Who's Speaking Up for Universal Healthcare? Well, ChatGPT for One

I've been enjoying reading Michael Mann's remarkable newsletter, "Planetary Health First Mars Next," available via LinkedIn. In today's issue, he asked ChatGPT what we could do to fix healthcare. The first response was to increase funding for medical research. The second and final response was to improve access to healthcare "by reducing the cost of insurance, expanding Medicaid, or creating a universal healthcare system."

He also got it to provide an extremely clear explanation of the Social Determinants of Health (SDoH).

I might have to change my mind about that little robot.

The newsletter also posted a link to a presentation by Russell Robbins, Chief Medical Information Officer at PurpleLab, discussing SDOH's impact on prescription medications, going beyond the conventional fill, reversal, and denial rates to address the harder-to-measure root causes through the lens of social determinants that underlie the missed med problem.

I've got a strong recommend rating on one of the smartest newsletters around. PurpleLab also looks like a cool company.

Why Do Biologics Have Such Funny Names?

If you still watch commercial television, chances are you've been lambasted with appeals to ask your doctor to prescribe you one of the new biologics coming out. The big print will feature the brand name, which is then repeated many times throughout the narrative. But the small print will give the generic name, which always seems to sound like a certain Phil Collins song.

Every year seems to bring a new parade of miracle cures, and every year the price of miracles seems to go up. I've started to refer to this trend as "Ransom-Level Pricing," because, at least in the US, the wonder drug revenue formula seems to be based on YMOYL.

I fully expect the next big med to be named after an actual rock and roll band.

What's the Rx Industry Expert Gab for 2023?

And, indeed, there is a site that blabs about all the money expected to be spent on the lab-tested snake oil in this year's pipeline. Or, if you'd rather limit your reading to a Fierce little summary, you could read an article about the drugs that will try to nab our hearts.

Or stab our kidneys. 

Or clear our minds, whatever.

But before you do even that, you might want to check out this fab decoder ring, which explains what all the suffix is about.

It's a -Mab -Mab -Mab -Mab World

Maybe the well-pharma wagon bringing just the medicine you need is coming down the street, right into your town, bearing a big shiny IV. You might even be one of the first to sign up for a jab!

 [And now, a word from our Sponsor: If you want to reach those doctors directly, check out the CarePrecise Enhanced Prescribing Clinician Fax Database™. Tell them Marty sent you.]

#aducanumab #donanemab #epcoritamab #lecanemab #mirikizumab

How to Save Money on Healthcare Provider Data

It might seem like this is a shameless, self-serving promo for CarePrecise provider data packages. Unsurprisingly, our name does come up a lot when companies stagger away in shock from the prices our competitors charge. But that's not what this post is about. We're going to talk about (mostly) free data.

Hopefully this post will help you find provider data that's available for free from the U.S. government. Using free data you can boost the information value in any provider contact list. If you're working with a helpful data vendor, chances are they'll help you find where you can download particular kinds of data you're looking for. For instance, we have a lot of customers who use our basic hospital database who need additional components that we don't package with the product, but we know where to find them and we're glad to share our knowledge. 

Of course, we could pull all of that data into our hospital dataset, but there's SO much out there, and if we did that the product would be very expensive indeed. That database sells for $939 but would be a couple of orders of magnitude pricier with all of just the 70 U.S. hospital data files listed in just one spot on the Centers for Medicare and Medicaid Services (CMS) website.

So, instead of trying to pack everything in, we bring together the hard-to-find/basic-necessity data, and assist customers in finding additional information specific to their particular need. Here are some of our more common recommendations.

When on the hunt for data gold, it can be painfully difficult to locate that needle in the haystack. The screenshot shows the count of the results of a search on the federal data website, data.gov, for "healthcare provider data." 127,500 datasets would be a daunting place to start digging. It's like, "Go get the gold! It's somewhere in that there mountain." Fortunately, we have had some experience with healthcare data excavation, and can often point our customers to pay dirt.

If you have talented data people, a good starting place is the NPPES dataset (National Plan and Provider Enumeration System), which contains about 7.4 million NPI records for individuals and organizations. The download file is much to large to use in ordinary office software, so your team will have to cut it into pieces. Or you can get the full NPPES already processed into a form to be used with Microsoft Office programs from CarePrecise. The CarePrecise product also contains additional data, such as sanctions, and whether or not a practitioner is enrolled to bill Medicare.

Once you have basic data on the providers, you'll want to add linkages between the clinicians and their practice groups and hospital affiliations. You can download the free Physician Compare database and have your tech team work its magic here, too, to make it useable on ordinary office computers. This used to be easier back when CMS included hospital information in the database, but now just to get all the hospital names and basic info you have to ingest ten additional datasets. The list is too big to include here, but highlights include the Licensed and Certified Healthcare Facility Listing where you'll find hospitals' CCN numbers matched to their names and addresses, and Medicare Inpatient Hospitals where you'll find some payment information. You'll want to head on back to CMS to pick up outpatient hospital info. These are just a few of the dozens of datasets we ingest on an ongoing basis to produce our monthly updates. For the datasets we monitor but don't regularly ingest, we're more than happy to help customers dig it up.

Hospital data is a bit easier to find and work with than practitioner data. For instance, the list of U.S. physicians is about 1.1 million doctors long, and that's too big to open in Excel. You'll need to get the physician files into a relational database for them to be very useful. If you're starting from the provider data catalog, you'll see the datasets for hospitals, home health agencies and other kinds of healthcare providers, as well as those doctors and other clinicians. You can also find physicians' CAHPS (patient experience metrics), as well as many of the types of procedures physicians perform.

Perhaps the best advice we find ourselves giving our customers who want to go it alone is to have a crackerjack tech team, or at least one person with a lot of database savvy, and start with buying a basic provider data product that you can use as a data structure template. Most federal data on clinicians is linked to their NPI number, so that's where you'll start building your relational database. Your next step is to talk with whoever sold you your basic data, and ask for help finding any missing components. CarePrecise prides itself on offering most of these, all ready to use, but some customers just enjoy the hunt, and even our most comprehensive data package can't contain everything you might want.

