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U.S. Healthcare Spending Waste, Unnecessary Cost and Fraud

This infographic details the cost of health care spending waste, overtreatment, and fraud on payers and the impact on patients in the United States.

Spotlight

MileStone Healthcare

MileStone Healthcare is a management and consulting firm assisting hospitals and other healthcare providers to establish new and improve existing post-acute care programs. As a leading national provider of post-acute care programs and services, MileStone has opened and managed over 200 post-acute care programs across the country for more than 20 years. MileStone’s corporate office is located in metropolitan Dallas.

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Health Technology, Digital Healthcare

Ways to Drive Practice Revenue and Reduce Your Accounts Receivable

Article | August 21, 2023

Managing accounts receivable (A/R) in private practice is a constant battle for physicians. Though most understand that lowering their A/R is critical for improving their practices’ efficiency and profitability, physicians often do not know how to address issues like lengthy collection periods and insurance claim denials. It can be complex to manage A/R, as doing so involves various parties, including insurance carriers, the patient, the front office and billing staff, and the provider. All must work together to achieve a clean claims rate and avoid denials. The best way to improve medical billing A/R is to reduce claim denials and speed up the patient collections process. In addition, you’ll need to ensure that patients and staff are filling out paperwork correctly and submitting claims on time. Other areas to manage are the follow-ups to correct errors and past-due accounts. Accounts receivable is a collaborative effort Each member of the practice staff plays an integral role in reducing claims denial rates. Take an all-hands-on-deck approach in order to identify issues and develop solutions. Start by making every team member privy to the A/R management process. This will ensure everyone is on the same page and involved. It will also help to increase efficiency, avoid redundancies, and eliminate mistakes that could waste time or profitability. The front office staff is the front line of A/R. They are the first to verify and update patients’ insurance and personal details like address and contact information. They must also ensure that patients sign certain documents, like financial policies. Providers are the next line of A/R. Providers select current procedural terminology (CPT) codes, and must be mindful of tedious details such as bundling correctly in order to ensure that claims are approved. A conscientious provider should not only select appropriate billing codes but also double-check the patient information that the front office staff provide. The billing office is a final line of defense and should triple check that the patient’s information and the CPT codes are correct. Billing office staff are also responsible for ensuring the claims are submitted on time and that duplicates are not submitted. Establish financial policies Every practice needs clearly defined financial policies around patients or clients. Having these policies in place helps to clarify financial details and creates workflows and processes for staff to follow. Here are a few elements to consider: State whether the practice will accept personal checks and, if so, what charges or actions are in place for bounced checks. Consider implementing technologies that convert paper checks to electronic transactions and verify them before patients leave the office. Include a financial responsibilities section with information about who is responsible for the claim(s) if a patient’s insurance carrier partially or fully denies their claim. Define the debt collection process. Patients should quickly know how long they have to pay their bills and at what point you may sell their debt to a third-party debt collectors agency. Medical records can be copious, and practices often need to make physical copies of them. Consider implementing a policy that covers a pay-per-page cost associated with medical records. Automate patient statements and payments Offer different payment options for patients by implementing technologies and creative solutions that make it easier for them to pay their bills. Look for solutions that reduce manual work and provide reporting that tracks efficacy across delivery modes. Here are a few approaches to consider: Automate sending statements via text message or email to help improve the rate of online payments. Add QR codes to online and paper statements to help patients quickly access payment portals. Offer payment plans, especially with low to no interest, to make it easier for patients to pay down balances. Establish a written collections process Not collecting patient payments at the time of service is the biggest challenge to patient collections. Establishing a written collections process can help to alleviate that pain point and clarify the practice’s policies and procedures so that patients can understand them more clearly and easily. Here are some guidelines to follow when creating your policies: Include when, how, and how often bills are sent. Provide information on payment plans and assistance programs, if available. Explain the different available payment options and whether patients can pay over the phone, online through a payment portal, etc. Clarify which extraordinary collection actions may be used, including selling the debt or taking legal action. One of the most important processes to develop with collections is to respond to patients’ behavior. Communication should not be a one-size-fits-all approach. Patients expect personalization, and reaching out to them based on their preferred means of communication leads to optimal results. Perseverance is vital when it comes to collections. By establishing clear policies and implementing integrated technology throughout your processes, you can improve the patient experience by eliminating confusion while streamlining workflow to reduce the administrative burden on billing and administrative staff. Although implementing these steps can help your practice lower your accounts receivables, sometimes choosing to outsource to a medical billing company can help you save time, money, and resources. Medical billing companies can provide medical practices with specialized expertise, technology, and infrastructure to efficiently manage the revenue cycle and ensure timely payments. Outsourcing medical billing can also free up staff time and resources, allowing healthcare providers to focus on patient care and other essential aspects of running their practice. Whether you choose to outsource or to keep your medical billing in-house, these tips will help you to reduce your costs and increase your revenue.

