Improving Patient Care through Analytics
Episode 466

Manisha Gulati, Chief Operating Officer at Clarify Health Solutions

Improving Patient Care through Analytics

Using data analytics to help companies and organizations gain insights and apply it to the realities of healthcare

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Improving Patient Care through Analytics

Episode 466

Recommended Book:

A Fine Balance

Best Way to Contact Manisha:

Manisha Shetty Gulati

Mentioned Link:

Clarify Health

Improving Patient Care through Analytics with Manisha Gulati, Chief Operating Officer at Clarify Health Solutions transcript powered by Sonix—the best audio to text transcription service

Improving Patient Care through Analytics with Manisha Gulati, Chief Operating Officer at Clarify Health Solutions was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2020.

Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.

Saul Marquez:
Welcome back to the Outcomes Rocket. Today, I have the privilege of hosting Chief Operating Officer Manisha Shetty Gulati. She is working at Clarify Health, leading the commercialization and scaling of Clarifies Growing Payer Provider Solutions portfolio. She guides the achievement of customer impact as the leader of implementation and customer success teams and beyond the operations. For many years, Manisha has been passionate about improving patient outcomes and promoting the shift to value, something that’s top of mind of leaders today and everybody listening. Prior to Clarify, she spent more than 15 years with different types of health organizations in the U.S., Europe and emerging markets to improve performance and patient care. More recently, Manisha was a partner at McKinsey, working in health care across health systems, medical products and life science practices. She believes that every individual should have access to the best possible health care, and the only way we could do that is to address the underlying cost and quality issues that we face. Clarify is pioneering that path for payers, providers, and life science companies to better address those issues in a way that keeps the patient at the center. It’s a pleasure to have Manisha here on the podcast. She also received her MBA from Harvard Business School and a Masters in Public Administration from the Harvard Kennedy School. Manisha, I’m excited to dive into the work that you and the team at Clarify are doing. And more importantly, to to share the things that are making a difference in health care with the solutions you guys are providing, so thanks so much for joining us.

Manisha Gulati:
And thanks for having me. It’s exciting to chat.

Saul Marquez:
micro finance,Manisha, what is it that got you into health care out of all of the things? Why health care?

Manisha Gulati:
Well, after college, I started my career wanting to do international development. So I took off. I went to India and I was working at a foundation there. And originally, I was working across education, microfinance, livelihood. And I really wanted to address income inequality and give people access to a better life. But as I was doing that work, I kept seeing that much of the root cause of what was barriers to people was health related. So girls were dropping out of school because they had to take care of a sick relative or the microfinance program that we had for people to take loans to start a business. People actually were taking loans because they had a health emergency in the family and needed the money. And so as I worked in that space more and more, I felt like health care is a fundamental need that we all have as humans that is preventing people from reaching their fullest potential. And that’s when I became more and more interested in health care. And it’s interesting because even though it’s a fundamental human need, as I said, it’s actually every health care system is so different. And the way we’ve set ourselves up to meet that need is really different and with varying levels of inequality. And no one’s really gotten it right. You know, we have challenges in the US just like emerging markets do. So I just spent the rest of my career since then working in different health systems, helping to think about how do we help organizations change to better address health care and give access to health care for everyone.

Saul Marquez:
bench markedWow. Yeah. You know, it’s interesting to hear that, you know, you started with figuring out ways to give people loans through microfinance which is a really fascinating industry in itself. And you found health care was the crux of a lot of the problems, and and you acted on it right away. And now you’re you’re doing the work that you do at Clarify as the Chief Operating Officer. You know, at the beginning, we talked about access to data, analytics, being able to influence behavior and patient care. Give us what you feel needs to be front and center in the health leaders listening to today’s podcast.

