Latest / Becker’s Payer Issues Podcast / AI's Impact on Healthcare: Transforming Member Experience & Responsible Innovation

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AI's Impact on Healthcare: Transforming Member Experience & Responsible Innovation · Becker’s Payer Issues Podcast

• 0:00
  Hello, everyone. This is Brian Zimmerman with the
• 0:02
  Becker's Healthcare podcast series. Thank you so much
• 0:04
  for tuning in. Today, I'm thrilled to be
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  joined by Amanda Burry, chief commercial officer with
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  InformEDICA.
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  Amanda, welcome to the podcast. Thanks so much
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  for coming on. Thanks so much for having
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  me. I'm really enjoying being here today.
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  Great. So just to get things going,
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  wonder if you could briefly give us an
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  overview of your your professional background in health
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  care so listeners out there can appreciate your
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  perspective as we move through this conversation.
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  Sure. So I always say that I started
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  my health care journey in 1988
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  when my mom started a medical billing service
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  from our home.
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  She did medical billing for just about 70
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  anesthesiologists
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  in the Chicago area. And so I grew
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  up around the business of health care. Back
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  in those days, it was dot matrix printers
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  and paper bills.
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  And in 2,001, she sold her company
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  as the transition to electronic medical records happened.
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  But I got to see firsthand growing up
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  really the business side of health care, which
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  turned into my love of digital health care
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  and all things,
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  member and patient engagement.
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  Yeah. I love love that too because we're,
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  of course, we're gonna talk about AI and
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  things have come a long way from those
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  those those days of paper. Right, Amanda?
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  Yes. And those days of the sticky notes,
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  you know,
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  nurses and practitioners putting sticky notes all over
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  the office. And,
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  you know, throughout my journey in health care,
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  and I've spent about the last 10 years
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  really focusing on member and patient activation,
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  engagement.
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  We have come a really long way, and
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  I know health care is hard and we
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  all feel like every day we're slogging up
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  the hill. But when I look back on
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  my journey when I started in 2001 to
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  where we're at today,
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  you really can see that we have made
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  strides. Now AI is definitely gonna help us
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  hopefully get there even quicker.
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  But I think over the course of presenting
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  the EHR as more of an engagement platform
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  in a place where patients go
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  to get all of their health care information
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  to the way that members engage with their
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  health insurer to understand their bills and and
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  coverage.
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  We have come a long way from the
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  paper, the post it notes, the phone calls,
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  but it is gonna take that next wave
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  probably to push us into
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  more of a seamless and interoperable transition that
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  we need to get into.
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  Yeah. And and we'll touch on that that
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  that Xwave, I'm sure, but also wanna get
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  to the current state. But I think you're
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  right. It's It's it's kinda human nature sometimes
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  to sort of forget or omit the the
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  progress that has been made over time.
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  Getting to that,
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  the advancements in AI, the rapid,
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  it's becoming increasingly clear that new technologies are
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  are transforming
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  health care.
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  And it seems like new solutions are coming
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  out daily. It's good. It's a crowded crowded
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  space right now.
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  Where have you seen AI influence the member
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  experience specifically,
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  and and how is that affecting health systems?
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  How is that affecting patients? But more broadly,
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  more specifically, how is it affecting health systems?
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  Yeah. I think all of these new technologies
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  and
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  the the talk tracks that are happening at
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  conferences and social
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  are giving whether you're a health system or
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  payer a little bit of FOMO. Right? What's
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  everybody doing? How are they implementing it? And
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  the word AI for the last couple years
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  has definitely been the buzzword, Gen AI, large
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  language models.
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  But really now I think we're at the
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  top of the roller coaster where we need
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  to see the AI tools that have come
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  out,
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  how they are transforming parts of health care.
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  And I see think you're seeing some of
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  the most successful ones in the ambient space.
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  So things that companies are doing like a
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  Nuance,
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  with Microsoft
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  or or Suki, what they're doing in terms
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  of ambient listening, I think is one of
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  the quickest wins that we see have seen
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  as well as a lot of the administrative
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  burden burden that's happening with pre charting or
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  pre authorization.
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  So some of those lower level ones, we're
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  getting more comfortable with. And I think as
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  that
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  comfort continues to increase,
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  not only on the patient side, but the
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  provider side, so patients understand and members understand
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  how AI is being used with them because
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  most of them, and we did a survey,
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  most of them think, ma'am, this is gonna
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  give me less time with my provider. My
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  provider is gonna treat is gonna be a
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  robot and and treat me like everybody else.
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  But what they need to understand and what
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  we have to educate them with is it's
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  gonna give you more personalized time with your
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  provider to actually talk about how you're feeling
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  than,
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  just having them push you into a queue.
