Healthcare payer organizations are navigating a complex landscape marked by rising healthcare costs, increasing regulatory pressures, and the urgent need for digital transformation. With the growing emphasis on value-based care and the integration of advanced technologies, payers are seeking solutions to enhance operational efficiency, improve data management, and deliver better patient outcomes. The shift towards cloud computing is a pivotal strategy to meet these demands, offering the scalability, flexibility, and cost-effectiveness necessary to stay competitive.

However, despite the clear advantages, many cloud migration efforts fall short of expectations. Payers often encounter significant challenges that lead to project delays, cost overruns, and operational disruptions. Understanding the underlying reasons for these failures is critical to navigating the path to successful cloud adoption.

Here are the five primary reasons why cloud migrations often fail for healthcare payer organizations, highlighting the pitfalls that need to be addressed to achieve a seamless and effective transition.

1. Lack of a Robust Cloud Strategy

Many healthcare payers embark on cloud migration without a well-defined strategy. This lack of planning can lead to unclear objectives, misaligned expectations, and poor execution. A successful cloud migration requires a detailed roadmap that outlines goals, timelines, resource allocation, and risk management plans. Often adopting a piecemeal approach to cloud migration can result in siloed systems that fail to integrate effectively. For healthcare payers, this can mean that different departments or processes are not leveraging the full benefits of the cloud.

Without a robust strategy payers risk facing unexpected challenges that can derail the entire migration process.

2. Siloed IT and Business needs

One of the primary reasons cloud migrations fail is the lack of understanding and communication between new IT initiatives (usually initiated by CIO or CTO) and the requirements of the business consumers. For instance, disconnect often happens when the focus for IT is to pursue cloud migration to enhance data storage capabilities whereas the business need is for advanced analytics to improve patient care and reduce costs. Therefore, before kickstarting the cloud migration process, it is essential to ensure that your cloud migration objectives are tightly integrated with the overall business objectives.

Key decisions like, which legacy applications should be moved to cloud, which technology or process debts could pose a possible hindrance in the process, should be discussed and agreed upon in the early stages.

3. External dependencies and risks not scoped

Healthcare payers operate in a complex regulatory environment and migrating to the cloud can expose organizations to various security risks if not managed properly. Many payer organizations fail to fully scope the extent of external dependencies and risks associated with cloud migrations, leading to significant issues such as operational disruptions, non-compliance penalties and data breaches. External dependencies can include third-party services, legacy systems, network configurations, and regulatory compliance requirements. Implementing robust security protocols, including encryption, access controls, and continuous monitoring, is essential to protect data integrity during and after the migration process​

A comprehensive assessment of all dependencies and a detailed risk management plan are essential for a successful migration​

4. Integration Challenges

Integration of legacy systems with cloud can be complex and challenging.  Legacy systems, built on outdated technologies, may not align with modern cloud infrastructures, causing software incompatibilities and communication problems. Additionally, data transfer from legacy systems to the cloud can lead to data corruption due to differences in data formats and structures, necessitating meticulous mapping and validation. Operational inefficiencies also emerge when legacy systems do not fully exploit the cloud’s capabilities, such as scalability and automation, leading to suboptimal performance and higher costs.

It’s crucial to understand that cloud migration is not merely a “lift-and-shift” process but requires careful planning and execution. Comprehensive integration strategies, including thorough assessments, phased approaches, and robust testing protocols, are essential to achieving seamless integration and realizing the full benefits of cloud technology.

5. Lack of Financial Prudence

Inadequate budgeting and tracking of cloud migration costs can lead to financial inefficiencies. Cloud migration projects often require significant upfront investment and ongoing expenses for maintenance and optimization.

Without careful financial planning and continuous monitoring, these costs can spiral out of control, negating the potential cost savings that cloud migration promises. FinOps, or Financial Operations, provides a strategic approach to managing these cloud expenses, ensuring that every dollar spent drives business value and aligns with organizational objectives. By leveraging FinOps principles, healthcare organizations can gain greater financial control, optimize their cloud costs and foster a culture of financial accountability. 

6. Skill gaps in the teams

Talent scarcity and resistance to upskill are significant yet often overlooked reasons why cloud migrations fail in healthcare payer organizations. There is often a lack of talent within organizations that comprehensively understands both the technical and process aspects of holistic cloud migration. While internal teams may excel in computing and microservices, they may lack knowledge in designing, implementing, and operating cloud models, and ensuring data integrity and compliance. Partnering with an external vendor with the right set of capabilities and deep domain expertise can bridge this gap and ensure a successful cloud migration.

Additionally, there can be resistance from team members to adopt new technologies and processes post-migration. Effective change management is crucial to overcoming this resistance. This involves clear communication of cloud migration benefits, training programs for upskilling employees and involving staff in planning and implementation phases. By fostering a culture of innovation and collaboration, healthcare organizations can ease the transition and gain buy-in from their teams.

Cloud migration presents a significant opportunity to enhance scalability, cost efficiency, and innovation. However, the complexity of the healthcare environment, coupled with organizational and financial challenges, can make this a daunting task.

By understanding and addressing the common reasons for cloud migration failures, healthcare payers can develop more effective strategies and achieve successful outcomes. A well-coordinated, holistic approach that aligns IT with business goals, involves all stakeholders, and includes thorough planning and risk management is crucial for realizing the full potential of cloud migration.

In today’s rapidly evolving healthcare landscape, payers are under immense pressure to reduce costs, improve care delivery, and maintain regulatory compliance. The complexity of managing vast amounts of data, integrating diverse healthcare systems, and ensuring data security adds to the challenges. As healthcare payers strive to enhance their operational efficiencies and meet the ever-growing demands of the industry, many are turning to cloud solutions for their agility, scalability, and cost-effectiveness.

Cloud technology can transform how payers manage data, optimize processes, and deliver services. By leveraging the cloud, payers can achieve significant cost savings, enhance their ability to innovate, and improve data interoperability and accessibility. The cloud’s flexibility allows payers to scale their IT resources according to demand, enabling them to respond swiftly to market changes and regulatory requirements.

The deployment of cloud solutions in the healthcare sector presents unique challenges that can impede progress and affect the overall success of cloud initiatives. From ensuring data security and compliance to managing complex migrations and integrating legacy systems, payers must navigate a myriad of obstacles to realize the full potential of cloud technology.

Download: Optimizing Cloud Costs for Payers: The FinOps Way

There are six key challenges of cloud deployment that payers often face, and addressing these can better prepare them for a successful transition to the cloud. By understanding and anticipating these challenges, payers can enhance their operational capabilities and deliver greater value to their stakeholders.