Manisha Gulati:
Well, yeah, a lot has changed since I first got into health care to now. And I think the thing that’s been so exciting has been the amount of data and the way that we can process that data and the potential that has to have an impact in healthcare compared to the interventions that we were doing fifteen, 20 years ago in the healthcare space. And so in a way, data is democratizing what we’re able to do in healthcare. And so I think it’s really important for every health care leader to be thinking about personalization of health care at scale. You know, we’re all consumers of other industries and all of us are patients are health care consumers. And what we’ve gotten so used to in the rest of our lives in terms of big data and personalization of analytics, giving us convenience, giving us tailored suggestions even for what we want to buy. But as healthcare consumers, we’re still used to a standard way of being. So that could be as patients getting a standard set of care guidelines are being shuffled from system to system with no interconnectivity. But even for clinicians and caregivers, they’re getting bench marked to averages in terms of cost and quality and saying do better but without a way that’s easy for their workflow and that is tailored to how they treat patients and what’s most important to them. And so having a way to be able to take big data and turn it into something that’s actionable both for caregivers, for life science companies and for patients. I think that’s really important. And so how we’re able to do that in a transparent and open way will be really important. One of the things that makes Clarify different is the breadth of the data that we bring to a customer. So there are a lot of organizations that are doing algorithms and making risk predictions on customer data, but they actually have to come to the organization, ingest their data and then use their own data to be able to make those prediction. And the challenge is when you only have your own data as an organization, whether you’re a payer provider or a lifetime’s company with clinical trial data, you are only able to compare against the breadth of your own data. Right? The power of Clarify is that you’re bringing clinical claims, social behavioral determinants of health, lab data prescription. All of that 250 million lives of it to the organization. And we often join data with our organization as well depending on what they want to look at. But the power of having the expected outcome to be across that full breadth of data and then to be able to compare yourself to that and have that 360 degree view is really unique. And it gives people a much bigger window into what they can do than when they only have their own data to use.

Saul Marquez:
So so, Manisha, you’re saying that this data that is really I mean, initially a customer doesn’t have it, but when they work with you and Clarify Health, now they’re opening up doors and windows to data that wasn’t there to help inform the insights that they could make based off their data.

Manisha Gulati:
That’s exactly right. And the example is a life science company having clinical trial data and making decisions based on that. But then instead opening up a world of information about what’s actually happening to these millions of patients in real life that are taking their therapies or providers saying, I want to look at physician performance but I can only compare them to my own health system, whereas actually, if you can do a precise case mix suggested expected outcome, whether it’s length of stay or cost of an episode using the full breadth of the nation’s data and adjusting in the right and precise way for those patient cohorts, then you can actually be much more precise and actionable about what that organization or the physician needs to do differently.

Saul Marquez:
For sure. And what is Clarify doing in that respect, Manisha, to provide insights. How are you helping people provide insights with their data?

Manisha Gulati:
So Clarify is a software as a service company. And our ambition is to enable better patient care at better value for the health system. So it’s a lofty ambition. And the way that we’re doing this is by providing advanced analytics and care optimization technology. And the goal is for that technology to address the critical issues that are impacting payers, providers and the life science businesses. We believe that all of the parts of the healthcare system are very important to be able to make a change and that everyone should have access to the same types of data to enable better decision making for those organizations themselves, that it shouldn’t be proprietary in a closed system. So what Clarify has done is it starts with a foundation of data. So we’ve brought together over 200 million lives of patient data and joined them at the individual level. So that’s claims data, it’s clinical data, prescription data, lab data. And really, interestingly, also social and behavioral determinants of health data. So that same data that other industries are using to tailor what their responses and their approach to consumers are, we’re thinking about that in terms of keeping people healthier and giving it an actionability around preventing risk. So what we’ve done then is we’ve joined all of that data. We have an analytics and tech stack on top of it that we’ve brought from other industries. So our two co-founders have come from financial services and also from healthcare. And so the idea is that we bring together all the best technology from other industries, but apply it to the realities of healthcare. And then we use machine learning and AI to be able to then help improve physician performance, help treat patients better, help find patients for clinical trials and to help understand the impact. The real world impact of therapy is when you look at actual real life data.

