Vital Conversations

Rural Dialysis Care: How TeleNeph Keeps Kidney Patients Close to Home

Tim Coan, Focus Solutions — Thu, 23 Apr 2026 12:01:00 +0000

Rural dialysis patients often travel 400 miles or more for care — sometimes by plane. TeleNeph is changing that. CEO Ron Kubit explains how his company partners with rural and critical access hospitals to deliver nephrology care locally, complete with dedicated nephrologists on call 24/7, portable equipment, and nurse training programs built for rural realities.

In this episode: how one Arizona critical access hospital admitted 126 dialysis patients in year one — all previously transferred out — generating $1.5 million in net revenue. The 90-day startup process. The push toward home dialysis. And what urban healthcare leaders consistently miss about rural America.

Host: Tim Coan | Guest: Ron Kubit, CEO, TeleNeph | Vital Conversations, sponsored by Focus

Chapters

(00:00:00) - Telenef for Nephrology
(00:04:59) - Benefits of a Rural Hospital System
(00:07:17) - TeleNephrology: Supporting dialysis patients with other diseases
(00:10:22) - Kidney Dialysis at Home
(00:11:02) - Vital Conversations: Rural Health Care

Your Google Ads May Be Violating HIPAA Right Now — Here's What to Do About It

Tim Coan, Focus Solutions — Wed, 25 Mar 2026 04:00:00 +0000

Your Google Ads may be violating HIPAA right now — and most practice leaders have no idea.

Mara Pritchard, lead Product Manager of Fresh Paint, breaks down one of the most misunderstood compliance risks in healthcare today: the intersection of HIPAA and digital marketing. If your practice runs Google Ads, has a website with tracking pixels, or uses any form of online advertising to attract patients — this episode is not optional.

You'll learn:

Why HIPAA applies to your marketing efforts — not just your patient records
How Google already knows who your website visitors are, and why that creates legal liability for your practice
What a Business Associate Agreement (BAA) is and why Google will never sign one
The real cost of turning off all your tracking to become 'compliant' — and why it means spending marketing dollars completely in the dark
How state regulations are now going further than HIPAA on behavioral advertising — and why multi-state practices need to pay attention
How to stay compliant, keep your marketing data, and still take advantage of Google's optimization engine

This isn't a scare tactic. Mara's take is that your compliance constraint is actually an opportunity to become a higher-performing marketing organization. This conversation will change how you think about your marketing stack.

If this episode helped you, please leave a review — it takes 30 seconds and helps other healthcare leaders find the show. And subscribe so you never miss a conversation like this.

Vital Conversations is presented by Focus Solutions.

Chapters

(00:00:00) - Vital Conversations: Healthcare Leaders
(00:00:20) - HipHIPAA and Digital Marketing
(00:04:51) - How to Become HIPAA-Compliant with Digital Marketing?
(00:06:47) - HIPAA compliance in the digital marketing world
(00:10:45) - HIPAA: The Business of Marketing

How to Get Physician Buy-In When You're Leading Change in a Medical Practice

Tim Coan, Focus Solutions — Fri, 13 Mar 2026 04:00:00 +0000

Getting physicians to embrace change is the hardest part of the job. Here's how Andre Beach does it.

Andre Beach is the Chief Operating Officer of Denver Arthritis Clinic — Colorado's longest-standing rheumatology group. In this episode, he shares the practical, people-first framework he uses to lead change without losing his team.

You'll learn:

How to assess whether your team has the right tools before pushing for change
Why data matters more to physicians — and how to present it in a way they'll actually act on
How to handle the 'historian of record': the long-tenured physician who's resistant to every new idea
Why informal authority is more powerful than any title you're given
How to manage your own change fatigue tendencies so you don't drag your team behind you at 100mph

Whether you're a practice administrator, COO, or physician leader, this episode gives you a real-world playbook for moving your organization forward — without breaking it.

