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Data Driving Healthcare

Gina Papush

Global Chief Data & Analytics Leader at Cigna

Papush comes to Cigna with more than 22 years of experience in analytics strategy development and the use of data science to drive business value. Most recently, she served as the Global Chief Data and Analytics Officer at QBE Insurance Group where she oversaw data and analytics functions for the firm globally. Prior to QBE, Papush held senior leadership positions focused on enterprise data and analytics implementation at Citigroup, Fulcrum Analytics and GE Capital.

Transcript

Melissa Campbell:

Welcome to the CDO Magazine series honoring the Global Power Data Women class of 2020. I’m Melissa Campbell, the chief revenue officer with Tamer, and I’m excited to host Gina Papush, who’s the global chief data and analytics leader at Cigna. Hi Gina, and thank you for joining me today and congratulations on being part of this distinguished group of women leaders.

Gina Papush:

Hi Melissa, and thank you for having me. It’s a real honor.

Melissa Campbell:

Yeah. Great. Well, I thought we would just jump right in. What we typically like to start with is just to understand a little bit about your career, what brought you to data, and how did you end up at Cigna?

Gina Papush:

I am a data and analytics professional by training, and I have spent probably over 25 years now in this space. I’ve been very fortunate to have the opportunity to study in the applied math, computer science, and stats fields early in my career, and I started off actually as a researcher in the environmental research space and shortly thereafter moved into the industry and that kind of stuck. I stayed in the industry and had an opportunity to work in many different areas, initially in financial services, then in consumer landing, and then pivoted into working for a small boutique data analytics consulting and services firm, and we were doing work across multiple different industries. So I got to work in specialty retail and in pharma and healthcare back then, as well as more financial services experience, and then I had a great opportunity to come back into the industry and I spent nine years at Citi Group in the data analytics roles, in the banking and consumer landing businesses, incredible exposure global company with absolutely fantastic people, and we had a chance to live through the financial crisis there.

Gina Papush:

So I was there before, during, and after the crisis, and being in the mortgage business, we had a front row seat, so to speak, but it was a very rewarding professional experience because in times of crisis, people pull together and the mission-driven orientation that we had in terms of helping our customers stay in their homes, helping our employees serve our customers better was very rewarding in many ways. Post-crisis, Citi Group is doing great. Wonderful company. I had the opportunity to make a pivot and I chose to go into commercial industries, spent four years in property and casualty working for a global company called QB there. They’re headquartered in Australia, but operates in 30 plus countries across the world, and two years ago, I had this incredible chance to get to know folks at Cigna and that I chose to [inaudible 00:03:31] to healthcare.

Gina Papush:

Cigna is an absolutely unique company. I got to know folks at Cigna at different levels, and we have such a strong orientation in terms of serving our customers and really thinking about healthcare as a social mission, not only business. We have an outstanding growth record. We have a truly innovative culture, but the people here and the mission that we all serve really makes it very special, and we’re really committed to solving healthcare challenges here. Our CEO and president, David [inaudible 00:04:10] talks about our mission. He’s very open about the needs, the opportunities, and we’re really oriented towards helping our customers receive better care, partnering across the ecosystem and making the healthcare more affordable, more predictable, and really simpler for people that we serve.

Melissa Campbell:

Wow, that’s such an impressive background, and then just the path that you followed to get to Cigna and to be at Cigna at this time and date, especially, is just so impressive and important, actually. What you’re working on is so critical. So what are some of the projects that you’re most proud of or excited about it Cigna right now?

Gina Papush:

Well, we have a lot going on, and in the two years that I’ve been at Cigna, we have broadened the level of efforts in the data and analytics space even further. We are not certainly starting from scratch. I was fortunate to come into the organization that was already very strong in the data and analytics arena, and we’re looking at ways to truly propel ourselves to an industry leading position and to continuously build the capability, because data and analytics space is so rapidly evolving. When I think about what we do, maybe two or three things I could highlight. There is a very broad range of analytics initiatives, and we are applying some of the most advanced methods now across the board with machine learning and augmented intelligence capabilities, but our real focus for of that effort is on creating better affordability.

