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The healthcare sector is complex and fragmented, often with misaligned incentives or a lack of coordination that leads to ineffective distribution of resources. Fragmentation also has a negative impact on patient outcomes, costs and quality of treatments.
During VentureBeat’s Transform 2022 virtual conference, 30-year AI industry veteran Jana Eggers, CEO of Nara Logics, joined Sachin Joshi, SVP, data and analytics engineering at Evernorth (a subsidiary of Cigna), to discuss what Cigna is doing to improve that fragmented care and bring down healthcare costs by using data.
Cigna has created a platform that allows the company to automatically identify situations requiring clinical attention, implementing interventions tailored to a patient’s clinical conditions and engagement preferences. The platform also provides 360-degree visibility into patient activity, resulting in the ultimate care-coordination program.
Complexities, impediments and failures of the healthcare system
According to the World Health Organization, the qualities of the delivery system in the healthcare sector affect how fast, effective and suitable the medical care is for the patients. Patients often make a wise decision by choosing an outcomes-based model of care that assures clinical targets and connects a patient’s touch points throughout the care continuum.
However, Eggers noted that a lot of people have encountered complexity in the healthcare sector. Rather than looking at healthcare concerns from the patient’s perspective, she asked Joshi to look at the view from inside the healthcare system. This fragmentation from the inside out, Joshi agreed , is the main problem.
“I know we as consumers feel that every day when we go to get our labs done, go to our primary care physician … go to get our prescriptions filled,” Joshi said. “Imagine trying to pull together that information to create better outcomes for our patients so that they’re not having to navigate all of those various channels without having the feeling that, one, they’re being intentionally priced gouged and, two, [wondering if] their whole health is being considered with all those different channels.” Joshi said that those on the inside see all of that and kn …