(US and Canada) Christer Johnson, Chief Analytics Officer at Healthfirst, speaks with Jake Dreier, Director, Strategy & Growth, HiLabs, about the challenges of shifting the health care industry and the ideal approach to AI and ML investments.

Johnson says that while margins are important in health care, a key goal is to change members’ behavior to make them healthier. Focusing on the metrics to improve someone’s overall health is a challenge from the start.

Thus, Johnson says, the challenge of trying to change someone’s behavior to buy a product or subscribe to a service is a much different animal than trying to get somebody to change their behavior to improve their overall health. This makes AI and ML even more integral to the health care industry. 

He points to another challenge — perfecting data before AI in ML. He stresses that it is incorrect because analytics is a better way to identify data quality problems. Every model-building process includes exploratory data mining to understand data statistically. 

He says people tend to focus on areas with high spending. This approach is risky because a big spend area doesn’t mean that’s where all the opportunity for improvement or cost savings is. Focusing on avoidable costs is a more viable approach. He concludes that it allows organizations to focus on building algorithms to identify areas where actual cost differs from expected costs.