Healthcare Musings

Get Off The SOFA: Winning the Fight Against Sepsis Denials

Increasingly, insurance companies and third-party auditors are denying sepsis claims and DRGs based on the “Sepsis-3” article published almost 10 years ago. 
Specifically, they contend that if there is no SOFA score of 2 or greater there is no sepsis. Not so fast. The article never said that, and this is crucial when fighting sepsis denials. On this episode of the podcast, Dr. Hassaballa discusses this crucial fact to help hospitals and other providers fight these ever increasing sepsis denials. Article link: https://jamanetwork.com/journals/jama/fullarticle/2492881

Leadership, Compassion, and the Future of AI in Critical Care: My Appearance on the Becker's Healthcare Podcast

I was honored to be a guest on the Becker’s Healthcare Podcast.
During the episode, I discussed how AI is transforming clinical care; the irreplaceable human elements of medicine; and the leadership values that guide my work. I also shared insights on physician excellence, system level improvement, and what inspires me as I look ahead to 2026. 

The Soundtrack of My Grief: "You Are The Piece of Me I Wish I Didn't Need"

Ever since the death of my daughter on June 7, 2009, I have written and reflected on many things that remind me of her, including many popular songs. It is one of the ways the Lord saved my life after her death. 
Today, on her birthday, I embark on a new series on Healthcare Musings: "The Soundtrack of My Grief," where I discuss those songs that have helped me cope with her death. 
The first song upon which I will reflect is "Clarity," by Zedd. 
Song link: https://music.apple.com/us/song/clarity-feat-foxes/1440861976 

Can AI Chatbots Make End-of-Life Decisions?

Can an AI Chatbot version of you make an end-of-life decision if you cannot make it on your own?
This possibility was brought up to me on a previous episode with Eiman Abdelmoneim. I was so intrigued by the possibility that I sat down with Dr. Muhammad Aurangzeb Ahmad, Resident Fellow at the Harborview Medical Center (UW Medicine). He is also Affiliate Assistant Professor in the Department of Computer Science at University of Washington Bothell and Affiliate Faculty member at Responsible AI Systems and Experiences, University of Washington. 
One of his main focuses of research is LLMs and end of life. It was a fascinating conversation. 

Metabolic Encephalopathy: Essential Guide to Accurate Documentation

Metabolic encephalopathy is a state of global cerebral dysfunction caused by systemic metabolic or toxic disturbances. Its presence raises the severity of illness of those patients afflicted with it, and it is a frequent denial target of payers. 
It is essential that clinicians document this condition in the record when it is present. In this episode, Dr. Hassaballa discusses this diagnosis and provides essential tips on how to properly document this condition. 

The Sepsis Confusion: SIRS, SOFA, and CDI…Oh My!!!

There are two competing definitions of sepsis, called "Sepsis-2" and "Sepsis-3." They are vastly different, and it is causing enormous confusion with respect to diagnosing and coding for sepsis. 
I assembled a panel of experts to discuss the proper coding of sepsis. Does a UTI with fever and tachycardia really constitute sepsis? Does CMS mandate a specific definition of sepsis? What about SOFA scores? 
We delve into all of this and more. The panel for this episode is: 
Dr. Erin Boyd 
Dr. Ronald Hirsch
Dr. Cesar Limjoco
Shirlivia Parker 
I learned a lot, and it has definitely affected my approach to patients with sepsis in the ICU. It has also further spawned future episodes about sepsis, so stay tuned. 

Seeing Healthcare From 30,000 Feet: My Conversation with Scott Becker

Scott Becker, Founder and Publisher of Becker's Healthcare, has a unique perspective on the state of the healthcare system in the United States. So, I wanted to sit down with him and get his insights as well. 
He had amazing observations and thought-provoking suggestions regarding: 
Healthcare Coverage for all
Healthcare Quality
Healthcare Cost
Healthcare Access
We delved into each during this fantastic conversation. 

More People Are Turning To AI Chatbots: How Doctors Can Properly Deal With This

The NY Times had an article detailing how people are turning to chatbots because they are frustrated with the medical system. As a physician and patient myself, I completely sympathize with both groups. We need to fix this problem. 
In this episode, Dr. Hassaballa
Summarizes the NY Time article (linked below)
Explains why this phenomenon occurs
Suggests what physicians need to do about this fact.
NY Times article: https://www.nytimes.com/2025/11/16/briefing/meet-dr-chatgpt.html?unlocked_article_code=1.2U8.wvrB.zA5xQrxE6LSR&smid=url-share

Is American Healthcare Doomed To Be A Zero Sum Game?: My Conversation With Jeff Alter

Insurance payers have the money. Providers - hospitals and doctors - want the money. This seems to be an irreconcilable conflict. Is there a middle way? 
I asked the perfect person this question: Jeff Alter of Sound Physicians. His insights were invaluable. 
Jeff Alter on Linkedin: https://www.linkedin.com/in/jeffreydalter/
Sound Physicians: www.soundphysicians.com 

“Poof, It’s Sepsis”: Are Doctors Using AI To Inappropriately Bill Patients?

There is a growing battle between payers and providers, each using AI to get the most money. Are doctors and hospitals using these tools inappropriately? 
Articles: 
AI by Doctors: https://www.statnews.com/2025/08/20/ai-scribe-use-doctors-health-insurance-bills-may-rise/
 
AI by Insurers: https://www.statnews.com/2025/10/31/health-insurer-ai-fights-hospital-ai-coding-billing/