Vinay Vaidya

Keep our rurals open but if you really want to help get the foreign equity owned GPO that sets the pricing for our hospitals BANNED from our state. Economies of scale are used by Vizient against Oklahoma rural hospitals. If you have 13 tiers, hidden tiers, and tier maxes…that’s not a contract, that a free for all nightmare of a scam we all fell for. Their awful written tiered agreements force our rurals to pay more for the exact same items that our large hospitals pay less for. Example box of gloves a large hospital system in the state will pay 6-8 bucks for a box of 250 exam gloves. That same box for a rural EMT? 24 bucks. There is no price transparency and you are forcing patients who live in rural areas to pay more because of the lack of infrastructure by the corporations serving them to effectively and economically get goods and services to these hospitals. And distributors who whine about the cost of delivering to rural hospitals all while posting BILLIONS in profit every quarter are the first on my 💩 list. Let’s keep our rurals open but let’s make them more profitable so that they can continue to add much needed services and gainfully employ more community members.

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Key Strategic Insights = A Successful OP CDI Program The challenge of value-based care starts with a collaborative approach, when launching an Outpatient Clinical Documentation Integrity (OP CDI) program. Here are some key strategic insights to success: 1. Engage with Population Health Understand Pain Points: Begin by understanding the specific challenges faced. This fosters collaboration. Tailored Questions: Use customized questions to facilitate productive discussions and ensure alignment with needs. 2. Effective Software Implementation Manage Patient (Pt.) Volumes: Implement software solutions to efficiently handle pt. volumes. OP CDI Calculator: Utilize a calculator to determine Full-Time Equivalent (FTE) needs. Data Analytics and Reporting: Emphasize the importance of continuous improvement via data analytics. 3. Workflow Creation Establish Robust Workflows: Create strong workflows before integrating reviewers. 4. Collaboration & Communication Promote Strong Collaboration: Encourage robust communication between key stakeholders. Leverage Software: Use technology to reduce physician burnout & streamline communication. 5. Patient-Centered Approach Address social determinants of health (SDOH) & ensure accurate documentation of conditions and care plans. Patient Outcomes: Keep patient care at the center of all doc. & workflow processes. 6. Regulatory Compliance Adhere to Guidelines: Follow regulatory requirements such as CMS guidelines on Hierarchical Condition Categories (HCC) coding to avoid penalties and enhance credibility. 7. Measurable Outcomes Set Clear Goals: Aim for measurable outcomes like improved HCC recapture rates, enhanced RAF scores, better HEDIS measures, and addressing SDOH needs. 8. Stakeholder Engagement Involve All Stakeholders: Ensure that executives, clinicians, and other relevant parties are involved in planning and implementation process. Success Stories Recently, I helped several CDI directors validate their cases for OP CDI programs within Accountable Care Organizations (ACOs). By engaging with population health leadership, we identified key issues such as RAF gaps and HEDIS measures, and tailored processes to address them. For instance, a CDI director I guided successfully identified HCC and HEDIS recapture as their biggest pain points. With strategic solutions in place, they are now ready to implement the project for the 2025 budget yr., aiming to improve their HCC recapture rate by 20%, leveraging data analytics for outcomes and improvement needs. Benefits of Implementing These Strategies Align Risk Stratification: Properly align risk stratification with chronic conditions and healthcare needs. Quality Measures: Improve quality measures and address SDOH. Collaborative Team: Ensure success with a collaborative team supported by technology. Overall, these strategic actions will enhance patient care and operational efficiency. #Healthcare #Leadership #CDI #PatientCare #ValueBasedCare #HealthcareInnovation

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In my weekly piece, I discuss AI-based services in healthcare. The integration of AI-delivered healthcare services is poised to revolutionize patient care, but a significant question remains: will payers equitably reimburse these services compared to care provided by human practitioners? my piece delves into the financial implications and policies surrounding AI in healthcare, highlighting the necessity for fair compensation frameworks. It emphasizes the potential benefits of AI for enhancing healthcare quality and accessibility while advocating for equitable reimbursement structures. Follow https://lnkd.in/ewwss6wy

