1 00:00:00,240 --> 00:00:02,240 Hi, everyone. This is Lucas Voss with Becker's 2 00:00:02,240 --> 00:00:03,759 Healthcare. Thanks so much for tuning in to 3 00:00:03,759 --> 00:00:06,240 the Becker's Healthcare podcast series. It's great to 4 00:00:06,240 --> 00:00:08,639 have you. Excited for a conversation on the 5 00:00:08,639 --> 00:00:12,740 foundational role of accurate provider data in modern 6 00:00:13,119 --> 00:00:13,619 healthcare. 7 00:00:14,174 --> 00:00:16,734 Care. And I'm very excited to be joined 8 00:00:16,734 --> 00:00:19,474 by Joey Soliske, director of digital health operations, 9 00:00:19,855 --> 00:00:22,114 Alghedi Health Network, and Preeti Subramani, 10 00:00:22,574 --> 00:00:25,934 vice president product management at Highmark Health for 11 00:00:25,934 --> 00:00:28,820 our conversation today. Joanne Preeti, thank you so 12 00:00:28,820 --> 00:00:30,100 much for being here today. It's great to 13 00:00:30,100 --> 00:00:30,679 have you. 14 00:00:31,300 --> 00:00:32,920 Yes. Thanks so much for having us. 15 00:00:33,460 --> 00:00:34,280 Yeah. Absolutely. 16 00:00:34,740 --> 00:00:36,340 I wanna kick us right off. We have 17 00:00:36,340 --> 00:00:37,700 a lot to talk about. There's a lot 18 00:00:37,700 --> 00:00:39,079 of elements to this conversation. 19 00:00:39,995 --> 00:00:41,914 I wanna talk about with something very start 20 00:00:41,914 --> 00:00:43,135 with something very important. 21 00:00:44,075 --> 00:00:46,795 What is the single most important area where 22 00:00:46,795 --> 00:00:48,174 Accurid provided data 23 00:00:48,554 --> 00:00:49,695 makes a difference 24 00:00:50,475 --> 00:00:51,774 within your organization? 25 00:00:52,155 --> 00:00:54,309 Joey, why don't we start with you? Sure. 26 00:00:54,309 --> 00:00:56,390 Yeah. So, just quick background on Allegheny Health 27 00:00:56,390 --> 00:00:58,949 Networks. We're a 14 hospital system in Western 28 00:00:58,949 --> 00:00:59,449 PA, 29 00:00:59,829 --> 00:01:01,989 with over 3,000 physicians and clinicians, and we 30 00:01:01,989 --> 00:01:03,909 have a great partner in Highmark Health. So 31 00:01:03,909 --> 00:01:05,829 I know Preeti will talk about that collaboration 32 00:01:05,829 --> 00:01:07,590 we have from a a payer and provider 33 00:01:07,590 --> 00:01:08,984 perspective across the network. 34 00:01:09,385 --> 00:01:10,504 But for us in the in the health 35 00:01:10,504 --> 00:01:12,584 system lens, you know, I think the single 36 00:01:12,584 --> 00:01:14,364 most important area where it matters 37 00:01:14,905 --> 00:01:17,325 is in relation to the clinician 38 00:01:17,704 --> 00:01:19,325 information being consistent. 39 00:01:19,625 --> 00:01:21,224 And what I mean by that is it's 40 00:01:21,224 --> 00:01:23,704 consistent across the various channels for how our 41 00:01:23,704 --> 00:01:24,204 patients 42 00:01:24,590 --> 00:01:26,750 could access our system. So whether that be 43 00:01:26,750 --> 00:01:28,990 through Google, whether that be through our website 44 00:01:28,990 --> 00:01:31,150 and find care, that same information about our 45 00:01:31,150 --> 00:01:33,709 clinician or location should be the same. Mhmm. 46 00:01:33,950 --> 00:01:35,230 And if we have if it's the same, 47 00:01:35,230 --> 00:01:37,790 then it builds that trust, and consistency so 48 00:01:37,790 --> 00:01:39,250 they keep wanting to come back. 49 00:01:40,034 --> 00:01:40,775 Yeah. Pratib? 50 00:01:41,634 --> 00:01:42,375 I think 51 00:01:42,834 --> 00:01:44,754 Joey hit on a key point here, which 52 00:01:44,754 --> 00:01:47,715 is trust in the information that we're providing. 53 00:01:47,715 --> 00:01:50,435 And the single most important area from, our 54 00:01:50,435 --> 00:01:52,215 Highmark Health insurance 55 00:01:52,750 --> 00:01:55,229 perspective is that member experience and their ability 56 00:01:55,229 --> 00:01:55,890 to find 57 00:01:56,269 --> 00:01:57,649 compatible care options. 