A decision intelligence platform for smarter healthcare—Exponential AI

When it comes to innovation in healthcare, pretty much everyone is all-in on AI. Functions ranging from diagnostics and pharmaceutical development to appointment scheduling and doctor-patient interaction are machine-learning-enhanced and algorithmically influenced in myriad ways across the sector.

In the era of value-based healthcare, digital innovation, and big data, healthcare decision systems have become vital for organizations to improve care delivery.

Healthcare has always involved the intersection of human judgment and scientific data. Advancements in Artificial Intelligence (AI) are bringing those two elements closer than ever—and the industry is feeling the impact. Artificial Intelligence is expected to participate more and more in healthcare decision making processes across clinical, operational and administrative processes, for example, doctors are increasingly using AI and machine learning devices to improve precision in diagnosis and identify therapy regimens.

Providing smarter healthcare with decision intelligence is what Exponential AI is all about. Exponential AI is a leading healthcare AI platform firm solving healthcare’s need to scale smarter processes to proactively respond to its increasing complexity. The company’s award-winning decision intelligence platform, ENSO, and various other solutions are being used by leaders across healthcare, delivering exponential improvements across business outcomes.

In conversation with Nikhil Mendhi, President and COO of Exponential AI

Q. How do you help clients adopt AI at an enterprise level?

While AI holds significant promise, enterprises are struggling with extracting the maximum benefit of this technology, or as we call it: “unleashing AI’s exponential potential.” That’s because healthcare AI is hard and complex.

More than 70% of healthcare enterprises have begun their AI journeys, but fewer than 15% of  AI models that get built actually go into production. The main reason: Most current approaches are generic, and disconnected from action. They operate like a black box with limited control, and that significantly hinders adoption.

So Exponential AI offers three essential pieces to empower our clients to take full control of their AI journeys, and even accelerate AI adoption at the enterprise level:

1. A production-ready Healthcare Decision Intelligence Platform called ENSO;
2. An integrated, reusable Decision Agent Ecosystem;
3. And healthcare domain expertise.

We’ve designed the platform to use AI to make better decisions. That ultimately drives better business outcomes, and that clearly establishes AI’s business value. The decision agent ecosystem includes a library of pre-trained agents with healthcare expertise across functions and processes. Together, they help our clients build tailored solutions that are customized to the context of their enterprise – and that drastically reduces the time (by a factor of 3X) and investments required to build AI solutions. All of this results in simpler and accelerated AI adoption.

Q. This is really interesting. Can you elaborate on the Decision Intelligence Platform and Decision Agents Ecosystem that you offer to your clients?

Sure. Healthcare’s complexity doesn’t allow for rule-based systems to effectively solve healthcare challenges. This is the main reason healthcare continues to rely largely on human expertise and involvement across even its most straightforward processes – it’s why so much healthcare AI can’t scale. So our decision agents are pre-built digital workers, trained to make functional decisions, just like humans. With decision agents, our clients can augment and scale human expertise, repeatedly, and in real time. The result is trusted, reproducible, and transparent decisions.

On an enterprise-wide scale, these decision agents create collective knowledge that can inform multiple solutions across transactional, operational, clinical, and corporate functions. That means AI can now easily be infused into any process where it can deliver value.

And because these agents are delivered within a decision intelligence platform that lets you drag and drop decision agents intosolution flows, all of this easily scales to current and future needs. That’s how we’re able to bring true digital scale to modern healthcare organizations.

The ENSO platform can be trained and customized withan organization’s own data for precisely relevant and contextual decisions.

Q. What benefits do your customers reap by engaging with Exponential AI for their business?

Our customers see immediate and guaranteed value, and are able to scale their AI adoption rapidly. Disruption to existing processes is minimal to nil because the ENSO platform enhances existing processes and systems rather than replacing them.

For instance, many clients run the platform in parallel to provide decisions and recommendations within existing systems such as claims adjucation, CRM and RPA. Adding more intelligence and value to static data helps create the fastest response rate in the industry and helps enterprises scale quickly. Deploying decision agents in real-time transactions enables restrospective and reactive processes to become prospective and proactive. Such shifts generate tremendous new savings and create greater control over operations. One healthcare customer now processes 4.5 million claims per day using the ENSO platform, relying on AI to identify errors, fraud, waste, and abuse in real time.

The days of vendor-driven processes that operate in silos with little to no transparency or insight into what’s being done and how are now over.

Enabling organizations to validate processes or replace them with autonomous ones also creates white box operations and significant control. Spending drops even as quality improves.

Q. What trust do you build with customers? How loyal are they to your services?

One of our Fortune 50 customers is a great example. They approached us to help them apply AI to transform their claims value chain process. We met their savings expectations in less than six months. The promise of replicating this success across other processes made them chose the platform as a one-stop destination for all things AI – ultimately building and managing 30 solutions. More than 80 percent of these solutions were created by their internal team. And they scaled across all their processes in 18 months, using the ENSO platform – three times faster than a manual approach would take. They ended up launching more solutions than originally planned and generated more ROI than expected.

Q. Which aspects of the healthcare sector see successful outcomes with ENSO?

ENSO is deployed within payer, provider, and life sciences organizations across a wide range of clinical and operational processes. We have created substantial savings, efficiency, and quality outcomes across all these implementations. The processes that are seeing maximum benefit include claims processing, payment integrity, contract management, utilization management, adverse event reporting automation, and clinical trials.

Q. What’s next for Exponential AI?

You’ll see more scaled AI implementations in the future through our platform, and we are working hard to enable that.

We’re seeing the strongest momentum with payers, and this has grown substantially since COVID. We’ve also built strategic partnerships with a number of global systems integrators and consulting companies that specialize in niche areas of healthcare. For business users, we’re focused on how the platform can further cater to specific challenges, and on increasing their ability to build their own solutions.

On the platform and technology front, we’ll continue to explore solutions to the challenges faced by data scientists and solutions engineers while they try to adapt AI to their business environment. We have many robust features in the pipeline, in addition to expanding our agent ecosystem.

The person driving ground-breaking innovation to help decision making in healthcare

Nikhil Mendhi, President and COO of Exponential AI.

Nikhil has spent 15+ years leading high-growth ventures. He has successfully led large-scale transformations and enterprise-wide initiatives for Fortune 500 Conglomerates in the U.S., South America, Middle East, and Asia. He has extensive experience in transforming operations, product development, platform delivery, strategic planning, and change management. Before Exponential AI, Nikhil was Vice President and Practice Leader at HM Health Solutions, a Highmark Health growth venture, where he led delivery of large-scale transformations and product development with high client satisfaction.

“Build Smarter AI Solutions Using Decision Agents.”