Month: November 2021

Despite initial skepticism around digital health, doctors are driving a lot of digital engagement now

Season 3: Episode #104

Podcast with Dr. Mark Weisman, CIO and CMIO, TidalHealth

“Despite initial skepticism around digital health, doctors are driving a lot of digital engagement now.”

paddy Hosted by Paddy Padmanabhan
To receive regular updates 

In this podcast, Dr. Mark Weisman, CIO and CMIO of TidalHealth, Maryland, discusses the role of analytics and informatics in identifying bottlenecks and the opportunities where technology may be harnessed to enhance the quality of care. Tidal Health is a two-hospital health system on the eastern shore of Maryland, serving largely the rural population of Delmarva Peninsula.

As a physician who’s well versed with emerging technologies, Dr. Weisman acknowledges the handicaps digital health care must overcome to reach the underserved population in rural America. The foremost focus of their digital journey is to improve patient access to healthcare. He demonstrates how certain digital health tools can bring in cost-effectiveness, reduce the administrative workload on clinical staff, develop effective programs, and provide better healthcare access to everyone.

Dr. Weisman advises digital health start-ups to approach health systems and healthcare as genuine partners in improving patient access and care delivery and not as a salesman merely trying to sell a product or service. Take a listen.

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Show Notes

01:15About Tidal Health, your role, and responsibilities
03:49What are your top priorities right now?
05:44Access and digital health go together. What are you doing in that space?
07:51 How have the physicians responded to digital engagement?
09:24 You largely serve the rural populations. Does that have any kind of a bearing on your adoption rates, for instance, for digital health tools?
11:20 How are you bringing the two words – data and analytics – together to really use data analytics capabilities to drive digital engagement?
13:23 How you go through the thought process of evaluating and picking vendors that you want to talk to?
14:54 Do you go with an EHR-first strategy when it comes to turning-on your capability? How do you see your vendors coming along when it comes to these kinds of newer capabilities?
16:38 What is your advice to startups or healthcare companies who want to contact you?

About our guest

Dr. Mark Weisman is the Chief Information Officer / Chief Medical Information Officer for TidalHealth, Inc. He is a board-certified Internal Medicine and Informatics physician, who has practiced in inpatient and ambulatory care settings in hospitals, high-volume clinics, and retainer-style clinics. As an executive leader CIO and CMIO, he drives technology changes to make the lives of our practicing clinicians better. He is responsible for improving the cybersecurity posture of the organization, creating transparency into IT project activity, and improving IT agility.

Q. Tell us about Tidal Health, your role, and responsibilities.

Mark: Tidal Health is two-hospital health system on the eastern shore of Maryland. We tend to be fairly rural as we’re growing as a health system. Currently, roughly 400 beds at Tidal Health are filled up with COVID patients like everyone else. We continue to acquire practices which are coming to us looking for help because of some of the financial pressures in the market now, so, we’re definitely busy. I became CIO in August. I was the CMIO here for about three years, and it’s been a very interesting couple of months since becoming the CIO. There’s plenty of work to do.

Q: How did being a CMIO prepare you for this role, if at all?

Mark: It did help. My initial focus as a CMIO was on making the lives of the doctors better. That grew into helping the nurse practitioners, the nurses, the physical therapists and really making the EHR easier for a lot of people. It was exciting, fun and people really enjoyed that but there’s a lot left to be done. While we’re not perfect, we’re certainly becoming better.

When the opportunity came up for me to lead the EPIC application team — that was about half of our team and the number of analysts is just unbelievable — we had a good team, and we did some great things. That’s how I got the CIO role. While I still have the CMIO role and I do both, the challenges became clear soon. Already being the CMIO, I realized there was some tech part to becoming the CIO that I had to get up to speed on very quickly. I got the EPIC, the medical part, and the operations part.

Q: You’re a physician and have been involved in tech. What are your top priorities right now?

Mark: The organization is in pretty good shape in terms of infrastructure, so, I get to focus on some of the more fun things though we do have some challenges around access and provisioning — pain points for operations. Every time someone new comes into the organization, we can’t seem to get their access right on their first shift and it’s not good. So, they can’t get in nor see what they have to see. We need to take out the people who have been with our organization for years and not offer them access anymore. I really want to improve that because that goes along with my initial launch of making the EHR better for everyone. While this is just a piece of the entire job, it’s an important one. That’s a focus area plus there are other security issues, though we’re not in bad shape there.

Playing around in the automation space has been the most exciting part that’s energized me. I’m helping others be more efficient. However, it’s in finance that I’ve never had the opportunity to help out. It could be something like scanning of papers for HIM but we’re going to look at automating that with some new technology. What’s cool about being the CIO is that I get to do more.

Q: Access and digital health go hand-in-hand. What are you doing in that space?

Mark: Our digital journey started with EPIC. While we had a portal, there wasn’t anything really exciting there so no one really went to it. In November 2019, after a discussion with our executive leadership, we decided to put all our notes and labs out there to give people a reason to go to the patient portal. And that’s how it started. One of the decisions that was made at that time was around telehealth. That wasn’t on our roadmap then, and we weren’t going to do it. We were going to focus on some other pieces of the digital experience.

But there was a little change in plans. So, eventually we went with telehealth via Zoom and introduced a little more of digital health patient engagement. Our weak point was, however, around appointment reminders since it was being undertaken by the front desk — picking up the phone, dialing, getting the next person, leaving a message — and not very modern. I proposed a solution.

We began using Phreesia by which a text message to schedule appointments would be sent out and the frequencies of these messages and their times could be controlled by us. Our aim was to free up the front desk staff so they could be more efficient. We found that previously, our front desk staff were reaching out to over 50% of the patients but their no-show rates were high, and they never took breaks. Now those numbers were far lower, and we could see immediate results.

Our digital journey right now has entailed getting to that point of better access. Though our appointment scheduling is still via the portal, there’s more to the digital experience offered there.

Q: And how have the physicians responded to digital health patient engagement?

Mark: They fought it tooth and nail when it came to certain parts such as, releasing all labs in real-time, releasing pathology though when we did that, I got just one phone call in six months. There are many who must have had questions or concerns, but it became easier when the government enforced it. That did help with some buying acceptance.

The doctors were initially a little skeptical about telehealth. Then, there were the early adopters who jumped on it during the pandemic and did very well. They just went out and got their own tools and started doing telehealth because they wanted to see their patients. I thought it was great. I’m waiting for our tools now. 

However, we’re seeing a lot less — under 10% — maybe 4-6% of our visits now are going by telehealth. The doctors are driving a lot of that; we must not underestimate how resilient healthcare can be to change. The doctors like seeing people in-person, where things are built around them rather than their patients. Healthcare will go back to the way it always was without some other mandate pushing it along.

Q: What about the patients themselves? You mentioned that you were largely rural? Does that have any kind of a bearing on your adoption rates, for instance, for digital health tools?

Mark: It does. When the pandemic began, we suffered with broadband congestion and poor connectivity. The final mile killed us, and we were facing 20% failure rates on video calls. We faced inability to establish the connection, or the patient didn’t know what to do – either way, the technology wasn’t easy, or they just didn’t have the bandwidth, and they became very frustrated.

