Srinivas Velamoor

Predictions for the Healthcare Analytics Space in 2025 Increased Integration Across Data Ecosystems As value-based care models continue to expand, seamless data integration across clinical, claims, and social determinants of health (SDOH) sources will become critical. Organizations will prioritize interoperability through networks like QHINs, Carequality, and CommonWell to create a unified patient view. Interoperability Will Become Non-Negotiable Regulatory and operational pressures will force healthcare organizations to embrace true interoperability, with frameworks like TEFCA, QHINs, and platforms like Carequality/CommonWell gaining momentum. Seamless data exchange will shift from a competitive edge to a baseline requirement. Shift from Retrospective to Predictive Analytics Organizations will move away from merely reporting past events and toward anticipating future risks, costs, and care needs. Predictive models will guide both operational efficiencies and patient care interventions. Demand for Transparent ROI Healthcare organizations will increasingly demand clear ROI from analytics investments, driven by financial pressures and accountability in value-based contracts. Solutions must demonstrate tangible outcomes like cost savings, care improvements, and enhanced risk stratification. Rise of Decentralized and Multi-Tenant Data Repositories As data ownership and governance become central, healthcare providers will adopt multi-tenant architectures to securely store and access aggregated data while maintaining control over proprietary information. AI and Machine Learning in Care Pathways(*) The use of AI to identify care gaps, optimize workflows, and automate routine tasks will grow exponentially. Providers will seek analytics solutions incorporating explainable AI to maintain trust and compliance. (*) Steep adoption curve Focus on SDOH for Equitable Healthcare Delivery Payers and providers will deepen their focus on SDOH to address health inequities. Analytics platforms will need to integrate SDOH data into actionable strategies for population health management. Emergence of Modular and Workflow-Specific Tools Comprehensive dashboards will give way to modular, workflow-specific tools that empower users to interact directly with data. These tools will emphasize usability and decision-making at the point of need. Partnerships Over Proprietary Solutions Collaboration between analytics providers and adjacent industries (e.g., tech, pharma, and public health) will drive innovation and adoption. Open ecosystems will gain traction over closed, proprietary platforms.

29

1 Comment

🚨New #JAMA Viewpoint 🚨 “Misaligned Pharmacy Incentives in Value-Based Care” The authors discuss how rising #prescription drug spending has been particularly challenging in the context of value-based contracts between payers and providers. This is partly due to confidential #rebates, which create misaligned incentives between payers/PBMs and hospital administrators. Read more below: 🔗 https://lnkd.in/dwzBT4WD #marketaccess #pbm #access #pricing #payer #valuebased #valuebasedcare #patientjourney #patientaccess #pharmacy #managedcare #pharma

10

Oracle Health announced plans to launch a next-generation EHR platform in 2025, incorporating advanced cloud and AI capabilities. This new EHR will feature Oracle's clinical AI agent, voice-activated navigation, and Health Data Intelligence, which integrates patient data from over 300 sources to enhance clinical workflows and improve patient outcomes. The platform aims to replace traditional EHRs, which often dictate rigid workflows, with a more dynamic system that allows for personalized care plans. Oracle Health emphasizes that the new EHR is a complete reinvention rather than an upgrade of the previous Cerner system. Additionally, Oracle plans to become a Qualified Health Information Network to facilitate standardized data sharing across the healthcare ecosystem. Executives at Oracle also unveiled new cloud applications to improve patient management and streamline front-office operations, reinforcing the company's commitment to enhancing healthcare accessibility and data utility while addressing interoperability challenges in the industry.

