Health IT startup, Hindsait, which enlists artificial intelligence and predictive analytics in a decision support tool for insurers to guide physicians as to whether or not a diagnostic test is necessary, has signed its first major customer — Magellan Health. It also has plans to pilot its technology with some Blue Cross Blue Shield plans later this year.
In a phone interview with Hindsait CEO Pinaki Dasgupta, he said the goal is to avoid unnecessary tests as a way to reduce healthcare costs. The StartUp Health company has also participated in Healthbox’s accelerator. Among its staff are an interventional radiologist, a nurse trained in health informatics and a clutch of data scientists. The data scientists draw their background from astronomy — the CTO was a black hole hunter. Another data scientists on the team identified caribou migratory patterns and Dasgupta came from the aerospace and defense industry.
“Our product can read and analyze text in clinical contexts,” he said. “It captures relevant fields in the EMR that reflect family history, surgical history, and plan assessment. Now, you can imagine the variables in any chart are huge so a simple, rule-based algorithm doesn’t work here.” It has the capability to make context-sensitive conclusions. In essence, it thinks like a clinician or doctor and can calculate whether certain procedures or diagnostsics should be approved or denied based on what it analyzes in a request.
The initial product is aimed at health plans and managed care companies to support the people who review these kind of diagnostic tests requests and whether they should be reimbursed. Dasgupta said it’s also developing analytics tools for providers as well. In a few years time, when they’re ready, hospitals will be on the hunt for bundled payment strategies. Then, providers will be interested in what it has to offer.
Magellan has evolved quite a bit since its beginnings as a behavioral health company. The health management company is used by health insurers, managed care organizations, employers and other groups for its analytics technology.
Although I understand the motivation behind using analytics and artificial intelligence to eliminate unnecessary tests, I hope there will be a balance between physicians knowledge and experience and these cost-saving tools.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
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