JOHN PISTONE

As I've continued to reflect on the recent Nashville Health Care Council Data and AI event, I found myself considering the intersection of data interoperability and the need to leverage healthcare data in a compliant way for AI to truly live up to its promise. At Integral, where we focus on automating regulated data compliance to enable collaboration and AI innovation, questions often arise about HCOs' data challenges, interoperability vs. collaboration, data quality impacts, and balancing innovation with risk. To gain some guiding thoughts on these topics, I phoned a friend Leigh McCormack, the co-founder and CEO of Platypus, and the former Data Science Lead for BlueCross BlueShield of Tennessee. Here's what she had to say: "Over the past decade, our progress in improving data quality for healthcare AI has been minimal, and we have significantly overlooked the importance of data collaboration. It's important to distinguish that collaboration goes beyond just interoperability. While interoperability focuses on the technical aspects of data sharing, primarily for operational needs, collaboration emphasizes the people and purpose behind utilizing that collective knowledge. As we work to overcome challenges in AI, data quality and interoperability remain crucial, but they can only take us so far. To truly advance, we must also adopt collaborative strategies and mindsets, allowing our foundational knowledge to evolve and enhancing our ability to use these technical tools for the benefit of the entire healthcare ecosystem." What are your thoughts on the evolving landscape of healthcare data, collaboration, and AI? #RegulatedData #DataInteroperability #DataQuality #DataCollaboration

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Take a break with Roberta Mullin's PL: Selling to Healthcare - Lisa T. Miller discusses navigating centralized versus decentralized decision-making and addressing budget constraints and supply disruptions. #SellingtoHC The Handoff - Joni Watson, DNP, MBA, RN, OCN welcomes back Dr. Brian Weirich, Chief Nursing Innovation Officer at Bon Secours Mercy Health, to discuss the transformative potential of ambient voice technology in #nursing. Trusted Health #TheHandoffPodcast #RevenueCycleOptimized - Uncover key missteps practices make in RAC audit responses and learn strategies to avoid compliance pitfalls that lead to recoupments. Learn practical tips to submit accurate, complete documentation that meets payer expectations and minimizes audit risks. Infinx Value-Based Care - Daniel J. Marino sits down with JBS Health’s CEO Vanessa Guzman and Co-founder Seth Hyman to discuss the GUIDE Model, a CMS supplement for caregivers of patients with dementia and Alzheimer’s disease. #VBCInsights Lumina Health Partners #TheVirtualShift - Tom Foley discusses the value of #virtualcare services; where we’ve been and where we should go. This Just In - Justin Barnes, FHIMSS records live at HLTH Inc. 2024 in Las Vegas. On this episode hear Antonio Nunes, Senior Manager, Healthcare & Life Sciences, AMD and Nick Patel M.D., Founder & CEO, Stealth Consulting. #ThisJustInRadio #HealthUnaBASHEd - Gil Bashe and Gregg Anthony Masters, MPH welcome Zachary Fink, CEO & Co-Founder of VyTrac a company committed to increasing access to care for all through encrypted #digitalhealthcare that empowers individuals and clinicians to view their responsibility and role in #healthcare via technology leveraged innovation. Healthcare de Jure - Matthew Fisher talks to Kristine Ashcraft, President and Founder, YouScript, about background and application of pharmacogenetic testing; importance of understanding impact of drug-gene interactions and more. #HCdeJure #DigitalHealthTalks - On the October Edition of Five Good Things Janae Sharp and Megan Antonelli share a rapid-fire segment highlighting positive developments in #digitalhealth. Janae and Megan share insights on recent innovations, successful implementations, and emerging trends that are driving progress in healthcare technology. HealthIMPACT Live AMCP Podcast Series – Listen Up - Host Fred Goldstein invites Elizabeth Powers, Vice President and General Manager, Regulatory Science and Study Innovation at IQVIA, to discuss Real World Evidence. AMCP #HealthcareRap - On the second episode recorded live at HLTH Inc. in Las Vegas, Jared speaks with Dr. Noura Abul-Husn, VP of Genomic Health at 23andMe. Noura shares an impressive list of ways that genetic profiles can lead consumers to a more preventive state of health, including many that you might not be aware of. Jared Johnson Zain Ismail https://lnkd.in/g7nmx9bK

