility for all, including those facing digital challenges. Everyone should be able to access the care that they need. 💪 Ongoing specialised training empowers staff to handle complex requests and maintain high care standards during transitions. 🗣️ Accurx can pair GP practices up with similar-sized practices through the Ambassador scheme so you can learn from each other. Did you attend the session? What were your takeaways? #PatientCare #TotalTriage

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This is a big deal. Tempus AI receives the first CPT code created to describe an algorithm-only analysis from a previously sequenced laboratory developed test using transcriptomic data. PurIST utilizes RNA data to classify pancreatic ductal adenocarcinoma (PDAC) into either basal or classical subtype and can help inform first-line therapy management. In our clinical validation study, PurIST can be used to stratify overall survival of classical patients between two, first line therapies, FOLFIRINOX and gemcotabine nab-paclitaxel. It’s our mission to build intelligent diagnostics using the experiences of patients in the past to inform therapy management for patients in the future. #appliedAI #diagnostics #healthcareAI

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If approved by the US Congress, this extension will drive significant innovation in telehealth, particularly in the Hospital-at-Home (#HAH) Care Delivery Model utilized by healthcare systems and #startups. It promises to enhance patient care while attracting substantial investments in this growing healthcare sector. The #HAH care delivery model continues to prove effective and efficient, addressing the increasing concerns about healthcare systems' capacities, throughput, patient experience, outcomes, and care delivery costs. Our initiatives in the #UAE align closely with the global advancements in Hospital-at-Home (HAH) programs. The developments in the #USA are poised to have a far-reaching impact on patient outcomes, particularly for the elderly population, not only within HAH programs across the region but also globally.

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What we learned at the AVIA Summit this week! We are at a tipping point where #technology has caught up with the needs that health systems are facing. 1. #AI is only as good as the workflows, data, and the problems you are trying to solve. Patient and staff experience MUST be at the forefront of any efforts to improve experience, not cause more friction. #humancentereddesign 2. Health Systems are only piloting this #technology and scaling is difficult because of the #complexity for each workflow. ( #clinicaldocumentation #clinicaldecisionsupport ). It's important to become autonomous #agile digital enterprises to drive the work forward. 3. AVIA is here to #accelerate your efforts from #aistrategy to #execution. We are experts with #digitaltransformation and what it takes to embed into workflows and navigating #changemanagement . It's time for #radicalreinvention! We are experts and passionate acceleration partners! Linda Finkel Eric Langshur Ted Meisel Patti Sweeney Melissa Masopust

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What makes Health AI Partnership special? It's about cultivating a community of practice among healthcare leaders who cross domains to leverage technology to solve problems. Three of the best AI leaders in healthcare today are Ashley Beecy MD, FACC from NewYork-Presbyterian Hospital Sara Murray, MD, MAS from UCSF Health and Karandeep Singh from UC San Diego Health. With executive leadership support from the likes of Robert Wachter and Christopher Longhurst, these individuals serve as Chief Health AI Officers. To learn more about the emerging role of the Chief Health AI Officer (CHAIO), check out their recent manuscript: https://lnkd.in/ejUTh4u5 The last paragraph: "One lesson of the past decade in health care is that the value derived from the implementation of a technology tool depends not only on the attributes of the tool itself but the “complementary innovations” in workflow, workforce, culture, and governance. Challenges abound, but with the right leadership and unwavering commitment, health care institutions can navigate the AI revolution and thrive in an increasingly AI-driven world. We believe that the establishment of the CHAIO role will be a crucial step toward data-driven and AI-optimized health care systems." David Vidal Mark Lifson Keo Shaw Danny Tobey, M.D., J.D. Suresh Balu Mark Sendak Alifia Hasan Jee Young Kim, PhD Steve Miff Trish Henwood, MD Brian Patterson Frank Liao Corinne Stroum Susan Kirsh MD MPH Tonya Jagneaux, MD, MSHI Paul Crews, MPH, FACHE Carmen Hughes, MBA Phoebe Nelms Dominic Mack Miranda Bogen Michael Sheppard Michael Burns Jeffery Smith Christopher Khoury Abdoul Aziz Sosseh Jordan Everson Sylvia Trujillo MPP JD Leila Mureebe Thomas M. Maddox MD SM Philip Payne Charles Jaffe, MD, PhD

