The healthcare industry is flooded with personal data and information. Here, Softheon founder and CEO, Eugene Sayan, shares his thoughts on why protecting health consumers' information is key for the industry moving forward.
Oliver Wyman Health: Disruption is a central issue in today’s healthcare environment. There are several sources of disruption, from new technology to the creation of a new consumer experience. How is your organization thinking about disruption?
Eugene Sayan: Disruption, as we all know, can take on many forms. With 2018 Open Enrollment Period upon us, we see three areas for major disruption:
In the short term, the current administration is determined to move government programs, such as Medicaid, back to states through a series of laws and executive orders. Some of these methods are block grants and private option programs, as demonstrated in Indiana (under then-Gov. Mike Pence and Seema Verma, current head of the Centers for Medicare and Medicaid Services).
As we tried bending the cost curve with Electronic Medical Records (EMRs) and Electronic Health Records (EHRs), we saw that the technology alone will not reduce the Consumer Price Index (CPI) growth rate of 2 to 3 times previous rates (CPI was 2.1% in 2016). We see that making consumers the ultimate stakeholders is the next frontier. Some states, such as the Healthy Indiana Program (HIP), enforce consumer competency by making the Medicaid recipients accountable for as little as $1 insurance premiums.
And finally, social determinants, which focus on the health conditions and demographics of people, including where they were born, grew-up, live, work, and their age. These circumstances are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between counties. Cloud, big data, and machine learning can analyze these social determinants to help pave the road to affordable, accessible, and plentiful healthcare for all those in need.
OWH: How can your solutions be a positive disruptor and play a key role in the future health market?
ES: The steady march of technology is, by and large, a positive one. If we continue to approach healthcare as we did the last 5 or 10 years, the initiatives in the future will require significant public and private investment. We have learned many valuable lessons from the Affordable Care Act. The technology landscape has radically changed with the advent of cloud, mobile, social media, APIs, and soon, artificial intelligence. Owning, building, and operating complex IT systems was once a great asset, but it is now a great liability.
We are already seeing how the use of APIs can change the way business is done with integration into Amazon Echo, Google Home, and smart wearables and devices. According to an independent sample of IT decision makers, 90 percent of organizations now see the importance of having an API strategy, and it is projected that by the end of 2017, 94 percent of those organizations will see benefits of that strategy first hand.
The future of healthcare is going to be remote diagnostics, telehealth, and telemedicine, and we are confident that our API strategy and cloud technology will be an integral part of the new generation of healthcare technology.
OWH: How is your organization driving the type of change that defines Health Market 2.0?
ES: First, our top priority is always security and ease-of-use for the member. We exceed every governmental regulation, including HIPAA, PCI, and NIST compliance. Response times are expected to be near zero in Health Market 2.0. Computers and internet connections are getting faster. People are in more of a rush, and they simply don’t have the patience to wait for a screen to load or deal with faulty technology. Softheon’s cloud infrastructure allows them to never compromise speed for security.
Second, whenever there is a change in the federal or state laws, our team immediately takes action by analyzing potential issues and then our developers begin work on any necessary updates. Our agile methodology allows us to quickly implement any new regulations and constantly adapt to growing industry needs.
Third, Softheon PaaS, SaaS, and BPaaS echo-systems have been expanding rapidly with partners including Bank of America, VISA, MasterCard, Lexis Nexis, Google, and many others, allowing us to deliver immediate value with no or little upfront investment and a pay-as-you-go revenue model.
OWH: Where do you see the health market in 10 years and your organization’s role in it?
ES: Obviously, I can’t see into the future, but with Softheon, I know we’ll be at the forefront of technology in whatever form that takes. We’re going to continue to provide the latest technology with the highest standards of security.
I believe that, considering the recent Equifax breach, protecting personal health information (PHI) from those with bad intentions will be the industry's biggest challenge. This was a big year for data breaches in healthcare, affecting millions of people and dozens of companies all over the world.
Protecting members' personal information is a top priority; at Softheon, we always remain vigilant. We employ the latest encryption standards and training, constantly certifying and recertifying from the top independent auditors and training companies in the business. With this increasing technology and sophistication, Softheon is always skating to where the puck is going, not where it is.