Veradigm Partners With American College of Cardiology on Next-generation Research Registries

The American College of Cardiology (ACC) has partnered with Veradigm, an Allscripts business unit, to power the next generation of real-world research on behalf of cardiovascular disease and diabetes patients around the world. As part of this partnership, Veradigm which simplifies healthcare with data-driven health insights and technologies to help manage costs and improve health outcomes will operate two registries.

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Best Doctors

The Best Doctors suite of expert medical services are part of the Teladoc Health family, helping patients get answers for their healthcare needs. The trusted expert resource brings confidence to care decisions by connecting members and their treating physicians with a network of the top 50,000 world-renowned experts in 450 medical subspecialties.

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Health Technology, Digital Healthcare

COVID-19: How do we get out of this quagmire?

Article | September 7, 2023

The COVID-19 virus (C19) pandemic is turning out to be the event of the century. Even World War seems timid in comparison. We are in the 4th month of the virus (in non-China countries) and have gone past the lockdown in many places. Isn’t it time we re-think the approach? What if there is another wave of C19 coming soon? What if C19 is the first of many such events in the future? Before we get into analysis and solution design, summarizing the C19 quirks: While a large section of the affected population is asymptomatic, for some it can be lethal There isn’t clarity on all the ways C19 spreads It’s known to affect the lungs, heart, and kidneys in patients with weak immunity It has been hard to identify a definitive pattern of the virus. Some observations in managing the C19 situation are: With no vaccine in sight, the end of this epidemic looks months or years away Health care personnel in hospitals need additional protection to treat patients Lockdowns lead to severe economic hardship and its repeated application can be damaging Quarantining people has an economic cost, especially in the weaker sections of society If one takes a step back to re-think about this, we are primarily solving 2 problems: Minimise deaths: Minimise the death of C19 and non-C19 patients in this period Maximise economic growth: The GDP output/growth should equal or higher than pre-C19 levels One needs to achieve the 2 goals in an environment of rising number of C19 cases. Minimise deaths An approach that can be applied to achieve this is: Data driven health care capacity planning Build a health repository of all the citizens with details like pre-existing diseases, comorbidity, health status, etc. The repository needs to be updated quarterly to account for patient data changes This health repository data is combined with the C19 profile (disease susceptibility) and/or other seasonal diseases to determine the healthcare capacity (medicines, doctors, etc.) needed The healthcare capacity deficit/excess needs to be analysed in categories (beds, equipment, medicine, personnel, etc.) and regions (city, state, etc.) and actions taken accordingly Regular capacity management will ensure patients aren’t deprived of timely treatment. In addition, such planning helps in the equitable distribution of healthcare across regions and optimising health care costs. Healthcare sector is better prepared to scale-up/down their operations Based on the analysis citizens can be informed about their probability of needing hospitalisation on contracting C19. Citizens with a higher health risk on C19 infection should be personally trained on prevention and tips to manage the disease on occurrence The diagram below explains the process Mechanism to increase hospital capacity without cost escalation Due to the nature of C19, health personnel are prone to infection and their safety is a big issue. There is also a shortage of hospitable beds available. Even non-C19 patients aren’t getting the required treatment because health personnel seek it as a risk. This resulted in, healthcare costs going up and availability reducing. To mitigate such issues, hospital layouts may need to be altered (as shown in the diagram below). The altered layout improves hospital capacity and availability of health care personnel. It also reduces the need for the arduous C19 protection procedures. Such procedures reduce the patient treatment capacity and puts a toll on hospital management. Over a period, the number of recovered C19 persons are going to increase significantly. We need to start tapping into their services to reduce the burden on the system. The hospitals need to be divided into 3 zones. The hospital zoning illustration shown below explains how this could be done. In the diagram, patients are shown in green and health care personnel are in light red. **Assumption: Infected and recovered C19 patients are immune to the disease. This is not clearly established Better enforcement of social factors The other reason for high number of infections in countries like India is a glaring disregard in following C19 rules in public places and the laxity in enforcement. Enforcement covers 2 parts, tracking incidents of violation and penalising the behaviour. Government should use modern mechanisms like crowd sourcing to track incidents and ride on the growing public fear to ensure penalty enforcement succeeds. The C19 pandemic has exposed governance limitations in not just following C19 rules, but also in other areas of public safety like road travel, sanitation, dietary habits, etc. Maximise economic growth The earlier lockdown has strained the economy. Adequate measures need to be taken to get the economy back on track. Some of the areas that need to be addressed are: One needs to evaluate the development needs of the country in different categories like growth impetus factors (e.g. building roads, electricity capacity increase), social factors (e.g. waste water treatment plants, health care capacity), and environmental factors (e.g. solar energy generation, EV charging stations). Governments need to accelerate funding in such projects so that that large numbers of unemployed people are hired and trained. Besides giving an immediate boost to the ailing economy such projects have a future payback. The governments should not get bogged down by the huge fiscal deficit such measures can create. Such a mechanism to get money out in the economy is far than better measures like QE (Quantitative Easing) or free money transfer into people’s bank accounts Certain items like smartphone, internet, masks, etc. have become critical (for work, education, critical government announcements). It’s essential to subsidise or reduce taxes so that these items are affordable and accessible to everyone without a financial impact The government shouldn’t put too many C19 related controls on service offerings (e.g. shops, schools, restaurants, cabs). Putting many controls increases the cost of the service which neither the seller not buyer is willing or able to pay. Where controls are put, the Govt should bear the costs or reduce taxes or figure out a mechanism so that the cost can be absorbed. An event like the C19 pandemic is a great opportunity to rationalise development imbalances in the country. Government funding should be channelized more to under-developed regions. This drives growth in regions that need it most. It also prevents excess migration that has resulted in uncontrolled and bad urbanisation that has made C19 management hard (guidelines like social distance are impossible to follow) Post-C19 lockdown, the business environment (need for sanitizers, masks, home furniture) has changed. To make people employable in new flourishing businesses there could be a need to re-skill people. Such an initiative can be taken up by the public/private sector The number of C19 infected asymptomatic patients is going to keep increasing. Building an economy around them (existing, recovered C19 patients) may not be a far-fetched idea. E.g. jobs for C19 infected daily wage earners, C19 infected taxi drivers to transport C19 patients, etc. In the last 100 years, mankind has conquered the destructive aspects of many a disease and natural mishap (hurricanes, floods, etc.). Human lives lost in such events has dramatically dropped over the years and our preparedness has never been this good. Nature seems to have caught up with mankind’s big strides in science and technology. C19 has been hard to reign in with no breakthrough yet. The C19 pandemic is here to stay for the near future. The more we accept this reality and change ourselves to live with it amidst us, the faster we can return to a new normal. A quote from Edward Jenner (inventor of Small Pox) seems apt in the situation – “The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases”.

