Electronic Health Reporter

Rohan Kulkarni, vice president of healthcare strategy and portfolio at Conduent, speaks here about Conduent’s healthcare strategy and the company’s move to brand following its separation from Xerox. While doing so, he steps back to look briefly at aspects of healthcare technology’s past then pivots to its future and what he’s most excited about in the space and how he hopes to be part of it. Finally, he describes wheat he would pursue if he were healthcare’s king, and what that would look like and how he would change the sector for the best impact to the patient.

You’re the vice president of healthcare strategy and portfolio at Conduent. Can you explain what the role entails, and how you approach it?

The transformation in healthcare that is occurring is generational and provides for unprecedented opportunities. As the head of healthcare strategy, I am responsible for identifying those opportunities that are relevant to us and help strengthen our portfolio. I then design and develop a strategy in collaboration with our business leaders that will help meet our growth goals.

Tell me how Conduent plays in healthcare and how its solutions specifically impact the point of care.

Conduent has perhaps the broadest solutions portfolio in the healthcare services, allowing us to connect the entire healthcare ecosystem.

Conduent provides solutions that help our clients overcome industry obstacles, including inefficient processes, inaccessible data, regulatory mandates and challenging economics so they can focus on improving patient lives through better, affordable, accessible healthcare. Our solutions are all designed to help our clients manage the health of their patient populations so they can improve healthcare outcomes. We help make the transition to value-based care models a reality, and we work with healthcare professionals to design solutions that meet their specific needs.

Conduent is dedicated to the efficiency of claims accuracy, facilitating bill payments and risk assessments, communicating benefits, driving medication adherence, improving patient engagement and technology education, and delivering on quality and care data across medical systems. Our solutions are designed to reduce preventable readmission rates for defined population sets, control costs by executing proactive engagement and provide ongoing management for patients with chronic conditions.

Conduent just completed its separation from Xerox. What does that mean for your company and for your customers? Why the move and why the rebrand? Why not build on the power of the Xerox brand? 

When reviewing the products and services offered across the business, we determined creating two independent, standalone entities – Xerox and Conduent – would give us the ability to create greater shareholder and customer value. The separation is based on a structural view of two of our businesses and with simpler, more focused organizations, we’ll be able to adapt to market demands and ensure we’re positioning the business to deliver tailored solutions based on our clients’ evolving needs.

How has healthcare IT transformed throughout your career? How has Conduent been involved in healthcare’s evolution?

I think most of the healthcare industry expected healthcare IT to be a driving force in improving how providers deliver solutions to their patients, but I don’t think we expected the rate of change to be so dramatic, especially over the last decade or so. We’ve seen vast improvements in how providers use health IT with the advent of electronic health records, mobile health technologies, telemedicine, wearables, analytics, etc., to improve communication with patients, personalize care and drive healthier outcomes. Since our introduction to the healthcare space, we’ve been helping businesses and governments better harness the influx of information to enable transformation. From the back office processes like billing and payments, to using Big Data to drive medication adherence, assessing risk and improving patient engagement, our solutions meet today’s challenges and prepare healthcare organizations to meet tomorrow’s needs.

What are you most concerned about in regard to healthcare’s future?

Healthcare economics continue to be single dimensional in that the focus is on the demand side, i.e., insurance. The Affordable Care Act (ACA), while it has streamlined the demand side, it has not addressed supply side, e.g., hospital charges, cost of medication etc. in any meaningful manner. As such, much of the debate in the public domain about healthcare is unlikely to make progress until both sides of the equation are discussed.

That said, there has been a bridge to the supply side with Value Based Payment mechanisms. The industry generally agrees fee-for-services does not promote the right behaviors to improve health. The move to outcome-based models has shown a significant need for payers, providers and consumers to align on what this actually means for patient care. While there has been significant progress so far, the industry has a long way to go to make value-based care a reality, and a big part of that has to do with getting patients involved in their own care plans. Studies show many patients don’t feel engaged in their own healthcare, and with so many technological options that provide an avenue for communication, the industry must learn how to be strategic in how they’re reaching their patients.

Most excited (specifically)?

Health consumers will continue to consume healthcare in new and improved ways, forcing the market to keep up with their needs. There is still a big opportunity to bring together data across the various healthcare segments and to leverage advancing technologies to provide the right insights at the right time to make healthcare more patient-centric, improving outcomes for specific patient populations. If the industry can use data to inform better healthcare decisions, we’ll be able to manage chronic conditions and dramatically change outcomes and drive down costs. The industry is already on its way to using exciting technology like wearables to gather information and inform care decisions, and I think we’ll see this market continue to grow in the years to come.

