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Surprise Bill for “out of network” Services

December 22, 2020, Congress passed a government funding deal, which includes a long-awaited federal fix for “surprise billing.” Most of the new requirements take effect with plan years beginning January 1, 2022

The new law ensures that patients receiving services in a hospital ED, or standalone ED

  • Must assume the same cost-sharing responsibility for such services, regardless of whether the provider is in-network.
  • Receive credit towards any applicable in-network deductible or out-of-pocket maximums for these payments.

Providers and payers will be able to resolve payment disputes through either negotiation between the parties or an independent dispute resolution (“IDR”) process to be developed by the Departments of Health and Human Services and Labor and Treasury. …


Measuring body temperature frequently may be the theme of the future. Have you recently stepped into a store or a restaurant where the staff is standing there with a thermostat taking your temperature before entering?

Now comes the Verily patch, an adhesive patch measuring your body temperature regularly. It is currently under FDA clearance as an approved electronic thermometer to address this public health emergency. This may be something that gets the FDA 501(k) approval in the future post-pandemic.

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The patch uses Bluetooth BLE to connect with the mobile app for monitoring. I anticipate the following in the future:

  • Verily’s involvement with “immunity passport” is already in development, and the patch is a required wearable to show active body temperature. …

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Telemedicine security

While I recognize the industry expert’s concern with using Apple FaceTime, Facebook Messenger video chat, Google Hangouts, Zoom, and Skype for video consults, these solutions are convenient. Health care providers must cater to simplicity for the users, and we need a mechanism to instill that philosophy with care delivery.

FaceTime provides end-to-end encryption but will not sign a BAA, is that the primary reason we are hesitant about accepting it fully for telemedicine?

Covid19 Vaccination Card

Health systems have spent so much money on technology but still passing out covid19 vaccination cards like the immunization card I had as a kid. As a healthcare technology leader, I am also guilty since we did not have an easy solution to address this quickly. …


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Due to the current pandemic, the healthcare industry has not focused much on CMS’s final physician fee schedule and telehealth expansion. The upcoming year provides a 10% pay decrease while expanding telehealth services. Health systems must shift their business models towards a “virtual first” mentality to improve the patient experience while aligning with the telehealth reimbursement model.

The key takeaway of the rule is that CMS finalized an expanded list of telehealth services, mostly temporarily. Make a bet as an organization that the allowable telehealth service will be a permanent care delivery feature. …


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The move to value-based care was already in full swing when the COVID-19 pandemic interrupted. But the health system’s response to the pandemic offers a clue to the bold idea that technology can enable healthcare delivery organizations to provide safe and cost-effective care.

Value-based care puts a premium on using approaches that get care to patients quickly, identifying problems as soon as possible, when they are less severe and can be treated at less cost and risk to patients. There’s been some adoption of simple solutions, but few bold initiatives had gained traction.

In-home solutions

In March, COVID-19 came like a freight train, and provider organizations had little option but to change practices immediately. Telehealth is a case in point; data gathered by Harvard University and Phreesia, a healthcare technology company, and published by the Commonwealth Fund showed that the number of telemedicine visits, as a percentage of all healthcare encounters, rose from 1 percent in mid-March to 14 percent of all encounters by April 19. Years of resistance to telehealth were reversed as clinicians and patients alike became addicted to the immediacy of access. …


Hospitals need to practice their security hygiene just like handwashing

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Three federal agencies — the FBI and the Departments of Homeland Security and Health and Human Services — issued a security alert for hospitals last week that they have credible evidence of an increased and imminent cybercrime threat to U.S. hospitals and health systems. The call to action is for the entities to protect their network infrastructure from these threats immediately.

Last week, ransomware hit six hospitals that took their systems down. …


Technology Team Burnout In Healthcare Is Real. Here Is What CIOs Can Do To Help.

Covid-19 has put unprecedented strain on the healthcare workforce, challenging clinical resources and departments supporting the clinicians. Healthcare CIOs worked extremely hard to transition their organization towards a remote workforce during the pandemic. While organizations are putting together a plan to manage remote workforces, leaders must now build a new culture with new philosophies for managing teams remotely, highlighting burnout prevention.

Studies have shown that remote workers increase their average workday by 8.2%, equating to an additional 48.5 minutes daily. A survey by online employment platform Monster found that over 69% of employees experience burnout while working from home. Increased work hours, coupled with things like homeschooling of children, increases stress and adds to burnout risk. …


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CIOs and CHRO have practiced their change management skills in the past few months to adapt to the future workforce. Remote workforce technology and the relentless focus on employee experience dominate the strategic and tactical initiatives. The time is now for IT and HR to partner closely to utilize technology to enhance its digital experience meeting the CEO’s objective. Here are the two themes that the CHRO is looking for from their CIO partner.

HR leadership is looking for employee insight while automating processes to improve employee experience and talent management. …


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Times are incredibly challenging as a professional technology sales executive. Simultaneously, the pressure is also tremendous for technology decision-makers such as the CIO, CTO, VP of technology, and other leaders during a pandemic. I am very empathetic for all industry professionals, and I understand the challenges that sales professionals face in the current climate. Travel bans and decision-makers are not taking any meetings from vendors that they do not have an established relationship with, makes it almost impossible for the vendor community to succeed. Here are some tips to help with sales enablement for the vendor community.

Vendors must focus on cross-departmental solutions to a problem. Assist the CxO with enterprise solutions to a current issue that they are facing. The solution must exhibit a business solution vs. a technology solution as the CIO is fighting for budget vs. their peers solving business problems. One of the worst questions to ask is, “tell me about your strategic initiative, or what are your upcoming focus in the next fiscal year?” Asking these types of questions shows that the vendor has not done enough research or lacks the industry knowledge about the challenges that the organization is facing. …


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Last week, Nuance Communications Inc. and Microsoft Corp. announced Nuance Dragon® Ambient eXperience™ (DAX™), an ambient clinical intelligence (ACI) solution, is now integrated into Microsoft Teams to broadly scale virtual consults aimed at increasing physician wellness and providing better patient health outcomes.

The integration of Nuance DAX and Microsoft Teams for telehealth is part of the ongoing strategic partnership to accelerate the adoption of ACI solutions to improve healthcare experiences by reducing administrative workloads that lead to physician burnout. This telehealth workflow solution built on Microsoft Teams:

Synthesizes physician-patient conversations during virtual visits through Microsoft Teams, allowing physicians to remain focused on the patient instead of taking notes on the computer. …

About

David Chou

Healthcare CIO with the CEO mentality. www.davidchou.health

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