1

🌟 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)

8

1 Comment

One key reason why healthcare technologies like AI, telemedicine, and software haven't structurally lowered costs or broadened access for the entire system after decades of experimentation (excluding pure financial engineering of payer contracts) is the limited reimagining of care delivery itself, with asynchronous telemedicine as a notable exception. In the same way that digitizing physical paper failed to exploit the capabilities of a new computing medium for word processing, hosting physician-patient conversations over video does not transform the actual delivery of care. In telemedicine, many of the inputs (e.g., clinician time) and therefore cost structures of in-person care persist, which is why we often see fee-for-service telemedicine companies struggle to achieve economies of scale (i.e., growing revenues non-linearly while growing costs linearly). Until we deconstruct the components of a medical appointment – from intake and triage, to chart review, history gathering, physical examination, diagnosis, treatment, and follow-up – we will continue to be underwhelmed by the disconnect between the transformative potential of these technologies and real-world patient/system impact. I’m optimistic that the emergence of reliable and performant medical AI agents will urge us to perform this deconstruction and redesign the fundamental building blocks of a “medical appointment.”

215

38 Comments

Key trends and takeaways from HLTH 2024: 1. AI's Evolving Role: AI dominated discussions, with executives acknowledging its potential while also recognizing challenges in accuracy and clinician trust. There's a shift towards focusing on the practical applications of AI, with a call for partnerships to ensure reliable testing and implementation. 2. Infrastructure Focus: Beyond the glitzy AI tools, there's a growing emphasis on the "picks and shovels" needed for healthcare data accessibility, including infrastructure, compliance, and interoperability. Executives believe that improving data flow will facilitate the effective use of AI. 3. Middlemen Under Scrutiny: Pharmacy benefits managers (PBMs) faced criticism for their role in rising drug costs, with discussions highlighting misaligned incentives and the need for transparency in healthcare pricing. 4. Women's Health Spotlight: Women's health initiatives gained attention, particularly following government funding announcements and personal stories shared by advocates. However, investment in women's health remains minimal compared to overall healthcare funding. 5. Interest in Psychedelic Medicine: The potential of psychedelics for treating mental health conditions garnered significant interest, with discussions about funding and research moving forward, especially within the Veterans Affairs system. Executive Takeaways: Leaders from various sectors emphasized the importance of consumer-focused strategies, collaboration, and the need for responsible AI usage. There was a consensus on the critical role of addressing healthcare accessibility, improving patient experiences, and fostering innovations that genuinely enhance care delivery.

2

As AI becomes more embedded in healthcare decisions, ensuring traceability from algorithmic decisions back to clear guidelines and submitted clinical evidence is critical. Recent findings on companies like EviCore reveal a disturbing gap where AI and algorithms drive treatment denials, often with little transparency. When decisions about patient care are delegated to AI, every outcome should be fully accountable—linking directly back to both the clinical guidelines and the evidence provided by the physician. For AI-driven decisions, transparency is not a nice-to-have; it’s essential. This traceability not only fosters trust among healthcare providers and patients but also ensures that cost savings don’t come at the expense of patient care or quality. As we advance AI in healthcare, let’s prioritize clear, traceable pathways that support both efficiency and patient-centered care. https://lnkd.in/gV-AP8j9 #HealthcareInnovation #AIEthics #PatientAdvocacy #HealthcareTransparency #PenguinAi #Healthcare #PriorAuth #Denials ProPublica Missy Krasner Peter Longo Kishore Ayyadevara

46

3 Comments

Now that our HIT industry has spent nearly 40 years figuring out how to effectively pass data between sites, settings, and institutions of care (and while that journey isn't completely over, we're well on our way), we can finally turn and look farther down the road and consider what's next. In my view, advancing process consistency, agility, and change is that horizon. The BPM community is focused on that challenge, and having recently transitioned into HL7 as HL7 BPM, is squarely trying to take this on. With today's press release, HL7 is truly open-for-business in this space. Thanks to the OMG for nurturing this work along and for HL7 for having made our next home for this effort. So much to do! https://lnkd.in/dAF96g3n

