Interview: Aetna's Innovation Leader Talks Tech's Potential to Improve Health Outcomes

Innovation labs are hot in the insurance industry right now, as carriers look to ways to incubate ideas that can improve their customer interactions and relationships. For health insurers, those kinds of customer-driven solutions are, logically, around helping their policyholders improve their overall health.

Michael Palmer, Aetna VP of Innovation and Next-Gen IT Strategy, has led the company's innovation labs since their inception about a year and a half ago. He says that the intersection of technology and medicine comes largely in leveraging data to marry the right prospects with the right clinical solution.

"We were focused on the next generation of clinical program that deal with chronic and other diseases in our first year, and now we're on the second area around tech innovation," he says. "Any clinical solution requires data to find who you point the solution at and how to measure it."

Initiatives that have come out of the innovation lab include a partnership with Eviti, a cancer treatment decision support platform, to help oncologists identify the best treatment options for their patients.

"In cancer care particularly, the research is moving so quickly, it's impossible for any human much less a physician to read and catalog all that in their head," Palmer says. "Being able to give them clinical decision support tools gives them a way to get access to the latest studies -- you just have to get it into their workflow."

Innovation in healthcare, in fact, revolves heavily around trying to change sometimes deeply ingrained practices both among providers and patients. That can include installing a new treatment decision platform into a physician's workflow, or in the case of recent word the labs have done around metabolic syndrome, changing patient behavior that puts them most at risk. Aetna recently partnered with Neutopia and GNS Healthcare to develop predictive models that identify patients at risk for the syndrome that affects the heart, and then present them with a plan to affect one or two of their risk factors with the goal of decreasing their overall risk.

"Those are the key tools we're using in the innovation labs -- the abilities to identify patient populations that fit a certain set of criteria, to go out and talk to the physican and the patent, and leverage tech and other assets we have at Aetna to reduce the risk," he says.

One happy customer of the metabolic syndrome research is Palmer himself, who used the genetic testing, health coaching, and food logging components in the metabolic syndrome program to help him lose 30 pounds.

"Step one is having people understand their numbers around blood pressure, waist circumference, or these other factors. Sometimes that's enough for them to say, 'I'm out of range, at risk, I should manage it,'" he says "Our hypothesis is that people will take the understanding of these factors and allow them to focus on one or two areas instead of all five. Once we get the sense they need to do something, we call that someone who has been activated. And 85% of the first 188 people that went through it didn't miss a coaching session in the first 10 weeks. We think this is a differentiator that helps people."

Innovation lab efforts can also be extended to Aetna's big group customers, who can help segment their employee populations and identify the right prospects for the solutions. It also helps Aetna meet obligations under the Affordable Care Act, Palmer says.

"When you get to the ACA, it's many people who haven't been able to get coverage because of a pre-existing condition," he says. "There's various plan designs in the ACA, and some have room for some wellness programs. To the extent we can roll these programs out to the population, we can get them to the market quickly for the people who are coming in on the exchange."

Nathan Golia is senior editor of Insurance & Technology. He joined the publication in 2010 as associate editor and covers all aspects of the nexus between insurance and information technology, including mobility, distribution, core systems, customer interaction, and risk ... View Full Bio