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How Technology is Shaping the Future of Healthcare Policy

In conversation with

Peter Preziosi

President & CEO, TruMerit

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More About This Episode

  • How Peter’s early career in nursing shaped his global policy perspective
  • The evolution of clinical documentation and the role of digital transformation
  • How AI, robotics, and interoperability mandates are influencing healthcare policy
  • The challenge of authenticity, digital credentials, and regulatory trust in AI
  • Addressing the global health workforce maldistribution through technology
  • Bridging the digital divide and lessons from Rwanda & Guatemala remote care pilots
  • Balancing innovation and overregulation in healthcare data interoperability

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Episode Transcript

00:01.11
Ratnadeep Bhattacharjee
Hello and welcome to another episode of Leaders Perspective. I am your host Ratnati Bhattacharji, co-founder of Tech Variable, where we focus on data integration, AI and technology solutions that power healthcare transformation.

00:14.57
Ratnadeep Bhattacharjee
Today, we are exploring a fascinating and timely question. How is technology shaping the future of healthcare policies? Healthcare policy is no longer shaped just by lawmakers and regulators, right?

00:28.90
Ratnadeep Bhattacharjee
It’s being driven by how technology changes what’s possible, you know, from interoperability to AI, to even value-based care. ah To unpack this, I’m joined by a leader who sits right at the intersection of policy, innovation, and healthcare delivery, Peter Priziosi.

00:47.33
Ratnadeep Bhattacharjee
ah Peter is the president and CEO True Merit. Throughout his career, he has been deeply engaged in advancing healthcare policy, governance, and innovation with a unique ability to bridge strategy and execution.

01:02.70
Ratnadeep Bhattacharjee
He brings a and you know decades of experience across healthcare leadership, advisory roles, policy shaping initiatives, and whatnot. Peter, it’s such an honor to have you on the show.

01:14.13
Ratnadeep Bhattacharjee
Welcome.

01:15.64
Peter Preziosi
Thank you very much. Thanks for having me. Looking forward to our conversation.

01:19.58
Ratnadeep Bhattacharjee
Oh, same here, same here, Peter. ah Peter, ah you’ve had a remarkable career healthcare you know leadership and policy, right? could you Could you start by sharing a bit about your journey and what drew ah you to focus on the intersection of technology and policy in healthcare?

01:38.91
Peter Preziosi
Absolutely. So I started i started my career um in healthcare care as a registered nurse and recognized early on that I wanted to be able to impact patients and their families at a, at a global scale.

01:57.13
Peter Preziosi
um You know, as a nurse in clinical practice, you can work one-on-one with individuals and their families, but you know, that wasn’t satisfying enough for me. I wanted to be able to do a lot more than that.

02:10.88
Peter Preziosi
And after, having a variety of clinical practices in New York City, in the US, um I decided to really hop into the policy space and ah was recruited into an association um called the National League for Nursing. It was the accrediting body for nursing education. So I really started looking at policy through education policy in healthcare, care which is foundational for clinicians, if you if you think about it.

02:47.01
Peter Preziosi
And moved on and did a lot of other things and a variety of social impact um challenges, um particularly in women’s health, which was interesting as a man to be both a nurse and then to get involved in women’s health. But it gave me a perspective um And this was ah actually really as the internet was just beginning to ah come alive.

03:18.62
Peter Preziosi
And then I ah worked in ah Mayor Giuliani’s administration, ah privatizing the Medicaid system in the United States for for New York City, where that is the payment system for indigent populations.

03:40.41
Peter Preziosi
And it was it was an opportunity to be able to better serve ah Medicaid beneficiaries um rather than government trying to serve them. We privatized it and oversaw the quality of those programs.

03:58.35
Peter Preziosi
And but my I would say my biggest foray into ah technology – was um getting involved in clinical documentation.

04:10.92
Peter Preziosi
i was running ah a nonprofit organization in the United States. And you might be familiar with this, RD.

04:21.10
Peter Preziosi
It was medical transcription, clinical documentation capture, the capture of that interaction between that patient and the clinician.

04:25.61
Ratnadeep Bhattacharjee
Yep.

