Health Tech: Amit Garg On How HiLabs’ Technology Can Make An Important Impact On Our Overall Wellness
Focus on the impact rather than the “coolness” of technology: Most technologists focus on the cool and cutting-edge technology, and then try to find the killer app for their technology stack. This bias towards technology leads to solutions that deliver incomplete or inferior outcomes. Sometimes, the simplest technology solutions solve challenging problems at the lowest cost.
In recent years, Big Tech has gotten a bad rep. But of course many tech companies are doing important work making monumental positive changes to society, health, and the environment. To highlight these, we started a new interview series about “Technology Making An Important Positive Social Impact”. We are interviewing leaders of tech companies who are creating or have created a tech product that is helping to make a positive change in people’s lives or the environment. As a part of this series, I had the pleasure of interviewing Amit Garg, CEO of HiLabs.
Amit is an engineer at heart with decades of experience across data applications, mathematics and technology innovation. During his Masters program at Yale School of Management, Amit was exposed to the technology and data challenges facing health plans. That realization led to his journey into entrepreneurship and the start of HiLabs where he is changing how health plans mine data so that they can deliver more critical insights that directly impact the outcomes of their members.
Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?
I was born in Dehradun, a small mountain city seven hours North of New Delhi, India. I always had a passion for solving problems, so I studied engineering at IIT Roorkee. I started my career at Infosys, a global IT firm, and then switched to working at a startup headquartered in Washington, D.C. I learned how fascinating it was to find solutions to complex problems through technology. My role was to oversee both the business and IT departments within the startup, giving me a unique perspective on how the two areas could better collaborate and create value.
Soon after, I moved to CNSI, a large health IT firm. At CNSI I began to develop my passion for healthcare when I designed the first web-based healthcare claims processing system. I also realized that healthcare data is extremely challenging to work with since it is often incomplete and spread across disparate, unconnected sources. I began to wonder if there was a solution I could come up with to solve this massive challenge. However, first I thought I needed to further develop my business skills.
While at CNSI, I pursued my MBA at Yale’s SOM School of Management with a focus on healthcare, finance, and entrepreneurship. While there, I met Neel Butala, an MD/MBA student who also shared my passion for healthcare and data. Together, we began working on a business plan for an entrepreneurship competition. To our surprise we placed in the top 5 with our business plan that focused on tackling data quality in healthcare.
In the years that followed, we realized that to achieve our end goal, we needed to focus on both detecting and correcting data errors for healthcare organizations to complete the value chain.
We were well-suited to build such a solution based on our collective areas of expertise — healthcare, big data and artificial intelligence.
Today, HiLabs is refining dirty data to unlock its potential for healthcare transformation. Our technology delivers the ROI — Return On Intelligence — that health plans need. We convert dirty data into a valuable resource for improving member experiences and increasing efficiency, and we do it on day one.
Can you share the most interesting story that happened to you since you began your career?
In 2009, I was working with a client — a State Medicaid agency — to replace their 25-year-old health claims processing system. The client rejected one of our project deliverables, creating a delay that was costing my employer 2.5 million dollars every month. I was assigned to find a solution and turn the project around.
My initial investigation revealed that the clients leadership had approved the deliverable, however, the operations staff had not. Both were required to sign off to make us successful.
Subsequently, I learned that the operations staff was demoralized with their management’s decision to make this change. This was a paradigm shift for the operations staff. The change required to moving the old legacy system to my employer's modern technology solution without much (if any) say in the decision was too much for them. As a result of this decision process, the operations staff complained endlessly over even the small and meaningless issues, which are inevitable in large implementations such as this. Although, leadership initially thought this was a software implementation issue, the root cause was inertia and the human instinct to fear change.
I managed to convince the operations staff to engage in a collaborative workshop in which we could hear them out and dispel their fears about the new system. Through this workshop, I wanted to demonstrate the efficiency and simplicity of our product over their existing system.
This would create the possibility of getting their approval and ending the project deadlock and our $2.5M loss every month.
On the workshop’s first day, my aspirations (predictably) hit the wall. The state staff, although very knowledgeable about Medicaid policies and procedures, had almost no experience with technology. On the other hand, my team, consisting mostly of programmers could not comprehend the state’s complex business processes. The first day of our workshop resulted in many disagreements and misunderstandings. In addition to different professional backgrounds and perceptions, the two sides had different cultural backgrounds. The state staff were all west coast Americans while the bulk of my team consisted of new or recent immigrants to the United States. The different styles of communication further impacted the dynamics of these conversations, adding even more complexities.
