Healthcare Rethink - Episode 115
Join Jonathan Wiik, Vice President of Health Insights at FinThrive and his guest, Caleb Anderson, Chief Sales Officer at Athena, as they discuss the evolution of healthcare technology and its impact on the industry. They explore topics like artificial intelligence, interoperability, telehealth and revenue cycle management.
Episode Transcript
Jonathan Wiik:
Hi, I'm Jonathan Wiik, vice president of health insights at FinThrive. I'm here with Caleb Anderson, the chief sales officer for Athena. We're going to talk today from HIMSS Live about what's going on. Caleb, welcome.
Caleb Anderson:
Jonathan, thanks for having me.
Jonathan Wiik:
Thank you so much. How's HIMSS going? What's that about? Are you having fun? Is this your first HIMSS or you-
Caleb Anderson:
No, no, this is probably 15th HIMSS.
Jonathan Wiik:
15th. Oh, you poor guy.
Caleb Anderson:
So walk around, it's like old home week. People move around, see different booths.
Jonathan Wiik:
Yeah, right. That's cool. That's awesome.
Caleb Anderson:
Check the layout out, out. But it's been great so far.
Jonathan Wiik:
I think it's my eighth or ninth. I try to come every other year, but I'm not in the EMR space like you. I'm in the hospital space a little bit more and it's overwhelming for me, but I bet you love it.
Caleb Anderson:
I do.
Jonathan Wiik:
I bet it's really cool to talk to everybody.
Caleb Anderson:
I do. It's good to see old friends, make some new friends. It's cool to see what everybody's working on. It's always great to be in Las Vegas for a very short period of time, before getting out.
Jonathan Wiik:
Yeah, 72 hour rule, right?
Caleb Anderson:
That's right. That's right. But seeing what's going on in the industry, seeing what people are working on, seeing what providers are interested in, and so it's been great so far.
Jonathan Wiik:
That's awesome. Well, you're into data. I want to talk about democratizing data a little bit and just Athena is one of my favorite platforms. Just what are you guys doing in that platform and how are you in that space of EMR, HR, practice administration systems, managing data, and how do you feel putting that data in the right place at the right time matters?
Caleb Anderson:
Yeah, so we've got, we're kind of at an interesting crossroads from Athena perspective. We started as a SaaS platform, so we've always had one instance of Athena, which allows us to pull a lot of data together and learn from that data in a really intelligent way since really the founding of Athena. On top of that, we're an incredibly open platform. So we've got 900-plus read/write APIs in and out of the platform.
Jonathan Wiik:
Awesome.
Caleb Anderson:
And so we not only see a lot of data come in that our providers are entering on a day in, day out basis, but then we have a lot of data going out of the system to third party platforms, to acute care hospitals, to other sites of care that are seeing the same patients. And so from my perspective, having been in the industry for over 20 years, we really spent the last 20, 25 years digitizing what was paper. And I think we're just at the crossroads on what we can do with the data across all these different platforms. So it's a really cool time.
Jonathan Wiik:
Yeah, it is a cool time. I think you got these eye rolls probably like two, three years ago when AI was brought up and now it's more of an engaging conversation.
Caleb Anderson:
That's right.
Jonathan Wiik:
It's more, "What are you doing with that? What's the data doing?" What are your thoughts on AI? What's the latest
Caleb Anderson:
Obviously you look around, it's on everybody's booth. So it's the buzzword of the conference, but I think as an industry ourselves, really as a world, we're starting to learn what AI can't do. And so you go back to the last point. Now we have all this data inside of healthcare. AI I think is an opportunity to unlock the insights inside of that data.
We spent years, again, digitizing records. There's a whole bunch of information about you and I and other patients across the ecosystem, but what can we do with that information? How do we make clinicians' jobs easier? How do we serve up information at the right time, at the right place to take better care of that individual? And I think AI is going to be literally the match that lights the fire of what is possible inside of healthcare.
Jonathan Wiik:
Great. That's a great analogy. I was in the keynote, you and I were chatting before we started and we were talking about this hospital in Seoul, Korea that's autonomous. And it was fascinating to me. The doctors and the clinicians and the extenders just walk around saying what they need for the patient. The room is listening, the record is listening, and the labs and the imaging and all the documentation just happen.
