Demand for Artificial Intelligence in Healthcare Market to Incur Considerable Upsurge During 2018 …

… Microsoft Corporation, iCarbonX, Welltok, Butterfly Network, Apixio, Pathway Genomics, and many others. Artificial Intelligence in Healthcare Market …

Artificial intelligence can be defined as the use of technology to perform tasks using different algorithms, decision-making capabilities and deliver solutions. Artificial intelligence in healthcare and medicine would induce the tremendous change in the current healthcare system. Artificial intelligence in healthcare would organize the patient data, treatment plans and would strengthen providers and payers by providing them the necessary information.

Artificial Intelligence in Healthcare Market: Segmentation: Artificial intelligence in healthcare market would provide various applications to the industry, and by different application areas, we can segment the market into the following: Data Management, Analytics and Research, Clinical Decision Support, Patient Health Management, Precision Medicine, Revenue-Cycle Management, Drug Development.Artificial Intelligence in healthcare market can also be segmented by end users which are as follows: Payer, Insurance Companies, Government, Others; Provider, Hospitals, Clinics; It is anticipated that the growth in artificial intelligence in healthcare market would be tremendous over the years due to the introduction of big data into healthcare. By deployment we can segment the artificial intelligence in healthcare market into the following: Cloud-based, On-Premise.

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Artificial Intelligence in Healthcare Market: Dynamics: Artificial intelligence in the healthcare market is primarily driven by a few key factors such as evidence-based healthcare decisions and clinical outcomes by introducing artificial intelligence in healthcare, analytics based on the vast amount of healthcare data, and improved healthcare setting. In addition to this artificial intelligence in healthcare market also observes significant growth due to its functionality in revenue cycle management for the healthcare environment. Artificial intelligence in healthcare market gains a great drive from applications such as claims management for insurance companies by detecting the number of fraudulent claims. Artificial intelligence in healthcare market will also strengthen the healthcare market by significant cost reductions.

Artificial intelligence in the healthcare market, however, require tools which can analyze unstructured data as most of the healthcare data is in the form of physician notes, and prescription reports which limit access to artificial intelligence in the healthcare market. Artificial intelligence in the healthcare market is also associated with a high cost for deployment and lack of skilled workforce which restraints the artificial intelligence in healthcare market growth over the period.

Artificial Intelligence in Healthcare Market: Region-wise Outlook: Based on geography, the Artificial intelligence in healthcare market can be segmented into five major regions: North America, Europe, Asia-Pacific, Latin America and Middle East & Africa. At present, North America holds a leading position in the Artificial intelligence in healthcare market followed by Europe. The major driving factors which have driven the growth of the Artificial intelligence in the healthcare market in this region is support from the government, and increase the number of operational setups by various companies. Following North America, European countries are also anticipated to show steady growth in the Artificial intelligence in the healthcare market. In the next few years, Asia-Pacific would show remarkable growth in the Artificial intelligence in healthcare market as it is developing at a very rapid pace and has shown the emergence of many regional players.

Artificial Intelligence in Healthcare Market: Key Players: In the past decade, the artificial intelligence in the healthcare market has witnessed a massive influx of players. Some of the major players operating in the artificial intelligence in healthcare market are IBM Corporation, Oracle Corporation, Microsoft Corporation, iCarbonX, Welltok, Butterfly Network, Apixio, Pathway Genomics, and many others. Artificial Intelligence in Healthcare Market has a presence of many regional players which have a huge market share in emerging countries.

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Implementation best practices: Getting healthcare analytics right

Data and analytics have become increasingly critical to the operation of any successful … These are a variety of best practices for analytics implementation in … chief medical officer at CloudMedx, a big data health analytics company.

Data and analytics have become increasingly critical to the operation of any successful healthcare organization. And with the advent of healthcare imperatives such as value-based care and population health management, analytics technology has become more important than ever.

Here, four experts in healthcare analytics technology offer their advice and suggestions for healthcare CIOs implementing analytics in their provider organization. These are a variety of best practices for analytics implementation in healthcare.

