Todd Doze, CEO of Janus Health, specializes in bringing AI to hospitals to connect the hospital revenue cycle management with the overall patient experience. Automating some manual RCM tasks, such as prior authorizations and referrals, has led to significant reductions in claim denials, faster processing times, fewer errors, and better compliance with recent legislation. Challenges remain to ensure the AI model's accuracy and to demonstrate clear ROI and a direct impact on the hospital's revenue.

Todd explains, "Today at Janus, we focus on helping providers improve their operational and financial efficiency. We work with about 250 acute care hospitals across the country, servicing some of the largest health systems in the nation by providing automations and AI-driven operational intelligence. This gives management insight into what their revenue cycle folks are doing to ensure they're taking the optimal paths to adjudicate claims and also automating as much of the laborious, tedious work that goes into treating patients in the most optimal manner."

"There are a lot of very manual pain points within the rev cycle experience. For example, many of us have been referred by our primary care physician to a specialty provider. A very common example is referring to an imaging center for an MRI or X-ray. And many times, to access an appointment with that specialty provider, the provider may need to submit a prior authorization request to the patient's insurance. And then there's also the communication loop process focused on the referral. And so there are many areas for error, and there are a lot of ways the patient experience can go south very quickly."

#JanusHealth #AIinHealthcare #HealthcareAI #HealthTech #HealthcareOperations #RCM

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Susan Grant, Chief Clinical Officer at symplr, reviews findings from their annual Compass Survey, which revealed the significant challenges hospitals face, driven by financial pressures, clinician burnout, and operational inefficiencies. Fragmented technology systems create significant administrative burdens, and there is growing recognition that unifying healthcare operations and strategically implementing AI are crucial to streamlining workflows. Clinicians' involvement in the design and implementation of new processes and procedures is essential to ensure that patients' real-world needs are properly addressed.

Susan explains, "The annual Compass Survey, is actually our fourth survey that we've done here at symplr, and the goal of the survey is to drive awareness around the need for and benefits of streamlining healthcare operations software. So it's a way to get feedback from our customers, clients, and leaders out in the healthcare world."

"I've been a Chief Nurse for the last 30 years in different health systems around the country, and we do tend to be a very reactive industry. However, I think it's built and intensified over the last few years because of issues we're seeing that have also intensified, including finances, workplace violence, clinician burnout, and cybersecurity. Those are some of the top issues our healthcare systems are dealing with. So I think that the reactivity of trying to really deal with those various issues has intensified and created this reactivity."

#symplr #CompassSurvey #HealthcareIT #HealthcareOperations #symplrOperationsPlatform #HealthcareAI

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Fawad Butt, Co-Founder and CEO of Penguin AI, is addressing the workflow challenges faced by healthcare payers and providers, particularly in prior authorizations and claims adjudications. These processes are inefficient and often yield inconsistent results because human reviewers interpret rules differently, and patients are denied care due to minor administrative errors. Penguin AI is bringing consistency and speed to adjudication, breaking down data silos and handling non-clinical administrative work, enabling agents to address patient-specific problems and ensure accuracy and safety.

Fawad explains, "When you look at the healthcare ecosystem, there are obviously the pharma side, the payer side, the provider side, and the PBN side. So there are lots of areas where opportunities exist. We think payers and providers are especially challenged, and I think the area where they struggle is in the administrative workflow. And these are things like prior authorization and risk adjustment, claims adjudication, and payment integrity on the payer side."

"There are things like scheduling and patient 360, or onboarding and referrals, as well as some risk adjustment for entities that are risk-bearing, and ultimately, all the functions around revenue cycle management for providers. I think the payers and providers have a tremendous amount of technology and resourcing support, but these functions have not really been what I would say reimagined in over a decade. And I think with AI, there is a real opportunity to come back and try to optimize."