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Advancing REMS Data Exchange at the HL7 FHIR January 14, 2025, Connectathon! As the Use Case Coordinator for the REMS (Risk Evaluation and Mitigation Strategies) Integration use case, I am excited to share our progress and plans for the January 2025 HL7 FHIR virtual Connectathon! This initiative continues to drive innovations in interoperability, making REMS programs more efficient and stakeholder friendly. Data Exchange Use Case Our use case focuses on enhancing connectivity between providers, provider intermediaries, and multiple REMS administrators. By building on last year’s Implementation Guide (IG), we are working toward seamless, standardized data exchange to reduce complexity, improve patient safety, and ensure timely medication access. Collaborative Efforts This initiative brings together a powerful team of manufacturers, REMS administrators, technology vendors, and regulatory stakeholders. Members like InfoWerks, Syneos, UBC, MITRE, the FDA, and BMS have been instrumental in shaping the use case and preparing for Connectathon testing. Success Stories In 2024, we achieved critical milestones, demonstrating how standardized FHIR-based workflows can streamline REMS processes across stakeholders. These successes laid the foundation for our 2025 efforts to enhance provider and intermediary connections and enable broader scalability of REMS data exchange. What’s Next Tomorrow, during the 2025 Connectathon, we’ll focus on advancing provider and intermediary workflows, planning for new real world use cases, and refining our IG to support real-world implementation. This is a key step in creating a robust ecosystem where providers can seamlessly interact with multiple REMS administrators via - a provider intermediary - interoperable solution. Join Us We invite you to explore how the REMS Data Exchange use case is shaping the future of healthcare interoperability. If you are participating in other tracks and have an interest, be sure to "pop in". Questions or collaboration ideas? Feel free to reach out to me at kelee.petzelt@synerio.com! Together, with the leadership of CodeX HL7 FHIR Accelerator and the incredible support of our members, we’re transforming REMS processes for better provider experiences and patient outcomes. CodeX HL7 FHIR Accelerator InfoWerks Data Services, LLCSyneos Health Commercial Solutions Syneos Health #UBC MITRE FDA Patrick LaRocque Jason Leedy Jeff Deitch Justin Wilson George Neyarapally Nicole Ng Bristol Myers Squibb Ammu Irivinti REMS Industry Consortium Brian vanOosten Susan Rand

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GASTROENTEROLOGY QUARTERLY UPDATES - 3rd Quarter - Live Webinar - July 10, 2024 - 1 hr web - 10am PT - 1 ceu from AAPC. SPECIAL DISCOUNT ADDITIONAL ATTENDEES - sign up first person at regular price - each add'l attendee(s) goes for $99 a person (includes their own connection, materials & ceu's) - limited spaces available at this rate, so signed up soon! Here's link to download registration and fax to (415)892-1271 or register online at McVey Seminars website - https://lnkd.in/g4SAuyic WANT AN AMAZING DISCOUNT? (for a short time this below discount has an extra $50 off for this week only - so take advantage of double savings for a limited time) TO GET THE NEXT 4 GI QUARTERLIES AT THE LOW PRICE OF $735.00 (BRINGS THE COST FROM $230.00 EACH TO $183.75> here's link to do all 4 sessions for 2024/2025 - https://lnkd.in/gNXFUe8 / #gastroenterology #gastroenterologist #gastrointestinal #gastro #gidoc #healthcare #medicalbilling #medicalcoding #medicalbillingandcoding #coding #billing

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Update to MA 2025 Final release ( more details are still required). The final (4/23/24) introduces changes to the regulations concerning agents, brokers, and Third-Party Marketing Organizations (TPMOs) in several areas: Unified Compensation Framework: The new regulations implement a unified compensation structure for agents and brokers across all plans. A single compensation rate is set for all plans, updated annually, which also includes a revision of the scope of items and services within agent and broker compensation. Separate payments for administrative services by agents and brokers are eliminated (administrative is defined but more details coming). Oversight and Compliance: Enhanced oversight measures are introduced to ensure that agents, brokers, and TPMOs (includes FMO’s) comply with the updated compensation structures and marketing rules. TPMO Marketing and Data Privacy: TPMOs are now subject to stricter marketing and communication rules. The final rule prohibits TPMOs from selling or sharing personal beneficiary data collected during marketing activities without explicit beneficiary consent. A new one-to-one consent structure is required, where TPMOs must obtain explicit consent from the beneficiary for each TPMO that will receive their data, ensuring more transparent and controlled use of beneficiary information. Prohibitions on Overrides: The regulations explicitly prohibit compensation structures that include additional payments known as "overrides" for TPMOs, which could influence the marketing and enrollment practices in favor of higher-paying plans. As we all know this will need further evaluation but recordings; trainings; portals etc will all be included in the total capped enrollment comp. #MAfinal2025 #medicareadvantage

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I really enjoyed my recent conversation with Patrick discussing the challenges and opportunities in the LTC space. 2025 is going to be a transformational year for our industry as reimbursement pressures create a burning platform requiring many different approaches to servicing our patient population. #LongTermCarePharmacy #PharmacyDelivery #HealthcareLogistics #Efficiency #Compliance #PatientCare #PharmacySolutions #FrameworkLTC #SDSRx