48

5 Comments

As 2024 concludes, healthcare leaders have gained critical insights amidst rapid advancements and challenges. Here's a glimpse of the year's key lessons: 🔍 Data as a Strategic Ally: Harnessing real-time analytics transforms operations and patient care. 💻 Telehealth’s New Era: Virtual care isn't just an option—it's expected. 🩺 Workforce Resilience: Supporting staff well-being is pivotal for quality care. 💡 Personalized Patient-Centered Care: Building trust through tailored approaches ensures loyalty and satisfaction. 📜 Adapting to Regulations: Proactive compliance safeguards growth and quality. 🚀 Tech Integration: Innovations like AI show promise but demand careful execution. 💰 Value-Based Care's Rise: Aligning rewards with patient outcomes reshapes operations. As we step into 2025, the focus remains on resilience, innovation, and care. These takeaways set the stage for a robust and adaptable future. What 2024 lessons resonate most with your healthcare journey? Let’s connect and discuss! #HealthcareLeadership #InnovationInCare #2024Lessons #FutureOfHealthcare

1

1 Comment

🏥✨ For many years, technology investments made by health organizations were rarely a driving force behind strategic #transactions. Explore in my latest article with Sam Prescott how #generativeAI has changed the game for Health CIOs. A must-read for leaders at the forefront of change! https://lnkd.in/gRWmi5AH

40

Here’s your recap of last week’s health IT news 🗞️ 👇 🤖 AI Clinician Assistant • Oracle Health announced the release of its AI-powered clinical digital assistant, which integrates “clinical automation, conversation-based note generation, and proposed clinical follow ups” directly within the EHR. • NextGen Healthcare released a version of their Ambient Assist designed for small practices, which includes Spanish support and specialty-specific workflows.    • Community Health Network has begun a multiyear Microsoft implementation including Nuance Communications Dragon Medical One and DAX Copilot. 🧑‍💻 Virtual and At-Home Care • Hackensack Meridian Health partnered with Medically Home to implement their hospital at home program. • Cleveland Clinic is integrating Masimo’s wearables in a new partnership focused on hospital-based RPM. • eVisit acquired UPMC Enterprises' inpatient teleconsult technology and an investment from UPMC’s innovation and investments arm as part of their $45M Series B funding. • PatchRx released an API-based tool allowing providers to sync data directly into their existing care platforms. 📊 Data & Analytics • Atropos Health added two new partners and a data scoring system to allow users to select the most appropriate datasets for their queries. • Xealth launched a metrics tool that allows customers to measure and track patient engagement with their digital health programs. 📋 Patient Administration • Fabric acquired MeMD from Walmart. 🔄 RCM • Inovalon joined MEDITECH’s interoperable product marketplace. • RevSpring released an update that integrates a lockbox solution for check processing within its existing payment platform. • Solventum Revenue Integrity (fka 3M Health Care) released its new AI CDI software powered by Sift Healthcare, Solventum Revenue Integrity System, which uses machine learning to predict denials before they happen. 🍎 VBC Data & Analytics • Arcadia acquired CareJourney leveraging their cost, quality, and benchmark data to enhance Arcadia’s data, analytics, and workflow tools. • Adventist Health selected The Garage In's population health management platform to support its VBC operation. 🧠 Food For Thought •  Coalition for Health AI (CHAI) released its draft standards guide for public comment. https://lnkd.in/eMUXGfvz • We really appreciated Daniel Yang, MD’s post about a recent article on the emergence of a new leadership role: the Chief Health AI Officer (CHAIO) https://lnkd.in/ejZxnJCj --- Reminder: you can sign up for the Elion Briefing to get the latest healthcare tech news delivered to your inbox each week 📬 👉 https://lnkd.in/e2UJ3ckP

36

To meet CMS’ commitment to have all #Medicare beneficiaries in value-based payments (VBP) by 2030, payers have to dig deeper into #VBP design flaws and explore new strategies like: •Creating a coordinated set of VBP model designs to cut wasteful or inefficient spending without asking one participant to forgo all the revenue. •Introducing real savings requirements for shared savings, or implementing a risk-score growth cap to encourage better care practices. •Leaning into mandatory participation in new VBP programs to help ALL types of Medicare beneficiaries – not just larger-scale organizations. Read more about how these solutions can help accelerate VBP adoption in a recent Health Affairs article I wrote with Amol S Navathe and Daniel Shenfeld (linked in comments) #HealthcareonLinkedIn