04:33.44
Peter Preziosi
And this was before… ah the beginning of ah speech language technology really picking up. And it was right as the internet was really taking hold.

04:50.66
Peter Preziosi
And we were discovering that you could provide these services anywhere in the world to support the United States healthcare care delivery system.

05:02.09
Peter Preziosi
That really changed the the perspective of people from a health policy standpoint. Because looking at it from a labor perspective, and I was representing the business of owners that were running these companies, as well as the practitioners that were delivering these services.

05:24.07
Peter Preziosi
And the the labor cost arbitrage that was occurring because the United States was paying much more for labor than other parts of the world like India or the Philippines, it really started to wake up a lot of healthcare system CEOs and business owners as to how to deliver this service in in in the US healthcare care system.

05:55.04
Peter Preziosi
So that’s really what began my career and in in technology and then went to an innovation incubator startup at Verizon, large telephone company.

06:07.63
Peter Preziosi
And we were looking at technologies that would ride on our backbone. So that because we were recognizing that anything that an individual would ultimately need would be able to be resting in the palm of their hand.

06:25.06
Peter Preziosi
And health was moving toward that direction. So we knew that we had to start looking at solutions that were creating greater engagement and accessibility to the consumer population as it pertained to healthcare.

06:41.82
Peter Preziosi
And we also knew that individuals, consumers, as they aged, didn’t want to go into a hospital. They wanted to age in place in their homes.

06:55.74
Ratnadeep Bhattacharjee
So, okay.

06:56.53
Peter Preziosi
So we were developing technologies that enabled individuals to be able to stay in their home and live comfortably, to be monitored, to ensure that in the event that they fell or that their biometrics were off,

07:15.08
Peter Preziosi
you know biometric were off that they were being monitored and an intervention could occur given the technology solutions that the Bluetooth technology solutions that we were working with.

07:29.97
Peter Preziosi
So I did a variety of other things after that. And, you know, now, well, you know, I was at the World Health Organization um at a time when we knew that we needed to get WHO guidance into practice more rapidly around the globe. And we built a global learning academy.

07:52.94
Peter Preziosi
and what we and And you’re like, well, what does that have to do with technology? Well, we were looking at digital credentials so that as an individual would learn, they would be receiving digital badges, digital credentials that would identify the learning outcomes that they received in one of our learning programs.

08:21.86
Peter Preziosi
And our learning programs were built based on WHO guidance and practice because we wanted to make sure that WHO guidance was getting penetrated throughout the world, in particular areas of greatest need in low and middle income countries.

08:43.57
Peter Preziosi
And then I was recruited into my current job where I’m president and chief executive officer of an organization named True Merit. You mentioned that before. It was formerly CGFNS International.

08:57.40
Peter Preziosi
And it’s a credentialing assessment and certification organization that evaluates the skill and competence of nurses and allied health professionals as they’re migrating around the world.

09:12.51
Peter Preziosi
We right now worldwide are experiencing tremendous shortages in the health workforce.

09:23.29
Peter Preziosi
And the only way that we’re going to rectify this issue is really partnering with technology solutions to extend the capability of healthcare care professionals as they’re working to care for populations around the world.

09:45.07
Peter Preziosi
Is that helpful?

09:45.35
Ratnadeep Bhattacharjee
right yes yes definitely you know this this gives me a lot of insights and you know i have a host of questions peter but you know i’ll i’ll i’ll keep my calm and go after those one by one uh so peter uh very interestingly you uh touched upon a lot of points uh wherein you came how you came from being a nurse to a

09:58.47
Peter Preziosi
Sure.

10:12.09
Ratnadeep Bhattacharjee
to you know touching the edges of technology and then getting really deep into technology and then how technology is starting to shape your career in terms of policy making as well. I also wanted to get an insight from you.

10:26.38
Ratnadeep Bhattacharjee
ah you know, considering the fact that increasingly technologies kind of shaping policies itself, don’t you think? What’s your perspective on how technologies from, you know, let’s say electronic health records to AI, you know, they have the influenced healthcare policymaking over the last decade? What are your thoughts?

