Debra Patt, MD PhD MBA

Sharing key takeaways on the CMS Hospital Inpatient Quality Reporting program for FY2025. - Seven new measures are added (which are welcome, with the caveat of let's see how they work out) -> Patient Safety Structural Measure beginning CY 2025 with payment determination in FY 2027 -> Age Friendly Hospital CY 2025/FY 2027 -> Catheter-Associated Urinary Tract Infection Standardized Infection Ratio Stratified for Oncology Locations (CAUTI- Onc) CY 2026/FY 2028 -> Central Line-Associated Bloodstream Infection Standardized Infection Ratio Stratified for Oncology Locations (CLABSI-Onc) CY 2026/FY 2028 -> Hospital Harm – Falls with Injury (eCQM) CY 2026/FY 2028 -> Hospital Harm – Postoperative Respiratory Failure (eCQM) CY 2026/FY 2028 -> Thirty-day Risk-Standardized Death Rate Among Surgical Inpatients with Complications July 1, 2023–June 30, 2025/ FY 2027 - Five existing measures are removed (which is a breath of fresh air) - the unpopular PSI-04, and measures related to 30-day episode payments for acute myocardial infarction, pneumonia, total hip/ knee arthroplasty, heart failure - Two existing measures are modified (Global malnutrition composite score expanded from seniors over 65 to anyone older than 18 - this is very positive; and Refined HCAHPS measure - will post details on this next week.)

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I’ve been given advice that the fastest way to monetize HER Heard without charging the end user (woman) is trackers and selling data. Instead, I’d like to build something more trustworthy. I don’t want to be in a headline like this. If you are not paying, then you are the product (you/your data are being sold). There are newer ways to deindentify data or even to aggregate things women search for that can be of interest to various stakeholders. In theory that could be okay to sell, but in a post-Roe world with laws encouraging bounty hunting, I am vetting the choices ahead. I am all for moving fast, without breaking things.

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Here’s your recap of last week’s health IT news 🗞️ 👇 🖊️ AI Ambient Scribes • CHRISTUS Health + Abridge: The 15,000 provider Texas health system adopted the ambient scribe enterprise-wide.    • Tampa General Hospital + Nuance Communications DAX Copilot: Over 500 providers at the health system will begin utilizing the AI ambient scribe.    • Texas Oncology + DeepScribe: The statewide oncology practice adopted the AI ambient medical scribe. (ed. note: scribes continue to be hot!) ☎️ AI Contact Center • Clearstep: The AI conversational chat vendor launched a new feature allowing patients to self-schedule specialist visits. 📊 Data & Analytics • InterSystems + CLEAR: The cloud-based patient data service is integrating the identity technology to expedite access to patient records.    • WakeMed + Bamboo Health: The health system is adopting the data interoperability and encounter notification service. 🥼 Clinical Decision Support • University Hospitals + Aidoc: The Cleveland-based health system is implementing the AI clinical decision support platform across 13 of its hospitals and additional outpatient locations. 🧑‍💻 Virtual and At-Home Care • University of South Carolina School of Medicine + Rimidi: The hospital group and an affiliated multispecialty clinic are adopting the remote patient monitoring platform to reduce complications from postpartum hypertension.    • Mount Sinai Health System + HealthSnap: The medical center announced a new remote patient monitoring and chronic care management program in partnership with the virtual care management platform.    • Wheel: The telehealth company released a new AI-driven virtual care platform designed to enhance the patient experience and offer resources to help partners scale their virtual care services. 💬 Patient Engagement • CipherHealth: The patient engagement solution focused on patient rounding released a new AI summary tool.    • DexCare: The care orchestration platform completed a $75M series C funding round 🩼 Durable Medical Equipment • Better Health: The medical device and peer support network completed a $14M funding round. 🧠 Food for Thought: • Silicon Valley Bank released an interesting report on the state of investment in AI in healthcare, including stats on AI usage at healthcare organizations and the impact of leveraging AI on startup valuation. https://lnkd.in/em7AfivT    • The journal Critical Care Medicine published an editorial on an “in clinico” evaluation of a machine learning-based early warning system to predict in-hospital deterioration. We found it to be an interesting look at the actual impact of a model’s deployment on care processes and patient outcomes in a critical care setting. https://lnkd.in/eQhZbVKu

