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I serve on the board of a rural health system. Prior to the pandemic, the health system had existing plans to stand up telemedicine to reach remote and underserved patients—many living more than 75 miles away from the nearest hospital or clinic.

Initially, the health system’s plan was to roll out telehealth over the course of 12 months, with a budget of several hundred thousand dollars and resources allocated to implementing the telehealth system. Once in place, the health system would need to convince the doctors and staff—who were already reluctant to work telehealth into their already busy schedule.  The initial adoption rate was planned to be less than 10% of physicians and only 10-20% of their visits would be virtual.  The physicians and staff worried it would interfere with their work, and many felt very strongly they would lose the connection with their patients.

Once the pandemic hit, the rural health system implemented telehealth in three days with over 50 successful virtual visits the first day.  It proved that the health system could innovate quickly, by doing things differently with great results while not compromising quality. The health system has increased its visit capacity by 25% with an anticipated increase in revenue while eliminating a key access barrier to care by bringing specialty care close to home for rural families.

Rural health systems face unique challenges, serving remote communities with limited providers, and extremely tight budgets. The telehealth virtual visits’ success opened the door for additional innovation and digital initiatives to create a better patient experience.

Sometimes, the best view of one’s soul is on the edge, looking back. Providers were pushed off the cliff for virtual visits because they did not have a choice due to the pandemic. And the results are incredible.

With telehealth, the physicians experienced increased efficiency that allows them to see more patients, have longer visits, and maintain a strong connection. Virtual visits have also provided an additional value with a window into their patient’s social determinants of health.  Observations during virtual visits provide not only the ability to clinically assess the patient, but they can also assess their social situation.  Virtual visits Telehealth has become a preferred method of accessing care in rural communities.

With this shift and change, telehealth increased the volume of visits physicians could take on, aligned reimbursements better, and provided improved access to quality, convenient care for members.

This pandemic has forced everyone to adapt and innovate faster than we ever thought possible. With technology and focused resources, this health system can now reach more members and continue improving care across the communities they serve.

Like all health plans, Safety Net Health Plans are gearing up for the explosion of data that will come with interoperability. Altruista Health Chief Technology Officer Craig Wigginton recently moderated an online panel of IT colleagues from health plans that serve the most socially and economically challenged members of society. These plan leaders have learned many lessons during the pandemic that are relevant to the coming wave of change interoperability will create in the industry.

Some members faced distinct barriers in accessing telehealth during the pandemic, as just one example. Some had problems with bandwidth in the home, a lack of technical skill, or even a preference to not have their home environment as a backdrop while they were speaking over video.

“The technology needs to be an enabler, not a barrier,” Wigginton said. He predicted similar concerns will arise when interoperability hits.

“Members are going to get data they’ve never seen before,” said Dan Dunkers, Vice President of IT at Johns Hopkins Healthcare. Members will head straight to the internet to understand what they are reading. Then they will call their health plan with questions.

This sparked a lively discussion about the impact to member services representatives who will answer these calls. How can they be trained to deal with the range of questions that might come in? Reps may be asked about technical issues that arise from the data download, along with related benefit questions and clinical inquiries. Will these reps be able to deal with all of this or will the call get dragged out trying to chase down answers? Plans need to handle this correctly, the panelist said, because members’ satisfaction with the process is going to affect Medicare Advantage scores.

Small Time Window to Impact Member Behavior

Wigginton said with the wave of data coming, there will be a wave of consumerism. “People are going to wonder, “if my Amazon purchase can follow me to Facebook, why can’t my health data follow me to the pharmacy or to my caregiver’s phone?”

The real-time nature of that data is important to capturing a member’s attention at exactly the right time to impact member behavior, the panel agreed.

Panelists weighed in about where plans should focus investments to get ready for interoperability. They agreed that data governance and security should top the list. The organizational siloes need to come down.

“The chief medical officer and IT have to work hand in glove,” Wigginton said.

