>>Welcome to this IBM Watson health client conversation here. We're probing the dynamics of the relationship between IBM and its clients. And we're looking back, we're exploring the present situation and discussing the future state of healthcare. My name is Dave Volante from the cube and with me are Alex Dillard. Who's a senior director data analysis at blue choice, blue choice health plan, and Darryl decode, who is IBM with IBM Watson health. Of course. Welcome gentlemen. Good to see you. Thanks for coming on. >>Hey, >>So, you know, you think about lasting relationships. They're the foundation to any partnership and this past year, and it's tested all of us. We've had to rely on both personal and professional relationships to get us through the pandemic. So Alex, let me start with you. How has the partnership with IBM supported you in 2020? >>Well, uh, I've just a piece of a larger puzzle. Uh, the relationship that Darrell and I have had is confined to IBM Watson health, but blue cross blue shield, South Carolina, which food choice is a wholly owned subsidiary of has had a standing relationship with IBM on the it side. Uh, we are a mainframe shop, uh, about 70% of our it infrastructure is on a mainframe. And, uh, that puts us as a segment one client for IBM, we're in the top 300 of all of their clients in the Americans. And more specifically we're the fourth largest, um, uh, Linux on Z shop in the world. So, uh, we've got a lot of diversification at blue cross blue shield of South Carolina and the mainframe and the vastness of that. It infrastructure reflects that, uh, diversification. We are more than just a crossing the shield. Uh, that's typically what people think of is insurance when they think of crossing shield, but we also have a division that does a lot of subcontract work for government programs, uh, track air, which is the military healthcare, uh, claims processing and Medicare claims processing. >>We were a subcontractor of other folks that use our back office, it infrastructure to, to run their claims through. So that's, that's the larger, um, aspect of our relationship that, that blue cross blue shield of South Carolina house with IBM, uh, as it relates to Watson health, we have been a client since 1994 and obviously that predates the IBM proper. Uh, we were a client of med stat and then Truven, who then, uh, was bought by IBM. So we have used the products from Watson health throughout our system to support provider profiling, uh, count group reporting, um, and ad hoc analysis and to some extent to, uh, support our value-based products with, uh, ACO and PCMH, >>Uh, products. >>Awesome. Thank you for that. So Daryl is very long-term relationship. Obviously, if people forget sometimes that, uh, how IBM has modernized the Z Alex talked about, uh, Linux on the mainframe. That's pretty cool. I wonder if you could talk about specifically the things that, that you've done with Alex in his, in his, in his team, you know, thinking back last year, what were your accomplishments that you really stand out? >>Yeah, so, so one thing that jumps to mind is, uh, given the long standing relationship, I relied heavily on Alex to help us work through a multi-year renewal. And it was, it was a, um, a good adventure for us. We, we were able to laugh along the way. We certainly had some, some phone calls that, that were a little bit challenging, but the great thing about it was that the relationship that Alex and I had, he really views it as a partnership. And that was just so encouraging and uplifting. So to me, from my perspective, that was absolutely, uh, one of the highlights of my year and working through even through the pandemic and all that, we figured it out. >>So you guys, when you get together, go ahead, please. >>That's what I had as well. Um, you know, the, the unique thing about the Watson health contract is because it involves data. Uh, we take the stance that it's an it contract, so I'm on the business side. So I've got to just, as Daryl has to navigate it with me, we've got to navigate a large of your it bureaucracy. Um, and, uh, it, it was challenging. Um, you know, the business people kind of smooth the tracks and then you get the lawyers involved in, it just goes haywire. So, um, we were able to navigate that. Um, uh, so yeah, so it was a big accomplishment. So Alex, it's not real sexy to talk about, but we got it done >>Well. So Alex you're, you're in sales, so you're, you're used to role playing. So imagine you're, you're, you're sitting down, uh, sorry, Darryl. You're used to, role-playing out. Imagine you're sitting down with Alex and you're thinking about 20, 21 planning, so, you know, take it away. W what do you, what would you ask, what would you talk about or share with us? >>Yeah, yeah, absolutely. So, so I, I know that, you know, one of the key objectives is, uh, continued to ingest, engage with your members and you have