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A good article about the need to build patient trust in Generative AI. One method not mentioned is allowing for the patient to "opt-out" for their own exposure to the tool. Dynamic Global Healthcare/Rev Cycle Staffing What Hospitals Need to Know about Patient Trust in GenAI - MedCity News https://buff.ly/3XhiDDT #healthcare #dallasfortworth

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In the evolving landscape of healthcare technology, the Fast Healthcare Interoperability Resources (FHIR) standard is revolutionizing how we manage and exchange medical data. Our latest blog post delves into the true strength of FHIR—not just its "resources," but its use of RESTful architecture combined with standardized data formats like JSON and XML. In the linked post we cover: RESTful Architecture in FHIR: How RESTful APIs simplify communication between diverse healthcare systems, making data exchange more efficient and scalable. The Role of JSON and XML: Understanding how these data formats ensure machine-readable and universally understood information transfer across platforms. Bridging Modern and Legacy Systems: Strategies for integrating new healthcare applications with existing legacy systems using FHIR, ensuring a smooth transition and interoperability. By embracing these components of FHIR, healthcare providers and technologists can enhance interoperability, improve patient care, and future-proof their systems against the rapidly changing technological landscape. 📖 Interested in a deep dive? Read the full article here: https://lnkd.in/d8MfYYje From all of us here at Outburn, have a lovey weekend! #FHIR #HealthTech #Interoperability #HealthcareInnovation #RESTfulAPI #JSON #XML #DataExchange Daniel Mechanik Meirav Malkin Amos (Kippi) Bordowitz Alex Baumberg Liron Shahar-Atia Sima Morgenstern Nir Rabinovich Uri Lerner Dmitry Baranov Irit Berezin

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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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It's been 8 months since CMS announced its final rule on prior authorization (PA) and interoperability. As we come closer the implementation deadlines, it's crucial to assess our readiness and understand the broader implications. The CMS rule on PA requires some key things: 1️⃣ Faster PA decisions (72 hours urgent, 7 days standard) start in 2026 2️⃣ FHIR-based Prior Authorization API implementation 3️⃣ Expanded Patient Access API and new Provider Access API from 2027 4️⃣ Affects Medicare Advantage, Medicaid, CHIP, and certain QHP issuers 🔗 The FHIR APIs Required by 2027: Enhanced Patient Access API: Now includes prior authorization data Provider Access API: Allows providers to access patient data from payers Payer-to-Payer API: Facilitates data exchange when patients switch payers Prior Authorization API: Streamlines the prior auth process 🔍 What's Missing? 1️⃣ FHIR Standard Adoption: Payers must use FHIR standard queries, but EHR changes aren't mandated. 2️⃣ EHR Integration Gap: The rule doesn't require direct EHR interrogation for PA requests, which could have eliminated most administrative friction. 3️⃣ Digital Endpoint Challenge: Payers need to discover digital endpoints for each entity, but there's no centralized database yet. 4️⃣ Medication-related PA inclusion 5️⃣ Other revenue cycle FHIR standards: While the rule addresses PA, it doesn't tackle the myriad other reasons for claim denials (e.g., coding errors, eligibility issues, medical necessity disputes). 🔍 Where are we now? - Many organizations are in the planning or early implementation stages - CMS is exploring a National Directory of Healthcare Providers and Services, potentially including payer endpoints. (https://lnkd.in/ghf28bDF) - Prior Authorization support has been built in to some of the most common implementation guides for FHIR (https://lnkd.in/gKP4Qdzn) 🤔 Critical questions at this stage: 1. How far along is your organization in preparing for these changes? 2. What unexpected challenges have you encountered in the implementation process? 3. How are you balancing these PA improvements with other revenue cycle optimization efforts? Let's share experiences and best practices. What insights can you offer to peers navigating this transition? #HealthcareIT #PriorAuthorization #Interoperability #RCM #RevenueCycle #CMS https://lnkd.in/gHB_i9Gu https://lnkd.in/gjegKF4g

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