Improving Healthcare Management with AI & Automation

Dayle Hall: 

Hi, and welcome to our podcast, Automating the Enterprise. I’m your host Dayle Hall, the CMO of SnapLogic.

This podcast is designed to give organizations the insights and best practices on how to integrate, automate, and transform their enterprise.

Today’s guest is an experienced leader with a demonstrated history of working in the health and insurance industry. He is exceptionally skilled in databases, programming languages, process improvement methods, and leadership across the IT organization. Please welcome to the show today, Chad Ellis, the Associate Director of IT for Humana. Chad, welcome to the podcast.

Chad Ellis:  

Hi, Dayle. Thanks for having me. I’m really excited about what your program is doing.

Dayle Hall: 

Yeah, me too. And again, I love talking to, obviously, smart people. That’s the first part, but people within the realm that SnapLogic covers. In all transparency, Humana is a customer of SnapLogic, but we’re going to focus less on our specific product and more around the challenges that you have in and around your organization.

But before we get started with that, why don’t you give us a little bit of background on you, how you came into this role, and the work that you do at Humana?

Chad Ellis:  

Yeah, sure. So I’ve been just shy of 18 years at Humana. I got an undergrad in Business Information Systems. And I got an MBA from IW. My MSBA is from University of Louisville. And then I’ve run a few different capabilities.

I’ve worked in several segments at Humana. My current capabilities are largely on workforce management, call recording and transcription, and then insight and interaction engines, really all just how do we deliver value for our members and internal teams.

Dayle Hall: 

Right. You’re the first person that I’ve ever talked to who did the exact same degree as me. I did Business Information Systems, too. Obviously, I was in England at the time. So obviously, we went to different colleges. But that’s awesome. We’re kindred spirits.

Chad Ellis:  

Yes, it definitely sounds like.

Dayle Hall:

You went down the smarter route, I just went into marketing, which is a little bit easier doing what I’m doing and what you did.

Anyway, let’s really dig into what you talked about in terms of your role, which is around workforce management. We’re hopeful that there will be multiple people that listen to this podcast, that are from different parts of the business and maybe some line of business and maybe some IT.

But you’re in what they call workforce management. Could you describe for everyone what that entails specifically? You mentioned a couple of technologies. But to the layman, what is workforce management as it relates to Humana?

Chad Ellis: 

That’s one of the pillars I’m in charge of. What most people think about with workforce management is scheduling and the big brother monitoring devices. I’d like to expand it a little bit further. We have some quality of life, as well as upskilling pieces that go into that framework as well. But in general, that’s what people think of when they think of workforce management, those areas.

Dayle Hall:

Right. I like that, upskilling quality of life. As you mentioned, that’s probably an area that people don’t necessarily relate or think about when it comes to your type of role. So let’s talk a little bit about some of the things that you’re doing within that area as it relates to automation and AI.

So what are some of the things that you’re using those technologies for on your day-to-day basis, whether it is the scheduling, the monitoring, quality of life upskilling, or whatever? Give us some examples of how you’re using some of these broad technologies today.

Chad Ellis:  

From a scheduling standpoint, we’re getting past the we need x bodies nine to five. And it’s doing a lot of predictive analytics, really focusing around not only when do we need people and the quantity of people, but what skills do those individuals need to best serve the population that’s coming in. So it’s more of a many-to-many type situation to cover the wide needs.

As far as the work-life balance, every day has a lull. How can we continue to skill associates? How can we give them appropriate breaks? How can we make sure that we’re not burning them out? And there’s lots of toolings, both in-house and external, that can facilitate that kind of effort on our workforce.

Dayle Hall:

There’s something that springs to mind. And again, I love the concept of that quality of life, work-life balance. As you start to look at these types of technologies to help with that, how do the employees take it? Did you have a challenge to help them understand the benefits for it?

I could imagine that there was potentially- if you’re an employee, there could be some skepticism or I don’t want to say negative reaction, but I worked at an AI start-up in my past and some of the tracking that it did, did cause some concerns with prospects and customers. But for this, how do your employees take these kinds of technologies to help them do their job?

Chad Ellis:  

Definitely around tracking, I believe that is something that makes people feel uneasy in any facet, work or outside. However, most of it happens behind the scenes without really engaging the front-end associate.