Saul Marquez:
Yeah, it’s it sounds like you’re grabbing all of these data sets and filtering them through the analytics technology stack to provide insights.

Manisha Gulati:
Yeah, that’s right.

Saul Marquez:
So does that does Clarify help customers better understand what insights they want? For example, you might go into a provider or say a Life sciences company and they’re just maybe wondering where to go. Maybe they don’t know what they’re looking for. Is that something that you guys provide as well?

Manisha Gulati:
Yeah, absolutely. And so, you know, we have a range of solutions and some of them are more traditional in the sense that it’s something that every payer or provider would be doing analytics on and looking for. For example, patient referral patterns and things like that. And those are more straightforward. But other health systems are saying, like, how do we just up our game in terms of delivering better patient care and better patient satisfaction, but at lower cost? And how do we keep one foot in the value based care world? But still, we’re straddling fee for service. And, you know, we talk about value based care and it’s kind of like a ship that’s left the shore and it’s moving probably slower than what we imagine. But at the same time, most organizations are straddling both. And so they do ask us, you know, where do we start or how do we manage our bundles program in our aco program, but at the same time have a fee for service program on the side. And, you know, Life science companies are doing the same thing there. So they’re used to working with data and analytics. That’s their bread and butter, but expanding that data set to what’s out there and then thinking about what that means for how they work with payers, it’s still a question. And so a lot of times we do work with our customers to think about what are your ultimate goals in terms of patient outcomes, right? And in terms of cost. Because one thing that we feel is really important is that when you think about reducing cost, which is important in our healthcare system, which is, as we all know, the most expensive in the world, but how do you reduce costs while keeping the patient at the center of that and keeping quality at the center of that? And so that’s a lot of the discussion that we have with our customers, to be able to be a thought partner, but also really hear what’s important to them and then be able to tailor the analytics around what they need.

Saul Marquez:
For sure. Yeah Manisha, I love that. And, you know, one of the things that I …just thinking through the solution. And when you have a partner like you guys like at Clarify that works across the aisles with pharma, with providers, with payers, you actually do something that if you’re in one of those silos, you don’t actually get the benefit of. You get to hear what the conversations are on the other side of the aisle, in the other silos. And that in itself provides a lot of benefits as far as working with clients right, so I think it’s neat that your service has encompassed these different care areas because that in itself is a value in my view.

Manisha Gulati:
Yeah, and I truly believe that. I mean, part of the reason that in my whole career I’ve worked across life science fair and provider and global public health is because I think that if we all stay in our silos, like as you say, we’re thinking in a certain way and we’re acting in a certain way. And so, you know, forget bringing ideas and innovation from outside healthcare. Even within healthcare, we have our own silo ways of thinking. And ultimately, if we want to improve outcomes for everybody, we need to be able to break down those silos and be looking at the same data and be able to understand where the other organizations are coming from to be able to whether it’s get better value drug prices for the outcomes that they’re delivering in the real world or whether it’s patient care itself.

Saul Marquez:
Yeah. Now that’s brilliant. And yeah, I mean, even like us as having a conversation with with another gentleman. He is at digital marketing and he happens to manage accounts of very large retailers and they also do health care. So the insights that he’s able to provide across those silos is huge. And so very valuable, very smart way that you guys are doing this, Manisha. So you guys have been working on it for a while. And you know, one of the questions that I love to ask, especially of successful businesses and leaders like yourself, is what’s a setback that you had and what did you learn from that?