Stakeholders, and required data

Implementing an analytics system first requires outcomes defined by multiple stakeholders that second drives alignment on what data elements are required, said Bradley Hunter, a research director at KLAS Research.

“Collaboration is a cornerstone to helping drive outcomes,” Hunter said. “In the absence of collaboration amongst key stakeholders in the organization there will be no alignment on which outcomes should be focused on, and unnecessary effort will be expended.”

The best practice is to bring all key stakeholders together to collaborate and debate on which outcomes will be key to the success of the organization, Hunter said. Once these are decided upon, then a strategy for achieving outcomes can be put in place – then one can go and get the data, he added.

The goal of getting the data is to tell the right story to the right people at the right time so they can make the best decisions, said Ryan Pretnik, a research director at KLAS.

“Good data drives great decisions,” Pretnik stated. “This is why alignment on outcomes is so key – it drives what data needs to be brought in front of the decision makers. Once the outcomes are defined, the needed data becomes apparent.”

This allows for the implementation of the data platform to be much more straightforward, he explained, adding that there are a myriad of available data sources, and knowing which data elements are needed before implementation helps to streamline the process.

“Those looking to implement an analytics tool should involve their end users early on in the process,” Pretnik said. “This will help organizations choose a solution that is easy for end users to navigate and understand. Involving end users early in the process ensures high adoption which leads to more consistent outcomes.”

A shared vision, and AI

In the past decade, new incentives and value-based programs that reward payers and providers for proactively managing the health of members have increased their collaboration and created an even greater need for data and analytics to get the right care to the right patient at the right time.

“CIOs at provider organizations seeking to implement analytics technology face a huge variety of choices and competing priorities, not to mention the work that goes into setting up and using analytics,” said Mark Morsch, vice president of technology at health IT and analytics vendor Optum. “Collaborate with a shared vision. To be successful in a business setting, investments in advanced analytics and AI must have a defined objective and align to your overall technology strategy.”

Further, healthcare is so specialized that it’s important to build a team of multi-disciplinary professionals who have advanced analytics technology paired with healthcare expertise one needs to drive clinical and financial performance, Morsch added.

“The right partner has this combination of industry experience and technology and business savvy to help CIOs make strategic investments that can build over time,” he said.

“An effective approach can be to focus on processes in either area – clinical or administrative – that have a well-defined business need and available data.”

Mark Morsch, Optum

Another best practice is to start with applications of data and analytics that can show an immediate impact by freeing up time and cost, Morsch said.

“These applications can span both clinical and administrative processes within a health system’s operations,” he said. “An effective approach can be to focus on processes in either area – clinical or administrative – that have a well-defined business need and available data. One of the most interesting recent developments is more applied uses of artificial intelligence, like natural language processing for revenue cycle management or deep learning models that support disease prediction.”

Applying natural language processing can help make sense of the vast amount of unstructured information in EHR clinical notes to gain new insights about cost, quality, and access and opportunities, he added.

“In a more practical fashion, natural language processing can help transform revenue cycle operations with intelligent assistance to coding and clinical documentation specialists to find the key diagnostic and treatment information in a medical record,” he said.

“Combining the information captured using natural language processing with machine learning is also emerging as effective technique to recognize indicators of undiagnosed conditions and facilitate connections between providers to identify gaps in care,” he added.

These use-cases must be backed by a business case and defined problem where technology can augment the human – patient, provider or administrator – experience, he added.

Change management

Analytics – and any IT infrastructure – needs to be pursuant to a business case: That business drives any technology first and foremost, and that requires a stakeholder analysis of existing conditions so one can best understand how the change management will affect each of the stakeholders, said Dr. Alan Pitt, chief medical officer at CloudMedx, a big data health analytics company.

“That business purpose is usually defined in a pre-state and post-state,” Pitt said. “Process, people and technology doing something. Better patient care, shorter length of stay, filling gaps in care, a myriad of reasons for justifying people, process and technology. The user of higher analytics and AI will change the process and technology for the business purpose.”

A second best practice would be that technology vendors and CIOs should work hand in glove with a clinical sponsor for all new initiatives, he stated.