Read More
Healthtech Security

Transforming Digital Healthcare Software through AI-Enhanced UX Testing

Article | November 29, 2023

Embracing the AI Revolution: Transforming Digital Healthcare Software through AI-Enhanced UX Testing The wave of demographic change sweeping the United States presents an urgent call to action for healthcare providers. According to the US Census Bureau, adults over 65 will account for a quarter of the US population by 2060, signaling a drastic shift in healthcare delivery needs. More than half a million of this demographic will be centenarians, accentuating the need for digital experiences tailored to seniors' unique needs. Despite the rapid advancement of digital health technologies, research indicates that many senior citizens struggle to adapt. A recent study reported that 40% of adults over 65 believe their telemedicine visit was inferior to traditional in-person care, with a meager 5% finding it superior. The promise of convenience delivered by digital health is often overshadowed by the frustration associated with technical difficulties. An astounding 75% of senior citizens admit they need assistance when using new electronic devices. Let's consider the patient portal app, a common touchpoint in the digital health journey. Despite its apparent simplicity, seniors find processes like logging in troublesome due to issues like forgotten passwords, technical bugs, or content readability. This scenario underlines the crucial need for comprehensive User Experience (UX) testing to eliminate these barriers and provide a seamless digital health experience. The Complex Landscape of Healthcare UX Testing The complexity of UX testing in healthcare has been exacerbated by the interplay of multiple modules, services, platforms, and vendors. Take Electronic Medical Record (EMR) systems, for instance, which undergo frequent updates, each one potentially impacting the system as a whole. Traditional manual testing methodologies are proving to be time-consuming and costly. Though automation has revolutionized sectors from automotive to finance, the healthcare industry appears to be lagging. A study by the Health Information and Management Systems Society (HIMSS) reveals that a mere 15% of healthcare providers have adopted modern test automation platforms. Meanwhile, a significant 41% still rely on manual testing. As EMR systems grow increasingly complex and customized, this over-reliance on manual testing poses daunting challenges. The gravity of this issue is amplified by a startling revelation from the HIMSS study - only 6% of healthcare executive leaders express confidence in their organizations' testing practices. In an increasingly digitized healthcare environment, such a low level of assurance raises substantial concerns about patient safety. Although 75% of the surveyed providers have invested in software testing to safeguard their bottom lines, nearly two-thirds confess feeling inadequately resourced in terms of time, money, and talent to meet future testing requirements. As the list of testing demands grows, QA teams are frequently stretched thin, leaving many potential user journey scenarios untested. The Power of AI in UX Testing for Better Patient Outcomes AI technologies hold the potential to revolutionize UX testing in healthcare. The modern healthcare application is a labyrinth of potential user journeys - a typical mobile application model can yield over 9 billion separate scenarios. To effectively navigate this colossal testing landscape, test automation tools employing Machine Learning (ML) algorithms are critical. By analyzing historical patterns, prioritized cases, and real-user insights, ML algorithms can auto-generate test cases and meticulously scrutinize each user interaction. This approach ensures an optimal digital experience and robust coverage of potential issues. The HIMSS study also provides a glimmer of hope, revealing that nearly 80% of healthcare providers plan to adopt real-time testing analytics for quality assurance. AI's role becomes pivotal in augmenting the capacity of software testing teams in this scenario. By leveraging historical patterns and prioritizing test cases, ML-powered testing tools can automate crucial tests across various platforms, devices, and operating systems. This symbiosis of human expertise and AI not only bolsters productivity but enables comprehensive testing coverage within tight time constraints. The Future of Healthcare Software UX Testing The path to perfecting a patient’s digital journey is fraught with challenges. Healthcare organizations venturing into automated software testing or contemplating in-house tool replacement must stay abreast of evolving healthcare testing requirements. This understanding is key when evaluating automation vendors against the backdrop of regulatory standards. Opting for a technology-agnostic solution ensures extensive test coverage, boosts efficiency, and guarantees longevity as technologies advance. Introducing your software QA teams to user-friendly, low/no-code test automation tools can simplify the onboarding process and fosters better collaboration with Dev teams and business testers. As we stand at the precipice of this transformative period in healthcare, it's clear that the AI revolution holds the key to unlocking the future of digital healthcare UX testing. By harnessing AI's potential, healthcare providers can ensure a user-friendly, seamless digital experience for the fastest-growing demographic, setting new industry standards in the process.

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Health Technology

8 Ways To Convince A Loved One To Get Help For Their Anxieties And Fears

Article | September 12, 2023

Do you know a friend or loved one who suffers from fear, anxiety, and depression and do not know what to do? It can be difficult to watch someone you know struggle with their mental health and not be able to do anything about it. As a result, here are 8 important tips on how to help the person you care about in these kinds of situations. 1. Learn as much as you can in managing anxiety and depression: There are many books and information that will educate you on how to deal with fear and anxiety. Share this information with the person who is struggling with their mental health. 2. Be understanding and patient with the person struggling: Dealing with depression and anxiety can be difficult for the person so do not add more problems than what is already there. Do not get into arguments with the person who is having a difficult time with their mental health. 3. Talk to the person instead of talking at them: It is important not to lecture the person who is struggling with anxiety and depression. Talk to the person about their issues without getting upset. Most people will listen if you approach them in the right manner. 4. Remind the person the importance of getting help: One way to convince the person who is struggling with fear and depression is to tell them what may happen if they don't get some assistance. Anxiety and depression can be difficult to manage and usually these mental health issues won't go away by themselves. 5. Find out why the person won't seek assistance: Address the issues on why the person will not get the necessary help. Many people who are struggling are fearful and frustrated. Try to find out the reasons why he or she won't get the help they need and then try to find ways that will overcome their resistance of seeking treatment. 6. Join a local support group: There are many mental health support groups in your area that can help you. Many hospitals, churches, and counselors in your area will be able to provide you with a list of groups. These mental health organizations will be supportive of your situation and they can give you additional advice on how to help the person who is struggling. 7. Talk to someone who has been there: Find somebody who used to struggle with fear, anxiety, or depression and have them talk to the person who is struggling. He or she could use their past experiences to try to reason with the person that you care about, and they might be able to use their insights to convince the individual to seek treatment. 8. Talk to a counselor: Talk to a professional counselor on how you can help your friend or relative with their mental health struggles. A counselor can give you advice and ideas on how to help out your friend. Your main goal is to get the person who is struggling to seek help from a mental health specialist.

Read More
Health Technology

Is Technology Working To Prevent Physician Burnout?

