To improve patient care out in the field, WellCare is turning to a combination of artificial intelligence and mobile technology.
The insurer, which serves Medicare and Medicaid patients, is creating one version of a new AI-powered system for patients and another for caregivers, Chief Information Officer Darren Ghanayem told The Wall Street Journal’s CIO Journal.
The company has rolled out an early version of its patient-focused system—called Care Plan—in three states so far and plans to deploy it to its full membership by the end of the year. The system works by analyzing data that members enter into the MyWellCare mobile app, along with WellCare’s own data, to suggest treatment plans and interventions for potential health issues it identifies.
The more data it gathers, the more successful Care Plan will be, Ghanayem told the publication, noting that WellCare has been encouraging members to download its mobile app.
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The caregiver-focused system, which the insurer plans to roll out next year, also will be packaged as a mobile app so it can be used when treating homebound patients. It will have many of the same features as Care Plan, plus those tailored to healthcare professionals, the article added.
In addition to those two new systems, Ghanayem told the WSJ that his team is working on another project that taps AI—a natural language processing system. The idea is to be able to translate specialized healthcare industry terms to help its customer service staff answer common questions and help patients better navigate their benefits.
WellCare is not the only insurer to delve into a branch of technology that once seemed confined to science fiction. Humana has been using an AI bot known as Cogito Dialog in its customer service centers to identify poor member experiences in real time and deliver instant feedback to its staff.
AI is also helping pharmaceutical companies streamline the drug development process by combing through genetic information and “druggable proteins” to determine if already-developed drugs can be used to treat another illness.
On the provider side, some hospitals are using machine learning and data analytics to predict patient admissions, while IBM’s Watson is driving innovations in areas like individualized cancer care.