Sanket Shah, the AVP of National Accounts at Blue Health Intelligence

The Next Wave of Healthcare Informaticists with Sanket Shah, the AVP of National Accounts at Blue Health Intelligence transcript powered by Sonix—easily convert your audio to text with Sonix.

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Saul Marquez:
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Saul Marquez:
Welcome back to the Outcomes Rocket, Saul Marquez here today, I have the privilege of hosting Sanket Shah. He’s the AVP of National Accounts at Blue Health Intelligence. He is a highly respected and experienced health care industry professional with expertise in health care data, business intelligence, organizational strategy, and advanced analytics. Over 15 plus years of progressive experience as a strategic thinker, Sanket is an executor with a history of scaling and driving, brand positioning of complex health I.T. solutions and growth-oriented environments, mature and emerging verticals. He’s well networked with a solid industry reputation as a trusted advisor and brand advocate who continuously diversified revenue streams via deep insight into the competitive landscape, market demand, risks, and customer value creation to solidify a dominant industry presence. He is just an incredible mind in the business of health care, performance history for him is directly related to health care’s most dynamic trends around data analytics, care management, coordination, population health management, value-based care EHR EMR. So he’s just doing an incredible job of that serving in the AVP role for Blue Health Intelligence, but also a clinical assistant professor at the University of Illinois at Chicago. I think the perspective that he brings is is really unique and I’m really excited to have him here with all of us. So, Sanket, thanks so much for joining us today.

Sanket Shah:
Thanks, Saul. Appreciate it. Thank you for having me.

Saul Marquez:
Absolutely. So before we get into the work that you guys are doing at Blue Health Intelligence and obviously listeners, you probably recall we had Swathi Abbott, who is the CEO of Blue Health Intelligence. We haven’t had a chance to listen to the interview. Please go ahead and take a listen. But before we dive into your take and the work that you and your team are up to Sanket at Blue Health Intelligence, I’d love to hear more about what inspires your work in health care.

Sanket Shah:
Sure. Yeah. I’ve been in this industry for, as you mentioned earlier, about 15 plus years. And what’s really inspiring for me is the ever so changing landscape within the industry, specifically from the technology side of things. We’re seeing just tremendous growth in terms of back from way, way back when we were kind of working with paper charging to the high tech to the EMR space, and then ultimately leveraging the data to provide better outcomes for our members and our patients. So that’s really, really inspiring to me. And kind of when you mentioned the University of Illinois Chicago program that I’m a part of, that’s really where I get most of my passion is listening to these students that are enrolled into the program, those that are looking to make a difference within the health care industry and really helping to guide some of the next wave of leaders. Listening from their perspective. They come from all walks of life, nurses and analysts, analytic folks, doctors you name it. They just getting their perspective on how they’re trying to tackle some of the biggest issues. And coming together to help solve some of those issues has been really inspiring for me. And I look forward to talking to them and working with them and really excited about just some of the great things that are coming out of the program and also within the space.

Saul Marquez:
For sure. And so you’ve got this unique perspective where you’re training and educating some of the rising talents as well as working in the industry. And so how would you say today, you know, the business Blue Health Intelligence is adding value to the health care ecosystem? And in particular, who is it adding value to?

Sanket Shah:
Sure. Well, what’s unique about BHI Blue Health Intelligence is that we have a very quite frankly, a sought-after asset. And that is one of the world’s largest health care claims databases. It’s conformed. It is being supported by our blue partner plants and within that warehouse and that database is essentially over two hundred million lives worth of data over 10 plus years. So you can imagine the types of analysis analytics that we can actually glean and insights from this dataset and what we’re doing that’s really unique with BHI taking a step beyond what I consider to be the traditional descriptive diagnostic analytics. really is what’s happening and kind of why it’s happening. But the industry itself is shifting and a lot of thought leaders and a lot of organizational leaders are really taking the next step of that journey and going from the diagnostic descriptive analytics more into the predictive space and the prescriptive space. So not only do I want to know what’s happening in life, having this kind of just part of business that nowadays. It is now well, what should I account for? What should I be looking out for in the next, say, three months, five years, and so forth? And then ultimately, what should I do about it? That’s what prescriptive analytics comes into place. And we’ve been heavily invested here and can be used to really bolster our analytic capabilities to help support our blue plan partners. And by way of that collaboration, certainly trickling down to the providers within the health systems that are engaged with the members. And ultimately, the beneficiary here is certainly those members. And our kind of goal here in BHI has always been using data to drive from decision making to lower costs for health care, but also certainly improve quality for our members for sure.