Article | August 16, 2022

Workers in the healthcare industry are among the most burned out demographics following the COVID-19 pandemic. In fact, a report by Medscape on physician burnout and depression in 2022 calculated a five-percentage point increase in burnout overall, from 42% in 2020 to 47% in 2021. Critical care physician burnout was also found to increase from 44% to 51% last year, placing them at the top of Maryville University’s list of physician specialties with the highest cases of burnout. This is closely followed by rheumatology physician burnout, which was 50% in 2021. At the bottom of the list, emergency medicine physician burnout still came in close at a rate of 44%. Burnout can result in, among other things, exhaustion and a loss of concentration, which can be dangerous in healthcare. With that, advancements in technology have been made to help mitigate stress and reduce the chances of burnout in healthcare. Maximum Tasks, Minimum Efficiency Reports show that many technological advancements in the healthcare industry actually aren’t appropriate for managing physician workloads. This is due to the range of tasks physicians need to perform, from creating treatment plans to managing EHRs. Our previous discussion on EHR-Generated Messages highlighted how the misapplication of this algorithm had actually led to these inboxes getting clogged. This has primary care physicians spending more than half their workday interacting with EHRs that only remind physicians to order certain tests, instead of dealing with critical messages from patients or colleagues. This has been counterproductive in terms of efficiency, leading to more burnout symptoms and the tendency to reduce clinical work hours. It is therefore important that technology integrations consistently consider the broader picture of the tasks of physicians. Tech Developments for Reducing Burnout Shifts in the industry have thus begun to focus on the quality of efficiency and physician assistance, rather than the quantity of technology available. Here are some notable examples of technology that has become finely integrated within the healthcare industry. Ambient Technology in Clinical Documentation Ambient computing streamlines the clinical documentation process by using artificial intelligence to respond to human behavior and needs. This provides front-end speech and computer-assisted documentation, reducing the time needed for physicians to work on admin tasks, and thereby minimizing burnout. Smart hospitals have started leveraging this through sensor-based solutions, and experts from Michigan University believe usage must be made easier and simpler to use for the provider if the healthcare industry is to further leverage ambient computing for CDI. As of 2021, adoption has only started to take off, especially in the revenue cycle. Computer Modeling in Vaccine Development The traditional process of designing novel vaccines usually lasts 10 to 15 years and can cost between $200 million and $500 million. However, a feature by News Medical highlights the recent development of COVID-19 vaccines, which uncovered the capabilities of computational modeling systems. This showed an ability to predict which parts of a pathogen may be recognized by the immune system’s B cells and T cells. This allows rapid identification of vaccine targets from a genetic sequence, which reduces the years required for preclinical research. Physicians are thus able to respond faster to vaccine developments, and reduce the overload of health systems during any future pandemics or epidemics in the long term. Patient Placement Technology The shortage of physicians is a common setback in the industry, one that staff at the Rice County District Hospital in Lyons, Kansas mitigated using patient placement technology. Patient placement technology coordinated care for patients inside the 25-bed, level 4 hospital, as well as those needing to be transferred to another facility. By integrating local EMS and other transport services with health systems, manual telephone calls were no longer necessary. Hence, physicians were able to quickly and effectively get patients the care they needed while managing time-critical diagnoses. This maximizes the limited resources available without stretching out the workforce. Physicians are able to focus solely on their patients, knowing that the time-consuming logistics are being efficiently handled by technology. The industry needs to continue to look into the practices of reducing burnout among physicians, more so as we continue to recover from the effects of the COVID-19 pandemic. By emphasizing physician wellness and efficient technology, we can continue to assure the health and productivity of healthcare workers into the future.

Read More
Health Technology, Digital Healthcare

Top 10 Best Practices for EHR Ethical Issues

Article | August 21, 2023

Managing accounts receivable (A/R) in private practice is a constant battle for physicians. Though most understand that lowering their A/R is critical for improving their practices’ efficiency and profitability, physicians often do not know how to address issues like lengthy collection periods and insurance claim denials. It can be complex to manage A/R, as doing so involves various parties, including insurance carriers, the patient, the front office and billing staff, and the provider. All must work together to achieve a clean claims rate and avoid denials. The best way to improve medical billing A/R is to reduce claim denials and speed up the patient collections process. In addition, you’ll need to ensure that patients and staff are filling out paperwork correctly and submitting claims on time. Other areas to manage are the follow-ups to correct errors and past-due accounts. Accounts receivable is a collaborative effort Each member of the practice staff plays an integral role in reducing claims denial rates. Take an all-hands-on-deck approach in order to identify issues and develop solutions. Start by making every team member privy to the A/R management process. This will ensure everyone is on the same page and involved. It will also help to increase efficiency, avoid redundancies, and eliminate mistakes that could waste time or profitability. The front office staff is the front line of A/R. They are the first to verify and update patients’ insurance and personal details like address and contact information. They must also ensure that patients sign certain documents, like financial policies. Providers are the next line of A/R. Providers select current procedural terminology (CPT) codes, and must be mindful of tedious details such as bundling correctly in order to ensure that claims are approved. A conscientious provider should not only select appropriate billing codes but also double-check the patient information that the front office staff provide. The billing office is a final line of defense and should triple check that the patient’s information and the CPT codes are correct. Billing office staff are also responsible for ensuring the claims are submitted on time and that duplicates are not submitted. Establish financial policies Every practice needs clearly defined financial policies around patients or clients. Having these policies in place helps to clarify financial details and creates workflows and processes for staff to follow. Here are a few elements to consider: State whether the practice will accept personal checks and, if so, what charges or actions are in place for bounced checks. Consider implementing technologies that convert paper checks to electronic transactions and verify them before patients leave the office. Include a financial responsibilities section with information about who is responsible for the claim(s) if a patient’s insurance carrier partially or fully denies their claim. Define the debt collection process. Patients should quickly know how long they have to pay their bills and at what point you may sell their debt to a third-party debt collectors agency. Medical records can be copious, and practices often need to make physical copies of them. Consider implementing a policy that covers a pay-per-page cost associated with medical records. Automate patient statements and payments Offer different payment options for patients by implementing technologies and creative solutions that make it easier for them to pay their bills. Look for solutions that reduce manual work and provide reporting that tracks efficacy across delivery modes. Here are a few approaches to consider: Automate sending statements via text message or email to help improve the rate of online payments. Add QR codes to online and paper statements to help patients quickly access payment portals. Offer payment plans, especially with low to no interest, to make it easier for patients to pay down balances. Establish a written collections process Not collecting patient payments at the time of service is the biggest challenge to patient collections. Establishing a written collections process can help to alleviate that pain point and clarify the practice’s policies and procedures so that patients can understand them more clearly and easily. Here are some guidelines to follow when creating your policies: Include when, how, and how often bills are sent. Provide information on payment plans and assistance programs, if available. Explain the different available payment options and whether patients can pay over the phone, online through a payment portal, etc. Clarify which extraordinary collection actions may be used, including selling the debt or taking legal action. One of the most important processes to develop with collections is to respond to patients’ behavior. Communication should not be a one-size-fits-all approach. Patients expect personalization, and reaching out to them based on their preferred means of communication leads to optimal results. Perseverance is vital when it comes to collections. By establishing clear policies and implementing integrated technology throughout your processes, you can improve the patient experience by eliminating confusion while streamlining workflow to reduce the administrative burden on billing and administrative staff. Although implementing these steps can help your practice lower your accounts receivables, sometimes choosing to outsource to a medical billing company can help you save time, money, and resources. Medical billing companies can provide medical practices with specialized expertise, technology, and infrastructure to efficiently manage the revenue cycle and ensure timely payments. Outsourcing medical billing can also free up staff time and resources, allowing healthcare providers to focus on patient care and other essential aspects of running their practice. Whether you choose to outsource or to keep your medical billing in-house, these tips will help you to reduce your costs and increase your revenue.