We don't shy away from telling our customers where they can find what they're looking for, even if the only place happens to be one of our competitors. In fact, CarePrecise data is compatible with data structures used across the industry. We even provide the Placekey for almost every record in our products, which connects our data with visitor traffic data and other Point of Interest (POI) products offered by other companies.

Many CarePrecise customers get our extended provider data package. CarePrecise Platinum has those elusive practice group and hospital affiliations, and software that makes it possible to get at exactly what you need without knowing anything about databases. It makes a great starting place for building your own bespoke database. 

About Updates

When you're finding and ingesting data, it's important to plan for updates. Some data sources are updated weekly, others monthly or quarterly, and some only on an annual basis. Create a table listing the resources and their update frequency, and build in the necessary automation to re-ingest them regularly.  This is especially important if your use case requires up-to-date information. This often overlooked step of building-in updates can be costly to do later on. Best if it's baked-in from the beginning. This includes your ingestion process for data you get from us, which you can automate to import the monthly or quarterly updates. We offer FTP delivery as an option, which can put the data directly onto your server, ready to be ingested by stored procedures that are triggered by the upload of the data, or by the modified date on the files.

If you want some help finding data sources, just speak with your CarePrecise representative. We may already have an affordable solution that will save you many hours of understanding an unfamiliar and often cryptic dataset. If we don't have it, your representative will help you find it.

One quick note... We offer these sourcing services to current CarePrecise subscribers. It would be great if we could open it up to everyone, but we have to keep our focus on our customers.

Using the ScribeFax Clinician/Prescriber Dataset

In 2019, CarePrecise implemented the data mining program that led to the development of ScriptFax, an enhanced pharmacy fax dataset. Soon after launching ScriptFax, which helps transmit prescriptions to pharmacies, our customers asked for something like the opposite: A dataset that facilitates fax communication with the prescribers – physicians, physician assistants, advanced practice nurses, nurse practitioners, dentists, and others who write prescriptions, edit and transfer patient records, and the like.

After tooling up to mine hard-to-find fax numbers for these clinicians, and a few weeks of testing, CarePrecise released ScribeFax: Enhanced Clinician Fax Database. It works differently from ScriptFax in that ScriptFax is a "flat file" of around 100,000 pharmacies, while ScribeFax is a relational dataset encompassing more than 5 million prescribing clinician and workplace records, plus all of the remaining 2 million+ records from the National Provider Identifier database (essentially all of the CarePrecise Complete active provider data, in addition to the mined fax numbers). 

The relational structure of ScribeFax makes it an easy addition to other datasets from CarePrecise and others. The clinician's NPI number provides the relational key across essentially all of each person's records within the massive CarePrecise Reference Database (CPRD). From each month's top-down update of the CPRD, all of the company's products are "packaged." While it would be easy enough to sell ScribeFax as a modular add-on, instead CarePrecise includes the core data on all of the providers as relational tables within ScribeFax.

Several Fax Numbers for One Prescriber: Which to Use?

ScribeFax data is delivered in CSV format for ingestion into the client's data environment. From there, clients' own internal systems dictate specific usage. But it's important to understand the meaning of several key data points. 

As our crowdsource partners use the data, they first choose the highest priority NPI/Fax pair based on the FaxSource/FaxType indicators. If that fax transmission fails, their system tries the next until the TX succeeds.

FaxSource: Where the fax number came from

ScribeFax, like ScriptFax, mines multiple fax numbers per location, and then assigns a priority to each based on its source. (This prioritization is independent of the Grade assigned, which is based on transmission success.) 

For instance, if a fax number is found on the clinician's own self-reported record, FaxSource is assigned the value of 100. Lower values identify higher priority, like "1st place," "2nd place," etc., so a FaxSource of 300, indicating that the source was the clinician's clinic record, may be considered a less direct priority than a 100 or 200. There are eleven FaxSource indicators in all, two of which are reserved for future use. FaxSource indicators between 000 and 099 are used to indicate external sources, such as crowdsource partner's data or a that of a third party. 200 indicates a clinician's personal Type 2 NPI record (for their owned corporation or other business entity); 300 indicates a group practice record; 400 a clinic record; 500 indicates that the fax was sourced from a co-located clinician's record; 600 flags an unproven Fax/NPI pair submitted by a third party but as yet untested; 700 is unassigned; 800 indicates a fax number associated with the clinician's co-located hospital record; and 900 is unassigned.

FaxType: What kind of address it's associated with

In ScribeFax, as in ScriptFax, there are two general types of healthcare provider address: the practice address(es) and the mailing address(es), with a few other distinctions. In order of priority: P in the FaxType field indicates a fax number that was discovered for a reported as the clinician's main medical practice physical location; S indicates a fax reported for a secondary practice location keyed to a clinician's record; E is an endpoint reported on a clinician-associated record; and M indicates a fax number found for a clinician-associated mailing address.

Fax Number Priorities

In this scheme, a user would first choose a fax number with FaxSource 100 and FaxType P, which would choose a self-reported pracice fax number. If that fails, the next lower priority would be tried, 100S; then 100E, followed by 100M, then 200P, and so on. When a fax number succeeds or fails, it is graded according to an A through F scale, with A being "reached the right clinician with a fax," and F being "wow this thing may not even be on the planet." Data mining is powerful, but it needs a human (or automated) assist.

Note that CarePrecise routinely checks for working fax numbers and assigns "F" to those proven to be stinkers (and "C" to the ones that do receive a fax but aren't proven to reach the particular clinician, etc.). We continue to report these, as an aid for customers who want to clean up their own internal data, and to avoid an endless cycle of retesting.

