Monica Weekes

We are a proud sponsor of the Texas Hospital Trustees 2024 Healthcare Governance Conference. As hospitals look to improve patient access and patient experience while improving costs; AI can be a meaningful differentiator. Please set-up time with Janine Pratt at the conference using the link below to understand how you can pragmatically deploy AI to transform your hospital and health system. #HospitalTransformationAI #WiproHealthcare

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Are We Listening to the Right Things? For over two decades, US healthcare has grappled with a quality chasm. Electronic Health Records (EHRs) were introduced to address quality by improving data availability, record sharing, and legibility. However, EHRs led to burnout and impacted patient-provider relationships, as the patient's history, needs, and care plan were lost in bloated notes with copy-paste errors. The purpose and value of notes has been lost. The importance for useful and concise notes paired with effective communication and collaboration increases as care moves more virtual and asynchronous. Clinical notes were not intended as transcripts of patient-provider interactions or for billing support. Rather, clinical notes were meant to provide a readable summary of the patient's status, concerns, and care plan while capturing diagnoses, clinical reasoning, and follow-up instructions. As the medical legal record, notes serve as a reference to improve ongoing care's efficiency and effectiveness. To reduce provider’s documentation burden, ambient listening is a current focus. However, data on its ability to do so is limited, nor does its use alone improve access or productivity without process and scheduling changes.  Unfortunately, EHRs digitized paper-based processes and added burdens. Subsequent efforts tried to “optimize” these processes and data collection instead of creating new processes enabled by technology. We should improve clinical notes in the context of creating a better process for the entire healthcare engagement and ongoing patient health journey, not just the time spent by providers creating notes. A healthcare engagement begins when a patient seeks assistance, shares information, and interacts with any staff.  Aggregating and summarizing patient information at the beginning of an engagement can alleviate time spent reviewing data in tabs (~1/3 of provider EHR time). The new process will engage patients, and support team documentation while creating notes that provide a quick reference for ongoing care through concise, legible, easily consumable elements and information. That includes capture of structured data with minimal clicks and NLP use. Using systems thinking design and leveraging AI and ML, the care engagement process can be reimagined and redesigned to deliver better outcomes with greater efficiency for all (instead of trying to repair broken EHR and billing processes that templates, copy-paste, and scribes did not fix). Value can be added throughout the care engagement process, missed care opportunities and medical errors (a key goal of EHR implementation) can be reduced. The goal is transformation not optimization. With a Virtual First mindset you can solve the right problems while achieving measurable efficiency with greater ROI. Let's not live with past digitized errors. It's time to take advantage of data and automation for all especially the patient.​​​​​​​​​​​​​​​​​​​​​​​​​​ #VirtualFIrst#CrosstheChasm

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An interesting article that highlights the importance of aligning strategies with value-based care #VBC goals to enhance patient outcomes and operational efficiency. One critical aspect is #datadrivencare management. Utilizing analytics platforms to aggregate and analyze data from sources like electronic health records #EHRs allows for population health analysis, risk stratification, and tracking quality metrics, all of which contribute to improving care quality. Additionally, placing proactive #preventivecare at the center of your strategy is essential. Implementing wellness visits, chronic disease management, and timely immunizations can boost overall health while reducing long-term costs. Another vital factor is enhancing #carecoordination. Developing care transition protocols, streamlining provider communication, and creating multidisciplinary care teams help ensure a seamless patient journey and better outcomes. Furthermore, increasing #patientengagement and education plays a crucial role. Addressing #socialdeterminants of health is also key. Screening for social challenges, building a community resource database, and ensuring proper referrals and follow-ups are necessary steps to support overall patient well-being. Finally, building #partnerships and aligning incentives with payers, community organizations, and technology vendors is essential. Collaborative efforts to align goals, share data, and explore innovative solutions lead to better patient care and organizational performance. By integrating these strategies into your healthcare business approach, you can effectively align with VBC goals and enhance #patientcare. #healthcarestrategy #resourceoptimization #performanceincentives #stafftraining #healthcareinnovation #hbr #leadership #strategy #lifelonglearner #digitaltransformation #innovations

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Value based care (VBC) 1.0 language was heavily oriented to language like "disruption". This language was like a punch in the mouth and was effective at building awareness of new opportunity - but disruptive punches to the jaw don't sound like a very attractive end state. It sounds pretty painful, and maybe that is one reason why VBC adoption has stagnated. VBC 2.0 needs to be about integration and partnership so that we can start to bring real value to patients and the provider organizations who serve them - and do that at scale. The pre-eminent leader in health plan clinical guidelines coming together with the most innovative AI provider of utilization management technology is a perfect example of this new paradigm. Kudos to the MCG Health and Cohere Health teams taking a leadership role to make the health care system work better for all.