10:48.40
Peter Preziosi
Absolutely. i just think about um all the personal protections and privacy protections that grew up as a result of electronic health record adoption.

11:04.14
Peter Preziosi
Because of the exchange of information and the need to protect a patient’s privacy,

11:12.62
Peter Preziosi
there were a whole host of issues that came up. around that, for instance. And then I talked about labor issues before.

11:22.67
Peter Preziosi
What do countries do now that they have to compete for labor, not only in their own country, but abroad? you know our art The name of our country company now, we we just renamed it this year to True Merit.

11:38.83
Peter Preziosi
Our tagline is Global Careers Care Anywhere. It’s not just about the worker that can move across jurisdictions from one country to another.

11:55.87
Peter Preziosi
Now it’s the work. Look at what’s happened in radiology practice. And I’m only focused on healthcare. care So I’m going to, my examples will be in healthcare right now.

12:08.35
Peter Preziosi
Radiology that’s being done in India. When people in the United States are sleeping, you have radiologists that are reviewing reports. This is not unusual anymore.

12:22.33
Peter Preziosi
It’s becoming more and more common. Take a look at what happened during the COVID-19 pandemic and and what that did to spur on technology to be able to continue to support and care for individuals when they needed to be protected from the virus.

12:42.52
Peter Preziosi
So, i mean, it’s it’s it it also had an impact on technology. And here in the United States, what occurred was they the regulation around telehealth solutions were lightened up, were reduced.

13:02.71
Peter Preziosi
I remember when I was at Verizon and we had developed technology a project where we were equipping paramedics and emergency personnel that were going out on 911 calls with a tablet that had a telehealth solution connected into it that would enable them to speak to physicians in the emergency department to talk with patients that they were going out

13:38.98
Peter Preziosi
on a 911 call, on an emergency call, to check to see if their issue was life-threatening or not. And if it wasn’t life-threatening, they would divert that patient into a primary care practitioner out in the community so that they wouldn’t have to take them to a very busy emergency room department that was much more costly And it freed up the clinicians in the emergency department to care for people that had higher needs.

14:17.02
Peter Preziosi
We couldn’t start that project until we went to the Texas state legislature because we were in Houston, Texas, to change the regulations allowing us to use that technology.

14:34.21
Peter Preziosi
So that’s an example of what we had to deal with.

14:34.12
Ratnadeep Bhattacharjee
Mm-hmm.

14:37.68
Peter Preziosi
And we see that over and over again, where technology is so much further ahead of the laws, of the regulations, and and of the social structures that have to catch up to the technology.

14:55.12
Peter Preziosi
And I’m sure that when talking to other guests that you’ve had on, they experience those same challenges. So that’s that’s that interface. That is so important. And the challenge today is that these technologies are becoming more and more complex.

15:18.72
Peter Preziosi
and and And the science behind them, the discovery behind them becomes more complex that the policymakers haven’t been able to keep up.

15:32.93
Peter Preziosi
So you have that divide there. And that’s why it takes a little bit longer for some of these adoptions, particularly when you’re talking about industry sectors like healthcare that have major impact on population safety, population health.

15:58.60
Ratnadeep Bhattacharjee
right no absolutely you know ah this is a this is an interesting ah point of ah ah my ah understanding of of the intersection, you know, intersection of healthcare care policies and technology, right? In 2025, I really believe we’re an interesting crossroads, right?

16:21.12
Ratnadeep Bhattacharjee
Value-based care, you know, interoperability mandates, you know, patient access rules, now AI governance, you know, with all those things which are, which has happened very recently, right?

16:32.32
Ratnadeep Bhattacharjee
You know, how, I can mention these CMS interoperability rules, recent ones, you know, TEFCA, AI oversight, you know Medicare advantage reforms, etc.

16:45.41
Ratnadeep Bhattacharjee
From your view, Peter, which areas of healthcare policy are being most influenced by technology today. did the Are these the ones that I’ve already mentioned just now or or or do you think ah even beyond these data are there are places where it’s making an impact?

17:08.58
Peter Preziosi
Yeah, i think I think we’re all focused right now on artificial intelligence.