1. Vendor Lock-in risks

Vendor lock-in is a widespread concern and there is an increasing pressure on CIOs to mitigate the potential risks that may follow. Vendor lock-in occurs when a healthcare payer becomes too dependent on a single cloud provider, making it costly and disruptive to switch providers. This dependency can limit flexibility, hinder innovation, and create challenges if the provider’s services change or become less favorable. Mitigating vendor lock-in requires strategies such as adopting multi-cloud environments, using open standards, and negotiating favorable terms in service contracts to maintain operational agility and leverage competitive advantages.

2. Governance and Compliance Concerns

Ensuring regulatory compliance and data security in the cloud is a significant challenge for healthcare payers. Cloud environments must adhere to strict regulations such as HIPAA, which mandates rigorous standards for protecting patient information. Robust governance practices are essential to manage data integrity, confidentiality, and access controls. This includes implementing comprehensive security protocols, regular audits, and continuous monitoring to detect and mitigate potential threats, ensuring that all cloud operations remain compliant and secure.

3. Network Dependence

Healthcare payers rely heavily on network infrastructure to access and manage cloud services, making network dependence a critical challenge. Latency and connectivity issues can disrupt operations, leading to inefficiencies and potential data access problems. Ensuring reliable and high-speed network connections is vital for seamless cloud operations. This requires investment in robust networking solutions, redundancy planning, and continuous performance monitoring to prevent disruptions and maintain optimal connectivity, thereby supporting uninterrupted access to critical healthcare applications and data.

4. Integration with Legacy systems

Integrating cloud solutions with existing legacy systems is a major challenge for healthcare payers. Legacy systems often have outdated architectures and compatibility issues that complicate seamless integration. This process requires careful planning and execution to ensure that new cloud services work harmoniously with established on-premise applications.

5. Scalability and Rapid Demand Changes

The need for rapid scalability to handle varying workloads while ensuring data security and compliance is challenging. Effective cloud strategies must include robust scaling mechanisms and proactive monitoring to adapt to fluctuating demands and market changes that payers face. Ensuring seamless scalability without compromising performance or security requires a careful balance of resource allocation, cost management, and compliance adherence to maintain operational efficiency.

6. Cost control

Cost management is a priority for payers in the current environment and predicting and controlling costs in cloud environments is becoming increasing challenging. This requires effective strategies such as detailed budgeting, continuous monitoring, and optimizing resource usage. Implementing FinOps principles can help payers align cloud spending with business objectives, prevent budget overruns, and maximize value. This proactive approach ensures financial stability while leveraging the benefits of cloud technology.

Addressing these challenges requires strategic planning, robust governance, and continuous monitoring to ensure a smooth transition and optimal operation in the cloud. By adopting effective cloud management practices and leveraging FinOps principles, payers can navigate these complexities, enhance operational efficiency, and maintain compliance.

At Emids, we recognize the transformative power of effective cloud services management. By leveraging advanced cloud migration strategies, we empower healthcare payers to create scalable, secure, and cost-efficient digital infrastructures that drive meaningful outcomes for both patients and businesses.

In the current healthcare economic climate, controlling costs while maintaining operational efficiency is challenging, and variable IT costs add complexity.  Migrating IT infrastructure to the cloud introduces new financial complexities in the shift from traditional capital expenditure (CapEx) models to the cloud’s operational expenditure (OpEx) framework.   

FinOps, or Financial Operations, provides a strategic approach to managing these cloud expenses, ensuring that every dollar spent drives business value and aligns with organizational objectives. By leveraging FinOps principles, healthcare payers can gain greater financial control, optimize their cloud costs and foster a culture of financial accountability. 

There are four key principles of FinOps that healthcare payers can implement to optimize their cloud expenditures. By understanding and applying these strategies, healthcare payers can not only control their cloud spending but also maximize the value derived from their cloud investments, ultimately enhancing their operational efficiency and improving their delivery of quality care and member experience.  

Unlock the secrets of cloud cost optimization in healthcare – download the eBook now.

Budgeting and Forecasting 

It’s important to maintain an ongoing cycle of budgeting, spending, and reviewing to ensure that financial strategies remain aligned with actual cloud usage and business objectives. By implementing continuous feedback loops, payer organizations can make real-time adjustments to their cloud spending, enhancing their ability to respond to fluctuating demands and unforeseen expenses. This dynamic approach not only ensures that financial plans are always up to date but also helps in identifying cost-saving opportunities and optimizing resource allocation for better operational efficiency. 

Cost Optimization and Value Alignment 

Maximize the business value of every dollar spent on cloud services by continuously monitoring price-to-performance ratio of cloud investments and identifying areas for cost reduction without compromising service quality. Strategies such as right-sizing resources, using spot instances and cost-effective storage can significantly reduce expenses. By aligning cloud spending with business goals and patient care objectives, payers can ensure investments directly contribute to improving operational performance and patient outcomes for higher return on investment. 

Proactive Financial Governance 

Proactive financial governance sets clear policies and diligent budget management to control cloud spending. Healthcare payers must establish robust financial controls, such as implementing spending limits, usage thresholds, conducting regular financial reviews, and engaging stakeholders in the governance process. This proactive approach helps in preventing budget overruns and ensures that cloud expenditures are always aligned with organizational priorities.  By taking a proactive stance, payers can mitigate financial risks, improve compliance with regulatory requirements, and maintain a stable financial environment conducive to strategic growth.   

Recalibration

Agility in financial practices allows healthcare payers to quickly adapt to changes in cloud consumption, evolving business needs, and accommodates rapid adjustments in spending. Dynamic forecasting, real-time monitoring, and automated budgeting tools enable payers to swiftly respond to unexpected changes in cloud usage, ensuring that resources are allocated efficiently.  

Adopting these four key principles of FinOps—can significantly enhance cloud cost management for healthcare payers. They provide a structured approach to aligning cloud investments with business goals, ensuring financial transparency, and driving operational efficiency. By integrating these FinOps strategies, healthcare payers can achieve optimal cloud cost control, fostering a sustainable financial model that supports rapid innovation, faster data-driven decision making, enhanced and secure patient data. 

Embracing FinOps is not just about cost savings; it’s about strategic financial stewardship in the digital age. Payers must adopt FinOps to fully realize cloud value and gain its benefits of fostering innovative healthcare solutions, operational agility and enhanced care and engagement of their members. 

In the ever-evolving landscape of healthcare, digital transformation is essential for enhancing patient care, improving efficiency, and reducing costs. As organizations seek ways to improve their digital services to better serve their customers, its paramount to align them with your business objectives. However, navigating this journey can often feel like exploring uncharted waters. 

