52. Training AI and Closing the Gaps with Matthew Cunningham of Availity

In this episode, host Sandy Vance chats with guest Matthew Cunningham, the EVP of Product at Availity. Matthew runs the end-to-end authorization product and strategy for Availity. He has a wealth of information about the industry and happily shares that info with Sandy and InteropNow’s loyal listeners. Together, they discuss what Availity has been up to and what they’re doing for the healthcare IT industry. They also talk about how specific use cases can help solve the challenges around interoperability.  For a while, it’s been a major issue that electronic prior authorizations haven’t been streamlined for payer organizations. That’s exactly why now is the time to leverage the new technology available to solve this problem. Matthew talks about how Availity is working to ease that tension in this space. He also emphasizes why it is collaboration between companies that will lead us on the path to success. In this episode, they talk about: Why it is such a big deal in healthcare, to make sure that electronic prior authorizations work for payer organizations The various challenges that payers and providers have had to deal with How standards will help automate the process, which–in turn–will reduce friction when it comes to reaching clinical records and asking specific questions How AI is solving the dialogue problem AI can read a clinical document much quicker than a human can To work, AI needs to be able to read structured and unstructured information and be able to extrapolate clinical concepts. But how long will it take before AI can understand clinical concepts? Applying AI where the use case makes sense to be transparent Your ROI when using Availity to put all the necessary components under one umbrella Measuring success based on automation vs adoption A Little About Matthew: Matthew Cunningham brings a unique background with nine years of military service, including command roles during the Iraq invasion and subsequent counterinsurgency operations. Transitioning to healthcare, he has spent over 15 years addressing the challenges in prior authorizations and utilization management. With a diverse career, Matthew played pivotal roles in scaling a services company from $20M to the largest healthcare benefit services firm, serving in capacities such as Head of Call Center Operations, Director of Product Operations, CIO, and leading integration for mergers and acquisitions. In his latest role, he drives innovation efforts automating prior authorization workflows for payers, providers, and patients.  If you want to know more about Availity, check out their website. To hear more about what Availity has been up to and what they’re all about, check out these episodes of InteropNow! “Availity’s Innovation Guru, Sam Schifman, on AI and Human Behavior Change for Better Health” “Upcycling Data for a More Wellness Focused Health System with Dr. Paulo Pinho, M.D, Vice President and Medical Director of Innovation for Availity Clinical Solutions”