Aditi U Joshi MD, MSc, FACEP

Shifting the financial model alone is not sufficient for the transition - the care delivery, workforce, and many other pieces of the ecosystem with which PCPs interact also need to adjust accordingly. Funding to allow for the startup costs of transformation must be made available. A comprehensive analysis from The Commonwealth Fund: To encourage participation, practitioners say upfront payments, investment in the primary care workforce, and less emphasis on simplistic quality measures are needed, as well as more support for practices to provide accessible, comprehensive care. #primarycare #integratedcare #teambasedcare #healthcare #healthcareonlinkedin

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It's wild to think in 2024 we're FIRST seeing the DOJ accuse telemedicine conglomerates of criminal drug distribution. How long have we known about these practices in brick and mortar care...? Answer: decades! Take it from someone who prescribed stimulants and other psychotropics to kids over the years - painstakingly measuring and documenting the need and impact - these appalling abuses by Done and Cerebral mean we need more calls for thoughtful pause when it comes to working with startups. Particularly about funding's role - my favorite topic! 🤑 How did we end up with venture capital and PE financing in healthcare that risk the safety of kids in the name of exorbitant returns? Not that all VC or PE dollars are bad, of course, but they're certainly key drivers who shouldn't be in that seat. Did we underestimate these funders as 'barbarians at the gate', much like the pharma reps of the 90's and early 2000's heyday? Have we not learned from Purdue Pharma's aggressive and deadly Oxoycontin marketing? Purdue pleaded guilty to criminal charges and paid $600 million in fines in 2007. Or TAP Pharmaceutical Products's Lupron kickback scheme for the prostate cancer drug? TAP also pleaded guilty to criminal charges and paid $875 million in fines in 2001. Or Pfizer marketing Neurontin, an anti-seizure drug, for off-label uses, such as treating pain and bipolar disorder, even though the drug was not approved for these purposes, and paying physicians kickbacks. In 2004, Pfizer pleaded guilty to criminal charges and paid $430 million in fines. Cerebral and Done's playbooks were practically the same thing, just with a modern mid-pandemic, low-regulatory scrutiny, digital-platform twist. Will appropriate regulation ever outpace American venture greed? Is it even possible to ensure patient safety AHEAD of tragedies driven by the intersection of innovation and venture funding? If you're keeping score, healthcare regulatory reactivity: 1 million. Healthcare ounces of smartly preventive policy: 3. Blech. 😖 When will we finally own that prevention in-house? #healthcare #overdoseprevention #suicideprevention

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The quality of the argument, along with true partnership and data liquidity, is where the real magic happens in #valuebasedcare contract negotiations. It’s easy to get caught up in the economics and risk adjustment discussions, but at the end of the day, the real measure is how do we map out a shared vision to get to X (I.e. #healthcaretransformation) in the long-term.

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🌟 Generative AI and Healthcare Transformation: A New Era of Innovation 🌟 I am constantly asked about #AI applications for healthcare transformation. I continue to take people back to the pain points or problems being solved. The healthcare industry is undergoing a significant transformation, driven by the integration of generative AI. This revolutionary technology is currently reshaping the way we approach care management, early disease detection, and administrative tasks. Early Benefits of Generative AI: Enhanced Care Management: AI serves as a "co-pilot" for healthcare professionals, assisting in managing patient care more efficiently and accurately. This leads to improved patient outcomes and more personalized care plans. Early Disease Detection: AI's ability to analyze vast amounts of unstructured data enables early identification of diseases, potentially saving lives and reducing healthcare costs. It's a game-changer in preventive healthcare. Reducing Clinician Burnout: By automating repetitive administrative tasks, AI allows clinicians to focus more on patient care. This not only improves job satisfaction but also enhances the quality of care provided. Affordability and Efficiency: AI-driven processes streamline operations, making healthcare more affordable and accessible. From optimizing workflows to reducing operational costs, AI is paving the way for a more sustainable healthcare system. Challenges and Considerations: Ethical and Legal Frameworks: Ensuring AI is used responsibly requires robust ethical, legal, and policy frameworks. Trustworthy AI adoption is crucial for patient safety and health equity. Technology Infrastructure: Organizations need to update their technology infrastructure, including cloud capabilities, to fully support AI implementation. As we embrace these advancements, it's essential to stay informed and engaged in the conversation about how AI can continue to transform healthcare for the better. #HealthcareTransformation #GenerativeAI #HealthTech #Innovation #AIinHealthcare Thanks to sources McKinsey & Company (https://lnkd.in/g7HZHEST) and MedCity News (https://lnkd.in/gi95t4qJ)