Enter Service Design—a powerful approach that places users at the heart of the design process while ensuring efficiency, effectiveness, and alignment with business goals.  

What is Service Design? 

Service design is a human-centered approach to crafting services that resonate with users and drive business success. At its core, service design involves defining a service’s value proposition and designing interaction and operating models that cater to both your customer needs and your business objectives. This work results in more intentional and well-orchestrated service components (touchpoints, information, people, etc.) that deliver better outcomes for all service participants (customers, employees, and other stakeholders). 

Service Design Benefits 

To fully appreciate the impact of service design, it’s important to delve into the specific advantages it brings to both businesses and their clients. Each of these elements plays a crucial role in not only aligning with your objectives but also in sustaining a competitive advantage in a rapidly evolving market.

• Improved Customer Experience: Service design focuses on understanding the entire customer journey. By identifying pain points and opportunities for improvement, you can enhance the overall patient experience. 
• Enhanced Efficiency and Cost Saving: By mapping out current processes, you can figure out solutions to streamline operations, reduce wait times and minimize administrative burdens. This can result in cost savings by reducing overhead expenses and improving resource allocation.
• Increased Patient Engagement and Satisfaction: By involving stakeholders early on, you can create solutions that better meet their needs and preferences. 
• Support for Innovation and Differentiation: Service design enables you to develop innovative services and solutions that will attract new patients, retain existing ones, and build a reputation for delivering high-quality, patient-centered care. 

Enter the Service Blueprint 

Service blueprints play a crucial role in service design; they provide a comprehensive view that combines the user journey with all the elements from the business that impact the customer’s experience. It serves as a roadmap, guiding the design and improvement of services by visualizing the entire service ecosystem—from touchpoints to backend processes. 

Why Service Blueprinting Matters

• Visualize your Service: A blueprint offers a holistic view of the service, bridging the gap between the customer experience and the business experience. 
• Identify Issues and Opportunities in your Service to patients: By mapping out the service process, including touchpoints, a blueprint helps pinpoint pain points, bottlenecks, and areas ready for enhancement. 
• Facilitate Cross-Functional Collaboration: Acting as a common language for multiple teams, a blueprint fosters collaboration and ensures a shared understanding across departments. 
• Enhance Service Design and Innovation: With a blueprint in hand, you can design and create services that meet customer needs while aligning with business objectives. 
• Optimize Operational Efficiency: By streamlining frontstage and backstage processes, a blueprint uncovers opportunities to enhance operational efficiency and improve service delivery. 
• Drive Customer-Centricity: Rooted in understanding and addressing customer needs, a blueprint fosters a customer-centric mindset and culture within your organization. 

Components of a Service Blueprint 

Understanding the intricacies of a service blueprint is essential for optimizing your service delivery and ensuring a seamless customer experience. In this section, we dissect the key components of a service blueprint, offering a comprehensive view of how each element contributes to the overall design.  

By delineating the front-stage interactions, backstage operations, and the line of visibility that separates them, we shed light on the invisible mechanisms that drive exceptional service and organizational efficiency. 

• Customer: The customer is placed at the top, with their actions and touchpoints broken down into steps. 
• Front Stage: This component constitutes everything the customer directly sees and interacts with. The actors the customer interacts with can be a provider, a health plan, an e-commerce company, etc. For each actor, a list of actions and touchpoints is provided for each step of the customer’s journey. 
• Backstage: This includes everything that happens behind the scenes to support the front stage but is invisible to the customer.  It includes the same actors as the front stage. For each actor, a list of behind-the-scenes actions and processes is provided. Components such as Capabilities, Regulation/Policy and KPI lanes may be included to the backstage, as they are invisible to the patient. 
• Line of Visibility: The boundary separating patient-facing interactions (frontstage) from internal operations (backstage). 

When to Leverage Service Blueprinting 

Whether you’re just beginning or well into development of a new digital solution, it’s always the right time to initiate the blueprinting process. 

• During Discovery: Blueprints are an efficient tool to understand the current state of the service and identify opportunities for improvement or innovation.
• As part of Design & Development: Blueprints are a starting point to designing new services or refine existing ones based on insights gathered during discovery. 
• During Implementation & Optimization: Blueprints will guide the execution of designed services for continuous improvement and operational efficiency. 

Examples of Service Design at Work 

Pharmacy Benefits Management 

In a major project to improve specialty pharmacy services, we worked with a pharmacy benefits management company, first focusing on understanding how patients, healthcare providers, pharmacies, and the client interact.  

By holding workshops and working closely together, we examined every part of the process to find weaknesses and opportunities for improvement. This effort brought everyone together to create a new, shared vision for the future of specialty pharmacy services, aiming to provide excellent patient care throughout the process. 

The Service Design Blueprint not only provided a snapshot of the current situation but also evolved into a valuable instrument that facilitated collaboration among various teams and stakeholders. It steered their attention toward addressing future requirements and mapping out subsequent actions. 

Health and Well-being Company 

This health and well-being company used service design to improve how they offer care to their members, particularly those going through significant life events like becoming a parent or moving. With our help, they developed easy-to-follow care checklists that members could access through the company’s online portal. These checklists were designed to be engaging and helpful, initially for certain health plan members, with plans to expand these services to others in the future. 

The team created a prototype—a test version of the online experience—that showed what essential features should be included initially (MVP) and what could be added later (Beyond MVP). They also made a playbook to guide the future development of these services. 

The result was a service that not only made it easier for members to understand what benefits and support were available to them during tough times but also helped the company’s care advisors provide better support. 

Conclusion 

At Emids, we recognize the transformative power of service design and blueprinting. By leveraging these tools, we empower organizations to create user-centric, efficient, and effective digital services that drive meaningful outcomes for both customers and businesses. 

For expert guidance on service design with your product, contact our UX and Strategy Team.   

In Agile software development, speed and adaptability are critical, and a well-maintained backlog is a secret weapon for project success. This principle is especially true for Agile Low Code development, where a robust backlog serves as a strategic roadmap that guides development efforts and promotes efficient resource allocation. This article explores how a backlog optimizes Agile Low Code projects, highlighting its contributions to planning, risk mitigation, and prioritized task execution. 

