Optum Insight sees AI as key to future

After years of working for Google, Madhu Pawar says she was intrigued by the challenge of tackling some of the biggest challenges in the healthcare industry.

Pawar says she enjoyed her time with Google, where she helped develop consumer engagement platforms, which she said was “delightful.” She says she appreciated the camaraderie and sharp mind of Google.

But as chief product officer of Optum Insight, Pawar says she sees the potential to make a difference in the healthcare industry.

“I'm a computer science scientist by training,” Pawar says. “I'm drawn to tough problems that technical solutions will solve. And in this particular case, in our industry, this is prime land for where AI can be helpful.”

Pawar joined Optum Insight nearly two years ago. She says she’s relishing the chance to come up with innovative ways on meaningful problems in the industry.

“We're very mission-oriented,” Pawar says. “And when one thinks about, well, where is it that I can have the highest, best use of my skills? Where can I contribute the most? It could have been in yet another consumer tech app where you can order pizzas faster, right? Or it could be in making the healthcare system work better for everybody. It could be in improving the lives of humans in this country.”

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Optum Insight, part of the United HealthGroup, is pouring enormous resources into AI capabilities. Optum has more than 10,000 AI engineers.

Optum Insight is leveraging AI in more solutions for payers and providers. Its clinical analytics platform uses AI to help improve scheduling for surgeries and use supplies more efficiently. Lehigh Valley Health Network used that platform to save more than $2.5 millions with the platform, the company says.

Pawar says the platform offers “real-time visibility to a hospital administrator on operating room utilization.”

Allina Health, based in Minnesota, has used Optum Real, an AI-powered system speeding up claim processing. Allina has piloted the solution for outpatient radiology and cardiology patients, and the health system has said it’s seeing fewer denials.

Pawar points to further gains with using AI in ways to streamline the work of providers and payers, with technological advances that weren’t conceivable not too long ago.

“It's been a quantum leap in terms of what one can now do with generative AI, with large-scale machine learning,” she says. “Because now you've got things that were really difficult to solve just five years before, now, are far easier to do because you've got AI systems that can learn, and perhaps even get more creative with the answers.”

Now, she says she focuses on a key question: “How do we bring generative AI to solve many more problems in the most responsible way?”

Pawar says she wants to develop more tools to help reduce obstacles that make it more difficult for health systems to care for patients.

“We are in the business of addressing those pieces of friction, getting those out of the way,” she says. “We want to help reduce the costs and improve the efficiency for the health systems as they run their operations.”

Many healthcare leaders are banking on AI to help make it easier to care for patients and run their businesses more efficiently, and AI has been the dominant topic of healthcare conferences over the past two years. More health systems are investing in AI products to automate workflows and reduce some administrative headaches from staff.

Pawar thinks the optimism for AI is justified, although she cites the need for utilizing new technologies carefully in the healthcare space. She sees AI’s potential in “reducing the cognitive workload of the humans that are in the system who are just trying to provide good care.”

“With the right guardrails, responsibly developed AI is a source of optimism for the industry, in particular, to address the labor shortage,” Pawar says.

“I do see an opportunity for that,” she says. “I don’t believe the industry is being overly optimistic and overly enthusiastic.”

Payers and providers often have strained relationships, particularly in terms of delays or denials in approvals for services. Pawar sees potential for AI technology to help improve relationships, and patient care.

While she hasn’t been in the healthcare industry for too long, she says she sees a greater desire among both sides to solve problems.

“The way we would think about it is … the acceptance of some of our innovations that do bring both sides together,” she says.

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