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It's wild to think in 2024 we're FIRST seeing the DOJ accuse telemedicine conglomerates of criminal drug distribution. How long have we known about these practices in brick and mortar care...? Answer: decades! Take it from someone who prescribed stimulants and other psychotropics to kids over the years - painstakingly measuring and documenting the need and impact - these appalling abuses by Done and Cerebral mean we need more calls for thoughtful pause when it comes to working with startups. Particularly about funding's role - my favorite topic! 🤑 How did we end up with venture capital and PE financing in healthcare that risk the safety of kids in the name of exorbitant returns? Not that all VC or PE dollars are bad, of course, but they're certainly key drivers who shouldn't be in that seat. Did we underestimate these funders as 'barbarians at the gate', much like the pharma reps of the 90's and early 2000's heyday? Have we not learned from Purdue Pharma's aggressive and deadly Oxoycontin marketing? Purdue pleaded guilty to criminal charges and paid $600 million in fines in 2007. Or TAP Pharmaceutical Products's Lupron kickback scheme for the prostate cancer drug? TAP also pleaded guilty to criminal charges and paid $875 million in fines in 2001. Or Pfizer marketing Neurontin, an anti-seizure drug, for off-label uses, such as treating pain and bipolar disorder, even though the drug was not approved for these purposes, and paying physicians kickbacks. In 2004, Pfizer pleaded guilty to criminal charges and paid $430 million in fines. Cerebral and Done's playbooks were practically the same thing, just with a modern mid-pandemic, low-regulatory scrutiny, digital-platform twist. Will appropriate regulation ever outpace American venture greed? Is it even possible to ensure patient safety AHEAD of tragedies driven by the intersection of innovation and venture funding? If you're keeping score, healthcare regulatory reactivity: 1 million. Healthcare ounces of smartly preventive policy: 3. Blech. 😖 When will we finally own that prevention in-house? #healthcare #overdoseprevention #suicideprevention

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Great conversation here between my colleague Blake Watts and our friends over at Leader's Edge Magazine! Blake discusses point solution fatigue, the importance of investing in health tech, and what makes Ochsner Connected Health a unique player in how we approach chronic disease management with employers nationwide. #HealthTech #EmployeeWellness #ChronicDiseaseManagement #DigitalHealth #ValueBasedCare #Diabetes #Hypertension #GLP1 #Obesity

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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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If over 50% of the births in Mississippi are financed by #Medicaid and over 75% of Medicaid recipients are in #managedcare, it makes sense to review contract requirements for managed care organizations. The organizations play a fundamental role in assuring timely, equitable, quality care and improving maternal health outcomes. In this article, Milbank Quarterly offers a close review of managed care contracts and shows that the absence of a national set of #maternalhealth standards has caused challenges in setting expectations for managed care performance. Table 1 in the study offers a summary of contractual findings, including in #Mississippi. Twenty-five contracts require perinatal risk assessments by the MCO or a provider, but most of these contracts do not require risk assessments throughout the full continuum of care. Only two states require risk assessment in the postpartum period (California and Louisiana). Yet nearly half of pregnancy-related deaths occur one week to one year after delivery, when most individuals would have left the hospital. All MCOs are required to include obstetrician gynecologists (OB-GYNs) in network, and seven states explicitly require high-risk obstetrician specialists (maternal–fetal medicine). Mississippi is not one of those states. Full article: https://lnkd.in/gF-45tJ2

