Reimagining Care Coordination Across the Continuum with Data and AI

In this episode, Robin Roberts, Director of Health IT Regulatory Affairs, PointClickCare & Novella Thompson, Hospital Administrator, Population Health, UVA Health, explore how health systems are transforming care coordination from hospital to post-acute settings through interoperability, real-time data, and AI. They share practical challenges, including discharge handoffs and medication accuracy, and highlight how predictive tools and stronger partnerships are improving outcomes across the continuum of care.This episode is sponsored by PointClickCare.

In this episode, FJ Campbell, MD, Chief Medical Officer at Ardent Health, discusses how virtual nursing, virtual physicians, and AI powered documentation tools are reducing clinician burnout while improving patient care and operational efficiency. He also shares how these technologies are expanding specialist access, strengthening rural hospitals, and helping health systems build a more sustainable workforce.

In this episode, Alex Laskey, Founder and CEO of CareCubes, discusses how deployable negative pressure units are helping hospitals reduce infections, expand capacity, and protect clinicians without relying solely on PPE. He shares his vision for making isolation as common and accessible as defibrillators, reshaping how health systems prepare for everyday infectious disease and future outbreaks.

In this episode, Scott Edelman, Executive Director of Burke Rehabilitation, discusses how inpatient rehab is helping ease hospital capacity challenges while improving patient outcomes and independence. He shares insights on culture-driven leadership, strategic investments, and building a continuum of care that supports patients long after discharge.

In this episode, Dr. Nasim Afsar discusses her book “Intelligent Health: The Movement to Unify Data, Harness AI, and Empower People to Thrive” and the shift toward person centered, data driven care. She shares how unifying data, applying AI, and empowering individuals can transform health outcomes while preserving the human connection in medicine.

In this episode, Dr. Sameer Amin of L.A. Care Health Plan discusses how building durable community infrastructure, rather than short-term programs, supports continuity of care amid Medicaid enrollment shifts. He explains how investments in housing, food access, and care coordination can deliver measurable ROI while improving outcomes and reducing administrative burden.

In this episode, Marcy Ainslie, EdD, FNP-BC, FAANP, FAAN, Assistant Professor of Nursing, UNH Nursing & Dr. Tracey Chan PhD, ANP-BC, FAANP, Assistant Professor, Interim Nurse Practitioner Program Director, Oakland University School of Nursing, Rochester, MI, discuss reducing variability in NP education and improving workforce alignment through clearer population-based preparation models. They share practical strategies to enhance hiring, onboarding, and patient safety across health systems.

In this episode, Cástulo de la Rocha, President and CEO, AltaMed, shares how a single clinic grew into the nation’s largest federally qualified community health center by prioritizing dignity, access, and trust. He discusses value-based care, financial stability as a driver of health, and how culturally rooted, community-based models can improve outcomes while lowering costs.

In this episode, Simon Nazarian, Executive Vice President and Chief Digital and Technology Officer & Nasim Eftekhari, Chief AI and Analytics Officer, City of Hope, discuss building the infrastructure, governance, and culture needed to scale AI responsibly across a complex health system. They explore AI literacy, agent orchestration, and how technology can expand patient access while supporting clinicians and improving care delivery.

In this episode, Brian Cheney, Division SVP of Sales Operations and Commercial Markets Growth at Health Care Service Corporation, discusses the launch of Unity Health Hub and how it helps employers navigate the growing number of digital health solutions. He explains how the platform integrates vetted vendors, improves member engagement, and delivers clearer data on outcomes and impact.