Why Backlogs are Essential for Agile Low Code Development 

A robust Agile backlog serves as the project’s compass, guiding the team through the Low Code development journey. Here’s why it matters: 

• Efficient Planning: Low Code moves quickly; very quickly! A well-populated backlog ensures that the team has a clear roadmap. It outlines the features, enhancements, and user stories that need to be addressed. Without this roadmap, development can become chaotic, leading to missed deadlines and scope creep. 
• Risk Mitigation: Low Code lends itself to proof-of-concept (POC) prototyping. By capturing a comprehensive set of requirements upfront in a POC, the backlog minimizes the risk of surprises during development. It allows the team to identify potential challenges early on and allocate resources effectively. 
• Prioritization: Backlogs help prioritize work items. The Product Owner collaborates with stakeholders to rank user stories based on business value, complexity, and dependencies. This prioritization ensures that the most critical features are addressed first. 
• Dynamic Backlog Management: Low Code platforms provide the flexibility to make quick changes. In an Agile environment, where the backlog is continuously evolving, this ability to swiftly modify and adapt is crucial. It allows teams to respond promptly to feedback from sprint reviews or changes in business priorities. 

The Low Code Advantage: Rapid Application Development 

Low Code platforms have revolutionized the way applications are built. These platforms empower developers to create functional software with minimal hand-coding, significantly reducing development time. The key advantage of leveraging low code in healthcare is rapid application development—a boon for businesses aiming to stay ahead in the competitive healthcare market. 

Here’s how the backlog plays a pivotal role in this context: 

• Story Refinement: Before development begins, the backlog undergoes story refinement. The team collaborates to break down high-level requirements into granular user stories. These stories are then estimated, ensuring that they fit within sprint boundaries. 
• Ready for Development: At least two sprints’ worth of stories should be ready for development. This preparation allows the team to hit the ground running. When the sprint starts, developers can focus on implementation rather than spending time clarifying requirements. 

Collaboration and Alignment: The Foundation 

Before embarking on a Low Code journey, alignment among key stakeholders is paramount. The Business Analyst, Product Owner, Client Architect, User Experience Engineer, and Client Engagement Lead must be in sync. Their collective understanding of project goals, user needs, and technical constraints ensures accurate requirement capture. This collaborative effort populates the backlog with actionable items, setting the stage for successful Low Code development. 

A well-structured backlog acts as the compass guiding Agile Low Code projects toward success. It enables teams to swiftly transform ideas into functional applications, all while maintaining alignment and collaboration across roles. So, next time you embark on a Low Code venture, remember: a well-prepared backlog is your secret weapon!  

If you’re ready to advance your projects with a partner who understands the intricacies of healthcare solutions, Emids is here to help. Let’s connect your vision with our expertise and embark on a journey to redefine the health landscape. Contact Emids, and together, we’ll turn the possibilities of today into the impactful health care solutions of tomorrow. 

As organizations recognize the importance of creating inclusive environments for those with disabilities, they may struggle with where to begin. At Emids, we used a systematic approach to evaluate our current state of accessibility and developed a strategic plan for improvement. By sharing our story, we hope to inspire other companies to work towards maturing their accessibility culture, while also seeing the value in doing so.  

Exploring Accessibility Maturity Models 

It is critical to assess our current state of accessibility before we try to improve it. To do this, we reviewed different accessibility maturity models (AMMs). An AMM is a ready-to-use self-assessment tool that allows organizations to evaluate their current state of accessibility, while curating a roadmap for the future.  

There are a variety of accessibility maturity models that are publicly available. When choosing the model to adopt, we considered various factors. We evaluated which models’ dimensions best suit our needs. We also considered complexity and viability, such as the required resources for evaluation using the model. Lastly, we considered the guidance and clarity that was provided on how to use each model.  

The Digital Accessibility Maturity Model (DAMM) best suited our needs at Emids. This model, similar to a rubric, consists of five dimensions scored using five levels. The dimensions and their corresponding goals are as follows:  

• Vision: The organization has a clear vision about why and how it is adopting accessibility. 
• Leadership: The organization is committed to investing in people and resources needed to deliver its vision. 
• Processes: Accessibility activities are embedded in every stage of the project development lifecycle. 
• Capability: The organization has the skills, tools, and resources to deliver its vision. 
• Procurement: The organization ensures that purchasing decisions are compliant and contribute to its vision. 

Researching our Current Accessibility Landscape 

By following a roadmap to keep us on track and accountable, we evaluated the model’s dimensions based on the five levels. We started with secondary research to better understand accessibility and best practices to curate a mature accessibility culture within organizations. For instance, we assessed industry standards and other leading companies’ accessibility initiatives. We looked inwards to see what exists within the organization when it comes to accessibility (e.g., training, tools, policy, etc). Then, we held interviews with leadership to get their perspective on the state of accessibility and asked them questions relevant to the model to better evaluate it. Lastly, we implemented targeted employee surveys across distinct teams to achieve a comprehensive assessment of accessibility within the organization.  

Recommendations for Building an Organization’s Accessibility Program 

In the journey to creating an all-encompassing accessibility program, there are several foundational building blocks that organizations should consider. Based on what we learned from the organization-wide audit exercise, we propose that organizations focus on these five building blocks: Leadership, education, culture, policies, and tools. 

Leadership  

First and foremost, leadership plays a pivotal role. It’s not sufficient for leadership to merely give approval or the proverbial “green light”; they must actively drive the initiative towards accessibility maturity. Achieving accessibility isn’t a passive endeavor—it requires leaders to champion the cause. Having leadership buy-in ensures that there’s ownership, accountability, and a continued emphasis on prioritization and awareness throughout the organization. For example, having an executive sponsor in the organization to support accessibility initiatives and secure a budget for implementation can significantly benefit an organization’s accessibility program. 

Education 

Education is another significant pillar. To foster a culture of accessibility, organizations need to devise a clear education plan marked by regular, efficient initiatives. This will not only build awareness but will also ensure that accessibility remains at the forefront of company conversations. Starting with foundational education on subjects like accessibility, diversity and inclusion is crucial. These topics should then be incorporated into mandatory trainings for all employees. Once a baseline understanding is achieved, the learning journey should be furthered through additional initiatives, such as workshops and inviting guest speakers. It’s also pivotal to encourage team and role-specific education. Making educational resources readily available and promoting spaces where knowledge can be shared will bolster the learning curve. 

Culture 

Shifting gears to culture, every organization aiming for inclusivity should prioritize building a network of champions and allies. These are individuals who are not only passionate about accessibility but are also committed to driving the initiative forward. Ideally, these champions should be integrated into a Diversity, Equity, and Inclusion (DEI) group. After all, true inclusion is impossible without considering accessibility. By empowering these champions with the right knowledge and tools, they can become experts on the topic and lead the charge. 

