Maximizing Care Management Via AI Chat with Yoni Shtein, CEO of Laguna Health

[00:00:02] [SPEAKER_00]: Hey everybody, welcome back to the Outcomes Rocket AHIP 2024 Insights here from Las Vegas at the amazing Wynn Hotel.

[00:00:10] [SPEAKER_00]: I have the privilege of hosting Yoni Shtein, CEO of Laguna Health. Yoni, welcome.

[00:00:17] [SPEAKER_00]: Thank you for having me.

[00:00:18] [SPEAKER_00]: Of course, again, right?

[00:00:20] [SPEAKER_00]: I know. Back home, I'm back home.

[00:00:22] [SPEAKER_00]: Yeah, so the nice thing and actually the cool thing that happened, we recorded an episode with Yoni and we actually happened to publish it day one of AHIP, which is pretty cool.

[00:00:31] [SPEAKER_00]: Yeah.

[00:00:32] [SPEAKER_00]: Now, we're going to give Yoni an opportunity to share with everybody what he's up to and then also walk through some insights from AHIP.

[00:00:39] [SPEAKER_00]: So, Yoni, talk to us about you. What got you into what you do?

[00:00:43] [SPEAKER_00]: Generally, you're asking about healthcare.

[00:00:45] [SPEAKER_00]: Because you weren't always in healthcare.

[00:00:47] [SPEAKER_01]: I wasn't always in healthcare. I was actually an investor at a large private equity credit fund before that.

[00:00:53] [SPEAKER_01]: And, you know, I was kind of taking a quick side because at a family event, I lost my mother-in-law and that was a big slap in the face.

[00:01:00] [SPEAKER_01]: But what's interesting is not only my personal story, it's how common it is to have a certain personal health event for digital health entrepreneurs to get into this industry.

[00:01:11] [SPEAKER_01]: And it's obviously a huge motivator that's frankly quite needed because it's not a trivial industry.

[00:01:17] [SPEAKER_01]: I don't know if there's any trivial industry.

[00:01:19] [SPEAKER_01]: Healthcare is certainly not one of them.

[00:01:21] [SPEAKER_01]: And you need that engine.

[00:01:22] [SPEAKER_01]: You need that passion to go through the journey successfully.

[00:01:26] [SPEAKER_01]: So, that's how I'm here.

[00:01:27] [SPEAKER_00]: Yeah, no, well, we're glad you're here.

[00:01:29] [SPEAKER_00]: You're bringing your insights and innovation.

[00:01:31] [SPEAKER_00]: In fact, I think we all benefit from outside industry coming in.

[00:01:36] [SPEAKER_00]: It brings new perspective.

[00:01:37] [SPEAKER_00]: It brings sort of open box ideas, which is what you're doing at Laguna.

[00:01:42] [SPEAKER_00]: So, for the benefit of everybody that doesn't know yet or haven't listened to your episode, tell us about Laguna.

[00:01:47] [SPEAKER_00]: What do you guys do?

[00:01:48] [SPEAKER_01]: So, Laguna is a conversational AI company for healthcare care management function.

[00:01:53] [SPEAKER_01]: To explain it in layman terms, the care management function is essentially a clinical call center.

[00:01:59] [SPEAKER_01]: And we focus mostly on the payer health plan side.

[00:02:02] [SPEAKER_01]: Hence, the conference that's predominantly kind of all the regional and national payers attend.

[00:02:08] [SPEAKER_01]: Certainly very aligned with us.

[00:02:10] [SPEAKER_01]: And we're trying to help the care manager who really has a quite difficult workflow or task in trying to balance all the systems and scripts that they have while trying to pay attention and help members in multiple chronic, high-risk, or acute episodes.

[00:02:27] [SPEAKER_01]: That is why payers have that.

[00:02:29] [SPEAKER_01]: We're leveraging conversational AI, which literally means being able to capture the conversation in real time, transcribe and summarize it, known these days as ambient listening.

[00:02:39] [SPEAKER_01]: Doing all of that frees up the attention of the care manager to actually pay attention to what the member is saying.