17:17.99
Peter Preziosi
Because the rate of development and evolution of AI is exponentially faster than any other type of technology.

17:33.11
Peter Preziosi
And why that can be a little bit frightening is we don’t understand some of the unintended consequences of it.

17:45.51
Peter Preziosi
And it’s very difficult. I mean, take a look at what’s happened ah with our social media platforms and what that did to social constructs, social interactions, and the unanticipated consequences that occurred with just raising your children. um and And what happened with cyberbullying.

18:16.22
Peter Preziosi
We had no idea that people would feel more, um you know, unencumbered in terms of being respectful during on a social media platform.

18:30.51
Peter Preziosi
because they weren’t seeing people face to face, they could remain anonymous. Never thought about those things. Similarly, with artificial intelligence, we don’t really know what we don’t know yet. um you know The expansion of you know what what some will call fake news,

18:53.36
Peter Preziosi
The ability to put things out there when um or or when you’re when you’re Googling and and or you know you’re you’re looking something up on the internet and an AI engine will pop up, you don’t understand the authenticity of that information.

19:12.77
Peter Preziosi
And it’s organizations like ours as a global nonprofit that have to ensure the public that we’re a trusted source.

19:24.66
Peter Preziosi
This was the challenge that we had in the medical transcription space. And let me explain that a little bit. Many of our medical transcription practitioners that were documenting that encounter and that had a question on medical terminology, on something that might have been said during the dictation process,

19:53.54
Peter Preziosi
would go to the internet and look that information up.

20:00.00
Peter Preziosi
And they didn’t know if that was from an authenticated source. So authenticity is really critically important. Now let me fast forward to what I’m doing today.

20:13.89
Peter Preziosi
we have to us and We have to make sure that the people that are coming through our programs are actually who they say they are. that their credentials are authentic, that they are real, that they are not fake, that they are truly licensed, that the that the education that they received was authentic, that it was properly accredited and vetted, that they weren’t coming from what we call these diploma mills.

20:51.55
Peter Preziosi
This is very important today. So AI is really beginning to uncover these issues around authenticity. So I think that that’s a big piece of of what’s happening right now, which makes individuals threatened to continue to evolve and lean in to the many opportunities that AI can provide as a partner.

21:22.47
Peter Preziosi
And this AI is going to also then accelerate adoption of robotics.

21:30.90
Peter Preziosi
And robotics can really be an augmentation to the challenges that we’re experiencing with the maldistribution of health professionals worldwide. Now I call it a maldistribution.

21:48.21
Peter Preziosi
Many people just think, I said it earlier and I proud i misspoke, that there are shortages around the world. There are shortages in certain countries that consume a lot of health personnel resources, but there’s an oversupply of health professionals especially in low income countries where they can’t afford to employ all of their graduates.

22:20.34
Peter Preziosi
So they’re they’re graduating in oversupply for their country, but it’s difficult for those individuals to become gainfully employed because they have to leave their country to go to another country.

22:34.66
Peter Preziosi
We’re seeing this in countries like Kenya, like Ghana,

22:41.32
Peter Preziosi
like Mexico.

22:44.59
Peter Preziosi
Now the United States, major shortages.

22:49.66
Peter Preziosi
So, but what will happen, i believe like that that’s getting, i really think that the use of technology will be able to assist in this distribution of personnel resources and to be able to create create um greater health equity around the world.

23:16.87
Peter Preziosi
However, a big concern that we don’t think about is that digital divide between the haves and the have-nots.

23:31.46
Peter Preziosi
Living in a very, very um economically strong country like the United States, we don’t always think about that.

23:43.60
Peter Preziosi
But there are even digital divides here in the US with um areas of the country that are very wealthy compared with areas that are very poor.

23:58.14
Peter Preziosi
And in lower resourced areas of a country and around the world, there are challenges around adoption of technologies because they’re not resourced enough.

24:14.11
Peter Preziosi
And we have a couple of projects right now. So we’ve started one in Rwanda in rural villages where we’ve equipped nurse-led clinics with a device by a company called MedWan.

