What do you feel are some of the trends and challenges in the healthcare space based on your own experiences?
There is a big push into tech-enabled services over the last five to eight years, and many pure technology solutions that are self-service are showing up regularly. However, most of these digital self-service solutions are incomplete from a consumer perspective. For example, there might be solutions for the medical sector that doesn’t cover pharmacy, specific medical conditions, or address comorbidities. They’re designed to close the gap in the healthcare industry, but will not necessarily solve all the issues that a member might experience. The shift from the notion that technology could solve all the problems, to maintaining a balance between the human component and the technology piece, is gaining traction today. Both are essential aspects; technology can be used to enhance experience, but the human presence is also vital for an inherently complex system like healthcare.
What are some of the impactful projects or initiatives that you are currently overseeing?
Quantum Health focuses on integrating AI and machine learning to unlock the interesting insights and predictive learning from conversations, and case notes outside the claims. Besides, we leverage data sciences—internal and external—and tools around natural language processing (NLP) to identify predictions based on conversations or early intercept opportunities. Our well-trained patient service representatives and nurses can pick up these things in the source of their discussions, enabling us to generate additional opportunities to intervene and engage with our members.
We are also looking at the idea of traceability of information at each point, as members move through an ecosystem consisting of both digital and human services in their healthcare journey. This will enable us to glean meaningful insights on how to deal complicated healthcare issues.
Along with the expertise to navigate people in their healthcare journey, the human component to understanding the complexity of the moment is pivotal for steering them to the right place. The blending of technology, human intelligence, and insights from mapping the consumer journeys can usher in excellent opportunities to drive seamless experience for all stakeholders.
Are there any checklists to identify the right partnership from the multitude of vendors out in the market?
Our partnerships enhance our vendor platform for delivery of potential healthcare technology and services, to create a broader membership appearance. The solutions we leverage foster benefits such as flexibility in technology, allowing us to add more services in the future. Consequently, a lot of it is focused around gathering real-time information and identifying opportunities as quickly as possible. For example, we’re looking at NLP to process the calls, chats, and more into searchable text on the fly, besides generating insights for us. To succeed in a dynamic market, it is crucial to identify nimble allies that provide a flexible platform that supports additional tools or changes.
Can you elaborate on some of the leadership strategies you adopt to steer the company ahead in the curve?
Our company was founded around consumer research; to understand how people experience healthcare, and where they face issues. We have two guiding metrics that drive many of our decisions, whether in technology, training, strategic decisions, or member experience. These metrics enable us to reduce costs for the employer, customers, and members in the healthcare space. Claim savings and Net Promoter Score (NPS) are the guides that boost our ability to process information in real-time, and proactively respond to member issues. Quantum Health has made considerable investments in data and data quality, normalizing data across more than 400 different solutions, because we know that lack of quality data results in confusion for members, and hampers satisfaction. We try to intercept every opportunity on the claims savings line in a meaningful way to serve as a thought partner for clients. The steady upsurge in our net promoter score is proof that our metrics work perfectly. Our ultimate goal is to deliver accurate, high-quality information in real-time at the fingertips of our care coordinators and members.
Can you draw an analogy between your personality traits and how they reflect on your leadership strategies?
The culture at Quantum Health revolves around others-centered mentality and fairness, and all the stakeholders benefit in some way, shape, or form, which adds value to the company. My leadership strategy is similar to this; it is not a command-and-control type one, but an empowering and delegating authority. I believe if my colleagues are well-trained to make decisions, there is no need for constant micromanagement or course corrections. They have to feel trusted, to accordingly make right decisions for the organization. It is vital in a high-growth company to not have too many layers of decision-making. I try to model strategies from such a standpoint to ensure that my people have a similar mindset, which is critical for a high-growth company to attain scalability in the long run.
What are some of the potential disruptions and transformations to anticipate in the future?
Today, the accessibility and availability of data is an exciting trend, where more people are willing to share their personal health information to trusted partners. We are currently in a unique spot, with trusted relationships and the right intent to drive seamless navigations and better healthcare experiences. Due to technologies like blockchain, people will soon have more control over their healthcare data, and know who has access to it, and therefore will become more willing to share that information with actors working on their behalf. This can trigger many positive outcomes for any consumer-focused business in terms of high levels of member and consumer trust. Conversely, players in the healthcare space who tend to impose more ownership over consumer data might fail to build that trust and struggle in the future.
In light of your industry experience as a CFO, what would be your advice to emerging players in the healthcare industry?
There is a phrase that we use here, ‘You are not your customer.’ It’s easy to lose sight of how your customers experience you, whether you’re an internal service provider, or in venture mode. You have to be laser-focused on understanding your customers, especially due to the recent influx of employer-customers and consultants, who act as intermediaries between employers and us, and also have members, employees, and dependents of their own. To focus on understanding the diverse range of customers, instead of making assumptions about them, is undoubtedly a key factor for success today.