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

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