58 00:01:58,109 --> 00:01:59,950 And one of the first things that people 59 00:01:59,950 --> 00:02:01,329 do when they get their insurance 60 00:02:01,950 --> 00:02:04,129 is look for which doctor is in network, 61 00:02:04,429 --> 00:02:07,155 and they want to understand exactly what network 62 00:02:07,155 --> 00:02:09,395 they're in, how much things are gonna cost 63 00:02:09,395 --> 00:02:10,995 when they go to that doctor, how to 64 00:02:10,995 --> 00:02:13,235 schedule an appointment with that doctor. So there 65 00:02:13,235 --> 00:02:14,754 are a lot of information that we need 66 00:02:14,754 --> 00:02:16,694 to kinda collect and bring together, 67 00:02:17,314 --> 00:02:19,635 for those individuals so they can understand how 68 00:02:19,635 --> 00:02:20,915 to go get the health care that they 69 00:02:20,915 --> 00:02:22,710 need and use the health insurance plan that 70 00:02:22,710 --> 00:02:23,689 they've just purchased. 71 00:02:24,550 --> 00:02:26,150 Yeah. And I think what's very interesting about 72 00:02:26,150 --> 00:02:27,830 this conversation, and and you both touched on 73 00:02:27,830 --> 00:02:29,110 it a little bit, it's sort of this 74 00:02:29,110 --> 00:02:31,990 this ecosystem approach. Right? There's so many connecting 75 00:02:31,990 --> 00:02:34,230 pieces to this, so many dots that need 76 00:02:34,230 --> 00:02:35,990 to be connected for this to be able 77 00:02:35,990 --> 00:02:36,730 to be successful, 78 00:02:37,395 --> 00:02:40,034 and and to be a successful approach, which 79 00:02:40,034 --> 00:02:41,955 is really important. And I wanna talk a 80 00:02:41,955 --> 00:02:43,715 little bit about some of the disconnects that 81 00:02:43,715 --> 00:02:46,854 you're observing in this, process in itself 82 00:02:47,235 --> 00:02:49,474 or then in turn also the opportunities that 83 00:02:49,474 --> 00:02:49,800 it 84 00:03:02,520 --> 00:03:04,965 Sure. Yeah. So Sure. Yeah. So for for 85 00:03:04,965 --> 00:03:05,465 us, 86 00:03:05,925 --> 00:03:07,925 it's also, you know, providers and the locations 87 00:03:07,925 --> 00:03:09,544 data. Again, because I think something we 88 00:03:09,844 --> 00:03:11,625 find is that there is inconsistency 89 00:03:12,004 --> 00:03:13,284 even in, like, you know, some of our 90 00:03:13,284 --> 00:03:15,950 branding name in downstream systems or, again, I'll 91 00:03:15,950 --> 00:03:18,189 use the Google example displaying this. The patient 92 00:03:18,189 --> 00:03:20,430 may go to their MyChart patient portal and 93 00:03:20,430 --> 00:03:22,030 see there have an upcoming appointment at a 94 00:03:22,030 --> 00:03:24,030 different facility name than what they saw on 95 00:03:24,030 --> 00:03:25,550 our website and Google. So if we get 96 00:03:25,550 --> 00:03:26,849 all that connected 97 00:03:27,230 --> 00:03:29,810 across a different, pillars within an enterprise, 98 00:03:30,175 --> 00:03:32,335 it makes that be consistent and feel easy 99 00:03:32,335 --> 00:03:34,354 for our patient and members again. And so 100 00:03:34,655 --> 00:03:37,235 for us, that is, really making sure 101 00:03:37,534 --> 00:03:38,034 that 102 00:03:38,574 --> 00:03:39,074 facilities, 103 00:03:40,094 --> 00:03:42,495 departments like our credentialing department, you know, for 104 00:03:42,495 --> 00:03:43,715 medical staff services 105 00:03:44,340 --> 00:03:47,460 is sending their information for to us. Also 106 00:03:47,460 --> 00:03:49,620 that our real estate department, they'll have the 107 00:03:49,620 --> 00:03:51,620 updated facility info is sent into this, like 108 00:03:51,620 --> 00:03:52,200 a platform, 109 00:03:52,740 --> 00:03:54,580 that you have the reviews about your clinicians 110 00:03:54,580 --> 00:03:56,020 coming in. And so when you connect all 111 00:03:56,020 --> 00:03:58,995 those different areas together into one, it allows 112 00:03:58,995 --> 00:04:00,514 for you to have that, I'll call it, 113 00:04:00,514 --> 00:04:03,574 cohesive experience downstream then, by doing that. 114 00:04:04,194 --> 00:04:05,955 And I think that the biggest opportunity, which 115 00:04:05,955 --> 00:04:07,394 I know Preeti will talk about, is for 116 00:04:07,394 --> 00:04:09,074 us being a pay biter or a payer 117 00:04:09,074 --> 00:04:10,674 and a provider health system here is we 118 00:04:10,674 --> 00:04:12,500 can really connect and have 119 00:04:12,879 --> 00:04:14,799 that clinician information be as up to date 120 00:04:14,799 --> 00:04:16,560 as possible for our members as well, which 121 00:04:16,560 --> 00:04:17,699 we're really excited about. 122 00:04:18,639 --> 00:04:20,479 Yeah. Priti, talk a little bit about that. 123 00:04:20,479 --> 00:04:21,860 How important is that piece? 