Carrie Kozlowski on Access, AI, and the Future of Health Care Data Utilization

In this interview, COO and co-founder of Upfront Healthcare Carrie Kozlowski, OT, MBA, highlights 3 key trends shaping the future of health care: a focus on health equity with actionable strategies for equitable access to care, a transition toward responsible AI utilization, and a push to maximize the potential of patient data while addressing privacy concerns.

Transcript

Looking ahead, what do you see as the future trends and innovations in health care, particularly in the realm of patient engagement and data utilization?

This is early 2024, right? This is the question everyone's asking, I think, and where we're going. I think there are 3 areas in varying degrees that we're seeing movement and trend on.

The first is health equity. Absolutely. I think we've had some fits and starts, I think candidly, over the last 3 or 4 years in health care on this. I think we are going to make a shift into an execution mode on how we really think about equity. And what tells me that is, go back to the client conversations that we get to have, this is where we continue to learn and are working in the market.

Last week, for example, we were meeting with another health system, one of the agenda items was setting our KPIs [key performance indicators] through the strategic plan for 2024 for what we're going to work on. And it started with the—and by no means is this a simple goal—but improving the number of patients who complete preventive care screenings. And that was exciting. And then someone paused and said, "Okay, that's awesome, but we can't just do that, because how do we know we're doing that equitably across the populations of people that we know need to do their preventive screenings?" And so we had a much longer conversation around how do we repeat some of the work we've done with other clients on closing the disparities.

So how do we look at the submetrics to make sure that we're not only moving the needle up, overall at the macro level, but that all subgroups are moving up, as well? And so, I think the key to that, as we were getting into it is really a one-size-fits-all solution isn't going to meet the needs. We get into those conversations, and it's okay, so as we look at these populations, and look at the individuals in these populations, what are the unique needs, this goes back to barriers to care, right? How do we overcome technical [issues and] remove friction from the process, think about barriers as far as socioeconomic [disparities], access to travel, access to childcare, all that stuff to help move those patients in that direction?

But I think that conversation these last 60 days is happening more and more, which is where I think we're making this big shift into action on how to health equity versus theory. And then another area, and this is somewhat related, and this one I'll say, maybe I'm a little bit more conservative on is going to be AI [artificial intelligence]. And obviously, AI has huge opportunities. I think what we're gonna see is this shift from hype, which has been fun and exciting and inspiring in lots of ways into deeper curiosity and discernment. How do we go from the excitement of what it can be to harnessing the power of it in a really responsible way into what it will be?

And this is where I do think it ties back to health equity. Right? We've seen a lot of concerns, the ACLU [American Civil Liberties Union] has raised some concerns around inherent biases in the data that's used to train AI. I think we're thinking about this at Upfront, health equity is a huge function of the work that we do with our clients. And so we're thinking: Okay we're using it as a suggestion tool to augment communications, but there's still an element of human control. So how do we continue to move forward, take steps, study those steps, and then take the next step forward?

And I think we're gonna see that shift of like, the pragmatic—again, maybe that's just my way of thinking about things too, but having been in health care for such a long time it's fun to get excited about innovation and then how do we actually apply innovation in a way that's meaningful and driving outcomes? I think that's where we're going to be kind of thinking about AI over the next year.

And then the last thing you mentioned, is data. And again, data is needed to drive AI, but I don't think we are really leveraging the data we have in the best ways possible. I think this is where health care gets maybe a little bit of a bad, but accurate, rap on our commitment to innovation. And so we've got huge consumer giants, taking 1 step forward, 2 steps back sometimes, right, I'm trying to get into the health care space, but what they're really good at is harnessing data and using that to drive experiences. And I think what we need to do, and what I would really like to see the health care industry be focused on in this next year, is looking at the hurdles that we have put in place for ourselves, some of them necessary.

But who owns data, right? [There is a] lack of clarity, because sometimes we can be risk averse, right? There's a lot of litigation risks, there's compliance risk, we don't have clarity. So let's just, we're not going to use data, we're not going to push forward. And I think sometimes we can be more conservative than we should be. Patients give us a ton of data. They're very vulnerable. They're sharing not only the clinical data but health systems, socioeconomic [information], family history, [and] you know what's going on in their personal lives. We could be using that to help them, to support them to guide them to get care.

I think there are some health systems who are doing that really well, and we enjoy working with them to really turn that into actionable patient experiences. But we still have some limitations. And we had this conversation, every time compliance said, "We can't do this." And I do think there's going to be an interesting shift in how we think about data, generationally. Our younger generations are sharing their data everywhere, all the time: health care data, personal data, like everywhere. And yet, we're still really, really conservative around reminding a female over the age of 40 [year], she needs a mammogram. Everyone knows that.

So, I think there's going to be this fine line of how we continue to be responsible, because we're seeing bigger and greater risk from a cybersecurity perspective, but if we have all this data, and we're willing to accept the risks associated with owning the data, then we should push for some of the rewards of supporting patients by using it to drive and support them and get the care they need. I think that will be another interesting area, probably exploratory this year, but I'd love to see us push the needle a little bit there on these conversations around data