Manisha Gulati:
Well, I think over the course of a career there are many setbacks. And so but it’s but it’s good because they’re all learning experiences. I mean, I think one of the things that I would reflect on and it’s part of what led me here is that a lot of the work that I’ve done in the past with organizations when they’re first thinking about, OK, we need to get on this digital train and we need data on, yeah, we’re gonna be on top of this, is that everyone tried to create something proprietary. You know, and I was working with organizations to do that. Like, oh, we need app. Or we need to buy this data set, and the reality is, like as a consumer, do you really want an app from every pharma company that you take a drug from or every doctor that you’ve ever visited and have separate apps for all of them? Probably no right? Yeah, me neither. And that was like that was what everyone is rushing to do. And the same thing with buying data. You know, people are like, oh, we need these data sets and we need to have exclusive access to these data sets because then it will give us competitive advantage. And I feel like organizations and myself as well, we’ve spent a lot of time in that space. And even though I personally was feeling a tug of life, is this the right thing? And now, fortunately, I feel like most people have moved, shifted mindset at least to say, OK, well, it’s not having the data itself. That’s like the proprietary competitive advantage. They know exactly how the data should be accessible to everyone, but it’s what you do with it that drives competitive advantage and also that you should meet consumers where they are. Right. I mean, that’s what personalization is. You should if people don’t want to deal with health care in a completely different way than they do with the rest of their lives, either as professionals or as patients. And so I think in the industry, there’s been a lot of money spent on that kind of activity and really taking a step back that, understanding how things can be interconnected and people can all leverage the data that’s out there. And a better way is way more important than what we were doing five years ago.

Saul Marquez:
Yeah, that’s a great point, Manisha. Just thinking about this democratization of data now is where the power happens when the data’s available and more people and more companies get to take a crack of that. How do I make this more insightful and Is it doing a really, really fascinating job of of that? And so I wanted to ask you, you know, obviously the success is there. One of the proudest leadership experiences that you’ve had there that you feel the company has experienced today.

Manisha Gulati:
Well, there have been so many exciting milestones for us, but I guess I would pick thinking about our member risk management solutions. This is actually using social and behavioral determinants of health as well as a more complete clinical profile. So really it’s a 360 degree view of the patient. But using our large numbers of data to be able to build risk models that go far beyond what the current risk models in the industry are. So instead of saying that, OK, this patient has a risk of 22, we were able to deploy the solution and customers say, OK, well, it’s actually not just that the person has a risk score that’s high. It’s actually what is driving that risk. And how has it changed over time? And what is driving that risk could be anything from address instabilities. For example, if someone has changed addresses three times in the last year, that’s a higher prediction of risk than if they live alone, right? Whereas conventionally within people say, oh. Is there a caregiver at home or not? Right. And being able to look at all of the social and behavioral risk drivers at the same level that you’re looking at, clinical risk drivers and other things that we traditionally look at in health care is really powerful. And being able to work with customers to deploy that and find that actually we’re catching patients months earlier to be able to intervene, to ask the question, even simple things like how are you getting to your next appointment? And actually, if you look at that over time and if you take and if you look at what was happening, you know, a year ago versus now, I think it’s making a huge difference in patients lives. And so that is really exciting for us because it’s directly impacting how patients are being cared for. And we’re seeing real results of actually the breadth of the types of things you can do for that patient, but also how early you can do them and what the granularity of insight to make it actionable for that caregiver, whereas whether it’s a care manager or a clinician or even a family member.

Saul Marquez:
Yeah, that’s so key and great that the analytics that you guys are providing really do hone in on social determinants. I mean, it’s it is so clear now. And so if you are currently trying to make an impact in this area of social determinants of health and you can’t figure out maybe how to then start or maybe you have an idea of how to start, you just want to get better, I think the folks at Clarify are doing such a such a brilliant job there to make a difference. Because overall it you know, it does improve outcomes. It does save on cost. And just just a great, great area to consider them for.

Manisha Gulati:
Oh, I’m just going to say no. We we always it’s common theory that social and behavioral determinants of health drive 60 percent of outcomes for patients, but actually only 10 percent of health care expenditure is on that. And so, you know, we’re all working on it and it’s a journey to get it right. But I think it’s super important to be able to figure out how to do that in a way that’s really beneficial for everyone.

