Revenue Leakage in Hospitals and Health Systems: What are You Missing?

| October 1, 2017

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Revenue leakage – those lost opportunities to collect money earned – has been a topic of conversation in healthcare for years. Granted, revenue leakage is a moving target, thanks to healthcare reform, constantly changing payer rules and disparate technology advancements. This pervasive problem, however, continues to tighten the squeeze on already compressed margins.

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Alliance Medical Group

Alliance Medical Group has more than 100 physicians including primary care internal medicine, pediatrics and 10 medical and surgical specialties. We are a multi-specialty group practice that provides effective care for our patient's health concerns. Whether you are in need of preventive health screening, a well patient visit or more specialized treatment for illness or injury, you will find the comprehensive services you need from local medical experts dedicated to keeping you well and getting you healthy.

OTHER ARTICLES

Health IT coalition to use data analytics in battle against COVID-19

Article | April 2, 2020

Healthcare organizations, technology firms, nonprofits, and academia are banding together to use their collective expertise, data, and insights for rapid deployment of innovative, open-source solutions to the global pandemic. The COVID-19 Healthcare Coalition, a private-sector led response, aims to mitigate the worst effects of the coronavirus by flattening the curve. A key component of this effort will be the use of real-time data for analytics that will help preserve the healthcare delivery system. LUMEDX client partners HCA Healthcare, the Mayo Clinic, and Intermountain Healthcare have joined big tech companies such as Amazon, Google, Microsoft, and others. For a full list, visit the website here. All coalition work is voluntary, and members are asked to pledge open cooperation and sharing. In addition to combining the best sources of information from around the world to provide data, analytics and insights to all, the coalition’s priorities include

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Telehealth emerges as access tool in healthcare transformation

Article | March 11, 2020

Healthcare organizations are faced with addressing the “triple aim” of improving cost, quality and access to medical care. Telehealth has been seen as a tool to improve access with its convenience and availability with mobile apps or personal computers. Regulators are seeing the value of the technology with states loosening rules about the practice of telehealth and reimbursement improving, the American Telemedicine Association said. However, it will take some time for telehealth to reach its full potential to blend telehealth into current care processes. Right now, telehealth is separate from many of the healthcare workflows, which is keeping the technology from reaching its fullest potential – in terms of quality and patient experience. This can be overcome by addressing the economics, whether that is in health plan design and also how providers are compensated. Despite recent improvements in telehealth reimbursements, many of the payments are tied to in-person visits. Healthcare providers, payers and regulators need to figure out what treatments need to be reimbursed. Telemedicine, which involves clinician-to-clinician remote consults, is immensely important in emergency care and has shown a great deal of use in treating stroke, since not every facility has neurology covered around the clock. Certain medical specialties, such as psychiatry or dermatology, have a real opportunity to capitalize upon telehealth, as well as non-emergency, urgent care.

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RANSOMWARE AND THE PARAMOUNT IMPORTANCE OF EVIDENCE PRESERVATION FOR HEALTHCARE ENTITIES

Article | March 10, 2020

Organizations regulated by the Healthcare Information Privacy and Accountability Act (HIPAA) must take special care to preserve valuable forensic artifacts at the outset of a ransomware or other cybersecurity event. The HIPAA Breach Notification Rule presumes a cybersecurity incident has resulted in unauthorized access to unsecured protected health information and the burden shifts to the organization to show a low probability of the compromise of the health information it maintains. Guidance from the Department of Health and Human Services Office for Civil Rights, the federal entity charged with enforcement of HIPAA, provides that the encryption of protected health information by ransomware per se constitutes an unauthorized disclosure of protected health information triggering the Breach Notification Rule. Consequently, the preservation of forensic evidence capable of disproving the unauthorized access or acquisition of protected health information is paramount and should be undertaken at the outset of the response to any cybersecurity incident, especially ransomware. Breach notification is extremely costly in time, money, and goodwill. Any time and money lost during the operational downtime required to preserve forensic evidence in order to rule out access to protected health information is significantly lower than the costs of notification.

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Blockchain in the Healthcare Industry