What is your vision for the future of healthcare? How do you plan to be a part of it?

The key challenge in our healthcare system is that it is too fragmented across types of health consumers, financing, care entities and more. While the possibility of merging them would be a herculean task and perhaps not practical, what is possible and should be done is the aggregation of data across these various healthcare segments that can then be leveraged to drive a level of seamlessness such as being able to have access to your EHR anywhere at anytime.

At Conduent, we have perhaps the broadest set of solutions across all healthcare segments. We see ourselves as being a principal in connecting that healthcare ecosystem around the health consumer in a meaningful manner that will aid both the financing, prevention and care aspects of healthcare.

We want to be part of the health rather than the sick care, we want to help our clients improve health outcomes, improve both consumer and care giver experiences and meaningfully optimize the cost of care.

What did you set out to do with your life (when you were a kid) and how, if at all, are you still working toward that goal?

Well as a regular kid I had goals that changed month over month, year over year. However, as I came of age I have looked for ways to contribute towards the betterment of the societies in which we live. To help solve challenges that are both hard but also have a deep and long impact when solved for. Improving healthcare in the U.S. has been a passion for a number of years and I continue to seek ways to both contribute to the discussion and explore new ways to help change it for the better.

What are the underlying advancements in technology needed to help take us to that future?

While constituents across the healthcare industry are interested in using data in new and innovative ways, the challenge lies with aligning how patients, providers and payers use and share the information to change habits, increase medication adherence, streamline the claims process and create care plans that work for specific patient populations. While the capability is there, improved interoperability will allow payers and providers to efficiently communicate with each other, and with their patients, across disparate systems. For example, a patient seeing multiple providers may have an EHR associated with each, making it difficult for providers to access and share the information across their unique systems. Until we have the interoperability backbone to support the influx of information from multiple sources, we will never see the full potential technologies like telehealth, wearables, EHRs and others promise to offer.

How did 2016 surprise you? Do you wish you could have stay on this side of the calendar longer or are you glad to turn the page?

Each year, the list of advancements across the healthcare sectors seems to grow, and 2016 didn’t disappoint in that regard. Xerox released results which showed the large disconnect between how patients and providers view their role in the process, which was surprising in a way and showed the industry has a long way to go in offering the technology solutions and engagement tactics patients yearn for. But I don’t think we can focus too much on what missed the mark in 2016, we must move on to the new year and focus on how we can build on the progress we’ve made to date.

In closing, what’s the one thing you’ve always wanted to have been asked, but never were? What’s your answer?

If I were healthcare king how would I change it?

I like to think of it as health vs. healthcare and it would have four aspects to it:

1. Education: Health education should start at a very early age so the right information can be provided to mold the right behaviors. These behaviors can contribute to the wellbeing of the family as well, given there is a high correlation of the child with the overall health of the family.
2. Prevention: Ensuring that everybody has easy access to preventive care, like telehealth, combined with the right incentives to utilize such resources is critical. The notion of going to a lab in one part of the town and then back to your primary care physician to review it is not particularly encouraging and that has to be consolidated.
3. Care: A focus on simplifying care from where you go – pharmacy based RN, urgent care, emergency etc. – to the admission to post discharge activities must be streamlined. Consider every family having a care coordinator who plays a variety of roles, such as getting patients to annual physicals and providing guidance on what sort of care the patient should seek.
4. Finance: This is perhaps the most critical part of the framework, given we can get anything we want if there were sufficient funds to pay for it. The path has to include both demand side and supply side economics.

• On the demand side a single payer system for everyone at the basic level augmented by commercial plans for catastrophic care similar to how Medicare is set up with Part A & B standard while Part C & D may be funded by those who want extra care.
• On the supply side I would also have a standard national rate card for all care, drugs and other care items that may be adjusted for local cost of living needs. This will ensure there is both transparency and predictability of health costs.

This framework would be defined and managed at the federal level but operated/managed at the local level. As part of the framework, all data would be aggregated in a single place that would be accessible to all based on the role they will play in this ecosystem.

Of course, there are always competing priorities that makes this framework difficult. But I hope that when it comes to our health, we are able to take a more refined path.