What if AI could help healthcare become more human? In this WBL: Women Leading Healthcare webinar sponsored by Carenet Health, industry leaders explore how artificial intelligence is transforming healthcare—not by replacing human connection, but by empowering professionals to focus on what matters most.
Rhonda Gibler, Chief Growth Officer at Carenet Health, moderates a conversation with Robin Davis (Founder & CEO, Metre), Susan Torroella (CEO, Progeny Health), and Amy Goad (Managing Director, Sendero Consulting) as they share practical AI strategies, real-world use cases, and insights on building trust in an increasingly tech-driven industry.
The following transcript has been edited for clarity and length.
Kelsey Grabenstein: Hi everyone. We’ll get started here in just a second. While we have a few more people joining, I’m Kelsey Grabenstein, director of Corporate Partnerships here at WBL. Thank you all for joining today. Very excited about this conversation. I want to say thank you to Carenet for hosting this webinar, and also thank them for being an annual sponsor of WBL.
So just one quick housekeeping thing, if you have questions today, please use the Q&A function. We will address those at the end. Otherwise, look forward to a great conversation. I’m gonna go ahead and hand it over to Rhonda with Carenet. Thanks, everyone.
Rhonda Gibler: Thank you everybody. Welcome, welcome. I’m so excited to be hosting this panel of esteemed women professionals here for healthcare. As Kelsey mentioned, we are a proud sponsor of WBL and we’re a strategic partner working with them.
Rhonda: We’re really looking forward to seeing all of you face-to-face, for those of you who are going to HLTH in October, and I always really appreciate the lively discussion that comes with this group. Take just a couple of minutes to introduce you a little bit to Carenet, if you’re not familiar with who we are and what we do.
We gratefully serve and have been serving the past 25 years, those top 500 payers, providers, health tech and services companies. We are healthcare only, so we pride ourselves on being able to jumpstart performance due to that being our sole focus. When you think about what we support, we support AI and data, humans, and build trust. And we do that with our AI voice and digital automation capabilities combined with our health advisors, both clinical and nonclinical, and we do that globally. So we have, of course, a huge presence here in the US, in Trinidad and El Salvador for our near shore locations, and the Philippines for our far shore location. In our group of services, we provide business services, so think of that as access and acquisition, and then we have a healthcare BPO, which think of that as really large-scale programs and solutions that we offer there. And then our specialty area is care management and medical cost management.
We did a recent acquisition of Balto Health, which is now a part of Carenet. We call that Carenet Launch. And it’s really given us the capability to help those startup companies as they’re entering the market, and if you need some extra support on some of the services, so you can kind of buy enterprise-grade services at a startup capability. We’re highly scalable. We have 3000 health advisors, like I said, and then 500 clinicians and techs, and we’re just really happy to be here.
Okay, enough with the commercial. We recently shared a point of view where we have the greatest healthcare in the world, but the costs are too great to ignore, and it’s imperative that healthcare leaders like us power the change to address them, and AI and automation can help, right? But it needs trust, it needs orchestration, it needs implementation in really smart ways, and right now it can be so overwhelming to know where to start and that’s really what we’re here to talk about with this group of panelists. So we’re gonna be super interactive, there’s a Q&A area here in the webinar, so please, put in your questions, if you wanna address those to individuals in particular on the panel, that would be great.
Rhonda: Let’s just jump into it. Let’s get started with introductions. So I’m Rhonda Gibler, Chief Growth Officer here at Carenet. I’m gonna move on to the stars of the show, and Robin, I’ll come to you first. Welcome.
Robin Davis: Okay. Hey, I’m Robin Davis. I am founder and CEO of Metre and we are a sales and proposal development firm. We also only work in healthcare and we help healthcare services and health plans win business through RFPs. So we come in and do all that heavy lifting for you, bring the project management, help you write it, and help you win.
Rhonda: Excellent. And I had a really special question for all of the panelists, and I asked them what their superpower was, right? So I’ll start with you, Robin.
Robin: My superpower is connection. I love connecting with people.
Rhonda: Excellent. Susan, how about you? Go next.
Susan Torroella: Good afternoon. I’m Susan Torroella, and I’m CEO of Progeny Health. Progeny Health is a maternal and infant healthcare company. We work with health plans, both Medicaid and commercial health plans to promote healthier pregnancies. We work with moms both during pregnancy and the full year postpartum, and we also work with our NICU families during the hospital NICU stay, as well as a year post-discharge.
My superpower, I would say, is relationships—really establishing deep and enduring relationships, and I’m so pleased to be here. Thank you.
Rhonda: Thank you Susan… and Amy.