Read More
Healthtech Security

NIS2 Cybersecurity Rules are Coming: Are You Ready?

Article | November 29, 2023

Embracing the AI Revolution: Transforming Digital Healthcare Software through AI-Enhanced UX Testing The wave of demographic change sweeping the United States presents an urgent call to action for healthcare providers. According to the US Census Bureau, adults over 65 will account for a quarter of the US population by 2060, signaling a drastic shift in healthcare delivery needs. More than half a million of this demographic will be centenarians, accentuating the need for digital experiences tailored to seniors' unique needs. Despite the rapid advancement of digital health technologies, research indicates that many senior citizens struggle to adapt. A recent study reported that 40% of adults over 65 believe their telemedicine visit was inferior to traditional in-person care, with a meager 5% finding it superior. The promise of convenience delivered by digital health is often overshadowed by the frustration associated with technical difficulties. An astounding 75% of senior citizens admit they need assistance when using new electronic devices. Let's consider the patient portal app, a common touchpoint in the digital health journey. Despite its apparent simplicity, seniors find processes like logging in troublesome due to issues like forgotten passwords, technical bugs, or content readability. This scenario underlines the crucial need for comprehensive User Experience (UX) testing to eliminate these barriers and provide a seamless digital health experience. The Complex Landscape of Healthcare UX Testing The complexity of UX testing in healthcare has been exacerbated by the interplay of multiple modules, services, platforms, and vendors. Take Electronic Medical Record (EMR) systems, for instance, which undergo frequent updates, each one potentially impacting the system as a whole. Traditional manual testing methodologies are proving to be time-consuming and costly. Though automation has revolutionized sectors from automotive to finance, the healthcare industry appears to be lagging. A study by the Health Information and Management Systems Society (HIMSS) reveals that a mere 15% of healthcare providers have adopted modern test automation platforms. Meanwhile, a significant 41% still rely on manual testing. As EMR systems grow increasingly complex and customized, this over-reliance on manual testing poses daunting challenges. The gravity of this issue is amplified by a startling revelation from the HIMSS study - only 6% of healthcare executive leaders express confidence in their organizations' testing practices. In an increasingly digitized healthcare environment, such a low level of assurance raises substantial concerns about patient safety. Although 75% of the surveyed providers have invested in software testing to safeguard their bottom lines, nearly two-thirds confess feeling inadequately resourced in terms of time, money, and talent to meet future testing requirements. As the list of testing demands grows, QA teams are frequently stretched thin, leaving many potential user journey scenarios untested. The Power of AI in UX Testing for Better Patient Outcomes AI technologies hold the potential to revolutionize UX testing in healthcare. The modern healthcare application is a labyrinth of potential user journeys - a typical mobile application model can yield over 9 billion separate scenarios. To effectively navigate this colossal testing landscape, test automation tools employing Machine Learning (ML) algorithms are critical. By analyzing historical patterns, prioritized cases, and real-user insights, ML algorithms can auto-generate test cases and meticulously scrutinize each user interaction. This approach ensures an optimal digital experience and robust coverage of potential issues. The HIMSS study also provides a glimmer of hope, revealing that nearly 80% of healthcare providers plan to adopt real-time testing analytics for quality assurance. AI's role becomes pivotal in augmenting the capacity of software testing teams in this scenario. By leveraging historical patterns and prioritizing test cases, ML-powered testing tools can automate crucial tests across various platforms, devices, and operating systems. This symbiosis of human expertise and AI not only bolsters productivity but enables comprehensive testing coverage within tight time constraints. The Future of Healthcare Software UX Testing The path to perfecting a patient’s digital journey is fraught with challenges. Healthcare organizations venturing into automated software testing or contemplating in-house tool replacement must stay abreast of evolving healthcare testing requirements. This understanding is key when evaluating automation vendors against the backdrop of regulatory standards. Opting for a technology-agnostic solution ensures extensive test coverage, boosts efficiency, and guarantees longevity as technologies advance. Introducing your software QA teams to user-friendly, low/no-code test automation tools can simplify the onboarding process and fosters better collaboration with Dev teams and business testers. As we stand at the precipice of this transformative period in healthcare, it's clear that the AI revolution holds the key to unlocking the future of digital healthcare UX testing. By harnessing AI's potential, healthcare providers can ensure a user-friendly, seamless digital experience for the fastest-growing demographic, setting new industry standards in the process.

Read More
Health Technology

5 Ways AI is Likely to Benefit Medicine & Improve Patient Care

Article | September 12, 2023

Do you know a friend or loved one who suffers from fear, anxiety, and depression and do not know what to do? It can be difficult to watch someone you know struggle with their mental health and not be able to do anything about it. As a result, here are 8 important tips on how to help the person you care about in these kinds of situations. 1. Learn as much as you can in managing anxiety and depression: There are many books and information that will educate you on how to deal with fear and anxiety. Share this information with the person who is struggling with their mental health. 2. Be understanding and patient with the person struggling: Dealing with depression and anxiety can be difficult for the person so do not add more problems than what is already there. Do not get into arguments with the person who is having a difficult time with their mental health. 3. Talk to the person instead of talking at them: It is important not to lecture the person who is struggling with anxiety and depression. Talk to the person about their issues without getting upset. Most people will listen if you approach them in the right manner. 4. Remind the person the importance of getting help: One way to convince the person who is struggling with fear and depression is to tell them what may happen if they don't get some assistance. Anxiety and depression can be difficult to manage and usually these mental health issues won't go away by themselves. 5. Find out why the person won't seek assistance: Address the issues on why the person will not get the necessary help. Many people who are struggling are fearful and frustrated. Try to find out the reasons why he or she won't get the help they need and then try to find ways that will overcome their resistance of seeking treatment. 6. Join a local support group: There are many mental health support groups in your area that can help you. Many hospitals, churches, and counselors in your area will be able to provide you with a list of groups. These mental health organizations will be supportive of your situation and they can give you additional advice on how to help the person who is struggling. 7. Talk to someone who has been there: Find somebody who used to struggle with fear, anxiety, or depression and have them talk to the person who is struggling. He or she could use their past experiences to try to reason with the person that you care about, and they might be able to use their insights to convince the individual to seek treatment. 8. Talk to a counselor: Talk to a professional counselor on how you can help your friend or relative with their mental health struggles. A counselor can give you advice and ideas on how to help out your friend. Your main goal is to get the person who is struggling to seek help from a mental health specialist.

