One place, one platform. How generative AI has transformed the healthcare experience.

By: Benjamin Nguyen, MD, Transcarent Lead Product Manager for Artificial Intelligence 

Complicated, confusing, and costly is how most people would explain the American healthcare system. Getting healthcare can be far from easy. The average person must wade through the complexity of insurance coverage, copays, deductibles, in- and out-of-network providers and benefits, doctors' schedules, and office locations – all before they get care. 

Many have tried to solve for this complexity with “Band-aid” solutions that have only made the experience more fragmented and confusing, exacerbating the situation for both patients and providers. To truly change the status quo, healthcare must move from a guessing game of disjointed transactions to a holistic and intuitive platform experience that people love to use and gets them what they need in that moment. 

This is possible when people have one place to go for their health and care; a seamless platform that knows them personally, that’s accessible from anywhere, at any time, and brings their healthcare experience together into the palm of their hand. Everything from on-demand care to weight health, surgery, pharmacy, cancer care, and navigation – including all their point solutions – should be easily accessible in one place. 

My team at Transcarent has been dreaming big and innovating responsibly by combining the power of generative AI and the expertise of our clinicians into the One Place for Health and Care. We’re taking a novel approach to innovation in healthcare with a platform experience that puts the power of generative AI directly into the hands of our Members. 

Generative AI: Powering a personalized health and care experience

Technology alone cannot solve for the complexity, confusion, and costs of healthcare. By taking a human-centered approach to combining them, we can finally transform the healthcare experience, making engaging in healthcare as easy as getting your groceries delivered same day.

Generative AI has opened up a new avenue of personalization that wasn’t possible before. Over the last few decades, innovation in data science and machine learning have focused on building big predictive models. That meant feeding data points about a huge sample population into a machine learning model and training it to make predictions about a person based on that data. You would take a single person’s data, perhaps medical history, symptoms, age, demographics - and feed that into the predictive model you trained. The model would offer a prediction about a patient’s risk factors and that could be used to direct them towards preventive care. 

But here’s where we failed in the last few decades: it doesn’t matter if you know what a person needs to do if you can’t convince them to do anything about it. Maybe the person doesn’t have the right health literacy, maybe they don’t speak English fluently or know the first step to take to access care. Predictive models are powerful tools, but they aren’t going to cross the communication and engagement gap. 

LLMs: The key to next-generation navigation 

This is where Large Language Models (LLMs) come in. LLMs have gotten a lot of attention recently and one of their most underrated capabilities is that they are very good at understanding imperfect, messy, misspelled fluent human language. They can take any concept and simplify it, translate it, and explain it at any level of complexity or simplicity needed, allowing a person to be guided through an experience in a way that is unique to them. This is one way that generative AI can reduce the structural biases of the healthcare system – by moving us from “one size fits all” to “many sizes for many needs.” 

Now with LLMs, people can Just Ask in their moment of need and get trusted answers that are specific to them in a way that an FAQ or call center can never achieve. This is what we built with Transcarent WayFinding. It’s next-generation navigation that allows people to Just Ask Transcarent in their moment of need and instantly connect to personalized healthcare and benefits information that is customized to their employer’s ecosystem, trusted clinical guidance to take the next step, and on-demand access to high-quality care -  all in one place from the palm of their hand. 

This means it’s possible to create materials that are tailored to the patient’s level of health literacy and education, in the person’s preferred language, including content that addresses the actual questions that they asked during their visit. A personalized healthcare experience like this takes us from predicting to empowering people toward action, resulting in better outcomes and lower costs.

Empowering people and providers is the future

I’m passionate about what’s possible with generative AI in healthcare because I see it restoring healthcare as it was meant to be – for both the people receiving care and the people delivering care. It democratizes access to healthcare resources, speeds access to treatment, improves provider workflow, and reduces their administrative burden. When that burden is lifted, providers can place a larger emphasis on the human connection and deepening trust with Members. Physician time can be preserved for caring for people, instead of administrative work, allowing them to practice at the top of their license.

AI holds great promise to revolutionize the healthcare experience for the better. We are committed to leading the industry with responsible innovation based on earned trust that puts people first and makes it easy for all people to access high-quality, affordable health and care. By putting the power of generative AI and expert providers into people’s hands we have created a healthcare experience that people love to use – one that will finally, truly change the healthcare status quo.