Cheryl Manchenton and I go back a long way—I once took a ride from a Las Vegas casino to the airport with her after an ACDIS conference well over a decade ago. And I’ve learned over the years she also happens to be as sharp—and as outspoken—as anyone I’ve ever met regarding the subject of healthcare quality, specifically measuring hospital quality with coded or abstracted data and how it all relates to the work of mid-revenue cycle professionals.

I think we even talked quality on the way to the airport.

So I was thrilled to get her on Off the Record to go deep on this topic, along with her Disney World obsession and other fun asides (Gandalf the Gray makes his way in to the conversation). This was a fabulous, wide-ranging talk on quality. Tune in and listen to:

• What Cheryl thinks about how we measure quality in healthcare, specifically through the use of coded data
• What quality-obsessed hospitals often get wrong about impacting outcomes with documentation and coding alone (with a deep dive into healthcare acquired infections, or HAIs).
• Borderline or unscrupulous practices done to artificially improve quality rankings
• What concrete steps would Cheryl take were she leading a small community hospital seeking to improve its observed/expected mortality ratio
• The recently-released 2026 OPPS proposed rule and the large number of hospitals potentially impacted by the new Safety Measures change (we both like this: presently a hospital can rank at the bottom for safety and still be 5 stars)
• The reality of “picking your poison” among many quality programs and getting aligned with what really matters to your organization
• Cheryl’s career north star, how she stays educated, and thoughts on her long career winding down
• Disney craze, grandkids, and best tips for navigating the theme parks

Some of us dream of being able to say, “Thank you for Coming to my Ted Talk.” Others wilt at the thought of getting on stage to deliver not just a lecture on a complicated or sensitive topic, but a performance.

My guest today Dr. Chris Petrilli has delivered. My first Ted Talk alumni on Off the Record (of which I’m aware) recently presented How AI could help doctors detect patterns before a Ted Talk audience.

This show delves behind the scenes of a Ted Talk. But it does a lot more: We get deeply into the subject of Chris’ talk itself, one I think about all the time—artificial intelligence, how we interact with it, what it means for the future of the mid-revenue cycle (and our humanity), and how AI and humanity can be reconciled. Chris practices internal medicine at NYU Langone where he is also tasked for developing AI solutions for the health system. This is his second appearance on the podcast.

On this show we cover:

• Ted Talk details: How it came about, preparation, and delivery: How many dry runs? Coaching, nerves, and tech assistance

• Impact of the talk.

• Humor and entertainment as a teaching tool and effecting change at work (including physician buy-in)

• How can humanity coexist with this powerful new technology—is Chris an optimist or pessimist or some blend of the two?

• Pattern recognition: Similarities and differences between humans and machines

• AI as an overcaffeinated intern, powerful and full of energy but with no idea what’s happening...

• Emerging clinical and mid-revenue cycle applications

Watch Chris’ Ted Talk on YouTube: https://www.youtube.com/watch?v=M0qIyowPr0E

I don’t know this with certainty, but I probably have more than one listener dreaming of starting their own business, in the mid-revenue or elsewhere. Others might be content in their current roles as CDI, coding, or mid-revenue cycle professionals, but are also looking forward to their big trip in August.

Today’s guest is living the best of both worlds.

Melanie Kiss started Chicas Abroad in 2021 with a small group of friends who shared a joint love for travel and adventure. Prior to that she had been a longtime HIM professional with stops ranging from the hospital setting to college classrooms to consulting, and even a long stint with AHIMA.

Today she’s leading worldwide curated travel. How does one go from HIM to Havanna, coding to Cebu? Listen to Off the Record as we discuss:

• Chicas Abroad: How it started and when Melanie realized it was time to go all in

• Melanie’s innovative marketing strategy (I learned a thing or two that I will adopt!)

• Entrepreneurship: Melanie’s words of wisdom and what learned about herself while taking risks and launching a business

• Following your bliss: When do you know it’s time to pursue something new?

• The coolest place she's ever been

• Off the beaten path experiences with difficult clients and other fun stuff. With a little HIM/coding talk, too, because this is a serious mid-revenue cycle podcast...