2978: CitiusTech - A Discussion About Generative AI's Role in Healthcare

[00:00:00] Is the future of healthcare already upon us? Well, today here on Tech Talks Daily I'm joined by Rajan Kohli, CEO of a company called CitiusTech and they are a leader in healthcare technology services. Today we're going to discuss how digital innovation is shaping the medical field

[00:00:22] and my guest today brings a wealth of knowledge with more than 28 years of experience in tech services and consulting, making the perfect guest to unpack the complexities of integrating cutting edge technologies like generative AI into the world of healthcare. Whether it

[00:00:39] be automating mundane tasks to reimagining patient care, we're going to explore the transformative potential and some of the challenges of digital tools in improving health outcomes and also how companies like CitiusTech are navigating these waters to deliver solutions that are

[00:00:56] not just innovative but also trusted and effective. I want to take a time out to express my gratitude to everyone who supports my mission of delivering daily content to you in 165 countries. I couldn't

[00:01:10] do it without you and I couldn't do it without my sponsors and today I want to give a quick shout out to Kiteworks who recently told me that defence contractors are facing immense pressure to comply with things like CMMC 2.0 security standards and finding a secure,

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[00:02:03] let compliance slow you down is what I'm trying to say. Simply visit Kiteworks.com to get started. That's Kiteworks.com to learn more about Kiteworks' secure content platform for CMMC compliance. But with my thank yous out the way it's now time to jump right into today's interview

[00:02:21] with a fantastic guest. So buckle up and hold on tight because no matter where you're listening in the world it's time for me to take your ears on a magical mystery tour all the way to New

[00:02:32] Jersey where my guest is waiting to speak with us today. So a massive warm welcome to the show. Can you tell everyone listening a little about who you are and what you do? Thank you Neil, great to

[00:02:46] meet with you and thank you for this opportunity. My name is Rajan Kohli. I currently run as the CEO of CTS Tech, a very large digital and tech services provider focused on healthcare industry.

[00:02:59] Prior to that I've spent 28 years in tech services consulting for clients, building teams and scaling businesses. Well thank you for joining me on the show today Rajan and every single day on this podcast I try and explore a different area that technology is transforming and very often an

[00:03:18] area that we might not associate with technology. So with healthcare rapidly evolving just to set the scene for our conversation today, what do you think are some of the biggest challenges and equally opportunities that you see for technology in this industry? What are you seeing? I look at

[00:03:35] scaling any innovation really in three aspects and when all three aspects intersect then you are able to scale that innovation. Those are desirability, feasibility and viability. So let's explore a little bit. Desirability is really are the consumers asking for more? Are they asking

[00:03:57] for difference and are the other participants in this case not just patient but also doctors and payers, are they asking for more and different and innovation in the systems? And the answer is

[00:04:12] yes. This is a very, very noble profession and everybody wants to do better. Second is really feasibility. Is there technology that's allowing us to improve the outcomes? And the answer is again yes and we'll talk more about components of the technology but JNI is just one of those.

[00:04:32] And they are available to consumer industry, available to financial services and are certainly available to healthcare. So the answer there is yes. But yet it is much more difficult for innovation to scale in healthcare and the reason really is centered around viability. And

[00:04:51] the big difference on that aspect really comes from the fact that the players in this industry have different time horizons. Payers which really control a large part of this value chain have a

[00:05:10] shorter term horizon in mind but consumer, that's me as a patient, obviously have a very long time horizon in mind. And why do payers have a shorter time horizon? Largely because vast majority of insurance is private through my employer based programs and people change on average their job

[00:05:33] every three years and their plans change. So it's very difficult for longer time horizon and there is obviously incentive mismatch in that. So that's what makes it more challenging and more difficult for innovation to stick and scale in this industry.

[00:05:50] So from your experience, I'm curious, what do you see as the common pitfalls that organizations typically face when implementing digital transformation strategies? Because you must see and hear a lot of similar mistakes happening out there. How can some of these pitfalls be

[00:06:06] avoided? Yeah, so the biggest pitfall is not to recognize that there is incentive mismatch and not to recognize that different players while they all want to do better for the end patient or consumer have different challenges in play. So the more people can realize that,

[00:06:33] they can try to solve it. So there is obviously more focus now on preventive care despite the challenges that I talked about and people are trying to create shared incentives within the peers and provider value chain for them to focus on these,

[00:06:54] the preventive care and value-based care. There are examples, good examples where things can be learned. Financial services and I've spent many years in financial services have overcome all of these issues. Obviously, in some cases at much more simpler scale,

[00:07:18] where now if you want to transfer your money, whether you're a bank, whether you're cross-border, there is standardization of methods and tools to transfer the money. There's an ecosystem between startups and large banks where they can transact in open banking, which has made it much easier for

[00:07:40] them to transact. In healthcare, for example, there's a small country like Estonia, which has solved this challenge where there is now a full 360 degree view and a longitudinal view of a patient's record between the peer and the providers all centralized, where you can now

[00:07:59] create more end-to-end incentives and outcomes for players. So, there are ways to do it. It won't be easy in healthcare, but piece by piece, it's a long game. One can start solving for these challenges, largely working around the incentives for various players.