That has played a big role for all healthcare in America, so we aren’t unique in this regard. We do not have broadband connections across our population neither do we have great cell signal. Some parts of our population are really isolated and that tends to be the segment that needs most care — the underserved with a lot of both, physical and mental health issues.

That segment would really benefit from this. We’ve tried to speak with the carriers — Verizon — and they’re like, we have the best coverage in the country. I get that. But in this little world, we need help. It’s just not realistic until the government coughs up the billions of dollars it’s going to take to get broadband everywhere it needs to be. Till then the rural areas will be struggling.

Q: It looks like the pandemic accelerated the shift towards digital, in a positive way and the early signs are great! It was all about data analytics. How are you bringing these two worlds together to really use data analytics capabilities to drive digital health patient engagement?

Mark: I got into data because I always wanted to win the arguments. The one with the data wins the arguments, so that still applies. When I present to the doctors, I show them the number of patients who are self-scheduling now, and the numbers are going up. The doctors are getting used to that but then, some do say that the patients scheduled in the wrong time slot. This happens all the time.

So, we have to check and see how frequently this happened and once the data is communicated, I don’t hear from them again. So, data will really help drive doctors when they go with the “it always happens or it’s never good” argument. We’re able to show that more patients are checking in online, switching appointments, finding their doctors and that data speaks to me, enough to help convince some of our executives, not just doctors.

Why are we investing in this? Why do we need our website to be something that brings in patients? Well, patients know how to find us for it’s a rural area and where else would they go? They want to connect to us through our website. So, we’re working on it.

Q: You mentioned a couple of partnerships that you have entered into to drive some of your digital initiatives, but the market is flooded with innovative solutions. How do you keep yourself abreast of what’s working and pick vendors you want to talk to?

Mark: It comes a lot from colleagues and via recommendations. I’m still a part of the CMIO forums. So, I’ll ask questions there and get some recommendations, periodically.

I went to CHIME for the first time and had a wonderful experience interacting with other CIOs. I found a whole bunch of other physician-CMIOs, which was very helpful because they’d walked in these shoes, so they knew some of the other technologies that I’d read about and heard of on other podcasts.

There’s no magic answer or one way to stay abreast of this stuff. There are so many vendors, it’s overwhelming and there’s a lot of overlap. Sometimes it’s hard to differentiate one from the other. The price obviously speaks volumes in these kinds of times. And for us, our budget has just been slashed. All the money goes to finding good nurses since they’re what we need right now. So, the vendors that can help us with that problem are very helpful for us.

Q: Do you go with an EHR-first strategy when it comes to turning-on your capability? How do you see them coming along when it comes to these kinds of newer capabilities?

Mark: That’s an interesting question. The EPIC App Orchard is a tool that I would use to locate new vendors because I know certain hurdles have already been covered, so I don’t really have to introduce this vendor to EPIC. In fact, they can start working out that partnership directly. It also means they probably have hit a certain level of maturity because they’re not getting into the EPIC App store without some basic security in place. So, there is some comfort to that. It’s also somewhat limiting. I’m not sure we get all the best vendors that we could ever want by only looking in the App Orchard. Certainly, there’s that bit on interoperability and integration.

I also don’t want people to say that going via a portal implies being out of their workflow. So, if we’re talking about a tool that is for clinicians, yes, I’m going to go EHR-first. If it’s finance there, they don’t really care because they want the best solution.

I’d also like to get some unified solutions for we have a ton of little silos, and it’s very difficult to understand how to run a business without the data even being able to flow back and forth or to see the impact when the census went up. So, how many nurses do we need? How many nurses do we have? How many are on standby? Without all those pieces connecting, it’s very different.

Q: What is your advice to startups or healthcare companies who want to contact you? Do you tell them to get certified on App Orchard first?

Mark: At CHIME, the vendors were certainly there, they were engaging though they were not overly sales-oriented. That’s their business so they’re there. But the ones I liked to connect with, were the ones who came with genuine partnership. They’re not there to sell you. Though I have heard from others, this is a real vendor connection.

There was one vendor who I’m very interested in working with their consulting firm and they have people on their staff who do nothing but work as technology advisors. They’re not selling anything but are around to help. They have a sales arm and other pieces that point to what they do and while I’m intrigued by this, it’s a sign of partnership. And there’s no charge on me calling them up or picking their brain. That’s helpful. Maybe they can guide me through some things or towards solutions that they’ve seen work for others.

Q: I must ask you about your podcast, now. You’ve been one of my favorite podcasters, and I’ve had the honor of being on your podcast as well. So, now that you’re CIO, do you have time for the podcast and will you be doing more? Where’s that headed?

Mark: Doing a podcast is a ton of fun. It was awesome at educating me and I learnt what others were doing. I also made connections — many of those I interviewed, I did run into over the last two or three weeks at Chime. That was fantastic.

Time is a challenge now that I’m both, the CIO and the CMIO, so I have been a delinquent. As my listeners would know, I haven’t put out content in quite some time. But there were some people who I ran into who wanted me to do some things and get back on air. And I would like to do that. So, it’s not dead; just on a little pause till such time as I get the team together and get things how I’d like to have them and convince the leadership that we’re stable and everything’s going to be fine.

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com  and write to us at  info@thebigunlock.com 

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity 

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

Healthcare affordability can be improved by removing financial barriers to care for patients

Season 3: Episode #103

Podcast with Srulik Dvorsky, Co-founder and CEO, TailorMed

"Healthcare affordability can be improved by removing financial barriers to care for patients"

paddy Hosted by Paddy Padmanabhan
To receive regular updates 

In this podcast, Srulik Dvorsky, Co-founder and CEO of TailorMed discusses how healthcare organizations can improve patients’ financial management and enable the chronically ill to reduce their out-of-pocket costs and financial burden, thereby enhancing access to care. TailorMed is a Tel Aviv-based innovative financial management platform.  

Better quality of care translates to higher care costs, resulting in an increased out-of-pocket burden for consumers. This can drill a gaping hole in patients’ pockets if they are uninsured, underinsured, or have little or no access to financial management. Data assumes a critical role in the digital healthcare landscape as it offers a personalized projection of patients’ out-of-pocket costs across their entire medical journey. Leveraging patient-related information and financial data can automatically help detect cost-saving opportunities based on insurance and treatment optimizations and matching financial assistance programs. Take a listen. 

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Show Notes

01:31 Tell us a bit about TailorMed. How did you start the company and what’s the market need you're trying to address?
03:17How does your company address that problem of affording healthcare? Are you focusing more on improving health equity or helping patients and consumers get more out of what they already have?
06:26Are you focusing on any one medical condition, or do you cover a broad range of medical areas? journey?
13:24 Who is your target audience that can benefit the most from your services?
17:48 What are some of the challenges that inevitably startups are going to face?
19:42 In a space with so many startups, how do you stand out? How does a healthcare organization cut through all the noise in the marketplace to understand where the value is?

About our guest

Srulik Dvorsky is the co-founder and CEO of TailorMed, the leading financial navigation technology company that helps patients and healthcare providers remove financial barriers to care

After serving as the primary caretaker for several family members following a cancer diagnosis, he started TailorMed with a personal mission to leverage technology to remove barriers to care. He brings to the company more than a decade of experience in the medical device industry.