#PenguinAI #HealthAI #HealthcareAdministration

penguinai.co

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Alexander Tsiaras, CEO and Founder of StoryMD, is addressing the critical problem of the fragmented health information landscape. The StoryMD platform unifies a patient's health history, including clinical records, wearable data, and personal diary entries, along with relevant data from a vast validated medical library of text and strong visualizations. This provides a coherent narrative about the patient that informs the patient, their healthcare providers, and caregivers, enabling more informed decisions and better outcomes.

Alexander explains, "So one of the huge problems that we have in healthcare is that when people go through a health journey, they have to cobble information together from so many disparate sources. You get a PDF here, you get a URL there, you get a screenshot somewhere else. And fundamentally, what happens is that you're trying to cobble the story of your journey together, and it's totally fragmented. You get fragmented medical records, you get fragmented information, and you share fragmented information with other sources. So really the story is constantly evolving, and you're trying to figure it out, and it's problematic."

"What we have now built is the largest coded medical library in the world, where we can take all of the information using HL7 codes. Now, HL7 is Health Level Seven International, which basically is the way that your medical records are coded. And we have mapped a piece of information using AI to your medical records. So when we see a lab report, we tell you a beautiful story about what your labs mean, and this way, we can actually keep longitudinal stories going, giving you insights into what's going on in your biomarkers."

#StoryMD #HealthTech #DigitalHealth #HealthAI #HealthJourney

storymd.com

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Seth Cohen, President of Cedar, is addressing the affordability of health care by shifting the emphasis from billing functionality to patient financial navigation by using technology to connect patients to underutilized financial resources. The Cedar Cover platform is designed to identify and enroll eligible uninsured or underinsured patients into Medicaid, ACA, available pharmaceutical copay subsidies, and untapped Health Savings Accounts, which can be used retrospectively to cover previous medical and ongoing bills, benefiting the patient and providers. An AI agent handles patient service calls to help patients navigate the challenges of connecting to these resources and identifying new coverage options in these uncertain times.

Seth explains, "Cedar is the largest independent solution focused entirely on the patient financial experience in healthcare. As you probably know, in the revenue cycle space, there are lots of vendors out there selling solutions up and down the revenue cycle, mostly with an emphasis on insurance reimbursement. We are the only one that we're aware of that is really driving at scale a better patient experience, so fully focused there. And so what that means is we are the entity responsible for sending bills to patients and helping those patients navigate their financial obligations to large hospitals, health systems, and large physician groups."

"But that word advocacy, I think, is very relevant now because what we've discovered and a huge, huge shift over the last decade is that most patients cannot afford the bills they're receiving. We're really in an affordability crisis. And so it's less about sending a bill with good billing functionality. It's more about helping the patient navigate how to manage that bill. And so there is a lot of advocacy in that."

#Cedar #FinancialSupport #MedicalBills

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Jim Foote, Co-Founder and CEO of First Ascent Biomedical, is changing the standard of care for cancer treatment from 'try and hope' to 'test and treat'. The First Ascent platform combines functional drug testing of fresh biopsies, genomic sequencing, and an AI engine to assess a large panel of drugs and identify the most likely to be effective. Clinical data show a high correlation between how cancer cells respond in the lab test and how patients respond to the same drug, and is seen as a treatment guide for refractory cancer patients to identify novel drug combinations.

Jim explains, "Fundamentally speaking, if we look at everybody on this planet from a DNA and RNA perspective, there are 8 billion people, and each one of us is different from the others due to our DNA and RNA. So if we acknowledge that biologically we're all different, then the problem that we're trying to solve is if we're all different, why are we treating each patient with the same standard of care? A process that has existed for a hundred years, and again, they've made substantial advancements, but functional precision medicine is really an opportunity to move away from a standard that's based on the laws of averages and really treat people based on an individual level, developed by results that come from their individual biology."