Links to Provider Data

ScribeFax links directly to both the clinician's provider data, and also to the fax's source provider data, both individuals and organizations. These data are included in the ScribeFax package: Practice and mailing addresses, phone numbers, specialties and facility types, licenses, MSA/CBSA and other location data. Linkage via CCN number is possible using an add-on module that includes a crosswalk between CCN numbers and hospitals' NPI records. Additional components are also available, including a practice group and hospital affiliation package, clinician procedure volumes module, and health system linkage via hospital affiliations.

Integration

ScribeFax is delivered in quarterly or monthly update packages consisting of 21 data tables in CSV format ready for ingestion into the client's data environment. Basic licensing permits use throughout the organization, and it may be placed in a data lake that is protected from outside access. 

Initial integration involves creation of ingestion routine automation, which facilitates quick assimilation of the monthly or quarterly updates, depending on which subscription plan is selected. That assimilation is the second step, which is greatly simplified by the fact that CarePrecise sends the complete dataset with each release, with all tables in sync to the release date, allowing simple drop/add of all ScribeFax tables.

Support

As with all CarePrecise data products, expert support is available from data analysts and engineers who work directly with ScribeFax and the related datasets. Depending on the subscription plan chose, free support ranges from 30 days to 90 days, with affordable extended support available.

Data for Healthcare Entrepreneurs

You're starting up a new healthcare-related business.  You've done your research, and you know exactly what you need to do to get the ball rolling. You want to make sure that your business is up-to-date with the latest, well, everything. You've got some fine talent onboard and now they need be fed with that most precious repast: Data.

CarePrecise offers special license pricing for Startups

Contact CarePrecise at (877) 782-2294 ext 9 for Derivative Product License and Redistribution License rates and details.

Where does all the healthcare provider data come from? Yes, frankly, most of it is "free." But it's in quotes because time – the time it takes to find and process unfamiliar data – isn't free. You need healthcare providers' information for your application, and you've got some ideas about where to get it. You want free stuff as much as possible, so you've surfed the Medicare sites, climbed the Department of Commerce mountains, tumbled into state certification board hollers, knocked on the unyielding doors of medical societies. It is a daunting task just locating the stuff, and you feel like you've just scratched the surface. Then you have to evaluate the data you've found, and figure out which components you'll have to put together to suit your particular requirements. There are hundreds of millions of healthcare provider records out there, in hundreds of datasets from dozens of data providers, both free and fee.

But reinventing the data-sourcing wheel is hardly the innovation you're aiming for, and it's an unnecessary limitation on your progress with a new development project. 

That first step is a tall one.

So skip it.

Review a healthcare provider data accuracy study...

Jump ahead to one of the handful of truly good healthcare provider data suppliers. These are the companies who are doing data search and integration full-time. It won't take long to survey the field. Five vendors' names come up immediately: Definitive Healthcare, IQVIA (formerly SK&A), LexisNexis, the AMA, and CarePrecise. Now it's just a matter of chatting with a data analyst at each to figure out if they have what you need (they all probably do), how they deliver the data (this varies) and what it will cost (boy, does this vary). 

Depending on your specific needs, four out of five of these vendors may cost an order of magnitude more than one of them. You'll find out soon enough which is which, but there are other questions you'll want answers to.

Reliability and Permanence

Which vendor and products can be expected to remain in the same format, and offer the same accuracy and freshness, for the long haul? Ask about backward compatibility; as a data product grows over the years, will it remain compatible with my internal processes, or will I have to spend ongoing time and effort adjusting to changes, either in data layout or in the way an API operates? And, of course, you wonder how long will this company remain in business and continue offering the components you need.

Development Costs

Over the 15 years that CarePrecise has been working with clients involved in development of entrepreneurial products, we have learned that the shorter the development time frame, and the fewer special competencies are required, the faster a product gets to market and reaches its earnings objectives. Obviously. Less obvious are the special gotchas of developing a data-based product. Make sure that whatever data package you choose will come to you in by far the most useful of data formats: a relational database. Whatever database management system you'll be using, now or in the future, one data format is sure to be supported. Relational tables, each packaged as a separate CSV file, is far and away the most reliable and long-term successful format. But whatever format you plan to use, make sure your data supplier can accommodate you.

For developers new to healthcare, provider data can be confusing, at least until you've taken a long leisurely hike through a data portal or software product that makes it clearer. For example, an Access database or other visualization front end where you can play with the data, learning the relationships. CarePrecise offers just such a "toy" for learning the structures of U.S. healthcare provider data, while performing real work, such as creating lists of providers by specialty, or by geographic radius. An hour of playing with a tool like this can be all the introduction you need.

If your application will be accessing the data through an API, you'll have lots of questions, not least of which is uptime. You'll also want to know if the API is robust enough for the particular complexities of your use case. Or you could instead go for a data package that allows you to download the whole database and all of its components to your local environment – doable if the dataset is very cleanly and sensibly laid out). In this latter case, your application may benefit from greater responsiveness, and coders will be better able to wrap heads around the data universe.

Ongoing Data-related Costs

Will the cost of the data subscription and license be a burden down the road, once the initial cash burn has passed? Also, the data package needs to be straightforward and intuitive enough that new hires will be able to pick it up quickly, with clear documentation. 

This is where a poor commitment to backward-compatibility on the part of your data supplier can create staffing strains, as the data team scrambles to accommodate some change in data layout. Or worse: A data product no longer contains what you needed! A painful example is the recent decision by CMS to drop hospital information (even its name and address!) from the Physician Compare data file, and to split it into two files in a relational format, where it had been a simple flat file. (CarePrecise customers experienced no outage from this event because it maintains alternative sources for this and similar drop outs.)

One license fee covers all CarePrecise flagship products...

What happens when your needs change? If you have a "universal" license that covers all of a company's data offerings, you'll skip the step of having to negotiate a new license for a change in data subscription. Try to negotiate a single fee that permits you to add data components later on, paying only the data subscription fee, with no license upcharge.

A Growing Field of Healthcare Apps

Healthcare applications – both consumer-facing and B2B – are taking flight all across the industry. May the best innovators, with the best data, win! 