Q: Tell us a bit about TailorMed — how did you start the company? What’s the market need you’re trying to address? 

Srulik: TailorMed’s been around for the last four and a half years. I co-founded it with Adam Siton, our CTO, with a mission that intensified over the last few years – that of removing financial barriers to care. Across the United States, it’s clear that over the last few years the cost-sharing dynamics between patients and their payers have been leaning more towards patients, than in the past. There’s a noticeable, dramatic increase in out-of-pocket expenses and premium expenses, basically meaning that a lot of patients requiring either chronic or critical illness treatments are unable to afford it. This is why we started the company. 

We’re working with healthcare organizations – providers, pharmacies, and other strategic partners within that ecosystem — to find those patients as early as possible in their medical journeys and locate opportunities to offset those out-of-pocket expenses by having other financial resources to cover that, whether it’s through different financial assistance programs, governmental subsidies, optimization of their insurance etc. 

That’s happening with very consistent value creation to both patients and our partners who’re large health systems, small clinics and large pharmacy chains so, they just continue to expand with the growing needs in the healthcare industry. 

Q: One-in-five Americans today, has a problem affording health care. How does your company address that? Are you focusing more on improving health equity or helping patients and consumers get more out of what they already have? 

Srulik: From my perspective, one-in-five Americans are facing the issue of affordability. There is also the fact of the dynamics of cost-sharing between patients and their providers. Another area of our focus when it comes to treatment and medication is on the amazing investments in clinical solutions and treatments that provide better clinical outcomes. But those innovative treatments are usually coming to market at steep prices and that’s creating an even bigger gap in access to care. 

Obviously, COVID exacerbated that problem when people lost their jobs and unemployment increased. A lot of people who were maybe under-insured before became uninsured and healthcare costs on the rise for years just continued. The way we are addressing that is first, looking at what patients are covered for and trying to make sure they are maximizing their benefits. Our core focus is on the abundance of different resources out there that can serve different patients depending on where they live, what treatment they are on, what type of insurance coverage they have, and then, offsetting some of that financial burden and having another entity cover that. 

So, for example, there are patients with diabetes who need to have their insulin medication on or may be on a monthly refill cadence, something that isn’t very affordable. They need to leverage opportunities out there ranging from a governmental subsidy if they are low-income earners to a co-pay assistance by the drug manufacturer to a diabetes foundation that can support patients with either direct medical expenses or their living expenses, if they are burdened by that, as well. 

What we are doing is leveraging data from our partners that can beat the diabetes clinic or the IDM that we are serving or a Walgreens Pharmacy that we contract with. We project it as out-of-pocket expenses for that patient throughout the year, while staying proactive about approaching those patients and connecting them with those cost-reducing opportunities, facilitating enrollment and ensuring that they are able to stay on. They require treatment without going bankrupt or seeing substantial financial distress. 

Q: Are you focusing on any one particular medical condition or do you cover a broad range of medical areas? 

Srulik: We do cover a very broad range and till two years ago, focused around specialty areas — Multiple Sclerosis, Oncology and Rheumatoid Arthritis. Unfortunately, the financial barrier to care is not only focused on specific areas, so our solution is completely is disease-state agnostic. When you think about where high prevalence, high-cost conditions lie, I think that Oncology is definitely one, but we are seeing the need and the ability to support across a variety of other conditions. COPD, heart failure is another kind of chronic condition example and others that I mentioned on the specialty care areas. 

Q: So, how many consumers really know about all the options available to make care affordable? This is huge information gap in the market, and you could translate that into literacy along multiple dimensions. What does your company do to bring this information to consumers? 

Srulik: Patients are indeed completely lost in many cases about not only what the treatment will inflict on their lives, but also why they should understand what we have in terms of the insurance benefits. They might have one plan or three, but what is the meaning of a deductible and a co-insurance? 

When we see patients and interact with our partners, first, we find that patients don’t have the ability to forecast or foresee what’s coming up next, whether it’s their next encounter, not to mention a complex drug regimen that can extend through a few months, or sometimes even a few years. 

That’s why, in many cases they abandon, refuse or forgo treatment or if they do get that treatment, a lot of them face a surprise bill at the end of that encounter. So, patients are not aware of the opportunities that are available for them out there, and a lot of times their providers are not aware as well. 

We look at two ways to stop that — One is providing transparency and not only to a specific encounter of what will be their next imaging scan cost, but also, what the next six months will be like. So, it’s like saying they are about to face a high financial event. But there is an out-of-pocket limit to their plan, and three months from now, they’ll probably hear that. So, let’s speak about what happens in these three months. 

If they’re fully covered for that, they can alleviate that by providing clarity to their out-of-pocket state, that’s on the transparency side. But to tell a patient, they’ve just been diagnosed and there is a very substantial out-of-pocket responsibility coming ahead without giving an actionable opportunity to alleviate that, this is where a lot of other solutions fall short. 

For us, it’s always about bringing this as what it is — their expected responsibility — but it’s with what we have found can alleviate that through either supporting their direct medical needs with pharmaceutical company co-pay assistance programs or with a foundation that can also help them alleviate some of the living expenses they have or support their transportation to that facility. It’s making sure that they see the financial impact holistically with what comes up next, but also what can be done. 

Q: Can you give us an example of how your company is actually making this work and talk about some real numbers? 

Srulik: We are working with the very different organizations and organization types. There are >100 facilities — hospitals, 350 pharmacies and 200 clinics working with our system, both on the provider side, which can be a specialty practice or a large health system in multiple regions. We also have independent specialty pharmacies like Alliance, Walgreens that we work with. For example, we are working with Providence in Oregon where they have put together an amazing team of medication assistants that basically get referrals (from across Oregon) from Providence providers — either hospitals or clinics. And their team finds financial resources or leverages replacement drug programs or feedback programs, as they call it, for their patients. 

And since we started there, we were able to increase the level of discovery of patients who may not necessarily be aware of their imminent financial distress, and introduce to them financial opportunities to bridge that gap and then, use substantial automation and predictive analytics to increase the throughput of programs that patients got enrolled into. 

As a result of that there’s a substantial win-win for patients — It removes their financial barriers to care or financial toxicity, enables their organization to collect revenues without relying on patients and decreases the cost of drug spends when it comes to replacement drug programs and leveraging data. 

On average, we see $1500-2500 in increased revenue for patients across our customer base and about $13000 of free drug programs being leveraged. These are big numbers for this system that are seeing such financial returns from our solution while serving their patients in a better way. 

Q: Is there a specific demographic that is your target audience that that can benefit the most from your services? 

Srulik: It’s a great question and one I’m asked frequently. My answer won’t be as intuitive as you think, though. When patients are indigent and might be on Medicaid, for the most part, they would be fully covered unless it’s maybe a carve-out drug. 

Obviously patients that have a very high income might be able to afford whatever is coming their way, although that’s not necessarily the case with the high cost medication, but the vast majority of the population, whether they are middle income families or individuals on Medicare, either on high deductible plans on the marketplace or by their employers or on Medicare, with high out-of-pocket limit or even without a prescription benefit plan — when most of them are required to pay more than 5-10% of their annual income, the families are not able to find those resources. 

