When Technology Meets Care Management, Outcomes Improve.

Q. Hi, Rob I’m Rohit Mahajan, Managing Partner and CEO at BigRio and Damo Consulting, and host of The Big Unlock podcast. It’s been a popular show for many years, and we’re continuing the tradition started by Patty Padmanabhan, the founder of Damo Consulting. Many healthcare leaders have been on this podcast, and it’s great to welcome you. Over to you for your introduction, Rob.

Rob: Terrific, Rohit. It’s a pleasure to spend time with you and with your audience. I’m Rob Posner. I’m the Chief Technology Officer for AbsoluteCare. I’ve been with AbsoluteCare for about two and a half years now. I joined because of the game-changing mission of this organization. I’ll get into that in a moment, but first, a little background.

Prior to AbsoluteCare, I spent the last decade in similar private equity–backed, provider-centric organizations that are changing healthcare. My passion for healthcare has really been about the transformation that’s needed—not just for those organizations, but for the country and the world. I truly believe in that mission and the role technology plays in achieving it. That’s why I decided to move into the healthcare industry.

Before that, I was in hospitality and entertainment. I live in South Florida, and the cruise lines are big here. I’ve worked with major cruise lines and Disney Parks in particular. I built a team and worked backstage at Disney Parks where we developed the MyMagic+ experience and led major aspects of that global rollout—transitioning to a managed guest experience. It was one of the early efforts in what’s now known as the experience economy, leading products and services by experience for consumers and guests.

Q. That’s awesome, Rob. I’m actually a fan, and I don’t think I mentioned this to you last time—Disney has a university where they run programs on leadership, quality, service, and a few other topics. I’ve been through all four of those. So great to know that background. Now that you’re at a healthcare organization, could you tell us more about AbsoluteCare—what the business model is, and how it aligns with your experience in provider-centric organizations that are really changing the healthcare industry?

Rob: Absolutely. AbsoluteCare’s mission is to improve the healthcare of the nation’s most vulnerable populations. We do this by improving outcomes through holistic care and care management.

We refer to those we serve as members—not patients—because we contract with payers for a panel of their members. So they become our members, and we take full responsibility for their care. Our tagline is “Beyond Medicine” because we deliver primary care, care management, pharmacy, behavioral health, and address social determinants of health in a comprehensive way. That’s what differentiates us from traditional care models.

We operate under a full-risk, value-based care model that demonstrates improved outcomes. We’re fully accountable—clinically and financially—for delivering on the triple aim of healthcare. We don’t just talk about it; we live it. That accountability is central to being a sustainable and impactful organization.

Q. And, and I understand you are in several markets and tens of thousands of patients now, so there must be some early learnings. 

Rob: We are rapidly growing. We were in seven markets at the end of 2024, and we’re about to be in 11 markets over the next couple of months. We serve tens of thousands of high-acuity, high-utilization managed Medicaid members. That’s important to understand—these are some of the nation’s most vulnerable individuals. They often have multiple chronic conditions, compounded by social determinants of health. We need to address all of those factors to be successful. 

Q. That’s awesome. And your delivery model is partly center-based and partly community-based, right? That seems like something unique AbsoluteCare brings to the table. 

Rob: Absolutely. We deliver about half of our care in our centers and the other half in the community. In each of our markets, we have a center located in the urban core to serve our members. But the reality is, it’s often difficult for our members to reach us. Since we’re responsible for their outcomes, it’s on us to go to them—wherever they are—to ensure we’re delivering care and care management that drives better outcomes.

Q. That’s amazing. I have a curious question—from my perspective. You mentioned that you get the cohort of patients from the payer side, right? Because they obviously want better outcomes. So, do you work with providers at all?

Rob: Our organization includes providers. In other words, we deliver the actual care. We have our own employed providers who deliver primary care services. We also employ care management teams, behavioral health specialists, and pharmacists who work in our pharmacies. So we provide comprehensive care and care management in our centers. Additionally, our providers and care teams go into the community to deliver care in members’ homes and other facilities. 

Q. So I understand that there’s a lot of technology at play here. Obviously, we are all leveraging all kinds of technologies to help better outcomes for these members and for these patient populations. So, would you please talk to us about your journey? Like how was Absolute care and then the how did you fast track? I think you were talking about fast tracking transformation. 

Rob: Oh, absolutely. Yeah. So I’m the first C-level IT executive in the organization. And not surprisingly, that means that usually there was—coming into it, I think the teams were doing the best they could with what they had, but they didn’t have a seat at the executive table. And so we found that the state of technology was not where it needed to be. And of course, that’s why they brought in a Chief Technology Officer.

So nothing was really surprising from that perspective. But systems were not configured for our mission. It’s not unusual because systems are not really made or designed—typical EMRs are not designed—for value-based care, full-risk provider models, right? So it’s not surprising they weren’t configured correctly.

The technology team was following the business rather than leading. There was a lack of appropriate governance. And like I mentioned, the teams were working really hard, and I’m proud of the work they did to get to that point. But clearly the organization recognized that more needed to be done.