Gina Papush:

So that’s a big area for us. We’re personalizing healthcare experiences for our customers. We’re creating proactive recommendations so they can make better, more optimal care decisions when they’re faced with a healthcare situation. We’re making sure that we are in front of them with helpful information, so they don’t miss a health risk and they address those timely, and then we’re also sharing this actionable intelligence with our partners, particularly providers of healthcare that we work closely with, many in collaborative relationships, so they are best equipped with the information and intelligence that we have, and they make a diagnosis when they decide on the course of treatment, and ultimately our job here is to create better health outcomes. So that’s one of the areas that I could spend probably the empower hour talking to you about, the things we’re doing in that area.

Gina Papush:

The second area I would like to highlight is our efforts around the improving data interoperability and generally the integration of data. This is a big challenge for the industry as a whole. We’re focused on creating the leading capability, which will enable our customers to access their data more readily, we’ll get the data to the right partners more readily, and ultimately better information flows into better decisions so we can lower the cost of care, but a lot of data work for us and an enterprise strategy and efforts around data specifically in addition to the analytics work, and then the third thing, I guess thinking back through my career, I landed in mortgage business before the crisis and lived there through the crisis. I truly thought this would be only happening once to me in my career, but here we are in the healthcare industry, living through the latest big challenge of the COVID-19 pandemic.

Gina Papush:

And our team has mobilized that as far of the rest of Cigna, because at this time, our biggest priorities are our customers and partnering with the employers and the policymakers and the federal agencies to make sure that we’re putting the best care forward for people who need it. So a lot of analytics work that’s oriented towards identifying potential risks, predicting those risks, driving proactive interventions, making sure that we are operationally fully enabled and ready, and the analytics are feeding into many of those business operations and decisions. A big point of pride, I think, for our team truly is distinguishing ourselves, and we can certainly talk more about it. It’s another topic I could spend all day talking to you about.

Melissa Campbell:

We would love to come back and talk to you more about some of that. That was one of my questions later on was about the impact of COVID to your company and how you’re using data to handle some of the challenges, but I don’t know if you have anything else you want to add to that, but that was great.

Gina Papush:

Let’s come back to that so we give it the appropriate time. That sounds good.

Melissa Campbell:

Yeah. No, for sure. Well then I guess on the flip side of the stuff that excites you in the projects that you’re working on, what would you describe as some of the toughest challenges you’ve seen with handling data and digital transformation projects in general?

Gina Papush:

Well, it’s always interesting when you look from the outside versus from the inside. I worked with many companies as a consultant. I’ve spent a number of years working on the company side in these capacities. There’s always data challenge. I don’t think there’s any company out there that would have said their is is perfect. I think for us … and this is very unique to healthcare, what I’m learning … and this is two years in, there is an incredibly complex ecosystem in healthcare. This is probably one of the most sophisticated industries in the sense that you have a lot of different counter parties who are interacting on behalf of the ultimate recipient of healthcare. You have obviously us, we provide insurance, we provide administrative services, and we work with employers who look for us to provide them these benefits plans, provide them these networks of doctors, hospitals, and other services that their employees can leverage. We work directly with all of those healthcare providers. Ultimately, all of us are here jointly to make sure that the end consumer receives the best care possible, and that’s our job.

Gina Papush:

Similarly, the ecosystem on the government side. We have multiple programs in this country, ranging from federal Medicare to state Medicaid programs. The Affordable Care Act enabled government options for people who may not be covered through their employers. All of those complex programs have to interact. Government agency is involved, regulation is involved, and all of us who deliver different components of care in this ecosystem, all of this has the undercurrents of data. Data connects all these different parts of what happens in our industry, and I would say this is probably both an advantage and a challenge, because the advantage is we’re an incredibly data rich industry and we truly can leverage data in so many different and unique ways to better serve our customers. On the flip side of it, our data is very fragmented across the industry.

