Spencer Dorn

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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It seems that the government is serious about finally realizing the vision of true health data interoperability. The attached Point-of-Care Partners blog post describes the recently released HTI-2 Proposed Rule which is another step in the fruition of that vision. Point-of-Care Partners can help your healthcare organization stay ahead of the waves of regulatory activity around interoperability. Let me know if you are interested in learning how.

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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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I’m thankful that I could share my thoughts at that very hearing. There is so much misinformation about 340B. For me, it comes down to two main points: 1- if hospitals need that money as a subsidy to fund everyday activities, they should just ask for a subsidy. Let’s open up the books of these institutions, which already get a huge subsidy with their non-profit status, and see why they are running in the red. Are they really losing money on Medicaid patients or are they just bloated and inefficient? 2- let the subsidy follow the patient. This is a drug benefit program. Why does the funding go to an institution? Imagine if we did that with SNAP, giving a bunch of money to large restaurant chains in exchange for their promise to use the revenue to provide food for poor people (with no oversight to ensure that’s done). We don’t do that; instead we give the benefit to the person who needs it. Let’s change 340B to match that model. Adam J. Bruggeman, MD, MHA, FAAOS, FAOA Daniel Choi Colin Yokanovich John Strom Peter Stein Adam Fein Deborah Williams Lisa Grabert Maya Babu, MD, MBA Katie Orrico Larry Bucshon, M.D. Ann M. Richardson, MBA

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Great commentary and details to be considered from post by Deborah Williams Too few probably understand what you've posted, the other major part of the problem. Commercial insured populations (employers & employees) pay the price for government policy failures that represent major hits on company bottom lines or lead to more individual bankruptcies today. #employeebenefits #employers #commerialinsurance #epcouncil.org

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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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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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There’s no question that AI is transforming healthcare, and understanding where industry leaders perceive opportunities is important. The latest research report from Arcadia is revealing. 63% of healthcare leaders say AI can analyze large patient data sets to identify trends and create population health intervention strategies 58% say AI can analyze individual patient data to identify opportunities to improve health outcomes 47% say AI can optimize the management and analysis of electronic health records Dive into the report to gain insights from top tech leaders and see where the industry is headed! https://lnkd.in/gf_wkWij

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Loper and #Medicare #Reimbursement: What Does the Future Hold? Ganny A Belloni from Bloomberg News wades in (in a terrific article) on the implications of #Chevron and the rise of #Loper on Medicare reimbursement issues. I'm quoted. My take? I think, as I say in the article, Loper will have less impact than people think. Loper eliminates Chevron “deference” by a court to an agency’s interpretation of a federal statute, where that law is “ambiguous”, meaning it can reasonably be read in different ways. Congress can (and will) significantly reduce the risk of litigation challenges in a Looer world by, as Ganny summarizes the point, defining statutory terms more precisely and "more clearly and explicitly giv[ing] the agency the discretion to decide issues". Further, many potential challenges can be avoided by CMS, as I say in the article, by framing "more ... [agency] decisions as ‘factual determinations’ or ‘adjudicative’ questions, where it still is entitled to deference, even after Loper.” To those of you who are fans of the administrative state, take heart. The sky, truth be told, is not falling. #healthcare Centers for Medicare & Medicaid ServicesU.S. Department of Health and Human Services (HHS) #CMS #HHS #APA #administrativestate #agencydiscretion #rulemaking #agencies #administrativelaw

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Today marks an important milestone with Emory Healthcare’s announcement of their statewide PHC and collaboration with Guidehealth. We began our commercial relationship with Emory Healthcare Network earlier this year on an interim basis and quickly progressed by fully integrating our technology and capabilities. In a short time, our joint efforts have created “speed to value”, demonstrating considerable traction and early wins on quality, patient care and overall performance. There are many people to thank - - and I'll start by acknowledging the network and service line leadership of Patrick Hammond, Tina-Ann Kerr Thompson, MD, MBA and their teams including Dan Salinas, MD and Susan Helton, Adam Tribbett and many others. Unless they saw the merits of us working together, we wouldn’t be here. We as a company have grown through inspiring engagement with Emory’s digital health leadership led by Alistair Erskine MD MBA and his team including Nitu Kashyap. The data science architecture, our use of AI and integration into Emory’s digital health strategy has transformed our business in many ways including accuracy and risk prediction, clinical prioritization, outreach and access, and scalable interventions. A shout out to Guidehealth's technology partners who have led us to unprecedented success and first mover advantage of our platform. I want to personally acknowledge Joon S Lee MD, Emory Healthcare CEO for his vision and personal attention to our collaboration. As also Chris Augostini, EVP and Emory University CFO. Their teams have been working closely with us to make today’s announcement a reality. Finally, to our leadership, at every level beginning with MARK SELNA, McKay Crowley, MD, MBA, FACP, CHCQM, Robert Alterman, Michael Gleeson, Roger Ou, Jeanne Wisniewski, ACC and their teams who’ve been working tirelessly to integrate technology and people into partner workflows, I want you to know that none of this would have been possible without your creativity, dedication and higher purpose that you bring to bear for patients and physicians every day. With today’s announcement, we now support six health systems in four states across a variety of contracts. With Emory, our collaboration extends across all patients and payers and is by far the most comprehensive and clinically integrated expansion of our model. And with it, we are honored to firmly plant our flag in the Peach State! https://lnkd.in/eARfUMnG

