How to Make Healthcare AI More Trustworthy w/ Steve Pappas, Head of Innovation, eGain

In healthcare, a wrong answer is more consequential than a bad customer experience. It's a denied claim, a missed medication, or a treatment that gets delayed past the point where it helps. Traditionally, a human health plan representative would catch that. Now, AI answers first, and unlike humans, it has no instinct for when something's off. So when a policy changes and the AI's knowledge doesn't, a new problem arises. That problem has a name, model drift. Today's guest says the fix isn't a smarter model, it's better data. And he's built a way for contact centers to catch drift before a patient does. Welcome back to Humanify Health Tech, where we explore how AI is rewriting the rules of healthcare and putting people back at the center of care where they belong. I'm your host, Brian Chi. Last episode, I spoke with Outpost Bio CEO, Dr. Jenny Yang, about how AI can help personalize healthcare with the right treatment for the right patient. But today we're talking about what happens when AI is wrong. AI is wrong? And worse, nobody knows about it. According to an NAIC survey, 84% of health insurers use AI across prior authorization, utilization management, and disease management. In an industry where policies change like the weather, a confident wrong answer can easily ripple out from the contact center and completely derail a patient's care journey. That's the problem today's guest is working to fix. Steve Pappas is head of innovation and healthcare go-to-market at eGain, which builds a knowledge platform that sits behind healthcare contact centers. Steve helped create eGain's AI healthiness assessment, a way for organizations to measure whether their AI can actually be trusted. Steve has spent two decades in regulated industries, including 13 years at knowledge management company Panviva. So he knows a thing or two about getting the right answers to the front line. Steve, thanks for joining us today.

Thanks for having me, Brian. I've really been looking forward to this.

Thanks. Thanks. Yeah, us too. And let me just start off with first question. Just out of curiosity, what does head of innovation entail for a company like eGain? What are you do? What do you spend your days doing, thinking, crafting, brainstorming? That sounds like probably the most exciting or interesting job I've ever heard of.

I'll tell you, when it came about, I was actually very excited because I get to look

at

not

only what

the past had, but what we need today that is also looking forward into the future. So let me explain that a little bit more. Especially around AI, there are so many areas to consider when it comes to AI that we need to move and evolve the entire platform moving into the future the right way. Because if we don't govern AI at the core or at the source, AI will give us wrong answers. And in the case here, healthcare could be affected in many ways. But when healthcare gets affected by a wrong answer, there's a waterfall effect. Other things happen. Organizations find that not only that one answer might have caused all kinds of grievances and reimbursements. Those might have then affected their scores, which means the government money coming back in might have