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Oracle Health’s new Autonomous Shield initiative can help health systems migrate to a comprehensive EHR and cloud infrastructure that can reduce cyber risk. Read how the automation and security of #OCI can help boost performance. https://lnkd.in/dX-6BYVt

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An insightful take by Dr Vikram S. & Ashish Atreja, MD, MPH on the transformative role of AI in healthcare. The possibilities for enhanced diagnostics, personalized treatment, and operational efficiency are truly exciting. As we head into 2025, integrating digital innovation responsibly into healthcare will be a game-changer for patients and practitioners alike. #AIinHealthcare #DigitalHealth #Innovation

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For health systems, providing effective value-based care involves having foundational building blocks of data analytics, this chief clinical officer says. https://ow.ly/sCZM50UEhc1

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🏥✨ For many years, technology investments made by health organizations were rarely a driving force behind strategic #transactions. Explore in my latest article with Sam Prescott how #generativeAI has changed the game for Health CIOs. A must-read for leaders at the forefront of change! https://lnkd.in/gRWmi5AH

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What are the most significant obstacles to using electronic health records (EHRs)? Klas Research asked 33,000 clinicians across over 300 healthcare organizations this question and compiled their answers in the 'EHR Interoperability 2024' report. When asked specifically about their experiences with patient data from external organizations, 47% mentioned the lack of proper integrations to access EHRs. At Tiga Healthcare Technologies, we utilize our expertise to develop healthcare IT products that enhance efficiency and lead to better treatment outcomes. Our Healthcare Interoperability product family, which includes Health Information Exchange (HIE) Viewer, Terminology Server, FHIR Stack and Enterprise Master Patient Data Index (EMPI), is designed to meet clinicians' most urgent needs around integration and data accessibility. This way, we offer successful solutions against health data inefficiencies affecting nearly half of the physicians and clinicians surveyed in the Klas report. Let's shape the future together with the power of interoperability, as always! Further insights from the ‘EHR Interoperability 2024’ report: https://lnkd.in/dvxJSJHN  #Tiga #HealthcareIT #PharmaIT #EHR #Interoperability 

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The growth of the health insurance marketplace is picking up steam, fuelled by Medicaid disenrollment. https://ow.ly/N1vW50Tafsq MMIT’s Erin Trompeter explains what these large-scale changes mean for providers, manufacturers, payers and health IT vendors. Get the insights by clicking the link in this post. #HealthInsuranceMarketplace #HealthInsurance #Medicaid

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Healthcare providers and payers are more willing to invest in advanced healthcare IT! A recent study by Bain & Company and Klas Research, titled 'Healthcare IT Spending: Innovation, Integration and AI,' reveals this growing trend. Over the past year, 75% of the providers and payers have increased their healthcare IT investments to streamline operations and reduce clinician workload. According to the report, the most critical investment category is IT infrastructure and services, followed by clinical workflow optimization and then data platforms and interoperability. At Tiga Healthcare Technologies, we're ready to improve these investments with our Healthcare Interoperability and Hospital Information System (HIS) product families. We enhance healthcare interoperability through many ways, like standardization with FHIR Stack and utilizing EHR with Health Information Exchange (HIE) Viewer, further streamlining administrative and clinical processes with HIS, meeting patient needs better and optimizing facility workflows. Moreover, the report underscores the rising adoption of AI and machine learning (ML) for data quality, informed clinical decisions and patient outreach. Our evolving AI & Analytics product family is well-rounded to support this data-driven future of healthcare. Thanks to our products, digital transformation occurs faster than expected. Let's shape the future together with the power of helpful healthcare IT investments, as always! Further insights from the study: https://lnkd.in/dr4s4UDY #Tiga #HealthcareIT #PharmaIT #HealthcareInteroperability #HospitalInformationSystem

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Predictions for the Healthcare Analytics Space in 2025 Increased Integration Across Data Ecosystems As value-based care models continue to expand, seamless data integration across clinical, claims, and social determinants of health (SDOH) sources will become critical. Organizations will prioritize interoperability through networks like QHINs, Carequality, and CommonWell to create a unified patient view. Interoperability Will Become Non-Negotiable Regulatory and operational pressures will force healthcare organizations to embrace true interoperability, with frameworks like TEFCA, QHINs, and platforms like Carequality/CommonWell gaining momentum. Seamless data exchange will shift from a competitive edge to a baseline requirement. Shift from Retrospective to Predictive Analytics Organizations will move away from merely reporting past events and toward anticipating future risks, costs, and care needs. Predictive models will guide both operational efficiencies and patient care interventions. Demand for Transparent ROI Healthcare organizations will increasingly demand clear ROI from analytics investments, driven by financial pressures and accountability in value-based contracts. Solutions must demonstrate tangible outcomes like cost savings, care improvements, and enhanced risk stratification. Rise of Decentralized and Multi-Tenant Data Repositories As data ownership and governance become central, healthcare providers will adopt multi-tenant architectures to securely store and access aggregated data while maintaining control over proprietary information. AI and Machine Learning in Care Pathways(*) The use of AI to identify care gaps, optimize workflows, and automate routine tasks will grow exponentially. Providers will seek analytics solutions incorporating explainable AI to maintain trust and compliance. (*) Steep adoption curve Focus on SDOH for Equitable Healthcare Delivery Payers and providers will deepen their focus on SDOH to address health inequities. Analytics platforms will need to integrate SDOH data into actionable strategies for population health management. Emergence of Modular and Workflow-Specific Tools Comprehensive dashboards will give way to modular, workflow-specific tools that empower users to interact directly with data. These tools will emphasize usability and decision-making at the point of need. Partnerships Over Proprietary Solutions Collaboration between analytics providers and adjacent industries (e.g., tech, pharma, and public health) will drive innovation and adoption. Open ecosystems will gain traction over closed, proprietary platforms.