Read More
Health Technology

Is Technology Working To Prevent Physician Burnout?

Article | August 16, 2022

Workers in the healthcare industry are among the most burned out demographics following the COVID-19 pandemic. In fact, a report by Medscape on physician burnout and depression in 2022 calculated a five-percentage point increase in burnout overall, from 42% in 2020 to 47% in 2021. Critical care physician burnout was also found to increase from 44% to 51% last year, placing them at the top of Maryville University’s list of physician specialties with the highest cases of burnout. This is closely followed by rheumatology physician burnout, which was 50% in 2021. At the bottom of the list, emergency medicine physician burnout still came in close at a rate of 44%. Burnout can result in, among other things, exhaustion and a loss of concentration, which can be dangerous in healthcare. With that, advancements in technology have been made to help mitigate stress and reduce the chances of burnout in healthcare. Maximum Tasks, Minimum Efficiency Reports show that many technological advancements in the healthcare industry actually aren’t appropriate for managing physician workloads. This is due to the range of tasks physicians need to perform, from creating treatment plans to managing EHRs. Our previous discussion on EHR-Generated Messages highlighted how the misapplication of this algorithm had actually led to these inboxes getting clogged. This has primary care physicians spending more than half their workday interacting with EHRs that only remind physicians to order certain tests, instead of dealing with critical messages from patients or colleagues. This has been counterproductive in terms of efficiency, leading to more burnout symptoms and the tendency to reduce clinical work hours. It is therefore important that technology integrations consistently consider the broader picture of the tasks of physicians. Tech Developments for Reducing Burnout Shifts in the industry have thus begun to focus on the quality of efficiency and physician assistance, rather than the quantity of technology available. Here are some notable examples of technology that has become finely integrated within the healthcare industry. Ambient Technology in Clinical Documentation Ambient computing streamlines the clinical documentation process by using artificial intelligence to respond to human behavior and needs. This provides front-end speech and computer-assisted documentation, reducing the time needed for physicians to work on admin tasks, and thereby minimizing burnout. Smart hospitals have started leveraging this through sensor-based solutions, and experts from Michigan University believe usage must be made easier and simpler to use for the provider if the healthcare industry is to further leverage ambient computing for CDI. As of 2021, adoption has only started to take off, especially in the revenue cycle. Computer Modeling in Vaccine Development The traditional process of designing novel vaccines usually lasts 10 to 15 years and can cost between $200 million and $500 million. However, a feature by News Medical highlights the recent development of COVID-19 vaccines, which uncovered the capabilities of computational modeling systems. This showed an ability to predict which parts of a pathogen may be recognized by the immune system’s B cells and T cells. This allows rapid identification of vaccine targets from a genetic sequence, which reduces the years required for preclinical research. Physicians are thus able to respond faster to vaccine developments, and reduce the overload of health systems during any future pandemics or epidemics in the long term. Patient Placement Technology The shortage of physicians is a common setback in the industry, one that staff at the Rice County District Hospital in Lyons, Kansas mitigated using patient placement technology. Patient placement technology coordinated care for patients inside the 25-bed, level 4 hospital, as well as those needing to be transferred to another facility. By integrating local EMS and other transport services with health systems, manual telephone calls were no longer necessary. Hence, physicians were able to quickly and effectively get patients the care they needed while managing time-critical diagnoses. This maximizes the limited resources available without stretching out the workforce. Physicians are able to focus solely on their patients, knowing that the time-consuming logistics are being efficiently handled by technology. The industry needs to continue to look into the practices of reducing burnout among physicians, more so as we continue to recover from the effects of the COVID-19 pandemic. By emphasizing physician wellness and efficient technology, we can continue to assure the health and productivity of healthcare workers into the future.

Read More
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Spotlight

MileStone Healthcare

MileStone Healthcare is a management and consulting firm assisting hospitals and other healthcare providers to establish new and improve existing post-acute care programs. As a leading national provider of post-acute care programs and services, MileStone has opened and managed over 200 post-acute care programs across the country for more than 20 years. MileStone’s corporate office is located in metropolitan Dallas.

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Keystone Healthcare Partners Establishes Partnership with Trinity Medical to Expand Emergency Medicine Footprint into Louisiana

