Implementing QHINs Interoperability Part 4

by | Jul 18, 2025 | Admin, Regulatory

by Ben Rosen, Sr. Client Success Manager, Netsmart

Interoperability

What You Need to Know About Interoperability and How it Affects You: Part 4

For over two decades, tech companies and government agencies have been moving toward the goal of interoperability in healthcare technology. At long last, standards and protocols are in place—and continually being improved—to support open data exchange networks. As a result, healthcare providers, including human services, post-acute providers and specialty practices, have more opportunities to participate in alternative payment models and adapt more readily to the evolving payment landscape.

This is part four of a four-part series covering the forces that are driving interoperability, as well as the future vision of open networks, and what it all could mean to your organization. Read Part One Here; Read Part Two Here; Read Part Three Here.

Interoperability in Healthcare

QHIN Implementation, Use Cases, and Benefits

Qualified Health Information Networks (QHIN) can support a range of use cases, including treatment, payment, healthcare operations, public health reporting and patient access to their records. These are referred to as Exchange Purposes (XPs), and all QHINs must facilitate a request for this data. The difference lies with how QHINs facilitate those requests and provide that information to you as a participant. The data uses the same network that all QHINs have built too, but there is value in what your current technology vendor can do with the data.

Complete Information Supports Decision-Making and Compliance

By enabling data exchange, QHINs help ensure providers have access to complete, up-to-date information that has the potential to improve decision-making and reduce redundant tests. The Trusted Exchange Framework and Common Agreement™ (TEFCA) network also supports the exchange of more robust types of data than before, offering participants more holistic views of individuals to support a whole-person care approach.

A QHIN can help your organization stay compliant with interoperability mandates designed to align technology with regulatory requirements, such as the 21st Century Cures Act and TEFCA. As the data exchange landscape shifts toward a more regulatory-based landscape with TEFCA at the core, remaining in compliance with certification requirements becomes increasingly important.

Complete Information Interoperability QHIN

Preparing for TEFCA and QHIN Participation

As outlined in Part 3 of this blog series, getting the most out of joining a QHIN starts with assessing your current interoperability capabilities:

  • Identify gaps in your data exchange processes and data needs
  • Collaborate with your EHR vendor to ensure technical readiness and ensure they can accommodate the QHIN data to be used with your EHR
  • Explore QHIN options and compare their offerings for your current EHR features and functionality
  • Understand and create a plan for your organization to use or increase the use of FHIR-based integrations

Once you’ve determined which QHIN will work best for your organization, you can begin nailing down specifics and start planning implementation.

Costs, Implementation and Onboarding

Costs vary by QHIN vendor and may include membership fees, transaction fees and additional charges for optional services.

Onboarding typically includes:

  • Technical integration into your EHR
  • Staff training
  • Testing and validation of data exchange
  • Establishing compliance with TEFCA requirements/signing agreements to participate

Joining the TEFCA network is built into some existing integration processes and capabilities. There are legal agreements specific to TEFCA to sign, but all technical implementations are much easier to facilitate as an already existing EHR client, assimilating into already existing workflows.

Security and Privacy

QHINs are required to meet strict security and privacy standards under TEFCA, including compliance with HIPAA and other relevant regulations. All QHINs are HITRUST-certified and ensure robust security backing for all network transactions and therefore must have incident response and mitigation procedures in place in case of a security incident. It’s important to understand the full enterprise security plan for the QHIN you decide to use and how they protect all of their solutions/programs, not just QHIN.

It’s important to understand the full enterprise security plan for the QHIN you choose and how they protect all their solutions/programs, not just QHIN. Choose a partner with a robust history as an ONC-certified EHR vendor so your data is protected in all facets of exchange. Verify enterprise-wide security procedures and incident response plans.

Regulatory Benefits and Use Cases

By selecting a QHIN and participating in a nationwide interoperability framework, your organization can stay ahead of regulatory changes, improve patient outcomes and reduce the administrative burden of managing multiple data exchange partners. With the changing regulatory landscape, including the HTI-1 and HTI-2 rules, all ONC-certified vendors must abide by those parameters. TEFCA is taking a more central role in helping to prep organizations and users to be compliant with those regulatory standards. For this reason, QHINs with a rich history of ONC certification and who have regulatory staff will have an advantage.