“They should not be done in isolation,” he said. “As it specifically pertains to analytics and AI, current problems that could be addressed include the overwhelming amount of documentation and reporting that providers are required to do leading to burnout. And that analytics and AI offer the opportunity to change our relationship to the sea of data that we have to deal with on a daily basis as providers.”

Twitter: @SiwickiHealthIT

Email the writer: bill.siwicki@himssmedia.com

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Providence St. Joseph snaps up blockchain-powered RCM platform Lumedic

Lumedic’s next-generation platform uses distributed ledger technology, smart contracts and machine learning with the aim of selling to providers and …

Dive Brief:

  • Providence St. Joseph Health has acquired Lumedic, a blockchain-enabled revenue cycle management platform based in Seattle, for an undisclosed sum.
  • Lumedic’s next-generation platform uses distributed ledger technology, smart contracts and machine learning with the aim of selling to providers and payers looking to increase efficiencies and reduce costs.
  • The deal makes Providence St. Joseph the first integrated provider-payer system with a scalable blockchain tool for RCM, the nonprofit system said Monday at HIMSS 2019 in Orlando, Florida.

Dive Insight:

RCM is an important area to providers, and a number of vendors are seeking to capitalize on it.

In a Connance survey, 70% of providers claimed it took more than a month to collect from patients. A 2017 Advisory Board analysis found the average 350-bed hospital lost up to $22 million due to revenue cycle issues. Respondents in a recent Billing Tree survey ranked collecting on patient bills the No. 1 payment challenge in 2018.

With pressure to boost financials, hospitals are eager for tools to optimize the billing and collection process and improve the customer experience. The major EHR vendors, as well as other companies, are investing in RCM products as demand for these kinds of services grows. Last year, officials at both Cerner and Allscripts touted RCM as strong growth areas.

Demand for RCM tools and services is also fueling consolidation in the market. Among notable deals was R1 RCM’s February 2018 acquisition of Intermedix’s healthcare division, which includes physicians and emergency services RCM, practice management and analytics.

The Lumedic deal is the latest piece in what Providence St. Joseph officials have described as a “broader vision of healthcare.” Earlier this month, the system launched a for-profit population management company called Ayin Health Solutions. The business will assist providers, payers, employers and governmental department seeking to reduce costs, enhance care and improve population health.

“New technologies like blockchain, artificial intelligence, and machine learning give us an opportunity to view the complexities of today’s health systems through a different lens,” Venkat Bhamidipati, Providence St. Joseph’s CFO, said in a statement. “Our acquisition of Lumedic’s innovative platform is yet another example of how we are pursuing all avenues of transformation, allowing us to redirect unnecessary spend towards either patient savings or care.”

Under the deal, Providence St. Joseph will create a new company with Lumedic’s assets and team, while retaining the Lumedic brand. The RCM business and system will work together to identify potential partnerships with providers, payers and other health-related entities.

The acquisition comes as Tenet Healthcare has been mulling the sale of its Conifer Health Solutions RCM subsidiary as part of a target cost-reduction program to bring down debt. The Wall Street Journal reported last summer that UnitedHealth Group was among several entities interested in the business as it continues to build up its Optum services arm through acquisitions.

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Providence St. Joseph Health acquires revenue cycle management blockchain startup

The platform builds on distributed ledger technology, smart contracts, and machine learning to deploy a more efficient revenue cycle, from eligibility to …

Providence St. Joseph Health has acquired Seattle-based Lumedic, a revenue cycle management company based on blockchain technology, with the aim of streamlining data sharing and improving claims processing.

The Renton, Washington-based health system announced at the 2019 Healthcare Information Management Systems Society (HIMSS) Annual Conference & Exhibition that it plans to leverage the blockchain platform to reduce inefficiencies in revenue cycle management. Terms of the deal were not disclosed.

Traditional health system and hospital revenue cycle processes frequently rely on physical correspondence and fax machines for sending medical records, legacy systems for data storage, and employees who spend hours calling insurers on the status of claims. In addition to the cumbersome workflow, healthcare billing and claims is still largely a manual process, which introduces the potential for errors.