A Marketer's Guide to Using Provider Data

Quality healthcare provider data is the foundation of any marketing campaign aimed at physician and dentist offices, the practitioners themselves, and every kind of hospital and medical facility. The good data just isn't free, even though it can be downloaded in thousands of pieces from various government websites. CarePrecise simplifies and maximizes the sometimes complex and hard-to-find (or shockingly expensive) resources by providing reliable and comprehensive data on healthcare providers in the United States at truly affordable pricing.

Free Healthcare Provider Data

Free data on U.S. healthcare providers is available from the Centers for Medicare and Medicaid Services. But with a few exceptions, the data files are difficult to understand, and many are simply too large to use in ordinary office computer software. Vendors like CarePrecise, Definitive Healthcare, and OneKey sell data that has been curated and organized for much easier use. This article is a guide to using purchased data, and will spotlight CarePrecise products. That said, CarePrecise also helps its customers locate freely available data to supplement its solutions.

The Good Stuff

CarePrecise offers a number of different provider data solutions to meet specific needs. Marketers want instant access to information like practice locations, practitioner specialties based on the standard Provider Taxonomy codes, co-located colleagues, their group and hospital affiliations, and more. With these details, marketers can create compelling campaigns for audiences that are more relevant and targeted than can be achieved with blanket campaigning.

CarePrecise data resides on your own desktop or laptop computer — there's no need to learn to code for an API, and no need for a database server. These data packages are designed for easy use with the familiar programs in Microsoft Office. You can search, sort, filter, and export data in formats such as CSV or XLSX to quickly capture insights. The complete database of all 7 million+ U.S. healthcare provider records can be used instantly to create tightly targeted campaigns, with no requirement for an Internet connection.

After you purchase a data package, you'll extract it to a folder on your computer. Depending on which components you choose, you'll use Microsoft Access or Excel to view and manipulate the data. If you've chosen CarePrecise Platinum, there's a software program, CP ListMaker, that "rides on top" of these enormous data files, and makes easy work of selecting the types of providers, their specific geographic locations by zip code, city, county, state, or the entire U.S., and with additional filtering by other attributes like gender, acceptance of Medicare, years in practice, and number of practitioners in the office. This data, priced in the tens of thousands of dollars by other companies, starts at $459. You can add additional modules as needed, and CarePrecise offers an upgrade path so you can upgrade economically. If you want the whole universe of CarePrecise's provider data,* The Collection offers what others charge $30,000 and more for at just over $3,000 — an order of magnitude less expensive — and you won't have to mess with an API or dodgy web access.

We'll cover some physician marketing specifics here, but most apply to other kinds of medical offices as well.

Marketing to Physicians

Connecting with busy physicians is one of the most arduous tasks associated with physician marketing, but good data and good tools make it simpler. 

Each physician holds the power to influence millions of dollars in healthcare purchases every year — a fact that has resulted in an overwhelming amount of marketing messages vying for their attention. The COVID-19 pandemic sent billions more marketing messages through the pipeline, from sellers of everything from masks and hand sanitizer to ventilators. While that traffic has thinned out now, many of those companies got a taste of physician direct marketing, built out the capability to deploy it, and are not likely to just walk away. We're in a whole new world of selling to frontline clinicians.

Here are the top things to keep in mind...

Different Strokes

Segment your campaign into blocks of providers with different attributes. If you’re unsure which patient practice will be your best prospect, testing out different specialties can provide the answer. CarePrecise Platinum simplifies this process by splitting your list into specialties, allowing for easy comparison of responses between a product landing page or reply card. Try it today to easily identify which of your ideal prospects spending money.

Do you sell primarily to large group practices, or small, sole proprietors? CarePrecise Platinum can help you target individuals or groups, and sort them by size.

Analyze various urban and rural areas, their proximity to a city's center, state borders, etc. to identify the most budget-friendly sections for your business operations. You can even layer these elements on top of one another in order to pinpoint precisely which areas will be the best fit for your marketing campaign. Maximize campaign ROI: Reach out to all market segments by putting together an impactful message that can then be tested and spread throughout each area once you've determined which is most effective.

Gender can be important, too. We live in a time of high sensitivity to gender, in our personal relationships, speech, and writing. Knowing the gender of the person receiving your message can help you to avoid negatives, and maybe pack in some positives. There are important differences in the responses of people identifying as women, men, genderfluid, and the many shades in between. Understanding the language of gender, and being mindful of its subtlety and power, and basic. Unfortunately, the U.S. Department of Health and Human services has not seen fit to allow healthcare providers to report as anything other than M or F, but CarePrecise faithfully brings all of that information to you, along with intelligent genderization of organizations' authorizing officials, whose records do not include a field for gender.

Make it Personal

It's essential that your direct marketing campaign is as tailored to the specific doctor you are targeting as a specialist. Since what might be effective for one type of physician may not apply to another, it's important to address each individually. Your product or service can assist a wide variety of specialists, yet when speaking directly with a sports medicine doc, specifically mention how it benefits them and their specialty - this will have greater impact than using generic language.

If you want to maximize the impact of your message, consider tailoring it according to geographical location. After all, rural doctors and hospitals may have unique requirements that suburban multi-physician practices don't typically face. Similarly, small or solo practice clinicians possess a different mindset than their counterparts in large organizations - this should be kept in mind when crafting messages for them as well.

This sort of segmenting is vastly easier when you have practitioner data in a form that's easy to manipulate, and the ability to create separate lists for each angle.

Maximize the physician's time and yours

Tap into your data sources to gain insight on the physicians you are mailing or telemarketing. Learn about their specialties, gender, and if they've recently started practicing. Acquire up-to-date addresses and phone numbers so that you can establish contact efficiently. Your communications shouldn't attempt a full curriculum, but a concise call to action. Motivate the physician to visit your website for helpful information, and follow up with postal mailings, since many doctors prefer paper over electronic correspondence.