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On October 8th, U.S. News & World Report released its annual rankings of Children's Hospitals, called "Best Children's Hospitals". It is a 174-page report describing the methodology and data tables which I scanned through. Appendix C-10 has the data on Pediatric Pulmonology which I took a deep dive into. In the attached carousel, I have recreated two datasets that matter. If I were to shop around for a hospital for my care, what really matters to me is the outcome data for a particular condition I am seeking care for and not the reputation score. However what separates the top-ranked "Best Children's Hospitals" is their reputation scores, not the outcome scores for selected conditions as in asthma here. It's a different matter whether the outcome scores used in the rankings are good measures. We will discuss them in another post. What are your thoughts? Feel free to like, share, and comment. #healthcare #hospitals #physician

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The quality of the argument, along with true partnership and data liquidity, is where the real magic happens in #valuebasedcare contract negotiations. It’s easy to get caught up in the economics and risk adjustment discussions, but at the end of the day, the real measure is how do we map out a shared vision to get to X (I.e. #healthcaretransformation) in the long-term.

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I get Dr. Yang's concern about large, wealthier health systems adopting AI sooner than smaller, poorer organizations, but this is actually a good thing...unless your time horizon is myopically short. Big organizations, with much larger budgets and sophisticated IT teams, can afford to take risks, make mistakes, and test out exciting (but still unproven) emerging tech while smaller organizations certainly can't (for the most part). So let the behemoths take all the risk, do the heavy lifting first, and then smaller organizations get to adopt truly proven solutions at lower risks/prices...once these have run the Kaiser, Mayo, Intermountain, etc., gauntlet. It's all part of the plan... #healthcare #startups #startup #ai #generativeai #digitalhealth #emergingtech Kaiser Permanente Cleveland Clinic Mayo Clinic Risant Health Intermountain Health https://lnkd.in/gckgQB_q

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Reminder—t-minus 12.5 months until the start of TEAM! ⏰ If you are a mandated particiapant, there is plenty to do to prepare to succeed in the model, such as: 📊 Data analysis and to identify tangible risks and opportunities, 🧑‍⚕️Identifying high value community providers like outpatient rehab (in clinic and in home), home health, skilled nursing, and more, 🚶Establishing a true hospital mobility program, 💪🏻 Developing and growing the teams that will make or break your success, like social work, case management, nursing, and rehab therapy providers, 🤝 Learning how to collaborate effectively with ACOs and primary care providers to meet program requirements and optimize your collaboration (facilitated by a new overlap policy rewarding both program types and participants for improved outcomes), And so much more! Check out the HCTTF’s overview resource on TEAM below 👇🏻 #TEAM #hospitalmobility #physicaltherapy #occupationaltherapy

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Looking forward to sharing recent KLAS Research insights at the upcoming The Millennium Alliance Assembly and learning from attendees their expectations in #digitalhealth for 2025. 🔎 What are the investment priorities of 100 healthcare provider executives and 50 payer executives over the next 2 years? 🔎 How do provider priorities compare to patient expectations? 🔎 What are the current digital health problems that you are trying to solve? 🔎 What digital tools do you plan to add, consolidate, or eliminate? 📢 CHALLENGE FOR THE LINKEDIN COMMUNITY Using 5 words 'What digital health trends do you expect to see in 2025? ' Fun fact: we are about to be 40 years since Marty McFly got in the DeLorean.

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Shifting the financial model alone is not sufficient for the transition - the care delivery, workforce, and many other pieces of the ecosystem with which PCPs interact also need to adjust accordingly. Funding to allow for the startup costs of transformation must be made available. A comprehensive analysis from The Commonwealth Fund: To encourage participation, practitioners say upfront payments, investment in the primary care workforce, and less emphasis on simplistic quality measures are needed, as well as more support for practices to provide accessible, comprehensive care. #primarycare #integratedcare #teambasedcare #healthcare #healthcareonlinkedin