Article | January 8, 2021

Prioritizing health and managing it, has become highly important because our lifestyle is continuously evolving in ways that take a toll on us mentally, physically, and emotionally. However, the major issue for the patients lies in the inaccuracy of treatment due to the lack of complete health records in any hospital. With the recent changes in privacy legislation and data management, patients are even unable to retrieve their own health records. For example, someone had an accident and was taken to the emergency room. The first thing they will need to do in their condition is to fill the hospital’s form. Then, for the treatment, if the injured person is conscious enough, doctors ask questions like if they are allergic to some medicines or do they suffer from diabetes or any other disease. Besides, what if the individual denies having allergies or diabetes in their half-conscious state? And the previous hospitals where they have already had treatment before have denied sharing the medical details of the person either due to privacy issues or data corruption. Well, it can create a lot of fuzz. Solely, to improve the health industry without compromising the security of the individuals, blockchain has remained in the discussion. It has the potential to address the operability challenges present in the healthcare industry. But, what is blockchain, what are its underlying fundamentals, why blockchain, and what are its advantages? Today’s blog will help in understanding every aspect of blockchain and its impact on the healthcare industry. So let’s get started! What is Blockchain? Blockchain is a P2P or peer-to-peer distributed or decentralized ledger technology. It stores a chain of data called blocks of information. These blocks are chained together by cryptographic signatures. These signatures are called hash that is stored in the shared ledger and backed by a connected processes network - node. These nodes reserve a copy of the complete chain and get continually updated by synchronization. Though, to include blockchain in the process it’s necessary to hire a developer who has prior experience and knowledge about its architecture and can work with the components efficiently as blockchain is a designed pattern that consists of three major constituents - a distributed network, a shared ledger, and all the digital transactions. a. Distributed Network As discussed before, blockchain is built on peer-to-peer networks. While having no central point of storage, it makes the information on the network less vulnerable to being lost or exploited. Unlike the traditional client-server model that has a centralized storage point or controlling party, all the information in the blockchain network is constantly recorded and transferred to the participants of the network that are also known as nodes or peers. These peers also own several identical copies of the information. That’s why blockchain is seen as a huge improvement to centralized models and is considered the future of data storage and ownership. b. Shared Ledger Each authorized participant in the network records the transactions into the shared ledger. If they want to add any transaction, it is important to run algorithms that evaluate and verify the transactions. If the majority of members agree to the transaction’s validity, a new transaction gets added to the shared ledger. The changes done in the shared ledger is reflected in minutes or even seconds in the copies of the blockchain. Once the transaction is added, there’s no way to modify or delete it. Also, as the copy is shared in the form of a ledger to each member, no single member can alter data. c. Digital Transaction Transactions are information i.e. data transmission to one block. During the process of data transmission, each node acts as a central point to generate and digitally sign the transaction. As the nodes connect each other in the network, each of them has to verify the transaction independently for its conflicts, validity, and compliance. Only after the transaction passes the verification, the information is added into the shared ledger. The major element that makes digital transactions successful is cryptographic hashing that encrypts the data for security. Why Blockchain technology in healthcare? It has happened so often that the patient remains unable to gather all of their previous medical records in one format from one place swiftly or sometimes cannot even collect the required information at all. Unfortunately, in most cases, the information of critical patients remains scattered across several different institutions of healthcare that too in different formats. Besides, the data management systems along with the security regulations also vary in different institutions making it difficult to trace and fix mistakes. But, what can blockchain do? A blockchain is a system used for storing and sharing information with security and transparency. Every block in the chain is an independent unit of its own and a dependent link among the collective chain that creates a network controlled by participants rather than a third party. As blockchains are managed by network nodes instead of central authority, they are decentralized that prevents one entity from having complete control over the network. With the incorporation of blockchain, the need for a central administrator will be removed by cryptography. Healthcare providers will be able to promote data management processes beyond perception. It will help in collecting, analyzing, sharing, and securing medical records. It will provide the access to healthcare workers for retrieving health records with the cryptographic keys provided by patients from anywhere without creating any privacy or security problems. Advantages of Healthcare Blockchain Although applications of blockchain in the healthcare industry are inceptive, some early solutions have shown the possibility of reduced healthcare costs, improved access to information among different stakeholders, and streamlining the entire business process. So, keeping aside the buzz, let’s see the real advantages of blockchain in healthcare. 1. Master Patient Indexes The master patient index helps in the identification of patients across separate administrative systems. It is often created within the EHR or electronic health record system. As these EHRs have different vendors, there are several irregularities of MPIs. In many cases, the data of a patient between these healthcare systems become mismatched. However, with the nature of decentralization in Blockchain, it possesses the ability to solve the issue. In the blockchain-based MPIs, the data will be hashed to the ledger and content will remain unique as only the authorized nodes of the data can make changes to the hashes while all parties with access can only check the related information. 2. Single, elongated patient records Blockchain technology is potent to transform health care by placing patients at the center of the system while increasing the security and privacy of health records. It provides a new model for health information exchange by forming electronic elongated patient records secured and efficient. Additionally, the fact that the data is copied among all the nodes of the blockchain network creates an atmosphere of clarity and transparency that enables healthcare providers and patients to know how their data is handled by whom, how, and when. It can also help healthcare from potential frauds, data losses, or security attacks. 3. Supply Chain Management Supply chain management in healthcare is a challenging aspect. With scattered settings for ordering drugs, medical supplies, and critical resources, there’s an inherent risk of compromising the supply chain that might impact patient safety. Indulgence of blockchain technology in the transactions can tap into the complete process of medicine or drug products movement. As all the transactions will be recorded onto the shared ledger with every block recording and maintaining every transaction, it will become easy to verify the vendor, distributor, and origin of the drug within a matter of seconds. It will also enable healthcare physicians and officials to check the authenticity of the supplier’s credentials. 4. Claims Justification Currently, the insurance claim processes face difficulties like lack of transparency i.e. most customers don’t even know how insurance works; human errors and inefficiencies i.e. insurances are full of confusion along with human errors that create inefficiencies that lead to the increased cost to customers; higher frauds in claims. But, blockchain technology can simplify and enhance recordkeeping, payment processing, claims registration, contract management, and closure with its immutable ledger. 5. Interoperability Interoperability is the capability of distinct healthcare information technology to interpret, exchange, and use data. Due to the privacy issues, the alphanumeric code to identify a patient has been revoked that caused problems in gathering the required record of the patient. Enforcing measurement standards for industry-wide interoperability is also a challenge in interoperability. With blockchain in healthcare interoperability, data can be shared in real-time on the trusted network and provides access to the patient’s record in a secured manner. Moreover, with the pri

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Spotlight

Alliance Medical Group

Alliance Medical Group has more than 100 physicians including primary care internal medicine, pediatrics and 10 medical and surgical specialties. We are a multi-specialty group practice that provides effective care for our patient's health concerns. Whether you are in need of preventive health screening, a well patient visit or more specialized treatment for illness or injury, you will find the comprehensive services you need from local medical experts dedicated to keeping you well and getting you healthy.

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