Just to explain the point—when I got there, within a month or so, we had a terrible situation where we had a significant outage of our EMR that went on for more than a day. And no one in the organization thought to tell me. Our EMR—which all of our providers and care management count on to do their jobs every day—was down. And she let me know that we were down. So it was the kind of thing where we had to change the culture, change expectations, and deal with accountability.

That was kind of the start of that story—saying, okay, that’s where we were. I installed new leadership within my department, got people who understood where we need to go, how to set expectations for our teams, reset what operational excellence means, and establish that culture of accountability.

We worked very rapidly to start reconfiguring our EMR. Even in terms of the governance—we had a steering committee for our EMR, but what we found was a whole bunch of leaders were sitting on calls that should be about strategy, and they were dealing with day-to-day issues. That pointed to the fact that we didn’t structure our governance well. We didn’t have core teams and the right people dealing with the day-to-day so we could address those, and then separately deal with things like: should we be moving to the cloud? Should we be on one instance of the EMR?

These things have to run in parallel, and you have to have the right people engaged in those conversations—and the right cadence. Those are some of the things we had to do very quickly to start dealing with the rapid transformation that we needed to make as an organization.

Q. Right. And you really had to do groundbreaking—or from the grassroots—you had to build a care management system, because the EMR really isn’t suited for that purpose, right? So please talk to us about that. It’s something very different, I guess, that you’ve done in the organization, and it’s like the bedrock for engagement.

Rob: Absolutely. And just about all EMRs you could categorize as being focused on delivering care in an office, in an ambulatory environment. What does that mean? For a patient visit, a member visit, in a center. That’s really what it’s designed to do.

But when you talk about all the work we need to do to provide longitudinal care for that member—it’s the things happening 99% of the time when they’re not in the doctor’s office. That’s care management, and that’s where a lot of the outcomes for our patients happen. But it’s not really addressed in EMRs. EMRs look at things like decision support for the doctor and care gap closures, but care management is its own thing. It has its own workflows, and we need to make sure they’re focused on what produces improved outcomes.

So, we determined that EMRs don’t really do that, and we brought in a full-fledged care management system. We implemented that and went live about a year ago. We also integrated it with our EMR, which at the time was a fairly significant step, because the objective was to let people work from one pane of glass.

If they’re in the EMR, they shouldn’t need to jump into the care management system to check on something—and vice versa. That’s been a journey. We’ve done the first couple of iterations to make it work. There’s more to do, but we’ve gotten our MVP product into the hands of our markets, and it’s being used successfully. It’s been a great success story, showing how we can integrate care and care management in a way that reflects our model. We have a care model, and we need to make sure our systems are aligned with that—not force people to work within systems that don’t fit.

Q. Absolutely. That’s significant. And it’ll always need to be taken to the next level, based on user feedback and the people who engage with it. So we talked about care management, Rob, and it’s fantastic that you were able to build a product to engage members and support all the stakeholders. How did you think about the tech stack? Because you’re operating at two levels, right—like we discussed before, also out in the communities?

Rob: Absolutely. And from what I’ve seen in the industry, these systems are typically designed to work in a facility—an office or a hospital—or maybe a hospital-at-home type setting. The assumption is that the technology stays in one place: someone is a remote worker, someone is working in a hospital, etc.

But in our integrated model, that’s not the case. We’re delivering half of our care and care management in people’s homes, which means our workforce is mobile. They’re in the field, moving between members’ homes. We have transitional care managers who go out into facilities when we get an alert that a member’s been admitted to the hospital or has visited the ED.

So we need systems that can work across a variety of environments. Our original tech stack wasn’t built for that—it was built for more stationary settings. So we had to completely rethink it. We tested different laptops, connectivity solutions, and carriers until we found a solution that worked. We looked at each market individually, since different carriers perform differently depending on the location.

We landed on a solution that includes new high-powered laptops, MiFi devices, and iPhone 15s. It turned out that the 5G technology—and specifically the antennas on that hardware—allowed us to overcome many earlier challenges. 5G really opened up the capability and gave us the bandwidth we needed to connect to an EMR in the field.

And once we did that, it really unlocked the power of our solution. I saw that firsthand when I did a round with our transitional care managers. One of them was at the bedside of a member who had been admitted to the hospital. Their job is to coordinate care, make sure follow-up appointments are scheduled so we can continue to support the member.

And right there at the bedside, the care manager was able to open the EMR, schedule the appointment, confirm it with the member, and ensure continuity of care. That’s exactly what we need to see—technology working in the field, making a real difference in the care and care management we deliver.

Q. That’s awesome. Yeah. Being able to schedule appointments at the bedside is, is fantastic. Even today to reschedule my appointment with my physician is a big task.

Tell us, you know, uh, Rob, that in building all these solutions to solve the problems that you saw, how did you go about the governance aspect of it? 

Rob: Yeah, governance is a really important aspect here. It’s really easy to focus on what system you use—there are great enterprise solutions for most of the challenges we face in healthcare, broadly speaking. We have our in-house pharmacy, so we implemented a pharmacy system. We have a care management system, our primary EMR—so we have the big pillars, if you will, of our clinical applications.