124 00:04:22,240 --> 00:04:22,899 I think 125 00:04:23,444 --> 00:04:25,625 Joey hit on it, you know, pretty well. 126 00:04:25,925 --> 00:04:28,824 We know that providers are struggling with managing 127 00:04:28,964 --> 00:04:31,284 their own data and the accuracy they have 128 00:04:31,284 --> 00:04:33,125 with that data. Mhmm. And then from a 129 00:04:33,125 --> 00:04:34,504 health insurance perspective, 130 00:04:34,805 --> 00:04:35,544 we have 131 00:04:35,860 --> 00:04:38,020 a multitude of providers that are in that 132 00:04:38,020 --> 00:04:39,860 same boat, and we are receiving a lot 133 00:04:39,860 --> 00:04:42,439 of inaccurate data from all of those providers. 134 00:04:43,060 --> 00:04:44,520 And then trying to determine 135 00:04:45,220 --> 00:04:45,720 what, 136 00:04:46,100 --> 00:04:48,580 data is accurate, what's inaccurate, and how do 137 00:04:48,580 --> 00:04:50,199 we showcase this to, 138 00:04:51,154 --> 00:04:53,235 our members in the right way. And so 139 00:04:53,235 --> 00:04:55,814 that that's one of the biggest disconnects upfront 140 00:04:55,875 --> 00:04:56,775 in the journey 141 00:04:57,154 --> 00:04:58,915 as we think about this. And we're starting 142 00:04:58,915 --> 00:05:01,335 to deploy different capabilities in that space 143 00:05:01,795 --> 00:05:04,915 to validate and ensure that data accuracy is 144 00:05:04,915 --> 00:05:07,860 there. Then the other disconnect comes more downstream 145 00:05:08,000 --> 00:05:10,720 in the customer journey when they're actually looking 146 00:05:10,720 --> 00:05:13,519 for care and then trying to schedule an 147 00:05:13,519 --> 00:05:16,419 appointment with that clinician or provider office 148 00:05:17,120 --> 00:05:19,120 when they don't have enough information on how 149 00:05:19,120 --> 00:05:20,660 to actually go get an appointment. 150 00:05:21,495 --> 00:05:23,175 So they might get only, that far in 151 00:05:23,175 --> 00:05:24,694 the journey, and then they can't figure out 152 00:05:24,694 --> 00:05:26,615 how to schedule an appointment. Sometimes they just 153 00:05:26,615 --> 00:05:27,274 give up 154 00:05:27,735 --> 00:05:30,395 or if they get frustrated through that process. 155 00:05:30,694 --> 00:05:32,855 And so those are both upstream and downstream. 156 00:05:32,855 --> 00:05:34,214 We're trying to figure out how do we 157 00:05:34,214 --> 00:05:35,675 solve that for people that 158 00:05:36,069 --> 00:05:37,990 we give them the right information and we 159 00:05:37,990 --> 00:05:40,230 tell them how to finish that full customer 160 00:05:40,230 --> 00:05:41,990 journey so they can actually go get the 161 00:05:41,990 --> 00:05:44,170 health care with that clinician that they need. 162 00:05:44,550 --> 00:05:47,029 Yeah. Actually, managing that relationship is so key, 163 00:05:47,029 --> 00:05:49,189 and that happens through that collaboration and and 164 00:05:49,189 --> 00:05:51,884 identifying those opportunities for improvement, which I think 165 00:05:52,045 --> 00:05:53,025 is is so important. 166 00:05:53,485 --> 00:05:55,564 Joey, let's talk about some of the the 167 00:05:55,564 --> 00:05:56,064 strategy 168 00:05:56,605 --> 00:05:59,485 pieces to this and how you're achieving this. 169 00:05:59,485 --> 00:06:02,605 Right? Can you share, an example of something 170 00:06:02,605 --> 00:06:04,845 that's worked in terms of a strategy that 171 00:06:04,845 --> 00:06:05,665 you've implemented, 172 00:06:06,360 --> 00:06:08,519 that's really improved this process? And and what 173 00:06:08,519 --> 00:06:09,879 are some of the things that you've learned 174 00:06:09,879 --> 00:06:10,779 throughout this? 175 00:06:11,399 --> 00:06:13,000 Yeah. I think there's a couple different things 176 00:06:13,000 --> 00:06:15,180 that, you know, from a process perspective, 177 00:06:16,120 --> 00:06:17,479 that we need to think about. Because, you 178 00:06:17,479 --> 00:06:19,000 know, if you have a technology or the 179 00:06:19,000 --> 00:06:20,839 connection points in place, that's great. But if 180 00:06:20,839 --> 00:06:21,979 you don't have the upstream 181 00:06:22,415 --> 00:06:24,654 data or information or the right operational leaders 182 00:06:24,654 --> 00:06:26,814 that know where and how they request a 183 00:06:26,814 --> 00:06:28,735 change and what needs to