Personalizing Patient Care Through Data and AI

The Fluid Intelligence Podcast

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Gain deeper insights into the future of healthcare on this episode of The Fluid Intelligence Podcast where we deep dive into the topic, “Personalizing Patient Care Through Data and AI.”

Watch Vivek Gupta, Vice President, Analytics at Factspan moderate an interesting discussion on personalizing healthcare with Sha Edathumparampil, Chief Digital & Data Officer at Baptist Health and Vaibhav Tewari, Co-founder & CEO at Portea!

In addition to addressing pressing issues like a shortage of specialists and data security, these prominent figures in the healthcare industry will also share their knowledge and insights on the promising applications of artificial intelligence (AI) in diagnosis, treatment, and clinical workflow.

Check out the complete episode to learn how the tech transformation is changing the way we think about health, from home care in India to hospitals in the U.S!

Full Transcript: 

00:39

Vivek 

Welcome to the video podcast on healthcare. I am Vivek, Vice President, Analytics at Factspan. As everybody knows, Healthcare is undergoing a transformation. And today’s topic is right at the intersection of experience and technology, Personalizing Patient Care through Data and AI. Today, we have two distinguished leaders with us who are spearheading all these transformational programs in their organizations. We have Sha, who is the chief digital and data officer in Baptist. Baptist is the largest hospital chain of South Florida serving 2 million plus patients annually through 11 hospitals and 100 plus urgent care centers. We have Vaibhav  with us who is the Co-founder and CEO of Portea. Portea is an Indian company, one of the largest in this space, focused on home care to patients. They serve 700K plus patients annually in 100 plus cities in India. Thank you, Sha and Vaibhav , for being with us today. So, before I deep dive into the primary topic today, I would like to start with the fundamentals. Why do you think personalization is important right now in healthcare? And then what trends have you observed in this pace in the last few years? It would be great Sha if we could start with you.

02:07

Sha

Sure! Thank you. Let’s review a little bit what personalized medicine is? So, using things like genetic testing, looking for biomarkers, using big data, artificial intelligence, bringing all those types of things together to personalize the treatment plan for a patient or a particular condition. So that’s how sort of my definition of personalized medicine is. In that, I think we are seeing quite a bit of traction as in some areas, specifically cancer related there is already whether it is breast cancer or a number of lungs, number of other categories. Using genetic testing, people are starting to identify areas that allow physicians to then personalized treatment for that particular condition and it’s very successful. It’s, I think, very broadly and widely adopted or being adopted now. There are other areas, too, such as chronic disease management, type 2 diabetes come to mind, which is sort of those that particular area of chronic disease management is perhaps in a little bit of earlier in the lifecycle. There are certainly physicians and providers working on those types of treatments for patients. But on the regulatory side, there is not as much clarity in terms of how those should be done. There is some concern about data privacy and those types of things as well. And then insurance providers don’t seem to really have sort of well-defined plans, if you will, in terms of how they would how they would pay for chronic disease management or personalized medicine, and chronic disease management. So, a little bit of a mixed bag, but oncology and cancer seem to be the area where it is being most widely used at this time.

04:06

Vivek 

Got it. Awesome. Thank you, Sha. Vaibhav  I would love to hear your thoughts.

04:10

Vaibhav 

So, I’ll probably bring it up a little bit more from India’s perspective—how, at least in India, the digital in personalization has played out. And if you look at the last couple of decades, we started in the mid-90s with satellite TV, right? And then from Doordarshan, basically we moved to having satellite and access to a lot of information available to us somewhere, and of course you had Internet, from which information started coming to you more personalized and basically more in your hands, right? And then, of course, mobile phones came, and smartphones came, and the information came into your pockets, right? What has happened with mobile phones, especially in the last 10–12 years? Even other devices, all point-of-care devices and all, started coming and became a lot more personalized for consumers or patients, if you want to call that, I would say that in the last 20 to 30 years, healthcare, of course, has always been a laggard in terms of leveraging technology. The last industry that enjoys the benefits of technology is healthcare, and the other big change which we saw was during COVID, right? Basically, we always look at healthcare pre-COVID and post-COVID and what everybody looked at during COVID saying that, how can you basically look at patients a lot more closely than what you have done? So, if you see the healthcare scenario in India over the last 10–15 years, every ecosystem player is a lot more focused today on handling patients. So, like 10 years back, the clinician was only the central point, right? Today, patients are equally important, right? Because now, if you look at the hospitals and pharmaceutical companies in India, and even insurance and all, they are continuously looking at how to make healthcare a lot more personalized for the patient and for the consumer. And I think that’s a big change that we are seeing. Of course, technology is aiding in that. And as I was saying, point-of-care devices are playing the biggest role in that right? The patches for continuous glucose monitoring, the other point of care devices, which can basically take all your vitals and everything. I think those are things that are redefining it as what data is available to you and what you can do with patients in terms of collecting data, acting on it and creating care plans. And if you see from Portea’s perspective, in homecare we have tried to leverage that quite a bit in the last couple of years where we are saying, how can you create personalized plans from elder care to, as Sha was saying, chronic disease management to basically personalized medicine actually? So, I would say that early days but very, very exciting. The way you would see it, Netflix is totally, basically tailored for you, right? on what you really like to see. And healthcare has to go that way because we are all very unique. Our tastes could be similar in entertainment, but our bodies are very different from each other, and that’s very, very unique. So, personalization in healthcare, I think, have a long way to go but are really important steps.

