Cigna Uses AI to Check if Patients Are Taking Their Medications

Cigna Uses AI to Check if Patients Are Taking Their Medications

Health insurer is expanding an AI-based system it acquired as part of the Express Scripts deal

After the AI system was tested and partially deployed this year, early results showed success in helping diabetic patients, Cigna said. Here, the health insurer’s headquarters in Bloomfield, Conn.

By  Agam Shah Dec. 12, 2019 1:19 pm ET
Cigna Corp. plans to expand a system that uses artificial intelligence to identify gaps in treatment of chronic diseases, such as patients skipping their medications, and deliver personalized recommendations for specific patients.
The product, called Health Connect 360, integrates data from a combination of sources and analytical tools, some developed at Cigna and others brought in as part of its $54 billion acquisition of pharmacy-benefit manager Express Scripts Holding Co., completed late last year. Express Scripts, which began developing the service two years ago, rolled out portions of it to some customers this year.
The complete system will be available next month to all customers of Express Scripts and Cigna that offer health benefits to employees, the company said.
Health Connect 360 was developed for treatment of chronic diseases, including diabetes and heart disease, as well as for pain management. The system aggregates medical, pharmacy, lab and biometric data—such as information from glucometers, which measure blood-sugar levels—into a dashboard that is accessible through an online interface. The dashboard will be visible to the service’s customers and to Express Scripts case managers and nurses with access rights. The system can also feed information to electronic-medical record systems for physicians.
More health-care organizations are looking to artificial intelligence to spot diseases, prioritize cases and improve patient outcomes—results that also have the effect of lowering overall costs for the providers.
AI systems’ ability to learn from an array of patient histories, medical tests and diagnostic tests makes them ideal tools for care. However, getting access to health data required for better outcomes can be a bottleneck.
“That was our concept around the acquisition of Express Scripts—it was much more than just simply buying a pharmacy-benefits management [company]. It was buying a set of care-management capabilities, and access to data and intelligence that would be very, very hard to replicate,” said Cigna Chief Information Officer Mark Boxer, who drives the company’s AI deployment.

Cigna is already using AI to predict whether patients might abuse or overdose on prescription opioids. Another Cigna tool, One Guide, provides personalized help to health-insurance holders on their benefit plans, appointments and health coaching.
The new Health Connect 360 system combines algorithms that analyze data such as clinical and pharmacy information with predictive models to generate recommendations and ways to best engage a patient, whether through an app or in person.
For example, collected data from pharmacy claims or high blood glucose level readings from connected glucometers could trigger an alert in Health Connect 360 that a diabetic patient needs help to stay on track with medications.
After the system was tested and partially deployed this year, early results showed success in helping diabetic patients, the company said.
Managing chronic conditions is much less expensive than engaging in some kind of corrective procedure, said Matthew Josefowicz, chief executive of research and advisory firm Novarica Inc.
“Across the health-care industry, as with every industry, the incredible growth in data availability and ability to communicate enables new kinds of interventions that were just too cost-prohibitive to even consider before,” Mr. Josefowicz said.
To keep the focus on its core health business, Cigna recently has been seeking a buyer for a unit that sells life, accident and disability-income insurance to employers for their workers, The Wall Street Journal reported Tuesday.


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