Artificial intelligence, real well-being

For a well-being company like Humana, artificial intelligence (AI) offers the potential to capture and analyze vast quantities of increasingly dynamic data from a huge range of sources to understand the full health story of Humana members. That data is rapidly evolving from claims-based information — which can be days, weeks or even months old – to more real-time sources of data that can help deliver more personalized, relevant care.

Busy Burr, a Vice President and Head of Health Care Trend and Innovation at Humana, made the case for intelligent use of AI in health care at The Economist’s recent Innovation Summit 2018 America event in Chicago. She was on a panel titled “From ER to AI,” with panelists answering the question, “How can AI democratize preventative health care on a global scale?”

Other panelists were Jaykumar Menon, chair and co-founder, Open Source Pharma Foundation, and research fellow, McGill University; Naveen Jain, chief executive, Viome; and Chris Mansi, chief executive and co-founder, The panel was moderated by Vijay Vaitheeswaran, United States business editor for The Economist.

The Economist said the goal of the event was to “bring together the world’s leading minds in artificial intelligence and machine learning to discuss the opportunities created by these technologies for business, as well as their implications on society at large.”

Busy noted that the amount of available data is growing exponentially. But it’s not all created equal, and more data means analysts have to do a better job of sifting out the noise. Data is also coming in faster, in real-time, which means agile companies have to respond to it faster.

“When we relied on claims data to inform our work, the data was never really fresh,” she said. “So if we responded to it in a few days – that was great. But now data will be minutes or seconds old.”

She said consumer expectations are changing – with same-day delivery, on-demand television and real-time navigation apps. And health consumers are demanding that same level of service. As an example, she talked about Humana partner Livongo.

“With a cloud-based glucometer like Livongo, if your blood glucose is out of range you will get a call from a nurse or diabetes educator – not within days or even hours but within minutes,” Busy said. “Imagine how great the member experience will be when we have their back – in real time.”

She said that over time, the data that health plans “own” – claims data and clinical data – may ultimately be surpassed by real-time, member-generated data from sensors and wearables, which consumers/members will own and control. Companies like Apple are making a bet here by building the interfaces to help consumers manage their health data.

And it’s no small task. The volume and velocity of data creates an urgent need to curate and process it – to help consumers understand its relevance.

AI diverges from garden-variety analytics because it is the technology that enables analytics to be dynamic, Busy said. AI uses machine learning to reassess assumptions and recommendations based on the actions and outcomes; new models and new insights are constantly being generated. AI is the tool that will enable the personalization and curation of the data – to give new kinds of highly personalized feedback to consumers so they can change their behaviors.

“Increasingly we will be able to form a broader understanding of our members’ lives, not just their physical health,” she said. “What is their living situation? Have they lost a close loved one? Have they seen their physician lately? Are they feeling well? AI will help us create solutions that meet the member where they are.”

But AI and data are just tools to help drive better experiences. Companies have to be able to process and act on all that data. “Data without action is just… data, not health. This means we need to be always on.”

She said that AI – by constantly learning and changing — can help sift through the noise to get the right, actionable data. That enables companies like Humana to tailor care plans, recommendations, interventions and engagements to a member’s specific needs at that point in time.

“New software technologies that incorporate machine learning and AI will connect and enable the whole care team – the member’s physician, nurses, pharmacists, social workers, health coaches, diabetes educators — to have highly personalized recommendations and suggestions for that member’s care,” she said. “We will be able to deploy the right care based on alerts and information we are receiving and potentially avoid an acute event.

“Imagine sending a podiatry tech to the home of a member when we are alerted to a high risk of a foot ulcer. Or having a diabetes coach visit a member just diagnosed with diabetes to provide support, education and help a member go through their pantry and fridge – on the same day as a diagnosis. Success here will take smart, connected software and analytics models.”

But ultimately, AI will empower members with knowledge that will make it easier for them to have more control as they manage their own health. This real-time, personalized information will put more health-care power in the hands of consumers.

She noted that technology itself isn’t care, but it augments care. The right tools can help develop better relationships with members.

“To bring these opportunities to life we will need to create new ways of working,” she said. “We need be thoughtful and careful as we get closer to our members in their home. We need to ensure the quality of the experience, be responsive in real time, and ensure we provide tailored, relevant and personalized care.”

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