key business strategies. I know you recently migrated over to a new PBM, and so there, there's some complexities that come with that. Um, but just, you know, Alex, if you don't mind, why don't you share a little bit about kind of your, your perspective on what 2020 would hold for you in your organization? Well, I think that due to the pandemic, we are, I personally kick the, can down the road on a couple of things, particularly >>Having a strategic roadmap discussion, um, you know, uh, I was going to get into this later, but I enjoy doing things face-to-face rather than, uh, over the phone or, or virtually. And so, uh, I guess I was a little too optimistic about maybe being able to get together late 2020 to have that strategic roadmap discussion. Um, I think, uh, given what has developed with, um, the pandemic and vaccines and stuff, I may, I may be able to get everybody on the same page later this year, hopefully. Uh, but certainly we want to have a strategic roadmap discussion. Um, we license, uh, Watson Hills, uh, cat group insights, uh, tool, which we use for employer group reporting. And we are currently in the beginning stages of rolling that out to our external clients, whether it's agents, brokers, um, those types of folks. And then it vanished we as our core product that we use for analysis, and that product is transitioning to what is called health insights. And so from an analytical standpoint, my staff and the staff of our cluster areas will need to sort of move to health insights since that's where it's going, uh, from an analytic standpoint. So we're going to work on that as well. Um, and then some more detailed things around database rebuilds and stuff like that. Those are all sort of on the roadmap for 2021. >>Yeah. So, you know, you talk about strategic planning and you think about the way planning used to be. I mean, sometimes you take a longer term horizon, maybe that's five years, you know, technology cycles, you know, even though they go very fast, but you see major technology shifts, they're like go through these seven year cycles, you see that in financial world. And then with the, with the pandemic, we're talking about seven day cycles, you know, how do I support people work from home? Do I open the store or not? You know, it's a day-to-day type of thing. So I wonder if you could each talk about personally and professionally w how, how is 2020, you know, changed you and maybe position you for, for what's ahead, maybe Alex, you could start, >>Well, you know, I'm an analyst, so I always fall back to the numbers. What are the numbers show us, um, you know, people can have four perceptions, but, uh, the numbers give us a reality. So the reality is that a year ago, pre pandemic, uh, just 13% of blue cross blue shield employees were working from home a hundred percent, uh fast-forward to today. And that number is now 87%. So think about, uh, just the lift from a it infrastructure to support that we almost, all of those people are using Citrix to get in to our network. Uh, we're using a remote desktop. So you've got this pipeline that probably had to go from, you know, this small, to huge, to get all this bandwidth, all this data and everything. So you've got that huge lift. Um, and then it affects different areas, um, differently. Uh, I don't have any first-line staff, any staff that are member facing, so I didn't really have to navigate, you know, how do these people talk to our member? >>How does staff talk to our members on the phone when they're at home, as opposed to in the office, and, you know, is there background noise, things like that. So I've got analysts, uh, they're just crunching numbers. Um, but my, my, my personal, uh, feeling was I like doing managing by walking around, you know, stopping and talking to other, working on. So that went away and I like face-to-face meetings, as I've mentioned, and that went away. So it was really a culture change for me personally, it was a culture change for our organization. Uh, and, and now we're having conversations with executive management that, you know, if you've got staff who have been doing a good job and they remain productive, you know, give me a reason they got to come back in, which is just, as you told me that I'm going to be the case a year ago, I would have been, you know, flabbergasted, but that's where we are right now. >>And so on a personal standpoint, you know, I went home for a little while and then came back. And so my wife also works for blue cross blue shield of South Carolina. Um, so, you know, she set up in the dining room working, uh, I have my own book in our living room working, and then we've got a great side, you know, the school is not in session, you know, in person. So he's doing virtual learning. So combine all those things, and you've got all kinds of crazy things that could happen. Uh, and then you've got staff who are in the same