- Hello everyone.
This is Jacob Emerson with the Becker's Healthcare Podcast.
Thanks so much for tuning in to us today.
I'm thrilled today to be joined by a very special guest.
Amanda Brewery is the Chief Commercial Officer
at Informatica.
Amanda, welcome and thanks
so much for taking the time to be with us.
- Thank you so much, Jacob, for having me today.
- So Amanda, before we dive into our questions for you,
I'm hoping you can tell us a little bit more about your
background in healthcare and what it is
that you do today at Informatica.
- Yeah, so my background in healthcare has been going on
for about the last 15 plus years.
I've been working with hospitals, health systems,
large payer organizations in the beginning,
really migrating them from offline to online activation
of their members and patients.
And in today's ecosystem, really focusing on engagement
and empowerment of those same patient
and member populations.
- Wonderful. So then it sounds like you know very well
that payers right now are very focused on their strategies
on how to advance value-based care, population health,
and of course overall member satisfaction.
Considering these pretty broad aims,
how does member engagement
and care navigation specifically play a role in those?
And what are you finding are some of the key challenges
that health plans across the country are
facing with these goals?
- Yeah. At, in Informatica, we're one
of the leading AI powered member engagement tool for payers,
providing clinically validated navigation
to help guide those members toward the most appropriate
and cost effective care.
And really what they're looking for today
and how they're looking to engage
and navigate these members is through technologies
that are creating automation, that are creating engagement.
And when we look at some of the key challenges
that they're facing is, number one, how do you identify
and really look towards, um, various tools
and technologies that are gonna help you get there,
but how do you also analyze those, knowing
how your members are going to react?
So we really wanna focus, um, on helping to educate
and empower patients
and members to really make sure that they're, um,
not only engaged in their plan,
but they are also taking steps forward to connect
with the right level of care at the right time.
- Understood. So not just engaged,
but engaged with the right kind of healthcare
and the right kinds of services.
Obviously implementing these new technologies like ai,
it's been a ubiquitous goal across the health plan industry.
Are, are you finding that there's opportunities
that you're seeing in terms of adopting these new tools
to drive better member engagement and,
and the care navigation tools that we just discussed?
And, and can you share a few examples of that
and how Informatica specifically is approaching this?
- Yeah, so I think people get really nervous.
We've just come off the course of a couple
of the first conferences of the season,
and AI has obviously been a topic and theme,
and I'm sure it will continue throughout the rest of the,
uh, conference season.
And what people are really looking at
and what the payers specifically that we work with and,
and we talk to are looking at is how do I take pieces of AI
and implement it into areas that are going to not only help
with operational efficiencies,
but also provide clinical guidance.
So at Informatica,
we're really focusing on this virtual care navigation
or virtual triage,
which takes members from the time they are feeling sick.
So think about it, Jacob, you have an ear infection,
it's 11 o'clock at night, you don't wanna leave the house.
What can you do? Well, you can use tools that are powered
by AI in the comfort of your living room to take you
through a symptom assessment, asking you questions and,
and personalizing it to your specific ailments.
So your right ear hurts, you know, um,
you've had a fever the last couple of days.
And then through that question and answer, the tools
and technologies are gonna then help guide you
to the appropriate level, uh, care endpoint.
Now we're taking, um, out of the equation,
somebody leaving their house in the middle
of the night going to the ED,
when in reality they can do a lot of this from their,
their device or their computer
and be connected with the right care,
and maybe they can go see their doctor tomorrow
or schedule a telemedicine appointment.
So leveraging tools like ai, um, in this specific setting
are ways in which not only we can create member engagement,
but also appropriate care navigation so
that those members stay in network and are
provided the most optimal experience based on
their plan benefits.
- Okay. So let me get to the key question here then. Amanda.
What is the ROI here for payers?
What kind of outcomes can organizations expect when they
leverage this technology in the way that you're describing?
Any, any outcomes, case studies, success stories
that really, uh, are sticking in your mind?
- Yeah, and I think case studies
and this idea of how do we learn from each other in ai,
I think a lot of what we have
to take into account is we have to be patient
and learn from each other and,
and really absorb what's happening.
And so knowing that 57% of patients, Jacob usually, um,
what we're hearing go to the doctor's appointment only
to discover it's not the right one for their condition.
And on the flip side, the providers are saying,
we're seeing patients that don't fit our, our scope
of work 24% of the time.
So we actually have a case study, um,
with the Reliant group, uh, an East coast base, uh,
medical group where when they had about 10,000 members
that we did this case study on,
we saw a couple really interesting pieces to this.
Number one, they wanted to increase appropriate use
of virtual care for their members via e-visit
or telephone calls.
By starting this process
inside their Epic MyChart application, what we were able
to do is through the series of questions, based on
how they were feeling, we were able
to increase telemedicine a appointments through this, uh,
a benefit for their members by 111%.
Not only did this provide the convenience to the members,
but it also alleviate a lot of the burden
of the in-office doctors, um, during the day, um,
for appointments that could have been handled much easier
via teleco, uh, telecommunication or telephone call.
The other part that I really liked was this idea that
during this study we knew that about 67%
of the members didn't know the appropriate
care for their needs.
And what we were able to do was we were able to not only
change the behavior
and care seeking behavior by those members, about 35%
of the time, they actually switched their recommendation.
So Jacob, think about it, you go through this, um, uh, uh,
triage, you're talking about your ear infection,
and you don't know really what you're gonna do.
You think you're gonna go to the ED
or you're gonna schedule an appointment 35% of the time.
We were able to divert, um, those members
to lower care care acuity acuities
and also leading to 26% fewer in-person visits.
Huge numbers, being able to take almost 30%
of your patient population
and in lower acuity settings,
have them either self-care at home
or treat in a couple days opening up those slots
for more important or potentially more urgent, uh, members
that need care at that time.
- Wow. Yeah, those are some incredible numbers.
Really appreciate you sharing that.
And I, I love that little anecdote about the epic
integration and the outcomes
you're, you're seeing there as well.
Before we go though, Amanda, anything else I'm missing?
Any final thoughts
or anything else our listeners should know?
- No. At Informatica, we're really excited
to attend our first Becker's round
table in a couple of weeks.
You can stop by Booth one 18 C, uh,
to learn more about our AI powered market leading
engagement tool for payers.
Um, I would also mention that in a lot of the work
that we're doing, we're also looking at a lot
of early detection work.
And so I think it's important as well for payers to identify
that triaging their members earlier on in their care cycle
could also help reduce, um, some of the, you know,
five most leading causes of death that we see,
which are heart attack, stroke, asthma, pneumonia,
pulmonary embolism.
So it's not just about treating people when
and where they need care, but also looking, um,
at some early detection work to make sure that
as their member populations are either aging
or their health might be deteriorating, they're able
to identify those issues earlier on,
getting them the care they need
to help not only reduce cost,
but also improve clinical outcomes.
- Well, I know I speak for all of us here at Becker's.
We're so excited to have Informatica
with us at the Becker's payer event here in Chicago.
But until then, Amanda, I just want to thank you
for taking the time to be with us
and for sharing your insights with our audience.
We truly appreciate it.
- Thank you so much. - We'd also like
to thank our podcast sponsor for this episode, Informatica.
You can tune into more podcasts from Becker's Healthcare
by visiting our podcastPage@beckerhospitalreview.com.
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