From the patient’s perspective, this is our main audience, but this is where most of the healthcare providers in pharmacy will see the biggest financial concern from providing care and being able to fully be reimbursed from those patients. 

Q: Now we’re in open enrollment season. Is this the time of the year when your services become more relevant? How do you approach the market now? 

Srulik: Open enrollment is a unique once -in-a-year opportunity for patients to have the ability to either keep their plan or adjust, because this is where pre-existing conditions would not be an issue for them to enroll on a new plan. 

What we do there is actually take the opportunity to adjust our health plan coverage as kind of addressing the core cause of underinsurance and definitely, people who are uninsured. So, if during the year one has to keep one’s plan and there is a financial obligation that might be mitigated by a co-pay assistance program, which is a great patch, one can do that cost benefit analysis and add a supplemental plan or Part D plan or Medicare, or pay a slightly higher premium and have a higher or a lower deductible plan. This will ensure one’s better covered. End of day, the costs out-of-pocket would be lower. 

What we’re doing is, in addition to just finding financial resources for patients, we’re detecting those within the patient population that either would be considered uninsured or underinsured. And then seeing if there is an opportunity within one of the marketplaces to optimize for that patient. For example, if a patient has a cancer diagnosis, and next year, they’re supposed to have a few chemotherapy cycles and obviously visits and imaging, and they have Medicare. But Medicare A and B only without any supplemental or Medicare Advantage plan. During open enrollment, they can elect to enroll in the Medicare Advantage. That would put a cap on their out-of-pocket limit or if they have a prescription medication that is not covered by Part B, they can include Part D (as in David). This is where it gets complicated. Fortunately, this is what we do for them within the system. We offer an educational tool for their financial counselors to be able to say “this is what you are supposed to pay with your care plan. This is what you can save if you add or switch to another plan,” even without mentioning a specific point. This tells them that it’s a time of year that they can optimize for, like the next insurance period. 

Q: Do you have these educational coaches/counselors on your staff? Or do you provide this information and educate staff in your client organization — How does this work? How does your target audience get to take advantage of your services? 

Srulik: It’s a hybrid model. We see providers and pharmacies that have their own staff but where they leverage our software solution to discover patients in financial need, those with an opportunity for insurance optimization, and then, the staff educates and exposes those patients. 

Where organizations have no staff or insufficient staff, TailorMed’s complete team comes into play. We have some of the experts in financial litigation working with us and training our team to be able to support patients or the financial counselor on the provider side. That can be seen as kind of telehealth to insurance optimization. It’s possible to go on a Zoom call and educate a patient that this is an opportunity to optimize or add an insurance plan or simply give that as a printout through their provider if they are coming into a visit. There’s a little bit of both, and each organization has their own priorities on how they want to engage and accommodate whatever is required. 

Q: I think the name of your company is very clever, TailorMed. In a space with so many startups, how do you stand out? How does a healthcare organization cut through all the noise in the marketplace to understand where the value is? 

Srulik: There are two things that help us stand out. One, the abundance of solutions within revenue cycle that are coming to optimize for either a better collection experience or a more streamlined payment plan solution. These are solutions that come downstream when a patient is faced with a bill that needs to be collected. We are going upstream. We’re trying to avoid the collection attempt by leveraging other financial resources and other pockets of revenues that can help an organization be “patient first” in their mindset and try to remove that financial barrier and increase access plus have robust financial resources to avoid going after patient collections. I think that’s unique. If you think about the holistic patient financial journey, we’re starting at the very beginning, either at the point of care or after the patient gets the cure and is trying to exhaust any other financial resource. Whatever we can find in the residual out-of-pocket, it goes downstream to the very many vendors that are trying to address that. 

Second, in general, there’s an amazing pool of companies, solutions and vendors that are providing digital health solutions. It’s very hard for providers to adopt everything, even if they wanted to. What we are very focused on is how to attribute our intervention to direct financial savings of the healthcare provider or the pharmacy and then make sure that the beneficiary is, always the patient? 

There’s a very clear business case and a very substantial ROI. As one of our latest case studies showed, they are paying for their solution within the first month or two of adopting it. So, the ROI is there and then, they are managing workflows, automatic productivity tools. But there is a very substantial attribution to financial statements. 

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com and write to us at  info@thebigunlock.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

Healthcare must embrace the cloud. That is where all the technology innovations are happening

Season 3: Episode #102

Podcast with B.J. Moore, EVP and CIO, Providence Health

"Healthcare must embrace the cloud. That is where all the technology innovations are happening."

paddy Hosted by Paddy Padmanabhan
To receive regular updates 

In this podcast, B.J. Moore, EVP and CIO of Providence Health discusses the organizational structure at Providence to drive transformation and how he draws on his 27 years of experience at Microsoft to drive change. 

Moore explains his vision to leverage emerging technologies such as cloud and voice recognition to support healthcare delivery, improve patient experiences, and increase caregiver productivity. He maintains that it’s important to partner with leading technology firms to create robust platforms to drive digital health.

Moore discusses Providence’s investments in digital health innovation and advises digital health start-ups to focus on consumer experience. Take a listen.

Our Podcast Partners:    

Show Notes

00:35What are the top two or three things that occupy your mind these days?
01:24Your colleague Aaron Martin was also my guest a while back. How does your role complement his, specifically regarding digital transformation at Providence?
04:22Can you share examples of innovative use of technology that you’re using to drive the organization forward in this transformation journey?
07:19 You've recently come to healthcare. Tell us about your first impression and how that has changed over the past one and a half years.
14:22 What are some of the challenges that inevitably startups are going to face?
16:00 What about the big tech firms?
20:01 What's your advice to the digital health startups?
20:51 Apart from voice and AI, what else are you keeping an eye on as a technology trend to watch?
23:37 What's your advice to other CIOs who are listening to this podcast, who are not from a Providence type organization or from mid-tier healthcare organizations?

About our guest

B.J. Moore is Executive Vice President and Chief Information Officer for Providence. He leads information services to support and enable the way Providence advances its Mission to deliver health for a better world. This includes partnering with other leading organizations in areas such as cloud computing and artificial intelligence (AI).

B.J. has an extensive background in leading initiatives for digital transformation, enterprise cloud services, strategic planning, operational strategy, and analysis, and guiding large-scale projects and teams. He holds multiple CIO and leadership awards.

Previously, B.J. served in multiple executive leadership roles at Microsoft, including Vice President of enterprise commerce and compliance for cloud and AI; Vice President of enterprise commerce for the windows and devices group; Vice President enterprise commerce IT.

B.J. holds a Bachelor of Science with Honors in business administration, finance/marketing, from Colorado State University.

Q: You’re the CIO of one of the largest and most complex health systems in the country. What are the top two or three things that occupy your mind these days?

Moore: One is obviously the pandemic and the things that come with that — how do we keep our communities safe and our caregivers productive? Then, the tools that come with that –remote care delivery, big data, modernizing. We’ve got a lot of technical debt here at Providence and so, we’re unable to be agile and innovate as we’d like. Those are probably the top three things on my mind now.

Q: Your colleague Aaron Martin was also my guest a while back. How does your role complement his, specifically with regard to digital transformation at Providence?