Thankfully, I have always endeavored to learn from my mistakes and try new things as quickly as possible when something doesn’t work. The very next day, I met the operations staff lead to strategize on how we could bridge the differences between the two groups. She appreciated my frank viewpoint and dedication towards the success of this project. I wanted to switch from a “one big group” approach to multiple small sub-teams with each having a near-even mix of people from both sides. In my opinion, smaller groups could bond more easily than one large group. I created each sub-team with the most favorable mix of knowledge, temperament, and maturity to bridge the professional and cultural differences between the two sides.
The workshop lasted for over a month (and another $2.5 million dollars lost). During the day, I observed teams’ discussions and during the evening hours, I brought those observations to my team and helped them to prepare for next day. Ultimately, my efforts created an environment of cooperation and compromise; after a few days, we broke the ice with our counterparts. At the end of the workshop, we finally received approval from the operations staff and our product went live. I consider this to be one of the most successful Medicaid system implementations in the nation. The system has, to date, paid more than $20 billion worth of healthcare expenses, under the leadership of the operations staff who once did not even entertain the possibility of using the system.
This situation reinforced my belief in “thinking beyond you”. Focusing on the solution rather than who is right and who is wrong paid off. Had I focused on whether it was the client’s problem or our problem, we would not have resolved the issue quickly (if at all). We all perceive things through our own experiences. There can’t be just ONE way to solve a complex problem.
At HiLabs we have a culture of creating an innovative and intellectually stimulating environment by allowing people to speak their minds and share their logic and thinking openly. I believe
HiLabs’ success is based on this culture that motivates its employees to constantly iterate and improve. We are never satisfied with the status quo and believe we are only as good as the next challenge we solve.
None of us can achieve success without some help along the way. Is there a particular person who you are grateful for who helped get you to where you are? Can you share a story about that?
It would not be fair or accurate if I just picked one time when I needed help (since I, like everyone else has needed help many times) and only one person (since so many people have helped me succeed). I will start with the angel investors who put money into HiLabs when it was just an idea on paper. Our angels made their decision (to invest) just based on my determination to make HiLabs successful. Along the way, several of my close friends, Yale professors, investors, and board members helped connect me with key hires, customers, and partners, while also offering invaluable advice and counsel.
Can you please give us your favorite Life Lesson Quote"e? Can you share how that was relevant to you in your life?
I strongly believe in focusing on what is right, not who is right. Sometimes you might upset some very important people with something that is true that they don’t want to hear, but in the long run, this approach always pays off.
You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?
Growth mindset: I believe you must always be a student. Taking an approach of constantly calibrating and improving my thinking in combination with listening to my instincts has helped me deliver constant and consistent value to customers.
Transparency: I believe in sharing successes and failures. At HiLabs we share outcomes from our successes and lessons from our failures regularly. In that process, you build an environment of true autonomy and continuous learning — which almost all successful people seek and appreciate.
Perseverance: I believe that you must go with your customers to the finish line: We truly differentiate ourselves from our competitors by focusing on helping them cross the finish line. We work as a true partner for our customers and help them realize the full value of our solutions. We have deliberately chosen the approach of working alongside our customers to ensure they realize tangible outcomes rather than extracting as many dollars as possible at the highest possible margin. That approach helped us build a platform that offers measurable results within our customers critical operations.
Ok super. Let’s now shift to the main part of our discussion about the tech tools that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve?
Healthcare data sources are expanding exponentially, and data exchange between healthcare entities is rapidly accelerating. However, each interaction risks creating new or propagating existing data errors, costing the healthcare industry over $300 billion annually. Inaccurate provider directories, claims data, and care management data lead to a host of problems in healthcare, including surprise billing, impaired access to care for health plan members, and lower care quality ratings for health plans. The HiLabs platform helps make data meaningful, cleaner, and usable, resulting in improved business outcomes and an enhanced member experience.
We are the only player in the industry to collect and augment provider directory information using automated ingestion. We also ingest plans’ internal contracting documents and a wide variety of structured and unstructured data, bringing it all together and refining it, uncovering the hidden potential in this dirty data.