Policies 

On the front of policies, organizations need clear, enforceable, and adaptable guidelines. Every policy should come with a severity rating, educating employees on the potential consequences of breaches. Exceptions to these policies should be rare and only granted through formal requests to leadership following a standardized process. Moreover, whenever new policies are introduced, they should be promptly communicated. It’s essential that employees are clear about what’s expected of them, particularly in terms of their roles and responsibilities around accessibility. 

Tools 

Lastly, in terms of tools, employees should be provided with all the necessary resources to seamlessly incorporate accessibility into their daily roles. Standardizing which tools are to be used by specific roles ensures consistency and efficiency throughout the organization. 

The Path to Improvement 

It is worth highlighting that there is no one-size-fits-all model. Depending on an organization’s structure and goals, adopting multiple models for its accessibility maturity assessment might be necessary. Also, we understand that the Digital Accessibility Maturity Model (DAMM) goes beyond a one-off application; it can assist us in creating a roadmap and tracking our progress. Like other initiatives, trying to implement all five dimensions at this stage could be overwhelming. Instead, our approach is to prioritize one or two dimensions at a time. Following best practices, we begin with vision and leadership. Finally, setting reasonable goals will serve as motivation for timely progress. 

Now, more than ever, our company is motivated to improve our culture, since we have a tangible plan using the model and applying best practices. With a well-defined plan and prioritization, we can surely improve our accessibility program. We encourage other companies to follow this path – assess where you stand, create a strategic plan for improvement, and start making that positive change. Inclusive future begins with your action today. 

Behavior change is the new frontier in healthtech 

Globally, seven out of the 10 leading causes of death are a result of – or exacerbated by – unhealthy behaviors. This is not lost in healthtech where the market value of mHealth apps currently sits close to $50 billion and is expected to more than double by the end of the decade.  

In traditional healthcare and public health, interventions to improve health behavior can vary in degree – from hands-on, in-person programs, overseen by medical professionals to more subtle, structural interventions such as the addition of a walking track in a local park. To attest to the effectiveness of these types of interventions, we can rely on decades of evidence. 

In the digital realm, the relationship between evidence and implementation is less fortified. While some health behavior apps can proport to be science-backed, the reality is, not every organization has the benefit of a Chief Science Officer or a behavioral design team to help drive product design decision making.  

What is Behavioral Design  

In healthcare and digital health, behavioral design focuses on creating technologies and interventions that encourage healthier behaviors. It leverages insights into how people make health-related decisions and form habits. The goal is to design apps, devices, and systems that are more engaging and effective at promoting positive health behaviors, such as regular exercise, healthy eating, medication adherence, or chronic disease management. By understanding the factors that influence behavior, these designs can effectively encourage patients towards better health outcomes, making it easier for them to adopt and maintain healthy habits.  

So how does a product team decide what to build if they lack behavioral design expertise? In this regard, the Behavioral Design (BxD) team at Emids has created solutions – built on years of research and practice – to enable teams to make better decisions when designing digital solutions aimed at helping people lead healthier lives. 

What is the Emids Behavioral Design Framework 

The Behavioral Design Framework (BxD) is a set of guiding principles aimed at facilitating the design and evaluation of optimal user experiences to elicit positive health behavior change. BxD is built upon a multidisciplinary approach, integrating insights from cognitive sciences, behavior change techniques, gameful design, and gamification. It’s applicable across various digital products or services that engage individuals and promote sustained behavior change. The framework includes defining product direction with behavior change strategies, creating or reimagining products with a behavioral design lens, and evaluating existing products against 12 best practice behavior change principles. 

The 12 principles capture the most effective aspects of digitally inspired behavior change and these are layered against 4 user-product stages that allow us to present the right interaction in the right moment of the journey.  

For a deeper dive on Behavioral Design consider these 8 Behavior-Change Design Tips. 

Considerations for Getting Started 

Consider best-practice principles – and then go beyond 

Download any well-reviewed health app, and the same behavioral hooks exist. They’ll ask you to set goals, show you feedback on your progress, send you motivational reminders, and reward you when you reach your targets. In today’s competitive health app market, these principles are the bare minimum expectations. When designing for behavior change there are additional principles, linked to evidence-backed theory, that can make your solution more effective in the long-run.  

One often overlooked mechanism is that of human connection. Research shows that support from a shared-experience community increases an individual’s capacity to change their behavior.  Product teams might be cautious to implement any social component, especially one they need to moderate. But human connection doesn’t have to be an ad-hoc social network. Knowledge of others on the same journey can be just as powerful. 

Health behavior also doesn’t take place in a vacuum. The environment around us can impact our actions. If there’s a thunderstorm outside, no level of motivational messaging from our phones will make us brave the harsh conditions and go for a run. Health apps need to account for the environment and adjust their service accordingly. 

Human connection and accounting for the environment are just two additional principles to consider. The important thing to keep in mind is to truly impact behavior, a digital product needs to include techniques outside the standard pale of ideation. 

Be conscious of how and when you implement behavioral principles 

Whether considering goal-setting or human connection, how and when behavioral principles are implemented can decisively impact the effectiveness of the app.  

The Emids BxD team asks guiding questions specific to each principle they recommend to ensure it is executed correctly. However, it is always important to integrate user research analytics for measuring the success of a feature as a starting point. 

For most product teams, the simplest place to start when implementing a behavioral principle is to consider the journey an end-user goes through when using a health app as described in this article. The most common error most health apps make is showcasing their behavioral principles at the wrong time.  

Consider an app, in which during onboarding it asks you to set goals and link your smart devices for enhanced feedback. Here’s the thing, health apps require a more rigorous explanation of their features, how they impact the health outcome, and especially health data transparency. Jumping straight to goal setting without educating users on its benefit to the end outcome or asking to link devices without showcasing your commitment to data privacy is – simply put – bad user experience, and will work against you when trying to get individuals to trust and engage with an app. In short, you can work with the best science, but timing is essential.  

Deciding which principles are most relevant for an app, how to implement them, and when they are best executed are vital to ensure the optimum user experience and to facilitate positive health behavior change. For expert guidance on behavioral design with your product, contact our BxD team.  

In today’s rapidly evolving technological landscape in the healthcare sector, developing a product that positively impacts both the end user and the developer is crucial. This necessitates building the product correctly, but often organizations are faced with the challenge of navigating through various factors impacting the process. A process that encompasses fostering a high-performance engineering culture, implementing effective metrics and encouraging innovation.  