Moore: Aaron and his team create the marketing brand, so, anything that’s kind of external patient community-facing, they own. And they own the front door for that patient experience. So, things like online scheduling, for instance, and anything that has a broad marketing brand front-door as it relates to Providence, is really Aaron’s team.

The handshake that happens when that front door is open is with my team. So, the actual infrastructure and digital assets – EPIC and its scheduling — happens in my space. All the caregiver tools that nurses and doctors use to deliver care is also on my team. All the other stuff, such as network and cyber are on my side along with the administrative tools and systems that support Providence. Once the front door’s cracked open and the handshake happens with my team, it’s a good partnership.

Q: For large organizations — Providence or Mayo Clinic — what I see is that from an old model standpoint, digital is really driven by a handful of senior executives working in collaboration. Is that almost the default model to move a big ship like Providence?

Moore: The strategic intent comes from this handful. But digital transformation includes basically everybody at Providence and within the Digital Innovation Group — everybody along with our caregivers. As far as setting the strategy, tone, direction, phases and approach goes, it’s Aaron and I that define that strategic intent. It is a huge effort.

Q: Can you share examples of innovative use of technology that you’re using in your world to drive the organization forward in this transformation journey?

Moore: There are two partnerships that we have. The technology we’re using entails to deliver better caregiver productivity. We’ve been partnering with Nuance and their DAX tool to work with ambient Artificial Intelligence (AI). It’s common knowledge that the biggest burden for many caregivers is really annotating, adding to the EHR, so, anything we can do to improve that experience for them especially during a pandemic and labor shortage, has been critical. Leveraging very nascent, ambient AI has been crucial. But how do you listen to a conversation and really have AI pluck out the necessary components and add that to the EHR while ignoring the rest of the chitchat in the room? That’s one of the pieces of innovative technology we’re using.

Second, we’re really aggressively moving to the cloud. All of the technology innovations are happening in the cloud now and our deep partnership with Microsoft enables us to move all of our data centers, assets to Microsoft Azure. That’s where it’s really paid off. During the pandemic, we built our big data model there. Once that’s in the cloud, we’re able to do machine learning and AI to predict the use of ventilators, PPE surges as COVID progresses etc. It’s a strong model which, within two weeks’ advance notice, can help tell us when a community will surge or pull back. These emergent technologies have been invaluable for us to navigate COVID and have helped us really deliver on that vision.

Q: The cloud is right there at the forefront of innovation in healthcare. Nuance is now part of Microsoft, and you too had a partnership with Microsoft. So, did all this make Nuance an easy choice?

Moore: We’ve been a Nuance strategic partner for a decade. Before the acquisition, we were already in a three-way partnership with Microsoft and Nuance to really look at AI. That made it easier as did my 27 years at Microsoft, my last role there was as part of the Azure team. So, my network is strong there and maybe I do have a bit of an advantage over the other CIOs. Many CEOs have been at Microsoft for 27 years and worked on Azure. So, I’d say all of those facets made the partnership easier.

Q: With 27 years at Microsoft, you must have seen a number of different industries. You’ve recently come to healthcare so tell us about your first impression and how that has changed over the past one and a half years you’ve been here.

Moore: I joined Providence about two and a half years ago, and initially, healthcare was really far behind. My observation of healthcare was the industry was 15 to 20 years behind other industries as far as using technology. Providence was further behind or further ahead than everybody else. And my assumption was based on the fact that they were change-averse; maybe just slow to adopt change and that’s been my biggest epiphany through the pandemic.

In the last 18 months, we’ve adopted more change at Providence and accelerated things more than we ever did at Microsoft. We always think of tech companies as agile and quick but we’ve moved quicker than I ever moved at Microsoft. We’ve accepted more change than ever.

Q: I wanted to touch on recent partnerships — Truveta, for instance — where you’ve you talked about AI. This one’s really the big head call for driving those kinds of initiatives. What’s the reason behind it?

Moore: Truveta was really a white paper, an idea that Providence had over three years ago, internally. But we realized the power of something like collecting patient information, voluntarily and being part of this kind of a study and anonymizing that data. But realizing the power of it was really about getting other health systems involved as well. So, we created Truveta. We were the founding members and now there’s over 17 other health systems involved and owing to that, the value is getting large with diverse datasets. We have complete coverage across the United States and having that breadth of data and the diversity of individuals really allows for better insights.

If you know anything about big data, the bigger the data, the better the insights of AI and ML. We’re just at the early stages but we’ve got some really good early insights on things like vaccine efficacy that wouldn’t have been possible before Truvada.

So, we’re really proud of what Providence did to help form that and I’m just amazed to see the progress that Truvada has made. You know, they’ve really hired a great leadership team and a great set of technologists to do some good work.

Q: Truveta also helps drive your own destiny with data and you can get your EHR system to pull it with other data. But when you bring your own data science capabilities and drive your own insights for your own outcomes, was that a move to go in your own direction, at your own pace?

Moore: There are a couple of things — Truveta being owned “by other health systems” being one. So, health systems owning the patient data and being stewards of that data was certainly a big part of it. We took a different approach with Truveta — instead of partnering with a tech company to do this, we basically created Truveta, who hired tech executives to drive it. We got access to that tech talent which was really aligned to the mission work we were doing at Providence and the mission work with other health system. So, it’s been a win-win.

I’ve got great engineers, attracted great talent, but frankly, the talent that Truvada’s been able to attract, you know, is at par with any tech company. We’re stewards of our patient data but we’ve got access to engineers that we would just not be able to touch within healthcare.

Q: Exciting! Providence has also incubated tech companies, partnered, invested in others, been deeply involved in the innovation ecosystem as investors and deployers of technology. How do these innovative new technologies – mature or not as well built-out as you’d like them to be — work? How do you sift through to the ones that have a shot at making an impact on Providence and then, stay for the long haul?

Moore: The first thing is to identify the patient or the caregiver’s experience that we’re trying to fix, where the existing ecosystem isn’t filling that niche. Then, once the area to innovate has been identified, the Digital Innovation Group starts to incubate that work. My team becomes Customer Zero. How do we jointly develop those solutions with Digital Innovation Group to ensure it can meet the needs of a health system? It’s always done in a way knowing that’s going to be spun out and the value would be Providence being just one of 30 or 40 customers. It’s an opportunity to innovate and to fill a niche that isn’t being served by others in the industry. It’s a really unique opportunity to spin these companies out and have them be standalone entities. So, it’s definitely a journey.

Like any incubation process, there’s some things that work amazingly and one hears about them. If they’re disasters, we don’t let anyone know about them. We just quietly — fail fast and move on to the next innovation opportunity.

Q: What are some of the challenges that inevitably startups are going to face? What do you look for them to cross before you can feel reasonably confident? Is it integration, interoperability, workflow?

Moore: My experience, especially coming from tech is that tech individuals seem to feel like they have all the answers. So, it’s one thing to be competent, capable and confident. You know what you want. I guess what I look for early on is a partner that’s willing to listen and learn, know what they don’t know and willing to partner and really use us as a subject matter expert. It’s like we think this is a problem to solve and we think we have a solution, but it’s got to be give and take. It can’t be that they have all the answers and we just accept it.

