Tackling Burnout and Inefficiency

I founded Nemedic after realizing that the complex bureaucratic environment within surgery is a significant factor contributing to burnout across the industry. This bureaucratic chaos often detracts from our primary focus on patient care, and it's clear that existing interventions have been largely ineffective in addressing this issue. Empirical evidence suggests that the implementation of support groups, lifestyle training, and “finding balance” has not led to a meaningful change in the trajectory of burnout. Alarmingly, in certain surgical fields, more than 50% of healthcare providers and their teams report an increasing sense of burnout and dissatisfaction with their work.

What if the cause of burnout is deeper than you think?

Fact: It is now a reality that artificial intelligence (AI) and algorithmic systems are increasingly dominating various facets of surgical care within the United States. The process of prior authorizations, for example, is predominantly evaluated through AI algorithms, a methodology that remains largely opaque to those outside the insurance sector. By creating scoring systems that are not transparent, the insurance companies have placed patients and surgeons at a considerable disadvantage.

It is important to note that these algorithm-based systems are currently subject to legal scrutiny. Despite ongoing litigation, their use persists, potentially prolonging the resolution of these issues for decades within the judicial system.

One recent example involves a lawsuit alleging that Cigna is using AI to reject claims.?

Ref:https://www.medicaleconomics.com/view/cigna-using-ai-to-reject-claims-lawsuit-charges

In today's rapidly evolving healthcare landscape, technology is reshaping the future of surgical care. As CEO of a leading healthtech company, I am acutely aware of the challenges and pressures facing surgeons, surgical practices, and hospital system executives. Our mission is to alleviate these burdens through innovative solutions that streamline patient prequalification, scheduling, and the prior authorization process.?

We believe that the current state of surgical care in the U.S. is fraught with inefficiencies, largely due to these opaque AI-driven prior authorization systems that disadvantage both patients and surgeons. The reliance on algorithms to score and approve surgical cases has led to increased administrative burden, and delays in patient care. Not only have we witnessed heightened surgeon burnout but light has now been shed on the real issue.

Unethical Implementation of AI and Algorithms is the root cause of our burnout

It is easy to say the cause of our frustration is our EHR’s but the problem is really deeper. It’s the Systems behind these Applications that have negatively affected surgery. The impact of these challenges on the surgical community cannot be overstated. According to the American Medical Association, the administrative complexities associated with prior authorizations result in delayed and disrupted patient care, with physicians dedicating an exorbitant amount of time to navigating these hurdles. This not only detracts from direct patient care but also contributes to the escalating issue of physician burnout.

"Health plans continue to inappropriately impose bureaucratic prior authorization policies that conflict with evidence-based clinical practices, waste vital resources, jeopardize quality care, and harm patients,” said AMA President Jack Resneck Jr., M.D.

In this quote by Dr. Resneck Jr., he goes on to highlight critical concerns raised by an AMA survey on the prior auth burden. Key points from this survey include:

• Delayed Care - More than nine in 10 physicians (94%) reported that prior authorization delayed access to necessary care.
• Disrupted Care - Four in five physicians (80%) said patients abandoned treatment due to authorization struggles with health insurers.

ref: https://www.ama-assn.org/press-center/press-releases/toll-prior-authorization-exceeds-alleged-benefits-say-physicians

Implementing a solution is easier than you think

In response to these challenges, our company has developed a solution designed to empower surgeons and their practices. By leveraging advanced AI and human expertise, we prequalify patients, efficiently schedule appointments, and assist in crafting prior authorization notes that are more likely to be favorably scored by insurance companies. This approach not only enhances the likelihood of case approval but also significantly reduces administrative workload, allowing surgeons to focus on what they do best: providing exceptional patient care.

Our methodology is clear and transformative, comprising three pivotal steps.?

1. Patient Identification: We begin by identifying the right surgical candidates for your practice, ensuring that your expertise is matched with patients who most need your care.

2. Efficient Triage and Scheduling: Utilizing a combination of AI and human insight, we triage and schedule patients effectively. Our system pre-scores patients in a manner akin to insurance companies, ethically reducing backend hassles and streamlining the path to surgery.

3. Optimized Prior Authorization Notes: We analyze patient data and entry points to assist you in creating more effective insurance notes. Better-scoring notes mean fewer appeals and administrative tasks, leading to quicker patient treatment times.

This approach is rooted in the foundational principle that initiating care with high-quality patient engagement enhances the overall experience for all parties involved in the surgical journey.

By embracing this core truth, we effectuate substantial improvements simply by increasing the number of high-quality patient interactions on your schedule, while minimizing encounters with patients that should be triaged immediately into medical management.

Making a small change will improve your life and the lives of the patients you treat

The benefits of partnering to use an AI assistant tailored to your surgical practice extend beyond improved operational efficiencies. We aim to create a healthcare ecosystem where surgeons are liberated from the constraints of administrative burdens, enabling them to deliver the highest quality of care to their patients. In doing so, we not only enhance patient satisfaction but also contribute to the well-being and job satisfaction of surgeons and their teams.

In a landscape where delay is the norm, our solution offers immediate relief and a strategic advantage. We invite you to join us in transforming surgical care, making it more accessible, more efficient, and more focused on patient outcomes. Let's connect and explore how we can collaborate to bring more surgical candidates to your practice, optimize your surgical prior auth scoring, and finally put burnout to rest.

Fire up!