The Future Is Now: Revolutionizing Healthcare Through Collaboration

Collaboration is key to overcoming administrative burdens and driving better outcomes in healthcare.

In this episode, Anna Taylor, AVP of Population Health and Value-Based Care at MultiCare Connected Care, and Heidi Kriz, Director of Medical Policy and Medical Management at Regence Health Plans, discuss their innovative approach to using FHIR for prior authorization and other administrative processes. Anna and Heidi highlight the importance of sharing operational workflows between payers and providers, much like other industries, to improve efficiency and patient care. Their pilot program for quality measure exchange demonstrated significant financial returns and operational efficiencies, earning enterprise buy-in for broader implementation.

Tune in and learn how curiosity, bravery, and collaboration can spark positive change in healthcare!

A Patient-First Approach to Innovation and Engagement

How can a healthcare system reinvent itself to put 'patients first, people always' while tackling the industry's toughest challenges?

In this episode, Mark Sevco, Chief Operating Officer at Sutter Health, discusses his dedication to improving healthcare through innovation, employee engagement, and patient-centered care, highlighting Sutter’s mission: “Patients first, people always.” He explains that engaged employees foster a better patient experience and describes Sutter's innovation lab as a collaborative hub for reimagining healthcare delivery and addressing challenges like access and billing. Mark also emphasizes Sutter’s dyadic leadership model, which pairs executives with physician leaders to improve collaboration and align organizational goals with patient and clinician needs. Sutter’s adoption of technology, such as ambient listening and digital scheduling tools, aims to streamline patient access and reduce burdens on providers. Additionally, Sutter is expanding ambulatory and urgent care sites, reflecting a strategic shift toward outpatient care to enhance affordability and adaptability in healthcare.

Tune in to learn how Mark Sevco is transforming healthcare through innovation, patient-centered care, and a bold mission to make 'getting better' unstoppable!

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:

Streamline data exchange. Our platform enables efficient and secure data-sharing directly between payers and providers, reducing administrative burdens and improving patient care without centralizing data.
Simplify connectivity and transaction routing. The Avaneer Health Network provides a single, interoperable platform with endpoint directory services, reducing the need for complex point-to-point connections.
Enhance consent management. We’re working on a decentralized, multi-party consent exchange service that will be validated at critical points along the workflow to ensure that patient data is shared only with authorized entities.

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

Skyrocketing Hospital Administrative Costs, Burdensome Commercial Insurer Policies Impacting Patient Care
While business leaders look inward for AI’s impact, tech leaders look outward
Reimagining healthcare industry service operations in the age of AI
Harnessing Technology to Restore the Doctor-Patient Relationship
Strategic Guidelines for Getting Started with FHIR

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.

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.

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.

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