Saul Marquez:
And, you know, there are a lot of things that you guys do and the different tools and solutions that you offer. We learn about some of them with Swathi. And so I would love to hear from you more about some of the ways that you guys are doing things differently than what’s available traditionally.

Sanket Shah:
Yeah, absolutely. One of the key areas that we’ve been, as I mentioned, focusing, focusing in on, and this is where it all kind of goes back to the program as well at UIC. And just a little bit of a side note there. That particular program has been also evolving over time. And that kind of speaks to what’s happening within and within the industry itself. And that is there’s this need for data science, but more specifically, this concept known as data science for all, so that you don’t have to be an individual that’s behind a series of algorithms and try to make the best use of it and then ultimately disseminate information where it really doesn’t get acted upon. But shifting that thinking and really making it available to everybody so that anybody can come in and really analyze the data sets and then ultimately come up with those conclusions that are the most meaningful. And the reason why I mentioned that that example is we’ve taken that approach within BHI as well. And what we’re really doing is bolstering up our analytic capabilities by bringing in the right individuals, investing in the right technologies. For example, we’ve invested in machine learning solutions to take all the information that we have in that warehouse and we did earlier and really unearth those meaningful insights, but ultimately predict, as I mentioned, what is to be expected and what can we do about it.

Sanket Shah:
So that’s one way that we’ve been really differentiating ourselves is taking the data and not only just traditional data sets, such as claims information and bolstering it and augmenting that with other data sources of things such as social determinants of health, clinical data sets, taking all this disparate data, stitching it all together so that we can create a holistic picture for an individual. And when you have that all those pieces working together, what’s really unique about that is that those predictive indices and those that accuracy greatly improves over time. And you’re going to get some more. What we believe and what we are strongly advocating is just more actionable insights. So it’s great to know that this particular individual lives in a potentially underserved area. They don’t have access to a PCP because they don’t have any transportation. Well, what can we do about that? Well, here are some suggestions that the data suggests that the data is telling us that may influence this particular individual to go see the PCP. It could be a sharing program. It could be more outreach from a social worker or case manager, whatever the case may be. So these are the insights that many of the CEOs that we’ve been working with are really, really heavily wanting to bring in-house so that, as I mentioned, they can serve the community.

Saul Marquez:
Yeah, that’s neat. And, you know, I think about the payer model, you know, who pays for health care? It’s, you know, employers plans, government. And so, you know, thinking about who pays the bill and who gets the information right. So be interesting to hear from you Sanket around. Are you guys distributing some of these learnings to employers as well?

Sanket Shah:
Yeah, we work hand in hand and side by side, if you will, with our partners in terms of the information that’s disseminated out. I absolutely do work directly with our blue partners who in turn certainly are involved with the employers. When you asked a question about the kind of who pays for health care, I always have the lens of add-on I too am patient. So that is the end of the day. For me personally, I want to make sure that my experience is seamless. I want to make sure that the treatment that I’m getting is appropriate and I’m not getting sent off for unnecessary services that can be. Harmful. I also want to make sure that, you know, that I’m taken care of them at the end of the day. and not only from a health perspective but also from my wallet perspective as well. So it’s that kind of mentality that really shaped our approach. We take that patient-centric look at things. And when it comes to disseminating information, absolutely. We do talk directly with our plan partners or other clients that we have partnered with. And again, the end goal is really to get the information out to those individuals that are making a difference, but ultimately those members that will benefit from these analytic insights, again, just to improve the quality. It’s a win-win for the entire community to continue with the story out for sure.

Saul Marquez:
I could see that. And so how about around COVID? Right. And some people are saying we’re going to have another resurgence of it. Are there any things that you guys are doing to help health systems and plans prepare for that?

Sanket Shah:
Yeah, we are. We have had the data starts to become more available. And there’s a lot of publicly available sources as well. Of course, we are tracking kind of these hotspots. We are tracking how COVID has really impacted the industry.