happen, then it's 184 00:06:28,735 --> 00:06:30,495 not gonna be accurate downstream. So you need 185 00:06:30,495 --> 00:06:32,735 to fix as well at the very start, 186 00:06:32,975 --> 00:06:35,699 core process item. And for us, one of 187 00:06:35,699 --> 00:06:38,199 the big buckets is, you know, annual review 188 00:06:38,259 --> 00:06:40,259 of the information with operations. So how do 189 00:06:40,259 --> 00:06:41,779 you do, you know, like, a yearly help 190 00:06:41,779 --> 00:06:43,540 check up, you know, on your information for 191 00:06:43,540 --> 00:06:45,779 your data with your clinicians, with your operators, 192 00:06:45,779 --> 00:06:48,384 for locations? And is that phone number still 193 00:06:48,384 --> 00:06:50,305 accurate, you know, for that primary care clinic 194 00:06:50,305 --> 00:06:50,965 in Pittsburgh? 195 00:06:51,824 --> 00:06:54,305 Is that clinician specialty still up to date? 196 00:06:54,305 --> 00:06:56,145 Then do they, you know, do they get 197 00:06:56,145 --> 00:06:58,145 additional information they want in their biography now 198 00:06:58,145 --> 00:07:00,705 to display on Google in MyChart again in 199 00:07:00,705 --> 00:07:03,120 member portal for our Highmark members? So the 200 00:07:03,120 --> 00:07:05,839 annual review and expectation setting, having a team 201 00:07:05,839 --> 00:07:07,920 who does that is important. The second point 202 00:07:07,920 --> 00:07:09,759 then is how do you make sure to 203 00:07:09,759 --> 00:07:11,520 make a request for a change in one 204 00:07:11,520 --> 00:07:13,439 location? So as a clinician, you know, if 205 00:07:13,439 --> 00:07:16,080 something doesn't look right, downstream, you know exactly 206 00:07:16,080 --> 00:07:17,665 where we need to go to to make 207 00:07:17,665 --> 00:07:19,745 a request for a change and that there's 208 00:07:19,745 --> 00:07:22,064 service level arrangements on that change being, you 209 00:07:22,064 --> 00:07:23,905 know, done by the next day by appropriate 210 00:07:23,905 --> 00:07:25,905 teams in your enterprise. So, those are a 211 00:07:25,905 --> 00:07:28,225 couple of the process related items we're really 212 00:07:28,225 --> 00:07:29,665 trying to think through to make sure the 213 00:07:29,665 --> 00:07:30,645 data can be clean. 214 00:07:31,060 --> 00:07:32,899 Yeah. Absolutely. Pretty same for you. What what 215 00:07:32,899 --> 00:07:35,319 have you observed? What what's working for you? 216 00:07:36,259 --> 00:07:38,419 So we we're doing a couple of different 217 00:07:38,419 --> 00:07:40,259 things, and I talked about one of them. 218 00:07:40,259 --> 00:07:42,579 So we're really taking all of the information 219 00:07:42,579 --> 00:07:44,579 that we're getting from providers and using a 220 00:07:44,579 --> 00:07:45,800 third party company, 221 00:07:46,615 --> 00:07:49,915 that looks externally at different, sources of information 222 00:07:50,055 --> 00:07:51,754 when using AI and ML 223 00:07:52,214 --> 00:07:54,615 to really validate all the information we're getting. 224 00:07:54,615 --> 00:07:57,274 So they look at credentialing systems and other, 225 00:07:57,814 --> 00:08:00,480 CMS and other, areas to say, hey. This 226 00:08:00,639 --> 00:08:02,560 information is accurate or not accurate, making sure 227 00:08:02,560 --> 00:08:03,860 that flow is going, 228 00:08:04,480 --> 00:08:06,639 through. We also took a look at our 229 00:08:06,639 --> 00:08:08,960 provider directory and how it was structured on 230 00:08:08,960 --> 00:08:10,639 the back end over the last couple of 231 00:08:10,639 --> 00:08:11,379 years and 232 00:08:12,000 --> 00:08:16,044 have completely untangled or unraveled it and then 233 00:08:16,044 --> 00:08:16,544 reorganized 234 00:08:16,925 --> 00:08:18,704 it into a cloud infrastructure, 235 00:08:19,725 --> 00:08:21,664 which actually just went live today. 236 00:08:22,524 --> 00:08:24,939 So we're super excited about that. And what 237 00:08:24,939 --> 00:08:27,259 that helps us do is, one, it drives 238 00:08:27,259 --> 00:08:29,660 better quality of how all of those all 239 00:08:29,660 --> 00:08:31,740 of that provider data is connected to our 240 00:08:31,740 --> 00:08:34,299 plan and network data, but it also drives 241 00:08:34,299 --> 00:08:34,799 accessibility 242 00:08:35,179 --> 00:08:37,740 of that information across a lot of different 243 00:08:37,740 --> 00:08:38,240 channels. 