Earn loyalty

Physicians want authoritative, credible information about new products and services that may be helpful for their patients or practices. Clear, concise, high-quality information builds trust. Getting a name or credential wrong is a forgivable human error, but it doesn't engender credibility with anyone, and practitioners can be very sensitive about mistakes. CarePrecise data is updated monthly with constantly changing information reported by the healthcare providers themselves.

Educate, starting with the first sentence

Physicians are professional learners. They diagnose by observation, seeking every detail to shed light on what they see. They tend to be more attracted to factual information than the average consumer. Making sure your message stands out and provides tangible value is key to success when targeting physicians. To ensure that critical information reaches your physician, it is important to cut out irrelevant details and create a succinct message. Make sure the communication is direct and professional so that gatekeepers will be able to recognize its importance quickly. This guarantees that vital facts are transmitted directly to the doctor without wasting time or getting lost in an overload of data. Generic-looking mailers with names and addresses in all capital letters, or a salutation like "Dear Doctor:" are lame!

The SharpMail tool in CarePrecise's CP ListMaker makes your written words to physicians look smart and professional by proper-casing name and address information. SharpMail saves time by creating intelligently "attention names" (the full addressee name, like Dr. Sandra Rosenfeld, DO) and salutations (the name part of that "Dear Doctor" greeting, like Dr. Rosenfeld or Ms Rosenfeld). SharpMail is aware of whether a particular person should be addresses as Dr., Mr., Mrs., or Ms, according to their reported preference of name prefix and/or status awarded the "doctor" honorific. SharpMail is designed specifically for the medical market, and it produces beautiful names and addresses, but it's offered as open source code within CP ListMaker, and licensed customers may adapt it to their own needs.

Consider mailing information about your product that puts indicators and counter-indicators for use right up front, so that physicians and their staff know that the information is important and to the point. You should check multiple sources, to know things like whether a physician is enrolled in the PECOS system (can bill Medicare), or has been barred from billing. CarePrecise combines all of these sources in a single tool.

Relationships Count

To make sure that invoices get through to their intended recipients, establishing connections with physicians and their team members is crucial. CarePrecise Platinum can help by keeping tabs on the lists used for various communications, maintaining an opt-out list for practices which require special care, and creating separate marketing lists depending on geographical area. You'll be able to match suitable representatives with each target without relying on any external CRM software – all thanks to extensive demographic data.

Direct Mail

Although traditional postal mailings still generate considerable leads, there are alternative channels that prove to be much more effective. Direct mail is the tried and true method, while email can save on costs; however, many emails sent to physician offices fail to reach their intended audience. Postal ad campaigns fare slightly worse, but remain an important ingredient in the marketing mix.

Text messaging

A newer channel of communication has recently been gaining traction for its successful lead generating capabilities. Text messaging (SMS) is the fresh kid on the block. However, use it cautiously; text messaging has a high rate of penetration, yet it can be seen as intrusive. The "untouchable" physician isn't all that untouchable if you have a CarePrecise email list, but be sure to keep the message short and compelling, and include a shortened link to a landing page with the straight info on your product. As for telemarketing, bear in mind that the majority of your recipients will view your attempt to market something on their mobile device as unsolicited commercial messages – phone spam. That never looks good.

Sending bulk text messages may be tantalizingly easy with SMS gateway services, but they usually have an anti-spam policy that requires you to obtain the recipient's consent prior to sending any texts. CarePrecise data sets contain around 1,100,000 phone numbers for physicians, but be aware that while some of these are smartphones and some will be turned into voice mail messages by the recipient's phone carrier, a significant number will hit landlines and office phone system dead ends. Despite any technical glitches, the biggest fear should be your relationships with current physicians. Diligent list preparation is required to eliminate anyone you already connect with via more user-friendly mediums. Nonetheless, we are aware of some companies that are currently testing bulk SMS to doctors, both opt-in and cold call. It's believed that this channel will experience explosive growth over the coming years; however, it remains uncertain whether its advantages surpass the risks associated with such invasive techniques.

Email campaigns

It feels kind of thrilling to push the "Send Campaigns" button on a few tens of thousands of email messages. When I do it I even sort of push down hard on the mouse or screen so I can get all the tingly feels.

Constant Contact reports that email marketing has a return on investment of $42 for every $1 spent. There are some gotchas, of course, but email is the winner in overall ROI, while remaining perfectly legal to send unsolicited. The ideal email list is one that was collected by the practitioners' medical society, journals, conferences, and the like. Screen-scraped email addresses just, well, suck.

The problem with cheap, uncurated email lists is that even just one low-quality, high-rejection campaign can wreck your web domain, blacklist it, and send your company's regular business email messages into the junk box. Getting off of the blacklists is an expensive and slow process. A huge waste of money.

We are extremely cautious with our careprecise.com domain and would never be so sloppy. Rest assured that we carry that same care into our CarePrecise Preferred Email data stock. Our buyers develop trusting relationships with the societies, event producers, and medical journal publishers. Dirty email lists would damage that trust on all sides. Good email addresses, particularly physician emails, are expensive to acquire and maintain, especially when we try to get only the ones that the addressee has given permission to share. CarePrecise has developed a unique system for email hygiene that combines this impeccable sourcing with constant re-verification and campaign analysis. This analysis step examines the campaign reports of some of our larger customers to know, for instance, which of the three or seven email addresses we have for one physician should be the most effective.

Tips on sending email to physicians and other healthcare providers would fill pages, so instead, here's a link to our email sending best practices.

Just the good data, please

Ultimately, if you are determined to get in touch with physicians and their personnel, it's essential that you understand the protocols. Obtaining accurate data from a trustworthy source will give you the ability to communicate professionally and efficiently. With careful planning and employing innovative strategies utilizing this data, your organization can cultivate relationships of lasting trust. The ways that you use the data will make the biggest difference of all, and will be a significant driver of your competitive edge.

With CarePrecise, you can rest assured that reliable and comprehensive data will always be accessible – right there on your computer drive – so you can concentrate on what really matters: crafting compelling marketing campaigns with precision targeting to successfully reach your target audiences.