06:58

Vivek 

Got it. And Vaibhav , so from Sha, we heard that in U.S. regulation may not be as ready for personalization then insurance companies may not be as ready for personalization. So, do you think in India also?

07:13

Vaibhav 

I think India’s early days, what happens and that’s like at least my learning in last couple of decades is that India basically bypasses certain things in the middle. So whatever U.S. learns like in 10 years, 20 years and we see the end of it, right. So, we just basically jump from here to there like India moved to fiber. We used to have copper wire cables, right, which used to go to all these buildings. We move to fiber immediately. We didn’t go through any of those in middle technology because we got into bandwagon much later. So, I would say healthcare also, there’s a lot more acceptance of this. And I’m saying in India of course clinicians have always been the central point and I think the balance has to come in next 10 to 20 years because patients are important in that sense. So, India regulation wise is basically forming our regulations as we speak. When you see all this now the healthcare had a digital mission and all of that which government has launched in the last couple of years, I think bases our success in Aadhar. Some of these things will basically help us to leapfrog the regulatory approvals and everything in a much faster way, because need of this is accepted, especially post-COVID. When India got COVID, we realized that we need to work on an infrastructure much more than what we had, right? And using digital and using personalization is like the central point is the key to that. So, India will work probably a very quick speed to do with the regulatory requirements or basically get the right regulatory clearances in place.

08:39

Vivek 

Makes sense. So now moving on and focusing on today’s topic, Sha, it would be very helpful if you could share some details on some of the key transformational programs that you and your team are driving in Baptist to imbibe personalization in the patient care.    

09:27

Sha

It is clinically driven in that we want to make sure that the providers have all the right tools and technologies that are necessary to be able to provide that type of personalized care for our patients. There is a big element of the data infrastructure and the machine learning infrastructure being able to bring in data from the medical records to the patients from in sometimes, you know, patients have been to other hospitals prior to coming to us and they would bring those records of being able to put all of that together and making it available for our providers to review them and so that’s bringing the data together is a big, big aspect of providing that and then there’s a number of other things that we do related to identifying the right patient cohort for things like clinical trials, for instance, which if, if your case, or if your record matches, we have capabilities that are being built that matches patients to clinical trials. And you know depending on the type of specialty, whether it is cardiology or oncology or any of the other specialties, each of those groups have their own programs and some of them are relatively unique in nature. So, we tend to work along with those physician leaders in many aspects to identify those needs and support them. And again, a lot of those tend to be digital and data capabilities that support them as they make the right decisions around what is best for their patient’s care.

10:41

Vivek 

Got it. And I I think Sha the point that you made bringing data together that’s something that we have heard from almost every leader in this space. So, I can fully understand. Vaibhav , some of the key initiatives that you are driving in your organization in this space.