[00:02:45] [SPEAKER_01]: But we go beyond that because ambient listening this day and age is becoming a bit of a commoditized table stakes.

[00:02:51] [SPEAKER_01]: You're expected to do it.

[00:02:52] [SPEAKER_01]: What we've built above that is a large language model that enables us to analyze what the member is saying, what the care manager is saying.

[00:03:00] [SPEAKER_01]: And it gets really interesting there because that introduces consistency and the ability to act on certain problems and barriers that may arise and drive certain benefits and pathways for the member during the engagement and after.

[00:03:16] [SPEAKER_01]: This is driving net-net higher efficiency of the care management function and better outcomes, higher effectiveness.

[00:03:22] [SPEAKER_00]: That's fantastic.

[00:03:23] [SPEAKER_00]: Yeah.

[00:03:23] [SPEAKER_00]: That's fantastic.

[00:03:24] [SPEAKER_00]: Such a great use of this new technology, Yoni.

[00:03:27] [SPEAKER_00]: And are most of these interactions happening through a call center?

[00:03:31] [SPEAKER_00]: Are they happening in person?

[00:03:33] [SPEAKER_00]: Talk to us about that.

[00:03:34] [SPEAKER_00]: Yeah.

[00:03:34] [SPEAKER_00]: It's a fantastic question.

[00:03:35] [SPEAKER_01]: Either way, most of our ICP, as it's known, ideal customer profile is the virtual, remote, multimodal, telephonic, chat, text.

[00:03:45] [SPEAKER_01]: In the provider side of the world, you're seeing amazing companies like Bridge or Ambience or Nabla or Suki.

[00:03:52] [SPEAKER_01]: And on the provider side, many, not all, but many of clinician-patient interactions happen not to dissimilar from this face-to-face.

[00:04:01] [SPEAKER_01]: I think what is exciting about the technology, the medium is not the point, right?

[00:04:06] [SPEAKER_01]: It doesn't matter how language is captured, whether it's kind of a phone or a microphone, whatever, that is capturing our interaction physically, or it's a virtual encounter.

[00:04:15] [SPEAKER_01]: As long as you're able to capture the language, you can provide the value from that language analytics.

[00:04:21] [SPEAKER_00]: Totally.

[00:04:22] [SPEAKER_00]: Yeah, it makes a lot of sense.

[00:04:24] [SPEAKER_00]: And thank you for the insights there.

[00:04:25] [SPEAKER_00]: Huge opportunities to derive information from these interactions to make a difference for the care managers and the patients.

[00:04:33] [SPEAKER_00]: All right.

[00:04:34] [SPEAKER_00]: So shifting to Ahib.

[00:04:36] [SPEAKER_00]: You've been in a lot of sessions.

[00:04:37] [SPEAKER_00]: You've been interacting with a lot of these payers and payers mainly here at the conference.

[00:04:42] [SPEAKER_00]: What's an insight that's risen to the top for you that our listeners and viewers could benefit that couldn't come here?

[00:04:48] [SPEAKER_01]: I think, again, kind of connecting it to a discussion about AI in 2023 and certainly more so in 2024, AI is top of mind.

[00:04:57] [SPEAKER_01]: And I think that creates certain opportunities and concerns.

[00:05:01] [SPEAKER_01]: And some of the panels were discussing that, right?

[00:05:04] [SPEAKER_01]: Kind of the impact of Gen AI, conversational AI on healthcare interactions and how you can drive efficiency through that.

[00:05:12] [SPEAKER_01]: I think that's on the positive.

[00:05:13] [SPEAKER_01]: On the quote-unquote negative, you have cybersecurity risks.

[00:05:18] [SPEAKER_01]: You have, as it's known, Gen AI hallucinations, how accurate, if you will, or human-like the outcome is.

[00:05:26] [SPEAKER_01]: And so some of these panels were discussing it quite openly, kind of AI in this day and age.

[00:05:32] [SPEAKER_01]: What's the kind of the net net of it?

[00:05:33] [SPEAKER_01]: Kind of if you step back the overarching point, I would say, and I think we touched on this actually briefly during our podcast,

[00:05:39] [SPEAKER_01]: like many hyped-up things, people tend to kind of develop strong reactions.