Exchange Purposes

Under TEFCA, QHINs will facilitate the exchange of multiple types of data, referred to as Exchange Purposes (XPs). Initially, there were six core XPs that were revealed for TEFCA:

  • Treatment –To support the provision, coordination or management of healthcare among providers
  • Payment–For activities related to billing, claims and reimbursement under HIPAA
  • Healthcare Operations–For administrative, quality improvement and other operational functions
  • Public Health–To support public health authorities in disease surveillance, reporting and response
  • Government Benefits Determination – To help determine eligibility for government programs, such as Medicaid
  • Individual Access Services – To empower individuals to access their own health data securely and conveniently

These XPs have now been expanded to include subtypes that can be read about here, via the RCE approved resource and SOP. As mentioned previously, all QHINs will be required to support the exchange of these XP’s, and all participants of QHINs will be required to respond to Treatment and Individual Access Services. An important deciding factor when choosing a QHIN is to understand the workflows to receive this information into your EHR, as well as the capabilities to persist and action the information.

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Interoperability Ben Rosen Netsmart
Interoperability Ben Rosen Netsmart

Ben Rosen is a senior client success manager and business unit owner for the interoperability solution suite at Netsmart. With more than a decade of healthcare experience, Ben has led numerous initiatives to integrate healthcare systems and enhance data sharing across the care continuum. His dedication to advancing healthcare interoperability drives his active involvement in industry initiatives and standards organizations, where he provides insight for frameworks such as HL7 FHIR, USCDI and others. Ben holds a Bachelor of Science in kinesiology from Kansas State University and a Bachelor of Science in nursing degree from the University of Nebraska Medical Center.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in the Netsmart blog and is reprinted here with permission. For more information or to request permission to print, please contact Netsmart.

Evaluating QHINs Interoperability 3

by | Jun 27, 2025 | Admin, Clinical, Regulatory

by Ben Rosen, Sr. Client Success Manager, Netsmart

Interoperability

What you need to know and how it affects you Part 3

For over two decades, tech companies and government agencies have been moving toward the goal of interoperability in healthcare technology. At long last, standards and protocols are in place—and continually being improved—to support open data exchange networks. As a result, healthcare providers, including human services, post-acute providers and specialty practices, have more opportunities to participate in alternative payment models and adapt more readily to the evolving payment landscape.

This is part three of a four-part series covering the forces that are driving interoperability, as well as the future vision of open networks, and what it all could mean to your organization. Read Part One Here; Read Part Two Here.

Interoperability in Healthcare

Evaluating QHINs for your Organization

As outlined in Part Two of this series, all Qualified Health Information Networks (QHINs) must apply and be accepted according to the baseline requirements outlined by the Trusted Exchange Framework and Common Agreement (TEFCA). While the rigorous testing and project tasks for each QHIN are the same, they may differ in services offered, geographic focus, technical capabilities, pricing and specific target markets. This blog will explore similarities and differences between QHINs, to provide insights that will arm organizations with the knowledge needed to make informed decisions about selecting a QHIN.

How to choose the right QHIN for your organization

As with any major business decision, consider what your organization is currently doing for data exchange and connectivity and how these factors are likely to change in the next 18 to 24 months:

  • The services you provide today and with whom you exchange data.
  • The communities you serve.

Prospective QHINs should have experience in serving the technology needs of the communities you serve and exhibit an understanding of how your service lines could impact the types of data transactions you use. If your strategic plan calls for expanding your services or community footprint – either organically or through partnerships with other providers – you’ll need to consider how your current needs will evolve and how that will affect your QHIN criteria.

QHIN candidates should have experience working with your electronic health record (EHR) vendor and be able to manage a smooth integration with your existing technology. Compatibility with your

EHR will help simplify implementation and further establish the network as a good fit for your organization. Integration capabilities of the QHIN should lend well to your current EHR build, such as being able to integrate the QHIN data directly to your EHR workflows.