Gina Papush:

It’s not something that’s a problem at Cigna necessarily, but if you think of all the different people involved in the delivery of care, and then you think of the way that doctors used to do business, even a few years ago, and some of them still do, where a lot of the data is on paper or it’s on somebody’s computer in the office, and the interoperability of this system is a huge challenge. I think our policy makers recognize that. I think there are a lot of issues around customer access to their own information, as well as the privacy of that information. We have strict regulations like HIPAA. There are issues with accuracy of data as it moves from place to place. One of the things that’s very complex in this industry is the doctors actually have to supply their data to multiple partners. It’s a huge effort for them as well, and the level of accuracy in the data when it has to flow through so many different participants in the system deteriorates as that happens.

Gina Papush:

So this is probably by far the biggest challenge for the industry, and the lack of standardization. We’re attempting to address this. There are new laws that have come out from the current administration that are starting to tackle interoperability issues. We’re fully participating and engaged in multiple consortiums that are tackling that, but that I think we have a long road ahead of us as an industry to solve for that, and the lack of standards and transparency is going to be a continued issue. If you think of healthcare, it’s not just a data issue, but I’m sure you’ll connect the dots to the data analytics aspects of it. This is the only industry I can think of where you actually request or purchase services and you don’t know the end price of that service early in the process. We’re in the business of providing healthcare, the doctors are in the business for finding the best treatment, but you can’t always know at the onset the definitive outcome or the cost of those services that’s will be associated with that, and it makes it very difficult for everyone who’s involved in the process.

Gina Papush:

This piece of it that’s truly an opportunity for us as an industry, and we are very focused heavily as a company, because we believe we have the capability to do this, is how do you inject not just data, but how do you use data to enable sophisticated, more accurate predictive capabilities? And if we can do that, we can have better diagnoses, we can have them sooner, we can manage care more effectively, getting the patient to the right doctor, to the right site of care, where they will get the best service at the lowest cost, and we can intervene before things happen rather than after things happen, which will really afford for us to get to a better health outcome. Ultimately, we want our customers to be happy, and David talks a lot about this challenge, our healthcare system in the United States has been reactive for a long time. We treat the problem. We don’t try to get ahead of the problem, anticipate and prevent the problem. The role of data and analytics in that is huge, but it’s challenging to do because you have to get all that information together and then you have to be able to put the tools in the hands of the consumer and their doctor.

Melissa Campbell:

That’s amazing. You’re right. As you were describing it, the industry is probably the most complex, and you did a really nice job of kind of simplifying where the complexity is, but it is … I liked your word sophisticated. It’s a big, big challenge and it’s an exciting industry to be in. When you think of the triangle of technology, people, and process, what do you see as the most challenging piece of that and how do you make it work together in your organization?

Gina Papush:

It’s interesting that you asked that. All of these are critical. All of these are critical. We talk internally at Cigna about bringing together our stakeholders, our data and analytics capabilities, our technology capabilities, and our digital capabilities. So for us, it’s actually kind of a quadrant or a four legged stool rather than a three legged stool, because we believe we need to drive everything we do through the stakeholder needs, and we need to be solving the problems that address some of these challenges that we face, but ultimately we’re solving this for the customer, for the patient, for the employer that provides the plans, for the government partner that provides the plan, and we need to work in partnership with providers. So that’s a huge piece of the stakeholder orientation for us. The three things that [inaudible 00:17:29] that, as you said, the business process is one, the composition of technology and specifically orientation to digital and virtual technologies, which have been really highlighted by what we’re living through right now.