[00:08:17] Yeah, I can only echo what you just said there about Estonia. I spent some time there last year and they've managed to digitize all of their society. I think it's about like 99% of all

[00:08:27] services are now online and it is a small nation, but the degree of startups, innovative startups are coming out of that country is nothing short of inspiring. And as for healthcare, I mean,

[00:08:38] it is a crowded market and something that impacts all of us no matter where we're located in the world. So, can you tell me a little bit more about your work, Powering the Future of Healthcare and ultimately how the company differentiates itself in the healthcare tech sector?

[00:08:53] Thank you for asking that question. It allows me to plug in a little bit of my company. We are 100% focused on healthcare. Our ambition is to enable our clients to use technology and our consulting and technology services to make a difference in the world.

[00:09:13] We are 8,500 plus people, largely distributed between the US and India, a vast majority being in India in a global managed delivery model, working for our clients. And our ambition is, and we currently do a lot of our clients' most difficult programs.

[00:09:36] And I personally feel that in the market of tech services, relevance is revenue. So, we want to stay relevant to our clients and the way to stay relevant to our clients is to solve their hardest challenges and to learn and deploy the most innovative

[00:09:55] cutting edge technologies to do that. And we do hear a lot about digital transformation initiatives in corporate America and businesses all around the world, but I would say less so in healthcare. We don't often champion some of the work that's going on there.

[00:10:13] What would you say are some of the key steps that healthcare organizations, especially if we've got anybody listening in healthcare, what do they need to do to overcome issues to truly embrace digital transformation? How have you adapted to assist organizations in meeting those goals, especially

[00:10:30] post pandemic because so much has changed in the last five years? Absolutely. It has changed and I think it has changed for the better. A few things that I think that can be done, again, sort of leveraging on what I just talked about previously,

[00:10:50] move to more disease management framework and preventive health, which means again, creating incentives for the right people. And we have examples, again, outside healthcare. A lot of the best examples, interestingly, are all outside healthcare where once you have

[00:11:12] the right data, you are able to actually identify the next best action for the well-being of consumer. I mean, imagine if Amazon didn't have the next best offer, it would just be like any

[00:11:28] other retail market. So they had the data and they had the algorithm to offer what the next best action is. Why can't that happen for preventive diseases, for disease management on behalf of the patient? Similarly, obviously, the second biggest issue, why some of these

[00:11:51] things, we talked about Estonia, why some of these things can't happen very easily is interoperability. There are so many different EHR systems. There are obviously some new standards coming in like FHIR standards, which allow us to handle data and transport data. But

[00:12:11] interoperability remains one of the biggest problems. This is the only industry I can think of where interoperability is a CEO challenge, not a CIO or a CTO challenge. So these are some of

[00:12:27] the things that we do need to overcome. But there is technology to solve them. There needs to be incentive alignment. There needs to be investment. There's still a lot of technology debt in this industry and lack of investment. And before you came on the podcast today,

[00:12:47] I was doing a little research on you and I learned that you've been in a position for a year now. And as you reflect on your first year as CEO, I've got to ask what are some of your biggest takeaways?

[00:12:59] You've probably learned so much in that year, but how would your experiences influence your outlook moving forward too? Now, thank you. One of the big reflections is and I'm thankful that I'm in healthcare and not only there is so much opportunity to do more, but also this industry

[00:13:20] is a little bit more stable compared to some of the other industries. And especially when you join in a downturn, you're thankful that you joined healthcare and not some of the other industries.

[00:13:30] But some of my lessons from my first year are things that we did or we did not do. And I learned from, I think, we sometimes overemphasize on solving for weaknesses, whether it is for people

[00:13:46] or for companies and capabilities. I think there is something to say about actually investing in the strengths because there is a reason a company exists. There's a reason why clients buy from that

[00:13:58] company, your ability to identify what those areas are and actually over invest in those areas or invest in those areas because over a period of time, some of these strengths atrophy. And that I think has worked really well for us to focus on building domain strength

[00:14:19] in the industry that we are in. I talked about interoperability, actually building world-class capability in that to solve for that. These are all strength areas that we actually double down on and I think that has worked. Second realization I've had and I've

[00:14:35] sort of known about it, but this is, I'm a first time CEO. So some of the things you learn about, you actually really realize when you start doing it. This is a much more simpler business than