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Interesting perspective on #TechnologicalDebt in health care by Dave Lamar focused on the provider market, but we seem the same issues within state depts and payers. While good data governance practices are key, there must be a better way to solve this common - if not universal - challenge in health care, if only by offloading some of the administrative responsibilities that require the individual management and administration of no-value-add administrative functions. #healthdata

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Two new proposed rules could be a game changer for health data interoperability... In early July (published in Federal Register August 5), ASTP/ONC released all 1,067 pages of its proposed HTI-2 rule, in which it proposed expanding its Certification Program to complement CMS' FHIR APIs. This included creating criteria impacting payers and public health IT. It reminded me of a line of questioning from ONC's electronic prior authorization RFI from January 2022, where the agency asked nearly ten questions about what certification criteria should look like to facilitate electronic prior authorization processes. The thought then, and even at the publication of HTI-2, was that certified modules wouldn't help payers much because payers are not the ones implementing modules. The vendors who provide the administrative platforms are. As it stands, there are only disincentives to certifying under the program for payer health IT vendors (i.e., bringing them under the information blocking rule), so payers are really at the mercy of their vendors. This is in stark contrast to the impact the program has on EHR developers. That was until HHS' ASFR and ASTP/ONC released another proposed rule on August 9 that would require all providers and health plans (that means you, MA plans) that receive HHS funding to use certified health IT or adhere to ONC standards at a minimum. So, what does this mean? Payers who receive HHS funding could now have the regulatory support to require their vendors to be certified... If passed as written, payer health IT vendors that want to maintain their contracts with federally funded plans would not be able to "unreasonably limit" the exchange, access, or use of electronic health information - including charging an unreasonable fee. They could be penalized up to $1M per violation if they do. This is a huge deal. Luckily, the team at Maverick Health Policy summarized both proposals (linked below). If you need help navigating these changes, we're here to help. HTI-2: https://lnkd.in/g4McbwMy Acquisition Regulation: https://lnkd.in/gWY--VPb

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The shift from fee-for-service (FFS) models to value-based care (VBC) represents a fundamental change in how healthcare is delivered and reimbursed. Here’s an overview of both models and the critical differences between them: Fee-for-Service (FFS) Models Definition: In a fee-for-service model, healthcare providers are paid for each service, test, or procedure they perform. This means that the more services rendered, the higher the revenue for the provider. Incentives: FFS encourages a high volume of services, which can lead to over-treatment and unnecessary procedures. Providers may focus on quantity rather than quality, as reimbursement is tied to the number of services provided rather than patient outcomes. Challenges: This model can contribute to rising healthcare costs, inefficiencies, and variations in care quality. Patients may receive more services than necessary, leading to increased healthcare spending without corresponding improvements in health outcomes. Value-Based Care (VBC) Definition: Value-based care focuses on patient outcomes and the quality of care rather than the quantity of services. Providers are reimbursed based on their value to patients, often measured by patient health outcomes and satisfaction. Incentives: VBC models incentivize providers to deliver high-quality, coordinated care, emphasizing preventive measures and chronic disease management. Providers are rewarded for keeping patients healthy and reducing the need for costly interventions. Benefits: This approach aims to improve health outcomes, enhance patient satisfaction, and lower healthcare costs. It encourages collaboration among healthcare providers and fosters a more patient-centered approach to care. Key Differences Payment Structure: FFS compensates for each service rendered, while VBC compensates based on patient outcomes and quality of care. Focus: FFS emphasizes the quantity of services, whereas VBC prioritizes the quality and effectiveness of care. Patient Engagement: VBC models often involve patients more actively in their care decisions, fostering better communication and understanding of treatment plans. Conclusion The transition from fee-for-service to value-based care represents a significant evolution in the healthcare landscape. By improving patient outcomes and reducing costs, VBC aims to create a more efficient, effective, and patient-centered healthcare system. This shift requires collaboration, data analytics, and a commitment to quality from all stakeholders in the healthcare ecosystem.

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AI startups ramp up their federal lobbying efforts to influence U.S. AI policy. The focus is on advocating for regulations that strike a balance between innovation and safety. This surge in lobbying underscores the industry's commitment to shaping the legal landscape for responsible AI development. #AI #Policy #Innovation #TechRegulation

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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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Happy to share my thoughts with HLTH about their HLTH and Vive events - and how Medicomp Systems, Inc. is able to share the latest related to our clinical intelligence engine with EHR vendors and other health systems. #HealthIT #Vive2024 #EHR #AI #ClinicalAI #Quippe

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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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