*Well, mostly the whole universe. A few packages that are designed for very specific applications, such as ScriptFax and ScribeFax, are not part of The Collection.

– Michael Christopher, Chief Analyst

Two Decades Later, CMS Releases Draft Rule on Claims Attachments

More than twenty years after the original HIPAA Transactions and Code Sets Final Rule established mandatory standards to simplify and expand the use of electronic data interchange (EDI) to transmit administrative healthcare messages electronically between providers and payers, CMS has finally released the Electronic Claims Attachment standard promised in that regulation.

More specifically, the draft regulation provides specifications for documents necessary to support both healthcare claims and prior authorizations. Also included are specifications for electronic signatures needed in association with these transmissions, and a version upgrade for some existing transactions already in use.

At a tidy 31 pages, the title is exuberantly verbose: Administrative Simplification: Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard. The first pages of the narrative are both a history lesson and a reference library tracing the development and evolution of the industry wide collaboration known as Administrative Simplification or, to participants, portmanteaued as "AdminSimp." I say "library," because as the authors, in explaining how we got to this point, generously footnoted -- and linked -- the key documents that mapped that progress.

For example:

9 CAQH CORE Report on Attachments: ‘‘A Bridge to a Fully Automated Future to Share Medical Documentation’’, CAQH CORE, May 9, 2019: https://www.caqh.org/about/press-release/caqh-core-study-reveals-five-opportunities-increase-electronic-exchange-medical.

That press release then points to the white paper: CAQH CORE Report on Attachments: A Bridge to a Fully Automated Future to Share Medical Documentation.

The comment period on the new regulation is open until 5 p.m. on March 21, 2023.  CMS will be hosting two informational calls with Q&A over the next few weeks. I'll be attending the one on January 25.

Physician and Nurse Burnout 2023

Beyond the increased patient loads due to the pandemic, and the increasing number of older Americans, other burnout-igniting factors are significant, if not as easily spotted. Data collection, which relies almost entirely on what clinicians record manually, has doubled in volume in the last decade. The increasing workload has had a dramatic effect on workflow efficiency and accuracy. This has caused both physicians and nurses to experience burnout as they struggle to attend to patient care needs while complying with burdensome regulations.

Many clinicians have had enough, and they're leaving the profession, or taking some time off. This has the effect of causing additional stress in the workplace as duties shift and workloads increase. Stressed administrators, who must deal with the costs and frustrations of staffing open positions, has risen along with frontline burnout. It's a vicious circle.

The causes of burnout

Burnout is a state of severe mental, emotional, and physical exhaustion typically experienced by those working in high stress environments. It can manifest itself due to an increase in workload, insufficient pay for workload, long hours and lack of rest or breaks, taking on an unmanageable patient load, or excessive amounts of mandated paperwork. All these factors can lead to feelings of extreme fatigue, cynicism about the job and its outcomes, and difficulty concentrating on tasks. If left unchecked and unaddressed, burnout can worsen over time and lead to depression or other health issues. Identifying the underlying causes behind burnout is essential in order to find ways of resolving them and reducing the negative externalities associated with this phenomenon.

The effects of burnout on patients and healthcare providers

Burnout among healthcare providers has a cascading effect on patients, leading to missed diagnoses or inadequate care. This is especially relevant in today’s world, where there is often a lack of physicians and significant nurse shortages. These issues can further compound patients’ suffering since they lead to long waits in waiting rooms with longer wait times for appointments. Burnout presents physical and psychological signs that require attention from both patients and healthcare providers; however, without sufficient numbers of providers and funding, burnout will continue to be a problem for the foreseeable future.

Steps that can be taken to prevent or reduce burnout

It's important for medical organizations to recognize these issues and take steps to reduce demands on frontline workers. Ultimately, we must find new ways to strike balance between improved workloads, accurate data usage, and the safety of patients.

To combat the effects of burnout, companies should take proactive measures to reduce stress among employees. Improved workflow can help by ensuring that processes are efficient and simple, so employees don't have to complete unnecessary tasks. Better equipment, such as faster computers with a quick response time can help employees work faster and with more confidence.

If a shorter work week is possible, consider allowing workers to come in for fewer hours, giving them a break from the hectic day-to-day schedule and allowing them to spend more time on leisure activities that can help to reduce overall stress levels. Finally, providing regular breaks throughout the day also helps reset focus and boost energy levels.

Staff up! Medical staffing is an art best practiced with the help of professional staffing companies, and offloading this part of the work can relieve some of the pressure on administrators, who keep their frontline staff informed about the staffing effort. This communication can relieve some of the concerns that the bosses aren't listening.

Coping with the burnout you feel right now

When you're already feeling the toll of burnout, it can be hard to take a step back. Self-care should be the first priority when it comes to handling burnout. Start by talking to your co-workers about how they are dealing with their workloads. Do not hesitate to ask for help and take some extra time for yourself during the day. Schedule some activities outside of work that allow you to re-energize and connect with others like social events or exercise classes. If possible, formally demand better equipment and systems so that everyone can manage their workloads more easily without sacrificing their well-being in the process. Self-care is essential when it comes to coping with burnout before it takes an even stronger hold on your life and job performance.

CarePrecise is interested in hearing from companies whose products or services can help alleviate burnout in the medical profession. Please contact us!

References

• Zhang, J., Grobler, L., & Saayman, A. (2017). Burnout: An Occupational Hazard in the Health Care Sector? Frontiers in Psychology, 8.

• Yirmiya-Rimmerman, N., & Yerushalmi Bar-Lavie, E. (2018). Conditions for preventing burnout among healthcare workers. International Journal of Nursing Studies, 84, 40-50.

• Harrison, C., Lobo, M., & Lambert, T. (2018). Staffing Strategies to Reduce Burnout and Increase Job Satisfaction among Healthcare Professionals: A Review of the Literature. Administration and Policy in Mental Health and Mental Health Services Research, 45(6), 867–876.

