After being fed data of past pneumonia treatments, the software automatically created cohorts of patients who had similar outcomes accompanied by the treatments they received at particular times and in what sequence. The program also calculated the direct variable costs, average lengths of stay, readmission and mortality rates for each of those cohorts, along with the statistical significance of its conclusions. Each group had different comorbidities, such as diabetes, COPD and heart failure, which was factored into the application's calculations. At the push of a button, the application created a care path based on the treatment given to the patients in each cohort.
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Might next year prove to be different? Yes, absolutely, especially given the coming mandates coming out of the Protecting Access to Medicare Act (PAMA), which will require referring providers to consult appropriate use criteria (AUC) prior to ordering advanced diagnostic imaging services—CT, MR, nuclear medicine and PET—for Medicare patients. The federal Centers for Medicare and Medicaid Services (CMS) will progress with a phased rollout of the CDS mandate, as the American College of Radiology (ACR) explains on its website, with voluntary reporting of the use of AUC taking place until December 2019, and mandatory reporting beginning in January 2020.
As a young adult, I was in a very serious car accident. I broke a lot of bones — my second vertebrae, my neck, ribs, a compound fracture in my leg... It’s a miracle I’m not a quadriplegic. I was on a respirator and couldn’t breathe because there was fluid between my lung and ribcage. I couldn’t move because I had this thing holding up my head. A nurse around every few hours to help me cough so I wouldn’t get pneumonia. Eventually after getting off the respirator, one nurse came around and he mentioned cannabis. He said, “Did you know cannabis does the same type of thing to your lungs? It’s a bronchial dilator. The drug I’m pumping into your lungs is a bronchial dilator.” From that point on I realized I had a choice. I never took another pain pill. I just used cannabis for the next eleven months to recover. I always loved cannabis, but now I had an even more personal connection to the plant.
Of course, inevitably, there was talk around the talk of the hype cycle involving artificial intelligence. One of those engaging in that discussion was Paul Chang, M.D.., a practicing radiologist and medical director of enterprise imaging at the University of Chicago. Dr. Chang gave a presentation on Tuesday about AI. According a report by Michael Walter in Radiology Business, Dr. Chang said, “AI is not new or spooky. It’s been around for decades. So why the hype?” He described computer-aided detection (CAD) as a form of artificial intelligence, one that radiologists have been making use of for years.
Collective Medical builds collaborative care networks. We help disparate stakeholders across the continuum — emergency, inpatient, skilled nursing facilities, mental health stakeholders, and even health plans and ACOs with their care managers – become aware when a patient needs them, particularly those vulnerable members who have figuratively fallen. We then unify their records collectively and help pick that person up.
The world is focused on these opportunities for good reason, but it’s a necessary but insufficient condition of driving coordination across an otherwise highly fragmented set of providers in a landscape. We have data silos and we need to unify those. We should have a single patient record that isn’t replicated with duplicative tests or because a patient goes from one site of care to another. However, it’s highly unlikely that the entirety of the country is going to be comprised of organizations like Kaiser, Intermountain, and Geisinger. Even those organizations — and I can say this because Kaiser and Intermountain are among the owners of our company — still have affiliated providers that they don’t own and that aren’t on their same record of care. They still require collaboration and coordination across those disparate providers.
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Looking back, Klomp sees a huge element of luck in their success story. “We work hard and try to be smart, but entrepreneurs chronically underestimate how much they get lucky or kind breaks from others,” he says. “I look back at the people willing to take a chance on a couple of unsophisticated kids from BYU who didn’t know a lot about healthcare but were trying to solve one of our mom’s problems. They gave us a chance and indulged us when we made mistakes. You look at Washington and it was just a stroke of luck.”
“Event notification systems and care coordination applications have historically struggled to provide actionable information to providers at the point-of-care,” Noah Knauf, partner at Kleiner Perkins, said in a statement. “Collective Medical is the first technology we’ve seen that allows the providers and payers in a local healthcare system to efficiently collaborate, delivering significantly better outcomes through risk analytics, real-time notifications, and shared care planning tools. Supporting this team is a rare opportunity to be a part of something that is meaningfully changing the way care is delivered in this country.”

You can either throw a tremendous number of expensive, scarce bodies at the problem, which isn’t scalable, or you can use technology. I’m not talking about mere notifications that an encounter has occurred, which we do, but a deeper level of collaboration. A mental health provider in the emergency department creates a crisis plan for the patient at 3:00 in the morning that involves a primary care provider who is affiliated with a multi-specialty clinic that is not connected to the health system and a Medicaid managed care manager. How do you help those individuals get on the same page and interact with the patient in sequence so that we’re not wasting resources or missing opportunities to help the patient navigate across the continuum, efficiently using the existing technology infrastructure of each organization? That’s the set of problems that we’re focused on.

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The premise of our business is that bad people don’t go into healthcare. That’s true even with the big, bad health plans that sometimes get painted into a corner. I’m not suggesting that there aren’t disagreements or even mistrust in healthcare and I’m sure there can be tense moments during contract negotiations between a health plan and a health system. But our job is to find the opportunities where there’s an alignment of incentives. When good people are reminded of why they joined up in healthcare and what their true purpose is, those instincts of competition or mistrust that might lead them to not want to share data fall away. When you give them a cause or a reason to collaborate, people will rally.
Located in Fresno County, the city began as a humble stop on the San Joaquin Railroad.  Land developers always arrive to do their thing, working land deals, about any new or proposed railway station.  In 1890-2, a group of Fresno businessmen brought the railway to town and in doing so, purchased the right-of-way from Clovis farmers as well as the surrounding territory. Sadly, this is formula of how to make big money. Insiders use insider information and have access to cash to take advantage of the situation. All the while, good honest work that forms the real backbone of the country strong my not necessarily be rewarded. While these entrepreneurs and their financiers are the catalyst in making it all happen,  too many low life gamers scoop off more than their fair share of the cream.  Does capitalism equate to insider deals and foul play?  No, cheaters cheat, to get more than their fair share, no matter what the system.
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