Anthem, Chief Data and Analytics Officer: Data is in the Center of Everything

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(US and Canada) Ashok Chennuru, Chief Data and Analytics officer, Anthem speaks with Neel Butala, Co-Founder, HiLabs, about the importance of building a high-quality data foundation to improve the member experience.

Along with its affiliate companies, Anthem serves over 107 million members, including 45 million members as part of the health plan.

With a digital-first approach, the company provides consumers an opportunity to engage in a spectrum of care services and interact with technology like chat bots, conversational AI, virtual care, and then have an in-person visit as needed.

Chennuru says that as data moves from one system to another within the organization, it's not enough to just have the traditional rules-based approaches to monitor data quality. It requires specialized solutions.

“Data is in the center of everything. Data quality is the foundation of everything we do. We need to be able to trace the data and have solutions that can measure the quality and the impact of the data and the governance around it,” he adds.

Anthem, in partnership with HiLabs’ MCheck™, is using AI-based solutions that can scale to monitor the quality end to end.

Chennuru mentions that there have been existing problems with the accuracy of provider directory data. The problems are caused by the lack of standardization, the fragmented nature of the provider market, and the task of registering accurate directory information being low on priority.

Anthem approached this problem by first understanding that it cannot achieve 100% accuracy and needed to adopt the probabilistic approach to improve the accuracy.

The company leverages a combination of internal data assets, such as claims data and existing provider data sets, with external data from the vendors and publicly available data sets from the web, such as provider websites.

“We needed to come up with an intelligent way to weigh these various sources to calculate an accuracy score and set thresholds for action based on the score and the approach. We started to deploy it in our Georgia market and, by the end of the year, we plan to have it rolled out in all our states,” Chennuru says.

He suggests that new startups and health tech entrepreneurs should look at whole-person health, consider the social drivers of health in addition to claims data and clinical data.

“We consider emerging data sets like genomics and we aggregate all of that data into what we call a longitudinal view, whole-person health,” Chennuru adds.

It’s important to focus on building solutions that can turn data into actionable insights and then check if those insights have created the needed impact.

“Measure and then repeat the same process until you achieve the outcome because sometimes data can generate unconscious bias and may not be trustworthy,” Chennuru concludes.