The panel strongly agreed that technology should not create inequities among members.

“There should be no member left behind,” Wigginton said.

Other panelists were Stuart Myer, Chief Information Officer, VillageCare, and Kalyan Narayana, Chief Information Officer, Commonwealth Care Alliance.

Unlike a startup or smaller regional plan, many national health plans have grown their businesses by acquiring multiple smaller health plans along the way. While national plans gain new members through these acquisitions, they also often accumulate older and disparate technologies. As a result, national plans are often disjointed in terms of process and workflow.

Whether they are looking for operational improvement, administrative efficiency, medical savings, or any other initiative, it can be challenging to move quickly. Even with adequate resources and funding, national plans’ size creates more steps they must take internally and, in the industry, to transform their business. As a national plan continues to grow and increase the number of people, departments, and locations, these decision-making hurdles and issues escalate.

I often hear national plans ask, “how can we bring these different areas together to make things easier and improve operational efficiency?”

To modernize and innovate, national health plans need interoperable solutions that seamlessly integrate and connect their operations across the country. Cloud technology and cloud-enabled software can bring all these different areas together, even while physically separate from each other. With cloud-based solutions, everyone at a health plan is always working with centralized data and up-to-date information, reducing maintenance delays and potential errors.

This is extremely valuable for larger health plans. Once everyone at the health plan is working on the same tools, it makes collaboration easier and more streamlined.

The COVID-19 pandemic highlighted where outdated technologies present administrative deficiencies and the need for cloud-based solutions.

The pandemic created an entirely new regulatory environment that health insurers needed to accommodate immediately. Things were changing quickly. A large plan with disjointed systems did not just need to make changes in one place; they had to make them in several areas. The health plans that invested in cloud-based solutions had the flexibility to react quickly to the regulatory changes with minimal business interruption.

Cloud-based solutions can completely transform a national plan; however, it takes investment for progress. Health plans need to think differently about where they want to be in ten years, partner with next-generation technology creators, and invest in their future.

Sometimes, issues people face might not even cross someone’s mind until they are in the same situation and feel the impact. It’s helpful to have ongoing conversations to share our experiences, and in turn, recognize someone else’s experiences. Even if their reality is not your reality, it’s essential to come from a place of understanding. Recognizing that everyone has a unique perspective is when real change will happen.

George Floyd’s murder last summer was a catalyst for change across the country, including HealthEdge. Our Human Resources team initiated individual and group conversations with the African American employees to share our experiences, feelings, and how the company could do better. These were raw conversations. Everyone listened. Similar to what was happening across the country, these conversations led to a broader, thoughtful dialogue that could focus on how a company can influence societal change.

We needed a safe forum to create more conversations about diversity and inclusion and sharing our experiences. It was clear that the HealthEdge leadership cared and did not want diversity and inclusion to just be a moment or hot topic. They were invested in taking steps to make a change and do it the right way.

HealthEdge signed the Mass TLC Compact for Social Justice aimed at increasing diversity programming and training, self-reporting demographic information, and expanding their talent acquisition pipeline resulting in more diverse hires.

After a few meetings, we decided to add more structure to these discussions and open them up to everyone. This sparked the idea for IBelongHE, an internal group that has regular, open conversations about diversity, equity, and inclusion. I serve as the employee champion of IBelongHE to ensure our employees feel heard and have a voice in charting our path forward to real change.

We’re making progress with the monthly IBelongHE meetings and recently launched a speaker series bringing in outside experts to guide our company in tackling such topics as unconscious bias that help us think of others’ perspectives and experiences.

Our work is not yet done.  The first step is acknowledgement followed by making a plan to do better. We’re best served by being thoughtful and purposeful in what we’re doing. We will continue to have conversations, learn from each other, and move toward being a more diverse and inclusive workplace.

