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Jeff Lin
Host of Payment Matters
Payment Matters is a monthly radio show focusing on real issues happening in healthcare payments. Jeff chats with industry experts and thought leaders to bring fresh perspectives on how providers, payers and consumers are all tackling the evolving healthcare payments market. Join the conversation on Twitter with #PaymentMatters.

On this episode of Payment Matters, Jeff is joined by Dr. Alan Young, Chief Medical Officer of Gyant. Jeff and Dr. Young discuss emerging technology and telehealth in response to the COVID-19 pandemic.

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Jeff Lin: You have an interesting perspective where you are on the healthcare front lines, but you’ve also transitioned to focus on healthcare technology. How did you move from being a practicing physician to technology and what drove that movement?

Dr. Young: I think it started back when I first was introduced to healthcare and realized that there’s a business side to healthcare, especially here in the United States. It’s a very complex health system and when I was pursuing my business degree, I realized that technology has played a pivotal and fundamental role in how other industries have really advanced the way that they operate. As I started practicing medicine and learning medicine, I think the opportunities came up to be involved in this technology development process.

You can imagine doctors, if anyone can still recall, actually had to write things down on paper and, and use pens and just write a prescription on a pad and give it to a patient. During my time in medical school, we started exploring the use of electronic health records and being a part of the development of what we call computerized provider order entry or physician order entry and building order sets where, instead of having to write everything down, we could use a mouse on the computer and click and actually render care and miraculously patients would receive a medication that we entered into a computer. I think that was this first start of being exposed to the design and development of these software tools.

As I worked in the consulting space, all of a sudden healthcare systems and executives were struggling with getting doctors to adopt the technology once they built a computer system or paid a vendor to deploy an electronic health record. How do they train them and how did you design it for maximum efficiency? So a lot of the work I did in the consulting space with Cerner and Epic was really around optimizing these solutions and training physicians and showing them how the technology could enable their current clinical workflows or make it more efficient and hopefully alleviate some of the burdens that they have. Which in some ways is contributing to ongoing physician burnout because of the continued demands of the system. There are aspects of the technology that I’ve found to be very beneficial in my early entry in technology and since then it’s just exploded as I’ve gotten involved in local organizations here in Southern California and across the U.S.

Jeff Lin: Can you talk a little bit about what Gyant is doing and how you are reacting to COVID-19?

Dr. Young: Gyant has built a platform that enables patient-centered communication by utilizing automation, machine learning and natural language processing to provide a virtual assistant for patients throughout their care journey or pathway. We believe that episodic care for patients contributes to high utilization and unnecessary ER or clinic visits. The way to prevent that is to create a communication channel where a patient who is at home and relatively healthy but may have some new symptoms or have questions about their medication, can have a direct communication channel to a reliable source of information without adding more burden to the clinical team.

That’s a great segue into what Gyant has been able to help with during this time of uncertainty and the stay at home mandates, as well as the many people now concerned about their health. As you know, the symptoms of COVID-19 are very insidious, and they want to reach out to a healthcare professional to be evaluated or reassured that they don’t have it. This has created a huge surge of demand for healthcare services in specific areas such as the emergency department or a nurse triage line. Unfortunately, the limiting factor is the number of healthcare professionals on the other end.

Here in the U.S., a lot of organizations are built to operate at near capacity in order to be as efficient as possible from a cost and revenue perspective. That doesn’t leave a lot of margin for error. When we have a surge like this, there are not enough human resources to meet the demand. Gyant has a platform already built-in with a virtual assistant that can automate a lot of processes and help guide patients based on their symptoms through the web or a mobile app and then tie that directly into what they should do next using the expertise and input from our health system clients. They can identify these patients who are maybe elderly or have a high risk for complications due to a preexisting heart condition or lung condition. We need to evaluate them and see them but do so in a way that doesn’t endanger the greater population. I think our tool has been able to reach hundreds of thousands of people now across the U.S. across multiple health systems. We’re just kind of beginning to really make an impact by helping guide patients not only to the initial point of care but also being able to provide the information if you still need to get tested. I think our tool is going to be able to enable patients to have access to information and get reassured that they’re getting care from their doctors or health systems in a way that wasn’t previously possible.