244 00:08:38,694 --> 00:08:41,014 So customers can engage with it through a 245 00:08:41,014 --> 00:08:41,514 chat, 246 00:08:41,975 --> 00:08:44,294 through an agent, through a voice channel, or 247 00:08:44,294 --> 00:08:46,394 through the search tool that we have today. 248 00:08:47,095 --> 00:08:49,254 Yeah. It's it's constantly advancing, it sounds like. 249 00:08:49,254 --> 00:08:50,394 It's you're evaluating 250 00:08:50,774 --> 00:08:52,875 constantly, which is which is awesome. 251 00:08:53,620 --> 00:08:54,360 Yes. Exactly. That's right. 252 00:08:55,300 --> 00:08:55,800 Yeah. 253 00:08:56,660 --> 00:08:59,379 You both talked about the importance of sort 254 00:08:59,379 --> 00:09:01,460 of this accuracy piece. Right, Joey? You talked 255 00:09:01,460 --> 00:09:03,220 about the fact that, hey. We need to 256 00:09:03,220 --> 00:09:05,139 know if that provider's address in Pittsburgh is 257 00:09:05,139 --> 00:09:06,899 still correct. That needs to line up. So 258 00:09:06,899 --> 00:09:07,800 that's a simple 259 00:09:08,325 --> 00:09:11,285 that's the simple accuracy piece. Obviously, that's what 260 00:09:11,285 --> 00:09:12,825 provided data does in itself. 261 00:09:13,365 --> 00:09:15,205 Can you talk a little bit about why 262 00:09:15,205 --> 00:09:17,065 it's also so important 263 00:09:17,845 --> 00:09:19,605 to leverage when it comes to sort of 264 00:09:19,605 --> 00:09:20,585 the more overarching 265 00:09:21,365 --> 00:09:22,665 theme of improving 266 00:09:23,309 --> 00:09:24,049 care coordination 267 00:09:24,429 --> 00:09:26,370 and then in turn really improving 268 00:09:27,309 --> 00:09:29,090 the patient and member experiences. 269 00:09:29,950 --> 00:09:32,429 We talk about trust, etcetera. Why is it 270 00:09:32,429 --> 00:09:34,690 so important from an overarching perspective 271 00:09:35,149 --> 00:09:37,470 as well, not just the accuracy piece that 272 00:09:37,470 --> 00:09:38,690 we already touched on? 273 00:09:39,035 --> 00:09:41,434 Yeah. Sure. I mean, I think for, like, 274 00:09:41,434 --> 00:09:43,675 Preeti sort of talked about it earlier too, 275 00:09:43,675 --> 00:09:45,835 but, a big strategy of ours as an 276 00:09:45,835 --> 00:09:48,315 organization is called the living health strategy and 277 00:09:48,315 --> 00:09:50,735 something we're working towards in the payer and 278 00:09:51,115 --> 00:09:53,274 the provider systems. And, ultimately, a big part 279 00:09:53,274 --> 00:09:54,415 of that is how do we 280 00:09:54,769 --> 00:09:57,330 reduce, you know, stress or frustration or fragmented 281 00:09:57,330 --> 00:09:59,250 approaches for our members and patients and make 282 00:09:59,250 --> 00:10:01,250 it feel seamless. And I think this is 283 00:10:01,250 --> 00:10:02,690 a huge part to it. You know, when 284 00:10:02,690 --> 00:10:03,750 we can have this 285 00:10:04,370 --> 00:10:06,710 accurate info that's integrated seamlessly 286 00:10:07,090 --> 00:10:09,730 into the member portal that Preeti talked about 287 00:10:09,730 --> 00:10:10,230 to 288 00:10:10,924 --> 00:10:12,445 know what's up to date and they can 289 00:10:12,445 --> 00:10:14,764 make their appointment more easier, that that really 290 00:10:14,764 --> 00:10:17,824 reduce that fragmentation. And it strategically helps 291 00:10:18,125 --> 00:10:20,044 our patients trust us and then continue to 292 00:10:20,044 --> 00:10:21,725 want to come back and, and to come 293 00:10:21,725 --> 00:10:22,464 to our facilities. 294 00:10:23,084 --> 00:10:24,845 I think the other thing we're really thinking 295 00:10:24,845 --> 00:10:26,464 about is, you know, once this 296 00:10:26,899 --> 00:10:28,759 info now if you have all this 297 00:10:29,139 --> 00:10:31,460 centralized about your locations and your clinicians, how 298 00:10:31,460 --> 00:10:32,120 do we 299 00:10:32,500 --> 00:10:34,340 redesign the way that a patient could come 300 00:10:34,340 --> 00:10:36,740 to our facility? Not traditionally, I was find 301 00:10:36,740 --> 00:10:38,519 a doctor. Now let's say, 302 00:10:38,915 --> 00:10:40,754 make it find care truly. You know, you 303 00:10:40,754 --> 00:10:43,315 should you now have all your locations info 304 00:10:43,315 --> 00:10:45,254 and your provider info. You know, a patient 305 00:10:45,315 --> 00:10:47,075 or member could search for my right knee 306 00:10:47,075 --> 00:10:47,735 pain hurts. 