11:00

Vaibhav 

So, from our perspective as I was mentioning earlier from especially post-COVID time we had basically that slogan or you can say the vision for the company was. So, we said go digital, go hundred. So, the whole point was that we should get to 100 cities, and we should be able to have our people on the ground to provide services in 100 cities and make everything as digital as possible. So, and I think that’s something which we have spent a lot of energy and investment in the last couple of years and today where we stand, of course we are in more than 100 cities now in terms of on ground presence and supporting patients and also our operations have become completely digitalized. Actually, I think if you ask me and we are 11th year of this organization probably is the biggest transformation we have been able to do where every single layer of operations are basically digitalized. So, the way we run our, the way our clinicians will go to patient homes. Now they all carry a mobile app, Android app and they all basically will all the patients vitals are collected using that, all the patient’s case files what we what we create case history is created using the app. All the interaction with the subject matter experts at the central level will happen with that. So, all the clinician operations as well as the patient interaction is happening using the digital technology and of course all our branch operations are also run using basically using dashboards and everything. So, how a branch runs and just for you to understand the very basically many too many operations there are out of 5000 visits a day, we are doing in patient homes and these people are present in multiple cities. And the patients are not in our office because it’s not a hospital and clinicians are not with us. So, clinicians go from their homes to patient homes and serve them. So, using one technology layer which will bind each of these becomes very important and that’s how you run. So today for example, a physiotherapist has to come to your house at 10:00 O’ clock in the morning for an appointment. How do I make sure if the person is reaching there? If the person is not reaching there? Somebody replacement has to come because it’s a healthcare service. It’s not like your food delivery or cab, right? I mean, if one doesn’t come, you can take another one, right? But a physiotherapist has to come at 10:00 O’ clock to take care of your back pain. He better turn up at 10:00 O’ clock, right? And if he’s not coming, somebody else has to take care of it. Right? So, to manage thousands of visits every day in that environment, it becomes very important that we use technology and our day-to-day operations are run using technology. So, every single lead from the time it comes to the time it’s delivered medically, operationally and patient connection wise, everything has to run real time and that is something which you would achieve in last two years. Today, at any point in time, if you have a basically if you have posted a lead, what we call on our website or to our call centers and there you’re looking at physiotherapist or a nurse or even an ICU setup at home where that lead is at any stage at every minute is known real time to the company across the board today which was not the case three or four years back, and that’s something which of course we invested in last couple of years and that is something which is, which has changed the way we operate. So, of course it has helped us to our NPS scores are much better, our patient interactions are much easier. Our branches are much more efficiently run, head office is much more efficiently run I would say that we have seen the real benefits of deploying a larger scale program in last couple of years and seeing the benefits out of it. So that was of course the big focus area and that’s where we are seeing the results.

14:23

Vivek 

Very impressive and what I hear from you Vaibhav , is that you have been able to digitalize all these complex operations, which is very impressive, taking a level deeper. What are the challenges that you are facing implementing, executing all these transformational programs especially focused on people and processes?

14:44

Sha

Yes, you look at the provider ecosystem and the challenges that we face, the biggest one is people really, the providers, there aren’t enough doctors and nurses to take care of the population that we are trying to serve and it is, you know, the baby boomer generation needing even more care the lack of the capacity concerns with respect to providers is taking center stage not just in the US but you know in most Western countries these days. So, then the question is how do we solve for it? There is it’s not like we can turn on the speaker and start getting doctors and nurses, right It’s a provision that takes a very long amount of time for the people to train and and practice and be ready to care for patients. So, then we that then leads to the fact that we have to do more with what we have, which is really an efficiency play, so we have to be able to, I think, do a couple of things, which is on the one hand provide the right level of technology, tooling support for the providers to be able to do more with, for instance the amount of administrative work that providers have to do, not just the US, but all over. It’s quite a bit you have to listen to the patient, you have to record the condition, you have to diagnose it. You have to also then document all of that in the EMR System. So, we have several technologies that are sort of being worked on right now or being implemented right now that allows the physicians or the doctors to just listen to the patient and the technology does a lot of the administrative work by itself. So that’s one big part of how we are, how we are going after that. There’s also, you know, the preventative aspect of it, right if people don’t fall sick, then they don’t need as much care, so that’s as a community system. There is an element of that in what we do and but really it’s at this time our focus is doing more with what we have operationally as well as in terms of supporting the clinical staff with better utilization of their own time when it comes to patient care.

17:14

Vivek 

Git it and Sha any specific challenge that you may want to call out around processes that that you face while implementing all these programs?

17:23

Sha

The technology aspect of it is so you know, we all of these records as with the patient medical record needs to get into the EMR system and those systems it is a necessity. It is a patient safety issue. So that’s not something you can cite. So, you absolutely have to do it. And then the question is how do you, how do you do it best, right? So, whether it is ambient listening or those types of things. So, we essentially either buy or build those tools that allow providers to take advantage of those tools and then but that integrate of getting the records from an administrative perspective, getting all of the right entries into the EMR system, as well as updating the records. That’s one of the bigger time-consuming activities, if you will. So that’s what we are trying to automate as one of the first things.

18:16

Vivek 

Got it! Got it! Vaibhav  it would be grateful to hear some of the challenges that you are facing implementing all.