Amy Goad: Yes. Thank you so much for having me. My name is Amy Goad. I’m the Managing Director at Sendero Consulting. We are a full-service management consulting firm that serves multiple industries, but I have the privilege of leading our healthcare practice, and we focus on advising our healthcare providers, payers, and technology companies. So we work with a wide spectrum of players in the industry, and so it gives us a unique perspective that we bring to the table in each of our engagements.
For my superpower, I think it’s bringing order to chaos, so I can take broad chaos and turn it into a color-coded spreadsheet pretty quickly, which comes in handy in my day-to-day.
Rhonda: I love it. I’m so glad you’re on this call. So I think we’ll start off, one of the things we’ve also done throughout this session is we have added polling questions. I want to do the first poll question. And that is: Are you using AI? Are you using AI in your everyday work right now?
Rhonda: And in every event, quite honestly, every event that you go to, it’s so hyped up on AI, and we’ve gotten to the point now where we’re not just talking about it and thinking about it and using it personally. Now we’re really starting to see how it matures and how we put it into the business. So I’d like to come to Amy. One of the questions I have here for the panel is maybe what’s the AI hack you’ve accomplished that you’re most proud of, that you’d like to share, and why?
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Amy: So, I have a professional and a personal example, because I think we’re all using it in every aspect of our lives, right? So professionally, I think the biggest win that we’ve realized with that is just being able to turn a large amount of inputs into something that’s simple that everyone can digest and understand, and that keeps our team and our clients on the same page as we’re progressing towards developing different strategies or keeping a large project or program on track. And so when we have long working sessions, or we’re taking in lots of information from lots of different teams, using AI to help us consolidate and put together a tight summary that then our team can edit and kind of tailor to take back to the different audiences has been a huge productivity multiplier and also catches things that we as individuals, when you’re having these workshops, you hear certain things, but AI catches it all.
And so it’s been really nice to make sure that we are capturing all of the great nuggets that come out of these discussions or all of the inputs that are provided to us from multiple angles of documentation or emails. And it can make sure that we’re thinking about the problems that we’re solving holistically.
Personally, planning trips it has been a game-changer. So we went on a big family trip this summer and said, here’s where we wanna go. Here’s how old our kids are, here’s kind of how we like to travel. And it’s been wonderful to help create ideas that we wouldn’t have thought of. That ended up being really fun.
Rhonda: I love that. I had to take a note on that one.
Amy: I highly recommend.
Rhonda: Yeah, that’s a great idea. Robin, how about you?
Robin: Yeah, well, we are a small but mighty team, so we use it a lot for back office operations because most of us are working on service delivery, and you know, ensuring the quality of the services that we are delivering. So it’s really to expand the capacity of our team, which is how we use it most often. I mean, examples are like, evaluating contract clauses, right? How putting in a clause and saying, this seems a little one-sided to me. As a vendor, how, you know, what am I at risk for? That’s been really useful for me and reduces legal costs for sure.
We use it for a lot of internal documentation, too. So simplifying our standard operating procedures, developing job descriptions, that sort of thing.
My personal favorite hack, because I did the same thing, Amy, is called instaheadshots.com, and they give really good headshot that look really realistic. You put in like 10 of your own photos and they come back. Almost all of them were really good. There’s a few where my neck was a little long or something was a little weird, but I got a hundred headshots for 70 bucks and they’re wonderful. So that’s great.
In terms of how we use it in our work, that’s a little scary for our clients. Of course, we’re in healthcare, right? So nobody wants to put anything into a system. And when we’re working in a, you know, procurement process and, you know, there’s, if someone wants to challenge or contest an award, then there’s the whole discoverability and everything needs to be pulled up. So even simple things like using AI note takers, most often we’re not even allowed to use. So basically, for research, in terms of looking up stuff that’s available, but we don’t put any information into the system, into any system outside. I’m really excited about AI agents, though. I’m just starting to explore that.
Rhonda: That’s great. I feel like we have to talk after this because I’m super curious just even in the RFP process, like how are companies now evaluating RFPs and how they’re using AI to really bubble up, you know, the things that are most elevated for them or the things that they’re most concerned about.
Robin: Yeah, it’s definitely gonna change our industry quite a bit.
Rhonda: Susan, how about you?
Susan: So my hack is Microsoft Copilot. I am myself, as well as my colleagues, we’re using it every single day, and it’s giving me a lot of, I think Robin used the word, additional capacity.