Sanket Shah:
I mean, it’s no secret that you’re seeing, for example, less utilization of services for routine care, for example. And one of the things that we’ve been looking at is what does that impact long term? So, for example, you know, during this pandemic, you may have not decided to go get your colonoscopy. You may have decided that for your children you’re going to wait on those yearly vaccinations and so forth. So, you know, those have potential impacts. And what does that mean for that particular individual if they’re not getting that routine care? How do we educate? How do we engage them to continue their course, quite frankly, for care? And those are some of the things that we’re really looking into to see what are some potential impacts that could arise from the pandemic. In addition to that, just looking for an analytic perspective, we’re also tracking looking at those particular profiles of individuals that have been diagnosed who may be a potential individual that could be highly susceptible to being diagnosed. Using all of the information that we have based on their genetic makeup, I should say, excuse me, the clinical make of previous history and other pertinent clinical markers. These are some of the candidates that could be, you know, impacted if another resurge were to make its way here to the states and into the local markets. So we’re tackling that in a variety of different ways. We certainly are keeping an eye out on what’s out there publicly, but we’re also leveraging the data that we have in-house and along with working together with the Association of Plans to really provide more direct insights for those members that we serve.

Saul Marquez:
Yeah, that’s super interesting. Yeah. And you know that that is a challenge. Right. And you think about all of the care that is not happening, the routine care, those checkups, those colonoscopies, the vaccinations. I mean, this stuff builds up and could become a second wave of concern from this pandemic.

Sanket Shah:
Yeah, I mean, there’s this whole thought process of, you know, I’ll give an example. I mean, during this pandemic, I probably should have gone and taken my routine physical. And I just didn’t you know,

Saul Marquez:
I didn’t either,

Sanket Shah:
I should have probably done it, but, you know, I wasn’t ready to do it. There’s a lot of consumer preference there. You know, it’s like maybe it’s not the right time. And by the way, you know, I’ve had a couple of friends that have the whole experience has changed. For example, now you’re not just kind of walking in and then checking in here. It’s no, you got a call from the parking lot and maybe this one example, sit in your car and then you get a text message and you come in and you get a temperature check. So the experience has changed, quite frankly, as well. And that could be also a turnoff for many individuals. You know, it’s too much just to get my routine exam done, and I don’t want to go through that again. And so these are these kinds of consumer behaviors that experience all coupled. And it’s challenging. Then on the flip side of things, is that when it’s time to kind of get this information, you know, hopefully, it’s not too late, but it’s like, OK, well, now some time has passed.

Sanket Shah:
I’m comfortable to go back in there. How are the health systems reacting to that? Are they getting overwhelmed with all of these resurgences of certain care that needs to be done? So, you know, I’ve got 40 colonoscopies that I have scheduled, that I don’t have enough bandwidth and time to get that all done. So, you know, you’ve got that kind of supply-demand slash load balancing that you have to deal with the health systems perspective as well. So it’s going to be interesting to see how it all shakes out. But I can tell you certainly that these routine visits and well visits have declined. I mean, there’s no doubt about it. It’s just a matter of how do we not lose sight of that from a patient perspective, but also from those that are helping those individuals to encourage them to come back in and get those routine checkups and those that bloodwork done because if you don’t, there could be some dire consequences that we want to avoid.

Saul Marquez:
Yeah. Now, that makes a lot of sense, Sanket. Thank you for that. And you know, around the idea of business model innovation, what would you point to as maybe a thing that you’re most proud of that you guys have been able to do to make business better for your customers?

Sanket Shah:
Well, we’ve done a few things that I would probably look at our analytics as a game-changer, personally speaking, for not only the organization but for our clients. And leveraging a large dataset to produce meaningful and precise analytics has been quite beneficial not only for us, certainly but also for our partners. What’s interesting about that approach and we’re really proud of, is that especially when you’re looking at very, very rare cases, you know, certain, certain, you need a large and large database to really do meaningful analytics. And because we have a warehouse that’s 200 plus million lives spanning every geography within the US over 10 plus years, we do have the volume to then really, really mine the data and really run it through some meaningful algorithms and build specific algorithms for those particular cohorts. And that’s been, in my opinion, quite advantageous, especially when it comes to information that most people don’t have readily available, especially as you mention rare conditions and diseases. So that does play a key role in that. In addition to that, we’ve been one of the solutions that we’ve rolled out as our identification stratification solutions in VHI. And that is really where I mentioned earlier about how we’re taking not only kind of what’s happening and segmenting this population across various risk factors, but more importantly, here’s what you should do about it.

Sanket Shah:
So here’s an example of where this is really valuable, in my opinion, is that a nurse manager, case manager has hundreds and hundreds of different cases to work with. Well, what’s interesting about this unique kind of approach is, well, you have hundreds of cases and maybe there are some folks that just don’t want to be engaged with. Maybe there is just kind of a list has no really any order or whatsoever. What we’re doing is we’re taking this information and it really unearthing those numbers that will be impacted the most by these prescriptive analytics. So here is an individual that is an ideal candidate for outreach. They’ll engage. They’ll be somebody that will benefit from your interaction. And sometimes you folks just kind of fly under the radar. So what we’re doing is really bringing these individuals up to the top of the queue so that those are the ones that are going to be the care very soon and engaging that strategy from a knowledge perspective. And that’s to me has been very interesting because, as I mentioned, it’s taking this huge caseload, really identifying and shifting it to focusing on those numbers that need the intervention right away and then essentially going out and making those outreach.

