(US and Canada) Derrick Higgins, Head of Enterprise Data Science & AI at Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas, speaks with Robert Lutton, Sandhill Consultants Vice President, in a video interview about the organization’s journey applying advanced analytics and AI, and the ethical challenges associated with their future applications.

According to Higgins, the AI journey begins with value demonstration, gaining credibility, and showcasing the technology’s potential with quick wins. The early work done by Higgins’ team was in claims processing to make it more efficient and accurate.

He explains that over time, the team can grow a level of trust with the business counterparts of the organization to start more ambitious initiatives, such as processing prior authorizations and health care management.

When asked about the recipe for success at Blue Cross Blue Shield, Higgins says that the idea is to start small and show value. He adds that the work has to be sustainable, flexible and scalable.

Regarding the ethical challenges of future AI applications, he says that with AI technology improving over time, organizations have adopted less transparent methods, posing ethical challenges for the future. Higgins stresses that health care is one space that must be mindful of how the models affect people and how much transparency is required to use them responsibly.

He shares that Blue Cross & Blue Shield’s model approval committee reviews AI models before they are implemented. The committee considers and discusses aspects such as biases and transparency.

Higgins adds that the team is working on formalizing the organization’s AI governance, which will result in a master policy. He concludes that it will help the organization be more opinionated about the guidelines for the acceptable use of AI, not just for things developed internally but also for licensing.

CDO Magazine appreciates Derrick Higgins for sharing his insights and data success stories with our global community.

See more from Derrick Higgins

AI and ML Lead to Intelligent Service

A Data-Driven Culture Is Part of My Job