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Revenue cycle inefficiencies were responsible for more than $500 billion in U.S. health care costs in 2018 alone, largely due to industry complexities and manual processes, according to a McKinsey & Company analysis.

Providence St. Joseph Health, a not-for-profit Catholic healthcare system operating multiple hospitals across five states, said it is the first integrated provider-payer system to establish a scalable blockchain platform to modernize claims processing and enhance interoperability between providers and payers.

“New technologies like blockchain, artificial intelligence, and machine learning give us an opportunity to view the complexities of today’s health systems through a different lens,” Venkat Bhamidipati, Providence St. Joseph Health chief financial officer, said. “Our acquisition of Lumedic’s innovative platform is yet another example of how we are pursuing all avenues of transformation, allowing us to redirect unnecessary spend towards either patient savings or care.”

RELATED: Aetna, IBM launching new blockchain healthcare network

“By disrupting these often cumbersome processes ourselves, we strive to lower administrative costs for both parties while getting deeper insight into the financial experience of patients and the ways we can simplify the process for them,” said Rhonda Medows, M.D., Providence St. Joseph Health president of population health and chief executive officer, Ayin Health Solutions.

Several healthcare collaborations have launched in the past year with a focus on using blockchain technology for healthcare use cases, with many initiatives aimed at increasing efficiencies in administrative processes. Insurers Aetna, Anthem and Health Care Service Corporation recently announced a collaboration with IBM to launch a blockchain healthcare network to address a range of industry challenges, including “promoting efficient claims and payment processing and maintaining current and accurate provider directories.”

In December, Change Healthcare bolstered its existing blockchain platform by acquiring blockchain startup PokitDok.

Lumedic, which launched last year, uses blockchain technology to modernize the financial operations of healthcare by creating more price transparency and speeding up the billing and claims process for healthcare providers, the company said. The platform builds on distributed ledger technology, smart contracts, and machine learning to deploy a more efficient revenue cycle, from eligibility to pre-authorization to billing.

RELATED: Change Healthcare bolsters existing blockchain platform with PokitDok acquisition

According to Lumedic, blockchain technology has the potential to modernize revenue cycle management as distributed ledgers are collaborative databases which allow multiple parties to share data with each other securely, privately and efficiently. As healthcare is a collaborative industry, requiring communication between payers, providers, and other third parties, blockchain technology can be valuable when changes to contract terms become necessary, the company said. The use of blockchain technology also can enhance the patient financial experience by providing “an always current, transparent, accurate and secure single reference point for patients with information from all parties.”

The health system has acquired Lumedic’s assets and team and plans to form a new company that will maintain the Lumedic brand. Lumedic will work with Providence St. Joseph Health sign up partnerships with providers, insurers, and other healthcare stakeholders.

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Health Systems Realize Significant Financial Benefits from AI-driven Revenue Cycle Solutions …

DENVER, Jan. 29, 2019 /PRNewswire/ — The nation’s premier integrated care delivery networks are replacing expensive and time-consuming manual …

DENVER, Jan. 29, 2019 /PRNewswire/ — The nation’s premier integrated care delivery networks are replacing expensive and time-consuming manual financial clearance solutions with AI-driven automation by Recondo Technology, the company announced. Recognized in 2018 as Best in KLAS for patient access software and solutions, Recondo made notable additions to its client base in 2018. Providers are drawn to the automated payer communication that processes large transaction volumes in a fraction of the time and cost it typically takes their staff. The results are increases in pre-service cash collection, reductions in denials and timely write offs, and huge resource efficiency gains.

“Epic” results for Bon Secours Mercy Health

In early 2018, Recondo launched RevSmart, which embeds automated payer communication directly into the Epic system via Epic’s real-time eligibility (RTE) and real-time authorization (RTA). Bon Secours Mercy Health was one of the first customers, along with its revenue cycle outsourcing partner Ensemble Health Partners, to select RevSmart to automate financial clearance activities. As a result, Bon Secours Mercy is now automating eligibility, authorizations, medical necessity and pre-service estimations, as well as utilizing Recondo’s ClaimStatusPlus solution in the business office.