• Gill, T., Lippel, K., & Gallagher, D. (2018). Work-Life Balance for Healthcare Professionals: A Systematic Review and Meta-Analysis of Interventions for Burnout Prevention. International Journal of Environmental Research and Public Health, 15(3), 466.

• Nasrin Shokrpour, Leila Bazrafkan,1 and Marzieh Talebi (2021) The relationship between empowerment and job burnout in auxiliary health workers in 2019.

Helping Patients Find Care: Calculating for "Near Me"

Our CarePrecise Gold™ and CarePrecise Platinum™ customers have been wild about the geographic lookup of healthcare providers since we first introduced geographic radius search more than ten years ago in our CP ListMaker™ software. It's not a hard thing to do, and I'll show you how it works so you can use it in your own applications!

 All you need is a Zip Code® table that incudes longitude and latitude for the center of each zip if you want a rough estimation of distance (included in CarePrecise Gold and Platinum), or you can purchase our SelectGeo database that has the rooftop-level latitude/longitude pair ("geocode") for every U.S. healthcare provider's address.

The code we offer here is also included in CP ListMaker as open source, and it relies on some of the built-in functions available in VBA: the Sin() and Cos() math functions (sine and cosine), and a few others like the Abs() function (returns the absolute of a number).  All of the build-in functions can be found fully described at support.microsoft.com.

You can use the first function, CalcDistance(), to just return the distance between two points, or along with the others to list all of the spots in a miles radius from a central point. If you want to see only all of the physicians located within a radius, you would first create a query that filters for just physician locations. 

The Calculations

The magic happens with just three little Visual Basic for Application functions, shown below, which are pretty easily converted to VB or other code. After you create the CalcDistance() function, you send it the latitude and longitude of both locations, and it calculates the distance between them. 

Here's the VB/VBA code (shown as used in a Microsoft Access module)...

CalcDistance

This function calculates the distance between latitude/longitude pairs, and returns it in miles.

Public Function CalcDistance(lat1, lon1, lat2, lon2) As Variant

'This function calculates the distance between two latitude/longitude pairs.

Dim theta

Dim dist As Double

theta = lon1 - lon2

dist = Sin(deg2rad(lat1)) * Sin(deg2rad(lat2)) + Cos(deg2rad(lat1)) * Cos(deg2rad(lat2)) * Cos(deg2rad(theta))

If dist > 0 Then

    dist = dist - 0.00000000000001

End If

dist = acos(dist)

dist = rad2deg(dist)

dist = dist * 69.09

CalcDistance = dist

End Function

The Radius Functions

Use these functions to return the points of interest within a radius from a central point:

Public Function acos(Rad)

  If CDbl(Abs(Rad)) <> 1 Then

  acos = (pi / 2) - Atn(Rad / Sqr(1 - Rad * Rad))

  ElseIf Rad = -1 Then

    acos = pi

  End If

End Function

Public Function deg2rad(Deg)

    deg2rad = CDbl(Deg * pi / 180)

End Function

Public Function rad2deg(Rad)

    rad2deg = CDbl(Rad * 180 / pi)

End Function

Geocoding Applications

One of the most common applications of this code, used in tandem with our healthcare provider databases, is in web apps that help patients find nearby providers. CarePrecise physician, hospital and clinic data powers many online applications and services – some may be familiar to you (we maintain NDAs with our clients so we won't list them here).

Once a patient has chosen a nearby provider, the CalcDistance() function is used to say just how far away it is. Integration with Google Maps or another mapping API can then map the route using the coordinates from our SelectGeo database. 

This is some of the hardest working code out there, and the uses abound. Play with it!

Note: CarePrecise does not offer technical support on the open source code we publish. We put all of our efforts into supporting our data products! To get a copy of CP ListMaker, complete with center-zip geocodes for all U.S. zips, you can either purchase CarePrecise Gold, Platinum, which have include data on all HIPAA-covered U.S. healthcare providers, or just the CP ListMaker add-on (with no provider data).

- Michael

Point of Interest Hooks for All U.S. Healthcare Providers

There's a new world of data available from a new class of vendors that can be linked together by the establishment of a universal Point of Interest code that pegs the physical location (the "where") and in some cases even encodes the business name (the "who"). In CarePrecise provider databases, POI-encoded facility information identifies essentially every facility in the U.S. healthcare system, and makes it connectable to other datasets. 

Visitor Traffic Reporting

Want to know how much visitor traffic a given doctor's office gets in a week? That data is available from third party sources, and can be linked in to the CarePrecise provider data using the Placekey™ POI code that CarePrecise appends to almost every* address in the NPI Registry and beyond.

Placekey Integration

CarePrecise invested heavily in creating a system that updates approximately 8 million healthcare provider POI records every month, keeping up with changes in address, new providers, and dropping deactivated providers. Furthermore, CarePrecise keeps historical data for every month, so that location changes can be tracked over time. 

Note: CarePrecise also provides a separate database, Select Geo, that contains latitude and longitude for every geocode-compatible U.S. healthcare provider location in the federal National Provider Identifier registry. This is used in applications that calculate distances and travel time between provider locations, and between patients and prospective providers, such as doctor-finder sites.

The addition of Placekey to CarePrecise data enables a clearer view into healthcare sites — clinics, physician offices, outpatient facilities, hospitals, and the whole panoply of facility types. Because CarePrecise links individual practitioners to their affiliated practice group businesses and the hospitals they are affiliated with, rich patterns emerge when connecting CarePrecise provider networks data to visitor traffic and revenues data. 

Competitive Healthcare, Meet a New Challenge

Whereas the healthcare industry is aggressively competitive, with organizations suppressing intelligence to the fullest extent possible, these new business intelligence pathways represent an unprecedented level of visibility into provider practices vis a vis their patient volumes. Reasonable, actionable assumptions can be made on practices' patient base—despite their closely-held business information—when cross-referenced with the demographic, psychographic, and economic data available on visitor traffic.