Reducing employee turnover and attracting the right talent is a top business imperative for 27.3 percent of health plan IT leaders today. Every time a company loses an employee, they must spend time and money on job postings, interviews, onboarding, lost productivity, and more. Employee turnover can cost companies hundreds of thousands of dollars every year. From my experience, the key to retaining top talent is robust, ongoing training.

If a company does not provide adequate training, employees can feel like they’re not qualified for their job because they don’t know what to do; at the same time, they are afraid to ask questions for fear of seeming incompetent.

I’ve seen this time and time again throughout my career.

People begin to ask themselves, “Why am I here?” “Am I in the wrong job?” “Maybe I should go somewhere else.” As a result, companies lose talented employees, and an opportunity to have that person speak up, improve processes, and advocate for your organization.

If an organization hires someone new, there’s only so much someone can learn on their own. The easiest and most effective way to ensure they succeed in their role is through training.

Every health plan is unique. Training helps organizations maintain a skilled workforce, ensure everyone is on the same page, and reduce errors.

When it comes to training, health plans should consider:

• What are you doing to train your folks on all of the systems that create your ecosystem?
• Succession planning- If someone left today, would anyone be able to step in the next day and do their job?
• What processes are in place to ensure you’re regularly updating training programs?
• How are you communicating with your company that training is available?

Especially today, as we support a blended remote and in-house workforce, employees have less day-to-day interaction with their peers. People might feel extremely alone in this work environment, and training is a productive way to take advantage of the downtime and engage with your teams.

The PeopleFirst HR Excellence Awards recently named Pradeep Bonda, Director, People Success Team at Altruista Health, a HealthEdge company, as a “Future Leader” in the individual award category.

PeopleFirst recognizes human resources (HR) leaders for their contributions to their organizations and the HR ecosystem. The Future Leader award honors “game-changing HR directors of the future,” who have made a significant impact and adds value to their organization.  This year’s nominations to the overall categories included 150+ entries from 50+ organizations across a cross-section of industries. A panel of industry experts evaluate the submissions and select the winners.

Pradeep, who is based in Hyderabad, India, provided some insight about receiving recognition as, company culture, and his outlook for the future of HealthEdge.

Congratulations on being honored as a “Winner—PeopleFirst HR Excellence Awards 2020.” What does this award mean to you?

This is a special recognition as it is different from other awards I have received in the past as a young HR leader or the 40 under 40s. It makes me stand along with the eminent personalities and the most experienced leaders in the industry that are shaping the future of global HR practices.

What drew you to Altruista Health and its GuidingCare® product?

I’ve been with this fantastic organization for over ten years. I was drawn to this company for its vision that blends business value to the customers and well-being of the society, making it a great place to be part of.

What are you most proud of during your tenure?

While I am proud of the many milestones I have achieved in this journey, Altruista’s culture stands out for me. Our people exhibit great Altruistic values. They help each other and enjoy each other’s success. We built a culture of transparency and openness, where employees feel free to express their ideas and thoughts without the fear of being judged. Even more excited is HealthEdge, our parent company shares these same cultural values.

What do you love about what you do? 

We strive to empower each employee to achieve his or her dreams and full potential. The smile and satisfaction I see in a happy employee’s eyes when they fulfill their professional and personal goals make me fall in love with what I do every day.

HealthEdge completed the acquisition of Altruista Health in December 2020. What are you looking forward to most with the newly combined company?

These are exciting times. I am looking forward to playing a pivotal role in integrating the organizations and simultaneously scaling the combined entity to be an employer of choice. We are now one company, with multiple products and many growth and learning opportunities.

Our Hyperbad location has several job openings, is there anything you want to share with prospective candidates?

We are one of the fast-growing health technology product organizations in Hyderabad. Our employees love us for two important reasons: continuous learning and tremendous growth opportunities. The people success team is committed to identifying multiple ways to identify and recognize talent. Employees feel satisfied when they see their work impacting millions of lives. If you are looking for a place where you can try your hands on every aspect of product development and have experience and expertise in scaling enterprise-grade products, we are the right place for you.