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I’m thankful to Healthcare IT Today for the opportunity to join a panel of experts to discuss how AI-driven predictive analytics and machine learning algorithms are being used to: ✅ Streamline hospital operations ✅ Optimize resource allocations ✅ Improve overall healthcare system efficiency At OneStep, we support providers by delivering solutions that apply to all parts of the healthcare ecosystem. Our predictive AI proactively identifies patients at risk of falling, ensures success in remote therapeutic monitoring programs, and provides objective data to support managed care conversations. Want to learn more about OneStep? Visit www.onestep.co to explore our digital care platform powered by motion intelligence. #HealthTech #AI #MachineLearning #HealthcareInnovation #DigitalHealth

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Healthcare Deals and News for Week ending December 20th, 2024: · Apollo Care Secures Major Investment from Flexpoint Ford · Nymbl Systems Secures Strategic Investment from Frontier Growth · Commure Acquires Memora Health to Enhance AI-Powered Healthcare Solutions · Aspirion Acquires Boost Healthcare via Varsity Healthcare Partners and Linden Capital Partners · SailPoint Acquires Imprivata's IGA Business via Thoma Bravo · MGA Homecare Acquires Ward Road Pharmacy to Expand Comprehensive Home-Based Healthcare Services via Flexpoint Ford · Everise, via Brookfield and Warburg Pincus LLC, Expands with Acquisition of Continuum Global Solutions' Verticals · StatLab Medical Products Expands with Acquisition of Spanish Histology Equipment Manufacturer Especialidades Médicas Myr · Solaris Health Holdings Expands Urology Network with Associated Urologists of North Carolina Acquisition via Lee Equity Partners, LLC · West Monroe Acquires Inspired Insight via Madison Dearborn Partners, LLC · Solis Mammography Acquires Avestēe Women's Imaging Centers via Madison Dearborn Partners, LLC and Ares Management Corporation · ENSIGN GROUP INC (Nasdaq: ENSG) Expands Healthcare Portfolio with Acquisition of Eight Facilities from Providence Health · Avenues Home Care Expands with Acquisition of Clear Path Home Care, via Capital Alignment Partners Venture and Other News: · Anatomy Financial Secures $19M Series A Funding led by Canapi Ventures to Revolutionize Healthcare Billing with AI-Powered Lockbox · Culina Health Secures $7.9 Million in Series A Funding, Revolutionizing Digital Nutrition Care Led by Healthworx · Scripta Insights Secures $17M Series B Funding to Revolutionize Prescription Drug Shopping led by Aquiline · Confido Health Raises $3 Million to Revolutionize Healthcare Operations with AI Digital Workers · Bluenote Secures $10M in Funding to Revolutionize Life Sciences Workflows with Generative AI led by Lux Capital Read all of this week's news by Clicking Here: https://lnkd.in/gDrUJumY JPM Healthcare Conference Jan 13-16th 2025 in San Francisco CA. Members of the Lawrence, Evans & Co., LLC healthcare deal team will be attending this year. Contact us today to schedule a meeting if you are in the city. info@lawrenceevans.com 614-448-1304 Research Read our recently released Healthcare Venture Studio Industry Report: https://lnkd.in/g2CfZrjr Register for weekly news and all industry reports - https://lnkd.in/gmsTiwn7 Lawrence, Evans & Co., LLC (LECO) is a leading national healthcare financial advisory firm. We specialize in capital raising, mergers and acquisitions, and restructuring for lower middle market private companies, delivering strategic solutions to maximize value and drive long-term growth across healthcare, technology, business services, and real estate.

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The Forbes article, authored by Randy Bean, discusses how Cleveland Clinic is using data analytics and artificial intelligence (AI) to innovate in healthcare. The Clinic leverages these technologies to enhance patient care, optimize operational efficiency, and promote better health outcomes. Key figures like @Christopher Donovan , Executive Director of Enterprise Analytics at Cleveland Clinic, emphasize using data to address social determinants of health, improve decision-making, and reduce healthcare waste. The Clinic is also building a robust data and AI innovation ecosystem, fostering collaboration with industry leaders to accelerate the adoption of new technologies. By democratizing access to AI and promoting internal innovation, Cleveland Clinic aims to upskill its workforce and remain at the forefront of healthcare transformation. Cleveland Clinic's approach includes predictive modeling to improve patient recovery outcomes and partnerships with tech companies to integrate AI into clinical and operational workflows. Their goal is to provide more personalized care and address large-scale challenges in the healthcare industry. Article Link: https://lnkd.in/eNMKdceM