*Not all address fields can be parsed to produce a Placekey code or geocode; in particular, street addresses in Puerto Rico use so many non-normalized (GPS readable) addresses. Even CarePrecise's proprietary CoLoCode (uniform address code) has difficulty with many such addresses, though GPS compatibility is not a factor in creation of the CoLoCode.

Again: Call for CMS to Release Tax Numbers

It's 2022 and still CMS fails to include healthcare organizations' tax numbers. Whether you call them TIN or EIN the numbers are not sensitive in any way, and the Centers for Medicare and Medicaid Services should release them. This is a repost of an article from 2010, more than 3 years after the first NPI Registry data was made public - except, of course, for those tax numbers:

____

The NPI Final Rule called for CMS to establish a system that would assign a National Provider Identifier (NPI) number to essentially every healthcare provider in the U.S. (HIPAA "covered entities"): now more than 3 million providers and growing. Great. But it was years before CMS released that data for the industry to use. CarePrecise personnel were at the forefront even back then, calling for CMS to release the data. If necessary, we were ready to fight for it, filing our own request under the Freedom of Information Act (FOIA). Federal agencies can't keep such kinds of data from the public. It's the law. CMS eventually looked at FOIA, and at their provider data, and decided that, sure enough, they were going to have to release it. We and our clients were ecstatic; now the industry would be able to produce the complex crosswalks necessary to actually achieve the efficiencies promised by the Final Rule.

Hurray... except CMS decided not to release one of the most useful data points of all. A provider's federal tax number is hardly a private number. Businesses have to give their tax number on every imaginable type of transaction. Employees see the employer's number on their W-2s. CMS's excuse was that sole proprietors and pretty much all individual practitioners would have to give their Social Security Number, or that busy doctors might type in the SSN in the wrong spot. Fair enough, but, as everyone who works with data knows, it's a piece of cake to parse a tax number field to determine if the number is a SSN or a business tax number. In fact, that's just exactly what CMS does in the Other ID fields of the NPPES (National Plan and Provider Enumeration System) database, replacing 000-00-0000 with a string of equals signs.

Instead of just redacting the SSNs, CMS decided it was best just to wipe clean the complete Employer Identification Number (EIN) field -- just in case some uppity docs got... uppity. Many of us have been hoping that CMS would revisit the issue of this gaping hole in the provider data, but it seems that the issue is to be ignored so that it will just go away.

So, here we are, once again, years into it, asking CMS to release non-SSN tax numbers/EINs so that we -- health systems and health plans large and small, clearinghouses, HIT vendors, medical billing and coding vendors -- can make this data do what it was intended to do for healthcare and for the taxpayers.

____

Check out the NPI information at CarePrecise.

Artificial Intelligence In Healthcare

The healthcare industry is on the brink of major transformation, thanks to healthcare-related advances in artificial intelligence. Healthcare organizations around the world, and governments, are beginning to integrate AI into their systems and processes. With AI, healthcare providers are able to improve medical diagnostics accuracy and automate administrative tasks, while improving patient care. In this blog post, we will explore how healthcare will change and the potential impact of AI on healthcare.

Advances in Medical Diagnostics

AI has the potential to revolutionize healthcare by greatly improving medical diagnostics accuracy. AI-powered tools are being used to help healthcare professionals diagnose diseases more quickly and accurately, as well as identify healthcare trends that may have previously gone unnoticed. Furthermore, AI technology can be used to monitor patient vitals in real time and detect early warning signs of disease.

Automation of Administrative Processes

The healthcare industry is full of administrative tasks that take up a considerable amount of time and resources, from filing paperwork to scheduling appointments and managing patient records. AI can automate these processes in ways that may not occur to human workers, to free up the humans to provide more focused care on the most complex cases. AI can also provide healthcare organizations with better insights into patient care and help healthcare professionals make more informed decisions.

Improved Patient Care

AI has the potential to drastically improve healthcare outcomes by providing healthcare professionals with improved data about patients, allowing them to take preemptive action or provide targeted healthcare services. AI can also be used to track healthcare trends and identify areas where healthcare quality measures could be improved.

Improved Clinician Workplaces and Opportunities

Physician offices can be made far more efficient with AI in the picture. HCC risk management is one area where AI can be used to find missed opportunities, and to strengthen Medicare reimbursement profiles. AI can often see what humans can't, either because some details just are not apparent, or because clinicians and admin personnel are overburdened with just getting through the day. In the constant struggle to keep patients as the top priority over paperwork, AI-driven systems from companies like Hindsait and MDOps can take on a share of the workload.

Caveats

From the patient's perspective, will AI depersonalize medical services? If workflow streamlining cuts the wrong corners, who will suffer? Artificial intelligence, by its very nature, is a "black box." In many cases, advanced AI is very much like a person, in that it can be difficult or impossible to understand how its "thinking" works. AI needs to develop better "talk back" capability, so that human users can interrogate the system to correct errors - to ask how it is arriving at a given conclusion, and then to correct its "thinking," much as you would reshape a human employee's perceptions to obtain the most desirable outcomes. At present, such capabilities are not present, or are not being adequately utilized by the system's handlers in some environments. Busy practitioners haven't yet "merged" with these systems such that deliberate feedback is part of the clinical workflow. This will take time, and probably a few high profile mistakes. Progress here is a bit like the early progress of the medical profession. We're just now emerging from the blood-letting phase of AI, and we must hone strategies for better control of the new tools.

As HCOs begin to adopt AI-powered tools, healthcare processes, patient care and healthcare outcomes are set to improve significantly. AI will allow practitioners to diagnose diseases more accurately, automate administrative tasks, and gain insights into healthcare trends, enabling them to provide more informed and targeted care to their patients. At the end of the day, AI has the potential to revolutionize healthcare and significantly improve patient outcomes, while the cost of progress is bound to include some failure. All stakeholders, from patients to health systems to government, need to be informed as AI involvement increases, and become girded for the journey.