"In oncology, these practices and standards have been developed over decades. And in some situations, some of these cancer protocols haven't been updated in decades. There had been continual advancements in things like immunotherapy. What I'll say is that in oncology, they're always looking for the silver bullet. It's in the genome, it's in a biomarker, it's in immuno-oncology, it's in an organoid, it's in all of those types of things. So they have always tried to find that silver bullet. Fundamentally, what we do in First Ascent is that we believe that we have enough bullets, per se. We have enough drugs, per se. We're just not using them in the right ways. "

#FirstAscentBiomedical #Cancer #Oncology

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Deb Nevins, Director of Product Strategy at POCN, emphasizes the expanding role and importance of Nurse Practitioners and Physician Associates in the American healthcare system. These professionals have evolved from being an extension of the physician to becoming autonomous clinicians who handle a wide range of patient care, including diagnosing, prescribing, and creating treatment plans for a significant portion of the patient population. In many cases, NPs and PAs are filling care gaps in rural and underserved areas and applying a more holistic approach to healthcare in an increasingly virtual healthcare environment.

Deb explains, "POCN is an organization that has been around for over 10 years now. It started really with the mission to support nurse practitioners and physician associates and help them practice at the top of their license. And we do that multiple ways, but specifically we like to say it's a learn, earn, care, and connect model. So we provide educational insights to them. We allow them to connect with each other on our platforms, and we also bring them forward to pharmaceutical companies to help them better understand the role that they play in patient care today."

"Well, it's really interesting because both nurse practitioners and physician associates have really stepped up their responsibilities and roles since the timeframe when COVID started, where there was such a backlog. So they used to be thought of as more physician extenders or as mid-levels, but we can no longer say that. So nurse practitioners, physicians, and associates will handle everything with patient care from the initial intake, counseling, diagnosing, creating the treatment plan, prescribing medications, doing the follow-up, and ensuring that they're managing during side effects or anything like that that might happen. They support the patient with access challenges as they try to get their medications. So they basically do almost everything that a physician, an MD or a DO would do, except that they're not doing surgery or they're not doing super complex cases, but they have autonomy."

#ElevatingCare #VoicesInCare #PatientsFirstCare #POCN #WomenInHealthcare #VisibilityMatters #HealthcareLeadership #AmplifyNPs #AmplifyPAs

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Jill Eubank, Division President of Professional Talent Solutions at Randstad USA, shares key findings from the Randstad Work Monitor Pulse Survey on the current landscape in the medical and healthcare industry. Noted is the significant shift from prioritizing remote work to job security, alignment with leadership values, and how AI is being used to improve job efficiency. In an environment facing a scarcity of qualified employees, retention drivers include pay increases that keep pace with inflation, flexible scheduling, and strong manager support.

Jill explains, "We're the largest staffing and workforce solution provider in the country and really in the world. We offer recruiting, staffing, HR services, whether it's on a temporary contingent basis or even all the way up to executive search and permanent placement. In healthcare specifically, our co consultants specialize in recruiting for those essential roles in the healthcare industry. Think medical, dental, and pharmaceutical sectors. We have a large, extensive network of not only clients in healthcare, but also candidates and a pool of talent in the market."

"I think during COVID, we saw, especially in the healthcare industry, people wanting to find a way to work remotely for a lot of various reasons. What you're finding is that it's now shifting to employability versus working remotely. And in order to stay in a role for, let's say, five years or more, what we're finding is healthcare workers are saying that the top three retention drivers are an annual pay increase that keeps up with inflation or above inflation, followed by manager support, which was something we hadn't seen as frequently in the healthcare space. And then obviously, something that has evolved over the last couple of years is alignment with leadership values. A lot of very interesting key takeaways, but things you're starting to see evolve with the market and what's happening just with the workforce in general."

#RandstadUSA #TalentStrategy #WorkforceInsights #FutureofWork #HealthcareJobs #TalenRetention #WorkplaceTrends #HealthcareLeadership #EmployeeWellbeing #FutureofWork

randstadusa.com

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