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As part of NJBIZ’s latest virtual discussion, experts from New Jersey-based organizations weighed in on how technology can be used to make health care delivery more efficient, inclusive and sustainable.

Moderated by NJBIZ Editor Jeffrey Kanige, the Sept. 26 panel featured:

• Susan Loughery; associate executive director; Catholic Charities, Diocese of Trenton
• Paul Marden; CEO for New Jersey, Pennsylvania and Delaware; UnitedHealthcare
• Kash Patel; executive vice president, chief digital and information officer; Hackensack Meridian Health

During the hour-and-a-half roundtable, panelists dove into topics such as the latest developments on electronic health records, potential uses of nanotechnology in health care settings and whether technology can help narrow the socioeconomic gap in treatment outcomes.

They also weighed in on the use of artificial intelligence and which pandemic-era innovations have proven to be valuable for patients, providers and insurers.

After the onset of the COVID-19 crisis, health care executives were forced to move quickly to ensure patients could continue accessing care in a manner that was safe. As a result, the sector saw some innovative changes, particularly when it comes to technology.

Patel said, “At Hackensack [Meridian], hospital executives made a decision to implement … electronic health records across all of our sites, so that’s 18 hospitals across three regions and every facility … That undertaking in itself was huge and we did it in record time, but the value that that gave us in the middle of COVID, it allowed us to create a single record of the patient that could give the clinicians a lot of information immediately and in near real time it was consistent across all of New Jersey.”

Replay: 2023 Health Care Technology Panel Discussion

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Marden said, “Virtual care exploded during the pandemic for obvious reasons and we’ve continued to build on options for members … Now, I think people expect to have access to virtual care through their health plans. And so, we’ve provided some choice. We have 24/7 access to virtual care. We’ve made it convenient so that members can access that through their smartphone or their computer tablet – however they want to do it. But, they have choice of virtual care options.”

“I think 88% of Americans are going to continue to use virtual visits when they can, when it’s appropriate. The second piece is really around virtual behavioral care because members have much higher compliance and prefer seeing behavioral health providers virtually in many cases,” said Marden, who noted there’s also been expansion into other specialties, like musculoskeletal, and expects further growth into different areas as time goes on.

Patel agreed, saying, “The demand is there. COVID sort of ignited it and the regulatory environment sort of caught up. But it’s absolutely here to stay.”

“The switch from telehealth to ‘I want to go and see a real physician’ is also important and not a separate appointment. It’s the continuum of care and we need to make access to either a specialty referral or the physician care piece much easier,” he said.

According to Patel, Hackensack Meridian is also experimenting with the use of chatbots to help direct a patient to the right doctor or specialist.

“Where you can have an interactive conversation with an avatar to answer all your initial questions – basic ones – sort of a triage,” he said. “At some point, I do see that technology evolving into more and more of an enhanced AI experience,” Patel explained.

New opportunities

Overall, participants are hopeful that technological changes to our health care systems will lead to better health outcomes for everyone; however, they believe more work must be done to improve equity.

Loughery said, “Telehealth, technology and health care just exploded during the pandemic. We had a lot of latitude for being in different places of service, and what we quickly learned – because we were in the field the entire time – is that we had to innovate very quickly because there were issues around facilitation. With seniors, for example, being able to access a telehealth appointment was something that really needed side-by-side support of a community health worker.”

“Then, there’s the issue of tech equity and being able to have a technology device with a data plan where you can engage in telehealth. So, we did a lot of facilitation. Nurse-led community health workers, really supporting individuals who struggled to be part of this new technology health care environment,” she explained.

“We see the need for a lot of integration for our patients – for the homeless, for individuals with disability and individuals who have struggles navigating the system to connect in a lot of different ways … Telehealth and telemedicine bring a lot of those services directly to that individual where they’re at. In addition, it brings specialty providers, which are oftentimes a challenge to access for individuals who are in poverty,” said Loughery.

She went on to say, “Being able to bring the technology to individuals where they’re at, you can really design a care plan around the needs of that individual and include the language, capability, specialty providers and really wrap around all social determinants of health. There’s lot of opportunities here.”

Loughery said, “In thinking about the new opportunities that we have with technology for us and community services, and in particular, for community public health for individuals who can’t access the system, the ability to have more providers is critical and specialty providers. And what technology does is it gives us a broader footprint to augment and to offset where we have those provider shortage areas and individuals that might have a lack of transportation, a lack of child care and inability to travel in order to get that health care.”