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In recent years, many GPOs have been acquired or exited the market, pushing health systems into exclusivity agreements. But do these contracts truly benefit your supply chain and patient care? Advantus works well as a secondary GPO to give health systems top-tier partnerships that complement their full supply chain needs. Dan Hurry, president of Advantus Health Partner, says, “A GPO that handcuffs you from options is not your partner. To drive value, you need options.” Just like consumers need both Trader Joe’s and Target, health systems need multiple GPOs to access the best deals and partnerships. Exclusive GPOs can’t offer top value in every category. Advantus offers vetted vendor partnerships with GE HealthCare, HHS, LLC, Medline Industries, LP, SupplyCopia, and more, along with unique PPI contracts negotiated directly. These options not only lower costs but also enhance patient care. Learn how Advantus’s partnerships can elevate your supply chain and patient care. https://lnkd.in/g7JygEN7 #Healthcare #SupplyChain #GPO #PatientCare #AdvantusHealthPartners

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Henry Schein, a leading global provider of healthcare products and services, has announced its decision to acquire Acentus, a prominent medical supply company. https://buff.ly/4fYMYgB This strategic acquisition is expected to enhance Henry Schein's product portfolio and expand its market reach, potentially increasing its influence in the healthcare sector. The move aligns with Henry Schein's ongoing efforts to provide comprehensive solutions to healthcare professionals by integrating Acentus' innovative offerings. #HealthcareInnovation #MedicalSupplies

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Mistakes in your revalidation process can lead to significant headaches and financial losses. Explore our latest blog to uncover the most common pitfalls and learn how to avoid them. https://bit.ly/3BrqmGR #Healthcare #Revalidation #MedicalPractice #HealthcareManagement

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It's official! Attending the CAHP conference soon? Swing by our booth to explore how we can enhance your organization's operations. Let's tackle the upcoming challenges in the dynamic realm of automation together. #CAHPconference #Automation #BusinessSolutions

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Payers are seeking new risk assessment tools to improve commercial underwriting accuracy and gain a competitive edge. Find out how these tools are evolving to evaluate risk better and set competitive premium rates. Read the article here: https://optumin.co/0iqu74   #Optum #healthplans #Payers #Underwriting #Riskassessment #healthcareanalytics #actuarial #predictivepower #riskevaluation

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Payers are seeking new risk assessment tools to improve commercial underwriting accuracy and gain a competitive edge. Find out how these tools are evolving to evaluate risk better and set competitive premium rates. Read the article here: https://optumin.co/0iqu74    #Optum #healthplans #Payers #Underwriting #Riskassessment #healthcareanalytics #actuarial #predictivepower #riskevaluation

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The rise in hospitalizations is fueling the demand for advanced hospital bed management systems, ensuring efficient allocation of resources for inpatient care. Leading companies like McKesson, Oracle, and GE Healthcare are leveraging strategic partnerships to innovate and gain a competitive edge. These collaborations drive advancements in patient care and streamline hospital operations globally. Learn more about the market: https://lnkd.in/dQHarJJC . . . #hospital #bed #management #systems #tbrc #thebusinessresearchcompany #marketresearch #marketintelligence

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📢 Senator Ron Wyden Demands Accountability in UnitedHealth Cyberattack 📢 Senator Ron Wyden is calling on the Federal Trade Commission (FTC) and the Securities and Exchange Commission (SEC) to hold UnitedHealth Group accountable for the recent cyberattack on its subsidiary, Change Healthcare. In his letter to FTC Chair Lina Khan and SEC Chair Gary Gensler, Wyden stresses the need for a thorough investigation into whether UnitedHealth’s “negligent cybersecurity practices” contributed to the breach, urging that top executives be held responsible. Key Points: 🔒 Significant Disruption: The cyberattack caused major issues for patients and providers and poses a potential national security risk. 🔒 Preventable Incident: UnitedHealth's CEO Andrew Witty admitted that the breached server lacked basic cybersecurity measures, such as two-factor authentication. 🔒 Call for Investigation: Wyden asserts that the breach was preventable and resulted from corporate negligence, urging the FTC and SEC to identify any legal violations. Wyden's Stance: “This incident and the harm that it caused was, like so many other security breaches, completely preventable and the direct result of corporate negligence.” - Senator Ron Wyden Implications: Wyden pointed out that the SEC has previously held top executives accountable for cybersecurity failures, as seen in the SolarWinds case. He argues that UnitedHealth’s board, responsible for overseeing cybersecurity risks, failed to fulfill its duties due to a lack of expertise. Action Needed: Wyden calls for regulators to hold the company’s senior officials, including the CEO and board of directors, accountable rather than scapegoating the head of cybersecurity. He emphasizes the importance of having board members with meaningful cybersecurity expertise to prevent such incidents in the future. #Cybersecurity #Healthcare #UnitedHealth #FTC #SEC #Accountability #SenateFinanceCommittee #DataBreach #CyberAttack #CorporateGovernance #RonWyden

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