Revolutionizing Health Care Administration: A Vision for Streamlined Solutions and AI Integration

In an interview with Harman Dhawan, founder and CEO of Bikham Healthcare, he offers his perspective on administrative tasks within health care. He emphasizes the need to streamline processes and use existing technologies and AI so health care professionals can focus more on treating patients.

Please introduce yourself by stating your name, title, and professional experience.

Harman Dhawan: My name is Harman Dhawan. I'm the founder and CEO of Bikham Healthcare. Bikham Healthcare is involved in developing products for the health care space, especially technology products to resolve mainly RCM issues, which is your revenue cycle management issues and other back-office administration issues.

Regarding back-office challenges, there seems to be a perception that health systems are currently in a state of crisis. What is your viewpoint on this matter?

Harman Dhawan: Crisis, as a word, is too alarming. But if you compare the B2B health care space right now as is to the consumer sector, for example, the airline sector or consumers like Amazon, there's no comparison to be made.

We are more than a decade behind when it comes to health care. Today, if you want to book a flight, you go to your laptop and book it. It's done. It's easier to book a flight than it is to book an appointment with the doctor.

You can't get appointments—it's 30 or 60 days out for certain specialists. So, it's all over the place, and it shouldn't be. Technology existed 10 years ago; it exists today. But there are hurdles there. Whether those are over-compliance or a mix of other things, the technology exists, and all this can go away. It should be as easy as shopping on Amazon. It should be easy to book your appointment with your doctor. Go ahead, get the results, have it on your app, and follow up – health care of all things should be made easy.

The health care system requires a transformative overhaul to enhance accessibility, particularly aligning with your suggested solution—potentially through a straightforward application. How do you envision such an app integrating into the health care system? Do you believe it could effectively address the back-office challenges?

Harman Dhawan: As a patient, good luck getting your records if you want to move them to another place; it will take months. If I have a patient history, I want it on my phone. I want to share it with whoever I want to share it with; I want a second opinion. But it should be on my phone, and it's not. Then you have HIPPA, which, of course, is a great act. It has to be there. But then again, it's over-compliance. There's so much regulation that stifles innovation.

There's so much stuff to look at in the health care space that innovation is stifled. So, many old-guard legacy systems are in place that prevent innovation in one way or another. But for now, I believe a lot of it, especially with ChatGPT, makes it quite clear that AI is now in the hands of the ordinary man. Anybody can go and build programs on top of it. We're in store for a lot of good stuff in the coming years. And as far as the back office is concerned, as I said, the technology already existed years ago. Whether it's RPA, robotic process automation, or AI intelligence, you can have bots algorithmically and logically thinking and acting on certain things and making things happen in the background. Providers should be focused on patient care, not pushing paperwork, filing claims, and all sorts of stuff that should be taken away.

Did you know that, on average, it takes anywhere from 2 to 4 months for a provider to start seeing patients? That 2 to 4 months goes into all those important, rightfully important tasks, like credentialing, enrollments, privileging, licensing, and everything else.

And technology? We developed it. It's there—instead of days and months, it can be done in minutes. Why no one has done it is beyond me. But we're glad we're among the first to do it.

Can you offer one or two examples where the health system could be streamlined?

Harman Dhawan: You can approach this in many ways, but I'll mention one that is quick and can make a huge impact. It's the back office. What we refer to as the medical staff office. That's where all your compliance, paperwork, exchanges, and, in some health systems, files are physically moving places. Then they've got not one but multiple software, so you have integration issues. You have interoperability issues between that software, and data gets lost. Not only is it a financial strain on the health system because you got a provider who's sitting there, not able to see patients for 2, 3 months, not able to take appointments, not able to bill out those claims right for those 2 months—all these things are a negative, not only for patients but for the health system as well.

And I think the back office is something that can be fixed. We have a catchline here: "from months to minutes.” It took us a while—we had to go in map 4,500 plus odd base 100 plus specialties, 50 plus states, and those had over a million combinations that we came up with. Then, you had to see them through. We mapped it and plugged in some AI automation. And now the system works itself.

And it's not like we developed some alien technology to do this. It's a simple technology. We just put together the intelligence and made it happen. And it's great to see at least paperwork and simple tasks, which are laborious, time-consuming, and frustrating, are automated.

Solving back-office issues is a quick fix that can make a huge impact.

Do you think the reluctance to evolve into a solution that can eradicate these back-office issues stems from hesitance due to the initial efforts required? Alternatively, is it more a matter of people not being well-versed in executing such transformations effectively, leading to a lack of readily available solutions?