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Healthcare has made improvements but there's still a long way to go to become truly digital-first. While we've seen advancements in telemedicine, electronic health records, and AI-driven diagnostics, the journey to fully integrate these technologies into everyday practice is far from complete. And the “door” to care – patient navigation – needs a lot of work. If we don't evolve, patient's will find others who do! https://lnkd.in/eSJKiHSR #patientcentricity #digitalfirst #digitaltransformation #patientnavigation

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I get Dr. Yang's concern about large, wealthier health systems adopting AI sooner than smaller, poorer organizations, but this is actually a good thing...unless your time horizon is myopically short. Big organizations, with much larger budgets and sophisticated IT teams, can afford to take risks, make mistakes, and test out exciting (but still unproven) emerging tech while smaller organizations certainly can't (for the most part). So let the behemoths take all the risk, do the heavy lifting first, and then smaller organizations get to adopt truly proven solutions at lower risks/prices...once these have run the Kaiser, Mayo, Intermountain, etc., gauntlet. It's all part of the plan... #healthcare #startups #startup #ai #generativeai #digitalhealth #emergingtech Kaiser Permanente Cleveland Clinic Mayo Clinic Risant Health Intermountain Health https://lnkd.in/gckgQB_q

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100% satisfaction in birth metrics! What is the secret? Cleveland Clinic achieved 100% satisfaction across five birth metrics, a notable feat that Becker's Hospital Review highlighted. Cleveland Clinic adopted TeamBirth in October 2022. TeamBirth is a care delivery model jointly created in 2021 by Harvard Pilgrim Health Care, Ariadne Labs and UMass Memorial Health. It emphasizes routine check-ins with all patient care team members and family at key points to streamline communication about birth preferences and patient status, using a whiteboard as a key tool. Since adopting it, the health system saw the rate of C-sections for Black mothers go down from 41% to 22%. Rates also improved for white mothers, dropping from 27% to 23%, bringing the outcomes for its patient populations to a more equitable level. ▶ Satisfaction went up across five categories in 2022 to a perfect 100% for: ➡ Friendliness/courtesy of the unit — up 10% from 2022. ➡ Staff concern, information about progress and baby’s condition — up 12% from 2022. ➡ Nurse promptness in responding to patient call — up 12% from 2022. ➡ Nurse's attitude toward patient requests — up 13% from 2022. ➡ Doctor and staff working together during birth — up 15% from 2022. Patient satisfaction grew by 23% — from 72% in 2022 to 95% in 2024 — for how well they felt Cleveland Clinic managed their pain during labour. Transparent communication is important to promoting safety and reliability in high-risk organizations. ♻ How is the communication in your organization? #healthcare #communication #reliability

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Some keen findings from this well researched Health Affairs: 1) "... the types of payment models and types of employing organizations are determining factors in VBC participation. The factors influencing the intensity of participation align with those affecting the extent of participation: those most likely to participate tend to do so across multiple models." --> If you're looking to grow your value-based network, best to look for current value-based providers and look to add them to a new model. 2) Specialists are no where meaningfully engaged in value-based care, "Policymakers have numerous opportunities to better engage specialists in a true team-based care approach". --> This concurs with where venture capital has been looking to place investment, the opportunity and need to grow specialist enablement. 3) OB/Gyn are the specialists most associated with capitated payments, "Obstetricians/gynecologists showed a higher likelihood of participating in capitation, which promotes coordinated care. This is consistent with payment schemes for obstetricians/gynecologists" --> Pregnancy as an episode, is likely still the easiest bundle for payers and provider to contract.