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  And so I I'm hoping that at some
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  of the upcoming events that we're gonna be
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  having in the fall and and at Becker's,
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  I'm looking for some real world implementations
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  of AI, and we're doing that as a
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  company today with some astounding outcomes. Again, very
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  much at that early stage,
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  but I'm excited to see how some of
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  these things snowball into larger, more meaningful workflows
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  that can really move populations at scale to
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  make that difference that we need them to
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  do.
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  Yeah. And, Amanda, to the I'll echo that.
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  The the anecdotal stories I'm hearing coming through
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  about the power of MB and AI are
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  really powerful. Just that our most recent Beck
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  Becker's conference heard a story or an anecdote
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  about a a mom sitting down to dinner
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  with her kids. She's a physician,
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  and she's at dinner eating with them. And
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  her her son looks up at her and
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  asks, why aren't you working, mommy? It's it's
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  it's some some powerful stuff is coming out
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  with this technology. Right, Amanda?
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  Mhmm. And we're seeing it too. Like, I'll
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  take a a not even a health care
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  example, but something maybe all of the listeners
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  would use who are in in on the
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  business side is we use a tool called
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  Fireflies.
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  Fireflies is a tool that you add to
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  your meeting invite,
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  and it is your AI notetaker. So gone
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  are the days of people on business meetings.
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  You know, you're trying to scribble down notes.
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  You're typing feverishly to get everything that somebody
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  says.
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  This AI scribe is listening to the meeting,
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  understanding the meeting, picking out the highlights,
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  and then giving you a a summary or
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  giving you a readout
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  after the call. Right? It's making light our
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  lives easier post call. Like, those are the
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  little wins, I think,
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  in that health care is adopting
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  that we probably need to share more of
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  because it's exciting for those clinicians
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  or,
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  different practitioners or administrators
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  who are really bogged down with a lot
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  of the paperwork, the charting,
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  and just the things that are taking time
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  away from clinic time or care time,
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  and making them more of,
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  paperwork time, which, you know, is not as
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  productive as it needs to be.
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  Certainly. And and wanna move here not to
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  regulatory
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  components here. Of course,
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  regulation, there's there's a lot of question marks
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  around what's gonna develop here. But, of course,
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  California's governor Gavin Newsom signed 17 bills around
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  the deployment
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  and regulation of generative AI in 2024.
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  Other states are likely to follow, of course.
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  So my question for you is, how can
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  leaders
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  a responsible
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  approach to to leveraging AI? And are are
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  there any other instances you call can call
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  out about how patients are benefiting so specifically?
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  Yeah. I I mean,
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  what we're doing in terms of regulatory, and
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  I think Europe does this very well. So
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  as a global company,
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  we have to perform regulatory
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  with the government bodies that are outside the
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  US as well. And,
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  they have a different legislation and a different
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  regulatory
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  lens than the US does. I think the
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  White House putting together this AI,
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  committee and these, different key
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  leaders from different parts of health care has
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  been really critical.
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  I think putting laws and legislation into place
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  that is guidance for people to understand
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  where AI starts and where it ends, how
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  it's impacting data and data privacy
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  is very important.
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  Responsible,
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  trustworthy,
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  and and and really
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  safe AI is very important. So we see
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  many of our partners and customers globally
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  starting to develop AI boards.
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  So because there are not as many guardrails
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  out there from a
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  regulatory perspective,
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  it can create bad actors or it can
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  create,
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  information,
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  that is not accurate or create biases.
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  And so we see a lot of our
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  customers actually putting together
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  AI boards where they meet with us regularly,
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  and we go through how the models work
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  and how they're built and and and and
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  and the tools and triages that they're using
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  to get those members and patients to the
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  right level of care.
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  And so what California is doing, I think,
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  is a great first step in not only
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  informing the public
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  about how we need to have certain bylaws
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  around AI technologies being implemented,
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  But also even taking a step further, some
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  of the things the White House and the
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  White House Council has done to put specific
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  leaders in place from very large health care
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  organizations that
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  see large populations of data and making sure
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  that we're taking a trustworthy, responsible,
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  and clinical safety approach,
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  to how these tools are being used in
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  the market.
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  Yeah. Yeah. A good first step in some
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  of this legislation,
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  you would say, but also I I gather
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  from your response that a lot of the
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  governance, a lot of the ethical use of
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  this, folks are gonna have to try to
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  to to figure it out themselves because the
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  technology is moving faster than maybe regulation can.
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  Am I reading that correct, Amanda?
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  A 100%. And I think you see that
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  both internally with themselves.
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  So I think internally, they have to ensure
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  their providers,
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  administrators, their employees that they're they themselves are
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  leveraging AI appropriately.