Consider technical requirements

Each QHIN will have to build to and abide by the same standards for exchange via TEFCA. These requirements are outlined in the Common Agreement and the QHIN Technical Framework documents. Differentiation among QHINs will come from doing an analysis of your organization’s data exchange requirements and then determining how well they match up with the technical infrastructure and capabilities of the QHINs.

If your service lines require special consent practices or you do business in a state with strict data laws, it is paramount that your QHIN be technically capable of handling your most complicated information sharing needs from day one. Network 

Technology

size and geographic coverage should also factor into your decision as well as the QHIN business itself. QHINs today fall into categories such as developer platforms, data exchanges, and EHRs.

Questions to ask your QHIN short list candidates

Use the previously mentioned factors to focus on your top candidates, then it’s time to start asking about specifics:

  • Cost structure and pricing

    • QHINs may charge a per-transaction fee for their connectivity services. The specific services they can charge for are outlined by TEFCA, but the amount they can charge is not. Be sure to ask about ongoing costs and transaction fees so you can accurately project costs.

  • Additional services, such as analytics or public health reporting

    • All QHINs can provide you with connectivity for data exchange. But you should also explore each QHIN’s ability to provide reporting, analytics and other value-added services that will help you relate that data to your organizational goals.

  • Customer support and ease of onboarding

    • Ask about the onboarding process, how long it typically takes and the level of support you can expect from start to finish.

  • Plans to implement FHIR

    • QHINs will all be held to the same FHIR (Fast Healthcare Interoperability Resources) standards for exchange via TEFCA. When evaluating FHIR capabilities for QHINs, it’s important to understand what the QHIN’s strategy is around subscription services and bulk data access. This also ties into the consideration that even though a QHIN may support FHIR standards, you need to evaluate how well those pieces of information are actually integrated so you receive the information in a usable form.

  • Ongoing compliance with TEFCA and security standards

    • Technology companies must meet strict standards to become a QHIN. But you should also inquire about further monitoring and safety measures that guard against breeches of security and other concerns.

  • Total transactions and how different kinds of transactions are managed

    • Ask vendors for metrics around total transactions facilitated on their network and how they manage the different exchange types that are available via TEFCA. You also should find out ratio of errors to successes they have with their current network participants.

Final Thoughts

Due diligence is always essential whenever you choose technology. Scrutinizing all the factors outlined above for QHINs is particularly important because of the potential they will have for enhancing data sharing throughout your organization. In the final part of this blog series, we will explore actual QHIN use cases and the benefits they may offer.

Coming soon in Interoperability Part 4:QHIN implementation, use cases, and benefits.

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Interoperability Ben Rosen Netsmart
Interoperability Ben Rosen Netsmart

Ben Rosen is a senior client success manager and business unit owner for the interoperability solution suite at Netsmart. With more than a decade of healthcare experience, Ben has led numerous initiatives to integrate healthcare systems and enhance data sharing across the care continuum. His dedication to advancing healthcare interoperability drives his active involvement in industry initiatives and standards organizations, where he provides insight for frameworks such as HL7 FHIR, USCDI and others. Ben holds a Bachelor of Science in kinesiology from Kansas State University and a Bachelor of Science in nursing degree from the University of Nebraska Medical Center.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in the Netsmart blog and is reprinted here with permission. For more information or to request permission to print, please contact Netsmart.

TEFCA and QHINs: Interoperability 2

by | May 29, 2025 | Admin, Clinical, Regulatory

by Ben Rosen, Sr. Client Success Manager, Netsmart

Interoperability

What you need to know and how it affects you Part 2

For over two decades, tech companies and government agencies have been moving toward the goal of interoperability in healthcare technology. At long last, standards and protocols are in place — and continually being improved — to support open data exchange networks. As a result, healthcare providers, including human services, post-acute providers, and specialty practices, have more opportunities to participate in alternative payment models and adapt more readily to the evolving payment landscape.

This is part two of a four-part series covering the forces that are driving interoperability, as well as the future vision of open networks, and what it all could mean to your organization. Read Part One Here.

Interoperability in Healthcare

The creation of TEFCA and QHINs

TEFCA (Trusted Exchange Framework and Common Agreement) is a national framework designed to enable seamless, secure sharing of health information across organizations. With respect to EHRs, this framework simplifies data exchange with other providers, payers and public health entities while enhancing compliance with interoperability requirements. TEFCA is touted as a nationwide federal and private data exchange network.