Gina Papush:

We’ve been all talking about telemedicine coming, but it’s arrived very quickly when COVID happened, because we didn’t have alternatives. Our digital team, which is led by Jason Suzuka, who is my peer and wonderful colleague, he’s doing an incredible amount of work in the digital space right now to make healthcare and all the information that we can make accessible through digital, and our business also is adopting a lot of virtual capability, and then data analytics and technology that powers that is a huge focus for us. All of those are equally critical, and you probably can’t say one’s more important than the other, but we look at that as a combination of capabilities that will together deliver the real exponential shift in what we’re able to do in the healthcare space, because right now, healthcare is just too complicated and too expensive, and so you’ve got to kind of bring all of those to bear, and without one of those ingredients, you’re going to have a hard time achieving that result.

Melissa Campbell:

So I work for Tamer and we’re a machine learning new technology, and I just am wondering from your perspective, how do you learn about new technologies and evaluate companies that you want to bring into Cigna?

Gina Papush:

So we do a number of things. There’s obviously a lot of information out there, and I do a lot of reading myself, but then we have team members who are very specifically focused on innovation. Within Cigna is Cigna Ventures Fund, led by another colleague of mine, Tom Richards, who heads our strategic planning and the Cigna Ventures team, and Tom and team do a lot of work in the community, as well as directly with the startup ecosystem, as well as the various organizations that do startups work. We do a lot of conferences. We gather information from many different sources. Our partnership with Cigna Ventures is oriented along several areas. Data analytics is one of those focal area. So we have folks in our team that’s work directly with Cigna Ventures, and another one of my distinguished colleagues, Dr. Glenn Stettin leads Cigna’s innovation team, and we work hand in hand a lot in terms of identifying innovation opportunities. Technology is a piece of that. We look beyond technology. Glenn and team had developed a digital formulary, which is a curated list of partners that we recommend to many of our stakeholders, in particular employer clients and other health plans that Cigna works with on the health services side, and the digital formulary is an example of how you’ve got companies that leverage data analytics, but they ultimately deliver healthcare services to customers directly through a digital platform.

Gina Papush:

And specifically in the data analytics space, we do a lot of work where we pilot things. We like to do piloting with an eye towards how would this technology align to solve a specific stakeholder needs or problem, and then we organize around that with our internal partners and try things out. We’ve done quite a bit of work in that space. One of the examples that you may have come across because we’ve announced it, is our partnership with [inaudible 00:21:22], which is a digital diabetes management company. Our analytics team was part of that pilot, but it’s obviously broader than just analytics. They have interesting analytics built into their platform. We also made an investment in GNS Health late last year. They are a precision medicine analytics company. They do a lot of very interesting advanced work in this space and we’ve done some of that with them as well. So wide range of ways we engage with companies, and we form commercial partnerships. So that’s just normal course of business for us. We’re constantly reviewing potential partners, whether they’re in the data space, technology space, analytics space, all of those are being scanned on a continuous basis.

Melissa Campbell:

You have such an exciting role and you’re part of such a critical industry, sophisticated industry, as we said, and you’re doing really new and cool different things with data. What do you see … I guess this is my last question. So as things continue to evolve, it’s hard to even imagine there’s just so much going on with machine learning and the AI and everything else these days, but what do you see as maybe some of the biggest changes coming down the pike in a few years in data?

Gina Papush:

Well, I think a few things will happen. In some ways, healthcare is on the forefront in another race. I think we’re coming a little bit from behind compared to other industries like financial services and tech, and we recognize that. Part of it is there is a different expectation from consumers, and that has caught up with us in our industry, where they’re looking for healthcare to be similar to online shopping. They expect information to be available. They expect access to information. They would like to gather information digitally and do their own research. It’s a big shift in healthcare, and I think it’s only accelerating with COVID-19. What we are now seeing is we’re shifting towards digital and virtual very rapidly. Something that maybe we were predicting, but it was taking much longer than we anticipated. It’s happening in real time now. COVID-19 experience has truly elevated the importance of accurate data.