Marden said, “There are absolutely certain places and a percentage of the population that do have issues with access. And we try and identify those by looking at our data for interactions with a health care system, whether it’s filling a script or a claim, whatever it may be … But we’re trying to identify people who actually are having problems accessing the system.”

While Marden stated that “the majority of the population and membership has access,” the insurer is “trying to make sure we have a lot of options available for those folks, and then for those who need help, we’re trying to get them help in various ways.”

Filling gaps

Amid workforce shortages and heavy workloads, health care providers are increasingly looking to artificial intelligence to improve operational efficiencies and innovate care delivery models.

Patel said, “With the advent of technology around AI, there have been some amazing conversations going on the last 12-18 months we’ve been in the thick of it. We’re a huge partner with Google specifically, so we’ve been working with them and others.”

Just a few uses being explored include using AI to help radiologists screen results quicker and condensing the notes a clinician reviews from dozens of pages to just a few paragraphs, he said.

While there is wariness surrounding potential misuse of AI by “bad actors,” Patel noted that Hackensack Meridian created a committee comprised of data scientists, bioethicists, physicians and lawyers to help govern how – or if – the technology will be put into practice.

Patel said, “We have these sort of gate reviews, where it goes from ideation to where does it make sense? Does anything make sense? Is it feasible? So, everybody in the room has an opportunity to have a conversation about it. Is it safe? Is it equitable? Is it the right thing to do? Can we even act on this? Is it actually actionable? We have all of these questions at every gate review, about every AI sort of conversation that we’re creating.”

“We’re learning all the time, so we might speak to a partner about it or another health system, too … We have really [been] deliberate and methodical about how we’re rolling it out,” he said.

Loughery said, “We’re looking at it in the context of efficiency and business process and augmenting where we have resources, staff resource shortages and making it a tool for the clinical managers. And we’re doing that in a couple of different ways. We’re looking at transportation routes and how do we facilitate? How do we use AI to maximize our routes and our transportation? We’re looking at it in the context of clinical supervision. How does it become a meaningful tool for clinical supervisors to really evaluate how their staff are doing. And I think there’s tremendous opportunity.”

“But I also get concerned about us creating a data footprint or an AI footprint that is not comprehensive enough for those that might be falling under the radar that might not be accessing the broader health care system that might be accessing the system in a fragmented way through maybe a charity care clinic here, or a mental health clinic there. And you know, how do we make sure that when we’re looking at AI for data-driven decisions and developing algorithms that we have that complete picture and avoid something like a black swan effect where we have unintended consequences,” she said.

“In the context of our overall public health, if we want to reduce disparities, we have make technology widely available to everyone who needs it. Because it currently isn’t and so we are starting to see that gap widen for individuals who went into the pandemic already with significant health disparities,” she said.

Reducing that shortfall and exploring what is best for the residents of New Jersey will require cooperation between “payer, provider and state government,” Loughery went on to say.

“We’re doing a lot of work in terms of informing our colleagues at Department of Health Division of Mental Health and Addiction Services on, you know, what could be or what the opportunities are, what we’ve seen in the field, and what we see that we need going forward. And right now, we’re functioning under a lot of temporary waivers. And so we’re at that point where it’s time to develop what the system will look like. And it’s a collaboration of every stakeholder, including the patients and the voices of the community on what they need and what they prioritize as important in their health,” she said.

When it comes to reaching those without access, Marden said he believes UnitedHealthcare has made “a great deal of progress” but “clearly we need more of it.”

“It’s getting into the communities that are underserved to provide them with money resources to get the care that they need. Because I think as a society, we all pay for that when somebody’s condition deteriorates. It’s going to result in higher medical care and lots of other downstream costs associated with somebody who cannot get healthy who doesn’t have stable housing, who’s hungry. And so I think that we need to continue to invest in ways to get underserved communities and better resources so that they can live better,” he said.

“And I really do believe that there will be an ROI for everybody living in any community if we can lift those folks up,” Marden said. “I think, it’s everybody’s responsibility, no matter what industry. If you’re an insurer, you’re a provider. you’re just a business. I think that ultimately we all pay the price when those folks are neglected, and it just results in lower quality of living and higher costs for everybody. And now it’s prevention can go a long way. So I think it’s multifaceted, you know … I think everybody would agree that certainly more funding, more attention. more resources in that community will benefit everybody.”

A full recap of the panel will be available in the Oct. 2 issue of NJBIZ.

Editor’s note: This article was updated at 10:14 a.m. ET on Oct. 6, 2023, to clarify a remark from Paul Marden that 88% of Americans, and not UnitedHealthcare members, will continue to use virtual visits.