End goal

One of TEFCA’s main goals is to standardize data sharing, therefore reducing the complexity of managing multiple connections and enhancing the interoperability of your EHR with other systems nationwide.

TEFCA was created by the U.S. Department of Health and Human Services’ Assistant Secretary for Technology Policy (ASTP). The ASTP is contracting with the Recognized Coordinating Entity (RCE), The Sequoia Project. The RCE is tasked with governing and maintaining the operations of the entities who are electing to implement the TEFCA network, these entities are referred to as Qualified Health Information Networks (QHINs).

Interoperability
Interoperability TEFCA QHIN

QHINs

The certification process

QHINs are the entities that build the frameworks to allow data exchange as specified by TEFCA and facilitate the national exchange of health information. A single QHIN may represent dozens or even hundreds of healthcare providers, referred to as participants or sub-participants, across sectors (i.e., acute, human services, post-acute) public health agencies, health IT vendors and payers.

Applicants must build their TEFCA connection, which is then subjected to rigorous technology and security testing. QHIN applicants must also sign the Common Agreement that is countersigned by The Sequoia Project. These rigorous standards have a time limit: Each QHIN who applies must have their network built, tested and designated by the ASTP and RCE within 12 months of the application acceptance date. As of this writing there are eight designated QHINs and two candidate QHINs.

Benefits of participating in a QHIN

  • Streamlined Data Exchange
  • Compliance with Federal Interoperability Mandates
  • Access to Broader Patient Data
  • Improved Care Coordination

The market is already seeing regulatory rules and guidance tied directly to TEFCA. For instance, HTI 1 rule laid the groundwork for TEFCA and the HTI 2 rule is expanding on the process for designation, as well as codifying definitions and use cases to be exchanged via QHINs. Overwhelmingly, one of the biggest benefits to using a QHIN will be the increased types of data exchanged via the network.

The Same, but Different

Data exchange via TEFCA will look different than what we are used to with other nationwide networks today, such as Carequality, EHealthExchange or CommonWell. Via TEFCA, QHINs will exchange more robust types of data, referred to as Exchange Purposes, and will deal with higher volumes as a network. A few examples of these Exchange Purposes are clinical documentation (CCD-A), benefits determination data, public health research data, and even lab data, just to name a few.

Another benefit will be seamless connectivity. Other QHINs should integrate with EHRs to facilitate data exchange, acting as a hub that connects your system with other networks, providers and stakeholders.

Coming soon in Interoperability Part 3: Not all QHINs are created equal. How to choose the one that’s right for you.

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Interoperability Ben Rosen Netsmart
Interoperability Ben Rosen Netsmart

Ben Rosen is a senior client success manager and business unit owner for the interoperability solution suite at Netsmart. With more than a decade of healthcare experience, Ben has led numerous initiatives to integrate healthcare systems and enhance data sharing across the care continuum. His dedication to advancing healthcare interoperability drives his active involvement in industry initiatives and standards organizations, where he provides insight for frameworks such as HL7 FHIR, USCDI and others. Ben holds a Bachelor of Science in kinesiology from Kansas State University and a Bachelor of Science in nursing degree from the University of Nebraska Medical Center.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in the Netsmart blog and is reprinted here with permission. For more information or to request permission to print, please contact Netsmart.

Interoperability

by | May 16, 2025 | Clinical, Regulatory

by Ben Rosen, Sr. Client Success Manager, Netsmart

Interoperability

What you need to know and how it affects you

For over two decades, tech companies and government agencies have been moving toward the goal of interoperability in healthcare technology. At long last, standards and protocols are in place — and continually being improved — to support open data exchange networks. As a result, healthcare providers, including human services, post-acute providers, and specialty practices, have more opportunities to participate in alternative payment models and adapt more readily to the evolving payment landscape.

Interoperability in Healthcare

What's driving the need for change?

Government regulatory agencies, together with payers and healthcare organizations, have long recognized the need to improve care coordination among healthcare providers. Making it easier to share information via a nationwide data sharing network is a critical component of this effort.