307 00:10:48,115 --> 00:10:49,634 What do I need to do? And we 308 00:10:49,634 --> 00:10:51,335 should know that that means, you know, orthopedic. 309 00:10:51,475 --> 00:10:53,159 You live here as your ZIP code, here's 310 00:10:53,159 --> 00:10:54,839 the nearest facility with an open appointment. It 311 00:10:54,839 --> 00:10:56,759 allows for us to get to that true 312 00:10:56,759 --> 00:10:59,559 fine care experience faster. So that's something, you 313 00:10:59,559 --> 00:11:01,159 know, in the future, we're really excited about 314 00:11:01,159 --> 00:11:03,320 designing and building. We have all this, you 315 00:11:03,320 --> 00:11:06,059 know, data accuracy upfront, in there. 316 00:11:06,595 --> 00:11:08,674 Yeah. Priti, you you touched on the the 317 00:11:08,674 --> 00:11:10,995 strategic lever that this can be, right, and 318 00:11:10,995 --> 00:11:12,754 sort of the the initiatives too that that 319 00:11:12,754 --> 00:11:14,674 you're working on to improve this. What does 320 00:11:14,674 --> 00:11:16,195 this look like for you, and and how 321 00:11:16,195 --> 00:11:19,014 is it streamlining that care coordination piece too? 322 00:11:19,750 --> 00:11:22,069 Yeah. And I think, you know, we've been 323 00:11:22,069 --> 00:11:23,829 using the word trust a lot, and we 324 00:11:23,829 --> 00:11:26,309 know that all of the provider data being 325 00:11:26,309 --> 00:11:26,809 accurate, 326 00:11:27,190 --> 00:11:29,509 that's bad data is just gonna erode people's 327 00:11:29,509 --> 00:11:31,509 trust. And when there's good data, it builds 328 00:11:31,509 --> 00:11:33,909 that trust. So that's obviously core to everything 329 00:11:33,909 --> 00:11:36,075 we're doing. And then on top of that, 330 00:11:36,075 --> 00:11:39,434 we're layering in additional information to make sure 331 00:11:39,434 --> 00:11:41,674 that when in the moment that they're actually 332 00:11:41,674 --> 00:11:43,455 looking for a provider, 333 00:11:43,835 --> 00:11:45,754 how do we give them information that they 334 00:11:45,754 --> 00:11:48,429 need to complete that task or journey? So 335 00:11:48,429 --> 00:11:50,850 how do we provide information about appointment availability? 336 00:11:51,389 --> 00:11:53,250 How do we make that more personalized 337 00:11:53,950 --> 00:11:56,990 with care gap information as well and make 338 00:11:56,990 --> 00:11:59,070 sure that they get the right information in 339 00:11:59,070 --> 00:11:59,889 those moments? 340 00:12:00,544 --> 00:12:02,485 We could suggest preventative screenings. 341 00:12:02,865 --> 00:12:04,485 We can also provide information 342 00:12:05,105 --> 00:12:07,184 if they don't have a, let's say, physical 343 00:12:07,184 --> 00:12:09,345 therapist within a 30 mile radius, how do 344 00:12:09,345 --> 00:12:11,924 we connect them to our virtual physical therapy 345 00:12:11,985 --> 00:12:12,485 services 346 00:12:13,029 --> 00:12:14,870 and make sure that they get access to 347 00:12:14,870 --> 00:12:17,269 the care that they need regardless of where 348 00:12:17,269 --> 00:12:19,029 they're located or their ability to kind of 349 00:12:19,029 --> 00:12:20,649 physically go into a location? 350 00:12:21,509 --> 00:12:22,950 And then the other piece of that is 351 00:12:22,950 --> 00:12:25,029 also to make sure that we're connecting them 352 00:12:25,029 --> 00:12:26,870 with information that they want to know about 353 00:12:26,870 --> 00:12:27,610 these clinicians. 354 00:12:27,965 --> 00:12:30,285 In some cases, they wanna have more personal 355 00:12:30,285 --> 00:12:32,924 connections if it's a primary care doctor. And 356 00:12:32,924 --> 00:12:34,845 we learned this a lot through our research 357 00:12:34,845 --> 00:12:37,725 that people are interested in understanding, you know, 358 00:12:37,725 --> 00:12:39,965 they speak their language, can they relate to 359 00:12:39,965 --> 00:12:42,544 this person? Do they offer virtual care options? 