By Robert Rowley MD – Utilization Management (UM) is ubiquitous in healthcare. It is a system of authorizations for procedures and some referrals, for the determination of medical necessity vs. elective, cosmetic or experimental procedures, for determining bed-day allowances in hospitals, and for establishing preferred drug formularies.
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By Robert Rowley MD – We are at the threshold of a new way of paying for healthcare. We have paid for it traditionally with fee-for-service, a legacy that goes back to the beginning of third-party payments for healthcare (insurance) in the early and mid-1900s.
By Robert Rowley MD – The recent article in the New England Journal of Medicine, “Time for a Patient-Driven Health Information Economy?” presents a good overview of the need for, and hurdles in achieving, a unified patient-centered data platform that can be accessed from everyone taking care of the patient.
By Alex Meshkin – What is “intelligent decision automation”? And why is it the future? Intelligent decision automation is a term used in some industries. It combines artificial intelligence (AI) with workflow automation and has the power to change the way business is done in nearly every sector of the economy.
By Alex Meshkin – Just over a year ago, in his 2015 State of the Union Address, President Obama announced the Precision Medicine Initiative. During the 2016 State of the Union Address, Obama announced the “Cancer Moonshot” to cure cancer, with Vice President Biden at the helm.
By Robert Rowley, MD – Medicine is often described as both an art and a science. One might think that the “science of medicine” should be fairly straightforward, driven by findings from clinical studies and evidence-based protocols derived from such findings.
By Robert Rowley MD – A recent study of healthcare organizations showed that most are not prepared to deliver standardized longitudinal care across multiple provider systems. Shared care plans will be the centerpiece of coordinated care delivery, incentivized by the move from fee-for-service to value-based care.
By Robert Rowley MD – Health care in the U.S. is on the threshold of fundamental change. Powered by advances in federal policy, the underlying way in which we pay for health care is moving from the traditional fee-for-service, pay-for-volume historic approach to one that pays for demonstrated value.
By Robert Rowley & David Harlow – The lack of coordinated delivery of healthcare is widespread in this country. It might even be called the norm. Most people in the U.S. receive their care in a disjointed way, where each clinician, and each facility, has her/his own system.