Chapters

(00:00:00) - Andre's background and Denver Arthritis Clinic — 50 years, 11 physicians
(00:01:03) - How a 13-year-old started at the very bottom of healthcare
(00:02:33) - How to assess if your team has the tools they need before pushing change
(00:04:13) - Why physicians and staff need completely different messaging
(00:05:44) - Getting a practice to shift from gut-feel to data-driven decisions
(00:07:20) - Navigating culture: respecting the past while building toward the future
(00:08:22) - Identifying early adopters vs. the 'historian of record'
(00:10:07) - Using AI to bring a resistant physician on board
(00:11:04) - When the physician owner is both the champion and the obstacle
(00:13:42) - Managing your key lieutenants through change — and your own pace
(00:15:53) - Andre's #1 goal for his first year: earning buy-in from every corner

Bridging the Gap Between Data and Patient Care

Tim Coan, Focus Solutions — Fri, 06 Feb 2026 00:34:26 +0000

Most clinicians don't need more data. They need data that connects to the patients in front of them.

Tim Coan sits down with Dr. Jill Goldenberg, an internal medicine physician, informaticist, and value-based care leader, to talk about what actually works when presenting data to clinicians.

What you'll learn:

Why numbers without patient stories are "just numbers"
The mistake of assuming every clinician understands your data
How to present financial data without losing your clinical audience
The documentation learning curve when shifting to value-based care
Generational differences in how physicians engage with data

Chapters:

00:55 Meet Dr. Jill Goldenberg: From hospitalist to informaticist
02:52 Speaking two languages: Clinical and data
03:35 Why numbers alone miss the mark
04:22 Don't assume every clinician reads the journals
06:08 Clinical data vs. financial data: Navigating the tension
07:51 What works in data presentation (pictures, graphs, and clear actions)
9:23 Value-based care and the data challenge for private practices
10:15 The documentation learning curve
11:51 Using data prospectively vs. retrospectively
13:49 Generational differences among physicians

Chapters

(00:00:55) - Meet Dr. Jill Goldenberg: From hospitalist to informaticist
(00:02:52) - Speaking two languages: Clinical and data
(00:03:35) - Why numbers alone miss the mark
(00:04:22) - Don't assume every clinician reads the journals
(00:06:08) - Clinical data vs. financial data: Navigating the tension
(00:07:51) - What works in data presentation (pictures, graphs, and clear actions)
(00:09:23) - Value-based care and the data challenge for private practices
(00:10:15) - The documentation learning curve
(00:11:51) - Using data prospectively vs. retrospectively
(00:13:49) - Generational differences among physicians

AI is Bringing Cardiac Care Closer to Patients

Tim Coan, Focus Solutions — Fri, 09 Jan 2026 16:30:00 +0000

What happens when you need a cardiac test but the nearest cardiologist is hours away?

Tim Coan and healthcare consultant Ron Guillot get into the reality of cardiac care access in America and where things are headed.

What you'll learn:

Why 50% of U.S. counties are considered "cardiology deserts."
The sonographer shortage and how it affects patient care
How new tech is cutting training time from 12 months to 6 hours
How to think about new clinical technology for your practice

Whether you're in a rural practice or just trying to keep up with what's changing in cardiac care, this one's worth 20 minutes of your time.

Chapters

(00:00:00) - The state of cardiac health and access issues
(00:03:02) - The role of AI in cardiac diagnostics
(00:05:55) - Addressing the sonographer shortage
(00:09:10) - Introducing Ultrasight: a game changer
(00:11:49) - Revolutionizing cardiac echo accessibility
(00:15:08) - Embracing innovation in healthcare

AI in Healthcare Billing: The Untold Challenges of Automating Revenue Cycle Management

Tim Coan, Focus Solutions — Thu, 14 Aug 2025 20:58:36 +0000

In this episode of Vital Conversations, Tim Coan sits down with Dena Langan, VP of Revenue Cycle at Frontier Dermatology, to talk about the real-world challenges of automating healthcare RevCycle processes. From coding complexities and payer contracts to prior authorizations, denials, and reporting, Dena shares why some automation promises fall short—and where AI has real potential to make a difference.

