Transitioning from AI Gee-Whiz to B2B Results

We at CarePrecise are as fascinated as anyone about the miraculous capabilities -- and astounding failures -- of the new Large Language Model Artificial Intelligence tools now battling it out in cyberspace. But we've been around too long not to reserve some skepticism about the hype cycle. The other day I was chatting with an LLM about a new medical device. It initially pointed me to the manufacturer's site and some related promo material, but when I told it I'd rather read content from actual users of the equipment it suggested some sites I generally prefer not to use. When I asked instead for Facebook Groups, it gave me a list of suggestions with very specific Group names.

None of which turned out to exist.

So, when pressed for different information than it had been providing, my chatty AI tool employed a very human tactic: MSU.

This suggests to us that perhaps the best way to effectively use AI will be to point it to data you know is good -- specifically, your own data about your customers and prospects.

This approach is already taking root in pharmaceutical marketing. Directing AI tools toward rich, highly accurate reference data will, we think, become a key component in making the new technology produce credible, and actionable, results.

Healthcare is the Healthy Thing, Right?

 An article out today in Fierce Healthcare looks at how the downturn in the economy is affecting healthcare funding and investment. Noting that 2022 was a bang-up year for private equity healthcare  deals, Fierce notes the drop in the S&P 500 of nearly 20%. So, what's happening in this rather healthy and "recession-proof" in 2023?

The article cites predictions from economists seeing recession ahead, and quotes Duane Fitch, national healthcare management consultant at Plante Moran as seeing "pretty much every dynamic going in the wrong direction" as a "perfect storm" for hospitals and systems.

I looked to some related reports to find that Bain Capital saw some optimism in January, particularly where "recession-resilient themes" are in investors' crosshairs. Followers of Jim Cramer will remember his December 2022 prediction of a banner year in 2023, and picking some winners: About Danaher (DHR), he says it's "one of the best-run companies in any industry." Cramer also held up Pfizer, United Health Group, Edwards Life Sciences, and he called the Humana the "best-of-breed" for managed healthcare stock.

Of course, no 30,000' overview of the market would be complete without taking a glance over at Motley Fool, where the merry jester noted that it all depends on the tune you're skipping to. Noting last July that, as is the conventional (and verifiable) wisdom, healthcare stocks are "one way for investors to hedge against recession risks." From there they danced through some of the familiar jigs, warning that "it wouldn't be too surprising if the economy actually did end up contracting in the near future," and recommending a fresh assessment of portfolio segments to see which are prepared for Fitch's storm, and which may not be.

The Fool sees continued, if muted, green in pharmaceuticals. Big pharma stocks won't sustain "major damage." Biotech, however, faces continued "headwinds."

CarePrecise is in contact with many technology-based business activities, including consumer-facing health-related applications and various healthcare marketing projects. Fourth-quarter 2022 was a busy time, particularly for marketing to clinics and medical practices. Development in provider management systems has been strong and growing, right up through January of 2023.

In a Chief Healthcare Executive article, Kristin Pothier, global lead, healthcare and life sciences deals advisory at KPMG, is quoted stating that providers have been stretched during the pandemic, and they "are also dealing with massive staff shortages, as staff have gotten sick, or sick of working." She says that hospitals should be using technology to reduce burden on their staffs, including telehealth and automation. 

A year ago, KaufmannHall pointed to the difficult year for hospitals in 2021, seeing the smaller number of M&A transactions being offset by a larger percentage of higher transactions. The trend has continued on a more-or-less steady roll.

My take-away is that healthcare technology should remain a healthy segment through a recession, though we do see the potential for a growing impact on hospital mergers and acquisitions. 

Surprise: You May Now Be Liable Under HIPAA

When the HIPAA privacy rule first went into effect, business associates of hospitals, physicians, etc. didn't have to worry about getting in trouble for releasing data in ways that violate patients' privacy.

No more.

In light of several years of clumsy handling of patient data by contractors and employees, it's perhaps not surprising that HHS is changing the rules to extend the strict HIPAA privacy rules -- and penalties for violations -- to external vendors and IT communities.

If you work in any way with patients' medical data -- whether as a data processor, consultant, IT contractor, EHR installer, whatever -- you'd better get familiar with the new rule that goes into effect March 26. It clarifies when breaches need to be reported to the Office for Civil Rights, scraps the old standards for the use of patient-identifiable data for marketing and fundraising purposes, and expands direct liability under the law to so-called “business associates” of HIPAA-covered entities.

Perhaps equally interesting is that patients once again will have the right to limit release of treatment records to insurance companies if they paid out-of-pocket on that treatment. Look out for problems and potential fines related to goof-ups related to granting access to the wrong business partners on the wrong data. Greatly increased penalties for privacy and security violations under the ARRA are explained in the new ruling.

Read the HHS news release.
Read the rule in the federal register (you've still got time to comment).

The Sunshine List

As lawmakers continue to push CMS to implement the Physician Payments Sunshine Act, and CMS mildly demurs out of concern that drug and equipment manufacturers won't be able to comply any time soon, CarePrecise has been busy getting prepared for a run on the databank.

As most of the players are beginning to realize, an accurate and up-to-date source of provider information will be a necessity in reporting payments properly. The CarePrecise master provider list contains all the hooks required to positively identify specific providers, and connects provider licensing and NPI numbers to such pertinent information as PECOS enrollment, Medicare billing eligibility, and the Office of Inspector General's excluded providers database. The current version of the CarePrecise Access Complete database identifies multiple providers practicing at a single location, using super-conformed location coding.

Sunshine Incoming

CarePrecise can process incoming lists of payments to providers using the advanced record-linking technology we use to build our master databases. Whether companies have NPI numbers or not, our system can use other data to identify payees.

CarePrecise data is already in use is installations where states have various types of Sunshine laws in place, and where organizations are preparing for the federal act to take effect. When we can all finally see who's paying what to whom (to whatever extent that will be truly possible), CarePrecise data will be part of this vital next step in controlling healthcare costs and abuses of influence.