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Walmart joins so many others in quickly entering and leaving or scaling back in healthcare after ambitious plans to scale. This morning, Walmart said it will close all 51 of its health-care clinics, as well as shut down their telehealth virtual care services. This is right after an announcement in March that they wanted to double the size of their clinical operations by opening up over 20 more locations this year and more next year. The reasons they cited? “Like others, the challenging reimbursement environment and escalating operating costs create a lack of profitability that make the care business unsustainable for us at this time.” As a physician, it’s been fascinating to watch over the past few years as so many non-medical companies try to get their bite of the huge percentage of the GDP that is healthcare. They pour money into trying to deliver healthcare at scale, ignoring the many concerns that hospital systems and physician private practices have been citing for years: declining reimbursements, shortages of clinicians, and expensive labor costs. Healthcare is broken, and those that are in it understand why. Patients need - and deserve - quality health care. This requires safe staffing practices, skilled clinicians who can feel good about what they do, and insurance companies that pay their bills. We can’t have a system where insurance companies can get away with record profits while finding more and more reasons not to pay for care and eroding away at the heart of healthcare. You cannot scale your way out of America’s healthcare problem. You actually need to fix the incentives, regulate insurance companies, pay clinicians appropriately, prioritize clinician well being and retention, and focus on the patient. The days of paying lip service to physicians leaving medicine and physician burnout are numbered. Supply and demand forces will necessitate real solutions that move the needle. Companies will come and go in the healthcare space when they realize how hard it is on the ground in healthcare these days. The question for patients and legislators is, who will be left to pick up the pieces if there’s no support for physicians, other healthcare workers, and hospital systems?  The percentage of clinicians leaving healthcare annually because they no longer recognize the heart of why they joined the profession is astounding, with over 1/4 of clinicians looking to leave within the next few years. Relying on the altruism of clinicians and the erosion of quality healthcare to support profits for corporations is just not a sustainable business model in healthcare - not to mention terrifying for public health. #HealthcareOnLinkedIn #PhysicianBurnout #PhysicianShortage #Walmart

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Title: Bridging the Gap: Public and Private Healthcare Collaboration On June 11, we hosted a pivotal meeting with key voices from both private healthcare providers and public healthcare regulators and providers. The consensus was clear: collaboration between the public and private sectors is essential to create a robust and sustainable healthcare system. Here’s how we can achieve this: 1. Unified Vision:Establish common goals like improving patient outcomes and increasing accessibility. 2. Leverage Strengths:Public systems excel in broad coverage and preventive care, while private providers lead in innovation and efficiency. 3. Data Sharing:Integrate data to enhance diagnosis, treatment, and preventive measures. 4. Joint Investment:Collaborate on funding for advanced medical technologies and telemedicine. 5. Policy Harmonization:Align policies to reduce bureaucratic hurdles and foster innovation. 6. Public-Private Partnerships: Pool resources to tackle infrastructure and rural healthcare challenges. 7. Continuous Improvement: Regular feedback and communication to adapt to changing needs. Our meeting highlighted the potential of collaboration in transforming healthcare. By working together, we can build a more efficient, equitable, and responsive healthcare system. Let’s commit to this collaborative journey for a healthier future. #UHC #medicalai #health #PPP

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As we move through 2024, the digital health landscape is undergoing a remarkable transformation. Here are the top trends that are defining the industry, and how Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) technologies are driving these changes: 1️⃣ : AGI's Advancements in Healthcare • AGI plays a key role in drug development to cost optimization. • RPM and CCM leverage AI/ML to process patient data • AI governance in CCM ensures transparency and addresses ethical concerns. 2️⃣ : Accelerating Data Interoperability • RPM and CCM enable unified patient records and advanced analytics. • Supports data exchange and meaningful insights across systems. 3️⃣ : Retailers as Healthcare Providers • Retail clinics are expanding into chronic disease management. • RPM and telehealth extend retailers' reach as healthcare providers. • CCM platforms integrate care pathways across settings. 4️⃣ : Digital Obesity Care and Personalization • RPM monitors lifestyle factors for a holistic obesity care approach. • CCM integrates personalized behavioral interventions for weight management. 5️⃣ : Nutritional Interventions in Healthcare • RPM tracks nutritional habits, providing insights for food-as-medicine. • CCM incorporates personalized dietary plans into care plans. 6️⃣ : Mental Health and Well-Being Solutions • RPM enables remote monitoring of mental health, enabling timely interventions. • CCM seamlessly integrates mental health support into chronic care. 7️⃣ : Women's Health Takes Center Stage • CCM allows personalized care plans and data-driven insights for women's health. • RPM provides valuable data to support women's healthcare decision-making. 8️⃣ : GenAI's Growing Role Across Healthcare - RPM and CCM facilitate GenAI integration, from diagnostics to treatment. - GenAI algorithms enhance clinical decision support. 9️⃣ : Convergence of Wearables and At-Home Devices - RPM enables continuous monitoring of vitals and chronic conditions through wearables. - RPM fosters increased patient engagement and active participation in care. Are you ready to transform your connected care offerings and stay ahead of the digital health curve? DM us now!!