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  And then their duty as, let's say, the
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  health plan or the hospital that is treating
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  them with their providers,
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  educating them about where AI is being used
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  in the process. So whether there's an ambient
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  scribe in the room or whether you're using
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  some sort of chat assistant when you're going
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  on to pay your bill or whether you're
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  using, you know, some sort of triage tool
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  to be able to be connected to the
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  right level of care.
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  We know health literacy in the US is
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  a is a challenge. So now we're adding
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  a step of complexity onto it saying, not
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  only do you have to understand all of
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  these hard health care technical terms about something
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  that might be wrong with you, but here's
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  also, you know, information about how AI plays
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  into that. So,
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  there's there's internal education and external education,
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  to make sure that both, patients and providers
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  know that the tools they're using, are trustworthy,
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  and are ethical.
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  Certainly. And and, Amanda, as we move to
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  the close of this conversation, I think it's,
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  of course,
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  important to sort of point to, you know,
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  organizations' health systems have to figure out also
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  how to how to measure the impact of
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  these tools, which are which can be challenging
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  and new. So
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  thinking about and, of course, the the a
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  big impact, a big thing they have to
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  measure is is ROI. There's a cost involved
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  here. So where can AI do you think
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  makes the biggest difference in reducing costs while
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  while boosting engagement, patient member engagement,
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  and and how how can folks measure that?
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  Yes.
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  ROI in digital health, I think, has been
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  notoriously
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  hard. Right? Just like all things in health
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  care are hard. I think ROI and cost
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  savings in health care is hard.
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  Where I think AI can make the biggest
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  difference in reducing, you know, that cost while
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  also increasing engagement is
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  really through the data and the information
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  that is being,
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  pulled and is being
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  understood during these different workflows.
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  So for instance, we talked a little bit
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  about the ambient space.
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  What is the cost
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  to the health system of that provider
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  leveraging those additional 15 minutes that they might
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  spend doing the charting and doing the,
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  post information
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  from that conversation.
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  I think it's making it easier for us
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  to connect the dots,
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  and it's also making it easier to connect
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  the top the dots between different parts of
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  the organization.
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  So from a health plan side, from the
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  time you engage those members, you could also
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  do more outreach. Right? It allows you to
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  stratify your members
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  into population
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  and start to add risks,
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  buckets to those members.
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  So the data is actually helping you to
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  also understand the the risk of your, population's,
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  message to them more clearly,
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  provide them more guidance,
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  maybe keep them out of the ED if
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  they are a frequent flyer or or visit
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  the ED or keep them engaged in a
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  diabetes program.
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  So I think from a provider side, you
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  can look at it as how much time
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  savings is happening happening to provide more care.
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  And on the pay on the patient or
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  member side, it's how do you engage them
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  in programs to try to make them healthier,
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  to try to make them more engaged,
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  within their health?
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  How do you steer them away from the
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  ED for a sore throat or a low
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  acuity case where they can potentially do a
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  telemedicine appointment or even maybe self-service at home
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  where the cost is low, not only for
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  the plan, but most importantly for the patient?
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  The patient has less out of pocket cost.
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  They spend less time trying to get to
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  their appointment,
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  and they get better care outcomes.
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  So I think that AI is going to
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  help connect more of those dots
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  and create more
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  prescriptive
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  messaging
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  to those populations
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  versus react reactatory,
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  messaging to those populations.
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  It's it's easy to to to imagine how
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  powerful that sort of prescriptive proactive messaging can
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  be. Amanda,
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  selfishly, I could- I could probably talk to
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  you much longer about this, but we- we
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  are up against time. So I was happy
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  to share anything else you'd like to share
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  that we didn't get to touch on in
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  our time today.
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  No. I think we covered it all. I'm
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  really excited to see the continued advancements that
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  AI is going to bring to the marketplace,
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  whether that's, the health system side or the
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  health plan side.
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  And I really hope that all of the
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  people listening to this podcast try to embrace
• 14:29
  one new AI tool, whether it's chat g
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  p t to help them rewrite an email
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  or maybe they try a tool like Fireflies
• 14:36
  to help them capture meeting notes. Because as
• 14:39
  we become more comfortable with it, the more
• 14:41
  adoption and the more engagement that both consumers
• 14:44
  and patients
• 14:45
  will have in our lives hoping to make
• 14:47
  health care better.
• 14:49
  Thank you. A great note to close on,
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  Amanda. Appreciate your time today.
• 14:53
  Thank you so much, Brian. Speak to you
• 14:55
  soon. Yeah. I also wanna thank our podcast
• 14:58
  sponsor,
• 14:59
  InformEDICA.
• 15:00
  You can tune to more podcasts from Beckers
• 15:02
  HealthCare by visiting our podcast page at beckershospitalreview.com.