End Game

The ultimate goal of providing access to complete, accurate patient information is to help drive down costs to providers and electronic health record (EHR) users. Through exhaustive work and years of innovation, we’re seeing the tangible outcome of this effort. Information now flows seamlessly across multiple healthcare networks. Using a concise view of the data, we can focus on broader population health initiatives that improve outcomes for chronic conditions, reduce emergency department (ED) visits, and prevent hospitalizations. The interoperability market is moving ahead at blazing speeds. Therefore, we must understand the players who are the driving forces behind the movement.

Interoperability

The Interoperability Highway

Who are the players and how do they work together?

Healthcare technology is complex. It’s not surprising, then, that getting the disparate systems to share information seamlessly and securely is a complicated process. In the last decade an increasing number of vendors, organizations, and healthcare players started working together to advance a useful interoperability market.

Some of the larger players in this space include government and regulatory agencies. To understand the role these entities play and how they coordinate with other organizations and efforts, let’s compare the process to building a national highway system.

Building an open data exchange network

  • Assistant Secretary for Technology Policy and Office of the National Coordinator for Health (ASTP/ONC): This federal agency sets the vision, rules and regulations for health information technology policy. Compare it to the Federal Highway Administration (FHWA), the federal agency that provides stewardship over the construction, maintenance, and preservation for all interstate highways.
  • Trusted Exchange Framework and Common Agreement (TEFCA): Established by the ASTP/ONC, TEFCA sets the rules for health data exchange over the network. This is similar to plans or blueprints for highway construction. This would also include engineering, construction and safety standards for the highway.
  • The Sequoia Project (RCE): The Sequoia Project is the Recognized Co-ordinating Entity (RCE) for TEFCA and is appointed by the ASTP/ONC. The Sequoia Project is a non-profit, public-private collaborative that leads the implementation project for nationwide data exchange. They approve and help regulate the TEFCA exchange, via QHINs. The Sequoia Project can be compared to a construction manager that approves contractors and oversees quality control measures to ensure standards are met.
  • Qualified Health Information Networks (QHIN)s: QHINs are data sharing networks built to operate the exchange network as outlined by TEFCA. In our analogy, QHINs are the highways, and the companies that build QHINs can be compared to the construction companies that physically build and maintain the roadways themselves.

Now that you’re familiar with the entities involved in developing the standards for interoperability and building the data exchange networks that make it a reality, we will next look at how these enhanced capabilities can impact your organization.

This is part one of a four-part series covering the forces that are driving interoperability, as well as the future vision of open networks, and what it all could mean to your organization. Check back for part 2, “How TEFCA affects your technology and what the heck is a QHIN?” coming soon.

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Interoperability Ben Rosen Netsmart
Interoperability Ben Rosen Netsmart

Ben Rosen is a senior client success manager and business unit owner for the interoperability solution suite at Netsmart. With more than a decade of healthcare experience, Ben has led numerous initiatives to integrate healthcare systems and enhance data sharing across the care continuum. His dedication to advancing healthcare interoperability drives his active involvement in industry initiatives and standards organizations, where he provides insight for frameworks such as HL7 FHIR, USCDI and others. Ben holds a Bachelor of Science in kinesiology from Kansas State University and a Bachelor of Science in nursing degree from the University of Nebraska Medical Center.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in the Netsmart blog and is reprinted here with permission. For more information or to request permission to print, please contact Netsmart.

Meaningful AI

by | Apr 24, 2025 | Admin, Artificial Intelligence, Caring for the Caregiver

by Scott Green, Care Dimensions at Netsmart

Meaningful AI in Post-Acute

Elevating Care and Efficiency with Integrated AI

Meaningful AI is more than plugging your questions into ChatGPT. It goes beyond Artificial Intelligence into Augmented Intelligence. 

After a long day of caring for patients, a home health nurse pulls into their driveway, bracing for the familiar evening grind — hours of documentation. They take a deep breath, one of relief. They’re not mentally preparing for hours at their laptop, documenting every visit, trying to recall every detail while fatigue tugs at their focus. Tonight is different.