During the ‘New-Now Studio’ roundtable discussion at the Emids Healthcare Summit 2023, we gained some fascinating insights from healthcare leaders on the importance of ‘Building product the right way’. The conversations explored deeper into the different elements that are essential for creation of robust and user-friendly products that align with market needs. 

Fostering A High-Performance Engineering Culture 

The creation of high-performance engineering teams is fundamental to success. This process requires a multifaceted approach, beginning with instilling a sense of purpose within the team. Leaders play a vital role in removing barriers to progress, ensuring alignment of goals and dedicating themselves to the success of each team member. A hallmark of these high-performing teams is their discipline, particularly exemplified by a commitment to avoid multitasking during meetings and sprint ceremonies and understanding the disruptive impact of “hero culture” on team dynamics which can often skew team performance. 

Equally important is striking the balance between prescriptiveness and autonomy. Teams need enough structure to stay on course but sufficient freedom to innovate and express their creativity. This equilibrium is essential for sustaining high performance without stifling the creative spark that drives technological advancement. 

Effective integration of new members into these high-performance cultures is another critical aspect. Through extended peer mentoring and buddy systems, new team members can seamlessly become part of the team’s dynamic. This not only helps in upskilling but also in ensuring that the team’s culture of performance and innovation continues to thrive with each new addition. 

Metrics and Measurements: Key to Efficiency and Productivity 

It is imperative to define the right approach for assessing the efficiency and productivity of engineering teams which is core to the right product development. The “Say Do Ratio” is one of the most critical metrics that enables leaders to ensure team accountability for their commitments. Moreover, establishing a baseline for team productivity is essential to demonstrate to teams their potential especially in fulfilling their goals under challenging conditions. Building this 1:1 ratio fosters trust both across the team and with clients, while enabling more accurate forecasting of work. 

Team Configurations and Coaching: The Art of Success 

Setting up a product for success involves strategically configuring and coaching your team, a process that leans more towards art than science due to the human element involved. Understanding and leveraging the unique talents within the team is key. Team configuration is an important factor and using complementary rather than competitive skills often result in heightened productivity. For high-performing teams, harmonious collaboration is essential. It is essential for leaders to promptly identify and address personality conflicts to maintain team cohesion and chemistry, which are critical for successful project delivery. While it’s not necessary for team members to be close friends, professional cooperation and mutual support are imperative. This entails coaching and modelling the right mix of collaboration and trust, rewarding the desirable behaviors and discouraging counterproductive ones. In today’s remote first world and work environment, creating a sense of belonging through shared experiences and perspectives is vital for building connectivity and a shared sense of purpose among distributed teams.  

Agile Rituals and Ceremonies: Enhancing Engineering Processes 

The importance of agile rituals in product development cannot be overstated, as they are instrumental in enhancing team efficiency and ensuring a streamlined engineering process. Agile rituals provide a structured yet flexible framework that guides teams in adapting to changes quickly, promoting continuous improvement and fostering a collaborative work environment. Implementing these rituals effectively is key to building products correctly and efficiently. 

One of the best practices in this domain is fostering team autonomy. By allowing teams the freedom to customize agile ceremonies, they remain engaged and committed, provided they adhere to their say-do ratios. This balance of autonomy and accountability is crucial in maintaining productivity and meeting project goals. 

Additionally, innovative approaches like the adoption of cross-departmental continuous improvement challenges, similar in nature to hackathons, have proven to be highly effective. This strategy involves engineering teams in addressing challenges outside their usual domain, stimulating creativity and broadening their perspective. Turning these challenges into a friendly competition with appropriate incentives not only addresses complex business issues but also enhances team building and interdepartmental collaboration. This method effectively creates a dynamic work environment where problem-solving and team unity contribute to the overall success and growth of the organization. 

The journey to establishing a high-performance engineering culture in software product development, though challenging, is achievable through alignment on vision, mission and core values. Setting precise, motivating goals is fundamental to igniting high performance in teams. These elements should not just be theoretical but the driving force behind every action and decision.  

A heartfelt acknowledgment to the participants of our roundtable discussion, whose valuable insights and contributions have helped shape this article. We thank:

• Marie Lamont – VP, Integrated Health Practice, IQVIA
• Karen Carlson – COO, NHPRI
• Michael Resenthal – VP, Software Engineering, Surescripts
• Raj Sethuraman – CPTO, Finvi
• Navaneetha Selvaraj – Software Engineering, Finvi
• Jung Kim – ex-Director, Healthcare Analytics, ex-Gainwell
• Ed Liebowitz – CPO, Solera Health
• Jerry Dennany – CTO, MatrixCare 

The advent of Generative AI in healthcare marks a pivotal shift in the industry, heralding a new era of technological advancement and innovation. As we stand at the cusp of this transformation, it’s imperative to grasp the full spectrum of possibilities that GenAI brings to the table.  

This article aims to unravel the intricacies of GenAI implementation, guiding healthcare organizations through the maze of choices and strategies available. From understanding the basic models of application to mastering frameworks for integration, we’re set to explore how GenAI can revolutionize customer interaction, operational efficiency and the overall landscape of healthcare services.  

Embarking on this journey requires not just a technological shift but a holistic reevaluation of operational, strategic, and human resource paradigms. Herein lies a roadmap for navigating this exciting yet complex terrain, where innovation meets practicality, and futuristic visions become tangible realities in healthcare. 

Watch Tarun’s talk on Implementing Generative AI in Healthcare from the Emids Healthcare Summit ’23

Implementation Flavors

The adoption of GenAI presents a range of implementation strategies, each tailored to fit different organizational needs and capabilities. As we delve into the specifics of these strategies, it’s crucial to understand the context and framework within which they operate.  

These models represent a spectrum of possibilities, from the simplest to the most complex, and offer insights into how healthcare organizations can navigate the evolving landscape of GenAI technology. 

Consume 

This is the most accessible approach for businesses. It involves leveraging pre-built applications powered by large language models (LLMs) such as GPT-4. This model is ideal for small to medium businesses or those new to GenAI, offering a low barrier to entry. This model is best for those looking to enhance existing processes or offer improved customer service through AI-driven chatbots, content generation, and automated workflows. 

Hybrid 

A blend of off-the-shelf solutions and customized applications, this approach appeals to businesses seeking a middle ground. Companies might use a base model from providers like OpenAI but customize it with their own data, tweaking it to suit specific business needs or to address unique market demands. This model allows for greater flexibility and differentiation from competitors who might also use off-the-shelf technologies. 

Native  

This is the most advanced and resource-intensive approach. Large enterprises or technology-focused companies might opt to develop their own LLMs and GenAI stack. This provides unparalleled customization and control over data and algorithms, making it ideal for businesses with unique needs that cannot be met with existing solutions. However, it requires significant investment in terms of money, time, and expertise. 