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This is an interesting article because EHR companies, like Epic and Oracle's Cerner, have made siloing data a major part of their business model. Overall, I like EPIC’s ability to review records from other EPIC shops. It also has a nod to interoperability with its “Care Everywhere“ feature. However, this is often a disorganized and outdated collection of information. Using it requires a ninja level of both tech expertise and medical knowledge possessed mainly by younger physicians and chief residents. I am a fan (and advisor) of companies like Zus Health focused on user-friendly, comprehensive, and up-to-date interoperable health care data tools.

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If health systems master the art of delivering a world-class consumer experience in urgent care, they can replicate this success across their entire operation, becoming market leaders and thriving in the long term. This is the core thesis of what we do at UCP Merchant Medicine. For nine years, UCP Merchant Medicine has partnered with 68 healthcare operators, most of whom are health systems, to create internal capabilities that allow them to thrive in consumer experience excellence. This isn’t just about having a world-class urgent care platform, this is about owning the future and the capabilities to expand these experiences across the broader health system. As healthcare shifts towards a consumer-driven model, the need for health systems to adapt is more critical than ever. Patients now have unprecedented freedom to choose their care providers, with 45% researching providers and costs before choosing a health plan, and 44% before making an appointment, according to McKinsey’s consumer Health Insights Survey. These improvements are not just numbers; they're about real people getting better access to the care they need when they need it in a way that they will love. This is what we stand for at UCP Merchant Medicine. Join us as we continue to innovate and lead the way in making healthcare more responsive, efficient, and patient-centric. Together, we can transform the future of healthcare! #HealthcareInnovation #PatientCare #UrgentCare #HealthcareLeadership #UCPMerchantMedicine Intellivisit Solutions

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AI in Care Delivery – It’s Here…Sort of As with many new technologies in healthcare, <insert name here> is going to “disrupt” and/or save healthcare from itself. “The next new widget has arrived” and will "bend the cost curve." Many of these technologies, though, are one-dimensional and fail to recognize, or adequately address, the disparity and multivariate inputs of the healthcare delivery ecosystem. In many instances these technologies are doomed to fail before they leave the nest. That said, with reduced payments to clinicians (especially from Medicare/Medicaid) coupled with the rising cost of delivering care, providers and health systems find themselves in a prickly position: how do we maintain, let alone grow, our margins? I’ve been a bit…cautious…about AI in healthcare for what should be obvious/glaring reasons. I’ve also been optimistic understanding that AI should, and will, play a greater role in future healthcare delivery/analytics/ decision making. Some emerging technologies show actual care-delivery promise. Lately I’ve noodled “ambient voice” or “clinical conversation” platform technology at the point of care. Ambient voice converts natural language (e.g. discussions) between clinicians and patients into clinical documentation. I’m interested in this technology primarily because it may help clinicians dig out from under the mind-numbing amount of documentation they perform which is, without argument, unproductive. While a little way to go (nothing in IT is ever “100%”), the benefits of clinical conversation can be: ·  assist in note/documentation clarity/accuracy ·  improve submission timeliness (e.g. reduced lag days from date of service to date of submission – cash acceleration) ·  enhance provider satisfaction/lifestyle (no finishing notes at midnight) · improve patient interaction/satisfaction (Dr. not staring into a computer while chatting with the patient) ·  provide, if desired, the opportunity to see more patients due to efficiencies ·  integration with current EMR vendors (some voice recognition services are integrated into EMRs like eCW and Epic) · per click, low cost (relatively speaking), and ·  some offerings are, or are heading to, a multilingual packages Shortcomings: · possible audio issues due to room set up, etc. (cleaned up with minor tweaks) ·  trial/error effort: > not unlike Dragon Naturally Speaking when it landed in the early 2000s. · Early adoption; some hiccups While no new (or maybe old, for that matter) technology is perfect, this AI-enhanced tech is certainly rowing in the right direction. With proper IT connectivity and “training” the new and upcoming offerings may go a long way to assisting clinicians at the point of care and maybe mitigating clinician burn out. Theoretically, the benefits may be immense in terms of coding/charging, human capital savings, accuracy, revenue cycle, and patient communication/satisfaction. Chalk one up for the tech that may have grown its wings! 