24:30.74
Peter Preziosi
It’s a remote patient monitoring and an evaluation device that assists nurses in evaluating patients and treating them and then telepresencing into a physician if needed in the city district hospital.

24:53.33
Peter Preziosi
And we’ve been successful. We’ve had like some 500 patients that have gone through the system right now.

25:00.21
Peter Preziosi
But we were finding that the uptake of this was difficult at first because they weren’t accustomed to the technologies. Now we’re replicating it in Guatemala and we’ll be finding out more learnings around adoption of technologies to be able to extend the capabilities, particularly in rural areas of the world.

25:30.82
Peter Preziosi
Because that’s the area that needs it, because they’re resource constrained, and could really benefit from those things.

25:43.20
Ratnadeep Bhattacharjee
Yeah, I mean, honestly, there are lots of aspects here, Peter, and I can see, you know, I can see why we kind of chose this topic for the podcast because this is this is something that’s not just important but highly neglected. Not just as you said, right, not just in one particular region but several regions.

26:09.19
Ratnadeep Bhattacharjee
what I mean, especially well-to-do regions, right? Because parity is one thing but parity in the thought process that itself is lacking, right?

26:19.82
Ratnadeep Bhattacharjee
So I completely agree with you, ah Peter. ah Peter, but to move, if if I have to, you know, point to a different direction here, you you have and you and i probably would have talked about data, you know, during our last one or two calls, right?

26:40.57
Ratnadeep Bhattacharjee
You know, data is the lifeblood of healthcare, right? So with interoperability mandates like like TEFCA, you know, which is gaining fraction.

26:51.79
Ratnadeep Bhattacharjee
Do you see, do you see regulations as keeping pace with innovation or is policy still playing catch up with what ah her technology enables?

27:03.50
Peter Preziosi
Well, yeah you know, it’s interesting. That’s a an interesting question. I think um one of the challenges that um can occur is some of this overregulation that then stifles innovation.

27:24.34
Peter Preziosi
And And, you know, when when it comes to um data, you know, again, we talked we talked before about data privacy um and protections.

27:35.93
Peter Preziosi
And what that does is it then it can preclude data data interoperability. And we had that challenge when we were really looking at um data interoperability requirements.

27:51.27
Peter Preziosi
when I was in the clinical documentation, medical transcription space and, and looking at um how we could um ah accelerate the ability for um data to be exchanged from one electronic health record system to another.

28:15.43
Peter Preziosi
And there are a lot of proprietary issues that cropped up. where ah certain companies didn’t want to have um that data interoperability because they wanted to maintain it all.

28:33.47
Peter Preziosi
um and And that was just one issue. um We were concerned about something that many people didn’t think about, which was um the the narrative report.

28:50.63
Peter Preziosi
Meaning, When a patient comes in to a health system and they’re getting their history and physical, and you have to capture that and put that into the medical record, a lot of that now has been structured into fields and there’s no narrative.

29:18.15
Peter Preziosi
So what does that mean? You don’t have a context. You don’t understand the broader story of that patient. And certain things are lost, missed, and how frustrating it is for a patient to have to continue to retell their story over and over and over again. So we created ah a tagging system that enabled us to look at exchanging narrative through clinical documentation architecture under the HL7 structures that existed.

30:05.54
Peter Preziosi
And they’ve evolved that technology since I’ve been there. But that was really important. I mean, um you know, you talk about, you know, these issues around data.

30:16.79
Peter Preziosi
um Again, no matter what aspect of technology that you’re talking about, um many times um certain issues get overlooked.

30:30.27
Peter Preziosi
And it’s going to be even more challenging as discovery is accelerated, things will get overlooked. And, you know, and I’m not, I’m, you know, again, it’s, it’s that risk posture that you have. I mean, I, I think we have to um speed up in certain ways, but, but also have to slow down it and take a look at, you know, different aspects of it. You know, it frustrates me at times when I think about how, how long it’s taking us to stand up some of these,

31:06.32
Peter Preziosi
um what we call point of care tests. The one that I mentioned in Rwanda, we’re replicating that in Guatemala. And there’s, you know, a lot of issues that we have to go through to establish these testing sites.