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Health Technology

Ways to Drive Practice Revenue and Reduce Your Accounts Receivable

Article | September 12, 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.

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Healthtech Security

Modernizing Caregiving: How a Robotic Emotional Support Animal Can Help Caregivers

Article | November 29, 2023

A wealth of evidence supports the health benefits of keeping pets: increased life span, exercise, improved mental health, and a sense of purpose. But for older adults and those with disabilities, the responsibilities and expense of owning an animal can be overwhelming, and caregivers are often forced to take on those burdens themselves. To make matters worse, dementia patients can pose a physical threat to live animals. What alternate solutions exist for those who cannot safely or practically keep a live pet? Fortunately, information technology and robotics have advanced to the point that realistic, robotic emotional support pets are becoming a legitimate option. As research in this area advances, experts have found that robotic emotional support animals can offer a myriad of benefits similar to those associated with live pets. Robotic companions can also help caregivers. Robotic Emotional Support Animals in Practice Imagine the following scenario: An elderly woman with dementia suffering from Sundowner’s Syndrome relies on a strict daily regimen established by her caregiver. This routine is a delicate dance, balancing the patient’s meals, medication, and personal care, all designed to keep her as relaxed as possible. One afternoon, as the caregiver prepares dinner, the caregiver realizes that the patient’s beloved dog is nowhere to be found. She runs outside to look for the dog, leaving the patient to fend for herself. The patient is agitated over her missing dog and suddenly alone in a kitchen with pots and pans boiling. Fortunately, the caregiver finds the dog outside, but the patient is now too overwhelmed to eat or take her medication. Despite the caregiver’s best efforts at redirection, it’s a rough evening for everyone. How a Robotic Emotional Support Animal Can Ease the Role as Caregiver As any experienced caregiver knows, consistent emotional support for patients is critical. A robotic emotional support animal can significantly ease a caregiver’s role in this respect. Robotic companions replicate many benefits traditional pets provide – affection, responsiveness, and companionship – without the associated caregiving demands, such as feeding walking, or veterinarian visits. The Benefits of Robotic Emotional Support Animals The owners of pets are known to enjoy Reduced impact of depression Lower blood pressure Reduced triglycerides and cholesterol Longer survival rates after a heart attack 30% fewer doctor visits after age 65 Longer life spans Robotic companion animals provide genuine comfort, mirroring the emotional connection that living pets provide while lightening the caregiver load. Uplifting conversations about the robot companion elevate the moods of both patient and caregiver, potentially reducing feelings of burnout. In embracing such technology, senior care and assisted living facilities can foster an environment that makes staff and residents all smile a little more.

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6 Tips On Discussing Your Mental Health Issues With Your Friends

Article | October 26, 2020

Do you have a difficult time explaining your mental health issues to your family and friends? If so, here are six suggestions on how to discuss your mental health issues with your friends and relatives. 1. Talk to a counselor: The most important thing that you need to do is to talk to a counselor about your mental health problems. Seeking professional help will go a long way in overcoming your current issues. In addition, a counselor will be able to give you additional advice on how to deal with your friends and family members. 2. Don’t argue with others: It is important that you do not get into arguments with those who are giving you a hard time. Your number one priority is getting your life back on track. Your health is more important than what other people may think. 3. Watch who you hang out with: It is important to surround yourself with positive people. Try to keep your distance from those people who are giving you a difficult time. Remember that your goal is to remain positive and hopeful. Do not let the negative people in your life bring you down. 4. You are not alone: It can be very frustrating to deal with your mental health issues when your friends and relatives are on your case. Remember, you are not alone. There are millions of people around the world who struggle with their fears, anxieties, and depression. The key is to find those people who can relate to you. 5. Stand your ground: It is important to stand your ground when dealing with family members and friends who are giving you a hard time. Explain your situation and your feelings to the people in your life, however don’t let them hassle you. Your number one priority is to get better and not to please everyone that you know. 6. Join a 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 regarding your problems.

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Spotlight

Best Doctors

The Best Doctors suite of expert medical services are part of the Teladoc Health family, helping patients get answers for their healthcare needs. The trusted expert resource brings confidence to care decisions by connecting members and their treating physicians with a network of the top 50,000 world-renowned experts in 450 medical subspecialties.

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