What a difference a year or two makes. What struck me about our 2019 OPEN MINDS Technology & Informatics Institute was the shift in focus to the consumer. While performance and value remain important goals for leveraging technology and the resulting data, improved consumer experience is now the key driver.
This focus on the consumer was an overarching theme for opening speaker Alison Nelson, senior vice president for technology at Optum, in her keynote Leveraging Technology To Expand Access, Enhance Consumer Experience & Improve Outcomes In A Behavioral Health Care Marketplace. “We have an opportunity to offer immediate care options, connective tools to schedule appointments and provide collaborative care” by capitalizing on technology [smartphones] in consumers’ hands “that enable us to be part of their lives in meaningful ways,” she said.
Ms. Nelson discussed how Optum, the health service platform of UnitedHealth Group, is harnessing technology to identify health issues earlier, improve access, guide choices and customize health care based on health, lifestyle choices, gender and more. The goal, she said, is to make personalization part of the process; and the organization is leveraging clinical data to guide consumers with a next-best-action care journey from medication alternatives to recommendations for screenings, follow-up appointments, and self-care options.
Optum also is using technology to improve consumer experience in three important ways: to match consumers with clinicians, improve access, and reduce wait times. By embracing technology, Optum invests more time on high-risk members, a front-end investment that makes business sense considering the costs that can be reduced or eliminated with early interventions.
And it’s working. Optum data shows that consumers accept recommendations more than 60% of the time including prescription recommendations and investments in “high-touch/high-engagement” consumer portals that use artificial intelligence (AI).
“I really do think as an industry we can do better and I actually think tech has a really big role” in that, said Ms. Nelson, who spoke on the 50th anniversary of the internet and introduced herself as an information technology professional and a mom with experience in the behavioral health system. She illustrated how technology can streamline the process in three ways.
Matching consumers with clinical professionals—The average consumer sees three providers before finding the right ‘fit’. Optum is using AI and machine learning algorithms to enhance search with medical specialty, gender and religion for better alignment. The team is using claims and consumer data as well as geography to build a better medical match for consumers, like dating services. Additional tools include virtual assistants, a call-back option to reduce phone waiting times, and online scheduling.
Improving access—One in five consumers uses health benefits when they need help, said Ms. Nelson, who added, “Far too many patients enter the behavioral health system for the first time at an inpatient facility.” To address that, Optum is integrating medical, behavioral and pharmacy data to identify consumers who are not adhering to guidelines and find ways to influence behavior before symptoms become acute. In terms of digital search, Optum is investigating ways to guide members to appropriate providers and to provide educational videos as well as cognitive therapies the member can use immediately.
Reducing wait times— “We need to act quickly when a member seeks treatment,” said Ms. Nelson, who noted that Optum has increased its behavioral health network by 30% including a 90% boost in MAT provider organizations in the last few years. Optum has also expanded its on-demand capacity with 5,000 clinical professionals available to provide services, including telepsychiatry and text therapy.
And Optum is not alone. According to our research, 90% of health plans are using analytics to identify and manage consumers in need of behavioral health (see Trends in Behavioral Health: A Population Health Manager’s Reference Guide on the U.S. Behavioral Health Financing and Delivery System).
Ms. Nelson encouraged provider organization executives to partner with payers to test technologies, from wearable tech to facial recognition software that recognizes stress and fear, and to ensure accuracy of a single source of provider data. While she focused on technology to personalize care, Ms. Nelson also fielded questions about how Optum ranks health care provider organization performance. She described Optum’s proprietary Achievements in Clinical Excellence program, which considers data on length of stay, readmission rates, follow-up rates, and evidence-based measures. The organization is also piloting value-based contracts with episodes-of-care to identify high-performing practices. “And when I say, ‘highest performing,’ I do not mean lowest cost,” she added.
While acknowledging a pervasive reluctance to embrace technology, Ms. Nelson made a persuasive argument that technology can be used to improve the system. “The tech landscape is obviously quite daunting and it’s changing every day,” Ms. Nelson said. “The impact of social media and the impact on behavioral health issues definitely causes concern but we can’t ignore the opportunity to educate members and provide a personalized, meaningful experience. We have to work together to find a better solution.”
In fact, provider organization executives will need to develop new operating systems that are compatible with the health plan initiatives to use machine learning and AI to customize care.
For more on how health care executives are using technology, check out these resources in the OPEN MINDS Industry Library:
- Using Technology To Personalize Consumer Care & Expand Access
- How Do You Compare On Tech Spending & Adoption?
- Engaging Consumers Was The Topic Of The Week
- Optum Launches Care Coordination Software For I/DD & Complex Care Needs
- PerfectServe Acquires AI Scheduling Technology For Clinical Professionals, Mobile Consumer Engagement Tool
- Microsoft Healthcare Bot Service Launched To Facilitate Customizable Messaging & Virtual Health Assistants
- Google Files Patent To Develop Technology To Predict Medical Events From EHR Record
- Spring Health Expands Its Service Functionality By Adding Digital Programs From Lantern
- AI Can Identify Blood-Based Markers Of Alzheimer’s For Earlier Diagnosis & Tracking
- mHealth Study Uses Wearables, Artificial Intelligence To Detect Internalizing Disorders
And join us in February 12 for the “How To Build Value-Based Payer Partnerships: An OPEN MINDS Executive Seminar On Best Practices In Marketing, Negotiating & Contracting With Health Plans” during the OPEN MINDS Performance Management Institute in Clearwater Beach, Florida.