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A recent discussion with a potential B2B partner highlighted to me a different viewpoint when looking at the problem digital health product interoperability. Specifically how to make digital health products 'functionally' interoperable across different countries and local B2B partners. Lots of attention is going into data interoperability to figure out how different data streams can be combined in an efficient manner. Its no surprise why, the push to personalise patient treatments (including the use of AI / ML supported tools) relies on the ability to cross analyse discrete patient data sets from different sources. Peach Health Asia's role in commercialising partner digital health products across different channels gives us a unique opportunity to explore setting up commercial partnerships with varied B2B partners with different needs, systems and capabilities. Rather than look at this as a 'customisation' exercise doing this cost-efficiently is more an interoperability question tied to how versatile a product is in being deployed under different scenarios. One of the key parameters to address this challenge is the modularity of the product and whether its features be turned off and on without disrupting the product functionality. It isn't something that is top of mind for digital health developers when creating their products, products are usually designed for a single product-market fit. However in the international market no countries market and 'market opportunities' are exactly the same. The article below covers some of the solutions needed to deal with this challenge, such as setting up functions in microservices to enable modulatory and using more widely used API's. It is incredibly difficult and costly to customise a digital health product for every new market or opportunity, especially when dealing with products where a class I or II SaMD registration limits the ability to modify a product once it is approved. Don't forget going international also comes served with the whole data interoperability challenge, which represents another issue that needs to be sorted out when exploring bringing a digital health product into SE Asia.

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Robin Goldsmith thanks so much for having Sameer Berry, MD, MBA on your show to talk about Oshi Health and our innovative care for #digestivehealth conditions. Such a great conversation around the challenges in #gastroenterology and how new care models like ours address them in ways that are a win for all stakeholders. #valuebasedcare #accountablecare #wholepersoncare

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The Illusion of Efficiency in Healthcare: A Deep Dive into ACA's Impact Remember the argument on the quality and efficiency of healthcare during the ACA debate? This argument led to policy changes in the ACA that facilitated hospitals buying up physician practices and insurance companies owning pharmacies and benefits managers—both industries becoming big in the process. The notion was that by becoming big, both industries could bring in efficiencies by eliminating wasteful expenditures. But what happened? Both industries consolidated their market share and raised prices for the consumer. Hang on, one might argue that while we could not reduce the cost, we have improved the quality, and quality comes with a price. Fair argument, right? Has the quality of care improved? Well, this paper answers that question with a resounding NO. At least in this study, the quality of healthcare—as measured by in-hospital mortality, 30-day mortality, and 30-day readmission rates among a select patient population of a large independent cardiology practice before and after their integration with a large academic health system—did not improve. Another argument used in the ACA debate was that vertical and horizontal integration would reduce the utilization of services such as labs and scans because they would be more easily accessible through electronic health records. Has this argument survived research scrutiny? Again, the answer is NO. This study found no difference in the utilization of services when comparing before and after integration. Funny enough, I asked Google AI, “Does integration of outpatient practices with hospitals improve quality?” The Google AI overview gave me this answer: “Yes, integrating outpatient practices with hospitals generally leads to improved quality of care by facilitating better coordination of patient care, streamlined communication between providers, and access to more comprehensive services across different healthcare settings, ultimately enhancing patient outcomes,” and provided a list of references. All of them were review articles by influencers saying how “it feels good.” None of them referenced how “it felt good.” I hope the L!nk€d!n algo will pass this post in its quality check. What are your thoughts? #Healthcare

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Looking forward to sharing recent KLAS Research insights at the upcoming The Millennium Alliance Assembly and learning from attendees their expectations in #digitalhealth for 2025. 🔎 What are the investment priorities of 100 healthcare provider executives and 50 payer executives over the next 2 years? 🔎 How do provider priorities compare to patient expectations? 🔎 What are the current digital health problems that you are trying to solve? 🔎 What digital tools do you plan to add, consolidate, or eliminate? 📢 CHALLENGE FOR THE LINKEDIN COMMUNITY Using 5 words 'What digital health trends do you expect to see in 2025? ' Fun fact: we are about to be 40 years since Marty McFly got in the DeLorean.

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