So everything from summarizing yesterday’s emails for me, and then I can click into something. I mean, I can then it helps me summarize and then take action, looking at a document or an email and giving it a prompt, make this more friendly or professional. So really it’s like having a personal assistant, and that’s helping me very much on the professional front. And then on the personal front, also giving me additional capacity is using the tool for, I think, also vacation planning, but also creating a poem for my mom’s 90th birthday or my son’s college graduation with little prompts about their hobbies or their accomplishments. Boom, is an amazing poem. So doing things that really give me extra capacity and effectiveness on both the personal and the business front.
Rhonda: I love that. Susan, you and I use AI very similarly on kind of the personal professional front, which is I have it, pull out Outlook teams, chats, all of that, and just memorialize that to me in the morning of what’s happening, right? What are the things that I need to spend my time on?
We as an organization are using an agentic agent on the back side of our health advisors and moving to the front side of our health advisors. So think of it as really allowing those individuals to focus on the patient or the member and have really thoughtful, meaningful conversations while AI is serving up to them, kind of that next best action that they should be thinking about, and making it easy to get information. And now we’re taking that and moving that to the front of the call. Because if you think about us as consumers, we just want things fast, quick, and easy. And if I’m calling in to confirm an appointment, I don’t need to have a professional human answer that for me. AI should be able to say, ‘Hey, Rhonda, are you calling about your appointment today at two?’ ‘Yes, I am.’ ‘Great. Let me send you instructions.’ You know, and really to help augment our human capital and make it easier for the folks that are calling into all of your brands throughout the day.
Rhonda: Okay, that was fantastic. Here’s another little speed round, but have you named your chat GPT or your AI assistant of choice? Robin, do you have a name for yours?
Robin: I do. And her name is Donna. So I’m a fan of Suits, and Donna was Harvey’s assistant, and like the best assistant, right?
Susan: I love Donna
Robin: Who doesn’t love Donna? I want a Donna; everybody needs one. So I named mine Donna.
Susan: I love it. It’s so good.
Rhonda: How about Amy or Susan? Do you have a name for your chat or AI functionality?
Susan: So, I don’t, but I am so inspired. I might, my first GPS in my car, I named Roxanne, and so I had Roxanne in my car for many, many years. And, I was thinking, I will, if we do a, if we come back together on for a follow-up, I’ll have a name, but Robin, I love Donna. Oh my gosh.
Robin: Yeah, perfect, right?
Amy: I am very inspired, Donna, but I don’t have one myself.
Rhonda: I don’t either. I’m like, what would I name it? Speedy? I don’t know. People have really come up with some amazing names. We have one of the folks on our team who calls ChatGPT, Chatty, and she’s like, ‘Ah, Chatty and I get up every morning and we start chatting.’ It’s like, oh my God. I love it. I love it. I love it.
Okay, for the audience, let’s do another poll. We are going to ask our panelists kind of the same question, so you guys kinda be thinking about this, I’ll bet a little bit more open-ended for us: Where do you think healthcare is missing the greatest opportunity to leverage AI right now? So we’ll give everybody a chance in the audience to answer, and then let’s see.
Rhonda: I think I’ll come to Susan first this time. So where’s healthcare missing the opportunity to really leverage AI right now?
Susan: Yeah, so when I look at the poll and I also think about this, there’s an, look at how equal it is. So interesting, everything. Yeah, so interesting. Yeah. So as I think about this, there’s one area that really could impact all four of the dimensions in your survey. And that is looking at the quality of member information. So, when you think of all of the different services that health plans do, as well as providers and service providers, if you can’t reach the member, then you really can’t. I mean, that’s where it starts, right? Being able to reach the member on the Medicaid side, close to 40% of the Medicaid member data is missing information or is incorrect.
And I think we have the opportunity to use AI to correct the information or augment it before it is then disseminated to different, to different parties. So there are different AI tools, I believe, that could look at data that’s missing and infer different things, flag different fields, flag duplicate data, flag a field, and infer what, how it could be populated better. So I think there’s an opportunity, and I know there are a lot of AI experts who, hopefully, are all over this using predictive modeling for missing fields to improve it, because that will improve. There’s a lot of time spent calling around trying to, you know, triangulate a member.
So in terms of the survey, like staff burnout of wasted effort, right? As well as improving outcomes by being able to engage a member more quickly. I think that’s an area that is really a huge opportunity.
Rhonda: Amy, I’ll come to you next.
Amy: Yeah, I agree with a lot of what Susan said. I think that the workforce productivity is a major opportunity. The healthcare systems right now are just doing so much for so many, with so many changing regulations and growing populations in certain areas, that it can be hard to keep up at times, and it’s just a very complex system. And since the pandemic, there’s so much burnout that we’ve gotta find a way to make both the clinical and the administrative side of operating a healthcare entity, whether you’re on the payer or the provider side.