Saul Marquez:
That’s interesting. And so is this data prompt something that gets sent to the provider or does it get sent to the payor? And where does the message come from?

Sanket Shah:
Yeah, it’s a little bit of both, and yes to both questions. So the way we’ve tried it, what we’ve done is and the way we’ve approached it is we understand that nurse managers and case managers have various different point solutions of various different tools. And that’s where half the time is being spent is just kind of pulling up this screen to look at the member enrollment information to this screen to figure out what programs they’re in, pulling up this screen to see if they’ve been engaged in the care management program. So it becomes just overwhelming. And our approach is not providing them with another tool. Here’s another tool to kind of add to your toolbox. Our approach is we’re going to give you meaningful data and distribute it to you through API technology and integrate it with your existing work. So there is no extra tool. There is no extra solution. It is what you’re already doing. And by the way, here is that pop up that comes up that says X, Y, Z that you need to know very quickly about this particular number and then ultimately integrating it with the existing operational flow that they have within the system. A good example of that in an ideal state would be if somebody calls into the team, you call the back of your insurance card about to get this particular surgery. And then this profile does come up where it does provide the member services individual and the nurse manager, whatever the case may be. So that permanent piece, those kinds of pieces of information so that sift through seventy-five different tools to kind of get that done.

Saul Marquez:
Wow, that’s really neat. So really, it’s the integration of the disparate data sources and then you integrate it into their workflow?

Sanket Shah:
That’s correct. Yeah, yeah. As I mentioned, it’s very difficult to kind of introduce new concepts, especially when you already have the reason why I brought up hundreds of cases, they have to hit those hundreds of cases. They can’t just, you know, not focus on a certain particular cohort. So the more time you kind of distract them with the more tools you provide them with, then there’s a give and take that right. And our thought process has been upgraded with what they’re doing so that we make the best use of their time and we make the best use of the time, quite frankly, as well. And then ultimately, those providers benefit as well because they’re getting the necessary information they need to then administer the right care. this concept of just why don’t you just take what I’m already doing, give me more information on it and automatically improve efficiency?

Saul Marquez:
Yeah, I love it. Sounds so interesting. Great example. Thank you for that one. Sure. And so, you know, these things are not easy to help. It is not easy. So I say that and wonder what is one of the biggest setbacks you’ve experienced and what was a big lesson that came out of it?

Sanket Shah:
Sure. And I did talk about a couple of ways. One of the biggest challenges is there’s just this shortage, in my opinion, of data scientists in the health care space. And I mean, if you try to go on a job search for I mean, they’re there, they’re posted out there. I mean, hiring managers and organizations are really trying to bring in talent in-house to take the information that they have available in their four walls and really make more meaningful use out of it. And to do that, you really need the right talent. And then actually within the program at UIC, we’ve heard that loud and clear from our students from years past. We built a healthy science track within the master’s program and it’s taken off. I mean, many, many students really gravitate towards that particular track because that’s kind of where the industry is headed. And so this lack of talent or the shortage of talent has become a focus area for many organizational leaders. And what they’re trying to do essentially is bring this information in-house and not only have that talent kind of provide those insights, but also disseminate that information throughout the organization.

Sanket Shah:
And that’s been a struggle, mainly because it’s just not enough individuals out there that do come into the health care space with that type of background. And now with just so much data that’s available, you know, especially you mentioned the EMRs information. You’ve got publicly available data sources, clinical data sharing. All that is a daunting task as you’ve alluded to. So finding those right individuals to put that puzzle together has been the primary focus. So that’s one of the areas that I think that certainly has been a challenge. And there’s been a call to action. And as evidence, as you can see, many of these industries are trying to really bolster their data science presence and their next-generation analytics, whether it be machine learning and some of the other obviously buzzwords that we call them. But there is some truth behind it in terms of AI and consumer-driven analytics. So that’s where one of the challenges certainly has been brought out to the forefront. And we’re and we also continue to really bolster our data science departments and staff as well.

Saul Marquez:
Well, you guys, this is your core competency right. I mean, you guys are this is what you guys do.