Keystone Healthcare Partners | February 05, 2024

Keystone Healthcare Partners a leading provider of emergency medicine, hospital medicine, critical care medicine, and telehealth staffing and management services, as well as revenue cycle management, recently announced that it has formed a partnership with Trinity Medical in Ferriday, Louisiana. Keystone's delivery of emergency medicine services at Trinity Medical will commence on February 1, 2024. This contract represents an exciting expansion of Keystone's regional influence into Louisiana; the company has managed contracts in Mississippi for decades. Glenn Adams, Keystone's CEO & Co-founder, notes, "We are excited to kick off another partnership with a client where we see opportunity for real impact. We've hit the ground running to shore up areas of frustration for the client and bring value-add and innovative solutions, such as Keystone Connect AI technology to the emergency medicine program." While the healthcare landscape has been challenging for rural and critical access hospitals, the two entities share a patient-centered ethos that will be paramount to the partnership. The two entities share a community- and patient-focus that is embodied by Trinity's motto, "People you know, caring for people you love." "We are very excited to start our partnership with Keystone Healthcare," states Keisha Smith, CEO of Trinity. "My goal for Trinity Medical has always been to provide our patients with the best healthcare and customer service possible in the Miss-Lou area. We feel that Keystone shares the same goals that we have and will be a true asset to our hospital. Henry Ford stated, 'Coming together is a beginning, staying together is progress, and working together is success.' We are looking forward to a long lasting, successful partnership with Keystone Healthcare." Trinity Medical, a 23-bed licensed facility, continues to grow and upgrade their services and facilities in addition to recruiting physicians to meet the growing needs of their expanding community. About Keystone Healthcare Keystone Healthcare™ is a leading provider of Emergency Medicine, Hospital Medicine, Critical Care Medicine and Telehealth clinical management services and staffing solutions for hospitals. We efficiently deliver high-quality, patient-centered care through strong physician leadership and involved management that drive our innovative and integrated business model. About Trinity Medical Trinity Medical is operated by Concordia Parish Hospital Service District No. 1. Trinity Medical, formerly Riverland Medical Center, opened in 1964 as Concordia Parish Hospital and has continuously served the residents of the area for more than 55 years. In addition to emergency and acute care, Trinity Medical offers surgical services, diagnostic imaging, infusion center, cardio-respiratory care, gastroenterology, lab services, otolaryngology, urology, and an in-hospital rehabilitation service as well as an extensive range of out-patient services, both diagnostic and for treatment.

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Digital Healthcare

UCI Health Reaches Definitive Agreement to Acquire Four Southern California Hospitals From Tenet Healthcare Corporation

UCI Health | February 02, 2024

The Regents of the University of California, on behalf of the University of California, Irvine, has entered into a definitive agreement with Tenet Healthcare Corporation to acquire Tenet's Pacific Coast Network. The network will become part of UCI Health, the clinical enterprise of UC Irvine. "UC Irvine has deepened its healthcare commitment to the future of Orange County, our region and California," said UC Irvine Chancellor Howard Gillman. "This journey in healthcare is deeply intertwined with the University of California's dedication to bettering our communities, expanding access to premier healthcare, and pioneering the medical innovations of tomorrow, today. Our vision will bridge gaps in regional care and reinforce UCI's place among the nation's leading academic health systems while advancing solutions to challenges facing healthcare." Pending customary regulatory approvals, clearances, and closing conditions, the proposed acquisition would bring four medical centers in Lakewood, Los Alamitos, Fountain Valley and Placentia and associated outpatient locations into the UCI Health system. UCI Health currently delivers care at UCI Medical Center in Orange and a growing network of multispecialty care centers. "At UCI Health, we are excited to add these new care sites to the UCI Health network and extend the benefits of our compassionate, high-level care, clinical innovation, and scientific discovery," said Chad Lefteris, president and chief executive officer of UCI Health. "As Orange County's only academic health system, UCI Health is unique in its ability to offer the highest level of advanced care powered by the research and innovation of a world-class public research institution." UCI Health recognizes a unique opportunity to build on the quality care already being delivered in the communities served by Tenet Healthcare's Pacific Coast Network. "These four hospitals are well-regarded in their communities for providing high-quality, compassionate care," said Saum Sutaria, M.D., chairman and chief executive officer of Tenet Healthcare. "The local communities will benefit from the nationally recognized advancements, medical knowledge, research, and community focus that UCI Health brings as an innovative academic health system. UCI Health recognizes a unique opportunity to build on the quality care already being delivered in the communities served by the Pacific Coast Network." In a region with a population greater than that of two dozen states, UCI Health operates the only Level I trauma center, locally based National Cancer Institute-designated comprehensive cancer center, high-risk perinatal-neonatal service and is the largest regional burn center and leading provider of complex tertiary and quaternary care. The system's clinical excellence has consistently placed UCI Health in the top 10 for quality and safety among the nation's leading comprehensive academic health systems. The acquisition also means more patients will have access to advanced therapies in the region's largest and most diverse portfolio of clinical trials, ranging from cancer to neurosciences, digestive diseases, orthopedics and internal medicine specialties. UCI Health and Tenet Healthcare's Pacific Coast Network patients can continue receiving care at their local facilities as they normally would from the care teams they know and trust. The transaction is expected to be completed in spring 2024, subject to customary regulatory approvals, clearances, and closing conditions. "It is a privilege to provide world-class care to Californians and we are excited to welcome the clinicians and co-workers from these Tenet Healthcare sites to UCI Health as partners in improving the health of local communities," Lefteris said. About UCI Health UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system in Orange County. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, Calif. The 459-bed, acute care hospital, listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation services. UCI Medical Center is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. About UC Irvine About the University of California, Irvine: Founded in 1965, UCI is a member of the prestigious Association of American Universities and is ranked among the nation's top 10 public universities by U.S. News & World Report. The campus has produced five Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UCI has more than 37,000 students and offers 224 degree programs. It's located in one of the world's safest and most economically vibrant communities and is Orange County's second-largest employer, contributing $7 billion annually to the local economy and $8 billion statewide. About Tenet Healthcare Tenet Healthcare Corporation is a diversified healthcare services company headquartered in Dallas. Our care delivery network includes United Surgical Partners International, the largest ambulatory platform in the country, which operates or has ownership interests in more than 480 ambulatory surgery centers and surgical hospitals. We also operate 58 acute care and specialty hospitals, approximately 110 other outpatient facilities, a network of leading employed physicians and a global business center in Manila, Philippines. Our Conifer Health Solutions subsidiary provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers, and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.