It’s critical that we figure that out and we have these really powerful engines and AI, I mean, just like we’re talking about with Copilot, there’s so much opportunity to automate and streamline these repeatable tasks that then open up the door for more kind of critical tasks working at the top of your license, you know, allowing people to really get back to the core of what they came to healthcare to do. So many people who come into this field are mission-driven, but then they get bogged down and burnt out with the paperwork and the calling a million people, like Susan explained, to get one answer. And so I think let’s focus on reducing those barriers and then allow people to work in a field of work that they came in to do.
Amy: Wearing my patient hat, I will say, I think that there’s so much opportunity in research. You look at things like women’s health, where it’s been so underfunded and under researched, and where we can leverage AI to take what we have or to generate more and create, you know, new solutions or new cures and new diagnoses for things that we haven’t been able to figure out before. I’m very excited about what AI is doing today and how much more it can do to help give families and individuals answers to health challenges that they’ve had that we just haven’t had the research or resources to be able to name. So I’m very excited about that component as well.
Rhonda: So true. Robin, did you wanna add anything?
Robin: No, just the inefficiencies, right? The healthcare cost trend just keeps going up and up and up and up and up and, you know, I think a lot of that is just, it’s gotten too inflated, and I think we can come back and reduce a lot of costs that way.
Rhonda: Yeah. I agree with all that you have added here, and I’m sure we have amazing things that are happening in the audience here. At the end of the day, it does come back to medical costs and consumer burden. How are we reducing the consumer burden and then tech debt versus transformative solutioning? Healthcare has been around a long time, so there is a lot of institutional knowledge, and there’s also a lot of technical debt that exists in the business. I have to say, I was at an Oliver Wyman session last year and they did a really cool thing…
Rhonda: Trust is so important as we get into this age of AI, and how are we going to build trust, and can an AI agent build trust? And they did a really cool innovation session where they had a patient and a physician, and the patient wanted to walk his daughter down the aisle for a wedding, and he had cancer, and he wanted to stop his treatments for two weeks to do that. And the doctor built a digital twin using AI and then showed him the progression of his cancer. Should he stop that for two weeks? Versus, you can still walk your daughter down the aisle, assisted, right? You’ll need help, but if you stay the course and you can start to contain your cancer and you can be on a much healthier path. It was amazing. But what it really showed me was transparency and trust, and as a patient, I’m able to make those decisions for myself, right, with my physician.
And it was just really, really powerful. So AI is just, you know, we’re just the tip of it. It’s gonna change so much over the course of time.
Rhonda: Another poll question for everyone in the audience: What is holding your organization back from embracing AI more fully? And there are quite a few answers that you could answer here. We’ll let the team keep answering that. And let’s go to our team: what’s holding you back? If you haven’t jumped into the AI hype, is there something that’s holding you back from doing that? So, Amy, I’ll start, start with you.
Amy: We work with a lot of clients who come to us and say, ‘We want to use AI’, or ‘Our leadership is saying we need to use AI, and we’re not quite sure where to start,’ and as we partner with them to kind of create that plan, a lot of it comes back to foundation. Oftentimes, we have to have a kind of Phase Zero of AI prep, and it’s making sure that the data is trustworthy and that they’ve got the right kind of data components in place, as well as the processes for their organization. If you need to automate certain processes or leverage AI to do them, we need to make sure everyone’s on the same page about how those processes should work. Because layering AI on top of inefficiencies is only going to exacerbate the problem.
So we have spent some time starting with that foundational piece of understanding the data, understanding the processes, and then selecting the right AI tool, or enabling the right tool they already have to solve the problems they’re trying to solve. So, having the right kind of focused effort: ‘What problem are we solving? Do we have the right kind of foundational pieces?’ And then leveraging that has been really important to get people going.
Rhonda: Fantastic. You’re in the heart of it, right? Like, you’re hearing it from your clients and they’re asking you to help them build what that looks like. Robin or Susan, do you have anything that you’d like to add there in the discussion?
And so that’s really important. So AI is just, you know, we’re just the tip of it. It’s going to change so much over the course of time, but okay.
Susan: Sure. I’m happy to add, at Progeny Health, we’re not resisting the use of AI. In fact, we’re using it to accelerate or enhance productivity in our business processes across the organization. What I will say, and it’s a little bit of a different take on this, is we’re exercising caution, especially in certain areas of our business, especially clinical operations, because of privacy concerns, compliance concerns, or client restrictions. At Progeny Health, we work with a large number of health plans, and each health plan has its own viewpoint. And so we want to be very mindful of always complying with each and every one of our contracts. So it’s not so much a resistance to using AI, it’s a really thoughtful approach and caution to make sure we’re using it in ways.