situation. Um, so it was a lot to handle. And the longer it goes on the novelty of working from home wears off, and you kind of realize, you know, I can't go do this. I can't go out to eat. I can't do all types of things that I used to do. And so that affects your mental health. So as, as a leader, um, of my small area, and then our executives really had to become more, uh, uh, in, in people's faces. So we've got, we've done a lot more video, uh, messages, a lot more emails. Um, I have been tasked with being very deliberate about checking on how everything is going at their house. Are they getting what they need? Um, you know, how are they feeling? Are they getting up and exercising, all those things that you took for granted, uh, beforehand. >>Yeah. So Daryl, anything you'd add to that in terms of specifically in terms of how you might, how you might change the way in which you interact with your clients generally, uh, an Alex specifically, Alex likes, face to face, you know, we can't wait. All right. >>Yeah, yeah. It's funny. We never quite got to do it Alex, but we were talking about doing a virtual happy hour at one point too, to just celebrate the success. Um, but for me, you know, typically I would travel and visit Alex face-to-face on maybe a monthly basis. And so it it's been really hard for me. I didn't realize how, how much I enjoyed that in-person interaction. And so that, that was something that I I've been, you know, working through and finding ways to, to still interact with people. And I'm certainly making, making the best of, of the video phone calls and, you know, that sort of thing. So, uh, just work working to maintain those relationships. >>I wonder if I could ask you when, when, when this thing, when we're through the pandemic, what do you expect the work from home percentage? I think I heard 13% prior to the pandemic, 87% today. What do you think is going to be post pandemic? >>That is a good question. Um, it, it may go back to maybe 60% at home. I think, I think there will be a simple majority, uh, working from home. Um, that's, that's from our planning, uh, space planning standpoint. That's, that's what we are, uh, what we're expecting, um, if, if production stays, um, at acceptable levels, um, >>Do you feel like productivity was negatively impacted positive? It will be impacted or it's kind of weird. >>Yeah. All the metrics that we track show that it was, it was sustained and in some areas even better. Uh, and if you really think about, um, sort of your typical day when you work from home, I found, uh, that I was logged on an hour earlier. That's probably what's happening with other staff as well is they're, they're motivated to get up and, and get online, uh, earlier. >>Yeah. Mostly tech leaders that I talk to share that sentiment, that the productivity is actually improved. So Darryl, I presume you see the same thing in your observation space. Yeah. >>Yeah. I, I do. And, and I have other clients too, and, and, and they are definitely looking at ways to continue to work remotely. I know that for a lot of people who are in the office all the time, uh, having a little bit more flexibility when you work from home can be a good thing. And, and like you said, you, you have to make sure that the productivity is still there and the productivity is up. Um, but I, I could see that the trend continuing absolutely >>I'd love for you to, to look at Darryl and say, and tell him what the kinds of things that IBM can do to help you both today, immediately 20, 21, and in the future and a Darryl, how, how your, how you'll respond. >>Well, I'll tell you that. Um, so in 2020, what, what changed most dramatically for us as a health plan? Uh, and, and I, it echoes what we see across the country is the gigantic shift in telehealth. Um, you know, if, if, again, if you look at the numbers, uh, our telehealth visits per thousand, so that's the number of visits per thousand members in a given month, went up 1472%. And so, you know, the common response to that is, well, you know, your visits overall probably, you know, were flat because, uh, you know, they just weren't happening in that. And that's not necessarily true for us. So if you look at visits overall, they written down four and a half percent. Um, so there was a shift, but it, it was not a big enough shift to account for, uh, visits overall sustaining the level that they were pre pandemic. >>Um, so as we look into 2021, uh, we will be investigating how we can maintain, uh, the, uh, the accessibility of our healthcare providers via telehealth. Um, you know, one of the projects that we started in 2020, uh, was based upon the choosing wisely campaign. So if you're not familiar with choosing wisely, it's a very well thought out process. It involves many, many provider specialties and its sole target is to reduce low value care. Uh, so we took it upon ourselves to Institute sort of a mirror of