00:00 – Welcome to Vital Conversations with Tim Coan & Dena Langan
01:00 – Dena’s background & Frontier Dermatology’s scale
02:35 – AI’s growing role in healthcare RevCycle
03:50 – The goal of automation: freeing humans from tedious tasks
04:40 – Why coding accuracy still needs human oversight
05:50 – The impact of AMA’s 2020 coding rule changes
07:10 – Could ambient listening scribes be the answer?
09:00 – Optimism for AI-driven coding improvements
09:35 – The challenge of automating contract loading
11:25 – Why eligibility & prior auth automation is still tricky
12:48 – The complexities of automating denials & appeals
14:14 – Reporting and analytics: manual bottlenecks
15:18 – Dena’s 12-month automation wish list
16:10 – Closing thoughts on the future of RevCycle automation

How Healthcare Leaders Can Use AI To Improve Productivity From A Private Equity Engagement Director

Tim Coan, Focus Solutions — Tue, 22 Jul 2025 14:57:22 +0000

AI is changing the healthcare industry, but not always in the ways we expect. In this episode of Vital Conversations, guest Jeff Freedman, Director of Private Equity Engagement at ModMed, brings his 30+ years of operational experience to the table to talk through how healthcare organizations can make smarter, more productive use of AI.

How to Avoid Revenue Leaks as a Private Equity-Backed Practice: Advice from a 30-Year RCM Leader

Tim Coan, Focus Solutions — Tue, 01 Jul 2025 18:56:42 +0000

In this episode, host Tim Coan sits down with Pete Martinez, a Vice President of Revenue Cycle Management (RCM) at National Partners in Healthcare, to unpack what happens when private equity (PE) meets healthcare operations.

They explore:
How private equity deals disrupt RCM processes
Why RevCycle gets misunderstood as just “finance”
Common mistakes made post-acquisition
How front desk attrition leads to massive revenue leaks
The importance of aligning operations and RCM
Key KPIs CFOs and RCM leaders must track
Why SOPs often fail in scaling physician practices
Pete’s new training platform: AskCWS.com – built to strengthen RevCycle teams everywhere

Whether you're a CFO new to healthcare, a RevCycle leader navigating PE ownership, or someone trying to stop revenue leaks, this conversation is packed with insights, strategy, and tools you can act on today.

Navigating Pediatric Leadership Challenges with the CEO of Allied Physicians Group

Tim Coan, Focus Solutions — Tue, 10 Jun 2025 17:01:21 +0000

The CEO of Allied Physicians Group, Dr. Kerry Fierstein, joins Vital Conversations host Tim Coan for a talk about the current state of pediatric care. They discuss the challenges faced by pediatricians, particularly around immunizations and the trust issues that have arisen post-COVID. Dr. Fierstein shares insights on recruitment and retention in pediatrics, the financial aspects of running a practice, and the dual roles she plays as both a practicing pediatrician and a CEO. The conversation also highlights the community impact of the Allied Foundation, which addresses critical needs such as diaper distribution and literacy programs for children.

Bringing People Together in Healthcare Leadership: Jim Haveman's Unique Healthcare Journey

Tim Coan, Focus Solutions — Tue, 20 May 2025 19:22:58 +0000

In this episode of Vital Conversations, host Tim Coan sits down with longtime friend and public health leader Jim Haveman for an extraordinary discussion that bridges domestic policy and international diplomacy. Jim recounts his unconventional journey from social work to leading Michigan’s $18 billion health department, and eventually serving as the acting Minister of Health in post-war Iraq. His stories go far beyond typical healthcare leadership—he shares how he rebuilt systems, empowered local leaders, and practiced humility while navigating both partisan U.S. politics and the volatile streets of Baghdad.

Listeners will gain rare insights into how to unite people with opposing agendas—whether negotiating Medicaid expansion in a divided legislature or rebuilding a healthcare system with no infrastructure. Jim’s leadership lessons are laced with wit, real-world strategy, and a human-centered approach that feels especially relevant today. Tune in to hear how listening, compromise, and walking the streets—not just sitting in boardrooms—can drive lasting impact.