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Wearable tech and patient-generated health data (PGHD) are poised to revolutionize electronic health records (#EHRs), offering clinicians unprecedented real-time insights into patient health. By integrating data from wearables, such as heart rate variability and oxygen levels, EHRs can help identify early warning signs, track trends, and personalize care in ways traditional visits cannot. However, to maximize impact, we must address challenges like data overload, privacy concerns, and the need for smarter, action-oriented EHR dashboards. As healthcare executives and physician leaders, 𝘯𝘰𝘸 𝘪𝘴 𝘵𝘩𝘦 𝘵𝘪𝘮𝘦 𝘵𝘰 𝘱𝘳𝘦𝘱𝘢𝘳𝘦 𝘧𝘰𝘳 𝘵𝘩𝘪𝘴 𝘸𝘢𝘷𝘦 𝘰𝘧 𝘪𝘯𝘯𝘰𝘷𝘢𝘵𝘪𝘰𝘯. Proactive planning will ensure your organization stays ahead of the curve. 𝗔𝗰𝘁𝗶𝗼𝗻 𝗜𝘁𝗲𝗺𝘀 𝗳𝗼𝗿 𝗛𝗲𝗮𝗹𝘁𝗵𝗰𝗮𝗿𝗲 𝗘𝘅𝗲𝗰𝘂𝘁𝗶𝘃𝗲𝘀: 🩺 𝗖𝗵𝗮𝗺𝗽𝗶𝗼𝗻 𝗜𝗻𝘁𝗲𝗴𝗿𝗮𝘁𝗶𝗼𝗻: Prioritize EHR upgrades that can accommodate wearable data and provide clinicians with user-friendly dashboards. 🛡️ 𝗦𝘁𝗿𝗲𝗻𝗴𝘁𝗵𝗲𝗻 𝗦𝗲𝗰𝘂𝗿𝗶𝘁𝘆: Invest in robust data privacy measures to build and maintain patient trust. 🤖 𝗘𝗺𝗯𝗿𝗮𝗰𝗲 𝗔𝗜: Leverage advanced algorithms to filter and highlight actionable insights, minimizing clinician burnout. 🤝 𝗖𝗼𝗹𝗹𝗮𝗯𝗼𝗿𝗮𝘁𝗲 𝘄𝗶𝘁𝗵 𝗣𝗮𝘁𝗶𝗲𝗻𝘁𝘀: Develop policies that empower patients to control what data is shared, fostering trust and engagement.

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My next Signal takes a closer look at the latest antitrust probe into large dialysis companies and the shifting role of non-competes in kidney care. A recent POLITICO article provides helpful background around topics like NCAs in dialysis and impacts on the adoption of home dialysis technologies. This is an important discussion, so I'd love to hear from you. If you have something you'd like to share, whether it's an anecdote, comment or question for other readers, please leave a comment or send me a message. H/t to Tom Mueller for sharing the article last week. https://lnkd.in/e95a23JF

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Collaboration born in the crucible of COVID-19 helped leaders in Dallas develop a Pediatric Asthma Surveillance System to better serve kids in their community. A new case study from the Common Health Coalition features work led by Phil Huang, Joe L., Steve Miff, and Brett Moran, MD. https://lnkd.in/eEC-9XGn

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Anyone else just swallow another healthcare cost increase in choosing benefits this month? This newly released NEJM Catalyst article is timely https://lnkd.in/exWdtwZq. Improving affordability is broadly seen in the U.S. as our #1 healthcare policy issue. Mark McClellan offers great insights here. Ultimately, without inappropriately stifling the juggernaut of tech innovation, we need to be laser focused on achieving the quintuple aim through new processes AND tech (and some appropriate gov regulation) that address this elephant in the room of massive expense. There are few studies that have shown such promise more than the hospital at home care model. Acute care alone constitutes over half of all Medicare costs. The opportunity is real. We at the Hospital at Home Tech Council are working diligently with partners to ensure that we build and enhance current/emerging tech (POC diagnostics, RPM, virtual visits, supply chain, etc) to leverage this opportunity to achieve the quintuple aim. Please join with us! And if you're heading to HLTH Inc. conference next week, ping me to connect on this topic. #patientsfirst #healthcareaffordability #healthcarepolicy #hospitalathome #healthcaretech #futureofheatlhcare #poc #diagnostics #remotepatientmonitoring #supplychain #nejm

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