31:23.18
Peter Preziosi
But at the same time, we’re still learning. Because there’s there’s this notion from technologists that you just throw the technology in there and then it’ll work.

31:37.05
Peter Preziosi
And people don’t take into consideration workflows, for instance. You know, you have to take and and the individuals that are using the technology.

31:49.79
Peter Preziosi
Do we take them into consideration when we’re building the technology? Do we take into consideration that end user? The Verizon story that I was talking about before when we were going into patients’ homes.

32:07.11
Peter Preziosi
If we were dealing with people that were octogenarians, people that were in their 80s with Bluetooth technologies that were not digital natives and didn’t feel comfortable using the technology, would there be adoption?

32:25.69
Peter Preziosi
So these are the these are the practical types of situations. you know And we’re getting better at that as as we’re using technology. But again, that’s where that digital divide will continue to widen if we don’t stay focused on really helping to bring everyone along.

32:48.29
Ratnadeep Bhattacharjee
This is fantastic, you know, such rich insights, Peter, honestly, i’m I’m kind of taken aback. In fact, I’m thinking that we should have a part two for this the particular topic because it’s it’s it’s huge, right? it’s It has so many repercussions and so many impacts and so many aspects to it.

33:07.86
Ratnadeep Bhattacharjee
it It isn’t possible to just, you know, conclude it in a single podcast. It actually will take a lifetime. But, you know, ah I mean, ah as as I wrap up, right, if you fast forward five years from now, Peter, how do you envision technology reshaping healthcare policies further?

33:32.36
Ratnadeep Bhattacharjee
Do you think we will see more proactive policymaking to drive technology adoption or will, you know, policies continue to react to innovation?

33:44.48
Peter Preziosi
Well, i I think policy will continue to react to you know technology innovation only because I i think it’s it’s quicker. um you know But I do think that um governments around the world are really stepping up to the plate and really looking at um these technology innovations And i bring I bring government into it because they’re the ones that are are are responsible for protecting the public good.

34:23.16
Peter Preziosi
And experimentation, innovation think centers and and think tanks are really critically important to be infused into government as they are creating policy.

34:37.89
Peter Preziosi
And then to have ah the subject matter experts available to policymakers as they are debating these issues and and thinking through them is critically important as well.

34:53.31
Peter Preziosi
And then that also becomes challenging because who ends up becoming the ones that are, um the the the best voices are the ones that are most resourced.

35:09.61
Peter Preziosi
So again, that’s where the divide occurs. it’s it’s The voiceless are the ones that are indigent. and And that’s where a lot of the challenges can occur. So that that that’s where where I think, um you know when you when you take a look at um equity and inclusion, I think that’s really important, particularly when it comes to technology adoption.

35:39.17
Peter Preziosi
Because then um if if you don’t think about those issues, you’ll have an une uneven, um you’re you’re not going to be able to ah leverage that technology the best that you can.

35:54.46
Peter Preziosi
You really have to look at, you know, how to be able to deploy at scale, giving the these um variables, taking into consideration some of these socioeconomic political um issues that are that you have to confront you know across the that that continuum, that socioeconomic continuum.

36:24.38
Ratnadeep Bhattacharjee
Yeah, i couldn’t I couldn’t have agreed with you more, Peter. Peter, thank you for joining us today and for sharing your perspective on how technology is shaping the future of healthcare policy.

36:38.64
Ratnadeep Bhattacharjee
It’s clear that the relationship between innovation and regulation will will kind of define the next chapter of healthcare, care right? ah So thanks for sharing all your i don views and pointers and perspective, Peter.

36:54.39
Peter Preziosi
Well, thanks for having me. Appreciate it Have a great day.

36:56.78
Ratnadeep Bhattacharjee
Yeah. And to our listeners, thank you for, yeah. And ah to our listeners, thank you for tuning in. Don’t forget to subscribe to Leaders Perspective for more conversation with leaders shaping the future of healthcare.

37:09.54
Ratnadeep Bhattacharjee
Thank you and keep innovating.

37:13.69
Ratnadeep Bhattacharjee
See you soon.