The Collective Voice of Health IT, A WEDI Podcast

Episode 162: Workgroup Voices, The Inner Workings of Prior Authorization

Michael welcomes 3 of the 4 co-chairs of WEDI's Prior Authorization Subworkgroup:

• Heather McComas, Director, Administrative Simplification Initiatives, American Medical Association
• David Delano, Senior Director of Services, Massachusetts Health Data Consortium
• Raj Godavarthi, Associate VP of Technology and Interoperability, MCG Health

The 3 discuss the changes in the workgroup and the industry since the January 2024 release of the CMS Interoperability and Prior Authorization rule, the exciting role of artificial intelligence in PA, and how their unique stakeholder roles offer a full, detailed dialogue during their monthly meetings. 

Tons of Prior Authorization-related education coming to you courtesy of WEDI. Visit wedi.org and click CALENDAR for more information

Ep 161: Simplifying Healthcare: WEDI’s Approach to Eligibility and Benefits.

Michael welcomes Donna Campbell (HCSC) and Amanda Abbott (BCBS of Kansas), WEDI's Eligibility and Benefits Workgroup Co-Chairs. The co-chairs discuss the workgroup's missions and the latest discussion topics that workgroup is undertaking, including improving efficiencies in the E&B process through standards and emerging technology.

If you are interested in joining the workgroup, contact Ariana Poole at apoole@wedi.org.

You must be a WEDI member to join. To become a WEDI member, contact Bill Allder at ballder@wedi.org

Ep 160: Top 10 Cybersecurity Tips for Health Care. A Chat with WEDI's Privacy and Security Workgroup Co-Chairs

The threat from cyberattacks is growing exponentially and health care organizations are particularly vulnerable. Michael chats with WEDI's Privacy and Security Workgroup Co-Chairs, Lesley Berkeyheiser of DirectTrust and Thanh-Thien Nguyen of Kaiser Permanente on suggested actions that health care organizations big and small can adopt, customize, and implement as they seek to establish good cyber hygiene.

 

The top 10 list will be available soon on wedi.org

Ep 159: Interoperability Matters, Sequoia Projects Payer to Payer Workgroup

From WEDI's Spring 2024 conference, Sequoia's David Pyke moderates a conversation with its Payer to Payer FHIR API Implementation Workgroup Co-Chairs, Robert Oakley with Evernorth and Nancy Beavin with Medica. Learn more about the workgroup here- https://sequoiaproject.org/interoperability-matters/payer-to-payer-api-workgroup/

 

Episode 158: Slow and Steady, How Health Care is Progressing Toward Value Based Care. Lynn Carroll, HSBlox

Guest host Michael Pattwell, WEDI Board Members, Co-Chair of its Payment Models Workgroup, and Principal Business Advisor with Edifecs, chats all things value based care with Lynn Carroll, Chief Operating Officer of HSBlox. 

The two offer a fascinating look at the progression from fee for service to value based care, recent models launched by CMS, and the importance of data interoperability and standards in improving value based care delivery and contract administration.

Episode 157- Embracing and Understanding Data & its Challenges in the Digital Health Age

Michael chats with RJ Kedziora, Co-Founder of software company Estenda about the evolution of digital health and digital therapeutics. The two discuss the advances in emerging tech, privacy and security challenges, the role of regulations and the hopes that digital health can break down those data silos that still plague us. 

Estenda is holding a webinar; Driving Quality in Digital Health: The Role of Generative AI in Testing, on June 14th from 12pm- 1pm eastern. Find out more below. 

https://www.eventbrite.com/e/driving-quality-in-digital-health-the-role-of-generative-ai-in-testing-tickets-902441475747

Episode 156- Streamlining Health Care: The Essentials of Administrative Simplification. A Conversation with CMS National Standards Group Director Michael Cimmino

The Centers for Medicare & Medicaid Services National Standards Group, within the Office of Burden Reduction and Health Informatics, focuses on reducing administrative burden and advancing interoperability and national standards. CMS engages beneficiaries and the health care community to understand their experiences, inform solutions, and infuse a customer-focused mindset throughout the agency.

Michael welcomes CMS NSG Director Michael Cimmino to the podcast to discuss the who, what, where, when and why of administrative simplification and burden and how a standard becomes a standard. 

This is part 2 of a 2 part podcast conversation with CMS NSG on Administrative Simplification. Coming soon, an episode on enforcement. Learn more about CMS' work on admin simp at go.cms.gov/adminsimp

Episode 155. Safeguarding Healthcare: WEDI Insights on Cybersecurity and Continuity

In April 2024, WEDI held a member position advisory (MPA) event on the critical topic of maintaining business continuity within healthcare organizations in the wake of cyber-attacks. The event, entitled, From Crisis to Continuity: Maintaining Health Care Data Exchange Following a Cyber Attack, offered best practices, suggestions, and key steps that stakeholders from HHS and the private sector can consider when exchanging data, processing information, and maintaining lines of communication. From WEDI’s recently concluded Spring conference, a debrief of the MPA event presented by WEDI’s privacy & security workgroup co-chairs, Lesley Berkeyheiser with DirectTrust and Thanh Thien Nguyen from Kaiser Permanente.

Episode 154: Hybrid Horizons: Balancing Security and Employee Satisfaction in the Workplace. Denis O'Shea, Mobile Mentor

Michael chats with returning guest Denis O'Shea, Founder and Chairman of Mobile Mentor, about their 2024 Endpoint Ecosystem Study, which explored the intricate dynamics of hybrid work in high-risk and highly regulated industries. Conducted across the United States, Great Britain, and Australia, the study involved 2,400 knowledge workers in healthcare, finance, government, and education to understand employee attitudes and their actions related to company security and their experience, and their productivity as remote workers.

Review the study at https://endpointecosystem.com/

Episode 153: (Part 2) Health Equity Data Efforts from a Federal Perspective

A continuation from last week's episode on health equity data efforts from the federal perspective.

 

Our moderator is Nancy Spector, Coding and HIT Advocacy Director at the AMA and former WEDI Board Chair.

Our panel:

• Kristie Clarke, CDR, US Public Health Service, Senior Advisor on Data for Health Equity, Office of Public Health Data, Surveillance, and Technology, US Center for Disease Control and Prevention
• Kelly Cronin, Director, Center for Innovation & Partnership, Deputy Administrator, Administration for Community Living, HHS
• Jawanna Henry, Interoperability Systems Branch Chief, Office of Policy, Office of the National Coordinator for Health IT
• Meagan Khau, Director of Data Analytics& Research Group, CMS Office of Minority Health