Rhonda: Yeah. Robin, I just have to ask, because you’re kind of in the nucleus of people who are going out to try to discover what might be new or next, I would love to hear from you. No trade secrets, but what are you hearing? What is coming through in those RFPs?
Robin: Yeah, there’s not a lot in the RFPs yet in terms of asking our clients how they’re using AI. I haven’t seen that yet. It’s coming, I’m sure. We get asked, of course, how we use AI because the, what’s most important to our clients, much to Susan’s point, you know, it’s all about security, and there’s still so much fear, around AI and putting information out into the ether, and it, everybody has access to that. And so, you know, our policy internally is, you know, no client information ever to be put into a tool. Now RFP wise, we use it to, when it’s a public RFP, we can put that in and help us create, like a compliance matrix or project plan in half the time, especially for these large, we work on jumbo accounts or, you know, Medicaid bids that are thousands of questions and requirements. And so it helps us on that front, but mostly we are bound by a lot of the things Susan was saying, too—by our clients and their comfort level with using AI. And like I was saying earlier, most times we can’t even record our meetings, you know, which would save everybody time and their dollars, and someone using that, but it’s, it’s just not worth the risk to them yet. So I think it’s just time.
Rhonda: Yeah. Great feedback and great poll too, by the audience. Thank you for that.
So we have spent some time starting with that foundational piece of understanding the data, understanding the processes, and then selecting the right AI tool, or enabling the right tool that they already have to solve the problems that they’re trying to solve.
Rhonda: We hear a lot about the AI hype. It’s like AI and the air we’re breathing are the same things, and there’s just such a big mind shift to embracing AI, and we hear sometimes about the fear of AI from a replacement, right? Like a talent replacement perspective. And what we always believe in, right, is like, you’re not gonna be replaced by AI, but you could be replaced if you don’t welcome it.
And so it’s really important that we’re learning, we’re doing sessions like this, we’re learning how others are using, we’re seeing how it could fit into a particular environment, and work safely and build trust with the members and patients. Super excited about where we’re going.
One more poll: Are you able to influence cultural changes needed to embrace AI in your organization? So, more of just your role and how you can make change and influence that change. What is the culture needed to embrace AI, and do you have an example of maybe where that exists? Robin, if you wouldn’t mind taking that, that’d be great. Maybe some dos and don’ts that you’ve seen.
Robin: I think culturally there needs to be trust, right? And, it comes from the top down. Accountability needs to be part of the culture. You know, and teaching teams how to use it and what tools to use, right? There are tools out there that feed back to the greater system. And then there are tools that you can put within your own systems that are looking just for your information. And what I’m hearing a lot is, ‘Yeah, I mean, we all kind of use it,’ but nobody really knows what they’re doing. And so I think that in a lot of cases it’s training, it’s teaching, it’s having a policy around how we’re going to use it, what tools we’re going to use, and then a governance structure, put in place that’s, that’s looking at that and making sure it’s being used in the ways that it needs to be.
Rhonda: Yes. So, perfect. Thank you. Amy or Susan, any follow-up?
Susan: In addition to having a governance approach within your company that’s established, I would say from a cultural perspective, having a culture of continuous learning is, and that is what we have at Progeny Health is a culture of continuous learning organization. And so that is helpful with many things, including in this topic, AI.
The other thing that I would say, and it relates to it, is, not just a top down, like, ‘Hey, we should explore AI;’ but ground up. We have an individual in our company who’s done really great work in leveraging AI for training materials. And we had, we showcased her in an all-company presentation. So here was someone who did good work, saved herself hours and hours, and so we showcased her and her specific use case.
In addition, we have user groups. So, everyone who has the Microsoft Copilot tool. So we have a user group where people can come together and share tips.
We also have a subset of people who have the paid version that has additional functionality, and they have a drop-in and share your tips of how you’ve been using it, and then essentially, so crowdsourcing within the company and then sharing those learnings. So I would say that helps in terms of a tipping point in a culture that’s looking at ways that can save all of us time.
Amy: What we’re doing is very similar to what Robin and Susan have talked about, but in the training component, the way we’re focused on training is very much kind of use-case driven. We want our team members to be using AI purposefully and in the right scenarios with the right tools, because like we’ve all talked about, it is a very powerful tool, but we need to be careful with how we’re using it and proceed cautiously so we’re not misusing it. Focusing on the use cases and helping to direct our team members on this is powerful; you can use it with the result in mind. You know, we need to be able to provide our clients with better recommendations and to make more thoughtful proposals. And so, how can AI be a means to an end to get to that point? That’s how we’re structuring that.