Choosing the Right Implementation Flavor 

Selecting the right approach depends on factors like budget, desired speed of deployment, security concerns, and the intended impact on business processes and customer experiences. Small businesses might prefer the ‘Consume’ model for its cost-effectiveness, while larger enterprises may lean towards the ‘Native’ model for its customization capabilities and data control. 

5 Point GenAI Framework

As you venture into the realm of GenAI, a structured and strategic approach becomes pivotal for successful integration.  

In this section we’ll introduce a 5 point framework, designed to guide organizations through the complexities of embedding GenAI into your products and services. This framework encompasses critical aspects such as financial planning, user experience redesign, risk management, operational maturity and workforce transformation. 

Each point in this framework addresses a fundamental area of focus, helping organizations mitigate associated challenges and adapt to the evolving technological landscape.  

Baseline Investment Appetite 

When contemplating the incorporation of GenAI the primary consideration should be to baseline your investment appetite. A common misconception is that integrating GenAI into existing web and mobile apps is as straightforward and cost-effective as attaching an API. However, the reality is far different. Deploying GenAI, especially models like GPT-4, can quickly become a significant financial commitment. 

For instance, consider an application with just 10,000 daily active users interacting ten times per day with a large language model like GPT-4. This scenario would result in around 100,000 daily transactions. While the daily costs might seem manageable at first glance, amounting to approximately $4,500, the annual expenditure escalates to about $1.6 million. This figure is substantial, even though it might be less than the cost of employing a team of machine learning engineers or developing a proprietary model. 

Therefore, it’s crucial to engage in thorough worst-case scenario planning.   

Reimagine UX Strategy 

The integration of GenAI demands a fundamental reimagining of your user experience (UX) strategy. Unlike traditional web and mobile app development, incorporating large language models (LLMs) introduces new complexities. These include potential latency issues due to internet-based API interactions and the inherent unpredictability of AI responses. 

LLMs are stochastic by nature; meaning their responses are probabilistic and not guaranteed to be consistent. This variability poses a challenge in maintaining a uniform user experience. However, as the technology matures, new frameworks are emerging to address these challenges. One notable example is guardrails ai, which allows developers to quantify expected responses from LLMs. If the response deviates from the anticipated outcome, a subsequent call can be made to adjust it. 

In addition to technical solutions, a significant aspect of reimagining UX involves adopting a ‘defensive UX’ approach. This approach involves designing systems that clearly communicate to users that they are interacting with AI. Major cloud providers and tech companies like Google, Microsoft, and Apple provide guidelines and strategies for building AI-powered UX. These resources, including detailed papers and design strategies can be invaluable for teams looking to integrate GenAI into their web and mobile applications. 

Understand and Manage Risks  

Addressing and managing the risks associated with GenAI is a critical aspect of its implementation. While there are numerous potential risks, a few recurring ones are particularly noteworthy: 

1. Bias in AI Responses: Since GenAI models are trained on vast datasets, they can inadvertently produce biased results. The exact composition of these datasets isn’t always transparent, leading to uncertainty in the AI’s responses. 

2. Prompt Injection Attacks: Similar to the older concept of SQL injection attacks in databases, LLMs face the risk of prompt injection attacks. Here, the prompts can be manipulated or injected with certain inputs to make the AI respond in unintended ways. 

3. Data Leaks and Confidentiality: When sharing sensitive or confidential company data with LLMs, there’s a risk of data leaks, potentially compromising important information. 

4. Hallucinations: This refers to the AI providing convincing, grammatically correct, but factually incorrect responses. These ‘hallucinations’ can be particularly challenging as they often appear credible. 

To mitigate these risks, several strategies can be adopted: 

• Reinforcement Learning Through Human Feedback: This involves training the model to reduce biases and improve accuracy based on human inputs. Tools like guardrails ai can assist in this process. 
• Adopting SOC 2 Compliant Models: For concerns about data leaks, using SOC 2 compliant enterprise versions of AI models, such as the one offered by OpenAI for ChatGPT, ensures better security and data privacy. 
• Defensive User Experience: Implementing a UX design that prepares users for AI interactions and manages their expectations can help mitigate the risks of misleading AI responses. 
• Mature Large Language Model Operations Tools: Enhancing the tools used to monitor and manage LLMs can help in identifying and rectifying hallucinations or other inaccuracies in AI responses. 

Understanding these risks and deploying appropriate strategies is essential for any organization looking to integrate GenAI into their operations. This ensures not only effective use of the technology but also safeguards against potential pitfalls. 

Mature your LLMOps Stack 

The fourth crucial aspect in effectively implementing GenAI is the maturation of your Large Language Model Operations (LLMOps) stack. As this field continues to grow, a plethora of tools are emerging, each designed to enhance the operational management of LLMs. These tools play a pivotal role in evaluating and refining the performance of your GenAI models based on various parameters such as cost, latency, parameter size, and the fine-tuning process. 

Key functionalities offered by these LLMOps tools include: 

1. Prompt Management: This feature allows technical and non-technical staff, including product managers, to experiment with different prompts, observe the responses generated by the LLM, and understand the nuances of AI interactions. This exercise is crucial for fine-tuning the prompts to achieve the desired outcomes. 

2. Version Control and Deployment: LLMOps tools facilitate versioning of these prompts, enabling you to maintain a history of changes and deploy the most effective versions directly through the LLMOps platform. 

3. Performance Monitoring: Another critical feature is the ability to monitor the performance of your applications that utilize LLMs. This includes tracking the effectiveness of prompts and responses, as well as the overall impact on app functionality and user experience. 

The continuous evolution of the LLMOps space promises more advanced and diverse tools, making it increasingly vital for businesses to stay informed and adapt their LLMOps stack accordingly. By doing so, they can ensure their GenAI implementations remain efficient, cost-effective, and aligned with their operational goals and user expectations. 

Rebuild Workforce Plan 

The final key element in integrating GenAI into your organization is addressing the human angle: rebuilding your workforce plan. This goes beyond the technical aspects of GenAI and focuses on the evolving roles and skillsets required in a workplace increasingly driven by AI technologies. 

When deploying GenAI applications, whether in customer service or developer productivity, it’s essential to consider: 

1. Role Evolution: How will existing roles transform with the introduction of GenAI? Understanding this will help in planning future organizational structures and functions. 

2. Training and Skill Development: What new skills and training will your workforce need to adapt to these changes and continue to progress in their careers? As GenAI becomes more prevalent, the demand for skills in AI management and interaction will rise. 

