Proper care and rich data lead to holistic health

A high-tech, high-touch solution is the key to improving health — connecting patients, physicians and communities in ways that build relationships so they can work together, according to two Humana experts.

Vipin Gopal, PhD, MBA, Senior Vice President of Clinical Analytics at Humana, and Jonas de Souza, MD, MBA, Medical Director in the Office of the Chief Medical Officer, will discuss how Humana is integrating the clinical and lifestyle aspects of health at the HIMSS Annual Conference in a presentation titled “IT Takes Two to Tango — Bringing Health and Care Together Through IT.”

As a data analytics leader and a physician-executive, they bring a joint perspective to the issue.

“In the past, health care was all about clinical interventions,” Dr. de Souza said. “But as Humana has transitioned to a true wellness company, we’ve gained a better understanding of our members and enhanced our ability to improve their well-being. We now have the tools to help them not only when they are sick, but before they get sick.”

Doctors and data experts can’t improve health alone, they say. Success requires building a comprehensive population health care strategy that incorporates social factors — like loneliness and food insecurity – and incorporating the right technology to facilitate better care and access.

Take the growing senior population, for example. By 2050, the number of people 65 and older will double, to over 83 million. About ten thousand people are enrolling into Medicare every day. And three in four Americans aged 65 and older has one or more chronic conditions. The need for care is growing exponentially, and the system will need better tools to keep up.

“We are really going deep in the personalization of care with analytics and technology,” Dr. Gopal said. “We have a rich suite of advanced analytical models that tell us a lot about any given individual and the risks that individual has with respect to their health. This includes models that predict the likelihood of suffering a fall, progressing in their Congestive Heart Failure (CHF) condition, needing back surgery or having a hospital admission. With these insights, we can provide them with the right care and be proactive in providing that care.”

It’s particularly important with older people, who can also be lonely and socially isolated.

“To address a social determinant like loneliness, we need to be able to identify which of our members have this challenge,” Dr. Gopal said. “We now have predictive models that can identify members who are most likely to be lonely, which means we can intervene and provide the right support. We can’t solve this by ourselves, but we can bring the issue to light and help connect the member to community resources.”

Humana has developed pilots by using digital technology to better support members where they are, and sharing that data with physicians.

For instance, Humana piloted a CHF Weight Monitoring Program that provides patients with a connected scale that transmits their weight to their physician’s office. Weight gain is a significant red flag for this population, and addressing it quickly can avoid a potential hospital admission.

Dr. de Souza also spoke of Humana’s use of artificial intelligence software that helps call-center employees have more productive conversations with members. By monitoring conversational cues – like a rising voice or other signs of agitation – the software can, in real time, send an agent cues to change technique.

The system’s computer engine analyzes hundreds of unique behavioral signals at 50 times per second. The artificial intelligence software identifies, measures and influences the subconscious biological activity that occurs during human interactions, and learns continuously. But all the member experiences is better service, more empathy and more compassion.

“Health is not just a function of health care,” Dr. Gopal said. “Health is a function of health care, and a lot of other things. We’re leading the way with technology and analytics to bring health and care together.”

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