Tonight, they step through the door, greeted by their kids clamoring to show off their school projects. Dinner is already on the table, and for the first time in weeks, they sit with their family—truly present. There’s no need to pull out the laptop after dessert, no late-night race against deadlines. Their documentation? Done. Completed during patient visits, thanks to an integrated AI workflow that not only captured essential details of their patient but also highlighted critical care needs in near real-time.

This isn’t just a glimpse of what’s possible—it’s the reality Meaningful Augmented Intelligence (AI) creates for home care & hospice providers. With AI-assisted documentation tools, caregivers are freed from after-hours work. Repetitive tasks are automated, and accurate, compliant records are captured during visits. As a result, clinicians can focus on what matters most: delivering care to their patients during the day and being present for their families at night.

Meaningful Integrated AI in Care at Home: How it Works and Why It Matters

Integrated AI doesn’t just automate tasks—it enhances every part of the care process. By embedding AI directly into existing workflows, solutions empower clinicians and administrators to work smarter, not harder. Predictive analytics, real-time documentation and automated data entry reduce repetitive tasks and administrative burden, clearing staff to focus on patient care.

Unlike generic AI tools, Meaningful AI supports clinicians at the point of care. It captures essential details during visits, highlights critical needs as they arise, and offers real-time guidance. This isn’t just about making work faster—it’s about making it more human. Integrated AI simplifies workflows and strengthens decision-making, whether it’s anticipating a patient’s end-of-life needs, identifying compliance risks, or supporting proactive billing.

The AI Trifecta

AI isn’t just about automation—it’s about Meaningful AI that directly addresses the needs of community-based providers. With our AI Trifecta, every aspect of care delivery is reimagined to optimize processes, empower staff, and simplify reimbursement.

Optimize Processes

Integrated AI helps organizations operate more efficiently by taking over time-intensive, repetitive tasks, allowing staff to focus on patient care. For example, guided assist tools integrated with clinical workflows proactively coach staff through complex tasks like completing the OASIS assessment or interdisciplinary start of care documentation.

Imagine a clinician documenting care after a patient visit. With AI-powered assistance, charting can pre-fill fields based on visit details, flag potential inconsistencies in near real-time and suggest changes to align with regulatory requirements for a supervisor to review. This reduces errors and speeds up documentation, freeing clinicians to focus on patients rather than administrative tasks.

Predictive analytics empower organizations to anticipate and address challenges early, supporting clinical benefits of Hospice Visits in the Last Days of Life (HVLDL) such as symptom management, reduced patient distress and honoring the patient’s end-of-life wishes.

Empower Staff

The backbone of any agency is its staff. Integrated AI tools relieve the pressures of excessive documentation and administrative burdens. These tools aren’t just about doing tasks faster—they help create a more sustainable work-life balance by addressing challenges like burnout and turnover.

Staff can also benefit from smart task prioritization. Meaningful AI tools can include the ability to log in and instantly see a clear list of priorities based on patient needs and compliance deadlines. This reduces time spent figuring out “what’s next” so that every action directly contributes to better patient outcomes.

Meaningful AI

Simplify Reimbursement

Some AI tools monitor claims for potential issues before submission. Imagine if your system could identify a missing modifier or mismatch in coding then flag the problem and provide actionable suggestions to correct it. This not only increases first-pass acceptance rates but also reduces the exhausting back-and-forth that often accompanies denied claims.

Beyond preventing errors, predictive tools assess patterns in denial risks and reimbursement trends, enabling organizations to adjust strategies proactively. Leaders can use these insights to negotiate better contracts or refine documentation practices, ensuring steady cash flow and financial health and upstream process improvement. This empowers organizations to invest resources where they matter most: improving patient outcomes.

About Netsmart myUnity® NX

With Meaningful AI at the heart of myUnity NX, every part of the healthcare process—from care delivery to financial health—works smarter, not harder. These innovations support not just operational efficiency but also the well-being of care teams. By embedding intelligent workflows, providers have the time and space to focus on what matters most—delivering exceptional, person-centered care. Learn more about Netsmart myUnity® NX

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Scott Green Meaningful AI
Scott Green Meaningful AI

Scott Green leads the Care Dimensions business unit at Netsmart. In his role, he leads a team focused on building out a comprehensive suite of solutions designed to support organizations as they digitize their operations beyond the EHR. Green has been with Netsmart for 10 years and has held many roles during that time including leading the Human Services business unit.