But what’s really important to unlock the value of those systems is establishing product teams, having effective steering committees, and creating a proper intake management process. It’s so easy to get lost in all the new requests that come in. You need a way to manage that, making sure we stay aligned with the business—both in terms of the strategic plan and the day-to-day changes happening.

So you have to manage between the strategic and the tactical. You can’t just do one or the other or you won’t be successful. Keeping that executive alignment—engaging the appropriate executives at the right times—and having an overall change management and governance approach are all key building blocks. If you don’t have these things, it doesn’t matter what systems you put in place—you’re not going to be successful.

And I think another point—not governance in particular, but related—is not forgetting the small things. Like I mentioned earlier about the community tech stack—one of the things we didn’t think about was the equipment itself. You’ve got to pilot everything. Don’t go live with anything without piloting it, because that’s where you learn the small things that make a big difference.

For example, we provided all this technology, but we didn’t have the right type of briefcases for the care management team. We eventually got them rolling bags—and they had to be locking bags—because of PHI. We’re a HITRUST-certified organization, which is business-critical to us. So we take the handling of patient information very seriously.

Those are the kinds of things that make a difference. If you don’t take care of the little things, you don’t get the adoption—and then you don’t see the business results. Which is why, at the end of the day, you’ve got to think about the big things and the little things. And together, that’s what makes a solution really work for the organization.

Q. That’s great. So Rob, no podcast would be complete without touching on AI and innovation. So, would love to get your thoughts on innovation, AI, and now GenAI. What are you thinking, and what are some of the use cases you might be coming up with? 

Rob: Sure. Look, AI is a really exciting topic in the industry, and for us in particular, I’m really excited about what we’ve been able to accomplish recently, and equally excited about the opportunities in the future.

So on the clinical side, rolling out ambient experience—ambient listening for clinical notes—is the critical use case. We’ve been able to implement that successfully. We went from pilot very rapidly to full rollout. We saw the results very quickly. And look, there’s a lot of change management to do with the providers—to get them used to the fact that this ambient listening device is there, making sure they’re talking to their patients about it and what it means, and how to leverage it effectively. And so that’s a learning process, and we’re definitely still going through that, but we’re already seeing results.

One of the immediate results is that our providers can engage our members more effectively, right? At the end of the day, they’re spending less time hands on keyboard, and more time engaging with our members, having the important conversations that they need to have to deliver care. And so that’s really exciting in terms of the impact on care delivery and outcomes.

Another piece on the clinical side—we implemented a system that detects diabetic retinopathy with fundus cameras. The solution takes the images in the office, sends them immediately to our partner in the cloud, they do a read of those images, and send back—within 30 seconds—a result and a recommendation for referral. What we’re seeing is that because we get that instantaneous result, our patients—our members—are actually going forward and getting that referral and follow-up appointment. And that’s really what we’re talking about: we’re changing the behavior of our members so they get better outcomes, address diabetic retinopathy early, and take care of it before it leads to something as serious as blindness. It’s a really urgent issue, and here’s an example where technology is really motivating our members to take care of their health. That’s amazing and exciting to see.

Additionally, we’re starting to see AI throughout all of our systems—it’s just almost happening organically, I would say, just by vendors providing it. So, certainly Microsoft Copilot, which has become pretty ubiquitous—we’ve rolled that out. We piloted it, saw great results, saw great adoption. I’d say of all the technologies that we’ve released, Copilot was one where we just put it out there, gave some training and tips and tricks, and the uptake was amazing. Unlike an EMR, where providers are required to use it and follow detailed workflows, with Copilot there was no requirement—and still the adoption was high. We’re seeing great productivity results and people learning how they can use AI in their day-to-day work. And that just rolled out recently. We expect to do a lot more with it. We’re doing workshops to enhance learning and help staff understand what’s possible with AI.

So that’s what we’ve implemented so far—those are active in our organization at the enterprise level. In terms of where we go from here, there are a couple of areas that are very exciting to us. Robotic process automation—though it’s not new—is an area where we can continue to refine the EMR experience for our providers and frontline staff. We’ll continue to look at automation opportunities and other AI capabilities within the EMR, like documentation and note summarization, translating into different languages to communicate better with patients, and reducing the multi-click environment of the EMR by automating routine tasks. The next area is really AI agents—looking at what’s happening outside our core platforms that could be managed with more automation and integration. That way, we can free up our team members to focus on what really matters—our members.

Q. That’s awesome, We actually did a seminar today, Rob, on Agentic AI in healthcare, and there was a great response to the webinar. It’s such an interesting topic—people are actively looking for use cases. We’ve worked on several use cases with our clients, and we definitely see Agentic AI as one of the key options to explore.

So I think we’re toward the end of our podcast, Rob. Any final thoughts or remarks you’d like to share with the audience?

Rob: Yeah, I would just say that it’s a really exciting time to be in healthcare technology. I believe we’re at a point of inflection—where not only do we as healthcare technologists see the opportunity, but the business side clearly sees it as well and is relying on the technology function to step up.

And I think that’s happening—as executive leaders begin to expect more from their technologists, but also expect the business side to think about how to leverage technology. That’s where we’ll really start to see the tech and business teams working together to solve meaningful problems and drive real impact.

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