that plan or that program at, at blue cross here in South Carolina. And so as we moved to 2021, obviously those low value services just because of the pandemic were reduced, uh, and some of the high-value care was reduced as well. And so what we are going to try to do is bring back habit, bring back that high value care, but not bring back that low value care and so low value care or things like vitamin D testing. Uh, it can be other things like, um, uh, CT for head headaches, um, imaging for low abdominal pain, things like that. So, uh, we want to focus on low, uh, eliminating what value care, bringing back high value care, >>Okay, Dale, you're up? How are you going to help Alex achieve that? So, so good news is, is that we've got the analytic warehouse and the database where all of the data is captured. And so we we've got the treasure trove of information and data. And so what we'll do is we'll come alongside Alex and his team will do the analytics, we'll provide the analytic methods measures, and we'll also help him uncover where perhaps those individuals may be, who had postponed care, um, because of the pandemic. And so we can put together strategies to help make sure that they get the care that they need. Uh, I also a hundred percent agree that tele-health hopefully is something that will continue because I do think that that is a good way and efficient way to get care for people. Um, and, you know, as a, as, as a way to, to address some of their needs and, and in, in a safe way too. >>So, um, I, I look forward to working with Alec and his team over this coming year. I think there is, uh, knowing Alex and, and the partnership and his readiness to be a client reference for us. You know, those are all great, um, recognition of how he partners with us. And we really value and appreciate, uh, the relationship that we have with blue cross blue shield, South Carolina and, and blue choice. Excellent. Daryl's right. The, the, the database we use already has some of that low value care measures baked into it. And so throughout 2020, I've worked with our analytic consulting team. Uh, it's under Daryl too, to talk about what's on the product product roadmap for adding to the cadre of live low value care measures inside advantage suite. Uh, so that's something that we'll actively be, um, uh, discussing because certainly, you know, we're, we're obviously not the only client only health plan clients. So there may be other plans that have priorities that very different made very differently than ours. Uh, so we want to give them what we're studying, what we're interested in, so they can just add it in to all their other client feedback, uh, for advantage suites, roadmap. Excellent. >>Look, my last question, Alex is how would you grade IBM, if you had to take a bundle of sort of attributes, you know, uh, delivery, uh, value for service relationship, uh, et cetera, how would you grade the job that IBM is doing? >>I, the thing that I enjoy most about working with IBM and Darryl specifically, is that they're always challenging us to look at different things. Um, things that sometimes we hadn't considered, because obviously it may be an issue for another health plan client or an employer client that they've got. Uh, they tell us, this is what we're seeing. You know, you should look at it. Uh, a lot of times they do some of the foundational work in producing a report to show us what they're seeing in our data that is similar to what is in some of their other clients data. So that's refreshing to be, uh, challenged by IBM to look at things that we may not be, uh, looking at, uh, or maybe missing, because we've got our eye on the ball on something else you >>Care to put a letter grade on that. >>Oh, definitely. Definitely. Thank you. >>Well, Darryl, congratulations, that says a lot and, uh, we have to leave it there and one at a time, but, but Daryl, anything that I didn't ask Alex, that you, you wanted me to, >>So, um, Alex re able to keep your tennis game up during the pandemic? Uh, I, yes, I tried as, as often as my wife would let me good. I would play every time I was asked, but, uh, yeah, so I, I did have to temper it a little bit, although when you spend all day with her and, and my son, you know, she may be a little more, uh, lenient on letting me leave the house. Well, maybe she's >>Yeah. The tribute to the late great comedian Mitch Hedberg, who says, uh, you know, when I, I played tennis, I played against the wall walls. Really good, hard to beat if it's pandemic appropriate. >>Oh, that's good. That's a true statement. And there was a lot of that going on, a lot of that play and playing against the wall. >>Hey, thanks so much, stay safe and really appreciate the time. Thank you. >>Thank you. Thank you. You're >>Really welcome. It was a great conversation and thank you for watching and spending some time with client conversations with IBM Watson health.