Caleb Anderson:
That's great.
Jonathan Wiik:
The docs are spending 200% more time with their patients. The patients are spending more time with their doctor and they're not clicking away, not looking at them. What are your thoughts? Is that where you see Athena going?
Caleb Anderson:
A hundred percent. A hundred percent. I think it has to. I think for years, the EHR has been somewhat of an impediment to providers and they just want to give really good care to patients. And when we digitized the records, we made them data entry clicks, and now the EHR can work in a way for them instead of doing something to them, which I think is really, really interesting. So I think this continues to evolve into the EHR truly being the clinical decision support tool that providers wanted all along. And it will bring back, I think, the provider to patient interaction that's been somewhat missing over the last several years.
And then you add in the fact that, look, we have the largest generation in history that's about to start consuming more and more healthcare.
Jonathan Wiik:
Absolutely.
Caleb Anderson:
At the same time, we have fewer and fewer providers going into healthcare. So we have this huge gap between supply and demand that's occurring and will continue to occur for the next 5, 6, 7 years. AI and the technology will enable the providers to be more efficient, I think, take better care of those patients and help bridge some of that gap that is going to be pervasive if we don't do anything else between the number of providers to give care and the number of patients that need care.
Jonathan Wiik:
It's fascinating. I call it the silver tsunami, and I'm hoping that it all gets figured out when you and I retire. We have a different care experience than we have today.
Caleb Anderson:
I hope so, right? I hope so.
Jonathan Wiik:
Not that there's anything's wrong with that. Telehealth, that's something that you're really passionate about too. That kind of bubbled up over COVID because it had to, and then it kind of floated back down. Is it going to pop or keep floating? Do you know?
Caleb Anderson:
I think it's here to stay. I can't imagine that genie going back in the bottle. I spent time at Teladoc in my career, I've been in Athena. I think it's one, from a patient perspective, it's a convenience factor. I have 13-year-old twin girls. I don't really want to pull them out of school. I don't want to take them to the doctor's office. So for me as a parent, as a patient myself, it's really, really convenient for those episodic things.
And then when I have something more acute, then I want to go in and have a much more deep conversation with a provider in person. So I think telehealth will continue to persist. I think the question is what are the use cases for it? And mental health, behavioral health I think is a great use case for telehealth. For episodic sore throats, earaches, those kind of things. I still think when you get into chronic care, there's going to need to be more hands-on with the patient. And so we'll see, we'll see how those things evolve. COVID was a way to, again, light a match. I don't see it going back.
Jonathan Wiik:
[inaudible 00:06:17] the bottle.
Caleb Anderson:
Yeah.
Jonathan Wiik:
I think it's going to hinge on how much the payment's there too.
Caleb Anderson:
That's right.
Jonathan Wiik:
What I see hospitals and providers doing, probably somewhat, I would say obtusely is saying, "We want to be paid the same for an in-office visit," which it isn't. And I've seen more innovative organizations say, "We're going to use this to accelerate what we're doing already."
Caleb Anderson:
That's right.
Jonathan Wiik:
"We're going to use this to stop readmissions or lower ED utilization rates or help patients get their scripts filled better." Do you see it ever being on par with an in-person visit or is it-
Caleb Anderson:
Maybe. There'll always be that push and pull between, "I did more care, therefore I should get paid at a higher level." I think as the value-based care model evolves, there's an opportunity for telehealth to play a different role. So to the extent you're trying to do care management of a larger population and you have stratified risk around that population, a PMPM payment or a PMPY payment, it makes more sense for you as a care provider to do that through telehealth than having them come into the office, which has also got a higher cost associated with it.
Jonathan Wiik:
Totally.
Caleb Anderson:
So I think some of it is how do the reimbursement models continue to evolve? What does value-based care do? And I think value-based care will continue to accelerate telehealth and virtual care in a way that the traditional fee-for-service environment really didn't incentivize.
Jonathan Wiik:
Yeah. I mean, we've gone from roughly single digit percent of all contracts, risk being a little under a third. It's getting there. I think you're right. And I think Medicare, for as long as we have it, will push that and we'll figure it out.
