Much like children over the course of a long road trip, every now and then healthcare leaders beg the question: Are we there yet? From automating the creation of digital clinical documentation and advanced clinical analytics to delivering real-time clinical guidance and amplifying patient engagement, AI/ML have been discussed for years as the catalysts we need to realize a more intelligent healthcare future. “I think my team might faint when they hear that,” he says, “but that's the timeframe that, as an inpatient entrepreneur, I've got in front of us.By: Navdeep Alam, Chief Technology Officer, Abacus Insightsįor a decade or more, healthcare leaders across the industry have been teased with grand promises of artificial intelligence (AI) and machine learning (ML) and the role these technologies will play in the future of medicine. Patel hopes to reach 100 million lives in the next two to three years. The funds could also be used to make strategic acquisitions of other data companies, Patel says.īut the big focus will be on scaling up operations. ![]() The company, which has around 80 full-time employees, will use the investment to continue hiring across the engineering and product teams, as well as grow its sales and marketing division. Abacus, which uses Amazon Web Services, is “purpose built” for health insurers, making the platform “as easy as possible and much more cost effective than building it yourself,” Spadafore says. While many insurers have historically been hesitant about handing over data, their stance has slowly started shifting as Amazon Web Services and other cloud companies have increased investments in security, he says. There is huge opportunity for Abacus to grow, since “healthcare has been a lagging adopter of cloud technologies,” says Mike Spadafore, managing director of the Blue Venture Fund. The company charges an implementation fee and a licensing fee for its software platform with contracts lasting three to five years. Abacus has contracts with six companies, including health plans and service providers, equaling around “10 million individuals worth of data,” according to Patel. Patel says Abacus grew out of a similar process of identifying a market need and building a solution as an entrepreneur. In 2012, Patel sold the company to iHealth Technologies, which is now part of Cotiviti. ![]() In 2008, he launched Care Management International, which outsourced support functions for health insurers to clinicians sitting in India, such as writing clinical guidelines and developing drug formularies. The name Abacus was suggested by his son, after Patel explained the new company was going to “help customers count.” His son, who was 10 years old at the time, said it should be named after the ancient counting tool.Ībacus is Patel’s second venture as a founder. In 2017, Patel left Horizon to found Abacus, with the insurer coming on as an investor. A simple analysis, such as figuring out how many members with diabetes live in a certain county, could take several months to process, he says. ![]() This means claims data is housed in one area, membership and enrollment in another and authorizations in yet another. ![]() “Even for internal analytics purposes, simple questions that you think you should be answerable by a point and click, given modern technology, were taking weeks to months,” he says.įor many insurers, data reporting is secondary to having functional operational systems, Patel says. Patel started to realize how “stuck” data was in health insurance, while working as chief strategy officer at Horizon Blue Cross Blue Shield of New Jersey. While Abacus is specifically focused on payors, one of the big health industry challenges over the past few years has been integrating the different electronic health records used by providers. On its face, it may seem silly that the healthcare industry has evolved a bunch of different technologies that can’t talk to each other over the past several decades, but it’s a frustrating reality many companies face.
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