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Health Technology

Beckman Coulter Unveils DxC 500 AU Chemistry Analyzer, Expanding Portfolio with Proven Six Sigma Performance

Beckman Coulter Diagnostics | January 30, 2024

Beckman Coulter Diagnostics, a clinical diagnostics leader, will unveil its new DxC 500 AU Chemistry Analyzer, an automated clinical chemistry analyzer, at Medlab Middle East in Dubai, taking place February 5-8, 2024. The DxC 500 AU Chemistry Analyzer is one of several recent Beckman Coulter solutions designed to address the complete needs of healthcare systems that are looking to complement central hub laboratories by advancing the technology and capabilities of satellite and independent hospital laboratories. "Healthcare systems around the world are strategically adopting hub-and-spoke models for better efficiency and healthcare access," said Kathleen Orland, Senior Vice President, Business Unit, General Manager, Chemistry and Immunoassay for Beckman Coulter Diagnostics. "Hub-and-spoke clinical laboratory models optimize resources to improve access to testing services and enhance overall standardization for quality testing and positive impact on inventory and cost management across a health system. The new DxC 500 AU Chemistry Analyzer advances capabilities of spoked labs with a broad menu of high-quality assays that deliver consistent, commutable results across Beckman Coulter's AU clinical chemistry systems, positively impacting clinical decision-making and patient outcomes." The DxC 500 AU Chemistry Analyzer features advanced automation technology, onboard guided workflows, and standardized reagents for use across healthcare networks. Its menu of more than 120 assays has been independently and objectively verified for high quality Six Sigma performance, supporting confidence in clinical results, reducing QC trouble shooting and lab operational costs. "Our Six Sigma assessment has shown that the DxC 500 AU analyzer easily exceeds the demands of the new, more stringent CLIA 2024 performance specifications," stated Sten Westgard, Director of Client Services and Technology for Westgard QC. The DxC 500 AU Chemistry Analyzer is for in vitro diagnostic use only. It is available throughout North America and the Middle East. Global commercial availability is planned for March 2024. About Beckman Coulter. Inc. A global leader in advanced diagnostics, Beckman Coulter has challenged convention to elevate the diagnostic laboratory's role in improving patient health for more than 80 years. Our mission is to Relentlessly Reimagine Healthcare, One Diagnosis at a Time – and we do this by applying the power of science, technology and the passion and creativity of our teams. Our diagnostic solutions are used in complex clinical testing, and are found in hospitals, reference laboratories and physician office settings around the globe. We exist to deliver smarter, faster diagnostic solutions that move the needle forward from what's now to what's next. We seek to accelerate care with an extensive clinical menu, scalable lab automation technologies, insightful clinical informatics, and optimize lab performance services. Headquartered in Brea, Calif., with more than 11,000 global team members, Beckman Coulter Diagnostics is proud to be part of Danaher. Danaher is a global science and technology leader. Together we combine our capabilities to accelerate the real-life impact of tomorrow's science and technology to improve human health. ©2024 Beckman Coulter. All rights reserved. Beckman Coulter, the stylized logo, and the Beckman Coulter product and service marks mentioned herein are trademarks or registered trademarks of Beckman Coulter, Inc. in the United States and other countries.

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Healthcare Analytics

Keystone Healthcare Partners Establishes Partnership with Trinity Medical to Expand Emergency Medicine Footprint into Louisiana

Keystone Healthcare Partners | February 05, 2024

Keystone Healthcare Partners a leading provider of emergency medicine, hospital medicine, critical care medicine, and telehealth staffing and management services, as well as revenue cycle management, recently announced that it has formed a partnership with Trinity Medical in Ferriday, Louisiana. Keystone's delivery of emergency medicine services at Trinity Medical will commence on February 1, 2024. This contract represents an exciting expansion of Keystone's regional influence into Louisiana; the company has managed contracts in Mississippi for decades. Glenn Adams, Keystone's CEO & Co-founder, notes, "We are excited to kick off another partnership with a client where we see opportunity for real impact. We've hit the ground running to shore up areas of frustration for the client and bring value-add and innovative solutions, such as Keystone Connect AI technology to the emergency medicine program." While the healthcare landscape has been challenging for rural and critical access hospitals, the two entities share a patient-centered ethos that will be paramount to the partnership. The two entities share a community- and patient-focus that is embodied by Trinity's motto, "People you know, caring for people you love." "We are very excited to start our partnership with Keystone Healthcare," states Keisha Smith, CEO of Trinity. "My goal for Trinity Medical has always been to provide our patients with the best healthcare and customer service possible in the Miss-Lou area. We feel that Keystone shares the same goals that we have and will be a true asset to our hospital. Henry Ford stated, 'Coming together is a beginning, staying together is progress, and working together is success.' We are looking forward to a long lasting, successful partnership with Keystone Healthcare." Trinity Medical, a 23-bed licensed facility, continues to grow and upgrade their services and facilities in addition to recruiting physicians to meet the growing needs of their expanding community. About Keystone Healthcare Keystone Healthcare™ is a leading provider of Emergency Medicine, Hospital Medicine, Critical Care Medicine and Telehealth clinical management services and staffing solutions for hospitals. We efficiently deliver high-quality, patient-centered care through strong physician leadership and involved management that drive our innovative and integrated business model. About Trinity Medical Trinity Medical is operated by Concordia Parish Hospital Service District No. 1. Trinity Medical, formerly Riverland Medical Center, opened in 1964 as Concordia Parish Hospital and has continuously served the residents of the area for more than 55 years. In addition to emergency and acute care, Trinity Medical offers surgical services, diagnostic imaging, infusion center, cardio-respiratory care, gastroenterology, lab services, otolaryngology, urology, and an in-hospital rehabilitation service as well as an extensive range of out-patient services, both diagnostic and for treatment.

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Digital Healthcare

UCI Health Reaches Definitive Agreement to Acquire Four Southern California Hospitals From Tenet Healthcare Corporation