So frankly, a lot of it has more to do with the partnership aspect versus the tech. Is it really a give and take? Does it have access to our clinicians or expertise? What works or doesn’t work in the real world? Its important to have a partner that’s willing to listen to that and flex; really introduce a design-thinking approach and then, it depends on the solution. Do we integrate three API to something like EPIC? Do we build new interfaces? While those things are more technical in nature, frankly, technical things are pretty easy to solve. It’s more of whether it solves a business problem or not or if it’s a great patient or caregiver experience and whether it meets the needs of Providence or another customer that’s critical. So, I’d say it’s the software things versus the technical things.

Q: What about the other end of the spectrum — the big tech firms?

Moore: I won’t pick on one of them because they’re all partners. I’ll keep it generic. In general, they tend to follow what Matt Campos started with — “We know it all. We’ve solved this problem already. We’re going to come into health care. We’re going to change the world.” Sometimes that kind of fresh thinking is really helpful. That’s how technology innovation happens. But a lot of times, these problems haven’t been solved. If they were easy, they would have been solved a long time ago. So, it’s maybe a little too much hubris on the part of these companies. Those tech partnerships where they’re more in the listening and learning modes — those tend to be more effective, and some tech companies do it better than others.

Q: With regard to the startups, the digital health ecosystem is awash in new companies and there’s billions pouring into it. What’s your take on this digital landscape? Is it too much fluff or are you seeing some really interesting ones that will transform care as we know it?

Moore: Let me give you a context before I answer that. What I describe when I’m recruiting other tech executives is to imagine it’s 1995. The internet is coming along. We’re talking about how amazing it’s going to be with AOL and MSN, and the browser wars that will get kicked-off. That’s where I feel we are in health tech. It’s a bit crowded right now, it’s not crystal clear who the winners are going to be but when we look back five years from now, it’ll be similar to 2000.

We’re just in the really early phases. There’re a lot of players and frankly, there should be more players in this space. I think the opportunity for technology innovation and impact are huge and it’s a numbers game. For every hundred people that dabble in the space maybe five succeed and those five to succeed will transform the way we deliver healthcare. I guess that’s a non-answer, but maybe having a context for where we are, gives people an idea of the level of maturity and the opportunity that lies ahead.

Q: That’s a great analogy! With regard to these startups, they all want to work for Providence but Providence can only work with so many. So, when they approach you, what’s your advice to them?

Moore: Healthcare has not undergone their own kind of consumerization of the experience. So, my advice to these startups is, if you are at the forefront of that consumerization, you think about what travel was like before Expedia, or what taxi-ing was before Uber. It’s a similar kind of metaphor for healthcare. If you’re playing in a space that makes patient engagement, access to healthcare easier or smooths navigation of this complex system, enables our health systems to manage patients and ensure better patient outcomes and solve real business problems, that’s fine. But through that lens of consumerization, what we don’t need is more complexity in health care. If you’re adding complexity, even if it’s solving a problem, I’d say that’s not a good match to be in.

Q: What kind of technologies are your betting on except voice and AI. What else are you keeping an eye on as a technology trend to watch?

Moore: AI is still in its formative years. Most people all over use AI, including in this conversation. We’re still at machine learning, not at true artificial intelligence. So, if it’s a 30 year journey, we’re on year two –still early on. And as far as technology trends we’re looking at is concerned, what became evident during COVID is this remote patient delivery tech like telehealth, remote patient care etc. What I see really emerging and transforming is the Internet of Things, especially medical devices.

We served over 20,000 COVID patients from home. If you could send somebody home with a smart pulse oximeter, a smart temperature gauge that was uploading that telemetry real-time to the cloud, really building real-time big data models for each patient, that’s where ML and AI can really shine, real-time monitor patient’s changes in behavior, start comparing large patient populations, start seeing trends that we, as human beings can’t. These are COVID patients that had good outcomes early on and that’s what they look like while patients of bad outcomes look different – such differentiation can be undertaken. These are things that are uncommon.

Those building blocks start with Internet of Things, streaming real-time data to a big data model and then, unleashing the power of ML and AI to change the way we treat both, individuals and communities. To me, that’s really where the innovation needs to happen, in day-to-day care. We’re going to always make innovation-progress there, but we’ve been working on that problem for under 200 years or a millennia depending on when you start counting. They’re really using big data and managing individuals or communities with big data and ML and that’s three years old. So, there’s an opportunity to have an impact — much more opportunity for innovation on that front.

Q: What’s your advice to other CIOs who are listening to this podcast, who are not from a Providence type organization or from mid-tier healthcare organizations?

Moore: My advice is to embrace the cloud. All the technology innovations for tech companies happen in the cloud. If you’re staying on-prem with on-prem software, you’re stuck. You don’t have the scale, the performance, and you’re not getting any of the innovation that you could get by moving to the cloud. So, embrace it; it’s real. That’s where the power is going to be. That’s where the technology innovation is happening.

I talked to a lot of CIOs that are still debating if the cloud is the right place to be or the right place to put patient data. And unfortunately, every day they pause on that decision, and those are the days they’re not innovating.

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com and write to us at  info@thebigunlock.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

Data is the key to simplifying complex operational processes in digital healthcare

Season 3: Episode #101

Podcast with Jason Considine, Chief Business Development Officer, Experian Health

"Data is the key to simplifying complex operational processes in digital healthcare"

paddy Hosted by Paddy Padmanabhan
To receive regular updates 

In this podcast, Jason Considine, Chief Business Development Officer at Experian Health, discusses the critical role of data in digital healthcare systems. He explains why organizations as data collators must first understand data privacy and security, adhere to regulations, and then use that data to better the situation for stakeholders in the healthcare domain. Experian is a data and technology company that transforms data into meaningful analyses to help people across the globe make smarter decisions – for themselves and their businesses.

Consumer-permissioned data offers valuable insights on the social determinants of health, such as access to food, transportation, and the need for financial support, in addition to patients’ physical ailments. Therefore, Jason maintains, it can be a valuable resource in reducing medical bankruptcy, developing financial assistance programs, and ensuring that the patients can focus on getting better rather than being burdened by bills. Take a listen.

Our Podcast Partners:    

Show Notes

00:37About Experian Health.
02:06How is Experian data used in the context of healthcare and how do you ensure privacy when using consumer data?
08:43Can you talk about your recent research on consumer preferences for access to care in the immediate wake of the pandemic last year, its highlights, and what are some of the trends that’ve evolved between last year and now?
17:41 Based on the data you have; do you see any differences between consumer preferences based on their demographic profiles?
23:24 Who are your primary audiences for the data? What are the challenges you encounter when you try to integrate data to target these kinds of interventions?
27:49 What would you say to healthcare executives when it comes to the opportunity to use the data from Experian Health? What should they consider ensuring they're staying within the norms?
30:42 What is your advice to healthcare organizations or policy makers when it comes to using your data for serving public health and social causes?

About our guest

Jason Considine is the Chief Business Development Officer at Experian Health where he is responsible for Corporate Development, Innovation, the Patient Collections product portfolio. Leveraging his diverse background in sales, business development, product management, and operations, Jason is responsible for driving the organic and inorganic growth of Experian Health.