3. Career Progression: Consider how career paths might change with the integration of GenAI. This involves identifying new opportunities and career trajectories that GenAI can create for your employees. 

The process of rebuilding your workforce plan is not just about adapting to new technologies; it’s about preparing your human resources to thrive in an AI-augmented environment. This preparation includes upskilling, reskilling, and sometimes even creating entirely new roles to handle the unique challenges and opportunities that GenAI presents. 

In summary, while technical considerations like budgeting, UX strategy, risk management, and LLMOps are critical, equally important is the focus on the human aspect. Rebuilding your workforce plan in the context of GenAI is about harmonizing technology with human potential to ensure sustainable growth and innovation in your organization. 

Emids is here to support you on this journey. With our expertise in GenAI and healthcare technology, we can help you navigate these choices, ensuring that the integration of GenAI into your services and products is both seamless and impactful. Reach out to Emids and let us help you transform healthcare delivery with the power of Generative AI. 

Generative AI is an emerging and exciting frontier with the capability to transform healthcare. Combining the realms of healthcare with artificial intelligence, particularly through the lens of GenAI can open the door to new and innovative solutions for care delivery and enhanced operational effectiveness. While the transformative potential of GenAI in healthcare is immense, it’s crucial to navigate its challenges and risks cautiously.  

Designing GenAI with the user at the center is key as well as ensuring that the technology is intuitive and builds a solid foundation of trust. It is also important to harness its capabilities to address ongoing healthcare disparities for a more equitable healthcare landscape. Utilizing this technology to generate insightful, data-driven analytics can significantly enhance decision-making and patient outcomes. 

It is imperative to acknowledge the ethical and regulatory challenges posed by GenAI. This involves ensuring patient privacy, securing data and upholding data ownership rights. 

There is a need to develop standards and policies that ensure its safe and ethical use. While GenAI is a powerful tool, we also have a responsibility to use it wisely. 

Utilize the Potential of Generative AI

How do companies utilize the potential of Generative AI for their organization, while also protecting their members and patients’ data?  

We heard some interesting insights on this from key tech leaders at the ‘New-Now Studio – Design roundtable discussion’ at the Emids Healthcare Summit 2023. 

With an eye toward innovation, ethics and improved patient outcomes, let’s delve into how GenAI empowers individuals by offering personalized health data for informed decision-making with payers and providers, how it can enhance clinical decisions by utilizing extensive data and streamline administrative tasks to boost efficiency, thereby helping in cost cutting and improved patient care.  

Consumer-Centric Approach

GenAI has redefined healthcare by leveraging data analysis to tailor treatment plans, predict health risks and recommend preventive measures, significantly enhancing patient outcomes. This pivotal shift emphasizes a consumer-centric approach, prominently demonstrated through the implementation of chatbots for customer service. The remarkable transformations driven by consumer-oriented AI solutions are evident as AI-powered customer service dramatically reduces call durations, boosting both efficiency and satisfaction levels.  

Moreover, the integration of virtual health assistants, empowered by GenAI, delivers personalized, real-time support, fundamentally elevating and personalizing the overall member experience in healthcare settings. Training AI models to aggregate data for streamlined customer service is a meticulous approach that emphasizes accuracy and prompt issue resolution, which notably reduces call volumes by 10-15%, resolving queries within an impressive 1-2 minutes. 

Mental Health Care: A Shift Towards AI and Agility 

The COVID-19 pandemic has undeniably served as a catalyst for change in the traditionally resistant mental health space, pushing it towards technological adaptation. One of the primary issues lies in accurately matching patients to the appropriate level of care and centralizing access to referrals. The traditional methods of patient assignment and referral management have proven to be inefficient and often lead to delays in treatment. 

AI can streamline the prior authorization process, effectively saving nurses’ valuable time that can be better spent on patient care. By automating the administrative tasks, healthcare providers can focus more on delivering quality care to their patients. 

AI goes beyond administrative tasks, rapidly comparing documents and uncovering crucial insights. In mental health care, it swiftly analyzes patient records, influencing treatment paths. Its role in document analysis is pivotal, focusing on enhancing user experience through responsive feedback mechanisms. Analyzing patient feedback enables healthcare providers to align services with patient needs and expectations effectively. 

Collaboration and Balancing Human Expertise 

AI is aimed at enhancing patient experiences, complementing rather than replacing human expertise, fostering a collaborative approach for optimal outcomes. Concerns arise about its potential to replace human decision-making and raises a concern of job security.  

Preserving the human element alongside AI advancements remains crucial for balanced, empathetic decision-making in healthcare and it is crucial to actively engage teams using AI to navigate this transition effectively, fostering a sense of trust and understanding that will help in product designing and future planning. 

Revolutionizing Patient and Member Experiences through Human-centered Design 

Human-centered Design prioritizes understanding patients’/members’ needs by directly engaging with them to grasp their challenges and processes. Amidst concerns about optimizing provider services and reducing medical costs, technology teams and CEOs are reminded to understand patient and member needs and use it to inform patient/member experiences. This approach enables the identification of key areas for improvement based on their primary concerns. 

Barriers to implementing GenAI

During the pandemic, behavioural health providers shifted from resisting technology as marginalized individuals struggled to access care. This led to a grassroots initiative, virtually connecting patients with suitable providers, streamlining referrals and care coordination. Tracking metrics such as wait times and satisfaction notably improved care delivery. 

Implementing GenAI faces significant barriers, notably trust and transparency. The challenge is not about imposing technology but ensuring its relevance to real healthcare needs. Uncertainty persists regarding responsibility for patient data understanding and the importance of data quality for effective AI outcomes. Overcoming these barriers require trust-building, genuine problem-solving and data clarity. 

As GenAI takes center stage in healthcare, successful integration requires thoughtful consideration and an emphasis on improved services, teamwork and retaining human skills. 

Special thanks to the participants of the roundtable discussion whose valuable insights and contributions have significantly enriched the content of this article:

• Terry Goertz, CTO, Hansei Solutions
• Leah Briggs – Director of Product, CVS Health
• Milind Shah – Director of Engineering, Elevance Health
• Shankar Checka – Sr. Director of Technology, Lumeris
• Kim Corace – VP Transformation, Royal Ottawa Mental Health Center
• Linda Leigh Brock – VP of Product Management, NASCO
• Samantha Shahani – Staff VP, CX Member Engagement, Elevance Health
• Paul Cox – CEO, Magic Medical
• Gary Garber – Director, Safe Medical Care Research