One of the challenges that continues to surface in these conversations is that healthcare has no shortage of data or technology. The tougher question is whether those tools actually reach the people who can use them to improve care.
Below are selected insights from my conversation with Dr. Gary Call, Chief Medical Officer at Gainwell Technologies.
On making AI meaningful in healthcare
“We’ve worked really hard to take AI principles and integrate them into our products in a way that’s really meaningful.”
Gary sees AI as an opportunity to make healthcare processes faster, more accurate, and more efficient. At Gainwell, that includes applications involving claims payment, prior authorizations, fraud, waste, and abuse, as well as reviewing medical records.
The goal is not simply to introduce another technology into the healthcare system. It is to use AI where it can make a measurable difference for payers, providers, and the people receiving care.
On using technology to improve access to care
“We’re impacting that by making the system work better.”
Although Gainwell does not provide direct patient care, Gary explains that the company can influence the patient experience by helping healthcare processes move more efficiently.
Faster and more accurate prior authorizations can reduce delays in care. Better management of healthcare dollars can help protect funding for Medicaid beneficiaries. Technology can also help identify fraud and waste so resources remain available for the people who depend on those programs.
The impact of technology, he notes, is sometimes indirect but still significant.
On the connection between data and health equity
“One of the biggest problems is that there’s tons of data, but so little of it actually trickles down to the people who can impact care.”
Gary believes bringing disparate data sources together can help healthcare organizations better understand the populations they serve.
That includes incorporating social determinants of health alongside medical information. By making those insights available to providers, care managers, and others involved in care delivery, analytics can help create a more complete picture of the factors affecting health outcomes.
The challenge is getting the information out of the silos where it has traditionally remained and into the hands of the people who can act on it.
On measuring whether technology actually works
“It sounds obvious, but I think having a clear view of what your objectives are, what you expect the technology to do for you, and how you’re going to measure those outcomes are really the critical steps.”
Gary believes healthcare organizations need to define success before implementing new technology.
At Gainwell, that can mean measuring cost savings, turnaround times, accuracy, and ultimately whether better use of data contributes to improved outcomes.
The technology itself is not the measurement. The results are.
On involving the people who will use the technology
“It’s critical to involve the people who are going to be using the technology on a regular basis in the decision-making and development process.”
Gary points to an example involving clinical reviewers who previously had to sort through large medical records to find the information they needed.
Rather than simply introducing an AI tool and asking employees to adapt, Gainwell involved the clinical reviewers from the beginning. Their experience helped shape how the technology could fit into their actual workflows.
That approach allowed AI to support their clinical expertise rather than replace it with another layer of complexity.
On leading employees through AI-driven change
“Our employees are our best asset.”
Gary believes healthcare leaders have a responsibility to recognize the uncertainty employees are experiencing as AI changes the nature of work.
Some roles will inevitably change or disappear. But for many employees, technology can remove repetitive work and allow them to spend more time using the expertise they have developed.
Gary describes the use of AI with nurses as one example. Instead of spending large portions of their time searching through medical records, nurses can use AI to surface relevant information and spend more of their time applying their clinical knowledge.
For leaders, that means paying attention not only to what technology can accomplish, but also to how employees experience the change.
What stood out from my conversation with Dr. Gary Call was the importance of connecting technology to the people who actually use it. Healthcare has invested heavily in data, analytics, automation, and AI, but technology only becomes useful when it improves the work happening on the ground. And that means starting with a clear problem, knowing how success will be measured, and involving the people closest to the work before a new system is put in place. As AI changes healthcare, leaders have to help employees understand where they fit and how technology can support the expertise they already bring. The real test of healthcare innovation may be less about how advanced the technology is and more about whether it makes the system work better for the people inside it and the people depending on it.
Originally published as part of my Healthcare Leadership Operating System interview series.