Industry Leaders from healthcare, law and workers' compensation share the advantages and drawbacks of the latest technology.
00:10:11 - 05:10:11
Julius Bogdan 0:06
Data first is a little bit of an outdated approach. And let me let me explain why. With the advent of the EMR, you know, healthcare really has become a data industry. We're collecting reams and reams of data. Data is the lifeblood of any oral healthcare organization today, the challenge isn't making isn't taking a data first approach because we're swimming in data. But it's to be able to derive actionable insight from that data. So a while ago, you know, very coming up through the ranks of technology in having worked with data and analytics and advanced AI capabilities, years and years ago, I remember doing data science exercise, data mining back in the day, where we analyzed their survival rate of passengers on the Titanic, right? So we used all sorts of statistical methods to come, you know, basically to come up with a conclusion that women and children had a significantly higher survival rate of all passengers on the Titanic. So the norms of the time were women and children first, obviously, this made sense, was this really, you know, this outcome of this analysis, Insight was an actionable, the point of the exercise was not to mathematically identify this relationship, but to show that analysis should lead to actionable insight, healthcare, identifying patients, that risk for particular conditions is a great first start. But is that risk score that you've assigned that patient actionable? Do you have clinical pathways identified to mitigate that risk for that patient or that patient population, that's where we need to get to as an industry talking about case reviews, peer reviews, documentation reviews, you're reviewing them for specific things. And that ontology has to exist, in order for you to understand what the relationships are, and so forth. AI can then take that map, those identify those relationships give you you know, hey, this is you know, what the common themes are across all of these, right? Create discrete elements, so you can analyze it more discreetly, there's an abundance of potential in this space, using those two technologies that are approved.
Paul Carroll 2:21
What's really happening is that the AI is managing the whole process, right? So you get something submitted. And it's not here's a whole dump for the underwriter, it's we've gone through these documents, even though a lot of them are PDFs or paper. So you have to scan you have to kind of understand what's going on. And we're extracting all that information. We're checking the submission against what we can find on the internet, third party data sources and so forth. And instead of just sort of saying here, Mr. Ms. underwriter, here's a packet figured out, a lot of that is organized. And that speeds the process greatly. And workers comp, the speed is not only for the sake of efficiency, but it also can fundamentally change the relationship between the medical provider safe it can the employer and the employee, because if you get hurt, you want somebody to acknowledge that you got hurt, you want something to happen quickly. And if it doesn't happen quickly, then you're thinking that dumb employer doesn't care about me at all. But if it does happen quickly, then that changes the whole nature of the conversation.
Julius Bogdan 3:30
Imagine
Jerrod Bailey 3:31
that if there's a lawsuit five years from now, like we got to produce something right? In right, what do we have to produce? From from the AI? Like, what do you what do you think we should be thinking about now like table stakes, what do we have to produce to
Matt Keris 3:44
worry? What should we be producing? It's, it's going to be very similar now. But more complex what healthcare professionals professionals are dealing with in terms of the audit trail discovery. A lot of times we all know this and standard practice, plaintiff's law firms are seeking the audit trail to find the aha moment where there's a records alteration after the fact, the audit trail was so that and part of the problem with one of healthcare systems is that you're they're buying a product that's that's created for them. And they can either, you know, it's an evolving system, and no one really has their arms around it. They really don't know how to get some information. You know, people in internally move on. And then you may even, for example, get a new product and the old EMR vendor doesn't want anything to do with the healthcare provider. They don't want to get involved in the litigation. If there's a real issue. They don't want to have to turn over their proprietary information, all those types of things. You could see that with AI if it's truly an AI error, you can see similar to the audit trail, expensive discovery, I want to go in I want to I want the production of the of the audit Israel, I want to, I want to know all versions that you use, I want to know the upgrades and amendments. And you may not be able to do that as a health care provider, because it's not yours, it's someone else's property. So and you may want to try to bring them in. But good luck on that. Why would they? Why would they voluntarily try to get back in to talk about? If it's truly a proprietary issue or or their error? Why would they want to actively get involved in litigation to basically talk or expose one of their problems with their products? So I can definitely see as thorough a discovery into the AI when it was adopted, who the vendor is retrospective analysis, as we're seeing right now with audit trail.
Jerrod Bailey 5:43
Or maybe just looking at hospitals, healthcare in general, what are people doing wrong most of the time? What are they missing most often? And then, and then who are the leader? What are the leaders really doing those that really have a good handle on their cybersecurity, cybersecurity infrastructure and best practices? Like what can we learn from, you know, kind of who's leading the Yeah,
Zach Fuller 6:06
good question. And there and this is no hit on hospitals, or it or the healthcare industry in general, they're often times you know, first of all strapped for their IT resources or technology resources for budget for things like security and compliance, local facilities, things like that have a really, really tough time keeping up with with the demand. So what they're doing is they're focusing on compliance, you know, kind of their requirements, right? HIPAA compliance, protecting PHSI. Right, that's the focus. To be effective in cybersecurity, we have to step back and we have to follow an industry recognized cybersecurity framework. What most people don't understand is that cybersecurity is not just getting a bunch of smart techie people in a room and, and having them figure out stuff to do on the you know, on the computers, it's not about make it up as you go, we're following we need to follow industry recognized best practices and standards. There are a bunch of them out there. A lot of people have heard of like ISO 27,001 standards. NIST, the National National Institute of Standards and Technologies, cybersecurity framework, or NIST, CSF is an excellent framework for people to follow CIS controls is another one. And what these frameworks are, is really just a big list of all the things that a company should do, an organization should do to be considered proactive in their cyber risk management. So it gives you it really gives you a path forward a direction and understanding of where you are today. And these things are readily available online, you can go to the NIST website, look up NIST CSF or NIST 853, there are a bunch of them out there. Reality is they all say about 95% of the same thing. They just laid out in different ways with some different verbiage, but what they're getting at? Are those core security controls you have you have to have
Matt Fendon 8:07
in place. Well, I just, I'm in the process of investing in the top notch practice management software. And so, case management software, in essence, where we will almost fully automate the firm. And so that will help us assist our clients better. It's going to enhance communication. It will help us decide, you know, which cases to take, literally have grading scales on cases, for new cases based on the criteria. You know, we'll be able to embed videos in automatic responses essentially, like when something changes on a case a status changes, and a video of me or one of the other attorneys will be embedded and it'll automatically send an email out. So this is what's happened. This is what's going on this is what's next. So the case management software alone that we're using, is just phenomenal.
Transcribed by https://otter.ai
Experts Across Healthcare
Julius Bogdan -VP of the Digital Health Advisory team at HIMSS (Healthcare Information and Management Systems Society)
Paul Carroll - Editor-in-Chief of Insurance Thought Leadership Magazine
Matthew Keris - Civil Litigation Attorney
Zach Fuller - CEO of Silent Sector
Matt Fendon - Workers' Compensation Attorney
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