So for example, [inaudible] have been working five hours, right? They’ve been working more than half their shift and haven’t taken a break. We can send pop messages to their leaders that, hey, you need to get associate A some time, they’re getting ground down. And the associate wouldn’t necessarily know the leader has been prompted to caretake for them. Same thing with like PTO and things like that. Hey, so and so had taken vacation days in x period of time, they were themselves then. Things like that.

Dayle Hall:

I have to tell you, one of the things I think makes a good leader, you lead teams too, is trying to remind people they do need to take vacation, they do need to take breaks. But I love the concept of this kind of technology that you’re looking at can actually be more proactive. Because sometimes not everyone thinks like I do. Not everyone thinks that, make sure your team is taking time off and support it. But you build that into the process. And I imagine that actually gives the manager and the leader another tool to help them be successful, which I don’t have. So do the leaders respond well to that kind of support, too?

Chad Ellis:  

It can be mixed, really depends sometimes generationally or people’s feelings about tracking devices in the first place. It can still maybe feel intrusive, you’re telling me how to do my job. But I think we at least have really honest conversations that it’s not a have-to, but it’s a good guardrail. Because we’re human, we’re gonna miss things. A set of queries and models tells a story. Any help is just that, it’s help.

Dayle Hall:

It’s interesting you say we’re human. As I’ve talked to other people on some of these podcasts that are involved in AI and automations, one of the things that is consistent is that AI is an augmentation of what we do, but humans should still be involved.

And I think what I love about what you just said is you’re using the technology to help people where they need it. Not enforcing that it has to be done this way. Because I think the humans being involved- first of all, it helps to be more productive. The other people that it impacts feel like they’ve got more tools and don’t feel like there’s big brother watching over them. I’m sure you see something similar in your organization, Chad.

Chad Ellis:  

Absolutely.

Dayle Hall:

So let’s talk a little bit about you mentioned- that was a good example around taking breaks or something like that. What about other things like top performers or retention? What kind of things is Humana doing? I don’t know if you’re using any kind of predictive analytics or different types of AI to help understand who are the people or our top performers we want to keep? Do you have challenges with retention? And how are you using technology to help address that?

Chad Ellis:  

Performance is not a single metric. And there are a lot of inputs that are required to really determine is someone adding value. I would frame it like this. There are a number of qualitative and quantitative metrics that go into trying to build that model. And then we also have feedback loops really from peers as well. It’s not so cut in stone, hey, the computer popped out this number and this is your value. It is more survey-based member feedback, your peer feedback, leader observations, and then we have core set of values that are important to us. And are we adhering to them and doing business the way we intend. And at the end, there’s review and that all kind of goes into it.

Dayle Hall:

Right. I like that concept of qualitative and quantitative. It’s obviously important. So what we mentioned earlier, which is using AI to augment other things, it doesn’t mean the tool, the technology, the process spits out a result, because I can imagine that would be terrible. I certainly want to be judged that way.

As you start to implement these kinds of technologies, how did you bring the group along? Humana is a massive company. Many employees, different skills. Who did you bring into the process as you started to add these technologies? Was it mainly with HR business leaders? Was it with other parts of the business? The functional leaders? How do you actually start to work on implementing these technologies?

Chad Ellis:  

Generally speaking, we follow a agile process. Most of our segments and business areas have product owners. There’s review of vendor products, things like that. We constantly get feedback on what’s going to potentially drive the most value. And it’s really a two-way dialogue. It’s not just the IT off going and building and buying tools or business solely. There’s a lot of collaboration that has to happen for anything to be successful. There’s quite a bit of research. How do we retain talent? How do we attract talent? How do we continue to upskill and make sure that the folks that we have that haven’t reached their ceiling can continue to build and deliver value in other ways?

Dayle Hall:

As you implemented some of these technologies and processes, was there anything that really shocked you, anything that surprised you, positive or negative, or some things that you were- a result, or anything that you thought, ah, we didn’t necessarily see that as a byproduct? Anything that really stuck out to you as you did this?

Chad Ellis:  

I expected the hard science, the metrics piece of it. I did not expect so many different vended applications and qualified professionals to have and think of the human in all these processes. And so the driver in the conversation wasn’t about a widget, it was about a person. And the use case stories were relatable. And that was a much different field, and maybe working in some other technologies that we really put it around a human being and their experience instead of just hard science.