Prior to joining Netsmart, he spent 13 years with Pfizer where he focused on building relationships and clinical initiatives with Integrated Delivery Networks.

Scott holds a bachelor’s degree in industrial psychology from Kansas State University and a graduate certificate in healthcare leadership from Park University.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared on the Netsmart blog and is reprinted here with permission. For more information or to request permission to print, please contact Netsmart. 

AI before AI

by | Jun 13, 2024 | Artificial Intelligence, New Tech, Partner News

by Tom Herzog, COO of Netsmart

Navigating the Next Era of Tech-Enabled Healthcare

While the talk is about Artificial Intelligence, the immediate opportunity is Augmented Intelligence.

Some thoughts from Tom Herzog and Matthew Arnheiter 

We are living through one of the most exhilarating times in healthcare, a journey made possible by significant milestones over recent decades. As healthcare technologists deeply committed to the cause + communities we serve, we’re excited by the promise of the upcoming era of technological empowerment. This phase is set to showcase and expand upon the extensive work done in digitizing healthcare, highlighting the relentless pursuit of innovation that has characterized our field. In conversations with colleagues and clients, we have recognized the need to explore these developments as we progress collectively. Matthew and I thought a series of reflections on these conversations would be helpful for all of us, providing insights into technology’s transformative impact on healthcare and the critical initiatives currently underway. We envision this dialogue as a series of posts throughout the year, sparking discussion and reflection as we navigate forward.

Back to the Future

In 2015, we envisioned a future where the concept of navigation as we know it would be obsolete, advocating for a universal search that is nearly autonomous, informed by the known context specific to every role. By 2019, we were discussing workflow automation, using the example of Lane Departure Warning systems in automobiles as a metaphor for technology that enhances outcomes through precision responses. The pace at which these technologies are evolving is astounding, moving beyond mere speed of thought to how we can iterate at the speed of innovation itself. Before we achieve the aspirations of true Artificial Intelligence, we must start with Augmented Intelligence, which may very well be the most significant technological innovation in my lifetime.

The Gentle Guidance of Technology: Augmented Intelligence in Healthcare

Artificial Intelligence (AI) and Augmented Intelligence stand as beacon forces driving innovation forward in this fast-evolving technology landscape. Drawing an analogy to driver assistance systems in modern vehicles, we explore the nuanced differences between these concepts, simplifying their understanding and underscoring the distinct roles in enhancing human capabilities.

Artificial Intelligence: The Autonomous Navigator

Imagine AI as the driving force behind fully autonomous vehicles, adeptly navigating complex terrains without human intervention. This epitomizes the grand aspiration of AI: to emulate or even transcend human Intelligence in specific tasks, thus granting machines the ability to function independently. It’s a prospect that is as exhilarating as it is intimidating, reminiscent of scenarios depicted in futuristic films. Such advancements bring to light profound questions about the limits of technology and the ethical considerations it entails. While we marvel at the potential, apprehension about the unknown shadows our enthusiasm. As we venture into this era, it’s imperative that we tread thoughtfully, balancing our ambitions with caution, as we unlock new realms of possibilities. Together, we must navigate this journey towards outcomes that are not only innovative but also meaningful and ethically sound.

Augmented Intelligence: The Co-Pilot’s Nudge

Conversely, Augmented Intelligence mirrors the driver assistance systems in vehicles – providing “nudges” or guidance while ensuring the driver remains in control. These systems bolster safety and efficiency, complementing human Intelligence with technological support. This partnership epitomizes the collaborative synergy between technology and human skills for a safer and more efficient driving experience.

The American Medical Association (AMA) aligns with this vision, emphasizing Augmented Intelligence’s role in enhancing human Intelligence rather than replacing it. The AMA advocates for the use of AI in healthcare as a means to augment the capabilities of medical professionals, not to substitute their critical thinking or clinical judgment.