[00:14:49] what sometimes people make it to be. Eventually, it's about people. It's about our clients. It's about our employees and it's about our partners and our ability to understand what each one of those players in the ecosystem need to get value for themselves and to deliver value

[00:15:09] to their clients really helps us position ourselves in the best. I think one of some of the lessons is that sometimes if we make decisions in haste and cut down the cycle time or the quality of the decision making or participation in decision making,

[00:15:31] we actually pay for it in terms of change management cost. So now I spend more time, I've gotten more people involved into the decision making process, especially for all decisions that touch people and impact our people, which is a large part of our decision makers in a company

[00:15:48] like ours. That has been very, very helpful for me to get everybody's point up. And of course, we're 15 minutes into a tech podcast and we've not mentioned AI yet, which means we might have broken a law somewhere. But seriously, I mean, it's a big topic right now

[00:16:04] in every industry. So how is generative AI currently augmenting healthcare treatment and what potential do you see for it to make in healthcare, make it more human and more innovative and getting that balance right? Now, the gen AI has been the biggest talking point

[00:16:22] for us and for me, whether we're meeting boardroom, whether we're meeting the COO or the CIO or the CTO or head of development for the application. Where I see it playing a big role for ourselves is in, I think, three different areas.

[00:16:42] One is in automating processes for our clients. Now, what are these processes? These are either clinical processes where through automation, they can reduce a lot of cost or these are decision support processes where decision support can be faster or with better quality with the leverage

[00:17:03] of gen AI. Some of these are consumer facing or patient facing processes where summarization, for example, you can summarize your report, you can make it more readable, more understandable for the patient. These are the processes. But for a company like us in tech services,

[00:17:28] one of the biggest area of transformation is just how work gets delivered, our way of working, auto-generated code or gen AI based code will transform the quality of work we do,

[00:17:41] the quantity of work we do and how we do that work and how we come together, what sort of teams are formed in the future to deliver that work. We are going all in into that. We feel that this is a net

[00:17:56] net positive for both the healthcare industry as well as for tech services and consulting firms like ourselves. Fantastic. There's so much going on here in that world of gen AI. Would you see its impact on productivity too within the enterprise? Anything you're seeing there?

[00:18:15] Oh yeah, absolutely. So let me talk a little bit more about the productivity aspect. If you look at the healthcare industry, the biggest gaps are, let's say labor shortage in nursing. There's so much of the work that to do. I'm not even talking about actual care and

[00:18:37] the actual future where you're talking about robotic based healthcare. I'm just talking about the back office work that the nurses need to do, which takes about 30, 40% of their day-to-day work. Extreme automation is possible use of gen AI in those and the benefit is in terms of their ability

[00:18:57] to actually care more about the patient. Diagnosis, right? Decision-making. I mean, there are countries where the doctor to patient ratio is nowhere close to even US and we complain about healthcare in US. Imagine what automated or I shouldn't use the word automated, but

[00:19:18] gen AI enhanced decision support systems can do to the care and retention that the doctors can now pay to patients in those countries. That's huge boost of productivity into the industry. And again, when I was doing a little research on you, I also found out that you've recently

[00:19:37] launched a gen AI quality and trust solution. So for anyone listening that has not heard about that, what is it? What does it do? And how is it helping organizations?

[00:19:48] Oh yes. That has been one of the biggest talking points for us. Our team came up with this idea because we were working with a client and they asked us a question, what's the biggest barrier

[00:20:01] to adoption of gen AI or even AI for that example? And the answer is really trust. So can we do something to build a framework that allows our clients to know that the solution is trustworthy?

[00:20:16] So the start point for us was to actually define the seven attributes that contribute to quality and trust, whether that's accuracy, relevance, robustness, hallucination, bias, efficiency, or toxicity. So we define these seven parameters. We define metric of what good looks like

[00:20:40] for these parameters. We have code libraries that can compute these metrics and then prebuilt libraries that can actually provide automated assurance and monitoring. And then obviously integration of this framework into the MLOps tools that we are building for our clients,

[00:20:59] or if they already have prebuilt for themselves, that allows us to continually monitor and report the quality and trust. Because you know that good quality today may not stay good because these are learning models. So you need this continuously. Toby Greenock Exciting times ahead. As a word of

[00:21:19] caution, one area that we must explore as well while I have you on the line is the increasing digitization of healthcare and the fact that cybersecurity is also a major concern. In fact, hospitals are one of the highest attacked businesses or places in the world. They seem

[00:21:35] to be hitting the headlines all the time for things like ransomware. So what best practices should healthcare organizations follow to ensure data security, patient privacy, and ensure that they're not one of those headlines where a hospital getting hacked? Anil Patel Yeah, I know it's very unfortunate. But

[00:21:54] you know, healthcare data is the most rewarding data for these bad players in the market, you know, 10 times more interesting than your credit card, for example. So all the bad players are focused on it. And some of the challenges that the industry has originated from the fact that

[00:22:17] there has been a lot of legacy systems in this industry. There is a tech debt built in because there has not been continual investment into upgradation of technology. And also,

[00:22:32] you know, talent crunch in the past, some of the best talent would first go to tech industry or go to financial services. And they haven't had access sometimes to the best of the talent.