360 00:12:42,920 --> 00:12:44,519 And so we wanna make sure we provide 361 00:12:44,519 --> 00:12:45,259 that enhanced 362 00:12:45,720 --> 00:12:48,220 provider information beyond just location, 363 00:12:49,160 --> 00:12:51,000 and how to contact them so that they 364 00:12:51,000 --> 00:12:52,840 can make that decision in that moment and 365 00:12:52,840 --> 00:12:55,320 don't have to do additional research on third 366 00:12:55,320 --> 00:12:56,360 party sites to, 367 00:12:57,294 --> 00:12:59,294 get the full picture that they need to 368 00:12:59,294 --> 00:13:00,894 make a decision and move forward with their 369 00:13:00,894 --> 00:13:03,375 health care. That extra Googling takes a lot 370 00:13:03,375 --> 00:13:05,615 of time. So I agree that this does 371 00:13:05,615 --> 00:13:07,315 really improve the patient experience. 372 00:13:08,014 --> 00:13:10,095 Exactly. And I'll say they've we've in our 373 00:13:10,095 --> 00:13:12,299 research, we saw they were using Google, Yelp, 374 00:13:12,539 --> 00:13:13,039 Nextdoor, 375 00:13:13,580 --> 00:13:15,580 everything they could to kind of find that 376 00:13:15,580 --> 00:13:16,080 information. 377 00:13:16,779 --> 00:13:19,179 Yeah. Absolutely. I wanna close this out with 378 00:13:19,179 --> 00:13:20,539 sort of a a little bit of a 379 00:13:20,539 --> 00:13:23,019 forward looking view on this. Right? So we've 380 00:13:23,019 --> 00:13:25,315 touched on what you all are doing, how 381 00:13:25,315 --> 00:13:27,634 it's working, and sort of the initiatives that 382 00:13:27,634 --> 00:13:29,794 you're you're trying to move forward in the 383 00:13:29,794 --> 00:13:32,274 next couple of years or even immediately right 384 00:13:32,274 --> 00:13:32,774 now. 385 00:13:33,235 --> 00:13:35,254 When we are doing this correctly 386 00:13:35,794 --> 00:13:37,975 and everything that we've mentioned so far, 387 00:13:38,559 --> 00:13:41,460 how does that accurate provided data then also 388 00:13:41,519 --> 00:13:42,899 set sort of the foundation 389 00:13:43,279 --> 00:13:43,779 for 390 00:13:44,320 --> 00:13:47,460 AI initiatives and other initiatives in your organization, 391 00:13:48,240 --> 00:13:50,980 and what should we consider as the prerequisites 392 00:13:51,440 --> 00:13:54,019 for success there? Joey, we'll start with you. 393 00:13:54,455 --> 00:13:56,254 Sure. Yeah. Thanks. I talked about it briefly, 394 00:13:56,254 --> 00:13:57,894 I think, on the last topic there. But, 395 00:13:57,894 --> 00:13:58,394 ultimately, 396 00:13:59,254 --> 00:14:01,894 if you have the information about a provider 397 00:14:01,894 --> 00:14:04,215 and the location and all this data about 398 00:14:04,215 --> 00:14:06,955 them, you can feed that information into, 399 00:14:07,350 --> 00:14:09,669 in the future, your AI agents for call 400 00:14:09,669 --> 00:14:12,230 center, your chatbot experience, and website or member 401 00:14:12,230 --> 00:14:14,549 portals. And a patient or a member could 402 00:14:14,549 --> 00:14:16,789 ask any question or they could say, if 403 00:14:16,789 --> 00:14:19,350 I may, doctor Joey, where he practices, and 404 00:14:19,350 --> 00:14:20,629 if we have all that feeding it, they 405 00:14:20,629 --> 00:14:23,054 can respond quickly and then also surface when 406 00:14:23,054 --> 00:14:25,134 that appointment's available with them. And so if 407 00:14:25,134 --> 00:14:27,054 you have a infrastructure or base of all 408 00:14:27,054 --> 00:14:29,134 that connected from the various parts of the 409 00:14:29,134 --> 00:14:29,634 enterprise, 410 00:14:30,095 --> 00:14:32,495 with the phone numbers, fax numbers of a 411 00:14:32,495 --> 00:14:32,995 facility, 412 00:14:33,615 --> 00:14:35,615 again, that clinician specialty where they work and 413 00:14:35,615 --> 00:14:38,034 their schedule availability, you can then truly 414 00:14:38,730 --> 00:14:40,649 enhance the next layer of engagement for our 415 00:14:40,649 --> 00:14:42,970 patients and members wherever that may be in 416 00:14:42,970 --> 00:14:45,129 the future. So you need that base layer, 417 00:14:45,129 --> 00:14:48,330 though, to enable that experience. I mean, I 418 00:14:48,330 --> 00:14:50,889 know Preeti is leading a great initiative across 419 00:14:50,889 --> 00:14:53,049 our enterprise, or our call center that can 420 00:14:53,049 --> 00:14:55,665 also help feed into that. Yeah. Brutee, feel 421 00:14:55,665 --> 00:14:57,665 free to elaborate on that. Yeah. And I 422 00:14:57,665 --> 00:14:59,665 think, you know, what Joe is referring to 423 00:14:59,665 --> 00:15:01,825 is we're really trying to shift the model 424 00:15:01,825 --> 00:15:04,625 in our contact centers from assistant service to 425 00:15:04,625 --> 00:15:05,125 self-service. 