Jeff Lin: Got it. So just to clarify, this is something that’s live today in the market and it’s already been released by your company?

Dr. Young: Yes, exactly. The COVID-19 Screener and Emergency Response Assistant, or SERA for short, is live right now. The best way for anyone to experience it is by just going to the website, www.Gyant.com. There are many large health systems with over a hundred hospitals down to single community hospitals that are deploying or already have deployed this tool. By notifying their patient population about this tool, they’ve seen immediate relief of some of the other channels we talked about.

So, I want to give an example of how we’ve been able to help in some cases. A lot of health inquiries happen outside of business hours. As you can imagine, no one gets sick between nine and five Monday through Friday. If someone is a frontline worker and they’re developing some symptoms, they’re not going to be able to get into those regular hours and get their answers addressed. Having a tool to guide them through and understand what to look out for, what symptoms they might have, where they can get testing, or what number to call is really valuable. It offloads a lot of the need for having a large number of phone operators or clinicians to answer all these questions one by one. We find that when you think about frequently asked questions, patients have asked the same question over and over again. Having a virtual assistant relieves a doctor or nurse from having to give those answers over and over again. I don’t think that’s the best use of their clinical skills and their license. However, we need to provide patients with information rather than sending them to a website or expecting them to go through all of the CDC webpages and become a COVID-19 expert. Having a conversation with a patient via a channel that’s useful and informative to them has been a big benefit for our health system partners. In one example, one health system that serves a large state actually saw a 30% drop in their telephone call center volume at around the same time that our tool was rapidly deployed and made available. So you can see that patients are turning to their mobile devices and their laptops to get information rather than picking up the phone and potentially getting a busy signal or being put on hold and being told there’s a two to four hour wait time, which is an experience that I know many people have encountered so far.

Jeff Lin: It’s great to hear that calls have gone down because it’s not only the clinicians that are getting impacted, it’s the call centers and the frontline staff picking up the phones or replying to the email inquiry.

What has the reaction been from the consumers and patients interacting with this machine learning natural language processing? Has there been any reluctance or any challenge from an adoption perspective?

Dr. Young: I think I could draw a stark contrast between where we were just a couple of months ago and where we are now with the recent surge in demand for these types of digital tools. Prior to COVID-19, we were slow to adopt these kinds of patient engagement strategies that are mainstream and widely adopted in other industries like retail, travel, banking and repayment. The use of mobile devices, on-demand services and automation are things we take for granted in other industries. In healthcare, I think there was a reluctance not only from some consumer segments but also from the organizations that deliver care. The idea of moving the industry from a fee for service model to a value-based model encountered a lot of obstacles. To make revenue, you want your patients to come in and get procedures and get tests so you can bill for them. A lot of these things don’t need to be done in the hospital or even in the clinic setting but can be done virtually. I think a lot of organizations were reluctant to admit that they can replace how they deliver a standalone traditional medicine in a clinic or hospital with a digital tool. Now, people are using these tools outside of their health insurance. They’re adapting to these concierge practices.

We’re also seeing a surge in populations that don’t even have a primary care physician or feel like they need one because they could just pick up their mobile phone, make an appointment for a concierge-type clinic, show up, get a full physical or even get a prescription sent to them all through an application on their mobile device. I think that the adoption curve was slow, but now you see that without that access or ability to go see your doctor, a digital option is necessary.

This shift is a very seismic one. I heard some chief digital and chief strategy officers say that it COVID-19 has advanced the adoption of telemedicine by 10 years on average in the places that they function now. I think we’re in a new paradigm now and the way healthcare delivery is going to be viewed moving forward is going to be fundamentally different.

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