Simha Sadasiva. Credit: Ushur
If live humans in health benefits want to use artificial intelligence technology successfully, instead of losing out to AI, they need to clean up their data.
Snarls of data, computers and networks make using AI to automate many boring, time-consuming health benefits tasks a nightmare, according to Simha Sadasiva, the chief executive officer of Ushur, a customer service firm that has Aflac Ventures on its list of investors.
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AI and AI-like systems have been helping to do some health plan tasks, such as answering simple benefits questions, identifying anomalies that might be signs of fraud, and powering personalized wellness programs, for years.
Ushur has developed AI systems that can help insurers respond to requests for quotes and handle more complicated plan participant questions, Sadasiva said.
Related: The promise and peril of AI in health care: Risks, policies and human oversight
Ushur has tried to move beyond the old animated flowchart AI systems and create more conversational AI systems that can use predictive analytics and other strategies to fill in gaps in data and reach their own conclusions.
They can comb through giant files of text for facts and patterns.
Sadasiva said experienced AI firms and the AI systems themselves may be able to overcome some of the current data jumble problem.
When Ushur sets up new AI systems, "we have been able to find a lot more commonality than our clients have anticipated," Sadasiva said.
But even the new-generation AI systems need access to data files in places they can reach, in formats they can read.
Too often, Sadasiva said, "benefits information, plan designs and other critical information for AI automation is scattered across disparate systems."
Sadasiva sees the plan sponsors as the people who can drive change.
"Employers should push for data standardization," he said.
Employers can also help by asking benefits service providers to standardize plan designs, processes and documentation, and to add "APIs," or data sockets, that allow for two-way data exchange, he said.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