Saul Marquez:
Let’s get good at it.

Manisha Gulati:
Yeah.

Saul Marquez:
It’s a worthwhile area of improvement. Yeah, that’s a very interesting stats there, Manisha. I mean, with that 10 percent spend there. But and 60 percent results, I think there’s an opportunity to to do better. And what would you say is is the exciting project or focus that you’re working on today?

Manisha Gulati:
Well, we’ve been doing a lot on analytics in general as we’ve talked about, right, and that’s also improving cost and quality at a provider. As I mentioned, finding patients for clinical trials, helping payers think about building networks and finding the best doctors for their patients. And so all of that has been super exciting foundational work. And I think what we’re starting now or we’re in the middle of it. But it’s really accelerating is turning that into real time. So how do you take insights which are actionable, but then gives them, deliver them I would say to the person who needs it at that moment that they need it in the way that they need it and that, you know, sometimes it’s digital, but sometimes it’s a printed piece of paper and sometimes it’s a phone call. And so that is what we’re going through now. And we’re working with our our partners and customers to say, OK, if you take a step back and away from a single solution point of view and you say, how do you put all of this together? Power the breadth of the data and the tech stack on top of it but across a bigger range of solutions and then make it real time for the people who need it, that’s going to be even more powerful. And so that’s been but also complicated, right? I mean, getting workflow is something that everybody talks about. And people have had varying experiences integrating their electronic health records system. And so we’re approaching it with, again, a personalization lens. So how did this work for your organization and what’s the best for you? And so it’s a big area to move into. But we think it’s really important to be able to get that real actionability, which is the core of what we do.

Saul Marquez:
Yeah Manisha, I’d love to hear an example of this. Like what’s a case look like with the adjusted time kind of method. I don’t. That’s what I’m calling it. Not that’s the name of it.

Manisha Gulati:
Yeah. So it could be, for example, in the example I was talking about earlier, how does the care manager get that information, whether it’s through their system or whether it is by how we ask the questions just in time. So instead of having to dig through a bunch of data and say, I need to understand one hundred things about this patient, it’s actually real time as the care managers visiting that patient. Here’s the five questions you should ask that patient. And the other thing Clarify is looking at is from a provider perspective. It’s saying, OK, well, when I am a physician and I’m making real time decisions, So, for example, a patient walks in my door. I’ve never that patient’s never been in my system before, how do I know enough about that patient in a more 360 degree view way and not relying just on the form the patient’s filled out such that I can treat that patient better? And how do I have that information in front of me? Right when the patient walks in my door.

Saul Marquez:
Got it.

Manisha Gulati:
And life sciences are given examples of patient, recruiting patients for trial. So right now it’s a long process, right? And patients want to be in clinical trials when they have critical diseases particularly, but it’s only through the doctors. And you know, there are a lot of companies that are now starting up in this space, which is great. But if you’re able to not just be able to create a trial protocol that has very specific inclusion and exclusion criteria of the types of patients you’d want to see and then see where all those patients are and who their doctors are, which is what our software does, but then say, actually, how do I be able to ping those doctor and get them into my network and be able to catch those patients in a moment where they are interacting with the health system for the ones that do want to participate in the clinical trial and make and really accelerate that time to trials, but then also help patients that actually want to be in the trials with the information that they need.

Saul Marquez:
Love it. Some great examples. Thanks for diving into those. It really it really helped clarify the new program that you guys are working on. And so, Manisha, super interesting work that you and your team are up to over there. It’s time for the Lightning Round. And after the Lightning Round, a favorite book that you recommend to the listeners. You ready?

Manisha Gulati:
Sure.

Saul Marquez:
All right. What’s the best way to improve health care outcomes?

Manisha Gulati:
I would say break down the barriers between the industries within healthcare. Our incentives are not aligned to have everyone working towards the same goal of better outcomes and better value.