426 00:15:05,904 --> 00:15:07,904 We know that's much more efficient for members, 427 00:15:07,904 --> 00:15:09,585 and then they can use a twenty four 428 00:15:09,585 --> 00:15:11,470 seven support model. So if they're laying in 429 00:15:11,470 --> 00:15:13,149 bed at 11:00 at night and need to 430 00:15:13,149 --> 00:15:15,149 find a doctor, they don't need our contact 431 00:15:15,149 --> 00:15:17,149 center to be open if we establish the 432 00:15:17,149 --> 00:15:18,610 right self-service capabilities. 433 00:15:19,389 --> 00:15:21,309 And the other place we're trying to start 434 00:15:21,309 --> 00:15:22,610 thinking about the AI 435 00:15:23,345 --> 00:15:27,904 utilization outside of just the conversational AI and, 436 00:15:27,904 --> 00:15:28,884 you know, virtual, 437 00:15:29,345 --> 00:15:29,845 assistance 438 00:15:30,225 --> 00:15:31,365 is also personalization. 439 00:15:32,305 --> 00:15:34,465 So if somebody has a care gap, how 440 00:15:34,465 --> 00:15:36,404 do we connect them to the right clinician 441 00:15:37,399 --> 00:15:39,799 and look at, hey. You have five clinicians 442 00:15:39,799 --> 00:15:41,399 in your area. We see that you're not 443 00:15:41,399 --> 00:15:44,220 attributed to a PCP, and these five have 444 00:15:44,440 --> 00:15:47,480 appointments available within the next thirty to sixty 445 00:15:47,480 --> 00:15:49,960 days, whatever the acceptable threshold is for that 446 00:15:49,960 --> 00:15:50,860 service type, 447 00:15:51,335 --> 00:15:52,715 and make those recommendations 448 00:15:53,095 --> 00:15:53,595 proactively. 449 00:15:54,535 --> 00:15:56,695 If we have a provider or a clinician 450 00:15:56,695 --> 00:15:58,535 that leaves our network and they need to 451 00:15:58,535 --> 00:16:00,535 find a new doctor that's in network, how 452 00:16:00,535 --> 00:16:01,674 do we proactively 453 00:16:01,975 --> 00:16:03,654 engage them and let them know that instead 454 00:16:03,654 --> 00:16:05,014 of saying, hey. Your doctor is no longer 455 00:16:05,014 --> 00:16:06,535 in network. You need to go find another 456 00:16:06,535 --> 00:16:08,559 one. How do we actually just use AI 457 00:16:08,559 --> 00:16:09,620 to make a recommendation 458 00:16:10,399 --> 00:16:12,160 on some new doctors based on what we 459 00:16:12,160 --> 00:16:14,100 knew about their previous physician, 460 00:16:14,879 --> 00:16:17,600 and also, you know, where they live, what 461 00:16:17,600 --> 00:16:20,899 their preferences are for virtual versus in person, 462 00:16:21,195 --> 00:16:23,274 and then make recommendations based on that. So 463 00:16:23,274 --> 00:16:24,654 we really wanna start utilizing, 464 00:16:25,754 --> 00:16:28,495 AI to drive those intelligent provider recommendations, 465 00:16:29,355 --> 00:16:32,394 and also driving more self-service capabilities so our 466 00:16:32,394 --> 00:16:33,595 members can serve, 467 00:16:34,554 --> 00:16:36,554 through any channel they want and when they 468 00:16:36,554 --> 00:16:37,054 want. 469 00:16:37,620 --> 00:16:39,460 Yeah. And I love that at the end 470 00:16:39,460 --> 00:16:41,139 of the day, this always comes back to 471 00:16:41,139 --> 00:16:43,160 improving the patient and member experiences 472 00:16:43,620 --> 00:16:45,620 across the board, whether that be through, again, 473 00:16:45,620 --> 00:16:48,660 improving trust or just streamlining this whole process, 474 00:16:48,660 --> 00:16:51,075 which is a fantastic goal to have. Joy 475 00:16:51,075 --> 00:16:52,434 and Priti, thanks so much for your time 476 00:16:52,434 --> 00:16:54,514 and insights today. This was a fantastic conversation. 477 00:16:54,514 --> 00:16:55,575 Thanks for being here. 478 00:16:56,434 --> 00:16:58,035 Thanks so much for having us. Having us. 479 00:16:58,035 --> 00:17:00,274 It was great. Yeah. Absolutely. And we also 480 00:17:00,274 --> 00:17:02,557 want to thank our podcast sponsor, Kairos Health. 481 00:17:02,557 --> 00:17:04,237 You can tune in to more podcasts from 482 00:17:04,237 --> 00:17:06,797 Becker's Healthcare by visiting our podcast page at 483 00:17:06,797 --> 00:17:09,297 beckershospitalreview.com.