Jason has previously held the following roles at Experian Health: Senior Vice President & General Manager – Patient Access, Collections & Engagement; Senior Vice President – Patient Collections & Engagement; and VP – Sales & Business Development.

Prior to joining Experian, Jason held sales, business development, and sales leadership roles at WebMD Practice Services, Emdeon Practice Services, and Sage Healthcare. 

Jason has a bachelor’s degree in science from Texas Christian University.  

Q: Experian is known globally as one of the big credit bureaus in the world. Tell us a little bit about Experian Health.

Jason: We’re certainly part of that large global organization but our focus at Experian Health is around simplifying the healthcare system for all the stakeholders, patients, providers, and payers. Experian has thousands of healthcare facilities across the United States that help simplify the operational complexities of healthcare.

We look at it from the time the appointment is scheduled by the patient all the way through the claims being filed to the payers and the money being collected from the patient. There are solutions to simplify that process for all stakeholders and some of the things being done with data in this new age of data and understanding patients more precisely is also an exciting opportunity for us in how to simplify healthcare.

Q: With reference to the use cases, you just mentioned in terms of how Experian data is used in the healthcare context, could you explain how you ensure privacy when using consumer data?

Jason: As a data and technology company, Experian Health is no different. The Experian data is core to all its products and services that are delivered to the healthcare industry. This helps make these experiences — for providers and for patients — simpler. So, right from scheduling an appointment all the way through that collections process, Experian data is involved to make it better for all the stakeholders.

From a data and privacy perspective too, it is paramount and core to everything. This just ensures privacy, security and protection of that data. That’s a big part of what we do in the health business, and what Experian does globally to ensure that as a company, it is compliant not only with the regulations that exist and all the different markets that it serves, but that it adheres to a very high standard of ethics and standards as well. And that extends to how this data can be used and leveraged in the healthcare setting.

Q: Your use cases with regard to data, are more to do with the revenue cycle payment integrity type situations. How do you use this in the context of clinical operations? Also, there’s substantial interest today in the social determinants of health so your demographic data is very pertinent here. How is your data used in that context, if at all?

Jason: It is an important part of the clinical setting and becoming increasingly critical. Experian has access to a lot of consumer-permissioned information. That’s one thing that sets Experian apart from its competitors and the industry – not just permission from the consumer but that the data is identifiable to a consumer – and that has a lot more value to a healthcare provider than this de-identified kind of aggregate cohort data.

This is very helpful in making decisions about, for instance, if somebody has access to nutritious food and if they are diabetic patients, then, many providers do help patients get access thus moving them onto a better track. However, if these patients don’t live in a community where they have access to nutritious food, it’s going to be difficult for them to remain compliant with a physician’s directions on how they get better.

Experian has healthcare providers who can see that and by using some of the consumer-permissioned data, are actually prescribing food to patients. If they can’t afford food, then they are given some financial abilities to go procure that food.

Such data helps understand a patient’s propensity to, for instance, adhere to their medication and even access transportation. One of the things that’s very interesting in some of these data studies is that many times, the patient leaves the facility and part of their treatment program is to come back in for rehabilitation. But, if they don’t have access to transportation or can’t afford transportation, then they’re unlikely to return and avail the rehab services they need. This could cause adverse downstream impacts on their condition and prove more expensive to the patient and the healthcare system.

A good solution understanding that is potentially offering a pre-paid rideshare type of a program to patients which can ensure or increase the likelihood that they’re going to return for some of those follow-up visits. There are lots of really interesting ways that some of this social determinant, non-clinical, socio-economic type of data can help providers understand other attributes of how a patient lives and how that might impact their overall wellness.

Q: Great examples! One important point you’ve mentioned is that of consumer-permissioned data and it’s critical because it enables effective targeting of investments. Your firm did some research recently on consumer preferences for access to care in the immediate wake of the pandemic last year. This was updated this summer. Can you talk about the research, its highlights and what are some of the trends that’ve evolved between last year and now?

Jason: The original reason for the research is that consumers have a different level of experience when it’s about non-healthcare work. Everything people do with Amazon, for instance, even a simple thing like going to get a haircut – can be scheduled online. But healthcare is a very different experience. The pandemic forced people to adopt new technology, and there was a big advancement in the adoption of digital solutions – something the research really spelled out.

Even this move to what we call Generation C — we’re all a part of Generation C — but this kind of expectation — as the pandemic’s still on — and going forward, around access to more convenient solutions in the healthcare setting is just a few things that is highlighted by the survey.

It was found that 78% of patients wanted the convenience of 24*7 self-scheduling, but only 40% of providers currently offered that service. There’s a big opportunity for providers to continue to improve in that area, and they agree. We surveyed both patients and providers, and they said that patients are 30% more likely to prefer online registrations. So, they’re seeing some of that in their own feedback they’re giving to us and they’re getting better.

90% of providers reported that improving the patient experience was one of their key top priorities. As the effects of the pandemic on all consumers becomes clearer, it will be noticed that providers will have to continue to improve that patient experience.

We’ve all scheduled online to go get a COVID test. I went to a conference a few weeks ago and digitally uploaded my vaccine card and moved through the process, digitally, to register and check-in for this conference. There are providers doing all this across other aspects of our lives but consumers may not want to go backwards. I think the expectation is that providers are going to continue to offer a way to do business with them in a digital setting that’s more convenient to the patient.

Q: I’ve actually read through the report and there are some fascinating insights in there, but quickly, what is Generation C?

Jason: Generation C was a term coined by a leader of a large financial institution and it’s this generation of consumers and people that are being affected by COVID. We’re all part of Generation C — this younger generation of people engaging in their care that this is kind of the first experience they’ve had.

Q: Your research findings show that consumers want the convenience of online or digital access to care and providers know that they must provide access. But you’ve also found providers cutting back on this. Explain that.

Jason: I think there’s a discomfort still out there with providers. For example, a lot of providers have very customized views of how they schedule appointments into their day and some people are very specialized providers. As they start opening businesses, patients either come in or defer services or only come in for COVID-related treatments or maybe post-operative visits on a certain day but a sub-specialist may want to ensure that patients they shouldn’t be treating aren’t ending up on their schedule.

Those are complicated business problems that digital solutions may find tough to manage and there is a concern with providers that they don’t have everything in place to manage this at scale on a go-forward basis. But there’s some revert. The technologies available have the ability to customize things and provide this experience that consumers want.

It’s important to impress upon providers that they partner with vendors and check the capabilities of the solutions because they can work together to improve the situation for patients and providers. It can actually provide a lot more control and opportunity to make it easier for providers to do business with. But that’s my take.

We were forced into this by the pandemic and now that things are going a bit back to normal in certain parts of the country, some people are reverting to the way things were before. We need to stay the course and continue to evolve as the health care ecosystem while providing patients and consumers what they expect.

Companies like Experian that offer these solutions have a certain responsibility to ensure that they are easy to implement and support the provider communities through that process because change is hard. It’s not just about installing a piece of software but there’s a lot of work and consultation that must be done between the technology provider as well as the provider to make sure that it’s done right.

Q: Based on the data you have; do you see any differences between consumer preferences based on their demographic profiles? About millennials, conventional wisdom holds them to be digital natives as they’re very amenable, but the reality may not be as simple and straightforward. Any comment?