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As our population ages, the strain on our healthcare system will continue to face unprecedented challenges, especially in caring for individuals with complex care needs. Coupled with this crisis, is an opportunity, to leverage new technology and innovation that can reimagine care delivery and the care experience. Questions we ideate on at AlayaCare include: How might we imagine, enable and empower physicians, nurses, therapists, and personal care aids to use technology to improve their practices and scale working in integrated care teams to keep people in their homes, where they want to be. One of the ways that we are answering these questions is by introducing the first-ever Large Language Model (LLM)-based smart AI assistant for home-based care. This new AI assistant will aid home care providers by providing real-time clinical decision support, reducing administrative burdens, and enabling more focused patient-centred care. Our goal is to mitigate risks of adverse clinical events, and hospital or institutional readmissions, but going further, perhaps one day even preventing them altogether. We want to optimize care schedules to make care providers' days just that much easier so that they can care for more individuals. Our true north is to find efficiencies and improve the quality of care that is being provided so that more of our loved ones can receive care in the place they call home. Thank you to the invaluable partnership of DIGITAL, Canada’s Global Innovation Cluster for this investment, trust and partnership as we continue to work to transform home-based care. https://lnkd.in/gN5Debhs

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This topic and these two experienced experts should be on your #Healthcareprofessional development bucket list! Sign up today! DM me and I’ll connect with more details!

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Collaborative Care not Hybrid or In-Person Care Virtual First is the framework to transform patient experience and outcomes using data-driven innovation to reimagine health and healthcare operations. This will impact staffing, facilities, technologies, and policy as collaborative care changes the frequency, nature, and value of care interactions. VF goes beyond optimizing encounters or hybrid care; it's about utilizing the most appropriate care mode to address needs at any point in the patient’s health journey. Health is not a single event or a series of disconnected occurrences. Traditionally, healthcare has been plagued by silos within and across systems, specialties, and care modes, resulting in fragmented workflows, communication, and data accessibility. Even within offices, experiences can be episodic, lacking continuity, leading to redundant questions and unnecessary steps. By leveraging data and insights, Virtual First supports seamless care continuity through ongoing collaboration, regardless of care mode. Virtual touchpoints are standard and expected. Good system design incorporates and utilizes virtual tools effectively for the patient, clinical staff, and payers. Virtual First encourages ongoing collaboration to support daily health decisions and needs, shifting focus away from the limited time people spend as "patients." The goal is not merely to offer convenience but to improve health and healthcare delivery by using the most appropriate mode of care, provided by the right person, at the right time, for the right need. Rather than debating the value of virtual vs. hybrid vs. in-person, Virtual First emphasizes collaborative care. Data supports care delivery by any mode at each stage of the health journey. Collaboration can occur between patient-provider, among providers, healthcare team-patient, with caregivers and others. Technology and data allow patient and clinical needs to start to be addressed at the earliest opportunity. Each collaboration informs the next most appropriate step, moving towards a more proactive and person-centric model. By design, Virtual First enables nudges, reminders, and communications as part of a trusted health relationship, not an unfamiliar service. The same virtual tools can be used for chronic disease management, acute care, mental health, preventive initiatives, and risk prevention without data silos or redundancy. Over time, the data collected will support the refinement of evidence-based practices, moving beyond current underperforming care models. Let's not simply reengineer current processes or create new silos. By embracing Virtual First, we can reinvent healthcare to not only be more responsive and efficient, but to address the increasing challenges of access, outcomes, equity, and cost. #VirtualFirst #ReInvent

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Let’s be honest – healthcare is fragmented and facing multiple critical issues. In order to harmonize healthcare across America, we must address our most pressing challenges. One of these issues is labor management, which is essential for a health system’s operational success. I enjoyed reading this recent article in Becker's Healthcare highlighting 4 key workforce innovation strategies to future-proof your organization. From technologies to successful partnerships, round-table discussants at Becker's 14th Annual Meeting shared insights into solutions that are helping retain and recruit their current workforce and prepare future workers. Managing staffing to benefit the organization, individual staff and, most importantly, the patient is essential to effectively achieve the ideal workforce scenario. Read their tips: https://lnkd.in/eFivXzm3