Augmented Intelligence in Healthcare: Enhancing the User’s Ability

Reflecting on the transition from conceptual frameworks to tangible applications, we’ve initiated the Augmented Intelligence family. These solutions are meticulously designed to support clinical, operational, and financial workflows across all healthcare roles. Aimed at simplifying user experiences, these tools provide the best available context and automate information for validation and use as needed. This initiative marks a significant step in harnessing the potential of augmented Intelligence, enabling transformative shifts in healthcare practices and outcomes.

Michelle Donelan MP, reflecting on the U.K.’s commitment to AI in healthcare, highlights the transformative impact of augmented Intelligence, “AI will revolutionize the way we live, including our healthcare system. That is why we’re backing the U.K.’s fantastic innovators to save lives by boosting the frontline of our NHS and tackling the major health challenges of our time”. Donelan’s statement emphasizes the government’s support for utilizing AI to enhance healthcare delivery and address pressing health issues.

Augmented Intelligence promises to extend the partnership between human capabilities and technological advancement to medical professionals. Vincent Liu, MD, from Kaiser Permanente, elucidates this synergy, stating,

“There is a stage at which regulations can stifle some of the innovation [that AI might advance] … There is a role for providing a safe harbor [from certain regulations] so that we can use our best data to improve our patients’ care.”

This perspective underscores the potential of augmented Intelligence to enrich patient care by integrating comprehensive data analysis within the regulatory framework.

From the inception of conversations at our annual user conferences in the early 2000s to the present, we’ve witnessed the evolving landscape of healthcare technology. The decades-long journey of healthcare digitization has set the stage for today’s advancements, where Artificial Intelligence and Augmented Intelligence solutions leverage data to significantly improve care and operational efficiency.

Navigating Ethical Considerations

The integration of Augmented Intelligence in healthcare navigates through a maze of ethical considerations. Upholding the sanctity of the caregiver-patient relationship, ensuring patient privacy, and addressing potential biases in AI algorithms are paramount. The objective is to leverage Augmented Intelligence in a manner that respects these ethical boundaries while enhancing patient benefits.

A Future of Collaborative Care

Looking ahead, the promise of healthcare augmented by Intelligence offers a landscape where clinicians are equipped with unprecedented tools and information. This era does not diminish the essence of human judgment or the significance of the human touch in medicine but serves as a potent ally to these irreplaceable elements of care.

A Journey of Human-Machine Collaboration

Augmented Intelligence in healthcare symbolizes the collaboration between human Intelligence and artificial capabilities. This collaboration is not about relinquishing control but about enriching human expertise to tackle modern healthcare challenges. As we continue to integrate this technology, it heralds a future where healthcare is more personalized, predictive, and precise. The path forward, illuminated by the gentle guidance of Augmented Intelligence, promises a realm of endless potential for improved health outcomes for all.

Our immediate focus is three-fold 1) providing the communities we serve with the benefits of  Augmented Intelligence, 2) ensuring we achieve Meaningful AI for every role, and 3) doing so through incremental progress so that AI now is a reality.

Final Thoughts

If you are reading this, you are likely one of the pioneers helping forge the path we are on today. If it were not for the initial efforts to digitize the ecosystem, we would not be talking about this today. Thank you for making this happen, for your perseverance and tenacity to find a way. Now we are at the transition from AI as a futuristic concept to its current role in shaping healthcare practices marks a remarkable chapter in the ongoing story of innovation in healthcare. It reaffirms the importance of digitization as the foundation upon which AI and other emerging technologies are built, enabling a future where healthcare is more informed, more empowered, and, ultimately, more human.

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Augmented intelligence Tom HerzogTom Herzog is responsible for leading solution and technology strategies focused on person-centric design to optimize workflow, efficiencies and outcomes. His teams work in collaboration with both clients and partners to deliver comprehensive solutions for the human services and post-acute care communities.

Tom oversees multiple business units, including Netsmart consulting organization, solutions, development, engineering, technology, innovation, product development, IT, support, human resources, legal and operational functions.

Tom’s additional experience includes leading teams to automate systems and integrate financial, document management and information systems. He has been recognized for his ability to create innovative approaches and strategies that deliver results through vision and building strong teams.

Tom earned a bachelor’s degree in business management and human relations from Mid-America Nazarene University. He serves on the boards of the Overland Park Chamber of Commerce and the United Community Services of Johnson County.