Additionally, governance is so important because once the cat’s out of the bag, people start using this, and we need to make sure we’re staying in line with our employees on how they’re using it. Are there any risks or things that we need to mitigate? Client confidentiality is, of course, so important. And so we’re watching that and monitoring it very, very closely. So we do have an executive level governance board that meets regularly and talks about our evolving policies and procedures and tools that we’re using, but in addition, we have a special interest group that meets regularly that all employees are invited to join, where they can show up and have open dialogue of, here’s how I’ve used this on my project. ‘Here’s a new tool that we’re hearing about. Has anybody else used this? Or, our client is using this. How are your clients using it?’ We try to keep open forums that allow everyone to join, share information across different team members, so that we’re all learning from each other.
Rhonda: Wow. You guys have just given me some great ideas.
Rhonda: There are some things that I think we do as a smaller team in a larger organization, but I love the cross-pollination and really rewarding people for trying, right? I always say failure-first attempt in learning, right? Like, just go try, but do it in a safe environment. You can’t hurt people, you can’t hurt the company, you know, just go try new things.
I was reading a Harvard Business Review interview with Andy Jassy at Amazon, talking about empowering people to make a two-way door decision. And the idea is if you walk through a door and you’re wrong, you can always walk it back. I really like that kind of thinking, you know, with AI and empowering people to experiment, which is what you all were just talking about, make it safe to fail as long as we all get to learn from that.
So, it’s riskier and it’s healthcare because it’s heightened sensitivity. There’s healthcare data and security, but that’s why it’s always smart to partner with orchestrators or super facilitators who’ve been through those doors both ways already!
We’ll share a whitepaper too, at the end of this, that we just published on this topic as well. Ally, I think you and probably Catherine have been manning the Q&A, and I just wanna pause before we go onto our next question and ask, are there any questions that are coming in that maybe thematically we want the panel to take a shot at?
Ally Thomson (VP, Marketing & Sales Enablement, Carenet Health): Yeah, we’ve gotten some great questions, and I’m gonna combine and pitch two back to you. Somebody asked specifically what board members are thinking about AI and what they’re asking of leadership among each other to guide the trajectory of AI in organizations, what’s being used, how they’re vetting solutions. I think probably to you or you, Susan or Amy, you know, what are you hearing and seeing from clients and from boards?
Amy: From boards, you know, often it’s operational cost cutting, kind of how are we leveraging our resources? And so usually the boards are making a kind of top level kind of strategic directional request of how can we leverage AI to cut costs by X or grow our business and our scale by why. And so that’s then coming down to the leadership team of saying, ‘Okay, we’ve been told to try to leverage AI, to make some changes here. How do we go about doing that?’ And so that’s where kind of we start with the workshops: What are the problems that we’re trying to solve? How can we leverage AI and bring those solutions back?
Susan: And on our end at Progeny Health, our board is regularly asking How are we thinking about AI? How are we using it or thinking about using it? It’s a regular question of, both as to where are there opportunities and where are the threats? They’re also very, very mindful of the fact that we need to proceed with caution in how we use AI. Reducing administrative tasks is great. Anything with clinical decision-making is off limits, right? And so they’re very understanding and mindful of that. It’s an ongoing conversation that they are very, very interested in.
Ally: Thank you both. That’s really helpful. It actually kind of dovetails into the next combined question two. One of the challenges that companies are facing in developing AI solutions is finding the right talent to lead and implement the AI strategic plan. Oftentimes, the technology is not less costly; just different costs due to the infrastructure and staff needed to implement and maintain it. So where would you suggest that healthcare organizations find or develop that AI, and prioritize the technology? How do you find the balance? How do you ensure the ROI and communicate that back to the board and fellow company leaders?
Susan: That’s a robust and juicy question!
Ally: I know. Sorry, I threw a lot in there.
Amy: We see this often, and one of the things I would caution organizations against is actually leading too much with technology, because I think sometimes we’ll find a tool that makes these promises to solve certain problems, and the tool itself is wonderful, but if you’re not leading with the business problem, that can create a lot of churn.
And there are implications that are unexpected that come out of that. And so when we are looking at kind of developing AI strategies or any technical strategy, we really try to find who’s that business sponsor? Who is the business leader? We kind of work in this two-in-a-box model where you’ve got your technical lead who can then answer all of the questions of what is possible, because you need that foundation, while making sure, side by side, there’s the business team member and business leader explaining what we’re trying to accomplish here.