21

1 Comment

AI is enhancing how payers approach member engagement in healthcare by offering tools like predictive analytics and personalized care navigation! By using AI to anticipate member needs and tailor interventions, payers can move beyond reactive models and focus on proactive, value-based care. This greatly improves member satisfaction while also helping to streamline resource allocation and improve health outcomes. #AI #MemberEngagement #Healthcare #VBC #ValueBasedCare

7

What does the future hold for retail medicine and virtual care? Walmart is the latest to announce their health center closure. https://lnkd.in/geZpMTkS. This following Optum news, VillageMD closing in Nevada, Teladoc Health problems, etc. What comes next? This is another in a long line of examples that technology and even consumer willingness are not enough when the reimbursement environment does not support particular care models. Are we getting ready to lose all the lessons painfully learned during the pandemic? Or will new virtual care models emerge following this round of closures?

2

The team at Define Ventures has published a paper on AI and how C-suite leaders at Payers and Providers are thinking about these exciting new technologies. Get the full report here:  https://lnkd.in/eVnp9N-k

12

Oracle Health, which acquired Cerner two years ago, just announced the launch of a next-generation electronic health record (EHR) platform in 2025, showcasing the company's latest advancements in cloud technology and AI capabilities. I wrote down a few thoughts. 1️⃣ 𝐀𝐟𝐭𝐞𝐫 𝐭𝐰𝐨 𝐲𝐞𝐚𝐫𝐬 𝐢𝐧 𝐬𝐭𝐞𝐚𝐥𝐭𝐡 𝐦𝐨𝐝𝐞, 𝐭𝐡𝐞 𝐂𝐞𝐫𝐧𝐞𝐫 𝐚𝐜𝐪𝐮𝐢𝐬𝐢𝐭𝐢𝐨𝐧 𝐢𝐬 𝐟𝐢𝐧𝐚𝐥𝐥𝐲 𝐠𝐚𝐢𝐧𝐢𝐧𝐠 𝐟𝐮𝐥𝐥 𝐦𝐨𝐦𝐞𝐧𝐭𝐮𝐦. After the big acquisition, nothing seemed to be happening. I even started thinking it was a $28B flop and that Oracle was simply moving on. Oracle stressed that the new platform is not a "refurbished Cerner EHR," but a reinvention of a digital medical record system: "You can’t bolt new innovation onto something built in the 1990s". 2️⃣ 𝐒𝐚𝐦𝐞 𝐬𝐚𝐦𝐞 𝐛𝐮𝐭 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐭 Even though the Tech is new, the philosophy remains the same. EHR incumbents will try to increase their (already too high) power in the hospital Tech stack. The solution won't come from incumbents. 3️⃣ 𝐌𝐨𝐫𝐞 𝐜𝐨𝐦𝐩𝐞𝐭𝐢𝐭𝐢𝐨𝐧 𝐟𝐨𝐫 𝐄𝐩𝐢𝐜 𝐢𝐬 𝐚𝐥𝐰𝐚𝐲𝐬 𝐠𝐨𝐨𝐝 𝐚𝐧𝐝 𝐎𝐫𝐚𝐜𝐥𝐞 𝐬𝐞𝐞𝐦𝐬 𝐭𝐨 𝐡𝐚𝐯𝐞 𝐠𝐨𝐨𝐝 𝐢𝐧𝐭𝐞𝐧𝐭𝐢𝐨𝐧𝐬 In May, an Oracle executive, Ken Glueck, executive vice president, wrote in a blog post that "Epic’s CEO Judy Faulkner is the single biggest obstacle to EHR interoperability." More pressure on Epic to open its system will always be a good thing. 4️⃣ 𝐖𝐞 𝐚𝐫𝐞 𝐞𝐧𝐭𝐞𝐫𝐢𝐧𝐠 𝐭𝐡𝐞 𝐩𝐨𝐬𝐭-𝐄𝐇𝐑 𝐞𝐫𝐚 As Tomaz Gornik, co-chair of OpenEHR (non-profit community interest organisation that aims to enable clinical healthcare to advance by better use of information and IT): "Today's solutions tightly couple data to applications. As health and care data is for life, it needs to outlive applications, so there is a clear need to separate them." The Catalonia region in Spain is a frontrunner and is setting new standards with its digital health strategy and new information system model based on openEHR. 5️⃣ 𝐇𝐨𝐬𝐩𝐢𝐭𝐚𝐥𝐬 𝐡𝐚𝐯𝐞 𝐚 𝐨𝐧𝐞-𝐨𝐟𝐟 𝐨𝐩𝐩𝐨𝐫𝐭𝐮𝐧𝐢𝐭𝐲 𝐭𝐨 𝐫𝐞𝐠𝐚𝐢𝐧 𝐜𝐨𝐧𝐭𝐫𝐨𝐥 Hospital executives need to understand the new tech dynamics and create an operating model that lets them stay in control, leverage the best technology, and keep it manageable to maintain (yes, not an easy task). In Germany, some innovative hospitals are making steps into the right direction: ➡️ A big private hospital chain is building its own EHR ➡️ Another hospital chain aims to use the patient portal as the backbone for designing digitally-enabled care journeys (on top of the EHR) ➡️ A public hospital chain is building a vendor neutral interoperability layer #hospital #ehr #epic #healthcare #healthtech