Harman Dhawan: First, I believe there is a technology out there right now, a single platform that does it. Secondly, it's not that they don't try; there are certain systems that are doing it really well. But they've got multiple systems in place. And then that takes training on those systems to adopt the technology—all that takes time, money, and effort. To the point where people say, "Don't fix what's not broken," which means, all right, I've got a couple of people, it's taking 2 months, and, in most cases, the status quo is accepted. "Oh, it's going take 2 months. It's going to take 3 months. That's credentialing. That's how the process works." We should start saying, no, we should not accept that. Why should it take 2 or 3 months when everything is available online? You can apply intelligence and automation to it and get it done in minutes.

I think we're in for a big change in the coming year or so- at least this part of it. We need to let health care truly focus on health care—providing quality care and innovation.

All of the data management and entry takes away from patient care and also leads to a lot of burnout for those working regular and double shifts and running back and forth to different rooms to treat patients. It's a lot to take on for just one person.

Do you feel that the health system will collapse if we encounter another pandemic without fixing all these issues?

Harman Dhawan: No, it's not collapsing. I would rather say that if you make these changes, it will lessen the impact. But it's not a quick fix to really overhaul a system. You have to go to the government level, policy changes, incubators for innovation from the ground up. It has to be reimagined. That's where, over 5 years, you'll see changes in the health care system. But, for now, I would say, you want to start where you can achieve quick wins, which is your administration side at least to get rid of that paperwork and have the bots take care of it.

So, what you described is the short-term fix. The long-term fix is to do what you said, approach legislation, and try and get a more overhaul of everything over the years.

Harman Dhawan: Absolutely. You must have the government involved for sure, whether that's on the HIPPA side or not–there's a lot of stifling legislation. Wherever you have overcompliance, it stifles innovation. Compliance must be there. It's health care you're dealing with lives, but it must be balanced: you have incubators, certain areas the government supports, and the loss of certain policies. So, it fosters an environment for innovation.

A young person can spend time in his garage to build something for the space but should not be concerned with paying hundreds and thousands of dollars in lawyer fees before starting this venture. So that's health care for you. If you want to do anything in health care, you must deal with lawyers and compliance fees; so much is required.

And another thing, it's not that the health systems are not using technology. It's just that technology health care doesn't work itself. It's so complicated. You need training for hours, if not days. It's so cumbersome. We need true technologies that work themselves. You program it once, and it only points out the exceptions to you where it cannot self-resolve the issue on its own.

Otherwise, they're just glorified portals and software. Humans sit on them and work, trying to resolve stuff, and nobody wants to log into the software. You want AI; you want intelligence that works itself.

In the spirit of having health care professionals focus more on patients, how can the technology landscape improve its offerings? What does a successful automation look like to you?

Harman Dhawan: It should start when the patient enters the hospital or visits a clinic. We should be able to pull the patient's history, automatically take notes of the current treatment via trained AI voice modules so handoff between departments/visits is seamless, and add decision support that queries databases of similar diagnoses with the most successful outcomes. The idea is to have one linear stream of medical information and events recorded to the minute details.

On the administrative side, even more can be accomplished, as fragmented data can be accessed and aligned in a meaningful and user-friendly way. For example, this could mean running the patient's insurance and getting preauthorizations via the automation software. For providers, it means staying compliant and all enrollments, licenses, and privileges are current—this last bit about provider data management and credentialing we've already automated.

All this will free up time for health care professionals to focus on what matters most-patients.

What is exciting about what I just mentioned is that the technology already exists to achieve all of this.

What's one thing you would like the audience to walk away with from this interview?

Harman Dhawan: We all started because we were in the enrollment space, and it was frustrating to follow up with payers—the whole system, whether those are license renewals or enrollments. And I said, "Why can't we fix it?"

I think we have some exciting times ahead of us. AI is coming in, especially in drug discovery-related fields, and decision support is right for doctors. How cool would it be if you had all your records with you? If you had an AI assistant that's going through all of it. And then it refers you to a central database and says, what you're going through, 68,000 patients went through the exact same thing, and out of those these patients, they were treated with this. So you probably might want to look at this or discuss this with your doctor. So, it encourages a second opinion. And that's AI, and it's all facts. It gives you exactly what you're going through, whatever that might be, and the technology refers to it against the data.

It's one mind versus what they call a singularity, meaning a collective mind, which is the AI. In the next year or so, people should look forward to loads of automation, especially the executives in the health care space. RPA AI is being applied to at least the health care administration space. And then, slowly, as there's more legislation and everything around patient care, and all of that more framework because you're dealing with lives, you'll also start seeing more AI products come on that side. But, for now, I think they should be excited; we've already got a product out on the market. It's called Provider Passport, and I'm sure there are so many other entrepreneurs and innovators working on other aspects of administration and automating that.