Access for All: The Key to a Healthier Future

Amid the rapid rise of AI and digital therapeutics, the true breakthroughs in healthcare lie in improving equity and access and tackling the social determinants of health.

On this episode, John Gorman, founder and chairman of Nightingale Partners, highlights the rapid innovation in healthcare, particularly around social determinants of health and health equity. He emphasizes that while technologies like AI and digital therapeutics are overhyped, significant advancements in areas like telehealth, remote monitoring, and AI diagnostics are promising. John stresses that health equity, reducing disparities in care, and making new therapies accessible to vulnerable populations are critical issues for the future. He also identifies the importance of addressing data exchange and interoperability challenges while noting the underappreciated value of social health interventions, such as food security, in reducing healthcare costs. John also points to the untapped potential in supporting minority physician groups and improving care for dual-eligible populations as key areas for progress.

Tune in to discover how innovative solutions are transforming healthcare and improving equity and access for all!

The Path to Healthcare Improvement: Collaborative Innovation

Healthcare’s future depends on embracing disruption and rethinking traditional approaches to patient care. 

In this episode, David Sylvan, Chief Strategy, Innovation & Marketing Officer at University Hospitals, shares his approach to addressing healthcare's inefficiencies by focusing on problem identification and leveraging technology, process reengineering, and partnerships. He highlights successful collaborations, including producing masks during COVID-19 and implementing Risk LD, an AI-driven solution to improve maternal and fetal outcomes. David emphasizes the importance of enhancing back-office operations and using AI to streamline patient and provider experiences. He believes healthcare must embrace disruption and innovation, with openness to partnerships across industries to drive positive change. 

 Tune in to discover how innovation and disruptive thinking are transforming healthcare and shaping the future of patient care! 

 

Avaneer Health collaborates to fuel innovation, interoperability, data governance, and privacy

We’re excited to share insights from our recent participation in the HL7 FHIR Connectathon. This important event, hosted by HL7 International Working Group, brings together industry leaders to collaborate, discuss emerging trends, and develop healthcare interoperability standards.

At Avaneer Health, we’ve been actively engaged in advancing healthcare interoperability that supports the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) through our secure, trusted network and platform. Our platform empowers organizations to exchange data seamlessly while maintaining data governance and privacy.

Through the Connectathon, we’re able to collaborate with clients and industry partners, exploring innovative approaches to address the challenges and opportunities presented by the CMS Final Rule. Our focus is on developing solutions that:

By participating in these collaborative efforts, we’re making significant strides toward a more connected and efficient healthcare ecosystem. We’re committed to improving payer-provider relationships by enabling them to meet the requirements of the CMS Final Rule and, ultimately, improving patient outcomes. In the coming months, we’ll share more details about our new solutions and how they can benefit your organization.

Stay tuned for updates on our progress and how Avaneer Health is simplifying healthcare interoperability.

Adria Sherman
Senior Product Manager
Avaneer Health

In This Issue

Industry Highlights

Skyrocketing Hospital Administrative Costs, Burdensome Commercial Insurer Policies Impacting Patient Care
American Hospital Association

Payers are using increasingly sophisticated algorithms to flag potential claim issues, especially for medical necessity. This has resulted in skyrocketing denial rates and care delays. Interestingly, an estimated 75% of denials are eventually overturned, which means they should have been paid in the first place. This has put an even greater burden on providers at a time when burnout and stress are already overwhelming.

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While business leaders look inward for AI’s impact, tech leaders look outward
Deloitte Insights

Which of the AI-related key performance indicators do healthcare organizations prioritize most: internal process-related benefits or external sales and customer satisfaction benefits? According to a survey by Deloitte, the answer depends on who you ask. These misaligned priorities have the potential to inhibit AI impact assessments and an organization’s ongoing AI investments.

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Reimagining healthcare industry service operations in the age of AI
McKinsey & Company

This insightful article explores the many elements that inhibit healthcare organizations from realizing even a third of their expected ROI from their “technology transformation” initiatives. This is vitally important as organizations set out to implement AI into their operations. The article outlines several use cases and best practices to ensure they get the most from their AI efforts. If you only have time to read one article this week, this should be it.

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From the Avaneer Podcast

Harnessing Technology to Restore the Doctor-Patient Relationship

In this episode, Dr. Ben Schwartz, a fellowship-trained orthopedic surgeon with more than 15 years of experience, discusses the transformative potential of artificial intelligence in enhancing clinical decision-making and patient outcomes.

Tune In

From the Avaneer Blog

Strategic Guidelines for Getting Started with FHIR

How do you evaluate where to begin implementing FHIR? This blog highlights important factors for payers and providers to consider during FHIR strategy development such as regulatory compliance, data quality, system readiness, security, and customization.

Read the Blog

 

Harnessing Technology to Restore the Doctor-Patient Relationship

With the rise of artificial intelligence in healthcare, the future of patient care hinges on bridging the gap between innovative technology and the essential art of medicine. 

In this episode, Dr. Ben Schwartz, a fellowship-trained orthopedic surgeon with over 15 years of experience, discusses the transformative potential of artificial intelligence in enhancing clinical decision-making and patient outcomes. He emphasizes the importance of bridging the gap between AI-driven recommendations and the nuanced realities of patient care, where decisions often involve complexities. Dr. Schwartz highlights inefficiencies in the patient experience, noting that healthcare could learn from other industries to create more seamless interactions. He provides insights for doctors engaging with startups, emphasizing the need for an open mind and adaptability in the fast-moving startup environment. Dr. Schwartz also advocates for restoring the doctor-patient relationship with technology, alongside a focus on developing effective value-based care models supported by better data. 