And that really reduces the unnecessary spend on systems that sometimes will go sit on the shelf because they’re, the business is not ready to adopt them. The processes are not mature enough to be used for that. So I think really caution teams against leading with the technology, continue to lead with your business, and then partner with the right technology leaders to work that together.
Susan: I love that so much, Amy. What are the business problems we’re trying to solve? And then seeing how we can solve them? I love that so much. I would add that one of the things that we have done is in terms of, I’ll call it baby steps or an incremental approach, is looking at are there business challenges that we have, things that are taking a lot of time, and can any of our existing tools that we already have in-house help us?
For example, if you have a telephony system that you use in-house, most likely, they have already built an AI component, just like I use my Microsoft Copilot, most telephony systems do. And so we have leveraged something that we already have in-house to help our supervisors to do auditing of calls to essentially save them some of that preparation work for them to then operate top of license in listening to calls. So I kind of added to the question of oversight. We don’t have one person. I think the real question, the original question, was who oversees this at Progeny Health? It’s really a team approach of our leadership team, including our com head of compliance, head of product, and certainly technology is involved as well.
Rhonda: Yeah, I was just going to add, I was chatting with a few CHROs the other day. I’m taking it to a little bit of a different pivot, but from a talent perspective, like the evolution of talent and who does existing talent become, or what does it look like for the future? Because most companies still have in their technology sector, right? They have technical debt. So, have people working in an old code or a legacy code environment. And in some cases, they’re doing that and they’re really rich because they need to work back with those plans or those payer environments that may still be on DOS, right? And so there’s this whole ecosystem of rich talent that has to keep the wheels going on the existing as the board and the CEOs are asking, well, I want this AI thing. I keep hearing a lot about it. I hear I can cut costs. How do I do that? But the complexities between making that transformation, you know, from old to new, it takes time and, you know, it’s a very different talent.
Once you make the full transformation, where you’re really looking for designers and customer experience individuals to drive the next generation, versus true hard code that exists today within our system. So it’s going to take us a long time to get there. I think we have to be patient.
Ally: Rhonda, I know we’re moving on to a couple more questions, but there’s another good one that Lynn put in the chat and in Q&A also to see if the panel or other WBL members are active in any way in state or federal standards and like the policy arena around the use of AI tools in healthcare. I know you mentioned some trepidation about that, both Susan and Robin, you’ve talked about that a lot. Are you active in policy spaces?
Susan: I am not, no. But maybe some folks on this call are, so that would be great to know.
Rhonda: Yeah, for sure. Okay. Is that it, Ally? Are we okay; I’m gonna go on to the next question.
Ally: Yeah, please.
Rhonda: All right. So, for the panel, then, what are some of the tactics and strategies you have in place really to avoid losing the humanization in this really tech-heavy world? It kind of goes right nicely into the audience’s questions and into yours. And Amy, maybe we start with you, you know, as to how are you amplifying the humanization part of what we do?
Amy: It’s part of, you know, going back to our earlier question, why I’ve maybe avoided naming an AI agent because I’ve tried to keep it separate from how easy it can become your best friend ’cause it’s in your pocket telling you what to do. And so I think that’s a real risk. You know, we’re seeing more broadly even outside of work, kind of the dangers of AI, and how we need to make sure that we’re helping to keep all of us sharp, and recognizing kind of what the limitations are from that connection perspective. So from a professional lens, you know, designing processes with humans in the loop—making sure that we’re looking kind of end-to-end. How are you using AI and where are those touch points where you have people or individuals continuously kind of influencing and learning from and governing your AI functions from a team member and even individually, you know, we’ll have certain meetings like, we’re not gonna use AI for this meeting. Or, you know, let’s challenge ourselves to like, not prompt it to get us going. Let’s really kind of dig deep and brainstorm and and see where we start. And we can lean into AI later.
I think it’s important to set those challenges for yourself even you know, I was trying to write a simple thank you email the other day, and it was something I would typically put into chat, and I was like, you know what? I’m gonna write it myself right now and just make sure that I can still keep that skill sharp. And I had the time, you know, not always, you have the time to sit down and be thoughtful that way, but I wanna make sure I don’t lose that skill personally. And so I think it’s just carving out those little tasks and little points in time where you could use AI, maybe you don’t, just to keep those key skills.
Robin: Yeah, I mean, that’s a great point. Like, I have not really used it for marketing content a lot, right? Maybe to edit it, but I don’t know, I always find it challenging for it to have the same voice as I have, you know, in the authentic way, that I speak. But that’s probably user error, right? I’m just not asking the right question or telling it to do the right thing. But I would actually challenge that I’m using AI to actually kind of make me more human, right? A better human. So I’m learning to be a better communicator, right? There’s a formula for how to write a prompt to get back what you want, right? Tell it who you want it to be, what you want it to give you, then give more specific information about that thing you want it to give you, and then how you want it delivered to you.