18:24

Vaibhav 

So, from our perspective and of course I will echo Sha’s sentiment, of course this what we call care givers or our medical professionals of course are in short supply and across the world and a lot of that is happening in India also now. So, when we build our capacity and of course when we build some of this digitalization, the big reason for that is of course for the people, because they’re lesser number of people. And of course, if the attrition all happens at training and retraining and that becomes like a big challenge in terms of how do you make sure that becomes a way of life, right? For us, it was like not “the way of life” like say, uh, three years back, now it has to become completely the way of life.

So, a lot of people are who are used to using quote unquote, legacy systems, right? Or using or running it their own way, that changing that across multiple geographies within the country becomes a big challenge, right? So, I think that’s something which we have which has been a big, big thing for us to overcome and that has happened once people start seeing the results of what the technology can provide them actually.

So, I mean once you know that, OK, how you manage X number of employees and what happened with each of the cases or each of the patients yesterday if that’s available your fingertips tomorrow, which you probably took two years to go through Excel and collect data from everybody and prepared then you see the immediate impact of that. And then people say then the aha moments happen. So, we have to basically create a lot of aha moments for people by doing internal POCs. They just show people value of what the what implementation of technology can do for them. So, I would say it has been like a multiple layer kind of implementation for us to do POCs, show value and do POCs in multiple areas and show value create role models across the company, right? Saying oh Delhi branch has done very well. Delhi Branch is 100% digitalized, right? So, everybody has to come around and do that. So, a lot of those things, a lot of softer aspects as you will call it apart from process because defining process following a process, all that has been a key part of it, right? But the fact is, I think the people challenges have been the biggest one to create the right momentum within the organization. So, I would say that now we are there in the middle, I have to say one day saying, look, you guys use this system or I’m taking away to the laptops. there is a date to take away your laptops actually say no, there’s nothing else but to use their mobile phones and see and see that work on dashboards, right? And so people know, OK, so July 1st, laptops may go away. So, then those kind of things have to do along with whatever you are implementing. But I would say people challenges in terms of making sure that they come on board, internal selling, I think, is what has been a big thing to work on.

20:57

Vivek 

It’s very interesting to observe that the challenges that you have shared are very similar across geographies. So very interesting.

21:06

Vaibhav 

Yeah, we both deal with illnesses, and we deal with people like.

21:10

Sha

Ultimately, it’s all humans.

21:12

Vivek 

So, the fundamental problem is the same across geographies. So, Sha how do you see AI use cases evolving in future?

20:55

Sha

AI is one of the tools, it’s not the only tool obviously with all with the technology advancing so rapidly, more is now possible with AI. The number one thing it can do for us pretty much immediately is again, I think you mentioned earlier where healthcare tends to be a laggard when it comes to adopting some of these technologies, any new technology that comes out, but other industries, whether it is retail or financial services, have been using machine learning and AI in operational type of areas where use cases for quite a while now. So those solutions are well established, proven and the adoption into healthcare is relatively straight forward and easy. Things such as predicting volumes or forecasting any number of things from an operational perspective. So that is definitely one of the things that we’ve done. And I think a lot of our peers in the industry are doing the same as well, helping operations, hospital operations as well as operations in general, and administrative functions take advantage of these machine learning and AI capabilities that are proven elsewhere to improve our own efficiency and operations. Now, with that Generative AI now sort of being a maturing and becoming available more broadly, that now allows us to do certain things we couldn’t do before assisting physicians. There is the administrative side of things that we talk about before, but also, you know, from as we also talked about the provider capacity issues and so on, so generative AI capabilities are starting to step in and do things like summarization, and instead of a physician having to read hundreds of pages of medical record, AI is able to step in and summarize it a succinct way where the physician spends 5 minutes or 10 minutes as opposed to 20 or 30 minutes, which then means he or she is able to meet more patients or see more patients and take care of them. So that side of things, which is leveraging generative AI is starting to broaden as more and more LLMs and LLM based capabilities come to play. So, it’s a really good mix of more traditional machine learning and AI use cases as well as the newer generative AI type of capabilities.

24:03

Vivek 

Awesome. Thank you. Vaibhav , your thoughts please.