Dayle Hall:

Coming from an IT, Business Information Systems background, I think it’s very easy to get into the technology, the process, the tools. But I love that concept of it’s about the human, it’s about delivering more value to the human. And this goes back to using AI to augment the process. I think, clearly, you’ve had some success at Humana because of that approach.

As you start to go through that process focused on the human, what about things like communication, and change management, and making sure that people are aware of why you’re doing it? Were you driving that? Did it come from HR? How were you involved in that to make sure people understood the benefits to the human?

Chad Ellis:  

There are several different segments, and it’s generally driven by a product owner. And so one group doesn’t necessarily have to take on the features or use all of the tools. And so it was really about showing what’s possible with a number of solutions and then what those segments were interested in. And did they want to do a test group? Did we already have someone using those features? And what was their experience for the, I’ll say, guinea pigs, the first through the door, wanting to try new technology. It’s just like anything else. What does this number mean? Help me read this report. And then getting feedback. So and so says it’s wrong. Are they reading it right? That kind of thing. We see that with really all kinds of data types. But that’s definitely the experience for the first through the door.

Dayle Hall:

Obviously, we see this with some of our customers and prospects. But in a lot of the conversations that I’ve had on this podcast series, one of the things that people have said- different types of customers, higher education, agencies, and nonprofits, one of the things that they’ve focused on is solving the business problem first, or understanding a problem that we’re trying to solve, and then trying to identify the technology or the people or the process to solve it. Was it the same at Humana that you set out- it doesn’t necessarily be a business challenge. It could be a business goal, it could be around retention. But did you start with that business challenge or business goal and then look at technology? How did it work at Humana?

Chad Ellis:  

We’ve been around quite a while, and so there have been existing tools. So sometimes it’s shopping for best in class that hits or meets the business needs. Sometimes it is we get like an OKR, right? We’re driving towards an outcome, like improving net promoter score or a key objective. And sometimes that is what brings the tooling forward.

When you talk about organization this large with really multiple businesses, one style, so we’ve done it multiple ways. Hey, we have a business problem, help us find a technical solution. Hey, we have an objective we’re trying to reach, then brainstorming across the org. How can we tackle this? We’ve done it multiple ways. Even the same tool. No segment necessarily came to it the same way.

Dayle Hall:

I’m sure in an organization that’s been around for a while but has multiple technologies, I can imagine you have some bigger challenges in terms of bringing people along.

Let’s move forward a little bit, because I know you’re using AI in a slightly different way and then we’ve talked so far around things like call transcription and sentiment analysis and so on. What are you doing today? And how are you using technologies to better serve your business for that kind of sentiment and call transcriptions?

Chad Ellis:  

That is the second pillar that we talked about in AI is instrumental there, what’s being said, and the value there goes beyond a lot of CRM or out-of-the-box applications that track calls. We want to understand what we are providing from a quality and empathy. We want to understand what are all the reasons and the experience that we’re providing. We’re trying to make sure that we have core metrics around a call, but do we actually know why. And then can we improve on the experience. Maybe even that means a bot or adapting a website using that AI to give us feedback and insights to provide a different route for our members or internal partners. There’s a lot to unpack there.

Dayle Hall:

Yes, definitely. And this is one of those areas where, when we talk about how employees understand the value and benefit this- I can imagine, as you were trying to roll these things out, that there was probably some skepticism or some concern around how you’re planning to use that. But what I love about what you said is it’s not just quality. And obviously, we all get those messages, this is recorded for quality assurance. We all hear it a hundred times.

But you said a very specific word, which was empathy. Given who humanity is and the work that you do, I can imagine that is probably one of the key things that you have to help people understand. Empathy for humanity is probably one of the key things you have to get across. So how did employees really take to that? And how did you make sure that they understood how the technology is there to align with your core business values and the values of the company?

Chad Ellis:  

Not to be a broken record is it can identify opportunities, and then leaders can act on it. Again, it sometimes feels, I’m sure, invasive. Supervisors can only listen to so many calls. And so understanding where that person is on the phone call and what they need, and then how we react when we deal with any industry, assuming it’s critical for someone to have to pick up a phone anymore and reach out, there’s probably anxiety, there’s need to be understood. And you need an empathetic ear. It’s critical to their experience.

