Daniel Salzberg | Healthcare Technology, Richmond VA

Originally published at danielsalzberg.com . Integration is an operating strategy Healthcare technology works only as well as the clinical and operational alignment behind it. Over the past twenty years, health systems have moved from scattered software to connected digital networks. Even so, bringing administrative platforms, clinical documentation tools and specialized applications together into one enterprise framework is still one of the hardest jobs facing healthcare leaders. To build a technology environment that supports providers and improves patient care, organizations need to treat integration as a core operational strategy and not as a string of separate IT projects. Start with a consolidated foundation Before you bring in a large platform like an electronic medical record (EMR) system, standardize the ancillary systems around it. When laboratory, imaging and administrative tools run on fragmented architectures, enterprise rollouts get costly delays and workflow bottlen...

Originally published at danielsalzberg.com . In healthcare and health tech, operational excellence is usually judged by numbers: turnaround times, system uptime and cost efficiency. Those benchmarks matter, but lasting resilience depends on an organization's culture and on how well its service delivery lines up with its goals. As digital health tools become part of routine care, executives have to make sure that scaling operations doesn't water down the experience customers and patients have. Closing the gap between technology and service takes three things: aligning internal teams, modernizing support, and building a culture that keeps improving. Turn support into a proactive function In health technology, customer service and support can no longer work as a reactive help desk. Operations teams need to anticipate bottlenecks before they reach clinical care or administrative workflows. Proactive service rests on three things: Clear escalation paths. Field representatives, ...

Originally published at danielsalzberg.com . Why operations matter now Healthcare is changing fast. Delivery models are evolving, technology is moving deeper into clinical workflows, and patients expect more personal service. All of that puts more demand on strong operational frameworks. For executive leaders, balancing administrative efficiency with excellent patient outcomes is more than an operational goal. It is the foundation of an organization that holds up under pressure. Take the friction out of workflows Operational friction in healthcare rarely comes from one system failing. It builds up in the handoffs between teams, systems and patient touchpoints. When customer service and operational protocols line up: Communication gaps shrink. Real-time data sharing means clinical and support staff work from the same information. Turnaround times improve. Streamlined administrative logistics let providers focus on patient care and not on system hurdles. Resources are used bette...

Originally published at danielsalzberg.com . Telehealth solved the immediate problem of patient access during a crisis. Access alone, though, doesn't make care effective or scalable. As healthcare moves toward value-based models, organizations are finding that a video visit is mostly a digital copy of the clinic appointment. It doesn't change how care is delivered or monitored. The next step in virtual care is to move from occasional telehealth visits to continuous, objective remote monitoring. Making that move in a health system or clinical practice is rarely a clinical challenge first. It's an operational and systems challenge. Without solid operations behind it, continuous data turns into administrative overload, alert fatigue and broken clinical workflows. To scale remote patient monitoring (RPM) well, leaders have to look past basic biometrics and deal with what continuous virtual care takes to run day to day. Beyond static numbers: movement monitoring First-genera...

Originally published at danielsalzberg.com . Expanding a remote patient monitoring (RPM) or chronic care management (CCM) program is rarely a technology problem. It's a problem of operational execution. Digital health tools promise better outcomes and wider reach, but scaling these programs creates friction in device logistics, data integration and patient follow-through. To build remote care that holds up, operations leaders have to look past platform features and remove the bottlenecks that drain resources and get in the way of care. Logistics: take the hardware drag out Buying, setting up and shipping cellular or Bluetooth-enabled devices to patients can swamp an internal team. When fulfillment is handled in-house without dedicated systems, tracking shipments, managing inventory and handling returns eat up a lot of time. Ship direct to the patient. Work with a logistics provider or device vendor that can pre-configure equipment and send it straight to the patient's home...

Originally published at danielsalzberg.com . If you run a remote patient monitoring (RPM) or chronic care management (CCM) program, clinical buy-in isn't enough. The program also has to pay for itself and stay on the right side of the rules. CMS keeps refining its reimbursement rules and tightening oversight, so a business case for RPM depends on keeping up with policy changes and getting claims through clean. To turn digital health from a cost center into something that earns its keep, operations has to line up with current Centers for Medicare & Medicaid Services (CMS) guidelines and the coding behind them. Know the core CPT codes RPM reimbursement depends on following the Current Procedural Terminology (CPT) codes exactly. If you misread a time threshold or a documentation requirement, you get denied claims and audit exposure. CPT 99453 (initial setup): covers setup and teaching the patient to use the equipment. Billable once per episode of care, after the device is set...

Originally published at danielsalzberg.com . I've spent much of my career watching healthcare buy technology faster than it can absorb it. Health systems have spent billions on EMRs, portals and analytics platforms, and clinicians are still charting late into the night. The next ten years won't go to the organizations that adopt the most technology. They'll go to the ones that turn it into better decisions where care happens. Here's where I think things are going. From snapshots to continuous data A lot of medicine still runs on snapshots. A patient comes in, we take a few measurements, ask how they've been feeling, and decide based on about fifteen minutes. What happened between visits mostly stays invisible. That's starting to change. Remote monitoring, wearables and measurement tools in the clinic give clinicians a running picture instead of a single frame. The point isn't to collect more data. It's to know sooner whether a patient is getting bett...

Originally published at danielsalzberg.com . In Part 1 I argued that movement is a vital sign we don't measure. The obvious next question is where you'd measure it, and my answer is not the clinic. Why the clinic is the wrong place to start A functional test at a clinic visit gives you one number. It's taken in a room the patient doesn't know, usually once or twice a year. That tells you how someone moved that day. It doesn't tell you if they're getting stronger, slowing down, or getting close to a fall. To see a trend you need a lot of readings, and the only place you get a lot of readings is at home. What the research shows so far The simple tests most clinicians already know, like the chair stand, five sit-to-stands and Timed Up and Go, seem to hold up when the patient does them at home. In one study, older adults did the tests in their own homes while one rater watched in person and another watched by video, and the two scored them almost the same ( stud...

Daniel Salzberg · VP of Operations, BioMech Health · Richmond, Virginia · danielsalzberg.com I've spent about 25 years in healthcare technology. Most of that time has come down to the same job: figure out what clinicians and operations teams actually need, then find technology that gets it done without making their day harder. Where I started My first healthcare job was at Vidant Medical Center (now ECU Health) in Greenville, North Carolina, where I built a documentation program for the Surgical Services department. From there I went to SUNY Upstate Medical University in Syracuse and ran technology for the Department of Surgery. Both jobs taught me early that the people doing the work usually know exactly what's broken. You just have to ask them. Nine years at Bon Secours In 2006 I moved to Richmond to join Bon Secours Health System. My first big assignment was standardizing our ancillary systems so they could connect cleanly into Epic. One project I'm still proud of ...

Originally published at danielsalzberg.com . Part of the Healthcare, Measured series: Movement as a Vital Sign, Part 1 of 6. Every clinic visit starts with the same few numbers: blood pressure, heart rate, temperature, breathing rate, oxygen level, and often a pain score. They take a couple of minutes, they're recorded the same way everywhere, and they go into the record where they can be trended, flagged and used by the systems that help with clinical decisions. What's usually missing is how the patient moves. Can they stand up from a chair without using their arms? How fast do they walk? How steady are they when they turn? For a lot of patients, especially older adults, people recovering from surgery and people with chronic conditions, that tells you more about their health than almost anything else on the chart. We mostly capture it by eye, in a line of free text, or not at all. This is the first of six posts in a series I'm calling Healthcare, Measured. The idea is to...