Q&A: Whither healthcare in America?

NASHVILLE — How will telemedicine, artificial intelligence tools and data be used to reduce rising healthcare costs?

That’s the question that Suzy Johnson, president and owner of Employee Benefit Advisors of the Carolinas, posed to her panel at the Workplace Benefits Renaissance conference on Friday.

In follow-up interviews after the discussion, some panelists expanded on their comments on how AI and telemedicine can be used to reduce healthcare costs most effectively.

Suzy Johnson, president and owner of Employee Benefit Advisors of the Carolinas:

“The objective of session was to introduce new technologies and data tools that advisers can recommend for their employer clients to begin an awakening that they can impact claim costs.
Mobile apps that employees use to access telemedicine, prescription best pricing and cost quality data to receive provider recommendation lead to better decision making and lower costs.”

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A blood pressure monitor stands in the diagnostic imaging area at the Hong Kong Integrated Oncology Centre in Hong Kong, China, on Tuesday, Nov. 3, 2015. Equipped with biopsy facilities, body scanners, and quiet 'VIP' chemotherapy rooms, the Hong Kong Integrated Oncology Centre is the first of a string of such facilities that TE Asia Healthcare Partners, a portfolio company funded by TPG Capital, is planning in Asia. Photographer: Xaume Olleros/Bloomberg

“Use of a tool like Benezon employer app can redirect an employee walking into a high cost hospital owned urgent care and remind them they have free telemedicine.”

“A data analytics tool can capture and report back use of telemedicine and show where dollars are being spent wastefully in certain facilities and also identify high risks within the employers group for reach out and savings direction individually and confidentially to employee or claimant.”

“These resources can be implemented into any health benefit plan even if plan is fully insured with an insurance carrier. These tools can provide enlightenment and knowledge so employers can make better decisions such as planning a path to become self funded.”

Curtis Cannon, managing partner at Axis Recovery:

On telemedicine:

“Remote analysis services, like telepathology and teleradiology, can contribute to lower cost and higher quality care as they enable highly trained professionals to work as a pooled resource. Use of these remote services enables low-volume providers to have around the clock coverage at a lower cost.”

“By offering telemedicine appointments, employers are able to provide remote healthcare benefits at a cost that is lower than traditional face to face consultation models. This in turn reduces costs to both employees and employees by enabling patients to receive care at a lower price point.”

On artificial intelligence:

“For Axis Recovery, artificial intelligence improves claims auditing software applications specifically when targeting future waste, fraud and abuse for the client. Using AI pattern recognition gives risk managers better predictive analysis about patient outcomes and other risk factors that impact cost. AI can better assess and forecast catastrophic claims exposure to self-insured employers.”

Cannon sees more virtual consultations, as well, including more video conferences “between patients and medical professionals, while medical physicians use machine learning to help analyze clinical data in a patient’s electronic health or medical record to provide more accurate and efficient care. Through AI it reduces healthcare cost through fewer repeat visits to the doctor, fewer ER and hospital visits for the same or related conditions.”

“AI can provide physicians with multiple scenarios to help determine the best and most efficient treatment plan for the patient. AI can help physicians diagnose conditions quicker and reduce the number of ineffective high cost drugs prescribed by physicians, which again, increase waste and cost.”

For employee engagement and wellness, “Al can make useful tools for figuring out how our own mind works… This lowers the cost of waste or loss on preventable diseases and remove healthcare expenditures that could be caused by unhealthy habits.”

Julian Lago, president of Benezon:

“I believe that it starts with engagement both as a high tech and high touch solution. Placing telemedicine on the mobile app allowing for AI reminders and point of care notifications can be an excellent way to increase usage. In addition however we find through a high touch advocacy engagement tool many times when they’re calling and searching for in network provider or facility, they can be reminded that telemedicine is immediately available and a convenient use of healthcare saving time and money for both members and employers.”

Dante Cook, director of strategic partnerships and alliances, Springbuk:

“Broadly speaking, the general purpose of building Artificial Intelligence is to program a machine to imitate intelligent human behavior and so that the program can learn to solve complex without needing to be taught how. This may be a bold statement, but in terms of building solutions to help reduce healthcare costs, do we really need Artificial Intelligence to help us do this? My viewpoint is that we don't.”

“The narrative we've grown to believe is that we need novel and complex solutions to solve the rising cost problem in our complex healthcare industry. The solutions to our problems are quite simple.”

“Although there is a lot of data out there, we don't need a neural network to help us find anomalies. Applying some simple algorithms to historical claims files can still reveal what we need to do from a strategy standpoint.”

“I believe that telemedicine is an effective solution to help us reduce healthcare costs. Telemedicine simply introduces an additional layer to access the healthcare system — telemedicine or virtual care is now becoming the first access point ahead of primary care, urgent care, specialty care, and emergency care.”

“However, I do believe there's something lacking in telemedicine. And, contrary to what I said earlier, it is AI but not artificial intelligence; it is Automated Intervention. In marketing, this has been around for over a decade now, and they are simple push notifications.”

“In order for telemedicine to be an effective solution to help reduce healthcare costs, people need to be reminded constantly about this additional access point so that they don't go to the Emergency Room for a headache. Instead, they can be routed or reminded to go to a different, lower-cost, higher efficacy facility when it's appropriate. The gap that we need to bridge through technology is helping to steer the member or patient, in a near real-time or real-time fashion so that they access the right point in the healthcare network at the right time.”

“It's technically and technologically simple, but because of certain laws, regulations, or a general unwillingness to implement new solutions, a simple solution becomes a complex hurdle to overcome.”

“There is a place for Artificial Intelligence in Healthcare, and there are some incredible technologies and companies who will help us make monumental leaps of progress to reducing healthcare costs, but I think for our purposes today, a simple push notification or text message will do the trick.”

How can or should AI and telemedicine be used to reduce healthcare costs most effectively? Do you agree with Suzy Johnson and the panel? Please share your thoughts on social media using #WBR2019 or in the comment section below.

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