And so what’s our word selection? It may be the 50th time you’ve answered that question today. But you know what, that’s the first time that person asked it. And it means their health, it means their banking, it means their order, it means their- and so we need people to come across empathetic. And there was a quote, unfortunately, I don’t remember who said it, what gets measured gets managed. This is a way to measure empathy or help identify opportunities. And so if we measure it, they know it’s important. We continue to coach to it. We’re going to guide them in the right direction for what we want for our members.

Dayle Hall:

I’ve heard our CEO mention that a number of times, what gets measured gets managed. And I think that’s true. And I think, again, these are just some sensitive areas with these type of technologies that I’m sure a company like you has to go through. Talking just a little bit around how we work together with Humana, how are you using integrations and automations today to help on either those kind of- the transcripts, where is that data going? Who’s using it? How is that being used around your organization today?

Chad Ellis:  

So without getting to very technical specifics, you have to imagine a very wide organization, a coalition of really different businesses that have different purposes, from claims, to enrollment, to billing, to ID cards and so on. So many toolings that need their applications to talk. They need that information to be shared and has to be shared specifically to the right group, right applications. 

And so those are areas where integration is incredibly valuable. I don’t need to jump to 10 applications, I need to jump to one or two that allow me to do my job fully. And so those are where those integration, those API calls, those ETL processes to feed certain areas really come into play.

Dayle Hall:

That’s a lot of data we’re talking about. Given the areas you mentioned initially around scheduling, monitoring, you’re talking about quality of life and upskilling. And then we’re talking about the sentiment analysis. That’s a massive amount of data that you have to manage. Who’s using that? Different parts of your organization, but does this go all the way up to the C-suite? Do they look at those kinds of things? Who’s really driving, looking at that data to actually make constant or meaningful improvements?

Chad Ellis:  

There’s different parts of the organization that consume that. And yes, all the way up to the C-suite. Obviously, the numbers and format kind of roll into different segments, different leaders. Obviously, the frontline-type leaders, they’re going to want to see very team-specific roles up to their leadership.

But then it kind of segues from managing people to managing experience, and then more of a global view of what’s the health of the entire system the higher you go. And so who gets that information? Or analytical teams. Sometimes it’s pushed into third-party vendors that offer services to kind of add a widget or add a reporting element. And then it all kind of rolls into all the areas.

I will say this, that most of our business partners are very savvy about what they do. And they usually have a technical team that really kind of jumps in and does process improvement, takes this feedback, takes action on it. Those projects get rolled up to senior leadership. Hey, these are the things we’re trying to do. This is how we’re going to improve this experience. This is why all those conversations happen with those groups.

Dayle Hall:

Again, this is one of the things that I mentioned earlier around having a business process or challenge or goal that you’re trying to solve is to make sure that you’re not just adding technologies that feeds a dashboard, and no one looks at the dashboard, or no one’s really using the data. I mean, I can imagine, we see across some of our larger customers, I’m sure you have it, too, is if you’re going to spend the time and effort to put these technologies in place, you need to make sure that the data is getting to the right people, that they can actually make a meaningful change, no matter what that is, right? And no one just needs another dashboard to look at. I’m sure you don’t either.

Chad Ellis:  

Truly, truly. I think that’s where some of the teams are uniquely equipped. Models will help call out certain items for review. We have analytical teams that are running regression to understand what impacts the R-square, what is going to impact this particular feature and type of business the most. And then they help articulate that to the business leaders. And again, they’re fantastic at consuming some complex things, but they know their space.

Dayle Hall:

We come back up to be more general around- one of the things we talk about at SnapLogic specifically is trying to automate the modern enterprise. That’s kind of our mantra that we have here. And obviously, with you, it’s the modern healthcare enterprise.

So what are the other challenges that you’re facing? And how are you using AI and ML with your data clouds, other parts of the business? What are the things that you feel like you’re really making a meaningful difference, with some of the other technologies potentially impacting how you’re using a cloud data warehouse or other aspects of your agents? What are you really excited about that you’re driving for Humana?

