Literature Review

Insurer responses to Change outage fail to impress provider Modern Healthcare, by Nona Tepper and Lauren Berryman; 3/18/24Insurers have modified claims and payment operations amid the Change Healthcare network outage, but providers contend the moves are not enough to address their financial challenges.

UnitedHealth Group cyberattack status update UnitedHealth Group Press Release; 3/18/24 Today [Monday 3/18/24], Change Healthcare will begin releasing medical claims preparation software, an important step in the resumption of services. This will be made available to thousands of customers over the next several days. The company expects to have third-party attestations available prior to services becoming operational. Following this initial phase, remaining services restoration will continue through ongoing phases of activation until all customers have been connected.

Use of machine learning to optimize referral for early palliative care: Are prognostic predictions enough  Journal of Clinical Oncology - Editorials; by Gary E. Weissman, MD, MSHP; Joseph A. Greer, PhD; and Jennifer S. Temel, MD; 3/15/24  The Takeaway In the article that accompanies this editorial, [Weissman] et al used a machine learning (ML) algorithm to identify patients with advanced cancer who were receiving non–curative-intent treatment and at risk of death within 1 year to allocate early palliative care services at least 6 months before death as a means to increase use of early palliative care in the context of limited resources. While ML prognostic models are one promising strategy for triaging palliative care services, initiation of palliative care based exclusively on estimated survival and in the months before death likely excludes patients who would benefit from early palliative care initiated at the time of diagnosis, regardless of their estimated survival.

Hines VA introduces new monitoring system for hospice and nursing home Veterans VA Press Release; 3/15/24 Edward Hines Jr. VA Hospital has begun integrating a new patient monitoring system to improve Veteran health and assist medical staff. The AvaSure© Continuous Video Monitoring System places portable cameras in patients’ rooms who may need closer monitoring. Staff can observe up to 15 patients simultaneously through a virtual interface to monitor for issues such as a patient out of bed or patient-caused medical device interference. ... The monitoring system will be used in Hines VA’s Community Living Center (CLC), which includes short- and long-term nursing home care and hospice. 

Google Cloud releases new clinical generative AI tools at HIMSS24MedCity News, by Katie Adams; 3/12/24 At HIMSS, Google Cloud announced new AI features designed to assist providers, payers and any other healthcare organizations seeking to make better use of their clinical data.

Providers push lawmakers to make telehealth provisions permanent McKnights Home Care, by Foster Stubbs; 3/11/24 More than 200 healthcare organizations including LeadingAge and the National Association for Home Care & Hospice recently signed a letter to congressional leadership urging the permanent adoption of telehealth provisions affecting Medicare beneficiaries. Current provisions, which are set to expire at the end of the year, allow beneficiaries to access telehealth services in their home. 

CMS Statement on continued action to respond to the cyberattack on change healthcareCMS.gov Press Release; 3/9/24 The Centers for Medicare & Medicaid Services (CMS) is continuing to monitor and assess the impact that the cyberattack on UnitedHealth Group’s subsidiary Change Healthcare has had on all provider and supplier types. Today, CMS is announcing that, in addition to considering applications for accelerated payments for Medicare Part A providers, we will also be considering applications for advance payments for Part B suppliers. 

Mayo's plan to expand AI tool access in 2024 Becker's Health IT, by Naomi Diaz; 3/7/24Rochester, MN-based Mayo Clinic has saved its nurses 30 seconds per In Basket message using generative AI. ... This AI-driven system assists clinicians by generating initial responses to patient messages that have nonurgent medical questions. ... The tool has been able to generate draft responses to 3.9 million patient messages in 11 months saving nurses approximately 30 seconds per message, leading to potential monthly time savings of 1,500 hours across the organization, according to the post. Editor's Note: Even without purchasing expensive AI software, many basic software systems / email systems have similar systems to generate sample response phrases, e.g. Microsoft Outlook and Google's Gmail. Your clinicians are sure to have honed out numerous time-savers. Ask! Compile results, assess best practices and reward their input. 

HHS intervenes in Change Healthcare hack Becker's Health IT, by Giles Bruce; 3/5/24HHS said March 5 it would help accelerate payments to hospitals affected by the Change Healthcare cyberattack and institute other workarounds for providers. The agency said hospitals facing cash-flow issues from the IT outage can submit accelerated payment requests, like those issued during the pandemic, to their Medicare Administrative Contractors for "individual consideration." HHS said more details would be coming from the contractors later this week. 

Pharmacy associations join forces to advocate for pharmacists during change healthcare outageNewswire Press Release; 3/3/24 Association executives from the American Pharmacists Association (APhA), the National Community Pharmacists Association (NCPA), the National Alliance of State Pharmacy Associations (NASPA), and the American Society of Consultant Pharmacists (ASCP) released an open letter to pharmacy benefit manager (PBM) executives and other insurance payers whose systems may have been impacted by the Change Healthcare outage. Pharmacists and pharmacies are asking for assurances that claims fulfilled during this outage will be paid, and paid in a timely manner, considering the challenges faced by pharmacies and pharmacists with predicting co-payments and determining eligibility and coverage. 

Change Healthcare's temporary funding program 'not even a Band-Aid,' AHA says Becker's Health IT, by Giles Bruce; 3/4/24 The American Hospital Association called Change Healthcare's temporary funding program for providers affected by the cyberattack on the UnitedHealth Group subsidiary inadequate, while a U.S. Senate leader asked CMS to speed up payments to hospitals. Change Healthcare set up the funding assistance March 1 for providers facing cash-flow issues after losing access to its payer systems, which have been down since the Feb. 21 ransomware attack. However, AHA President and CEO Rick Pollack wrote in a March 4 letter to UnitedHealth Group that the program is "not even a Band-Aid on the payment problems you identify."

How AI will help the world's top hospital CEOs transform health careNewsweek, by Jeff Young; on 2/28/24Artificial intelligence is quickly showing the potential to revolutionize many aspects of care giving, from cancer diagnoses to clerical work. But AI also presents new risks, uncertainties and vexing ethical questions. With the release of Newsweek's ranking of the "World's Best Hospitals," executives at leading hospitals around the world told us how they are using the power of AI.

Driving Accessibility in HealthTech: 3 things founders should consider for thoughtful AI implementation in 2024MedCity News, by Justin Williams; 2/23/24As we stand in the new era in healthcare, the promises of artificial intelligence advancements have electrified us all. But while innovation is being pursued, it’s critical to be aware of the possible pitfalls that could make already-existing inequities in healthcare outcomes worse. Precision and inclusion are pivotal in the venture capital space since startup founders significantly influence how healthcare technology develops in the future.