Artificial intelligence helps patients find the right care

When a Lowe's employee who's deemed “high risk” gets diagnosed with diabetes, a nurse will reach out to offer support and guidance.

The nurse might help the patient figure out treatment options, payment possibilities and access to care, combining a personal 
approach with data-driven analysis.

Lowe's employees are some of the 1 million people from self-insured employers and health plans who are customers of Accolade, which helps guide patients through the healthcare system, assisting with the navigation of the healthcare system's doctors, insurance claims and other decisions.

Using a combination of real-life humans and a digital platform that includes artificial intelligence, Accolade supports customers' employees throughout their experiences in healthcare, engaging them and saving clients as much as 15% in healthcare costs.

Whereas the average annual increase in healthcare spending is between 4% and 5%, the average annual increase for companies using Accolade is less than 1%, said Mike Hilton, chief product officer for Accolade.

“We think we're bending the cost curve,” said Gregor Teusch, vice president of total rewards at Lowe's. “That's good for employees and that's good for us.”

Accolade and other similar companies, such as Health Advocate, draw on data to assist employees. With that information—from pharmacies, biometrics, third-party providers, claims and other sources across the industry—Accolade can, for example, identify some of the employees who can't afford recommended medication. When it finds an issue like that, Accolade will reach out to the employee, and in the case of medication, help find manufacturer coupons or talk to a provider about lower-cost options.

But most interactions are initiated by employees, who often call with benefits questions, and in doing so create an opportunity to engage. When they call, the covered employee will speak to Accolade's “health assistants,” who go beyond answering the exact questions at hand, Hilton said. “We take it as an opportunity to understand what's going on with you before it becomes part of your medical history in your claims history,” he said. “A simple ID card or benefits question typically turns into a more involved engagement.”

As part of that, the health assistants might do a little digging after someone calls with an issue and find out the person has, say, trouble accessing care. “That will trigger a whole bunch of activity on our side,” Hilton said, including reaching out to find the best provider for the employee.

The health assistants aren't doing the research manually. Instead, they're using Accolade's platform, which includes an intelligence engine that combines two of healthcare's buzziest techniques—artificial intelligence and the closely related machine learning—to point them to possible solutions.

“We're applying a lot of the same strategies that consumer experiences, like Amazon and Netflix, are using,” Hilton said, noting that because “we're obviously not about movies and goods and services, our smart recommendations are more about what's the next best thing we can do for you or you can do for yourself to get the best health outcome.”

The Accolade platform's artificial and “natural” intelligence—that is, the computer and the humans—are in a symbiotic relationship, building off each other's strengths. Whereas AI computers can comb through tons of data, humans, on the other hand, can play a role tied more to emotions. Healthcare is personal, Hilton pointed out, so it's important to have both sides of the equation at work.

It's also important, he noted, to solve problems both large and small. If Accolade's health assistants help employees understand their benefits, they will be more likely to turn to the service with more complicated, personal questions. Trust begets more trust. And that, in turn, begets industry-level benefits.

“Our influence is about making smart decisions and getting people to the right care the first time,” Hilton said. “If you do this really well, you not only have really delighted and healthier consumers, you save meaningful amounts of money on healthcare costs, because you eliminate waste.”