[00:22:47] But obviously, all these need to be overcome. And clients need to start building, you know, upgrading the systems, building solutions with the zero trust framework in mind. A lot of the threats obviously come from inside, you know, sometimes because of lack of awareness, sometimes stupidity,

[00:23:08] and sometimes the systems are not robust enough to catch that. And we should absolutely leverage AI and JNI in prevention because the bad players are going to use and they're going to weaponize this technology. We need to use that to the benefit of our clients.

[00:23:31] And another area I'd love to talk about is social determinants of health or SDOH. They're often considered crucial for patient care, but often underutilized. And here in the UK, your general health and your lifespan can be determined by whereabouts in the country you live. And

[00:23:48] I suspect it's very similar in the US too, and we don't talk about this enough. So, how can healthcare providers better leverage SDOH data to advance care and indeed outcomes? Yeah, no, so where you are born and the circumstances you're born not generally

[00:24:05] just determines your health, but many, many other things, but most certainly, your health. So, you know, to begin with, there needs to be a comprehensive data collection of the socio-economic factors, education environment, and then these need to be

[00:24:25] integrated into the EHR systems to enable holistic and personalized care plans. And the insights that are generated from this should be then used for outreach programs and for allocation of resources by the government and providers and the peers. And this should be

[00:24:48] used to inform, the learnings on this should be used to inform the public at large so that these can be customized and the trainings and learning can be customized to those. There is though a technical challenge in this, that the standards for coding,

[00:25:06] there are no real global standards for coding of the socio-economic data determinants for health and interoperability then becomes a problem in this. But those challenges can be solved if we follow the threefold step process that I just talked about. Well, we've covered so much in our

[00:25:31] 30-minute podcast interview today, and there is so much more that we've not even scratched the surface on. So what's the best place for anybody listening to find you, your team online, or we'll just find out more information about anything we talked about today, including the quality and trust

[00:25:48] solution and generative AR that we were talking about. Yeah, thank you for asking that. A lot of our thought leadership, we share it through our LinkedIn channel, but also on our website, we have a section called CTS vision. A lot of our thought leadership is shared openly

[00:26:10] through that channel and I would love for us to have people visit there. Well, a huge thank you for sitting down with me today. As I said, we covered so much from digital transformation in the industry, the lack of a data-driven culture and processing efficiency

[00:26:25] that have traditionally bogged down the industry. But we're now reaching this point of reimagining healthcare and not just embracing AI, but also ensuring trust, maximizing the effectiveness of gen AI solutions for monitoring the quality and trust with that new tool. So much to talk about

[00:26:42] there. I'd love to hear what everybody listening thinks about what we talked about today, but more than anything, thank you for shining a light on this. Really appreciate your time today. Thank you, Neil. It's been a pleasure talking to you and I've really enjoyed our conversation

[00:26:54] and I hope your listeners enjoyed too, but thank you. So today we've traversed a landscape where technology meets healthcare, driven by the promise of generative AI and the critical need for digital transformation, but also shedding light

[00:27:09] on Cityist Tech's role in pioneering solutions that prioritize things like trust, quality and patient-centric innovations. And for me, that is the big takeaway. We're talking about AI and emerging technologies, complex, sophisticated technologies, but keeping that human element

[00:27:29] alive, trust, quality, patient-centric, that is the big takeaway. And that's one of the reasons I was excited to get Rajan on the podcast to join me today. But how do you see digital innovation further integrating into your healthcare experience? What excites you? Is there anything that makes you

[00:27:47] feel uncomfortable? I'd love to hear your thoughts on anything we talked about. So please reach out and share your views on how technology can continue to redefine our healthcare landscape, and also your thoughts on social determinants of health, SDOH for short. I suspect wherever you

[00:28:05] listen in the world, where you are raised, where you work, the people you hang around with, the food that you eat, these all play a big part in your healthcare. How do we move past that? And

[00:28:17] what tech can help ensure that just because you live in a certain area, you don't have the same opportunities? I know it's a huge topic, but as always, techblogwriteroutlook.com, LinkedIn, Twitter, Instagram, just at Neil C. Hughes. Let me know your thoughts. We'll carry on the conversation.

[00:28:35] Other than that, it was healthcare today. Tomorrow is a completely different topic, and I implore you to join me once again. So thank you for listening today though, and until next time, don't be a stranger.