Caleb Anderson:
Yeah.
Jonathan Wiik:
FinThrive and Athena have been working together on the finance side. That's been a good partnership.
Caleb Anderson:
Yeah.
Jonathan Wiik:
We're trying to really change that ecosystem and advance healthcare there, from a finance perspective. What are your thoughts there on the finance side of all of this?
Caleb Anderson:
Well, I love the work that you guys-
Jonathan Wiik:
Great.
Caleb Anderson:
... are doing and obviously that we're doing together. I think, again, as the reimbursement model shifts, I think what we're trying to do together is make sure we maximize the payment for the providers that we serve in a way that is appropriate. Let's take the friction out of the system, let's make sure people get paid correctly, on time. I continue to say, healthcare is the only industry I know of where I can see you today, and then I don't get paid for it for 30, 60, 90 days. And so I think the good work we're doing together to connect care delivery to how they get reimbursed for those services accurately and on time is what the industry is ultimately after.
Jonathan Wiik:
Absolutely. Yeah. I had a CFO tell me in the Pacific Northwest that healthcare's legalized shoplifting, which-
Caleb Anderson:
Yeah. That's basically right.
Jonathan Wiik:
... I thought it was hilarious.
Caleb Anderson:
They do anything they can to not pay you in the right way.
Jonathan Wiik:
Right. And it happens on the payer level too, I think.
Caleb Anderson:
Sure.
Jonathan Wiik:
What are you excited about at this conference? What are you seeing besides the AI stuff that's making you excited?
Caleb Anderson:
Well, obviously AI and just trying to talk to people about what the immediate use cases are. So there's a lot at the show, obviously around clinical AI and how you can, to the analogy you used or the keynote this morning, take the EMR out of the conversation. I think there's equal amount of excitement around what AI can do for revenue cycle. I mean, as you know, we still have a lot of human touches-
Jonathan Wiik:
Absolutely.
Caleb Anderson:
... and a lot of friction in the revenue cycle that I think AI can help evolve over time. And then maybe outside of AI is there's still a lot of talk around interoperability. You still have these silos of where all the data exists, and I think we're now as an industry, hopefully moving to a place where let's make it easier for the patient to go back and forth to other care venues, and let's really take the friction out of how you get your record from the acute care hospital into the ambulatory venue and back and forth.
Jonathan Wiik:
Yeah, I would love to take the claim and the admission out of revenue cycle through AI, right?
Caleb Anderson:
That's right.
Jonathan Wiik:
Because they aren't needed. They are things that are shuttled throughout the process that really already existed. Or it could be, I would guess, dynamically entered and talked about,.
Caleb Anderson:
I think that's right.
Jonathan Wiik:
And it's really interesting to me how many tennis matches or times we go back and forth. FinThrive's really working hard on the AI to remove that friction, like you talked about.
Caleb Anderson:
Yeah, look, we've been trying to do it through labor arbitrage and offshore and all those things over time. I think AI can automate a lot of those tasks. There's also a lot in the revenue cycle space that we already know about the patient and the clinical record. We just need the systems to go talk to one another in order to pull that information out. And AI is great about chomping through a large data set, finding the little needle in the haystack that you need to fulfill that claim, get it paid in the right way, and apply the rules to go along with it.
Jonathan Wiik:
Totally. Twin daughters, you said, huh?
Caleb Anderson:
Yeah. You want them?
Jonathan Wiik:
If they were younger, maybe, because the teenagers are hard, man. I have two teenagers myself there. I call them the redheaded orangutans. I'm an ATM machine in my household, basically.
Caleb Anderson:
That's basically it. That's basically it. "Dad, I need money."
Jonathan Wiik:
Right. That's all they're for. Well, hey Caleb, I really appreciate your time.
Caleb Anderson:
Hey Jonathan, thanks for having me.
Jonathan Wiik:
You take care and thank you so much.
Caleb Anderson:
Thanks for the partnership.Jonathan Wiik:
You bet.
Caleb Anderson:
All right.
Jonathan Wiik:
Jonathan Wiik, healthcare industry insights at FinThrive. Thank you so much for watching this and have a great day.