Coupled with best in class workflow and Ensemble-led optimization of the HIS system, Mercy has since seen a 50 percent gain in pre-registration and authorization days out, and point-of-service collections are up 95 percent in the first six months of implementation. In addition, Ensemble was able to reallocate 118 FTEs, resulting in $7.6M in FTE cost savings for Mercy Health.

In total, the combination of RevSmart and Ensemble’s focus on operational execution have resulted in a $15M net revenue increase in a single year.

“Embedding Recondo’s revenue cycle automation capabilities and content into Epic, in combination with Ensemble’s KPI-driven workflow maximization, have driven results beyond our expectations,” said Shannon White, Chief Operating Officer of Ensemble Health Partners. “We’re excited to see how our expanding revenue cycle services, combined with new developments in Recondo’s technology with respect to machine learning and natural language processing will automate more manual processes for our clients.”

New customers for automated claim status checking

Recondo customers are also reaping returns by automating retrieval of enriched claim status data from payer websites, enabling expedited and intelligent workflow routing and making 80% of claims “touchless” in the business office.

Historically, this function has required considerable staff, who could never reach the end of an endless backlog of claims needing follow up through manual effort. With Recondo’s ClaimStatusPlus™ solution, new customers such as Montefiore Health System, Henry Ford Health System, Spectrum Health, and Stormont Vail can process tens of thousands of outstanding claims in a matter of hours.

For customers like Avera Health, this newfound efficiency has resulted in cash flow improvements of over $20 million. Avera Health’s Vice President of Central Business Office, Mary Wickersham will be presenting the results of robotic process automation for claim status in Session 79 on Tuesday, February 12 at 4:15pm PST in Room W308A at the upcoming HIMSS19 Annual Conference.

Accolades for innovation

In 2018, Recondo was the first company to receive the coveted HFMA Peer Reviewed status for automated authorization and claim status verification, which contributed to expanded services to existing customers including Avera Health, University of Colorado Health, among others.

Recondo’s leadership in AI-driven technology for revenue cycle management was also featured in multiple publications, including Healthcare Finance News, HFMA’s Revenue Cycle Strategist, Inside Big Data and others. The company pioneered the use of robotic process automation to query, retrieve and normalize answers from payers in multiple data formats, and today, is further innovating this capability with machine learning and natural language processing to make communication with payers virtually touchless.

“Strategic partners like Ensemble, and other forward-thinking clients, push Recondo not just to continuously innovate our AI technology platform, which has led the market from the earliest stages of RPA, but to do it in collaboration with workflow design and system integration. This powerful combination results in highly scalable solutions that quickly drive transformative business impact in the tens of millions,” said Jay Deady, Recondo’s CEO. “Look for next generation AI like machine learning and natural language processing to be powering our solutions in 2019.”

Recondo leadership and customers will speak about and demonstrate these capabilities at various industry events in 2019, including HIMSS19 in Living Room #3 and Session 79 where customer Avera Health is co-presenting with Ryan Ayres, Recondo’s Senior Vice President of Strategic Solutions; in Booth PL3 at HFMA Region 5’s Dixie Institute on February 24; at the CORE User Group meeting on February 27; and HFMA’s Annual Conference in June.

About Recondo Technology

Recondo’s cloud-based solutions deliver industry leading automated, accurate, and actionable financial clarity to all participants within the healthcare revenue cycle. Recognized by Black Book Research as one of the top three leaders in revenue cycle management software, Recondo empowers more than 900 hospitals with solutions that connect providers, payers, and patients to ensure proper payments across the care continuum. The company’s patented software and expertise streamline operations and allow providers to be paid more, faster, and at a cheaper cost. Recondo brings efficiencies and cost savings to patient access through to payment processing—a continuum today where inaccuracy and inefficiencies currently cost U.S. healthcare a staggering $480 billion per year. Learn more at www.recondotech.com.

Media contact:

Stephanie Janard

Amendola Communications for Recondo Technology

sjanard@acmarketingpr.com | 828.962.2054

SOURCE Recondo Technology

Related Links

https://www.recondotech.com

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