The AI platform at Heaps Health delivers data-driven insights. This benefits both hospitals and insurers by allowing them to deliver excellent patient care without being burdened by excessive costs.
Suman Katragadda, a technology consulting expert visiting India, was hospitalized owing to a serious kidney stone disease that was managed but left him with some adverse effects. This encounter prompted Suman to consider how the whole healthcare system operated, and he saw that three major constituents – patients, hospitals, and insurance companies – were functioning in data silos with little connection, posing several issues.
Higher medical expenditures for patients, insurance companies paying out more claims, hospitals unable to properly utilize their infrastructure or losing patients, needless hospitalization, and so on were among the issues. Suman’s career as a technology with consulting company PwC convinced him that artificial intelligence (AI) could be used to create a platform that brings all three constituencies together to allow more openness and efficiency.
Suman founded HEAPS Health Solutions in 2021, with its headquarters in Bengaluru, and company was begun on a shoestring budget. Each constituency in the healthcare business faces its own set of issues. For hospitals, the concern is always how to develop ongoing engagement with their patient base in order to create a foundation of loyal clients, otherwise they will migrate to the competitors. The creator of Heaps Health thinks that hospital involvement with patients falls under four categories: education, awareness, self-management, and proactive evaluation. This can truly aid in the early discovery or raising of any health concern.
The primary characteristics that define a hospital’s performance are its experience, cost, mortality, and infection rates. According to Suman, around 30% of patient hospitalizations are preventable.
Heaps Health Solutions has now developed an AI-driven tech solution that brings these three constituencies together on a single platform and gives actionable insights based on the data it collects.
“Hospitals need more patients, while insurance companies need fewer claims,” Suman adds, “and we need to find a tight balance.”
The development of this platform took several years, during which Heaps combed through massive quantities of data using a trial and error process.
Heaps’ healthtech platform works with the objective of cost optimization without sacrificing quality, and it is a win-win situation for everyone. Under the Heaps model, it has built a value-based care model with the goal of maintaining quality of care while reducing costs. In this system, Heaps only works with high-performing hospitals, and insurance companies may negotiate prices with them rather than adopting a fixed-price model.
“We want insurance companies to come into the hospital and negotiate a value-based care system in which they are rewarded for good outcomes,” Suman adds.
Heaps Health Solutions gives information to all of its partners to assist them in making the best decision. Suman says that their technology offers customised treatment for patients by using data insights to ask highly specific queries about their health state.
In this scenario, for example, proper diagnosis can lead to lesser hospitalization, which benefits the insurance company, although in the event of severity, it benefits the hospital because the expense of treating such diseases is significant.
GrowthHeaps Health Solutions’ platform includes 45 hospitals and two insurance providers. Another 8-10 insurance companies are expected to join soon. More corporates are also expected to join this platform.
Heaps Health Solutions’ whole IT platform is managed by the highest levels of data security. Suman says that their technology offers customised treatment for patients by using data insights to ask highly specific queries about their health state.