UCI Health | February 02, 2024

The Regents of the University of California, on behalf of the University of California, Irvine, has entered into a definitive agreement with Tenet Healthcare Corporation to acquire Tenet's Pacific Coast Network. The network will become part of UCI Health, the clinical enterprise of UC Irvine. "UC Irvine has deepened its healthcare commitment to the future of Orange County, our region and California," said UC Irvine Chancellor Howard Gillman. "This journey in healthcare is deeply intertwined with the University of California's dedication to bettering our communities, expanding access to premier healthcare, and pioneering the medical innovations of tomorrow, today. Our vision will bridge gaps in regional care and reinforce UCI's place among the nation's leading academic health systems while advancing solutions to challenges facing healthcare." Pending customary regulatory approvals, clearances, and closing conditions, the proposed acquisition would bring four medical centers in Lakewood, Los Alamitos, Fountain Valley and Placentia and associated outpatient locations into the UCI Health system. UCI Health currently delivers care at UCI Medical Center in Orange and a growing network of multispecialty care centers. "At UCI Health, we are excited to add these new care sites to the UCI Health network and extend the benefits of our compassionate, high-level care, clinical innovation, and scientific discovery," said Chad Lefteris, president and chief executive officer of UCI Health. "As Orange County's only academic health system, UCI Health is unique in its ability to offer the highest level of advanced care powered by the research and innovation of a world-class public research institution." UCI Health recognizes a unique opportunity to build on the quality care already being delivered in the communities served by Tenet Healthcare's Pacific Coast Network. "These four hospitals are well-regarded in their communities for providing high-quality, compassionate care," said Saum Sutaria, M.D., chairman and chief executive officer of Tenet Healthcare. "The local communities will benefit from the nationally recognized advancements, medical knowledge, research, and community focus that UCI Health brings as an innovative academic health system. UCI Health recognizes a unique opportunity to build on the quality care already being delivered in the communities served by the Pacific Coast Network." In a region with a population greater than that of two dozen states, UCI Health operates the only Level I trauma center, locally based National Cancer Institute-designated comprehensive cancer center, high-risk perinatal-neonatal service and is the largest regional burn center and leading provider of complex tertiary and quaternary care. The system's clinical excellence has consistently placed UCI Health in the top 10 for quality and safety among the nation's leading comprehensive academic health systems. The acquisition also means more patients will have access to advanced therapies in the region's largest and most diverse portfolio of clinical trials, ranging from cancer to neurosciences, digestive diseases, orthopedics and internal medicine specialties. UCI Health and Tenet Healthcare's Pacific Coast Network patients can continue receiving care at their local facilities as they normally would from the care teams they know and trust. The transaction is expected to be completed in spring 2024, subject to customary regulatory approvals, clearances, and closing conditions. "It is a privilege to provide world-class care to Californians and we are excited to welcome the clinicians and co-workers from these Tenet Healthcare sites to UCI Health as partners in improving the health of local communities," Lefteris said. About UCI Health UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system in Orange County. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, Calif. The 459-bed, acute care hospital, listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation services. UCI Medical Center is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. About UC Irvine About the University of California, Irvine: Founded in 1965, UCI is a member of the prestigious Association of American Universities and is ranked among the nation's top 10 public universities by U.S. News & World Report. The campus has produced five Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UCI has more than 37,000 students and offers 224 degree programs. It's located in one of the world's safest and most economically vibrant communities and is Orange County's second-largest employer, contributing $7 billion annually to the local economy and $8 billion statewide. About Tenet Healthcare Tenet Healthcare Corporation is a diversified healthcare services company headquartered in Dallas. Our care delivery network includes United Surgical Partners International, the largest ambulatory platform in the country, which operates or has ownership interests in more than 480 ambulatory surgery centers and surgical hospitals. We also operate 58 acute care and specialty hospitals, approximately 110 other outpatient facilities, a network of leading employed physicians and a global business center in Manila, Philippines. Our Conifer Health Solutions subsidiary provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers, and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.

Read More

Health Technology

Beckman Coulter Unveils DxC 500 AU Chemistry Analyzer, Expanding Portfolio with Proven Six Sigma Performance

Beckman Coulter Diagnostics | January 30, 2024

Beckman Coulter Diagnostics, a clinical diagnostics leader, will unveil its new DxC 500 AU Chemistry Analyzer, an automated clinical chemistry analyzer, at Medlab Middle East in Dubai, taking place February 5-8, 2024. The DxC 500 AU Chemistry Analyzer is one of several recent Beckman Coulter solutions designed to address the complete needs of healthcare systems that are looking to complement central hub laboratories by advancing the technology and capabilities of satellite and independent hospital laboratories. "Healthcare systems around the world are strategically adopting hub-and-spoke models for better efficiency and healthcare access," said Kathleen Orland, Senior Vice President, Business Unit, General Manager, Chemistry and Immunoassay for Beckman Coulter Diagnostics. "Hub-and-spoke clinical laboratory models optimize resources to improve access to testing services and enhance overall standardization for quality testing and positive impact on inventory and cost management across a health system. The new DxC 500 AU Chemistry Analyzer advances capabilities of spoked labs with a broad menu of high-quality assays that deliver consistent, commutable results across Beckman Coulter's AU clinical chemistry systems, positively impacting clinical decision-making and patient outcomes." The DxC 500 AU Chemistry Analyzer features advanced automation technology, onboard guided workflows, and standardized reagents for use across healthcare networks. Its menu of more than 120 assays has been independently and objectively verified for high quality Six Sigma performance, supporting confidence in clinical results, reducing QC trouble shooting and lab operational costs. "Our Six Sigma assessment has shown that the DxC 500 AU analyzer easily exceeds the demands of the new, more stringent CLIA 2024 performance specifications," stated Sten Westgard, Director of Client Services and Technology for Westgard QC. The DxC 500 AU Chemistry Analyzer is for in vitro diagnostic use only. It is available throughout North America and the Middle East. Global commercial availability is planned for March 2024. About Beckman Coulter. Inc. A global leader in advanced diagnostics, Beckman Coulter has challenged convention to elevate the diagnostic laboratory's role in improving patient health for more than 80 years. Our mission is to Relentlessly Reimagine Healthcare, One Diagnosis at a Time – and we do this by applying the power of science, technology and the passion and creativity of our teams. Our diagnostic solutions are used in complex clinical testing, and are found in hospitals, reference laboratories and physician office settings around the globe. We exist to deliver smarter, faster diagnostic solutions that move the needle forward from what's now to what's next. We seek to accelerate care with an extensive clinical menu, scalable lab automation technologies, insightful clinical informatics, and optimize lab performance services. Headquartered in Brea, Calif., with more than 11,000 global team members, Beckman Coulter Diagnostics is proud to be part of Danaher. Danaher is a global science and technology leader. Together we combine our capabilities to accelerate the real-life impact of tomorrow's science and technology to improve human health. ©2024 Beckman Coulter. All rights reserved. Beckman Coulter, the stylized logo, and the Beckman Coulter product and service marks mentioned herein are trademarks or registered trademarks of Beckman Coulter, Inc. in the United States and other countries.

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