Jason: There are differences and I’ll give a personal example. My mother is 70 years old and she is one of the most digitally-savvy people that I know, and she engages with her provider online. We see different segments of the population and people have different personal preferences. That speaks to the power of that consumer-permissioned data.

One has to be careful when looking at large cohorts of data or cohorts of populations because there are segments and individuals within those cohorts that prefer different things and providers have access to information that can really allow them to engage with people, in a personal way, and provide the right solutions to attract the right kind of market to their unique personal preferences.

Q: Now, about the consumer data industry. One of your competitors, TransUnion Health, was in the news recently on getting acquired by a larger organization on the revenue-side. While you mention a better understanding of consumer profiles to improve payment integrity, what’s driving that interest in consumer data today when you look across your client profile?

Jason: It’s a fascinating time and I think the clinical providing better care is certainly driving a lot of interest in consumer data. I mentioned social determinants, but when I put consumer data with clinical data and derive insights from that, it’s still early innings of understanding what’s going to be possible with the combination of all these data sets. When I add genetic data to that, there will be different types of results that will emerge from this analytical era we’re in and enable understanding of better ways to take care of patients. But it extends way beyond that.

Think back to just a few years ago and even today, largely, patients are treated very uniquely in the clinical setting. Every other thing that they experience from a provider is pretty standard – the same bills and similar marketing techniques and so, the experience doesn’t feel very individual and it doesn’t have to be that way.

Now, data is being leveraged significantly to understand, for instance, that, this patient has a unique financial situation, and perhaps, shouldn’t get billed $5000 because they qualify for our financial assistance program. If the provider knows that up-front, a patient’s outcome may be very different. They don’t get a $5000 bill but are offered financial aid upfront. So, patients can then, focus on getting better and not worrying about how they are going to put food on the table.

That information and being able to provide a personalized financial, administrative experience and even how to market to patients is an interesting learning that emerged through the research at the beginning of the pandemic.

There were huge job losses and people were moving to different parts of the country to find work. After that, and even during that same time, online work boomed. So, if one didn’t need to go into the office, one could also move and work from anywhere. As a result, there was a lot of moving and so, providers found themselves with a bunch of new patients and the communities they served. Understanding who those patients are and how they can reach out to them and get them in for care was important.

Maybe they deferred visits during the pandemic or just came in for four different wellness visits or perhaps even attracted new patients, but the point was to grow as a provider and a business in the community. There are considerable opportunities to leverage data to be very precise about how one can identify those people and then, reach out to them and get those patients into one’s health care system.

Q: Let’s talk about hospitals and health systems. Who are your primary audiences for the data? What are the typical challenges you encounter when you try to integrate data to target these kinds of interventions?

Jason: All stakeholders are often impacted and in a decision around data, there are use cases that are more marketing centric. So, we approach the Chief Marketing Officer. The CEO, CTO, CFO and CIO are also often very important buyers/stakeholders within a health care organization. That’s because one of the things revealed by the research was, improving the patient experience was a key organizational priority.

So, this decision to use data to get smarter about how best to engage patients is something happening all the way up at the highest levels of organizations and there are plenty of challenges and opportunities — around data privacy and understanding how this data is secured and used — encountered along the way.

We’ve talked about data and experience rolling data. Organizations are trying to understand how data is governed in use by companies like Experian. It’s a tough place for hospitals to be in, because this data market – the consumer data — has been around for a long time and is used in a lot of different industries. It’s an incestuous market – there are data brokers that buy data from other data suppliers, who buy data from other data suppliers. But by the time a health care organization gets hold of data like that, who knows what the consumer really gave access to?

That lends a kind of creep factor component to data. The question that must be asked is how is that data something one should be using? How is the vendor treating the data? How is my data going to be treated – will the vendor sell my data?

We work really hard with our health care and hospital customers to ensure everybody’s comfortable with how the data is secured, how it’ll be used and help drive these specific use cases. We reassure them that we’re not just going to go and market their data to a data broker. These then are the challenges we work through from a security and compliance perspective.

Then there’s operationalizing the information – and that can be a challenge to really be impactful. The data needs to get to the right person in the right spot of the patient journey to make an effective decision or if it’s the patient themselves, give them the right solution that they need to engage with it, irrespective of where they are in the health care journey. Ensuring that we have the right integrations and getting access to the right person at the right point in the journey is a really important part of the process as well.

Q: Some very good points there. What would you say to healthcare executives listening to this podcast when it comes to the opportunity to use the data from Experian Health or anyone else in intervening either in a marketing, financial or medical context? What should they consider ensuring they’re staying within the norms?

Jason: Great question! We like to bring privacy and compliance to the start of the conversation because that’s the first thing we discuss, and you have to ask the right questions. If you’re an executive, then, and a health care organization, then you must know where the data comes from. Experian’s data is consumer-permissioned, and that’s important. We spend a lot of time, energy and effort, in not only securing the data and ensuring its privacy is all within our control, but also that we have timely access to it. So, we have a direct relationship with the consumer.

If the consumer decides to stop sharing that data, we maintain that relationship with the consumer and we put that into place efficiently and effectively. We can also maintain and promise freshness of the data while adhering to the governance around that. That’s what we offer as a data supplier. Organizations need to ask those questions and understand where the data organization they’re working with, is getting the data from and how they are procuring it. How’re they maintaining it? How’re they managing consumer positioning?

These are as critical as understanding what data we’re going to be combining with that consumer data to draw new insights and how our partners may be leveraging that information. I would recommend they bring privacy compliance in that discussion earlier in the process because it’s as much or more important than operationalizing and just building the insights on top of the data.

Q: Now, the consumer data from organizations like Experian Health can be a force for good, especially when it comes to improving health equity or healthcare affordability health care outcomes, especially for underserved or vulnerable populations. What is your advice to health care organizations or even policy makers when it comes to using your data for serving public health and social causes?

Jason: Great question! When I think about who we are as a global organization, it’s all about the experience. And how we can use our data to try to make consumers’ lives better. It’s no different in health care and so we access this consumer information and data which when combined with health care information helps us do so many great things.

They can tell us when a patient lives in a community and can’t afford or access nutritious food. That can help us understand when patients are likely to remain non-compliant and take other medicines. It can help us understand when people can’t get access to transportation to even get to the doctor. We’re seeing that drive awesome innovation inside of providers on how they can get people access to food. Maybe they’re going to send nurses out to peoples’ homes for some follow-up work if they cannot afford the trip to the clinic or take a day off to do so.

There are awesome opportunities to use data in that clinical setting. With health equity and consumer data, we know who can afford health care and who can’t before they even come in for their visit. There’ve been a lot of studies on the fear of how you’re going to pay for your bills at the end of a cancer treatment regimen and there are horrible things that people do because they are fearful of how they’re going to put food on the table and how that may impact their families.

Medical bankruptcy is one of the largest causes of bankruptcy in the United States so, we use data as a force for good and get people into financial assistance programs and remove that burden from their head so they can focus on their treatment and getting well. Those are all things that this data can be used for — to make health care better for all stakeholders — patients, providers and payers.

We hope you enjoyed this podcast. Subscribe to our podcast series at www.thebigunlock.com and write to us at info@thebigunlock.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.