Gina Papush:

I mean, we can spend time talking about that more, but the fact that we’re still debating whether testing data is accurate, whether hospitalization data is accurate, whether it’s available in a consistent, timely manner across the country of our size, there are a lot of different challenges and gaps with that, and we’ve partnered very effectively. Particularly our digital team has formed partnerships where we’ve moved towards cell diagnosis for COVID very rapidly, in a matter of weeks after the pandemic started sweeping the country, and all of those capabilities will become our normal way of receiving healthcare. We think virtual care is here to stay. Telemedicine is here to stay. We’ve seen a lot of adoption, so that’s one big trend. All that needs to be powered by data and data has to be real time for all these things to work, and you need a lot more sophisticated analytics, because the data is not going to be not flowing anymore through spreadsheets through the doctor.

Gina Papush:

You’re going to have people expecting information exchanges real time. Two other things that I think will be happening as we look forward is in the data space, many of us have historically been oriented towards more of a regulatory aspect of data governance, data controls. That’s certainly not going away. It’s going to continue to be very important, particularly in our industry. We feel very strongly that we are the custodians of data on behalf of our stakeholders. We have to apply responsible data practices across the board, but I think there is a shift where we’re looking for folks in the data space to really have more business impact orientation as well, and orient towards solving the stakeholder needs rather than just meeting the regulatory requirements. So good example of that is our interoperability initiative.

Gina Papush:

There is a significant set of new regulations that came out earlier this year. We are actively fulfilling on those, but we intend to not just do what the regulators require, but go a step further, because we want the consumer to have access, with the right controls, and we want them to have a better experience. I mean that’s very important. If you think of your own healthcare experience, it’s not simple. You have to make lots of calls. You have to go to all sorts of places to even get access to your own information. Making that healthcare simpler is huge, and data plays a big role in that. So it’s orientation towards much more of how do we impact our stakeholders and not just comply with regulations via the [inaudible 00:26:46]? how do we make sure that we are very much thoughtful about any inadvertent and unintended biases as we do that? As we adopt machine learning and other automated modeling processes that we actually are maintaining the same controls and putting responsible algorithms in place that are not going to create more bias than if humans would have.

Gina Papush:

And we’re going to see a lot of data automation. I think that’s a big portion of our future. Whereas today, a lot of these controls may be done more manually by a person, we’re going to see a ton of automation, and in the analytics space, I think we are starting to see the AI hype died down a bit. You used the term machine learning. I like that term a lot. I think AI, it means a lot of things to a lot of people. There’s nothing wrong with the academic term, but we haven’t really seen all the hype that’s been created about it to translate into meaningful results. In our industry, it has very limited the areas where we’ve seen success. The diagnostics have seen good success, but other areas not so much, but where we see success is typically a combination of machine learning and deep learning.

Gina Papush:

And we think the future is in machine learning, deep learning, and sort of the concept of augmented intelligence, where machine intelligence is married to human expertise, and I think it’s particularly true in healthcare. I don’t think we are ever going to be living in a world where we don’t need doctors, nurses, and healthcare professionals. For us at Cigna, that’s a philosophy, and we don’t delegate decisions entirely to machines. We provide data intelligence to the healthcare professionals who make those decisions, because our data is never going to be perfect and they’re going to get information from the patient in real time that may not be accessible to us, but equipping them with all the intelligence we have in a very usable form will make their lives a lot easier and enable them to make much better decisions. So I think for us in the industry, those are the big trends that we anticipate.

Melissa Campbell:

I’m so thrilled to hear some of what you described. Just in our company alone, I mean we are a machine learning based company, but it’s all about the human in the loop as well. So Gina, what a pleasure. Thank you so much for joining us today, and all those that are watching, please visit CDOmagazine.tech to see additional interviews like this one with Gina, and I just want to thank you again.

Gina Papush:

Thank you for having me. This was real fun. Thanks, Melissa.