Josh Goode, Chief Information Officer, SCAN Health Plan
There’s no denying that the healthcare industry is primed for innovation. While our industry has traditionally lagged in comparison to other sectors when it comes to technological innovation—for a number of reasons—we’ve seen a real shift in the last several years. For example, advanced technologies like Artificial Intelligence (AI) have given us the ability to analyze voluminous data sets quickly and take actions that previously were not possible. While these technologies are vital to the advancement of healthcare behind the scenes, I see real opportunity in tech’s ability to enhance and transform the way we deliver care and improve health outcomes for older adults.
It starts by having a deep understanding of this population’s complex and unique needs, and the challenges they face in getting those needs met at every step along the aging journey. One of the methods in which we at SCAN are able to gain insight into the pain points, trends and patterns among our members is through the use of Natural Language Processing (NLP). This form of AI allows us to decipher and interpret the language used during a phone call through the identification of a predetermined set of key words and phrases. We can then analyze the data generated from the calls to identify common topics and trends in order to better understand the issues our members are facing. This has allowed us to tailor support and interventions, expediting our reaction time to address specific needs and/or challenges.
My colleague Archie Dey, SCAN’s director of consumer experience and insights, and his team took the lead on our NLP analysis, collaborating closely with our Healthcare Services and Member Services teams. He states, “Through our member interactions, data and advanced analysis derived through NLP, we are able to piece together information and address pain points and other areas of concern, driving a more personalized member experience.”
One of the specific pain points we’ve been able to address through this analysis is helping members with out-of-area coverage. We’ve not only been able to make interventions on an individual basis, but also look deeper into how we’re educating members overall on their out-of-area coverage.
Quick Pivot to Address COVID-19
As the information around the pandemic quickly developed, SCAN immediately ramped up efforts to identify the needs of seniors at highest risk within our communities and among our membership. We understood this situation would amplify the severity of the challenges and concerns common among this group, including food insecurity and isolation, posing a negative impact on their health, independence and wellbeing.
"Through our member interactions, data and advanced analysis derived through NLP, we are able to piece together information and address pain points and other areas of concern, driving a more personalized member experience."
In adjusting our NLP to track questions and concerns related to COVID-19, we’ve been able to quickly examine call data and rapidly conduct service interventions, connecting members with the support and resources they need. This tool has also provided us the ability to understand the scale of these concerns, enabling us to focus our efforts where needed most. And, since NLP is a dynamic process, we continue to adjust as the situation changes to ensure we are tracking what’s most relevant.
Our goal here at SCAN is to integrate the use of tech with our long-standing high-touch approach to service and care. Doing so enriches our interactions and ensures we’re responding appropriately. Ultimately, we’re able to deploy interventions that aren’t simply quick and efficient, but are highly impactful and highly personalized.