Navigating the Complexities of Multi-Location Healthcare

Tim Coan, Focus Solutions — Tue, 29 Apr 2025 18:52:54 +0000

In this episode of Vital Conversations, Tim Coan sits down with Bill Duke, CFO of Connecticut Skin Health, to discuss the operational challenges of managing a multi-location dermatology practice. With 10 offices, over 100 employees, and more than 30 providers, Bill shares the complexities of staffing, onboarding, and maintaining consistent patient care across rural and urban locations. He emphasizes the critical role of thorough onboarding and the need for constant communication and coordination among staff to keep operations smooth. The conversation highlights the delicate balance between centralized systems and maintaining a local, familiar feel for patients, while tackling staffing shortages, retention struggles, and increasing demands for operational efficiency.

The discussion also dives into the role of technology and data in synchronizing patient demand, provider capacity, and staffing - revealing that while tools and automation (especially around eligibility verification) have helped, human oversight remains essential. Bill reflects on the financial implications of operational optimization, explaining that consolidating information and streamlining processes across locations significantly improves a practice’s financial health. The episode wraps up with insights on the importance of treating multi-location management as an interconnected system rather than isolated units, showcasing how even small improvements in efficiency can lead to major gains.

Can Functional Medicine Fix Healthcare? Dr. Daniel Urcuyo Breaks It Down

Tim Coan, Focus Solutions — Tue, 08 Apr 2025 18:13:08 +0000

In this conversation, Tim Coan interviews Dr. Daniel Urcuyo about functional medicine, exploring its principles, the shift from traditional medicine, and the challenges faced in the healthcare system. They discuss the importance of nutrition and lifestyle changes, the role of technology, and the impact of political influences on the field. Dr. Urcuyo emphasizes the need for a systemic approach to health and the challenges of the current business model in functional medicine.

Doctors, Data, and the Future: How AI is Changing Healthcare

Tim Coan, Focus Solutions — Thu, 20 Mar 2025 16:11:44 +0000

In this episode of Vital Conversations, host Tim Coan dives into the future of AI in healthcare with Dr. Jeffrey Jensen, Dean of the Arizona College of Podiatric Medicine. Together, they explore how AI is transforming the doctor-patient relationship, streamlining medical documentation, and reshaping clinical research and education. Dr. Jensen highlights AI’s potential to reduce burnout, improve diagnostic accuracy, and enhance medical training while addressing its challenges, such as ensuring evidence-based use. The conversation also touches on the evolving role of technology in patient empowerment and its implications for healthcare professionals. Tune in for a forward-thinking discussion on the intersection of medicine and AI.

Automating Healthcare RCM: Lessons from Innobot’s CEO Natasha Schlinkert

Tim Coan, Focus Solutions — Thu, 06 Mar 2025 18:44:05 +0000

In this episode of Vital Conversations, host Tim Coan speaks with Natasha Schlinkert, CEO of Innobot, about revolutionizing healthcare revenue cycle management through automation. Natasha shares her journey from decades in the industry to founding Innobot Health, addressing the challenges of robotic process automation (RPA) in healthcare. She explains how combining domain expertise with advanced technology can transform operations, reduce inefficiencies, and improve outcomes.

The conversation delves into the nuances of RPA, its potential to optimize repetitive processes like claim status checks, and its limitations with tasks requiring human intuition. Natasha highlights Innobot’s unique approach to bridging the gap between operational workflows and automation, offering practical insights for organizations looking to enhance efficiency while maintaining human oversight.

Reimagining EHRs for Collaborative Care: Healthie’s Innovative Approach

Tim Coan, Focus Solutions — Tue, 18 Feb 2025 21:08:16 +0000

In this insightful episode of Vital Conversations, Tim Coan sits down with Erica Jain, CEO of Healthie, a groundbreaking ONC-certified EHR platform designed for virtual-first, longitudinal, and collaborative healthcare. Erica shares the personal inspiration behind Healthie, stemming from her parents' transformative health journey, and discusses why traditional EHRs fail to meet the needs of modern healthcare providers.