Our unique medical and health insurance expertise has enabled us to build an AI/ML technology that is perfectly suited to the needs of health plans, applying industry standard business rules and ontologies to enhance data quality rapidly, with minimal ramp up and AI training time.
How do you think your technology can address this?
HiLabs has demonstrated its AI capabilities and deep healthcare domain expertise by solving complex data quality problems for some of the largest health insurers in the U.S. HiLabs’ core AI platform, MCheck™, proactively detects and corrects data errors throughout the health plan enterprise. MCheck rapidly improves operations and analytics, resulting in significant cost savings and opportunities to improve care for individuals and communities. For example, nearly 50% of provider directory entries are inaccurate, which impacts the member experience and leads to surprise billing and poor access to care. MCheck has improved directory accuracy by over 29% at a major national health plan. Additionally, MCheck has helped another major national plan onboard and quality check billions of clinical records, while saving $11M in operational cost. HiLabs’ AI has also identified errors which would have affected over 5% of a health plan’s member population attributed in value-based care arrangements.
Can you tell us the backstory about what inspired you to originally feel passionate about this cause?
When Neel and I met at Yale, we discovered that we both had a shared vision for predicting illness through AI, but quickly learned this wasn’t possible due to the poor quality of healthcare data. Now, we partner with some of the largest health insurers in the U.S. to proactively detect and correct data errors — enabling our customers to leverage this data to do higher quality analytics and avoid costly, downstream impacts.
How do you think this might change the world?
The world is rapidly moving towards a highly data-driven environment. From shopping experiences to self-driving cars, almost everything these days depends on good, accurate data.
Dirty data not only results in inefficiencies and bad customer experiences, but can also lead to life-threatening incidences in the realm of healthcare where the stakes are very high. We are on a mission to build technology to solve dirty data problems intelligently, at scale, with maximum efficiency and security.
Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this technology that people should think more deeply about?
Data errors are everywhere in every industry. Our technology shines light on these errors and enables health plans to undertake advanced analytics effectively. If anything, our technology helps protect against the potential adverse consequences of advanced analytics to answer questions by ensuring the data feeding these analytics are accurate. At the same time, people should not just rely on our technology blindly, cutting corners in critical processes to make critical data-driven decisions. Technology can never replace humans; it just enables us to be exponentially more efficient and productive.
Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”? (Please share a story or an example, for each.)
Focus on the impact rather than the “coolness” of technology: Most technologists focus on the cool and cutting-edge technology, and then try to find the killer app for their technology stack. This bias towards technology leads to solutions that deliver incomplete or inferior outcomes. Sometimes, the simplest technology solutions solve challenging problems at the lowest cost.
Focus on disruption through collaboration: Many times, we tend to misinterpret “disruptive” solutions as those that completely replace existing solutions. However, co-existence alongside other solutions can create a better overall outcome. Being sensitive to your customers’ existing investments and respectful towards other solutions and processes (including your competitors) results in a larger and faster value add to your customers by creating easily integrable, lower lift solutions.
Sensitivity around adoption: Successful solution providers are sensitive toward building technology that is easy to learn and use. Many impactful solutions die out if they are too complex to use for the average person.
Iterative and adaptable approach: We, as technologists, often wait for a perfect solution before going to the market. These solutions do not exist, and an approach to release MVPs and quickly learning and iterating offers opportunities to constantly adapt to customer feedback and create a world class solution rapidly.
Value add rather than feature add: What worked for us is taking an approach where we always asked “why” about every potential enhancement in our platform, rather than looking to add the coolest new feature without thinking through the actual value add.
If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?
Think about the big picture. It doesn’t happen overnight, you need to be persistent, patient, and have true grit — even Facebook took a decade to get to 1B users. Engineers tend to get specific and use jargon very quickly. However, the story behind your technology must be simple, easy enough for your grandma or five-year-old relative to understand.
Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. 🙂
James Goodnight, Co-founder, and CEO of SAS Institute, because of his style of leading by offering intellectual challenges and removing distractions for employees in order to help them succeed.
How can our readers further follow your work online?
● Website: https://www.hilabs.com/
● LinkedIn: https://www.linkedin.com/in/connectamitgarg/
Thank you so much for joining us. This was very inspirational, and we wish you continued success in your important work.
Health Tech: Amit Garg On How HiLabs’ Technology Can Make An Important Impact On Our Overall… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.