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Oracle’s clinical and operational technologies are helping health systems like Ascension to manage, innovate and simplify processes. Read why “Ascension is betting on Oracle” here. https://lnkd.in/gtDTCyy9

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An Outpatient Clinical Documentation Improvement (CDI) program offers substantial advantages to healthcare organizations by elevating patient care and operational efficiency. By integrating risk stratification with chronic conditions, enhancing quality measures, addressing social determinants of health, and establishing a collaborative team empowered by technology, such strategic initiatives result in improved patient outcomes and streamlined operations.

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Reflecting on the implementation of structured, value-based care models: The foundation of effective clinical intervention is a deep understanding of the health system and its key stakeholders. These models must center on the individuals receiving care. Evidence-guided and value-focused care optimizes available resources within health systems, specialty programs, and health services, leading to qualitative and valuable care delivery. The result? Better resource utilization, improved outcomes, and enhanced individual health. This approach is essential for organizations that design true care pathways rather than virtue signaling or creating superficial content. Having been intimately involved in Value-Based Care design and implementation, I'm eager to partner with forward-thinking organizations to continue this vital work. The result - a healthcare system that truly serves its patients and stakeholders - is a goal worth pursuing. If you're passionate about transforming healthcare delivery, let's connect and explore how we can drive meaningful change together. #ValueBasedCare #HealthcareInnovation #ClinicalPathways #HealthcareTransformation #letstalk

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What does the future hold for retail medicine and virtual care? Walmart is the latest to announce their health center closure. https://lnkd.in/geZpMTkS. This following Optum news, VillageMD closing in Nevada, Teladoc Health problems, etc. What comes next? This is another in a long line of examples that technology and even consumer willingness are not enough when the reimbursement environment does not support particular care models. Are we getting ready to lose all the lessons painfully learned during the pandemic? Or will new virtual care models emerge following this round of closures?

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EXCITING NEWS IN HEALTH POLICY!!! The Centers for Medicare and Medicaid Services propose introducing baseline requirements for hospitals and critical access hospitals (CAH) in obstetrical services, marking a pivotal step towards revolutionizing maternal healthcare. The proposed rule can drive robust maternal quality improvement initiatives that set foundational standards for the organization, staffing, and care delivery within obstetrical units. Safeguarding emergency services readiness and establishing seamless transfer protocols for obstetrical patients can significantly enhance the quality and safety of maternal care. Furthermore, the rule requires annual staff training on evidence-based maternal health practices and cultural competencies, equipping healthcare professionals with the knowledge and skills to provide compassionate, high-quality care to every mother. This policy intervention promises to elevate the standard of maternal health services nationwide, ultimately saving thousands of lives and improving outcomes for countless families. https://lnkd.in/eAPr6Tg9 #MaternalHealth #QualityCare #HealthcareReform #SafeDeliveries #MaternalWellness #CompassionateCare

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“We envision a future where every child receives personalized, high-quality care. To make this vision a reality, we must overcome the challenges of #carecoordination,” said Dr. Amanda Furr, VP of #PopulationHealth at Pediatrics Associates Inc. “We understand the value of #dataanalytics, risk adjustment, quality gap closure and empowering #pediatric clinicians to improve outcomes. As our organization continues to grow, it’s imperative for us to scale our #PHM capabilities. The #Innovaccer platform enhances our understanding of patient populations and helps us make accurate diagnoses, establish and automate TCM protocols, and bridge care gaps. This holistic approach helps us to deliver a seamless, comprehensive #healthcare experience for our patients and families.” “We have an established relationship with the #PediatricsAssociates team, and we are excited to be working with them again as we are setting a new standard for #healthcare, where #technology and compassion converge to enrich the lives of children and their families,” said Abhinav Shashank, cofounder and CEO at Innovaccer. “Pediatric Associates has an impressive track record in managing over 1.5 million lives across Medicaid and commercial contracts. Innovaccer’s AI-powered, scalable PHM platform will help them effectively manage patient populations to meet their goal of managing over 1 million covered lives in the next two years. We look forward to supporting Pediatric Associates in its mission to launch a new era of pediatric care that is both proactive and profoundly impactful.” https://lnkd.in/gvUD-sm4