That makes me a better communicator in everything, right? Because there’s often, as a visionary, CEO, you know, I make a lot of assumptions about what I think people know. Oh, they get it, they know what I mean. And so I’m getting better at describing and explaining because of using AI what it is that I need, so that I’m getting back exactly what it is I need. And the person on the other end is a lot clearer, so we’re both happier in that interaction. It’s really helping me that way.
Then, when it comes to note-taking, always having it in my meetings, I can be more present. I can ask better questions. I can facilitate the conversation much better if I’m not worried about, ‘oh, I gotta jot that down. Hold on just a second,’ right? In those ways, it’s making me a better person.
Amy: That’s a great point.
Rhonda: Susan, any thoughts?
Susan: I agree with what has been shared, and I would say, for us at Progeny Health, we always say that we’re high touch and high tech. We lead with touch. And so the virtue of what we do and our whole philosophy, it is human connection first to establish trust with members. So we have dedicated case managers throughout the entire pregnancy. It’s that one-on-one relationship. Anything related to AI is more to allow someone to operate top of license and reduce administrative tasks and not replace the human connection.
Rhonda: Yeah, I love that. And Robin and I can relate to your comment. You know, we here at Carenet we talk a lot about helping humans be more human. And really, AI can help to facilitate that. At the end of the day, if we’re doing the right things by people and we’re helping them confidently accomplish what they need in the most efficient manner, be it our staff or patients or members, I always say, ‘we can’t go wrong doing the right thing,’ right? It’s just humans being humans. I think I asked asked Ally the other day, she has an 8-year-old, and I was like, ‘how are they using AI in the classroom?’ You know, how are they– Amy kind of, to your point of like, when does it cross the line where AI’s doing all the work and the homework and the student is showing up and getting credit. So it’s interesting times. Ally, keep me honest here, do I have time for one more question?
Ally: I think you have time for one more.
Rhonda: Okay, so what are the measures of success that you’ve realized or witnessed, regarding the implementation of AI? Anything unique or different?
Amy: One of the things we focus on is just business outcome improvements. So, not measuring AI success in a vacuum, because then we lose the point; but measuring the impact that AI has on the measurements that we’re using already to make sure our clients’ businesses are healthy, or our businesses are healthy.
So we have some kind of KPIs that you can say, like how often are we using that, and can we kind of grade prompts or other things, but from a true measure of success that we’re really focusing on are the business outcomes and making sure that those are improving. Perfect purpose.
Rhonda: Excellent. Susan, anything there?
Susan: I would add to what Amy said, and that is time saving. So something allows someone to operate top of license and spend time on their highest use and reduce of time of tasks that are not top of their license. So that relates to what Amy’s saying about outcomes. It also relates to staff satisfaction.
Rhonda: Yes, so much, you know, when we go do focus groups with our health advisors and we say, ‘what are the calls that you’re taking that you’re like, I don’t wanna take this call because…,’ you know, it might be a clinician and it got to a clinician, it shouldn’t have gotten to a clinician. Those are the ones that we go focus on and try to figure out how to offer those to AI before it gets into these incredibly professional individuals that have a license that do really good things for humans. So, really appreciate that.
We still think it comes down to the same, you know, some of the very traditional measurements, right? For ROI, medical cost management, are we closing gaps in care? Are we helping patients navigate to the ED when they need to or not? And readmission and medication adherence, a lot of that comes down to the standard blocking and tackling. It’s just another way to accomplish the task.
Rhonda: Well, I want to thank all of you for joining us today. A special thanks to Robin and Susan, and Amy for the great discussion. If you’ll be in Las Vegas around HLTH in a few weeks, please connect with us. We are sponsoring the AI Pavilion, and we’ll be hosting two great presentations about how AI is helping humans be more human in healthcare. And we’ll also have a booth that we’re hosting, and we’re hosting a WBL breakfast and a VIP event. So we’re gonna be everywhere to see you. Just as a close for this, we do have hot off the press a white paper on this topic. And then of course you’ll get the recording of this session. And if you’d like to continue the discussion, you can email me directly. I’d love to collaborate with all of you. But thank you everyone, and really, thanks for your participation and let’s us as a team continue to power change. Thank you.
Kelsey: Thanks everyone. Rhonda, everyone, thanks so much. It was an excellent conversation, very engaging and authentic, and appreciate all of you. So look forward to seeing many of you at events coming up. Make sure you check out the events calendar on our website or in the member portal. Thanks so much, everyone. Have a great rest of your day!