24:06

Vaibhav 

So, I tend to agree with Edathumparampil. I think the one area where AI is going to help a lot and already doing is basically in terms of efficiency improvement, whether it is for providers or for the or the way we look at data from patients perspective. So, I would say that efficiency improvement is the single biggest thing and India will benefit a lot with that because you know, our ratios of doctors to per 100,000 patients is much, much lesser compared to already number of beds available per 1000 patients is probably one of the lowest in the world. Right. But using technology, can you just bypass some of those thing is something which is there. And I would say that AI and technology both will help in that in a significant manner, and we are seeing some impact of that already and there are technologies being used already in the hospitals where nurses can basically collect vitals rather than going to the patient bed like four times a day or something. They can collect it like with their device. And of course somebody can analyze that at a backend. So, nurse’s efficiency in the hospitals in India I think has that it’s on the path to improve that particular thing. Other areas diagnostics side I think again AI will play a significant role the basically diagnosing the disease actually I think this like larger scale screening program those kind of things AI again will help significantly from India’s perspective. And third one of course, as we discussed I think the topic which we had seen the personalization of healthcare for patients, I think again that now you’re able to collect a lot more data with point of care devices. With that, you can really create personalized plans and there again AI will help you in terms of managing your sugar or managing your BP and things like that. Simple examples. I’m taking so that But that ability to collect a lot more data and ability to mine the data I think will, will get you a lot of insights and help patients to basically create personalized plans.

25:51

Vivek 

Awesome. And Sha follow up question, especially for you. So, what I heard from Vaibhav, especially in the Indian context, that regulators are evolving as the industry is evolving, whereas in U.S. the regulators are a lot more matured in comparison to India. Now, with all this AI evolution happening, how do you foresee the role of regulators in all this in U.S.?

26:18

Sha

Yeah, I think they are starting to step into some of these regulations that guide like, for instance, the definition of a medical device. A lot of these tools that we talk about are classified as medical device. And I think that regulation came out in the early 2000. So, a lot of that is that predates the latest developments in this field. I think recently there was an executive order that clarified a number of these types of things. But I think the field is growing so fast, the capabilities are sort of exploding, if you will, week to week, month to month. So there needs to be a very comprehensive look at what’s available today. How are they being used? How can they be used going forward and then put in place a framework that allows people to safely use it because ultimately, that’s the goal of a lot of these things, which is patient safety and quality of care. There’s a lot more work to be done and I think there is a lot of that happening right now and I hope to see, especially later this year, more clarity is coming out of the administration how these things should be used and can be used which I think will help bring clarity across the board.

27:37

Vivek 

So, Sha how do the data and AI consulting firm like Factspan play a role in the transformational digital journey that you are embarking in your organization?

27:51

Sha

Yeah, there is a lot to do. Healthcare as an industry is catching up. There isn’t enough capacity for all of us, meaning as providers, to build all these things ourselves. So then partners such as Factspan step in and fill that gap to a large extent, especially when a certain type of project or initiative is completed successfully at one provider in many cases, we are able to take advantage of that know how and that experience in building those types of capabilities then and bring it to our system by leveraging partners such as Factspan and others. So, I think that’s so far that has been a big help for us. And again, we are not a technology company, we are not a digital product company. So, our goal is still to run hospitals and care for the patients in our community. So, from that naturally means that we don’t have all the capacity to go and build all of the different capabilities that we do need. So, we are going to have to rely on the partnership ecosystem to bring in a number of these new capabilities. And again, things are growing at a rate that very few people can keep up with. So, unless we take advantage of the ecosystem and the partners in it, it’s going to be really difficult for any of us to truly leverage the power of some of these capabilities.

29:23

Vivek 

Good to hear that, Sha. Your thoughts please, Vaibhav ,

29:28

Vaibhav 

From our perspective, I think we are at a stage where leveraging your knowledge, which some of the companies like Factspan bring to the table will be very powerful. I mean, of course you have more experience worldwide. A lot of those trends, a lot of the learnings from other countries could help us as well. I think that’s something which is there. But overall, from our perspective, we are just I would say, early stage for us of the data analytics journey actually Digitalization has happened of course lot more data is being collected clean data is getting collected, quote unquote, as my CTO says, and that what we do with that data so we know what business problems to solve, now what problems to solve for the patient, how to leverage data effectively to, to solve those problems. I think we could do a lot with the with the help from providers like yourselves, Probably at the very early stage of our very promising. and we look forward to benefiting from companies like Factspan.

30:19

Vivek 

Thank you Sha, Thank you Vaibhav  for sharing all these insights. It is always a pleasure to talk to both of you, especially on a topic like Data and AI which is so close to the Factspan community. Thank you. Audience, for tuning in. I hope you found the conversation engaging, insightful and informative. Feel free to tune in to our feed to hear more similar conversations Thank you See you soon