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In crude numbers, we need about 50% more FPs, Peds, IM, NPs, PAs in primary care to provide adequacy. That 1975 FP grad put in a standardized 25 years, the current crop of grads will do a fraction of that. I'm personally a 1981 grad, and put in 39 years. The baby boomer retirement cliff will make these numbers look very conservative. There's not much time left before the system begins to crash. What will YOU do to help restore and reinvent this US healthcare system???? healthcarereinvention.com

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The biggest EHR overhead for Healthcare providers is cognitive. It comes from a presentation layer that does not mesh well with our thirst for synthesis or how all the myriad of concepts fit together. They also do a terrible job at scaling our cognition from higher level concepts to lower level concepts. This is the essence of modeling. Let's start a movement towards modeling/design tools in healthcare.

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Now that our HIT industry has spent nearly 40 years figuring out how to effectively pass data between sites, settings, and institutions of care (and while that journey isn't completely over, we're well on our way), we can finally turn and look farther down the road and consider what's next. In my view, advancing process consistency, agility, and change is that horizon. The BPM community is focused on that challenge, and having recently transitioned into HL7 as HL7 BPM, is squarely trying to take this on. With today's press release, HL7 is truly open-for-business in this space. Thanks to the OMG for nurturing this work along and for HL7 for having made our next home for this effort. So much to do! https://lnkd.in/dAF96g3n

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The landscape of health care changes fast. Advancements occur at lightning speed. And yet one relic has remained unchanged for decades: the nurse call button. But why? Reflecting on this stagnation prompts us to consider the incredible progress we've made in other areas of health care. Take, for instance, the story of the Kennedy baby – born prematurely during JFK's presidency. Despite access to the best care available at the time, the baby tragically did not survive. Fast forward to today, and we possess the remarkable ability to save premature babies born as early as 22 weeks. Such advancements underscore the vast strides we've made in medical science and technology. However, amidst this progress, the workload for nurses has intensified. With increasingly complex patient needs, including more medications, charting requirements, and sicker patients, nurses are stretched thin. While some tasks could be delegated to other health care professionals, many requests still funnel through the nursing staff. Attempts to introduce technology into patient rooms, such as Alexa devices or iPads, have often led to more distractions and added burden for the nursing team. Recognizing the need for innovation while preserving efficiency and patient experience, we embarked on a journey to reimagine the role of the nurse call button. Enter Helen – our novel solution that modernizes patient care. Rather than burdening nurses with non-clinical requests, Helen uses connected apps in the patient rooms and the hands of nurses to redirect non-clinical requests to a dedicated team. We affectionately call these people Helen concierges. This innovative approach gives immense time and energy back to nurses and reserves the call button for its original and intended purpose: urgent medical needs. Feedback from our multiple pilot programs has been overwhelmingly positive. Nurses report saving an average of one to two hours per shift, previously spent on fulfilling non-clinical requests. Patients, too, view the introduction of Helen as a welcome enhancement to their hospital experience, giving them comfort and control like never before. While our pilot program is not without its challenges, we remain committed to continuous improvement. After all, that’s what true innovation requires. As we celebrate Nurses Week, let us reaffirm our dedication to alleviating the burdens faced by our incredible nursing staff – and help them return to the work they love. To the nurses who tirelessly care for our community, your unwavering dedication and compassion inspire us all. #NursesWeek #HealthcareInnovation #NurseCallButton #PatientCare #HealthcareTransformation #InnovationInHealthcare #Nursing #PatientExperience #HealthcareAdvancements

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