She dives into how Healthie empowers providers in behavioral health, nutrition, coaching, and women's health by offering intuitive tools for hybrid care, seamless patient-provider integration, and efficient documentation—solving the pain points of outdated systems. If you’re curious about how technology is reshaping healthcare beyond legacy platforms, this is a must-listen episode!

Listen now to discover how Healthie is redefining digital healthcare!

House Calls Reimagined: Personalizing Senior Care with Meridian Health

Tim Coan, Focus Solutions — Tue, 04 Feb 2025 19:42:17 +0000

In this episode of Vital Conversations, Tim Coan from Focus Solutions sits down with Dr. Chris Chumley of Meridian Health to discuss the evolving landscape of home-based medicine for at-risk seniors. Meridian Health focuses on providing primary care to seniors in their residences, whether in assisted living facilities or private homes, helping to manage complex chronic conditions. Dr. Chumley highlights the advantages of this model, such as improved patient compliance, longer face-to-face visits, and a more personalized approach that includes evaluating living conditions and even diet through what he calls a "fridge biopsy." The discussion underscores how home-based care reduces hospitalizations and ER visits, ultimately improving patient outcomes while lowering costs.

The conversation also delves into the technological and data challenges of this care model. Dr. Chumley explains how advancements like cloud-based EMRs, 5G connectivity, and interoperability tools help overcome hurdles in accessing and sharing patient data across multiple healthcare systems. However, he notes that the industry still has a long way to go in optimizing data utilization for improving patient care and scaling home-based medicine. The episode concludes with an optimistic outlook on the future of value-based care and innovations like hospital-at-home programs, emphasizing the need for continued efforts to refine healthcare delivery for the most vulnerable populations.

Building Better Healthcare: Kelly Poole on Process Excellence

Tim Coan, Focus Solutions — Wed, 15 Jan 2025 14:54:00 +0000

In this episode of Vital Conversations, Tim Coan is joined by Kelly Poole, a seasoned healthcare leader and innovator with a remarkable blend of clinical and operational expertise. The discussion dives into Kelly’s unique journey from bedside nursing to becoming a vice president of operational excellence and transformation, as well as the founder of her consultancy, The Improvement Space. Kelly shares insights from her two decades in healthcare, focusing on the intersection of clinical care, technology, and process optimization. Viewers will appreciate her dynamic approach to solving complex challenges in healthcare organizations.

Listeners will gain valuable perspectives as Kelly recounts her experiences leading technology and process improvement initiatives, including the critical role of aligning technology with real-life workflows. The episode explores key themes like optimization and standardization, addressing common pitfalls such as over-reliance on technology without a foundational process and the challenges of implementing best practices across diverse teams. With practical anecdotes, Kelly demonstrates how understanding the "why" behind processes and tailoring solutions to specific needs can drive meaningful outcomes for patients and providers alike.

Whether you're a healthcare professional, an organizational leader, or someone intrigued by transformative solutions, this episode is packed with actionable advice and thought-provoking dialogue. Tim and Kelly’s rapport, rooted in years of professional camaraderie, makes for an engaging and relatable conversation. Don’t miss the chance to hear Kelly’s expert guidance on navigating the complexities of healthcare operations while fostering innovation and excellence.

Hawk Sindel: How a Collaborative Network Uses Shared Data to Improve Experiences

Tim Coan, Focus Solutions — Thu, 02 Jan 2025 16:28:25 +0000

In this episode of Vital Conversations, host Tim Coan interviews Hawk Sindel, CEO of Urology Associates of Mobile and managing partner of Southeast Urology Management.

They discuss the Urology Alliance, a collaborative network aimed at improving urology practices without mergers or loss of autonomy. The conversation explores how the Alliance uses shared data analytics to enhance patient care, reduce costs, and tackle key initiatives, like advanced prostate cancer care.

They dive into the challenges of normalizing data across platforms, improving patient appointment adherence, and the role of pharma partnerships in closing care gaps.