Sanket Shah:
It is. And we’re always looking for more and more tailored because there are always great ideas out there. We certainly have our own individual ideas that we’ve come up with and just give more kind of viewpoints. And the more expertise that we want to bring into the organization, only better as opposition, certainly. And, you know, many organizations are trying to do the same thing and they’re there on their journey that you never heard of. A chief analytics officer, a chief data officer back in maybe, say, 10 years ago or so. And you’re starting to see many organizations that are really putting these positions because it is very important. We’re in a data-driven world right now. And what is the strategy for data and analytics for organizations? Because without it, it’s going to be hard to survive. And so, so many organizations, as I mentioned, are really investing heavily into really bolstering that aspect of the business.

Saul Marquez:
Man, that is so true Sanket. Well said. Well said. I appreciate that perspective. And so the shift, it’s happened, you know, the divide between the way it used to be done, to how it’s being done today. You know, there’s been a departure. And so what would you say you’re most excited about today?

Sanket Shah:
Well, I’m certainly excited about more applications in terms of the analytics space. So right now, I think we’re very much scratching the surface. You hear a lot of folks saying that, oh, we’re totally an AI shop and, you know, really, what does that mean at the end of the day? You know, it’s nice to say, but, you know, kind of getting the theory into practice is really the hardest part. And so what I’m excited about is exactly just that. It’s taking this information that we passed and really making it meaningful and usable for all. And, you know, this is a journey. Don’t get me wrong. It’s not something that can happen overnight. But just seeing some of this, some of the insights that we’re pulling, it has been incredible, especially now that there’s just so much data out there that can be leveraged for, you know, as I mentioned, precise targeting and precise analytics. It’s it’s fascinating. And, you know, you’re starting to see kind of a shift where I mentioned a little bit about the clinical data, but then there’s consumer data that that’s really getting me excited. So things such as wearables, your phone, some of the vitals that it captures and just some of this data that’s been driven and created by the consumer itself and some of the behaviors coupling all of that into some of the analytics is going to be an extremely important step for the analytics within health care. And I’m just really excited to see it all come together. Many organizations are piecing these things together. VHI certainly heavily involved in that space. It’s just exciting to see where it goes next. And honestly, as the data science aspect is, more individuals becoming more familiar with analytics and educated about it, you’re going to see that rapidly move forward.

Saul Marquez:
That’s certainly exciting times when the analytics that you get are actionable, which is what Sanket is talking to us about today. That’s when the decision making power, the strategy you put together becomes so much more powerful and so Blue Health Intelligence. You guys could find them on the web at BlueHealthIntelligence.com, and obviously in the show notes go to OutcomesRocket.Health blue health intelligence, You’ll see Mr. Sasnket Shaher there. You’ll find the entire show notes and transcript. But this has been such a neat interview. I’ve really enjoyed it with you Sanket. Why don’t you go ahead and leave us with a closing thought and the best place for the listeners to get in touch with you.

Sanket Shah:
Sure. Yeah, well, I think one thing to look out for is this concept of the thought process that analytics are created in a silo and then kept in that guarded area is shifting. And what’s happening now is many organizational leaders down in the very top, down to the individual staff and supporting operational flows want data, They want analytics. They want information so they can, as you mentioned, make better decisions. And so this concept for data, for all our analytics, for all is really the shift that’s occurring. And you’re seeing that with technology stocks that used to be really meant for kind of these hard core coders and developers that’s now very user friendly. And anybody can come in and produce the report and anybody can come in and ask a question and get the answers that we’re seeking. And that ship is then moving into some of the predictive analytics and some of the prescriptive analytics mentioned earlier. So that’s where the industry is headed and that’s where I think many folks are very excited about and really want to be a part of an interview within BHI. That’s exactly what we’re striving for as we kind of evolve as well. And in terms of finding me, you can seek me by way of Blue Health Intelligence. You can look me up on Twitter @ITHealthProf or certainly visit the University of Illinois Chicago Health Informatics Web page if you’re interested in participating in the program and rolling. Take a look and feel free to reach out.

Saul Marquez:
Sanket, thanks for that. And listeners, there’s an opportunity to engage however you feel that this is the future and definitely always benefits us from learning more and becoming experts in that which will shape the future of health care. And with that Sanket’s invitation to engage on the UIC front, as well as the blue health intelligence front is there. It’s up to you to make that move. So Sanket just want to say thanks again for spending time with us. It’s certainly been an insightful time together.

Sanket Shah:
Thank you for having me. Had a great time. Appreciate it.

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