536

31 Comments

To accelerate the shift to value-based care, payers and providers should embrace solutions that promote interoperability and immediate insights. By enabling collaboration across the healthcare value chain, data integration allows timely decision-making and improves care coordination. Though workforce shortages persist, investing in AI-driven tools that simplify workflows can be essential in achieving long-term, sustainable success for all parties. #VBC #ValueBasedCare #Healthcare #AI

3

Here’s your recap of last week’s health IT news 🗞️ 👇 🤖 AI Clinician Assistant • Avaamo launched an AI ambient scribe solution with support for over 50 specialties with pre-trained models. • Wound AI, an AI clinical decision support solution built by VANTIQ, Telemedicine Solutions, LLC, and NTT DATA, launched and is now available 📞 AI Contact Center • Premier Inc. awarded a group purchasing agreement to TeleVox Healthcare. 🏥 AI Facility Management • Medely has integrated with Oracle, allowing users to leverage Oracle’s Cloud HCM capabilities. 🌡️ AI Remote Patient Monitoring and Triage • The Alliance for Smart Healthcare Excellence—established by care.ai, now a part of Stryker, and developed with assistance from CHIME—was established to promote the Smart Hospital Maturity Model (SHMM). 📈 Data & Analytics • Epic expanded its set of APIs available to developers to support USCDI v3. • Health Catalyst will acquire Intraprise Health, a cybersecurity provider; it was also selected for analytics and interoperability by CyncHealth, Iowa’s health information exchange (HIE). • Health Commons Project acquired OneHealthPort • Socially Determined released a new application that helps organizations access data for minors. 🧾 Orders & Fulfillment • Surescripts is expanding its Medication History for Populations product to health plans, enabling care management teams to identify gaps in care and improve outcomes. 🧑‍💻 Virtual & At-Home Care • Mass General Brigham launched a partnership with the New England Center and Home for Veterans to provide hospital at home services for veterans experiencing homelessness. • MedStar Health expanded its partnership with DispatchHealth to support care transitions.    🍎 VBC • i2i Population Health is partnering with CureMD to surface actionable data to providers at the point of care. 🧠 Food For Thought • Brendan Keeler shared an interesting post differentiating AI solutions across augmentative vs. autonomous and then further breaking down each. One take we found interesting was, “Active interfaces are fun, but ultimately have some of the same problems as Siri - they require explicit engagement and cognitive overhead to use. This means their adoption and impact often fall short of expectations - users must actively remember to use them and overcome the friction of engagement.” https://lnkd.in/eR39qFpK --- Want the latest healthcare tech news delivered to your inbox each week? Sign up here 📬 👉 https://lnkd.in/e2UJ3ckP

34