Saul Marquez:
Love it. What’s the biggest mistake or pitfall to avoid?

Manisha Gulati:
Trying to reduce costs without keeping the patient at the center of the decision making. It’s a lot of arbitrary cost cutting and talk about costs, but we’re not doing it in a sustainable way for the system.

Saul Marquez:
I will definitely…I love that one. How do you stay relevant as an organization despite constant change?

Manisha Gulati:
Well, as a growing startup, we are always in constant change. But I would say the way to remain relevant is to always be looking outside of healthcare for ideas and innovation and bringing that in a way that applies to healthcare so that we’re keeping pace with all the rest of the great innovation that’s happening.

Saul Marquez:
What’s an area of focus that drives everything at Clarify Health?

Manisha Gulati:
Clarify Health is really about offering insights which are actionable to our customers and really enabling every organization or every healthcare decision maker to have that actionable information at their fingertips so that they can make the best decisions for their patients or for their organizations. And that actionability is really what’s driving what we do.

Saul Marquez:
Love it. What book would you recommend to the listeners, Manisha?

Manisha Gulati:
This is a tough one. I usually read fiction outside of work because I love being able to see things from other people’s viewpoints. So I would say two: A Fine Balance by Rohinton Mistry and also The Power of One by Bryce Courtenay. And one is set in India in the 1970s during Indira Gandhi’s emergency rule and one is set in South Africa, about a little boy during apartheid who becomes a boxer. They’re both really amazing books. But I think for me it’s about seeing a different culture and a different world view through someone else’s eyes and perhaps a different time period, too. And to be able to immerse yourself in that, because I think that’s a real learning experience, that we’re always to take ourselves out of our own skin, to be able to see into other worldviews and windows. So what I would recommend.

Saul Marquez:
I think those are great recommendations. You know Manisha and in thinking about how we as health care leaders make an impact on the lives of the customers and people that we serve, whether it be patients or other businesses. This idea of putting yourself in their shoes, I don’t think we do it enough. And your recommendations lead, you know, the listeners to that is put yourself in their shoes, get out of your shoes and (Exactly) put yourself in their shoes, right. ah. Nice, It is powerful. I love your recommendation. And great ones for us all to consider. And listeners, obviously, you know, go to OutcomesRocket.health in the search bar type and Clarify Health. You’re going to find all of the resources we’ve discussed, including links to the books, a full transcript, ways to get in touch with Clarify. And so. Yeah, just go there and Manisha, time flies when you’re having fun. I would love if you could just leave us with a closing thought. And then the best place for the listeners could continue the conversation with you or somebody at the company.

Manisha Gulati:
Well, I love the way you put it, actually, to put yourself in someone else’s shoes, but really around, but doing that in a way where you’re thinking actually from the end result, what is it that actually we want to drive change around and actually how can we do that in a way that’s sustainable? And what information do we need to be able to do that in a real way? Because I do think we are making huge strides in how we think about quality of care. And it doesn’t have to be in such a rote way. And so I would encourage everyone to really think about that and think about the power of how technology is changing other industries and then really say, what does that mean for me and how could how could we do things differently?

Saul Marquez:
It’s a great message, Manisha. And and if the listeners wanted to learn more, where can they go or how can they get in touch?

Manisha Gulati:
There are many ways to get in touch with us. We have our website at Clarify Health Solutions. I’m free to take any listeners’ questions as well. And also through LinkedIn.

Saul Marquez:
Outstanding. There you go listeners. Reach out via the Web site, LinkedIn is another option. Manisha Gulati, Chief Operating Officer, Clarify Health. I mean, it just was an extraordinary conversation with you today. And just really thank you for the insights and ideas that you shared with us today.

Manisha Gulati:
Thank you. It was great to talk.

Thanks for listening to the Outcomes Rocket Podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration and so much more.

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