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Leveraging Informatics in Revenue Management for Health Network Mergers and Acquisitions In today’s healthcare landscape, mergers and acquisitions (M&A) are reshaping health networks, promising expanded services and improved patient care. However, integrating revenue cycle management (RCM) across newly combined entities presents significant challenges—data silos, incompatible systems, and inconsistent workflows often lead to revenue leakage, compliance risks, and inefficiencies. Informatics plays a critical role in overcoming these barriers by enabling: 1. Data Integration and Interoperability Unified data governance frameworks ensure seamless integration of disparate billing, claims, and patient accounting systems. Informatics tools standardize coding, charge capture, and reporting across systems, reducing redundancies and errors. 2. Analytics for Decision-Making Advanced analytics provide insights into payer performance, denials management, and revenue trends to identify opportunities for optimization. Predictive modeling aids in assessing financial risks and forecasting revenue impacts post-merger. 3. Automation and Efficiency Gains AI-driven automation streamlines prior authorizations, eligibility checks, and payment posting processes. Informatics supports robotic process automation (RPA) to minimize manual tasks and accelerate cash flow. 4. Compliance and Risk Mitigation Centralized dashboards monitor compliance metrics, ensuring adherence to regulatory standards during system migrations and transitions. Informatics solutions track audit trails to safeguard against fraud and billing inaccuracies. Key Takeaway: Health networks undergoing M&A must view informatics not just as a tool but as a strategic asset in revenue cycle transformation. By aligning data governance, analytics, and automation strategies, organizations can reduce revenue disruption, improve financial performance, and enhance patient satisfaction—turning complex integrations into opportunities for growth. 💬 How has your organization used informatics to streamline revenue management post-merger? Share your insights below!

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Excited to be part of this launch and the ability to share our solution with payers and providers to use themselves. For all of my payer friends, if you have internal teams completing payment integrity reviews, just starting on the journey to create an internal team, or even thinking about the possibility - let's chat! ProperPay and our team of experts are here to help support you no matter where you are in your journey. As a business and technology company, we believe in strategic partnership and a holistic approach - technology transformation, data management, process optimization, and strengthening payer/provider relationships. Best of all - we love your feedback! Reach out today to schedule a demo and tell us what you think. #paymentintegrity #revenuecyclemanagement #AIinpaymentintegrity #ProperPay

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The collaboration between Zing Health and Story Health is a promising partnership and a positive step towards improving #CardiovascularCare, especially for underserved populations. 🙌 By combining Zing's focus on high-risk Medicare Advantage members with Story Health's personalized care model, this partnership has the potential to significantly impact patient outcomes. 🗯 I'm particularly impressed by the emphasis on patient convenience and choice. Offering patients the option to access care remotely and without the need for in-person visits aligns with the evolving healthcare landscape. Additionally, addressing social determinants of health through services like prescription affordability and home delivery demonstrates a comprehensive approach to #PatientCare. It will be interesting to follow the progress of this partnership and measure its impact on patient outcomes and healthcare costs. If successful, this model could be replicated for other chronic conditions and patient populations. 👏 #DigitalHealth

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Join me for an interactive webinar that will dive into #PatientExperience pitfalls and discuss new, innovative ways providers can address this ongoing yet evolving challenge. Abhishek Singh Manu Aggarwal Hanupriya Nangia Kaushik Sundar

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Modest improvement in Medicare Advantage margins will be partially offset by continued Medicaid profit pressures through at least the first half of 2025 for U.S. health insurers. Fitch currently maintains its Neutral sector outlook. Learn more: https://ow.ly/fj5950Us0lw In case you missed it, view our recent webinar, U.S. Healthcare & Insurance #CreditOutlook 2025: https://ow.ly/263m50Us0lx #FitchRatings #FitchOutlooks2025 #HealthInsurance #Healthcare

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