John discusses analytics use cases in healthcare.
Sramana Mitra: Let’s start by introducing our audience to yourself as well as to Pareto.
John Steele: I’m the CEO of Pareto Intelligence. Pareto is an analytics and technology company focused on improving outcomes under value-based care arrangements in healthcare. We started right around 2014 and were born out of some of my prior consulting work, which has led us to our current model of SaaS and Analytics-as-a-Service.
Sramana Mitra: Let’s double-click down on what specifically is the customer problem that you’re solving and how you are solving it.
John Steele: There are two customer problems that we focus on. One is there has been a shift in healthcare toward value-based care. The integrity of that revenue, meaning how they get paid, is very complex and is based on the health status of the members and patients.
A lot of our analytical work makes sure they receive the right level of reimbursement under those complex formulas. We focus a lot on making sure that the integrity of the data that’s being used is intact.
Sramana Mitra: Who is the customer – payer or provider?
John Steele: It can be both. Historically, it has been the payers. We do have some risk-bearing providers that are also using the same solutions.
Sramana Mitra: What is the second customer problem?
John Steele: It’s this increasing volume and velocity of healthcare data. Models are becoming more complex but open. That’s because of some of the new interoperability standards that allow some of the healthcare data to move freely between a provider’s EMR to a payer’s enterprise data warehouse.
That has become a real challenge for our payer clients because they’re not used to that sort of variety as well as velocity. Historically, a lot of claims reimbursement data is lagged. There’s a big latency that happens from when the event or care is delivered to when that data is available. We’re seeing people getting information quicker, but it tends to be more unstructured. The fidelity is not as trustworthy.
One of the problems that we saw is being able to bring together both the clinical and social determinants, as well as some of that claims and reimbursement data to bring a more holistic picture of a patient that somebody has.
Another challenge is decreasing the latency. We found that to be a big challenge for our payer clients as well as some of our provider clients. It is critical to able to bring all that together into one 360 model so we can make informed decisions and take actions in a more real-time fashion.
This segment is part 1 in the series : Thought Leaders in Healthcare IT: Pareto Intelligence CEO John Steele