[00:05:46] [SPEAKER_01]: It's either kind of this panacea that will solve everything or it's all BS, pardon my French, and like just hyped up.

[00:05:54] [SPEAKER_01]: And the truth is somewhere in the middle.

[00:05:55] [SPEAKER_01]: Yeah, yeah.

[00:05:56] [SPEAKER_01]: And that is kind of what is really important.

[00:05:58] [SPEAKER_01]: And some of the panels have been doing a great job of discussing this is a pocket of opportunity.

[00:06:02] [SPEAKER_01]: This is a pocket of concern.

[00:06:03] [SPEAKER_01]: You want to take steps one, two, three to avoid it.

[00:06:07] [SPEAKER_01]: And it's amazing kind of hearing from some of the biggest thought leaders in the industry and having the opportunity to discuss after the panel.

[00:06:14] [SPEAKER_00]: Yeah, no, that's really great.

[00:06:15] [SPEAKER_00]: Thanks for sharing that.

[00:06:16] [SPEAKER_00]: And as everybody listens and watches, as you look to formulate your own strategy and thoughts around AI in the healthcare space,

[00:06:25] [SPEAKER_00]: whether the provider or payer space, I think Yoni's insight here is that it's pockets.

[00:06:30] [SPEAKER_00]: You can't generalize.

[00:06:31] [SPEAKER_00]: If you generalize, you're going to miss opportunities.

[00:06:34] [SPEAKER_00]: Yes.

[00:06:34] [SPEAKER_00]: Or you're going to miss credibility.

[00:06:36] [SPEAKER_00]: Yeah.

[00:06:36] [SPEAKER_00]: Great point.

[00:06:37] [SPEAKER_00]: So love that.

[00:06:38] [SPEAKER_00]: Thank you for that insight.

[00:06:39] [SPEAKER_00]: I think that's something everybody can benefit from.

[00:06:41] [SPEAKER_00]: As we close today, what call to action would you leave our viewers and listeners with?

[00:06:47] [SPEAKER_01]: Maybe going back to your first question, what got me into this is to the kind of the listeners and viewers that would challenge and invite them to make a positive impact in healthcare.

[00:06:57] [SPEAKER_01]: It's a difficult industry, but I can think of few other industries that are as meaningful to the society we live in and to us as individual people and health consumers.

[00:07:09] [SPEAKER_01]: So conference like these ones and others provide the opportunity to build thoughtful insights about the pockets of opportunity AI or otherwise and some of the risk and rewards of doing that.

[00:07:23] [SPEAKER_01]: So kind of my firing words, if you will, would be please help all of us make a difference in this very important space.

[00:07:29] [SPEAKER_00]: Well said, Yoni.

[00:07:30] [SPEAKER_00]: Well said.

[00:07:31] [SPEAKER_00]: Let's take action on that, guys.

[00:07:33] [SPEAKER_00]: If you want to take action and it means improving your chronic care management program, what's the best place to get in touch with you?

[00:07:40] [SPEAKER_00]: LinkedIn or email.

[00:07:41] [SPEAKER_00]: Excellent.

[00:07:42] [SPEAKER_00]: Yeah.

[00:07:42] [SPEAKER_00]: Fantastic.

[00:07:43] [SPEAKER_00]: Well, Yoni, thanks again for being with us.

[00:07:45] [SPEAKER_00]: I always enjoy our conversations.

[00:07:47] [SPEAKER_00]: Thank you.

[00:07:47] [SPEAKER_00]: I always end up learning something new.

[00:07:49] [SPEAKER_00]: Vice versa.

[00:07:50] [SPEAKER_00]: Thank you.

[00:07:51] [SPEAKER_00]: Thanks again.

[00:07:51] [SPEAKER_00]: And everybody, make sure you check the show notes.

[00:07:53] [SPEAKER_00]: We'll link up Yoni's LinkedIn profile as well as Laguna Health's website so you can take action on the things you learned today.

[00:08:00] [SPEAKER_00]: Thank you all for tuning in and stay tuned for more insights from AHIP.