Chad Ellis:  

I’m really excited about some of the things that we’re doing to remove barriers to healthcare. It’s overly complex. And so we’re currently working on some proof of concepts, some bleeding edge stuff, where we can help improve health literacy or remove some of the complexity of what a member would go through. Hey, you you need a paracentesis. What’s a paracentesis? How can we connect them with plain language that everyone can understand, and then the right resources that have been vetted and approved by providers and put that in their hands.

Things like that are really exciting because I believe, and some of the research shows, if we make it plain and understandable, people will take better care of themselves. So informing people and not just data teams is really exciting. It’s getting the data back to the member in a usable form.

Dayle Hall:

I love that concept. And again, I think that is a very- for a company like Humana, an amazing goal to have is to make it simple for people to understand, and as you said, take better care of themselves, understand what they’re being asked to do, because it can be a very scary situation when some people have health issues. And I love the fact that you’re looking at technologies and other ways to help people get more, what do you call it, health literate?

Chad Ellis:  

Health literacy. It’s a gap where you can only follow the instructions you understand. And unfortunately, or fortunately, we have really smart providers, but they’re very much speaking their language. And they’re very comfortable in their space when most of us, to your point, we can be full of anxiety or just confusion. That short conversation can be very complex, and we can miss things. And so if we don’t understand that we don’t capture it all, we’re not going to take the best care of ourselves.

Dayle Hall:

I think that’s great. Well, look, as we come towards the end of this podcast, again, this has been eye opening. For me, I love how you and Humana are thinking about helping not just your organization, your employees, but then helping the rest of us as we’re trying to deal with our own healthcare.

If there’s organizations or other people out there that are in a similar situation to you, they have responsibility within an IT organization, similar to you, maybe not in healthcare specifically, but they’re looking at how they can solve certain challenges that they have with AI, with automation, what’s the guidance that you would give them? Where do they start?

What I try and do on podcasts is make sure that people can take something away. So if you have some advice for someone, they’re going to listen to this in their car on the way to work. Now some of us are going back to the office. But as we’re listening to this, what guidance would you give them to say, look, these are the core things you need to think about as you’re starting to implement these types of technologies?

Chad Ellis:  

The philosophy I would say is measure twice, cut once. Really take time to understand the scale and use case for your business. There are a lot of solutions. And you don’t necessarily need a team of experts that code in R and Python are swarms of costly talent. There are some out-of-the-box solutions and tools that may fit the need. And with the growing need of the field, there are tools that make it much easier to do some of this work than previously. You don’t need a PhD necessarily to have a real impact in the space. And so really understand the need, and then take the time selecting the tool. You don’t want to overbuy in those scenarios.

Dayle Hall:

And I think that is probably one of the best pieces of guidance I’ve heard on this podcast series that we’re doing, which is- I’ve heard measure twice, cut once, but I love the concept of you don’t need to have- don’t go hire a hundred costly developers or data scientists, whatever. There’s definitely low-code, easier interface tools that you can use. I think it’s a great piece of advice. And coming from someone in IT, that’s not always what people like. It’s not always what people enjoy doing. But you’ve clearly been through that experience yourself.

Well, look, this has been a great podcast. I loved some of the concepts you’ve talked about around how you’re helping on workforce management moving beyond just the regular scheduling, monitoring, but also really helping people learn new skills or understand the quality of life and helping people understand when someone may be struggling, to take a break or needs a vacation.

I loved what you talked about, which is thinking about the human, keeping the human involved in the process, and that even with the technologies, with AI, with automations, that the driver of this should be around the human and helping the human be more successful. That was very insightful.

And I loved that concept of health literacy. Did I get that right? And what a great goal for your organization. But even someone all the way down and clearly your role in IT, you see that as something that you’re helping to enable. And I think that’s a testament to you and to your organization, the fact that you take that as one of your exciting future developments and how you’re helping people, regular people like me really understand that.

So I really appreciate your time today, Chad. Thank you for joining us, and hopefully, we’ll get to have more conversations like this in the future.

Chad Ellis:  

I would really like that. I appreciate it. Thank you.

Dayle Hall:

Okay. Thank you everyone for listening to this episode of Automating the Enterprise. I’m Dayle Hall, and we’ll see you on the next one.