 Tune in as Dr. Ben Schwartz explores how artificial intelligence is transforming healthcare and enhancing the doctor-patient relationship! 

 

Innovating Implementation

One of the biggest challenges with acquiring new technology is the onboarding experience. It can take a significant number of resources and often can disrupt daily operations. At Avaneer Health, we are changing that. We’re flipping the script on onboarding by making it a seamless and, dare we say, simple experience.

Why put so much effort into the implementation process? We are passionate about our mission and take pride in how we simplify the business of healthcare. It is a part of our culture to continuously iterate and look for even the smallest of opportunities to enhance our partners’ success, starting from day one of implementation.

Here's a glimpse of what you can expect during the Avaneer Health onboarding experience:

Stay tuned for more information about what we’re working on next!

Jessica Willoughby
Sr. Director of Client Success & Operations
Avaneer Health

In This Issue

Upcoming Avaneer Webinar

3 Ways to Finally Win the War on Denials

Denials cost providers millions of dollars per year, including administrative costs and lost revenue. Further, analysis has shown that 20% of first-pass claim denials are due to avoidable coverage-related reasons. Reverse this trend at your hospital and health system by:

Providers, join this webinar to learn more about implementing these 3 new ways to prevent denials and lower administrative costs, saving up to $5.75 per claim.

Register today

Industry Highlights

Survey: AI most exciting emerging technology in healthcare
Xtelligent Healthtech Analytics

This eye-opening article lays out the findings from a recent survey, “Top of Mind for Top Health Systems,” which asked leaders from 55 healthcare organizations their thoughts on AI. The shared results include which AI applications healthcare leaders are most excited about, which they consider to be most useful, and which they feel have the most potential to solve our industry’s problems. The article also shares which aspects of AI leaders are most concerned about.

Read More

Novel AI Model May Enhance Health Data Interoperability
Northwestern Medicine News Center

What do you get when you combine GPT-4, Open AI’s large language model, with FHIR? The answer is a new AI model that transforms clinical data into FHIR resources with the goal of improving the exchange of health data. “With the help of large language models, we can standardize the data into a standardized format so then we can build a large data set and it is easy to communicate with different stakeholders in healthcare.” Learn more about the use of this new AI model in this fascinating article.

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Podcast: The ONC’s Micky Tripathi on creating a connected healthcare system
Fierce Healthcare

In this podcast, Micky Tripathi, Assistant Secretary for Technology Policy, National Coordinator for Health Information Technology, and Acting Chief Artificial Intelligence Officer at the U.S. Department of Health and Human Services, talks about what he sees as the ONC’s most significant accomplishment over the past 20 years. He also talks about the barriers our industry still faces when it comes to advancements in data sharing, which he connects with organizational culture and workflows and a poor economic construct based on a fee-for-service model. Tripathi also discusses what’s next for the ONC and the future of healthcare. Don’t miss out on this insightful conversation.

Listen here

Despite Increased Investment and Early Enthusiasm, Data and Risk Remain Key Challenges to Scaling Generative AI, Reveals New Deloitte Survey
Deloitte

Regulatory compliance, risk management, and data governance are top barriers to successful GenAI deployment, according to a recent global survey by Deloitte. The drivers most cited are “model bias, hallucinations, novel privacy concerns, trust, and protecting new attack surfaces.” Forty-one percent of organizations surveyed said they’ve yet to take their GenAI initiatives beyond proof-of-concept.

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Digital bonds: How Virtual Adventures Strengthen Real-World Engineering Teams
Builtin Chicago

Avaneer Health software engineer Jonathan Walker was highlighted in this industry article about the bonds created among virtual engineering teams. “Our success proved that when we blur the lines between roles and support each other unconditionally, we can achieve remarkable results.” Congratulations Jonathan!

Read More 

From the Avaneer Podcast

How Data Sharing is Transforming Healthcare Delivery

Healthcare innovation requires passion and a deep understanding of the industry’s complexities, which are often uncovered through diverse experiences. On this episode of The Spark, Shruti Kothari, Director of Industry Initiatives for Health Care Reform at Blue Shield of California, discusses her experiences working in different areas of healthcare, from frontline care in underserved communities to driving innovation and policy at large organizations.

Tune In

From the Avaneer Blog

Enhancing the Patient Experience by Improving Administrative Processes

Information is vital to a payer’s ability to effectively manage risk and collaborate with providers on their members’ behalf. But when it comes to sharing coverage information, things can get messy. But not anymore. Today, one of the nation’s largest payers is using a solution that enables them to share data directly with providers without the need for APIs, data aggregation, or sending data to third parties. The result is significant cost saving and improved data security.

Learn more

Gaining Coverage Insights as a Path to Payment Integrity

Payers often struggle to identify accurate and complete coverage information for their members, leading to payment integrity issues, operational inefficiencies, and poor member experience. Avaneer Coverage Direct provides a direct connection between payers and providers on the Avaneer Network, enabling the real-time sharing of primary, secondary, and tertiary insurance information without data aggregation. This helps payers reduce first-pass denials, increase coordination of benefits leads, improve insurance primacy validation, and lower provider calls, resulting in significant cost savings and improved member satisfaction.

Learn more

Events

HL7 FHIR Connectathon 37
September 21-22, 2024

Members of the Avaneer Team will participate in the upcoming Connectathon in Atlanta, Georgia to work with others in the industry developing FHIR-based solutions and exchange data with FHIR interfaces. These industry work sessions promote cross industry collaboration and innovation.

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