AI and APIs team up to solve provider directory problem for patients

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Ribbon Health’s AI technology powers Health Karma’s provider navigation and patient-friendly telehealth service.

In an age where the digitalization of healthcare turns parts of it into commodities, but outdated supplier directories continue to thwart successful patient-provider connections, some providers are stacking technologies like double-decker sandwiches to improve patient experience and navigation, aimed at reducing emergency room and emergency care center visits.

One example is the recent collaboration between patient navigation and the telehealth service. Health karma with the AI-powered application program interfaces (APIs) created by Ribbon health. Health Karma says its new service gives patients more accurate and reliable provider directories, as well as navigation that focuses on the specific specialties of providers that patients are looking for.

Ribbon Health’s technology approaches the problem of supplier directories differently from traditional approaches, which often end up flawed or stale.

“Ribbon brings together over 1,000 different sources of supplier data at any given time,” says Nate Maslak, CEO and Founder of Ribbon Health. “We have partnerships and data licenses, and are scratching the open web, open government data sets, whatever there is, to make sure it hits our system.”

Nate Maslak is the CEO and Founder of Ribbon Health. Photo courtesy of Ribbon Health.

The data collected is filled with duplicates and conflicting information. “We see over 50 phone numbers per doctor,” Maslak says. “And these are just phone numbers.” Physical addresses and accepted insurance plans may also return their own set of conflicting results.

Ribbon Health then applies machine learning to these datasets to predict what information about each vendor is currently accurate. “If 800 sources say Dr. Smith is at 123 Main Street, and 200 sources say she is at 400 University, what is the probability that one or both of those places are correct at that time?” Maslak said. “Our algorithms assign a trust score to this, and that’s what we deliver to our customers.”

Ribbon Health customers, such as Health Karma, receive their own copy of Ribbon Health data through the Ribbon Health API and can modify or edit that data as they see fit, Maslak explains.

Other Ribbon Health customers include Care Navigators and Insurance Brokers. “There are a lot of referral management workflows that we feed and take care of behind the scenes,” says Maslak. “Our goal is to make it easy to integrate with anyone anywhere.”

In many cases, the automation of Ribbon Health has replaced physical binders of outdated reference information at healthcare providers that required vast patient navigator human resources to operate and maintain, resulting in too many unnecessary visits. of patients to emergency departments and emergency care, explains Maslak.

For digital-first Health Karma, data from Ribbon Health is fueling a patient experience aimed at making healthcare navigation easier, not only for the uninsured, but also for patients who find the websites of the little ones. Individual or employer-provided insurance plans are too complex, error-written, or outdated to be useful, says Michael Swartz, president and co-founder of Health Karma.

In addition, Health Karma provides monthly telehealth and behavioral health services at low cost, says Swartz. “For many people, the greatest value is in our virtual primary care and behavioral health programs,” he says. Prescription drugs at a reduced price are also available on the Health Karma site.

Michael Swartz is the president and co-founder of Health Karma. Photo courtesy of Health Karma.

In the future, Health Karma plans to offer online appointment booking, but for now, its supplier directory is directing consumers to the supplier’s phone number.

If a consumer visiting Health Karma already has insurance and registers on the site, the site can ensure that the consumer sees a doctor in the network, or they can use Health Karma’s virtual primary care until they are satisfied. he needs to go to this network. doctor, he said.

In addition, Health Karma arranges for small employers to enroll their employees in a personalized Health Karma navigation service, using Health Karma’s more up-to-date supplier directory, adds Swartz.

“We realized that most people just don’t have the knowledge to be a health care consumer,” Swartz said. “This lack of knowledge made people hesitate to interact with our market or with healthcare as a whole. So, two and a half years ago, we stepped back and said we needed to bridge the trust gap. “

One of the ways that Health Karma differentiates its virtual offerings from others is by letting patients choose and retain their providers, thus creating an ongoing relationship between patients and providers, instead of being helped by different providers on a visit. to the other, explains Swartz.

And unlike pure telehealth offerings, Health Karma can direct consumers to physician and physical therapist locations, depending on the insurance they purchase, he adds.

“We don’t offer insurance plans,” he says. “We are able to integrate with over 2,000 different insurance plans. We work with many brokers, and it is possible in this way to make it easy for you to decide whether Plan A or Plan B is better for you, potentially. “

Swartz compares Health Karma to some of the easy-to-use fintech startups, such as Nerd Wallet, which helps financial consumers choose from a mix of credit cards, investing, insurance, loans, and banking, among others. .

But to create this service, Health Karma needed to have “top-notch” insurer data, which Ribbon Health provides.

To better understand the expertise of suppliers, Ribbon Health acquired data on complaints from several private, proprietary sources, according to the company. This data allows visitors to Health Karma to select providers based on a sophisticated set of search terms.

“Let’s say you want a mental health therapist who focuses on ADHD, [and] has experience treating 13 to 21 year old girls, ”says Swartz.

Using such criteria, consumers can sift through hundreds of potential suppliers to reach a handful that precisely meet their needs, he says.

“That’s what we’re trying to do, not just with mental health, but with all of the different types of research,” says Swartz.

The Health Karma site also relies on vendor ratings generated by Healthgrades.com, although the Ribbon Health approach gives consumers much better search results than they would get by simply visiting Healthgrades, adds. he.

Scott Mace is a contributing writer for HealthLeaders.

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