HIStalk Interviews Abhishek Begerhotta, CEO, 314e

Abhishek Begerhotta, MS, MBA is founder and CEO of 314e of Pleasanton, CA.

Tell me about yourself and the company.

I founded 314e in 2004. I used to work as a programmer on a project that IBM had undertaken to create a clinical information system for Kaiser Permanente. In around 2004, I think, Kaiser fired IBM and hired Epic. The rest is history. That’s when I founded 314e to provide services to Kaiser. Since then, we have worked with over 250 organizations across the healthcare value chain, including providers, payers, med tech, and life sciences companies. Our core areas of competence are EHR implementations, cloud, data engineering and analytics, interoperability, and automation. We take pride in delivering high quality at a reasonable price to our customers. 

How are hospitals complying with the requirement to send ADT messages to the patient’s other providers?

We are working with a few customers on this. They all seem to have different issues and challenges, but I am unfortunately not up to speed on all of the details. I know that there are newer healthcare communication platforms emerging that facilitate this. 314e’s Muspell XI tool can also send ADT notifications, and we are working with a customer to integrate our tooling into their enterprise service bus to deliver these notifications to the right providers.

Where do most health systems fall in your eight-level Healthcare Analytics Adoption Model, and how are they prioritizing their next steps?

We think that most are somewhere in the middle, Level 3-5. We certainly have customers that are at Level 7, and we have helped them get there. Most organizations we know struggle with managing complex ETLs and getting data to a warehouse. The processes are brittle and do not support any form of self service or business agility.

We are seeing a trend towards adoption of cloud analytics platforms like Databricks on Snowflake running on Azure / AWS. These systems give the basic infrastructure on top of which high quality BI, AI/ML workloads, etc. can be run. Our customers are tapping us to migrate from decades-old warehouses to such more modern data lake / warehouse environments to get to Level 6 and higher. In fact, we are helping several customers today in collating EMR, imaging, lab, registration, claims, patient satisfaction, and home health types of data into FHIR-based enterprise data lakes. This results in getting to Level 4-5 in under a year.

Will the move to virtual implementation and support services continue even after some degree of normal travel resumes?

The pandemic has really exposed a lot of inefficiencies and waste in the healthcare industry, and one of those is the cost of travel and lost productivity for implementation consulting.  With the shift to virtual, we’re adapting and becoming accustomed to doing things remotely, leveraging modern technologies like Teams and Zoom.  

There are certainly some things lost by not having those face-to-face interactions where you build and strengthen relationships and alignment between IT and operations. So I do believe that some key personnel will start traveling more frequently when normal travel resumes. But overall, my gut tells me this trend of virtual implementations will continue.  

Training and at-the-elbow support, specifically for new implementations, are two key areas that are presenting unique challenges for our clients to deliver virtually. I anticipate, at least for new implementations, that we will see those services resume to more in-person.  We have spent considerable investment developing solutions and a product for our clients to address ongoing new hire training and ongoing on-the-job performance support which can be delivered digitally anytime, anywhere and provides on-demand targeted training assistant embedded in the EHR workflow. That trend is moving to more virtual.

How much interest or potential are you seeing in robotic process automation?

RPA adoption has been turbocharged by the pandemic. Providers and payers have both realized that RPA can make the processes more efficient and reliable in addition to the cost savings it brings. A Gartner report published in the middle of 2020 said that around 5% of healthcare providers in the US have invested in RPA and that this number will reach around 50% in the next three years. However, almost all of our customers have started at least one pilot initiative around RPA in some way, shape, or form, and many have at least one proof-of-concept in place. Most of them don’t have in-house capability to deal with this and are working with partners like 314e. 

As a company, we are very bullish on automation, web automation as well as desktop app automation. We are building products to help customers deploy RPA to automate enterprise workflows. We believe that there is a need for an RPA framework which can allow healthcare providers to quickly and easily deploy an army of bots for different problems and design an orchestration system to manage these bots. We are piloting our bot orchestration system with a customer today. 

How will payer-to-payer data exchange improve member experience?

CMS mandated the payer-to-payer data exchange to prevent fragmented member data from getting stuck in silos with different payers. Members can now have one unified record of all their health data, including claims data. This allows for a true continuum of care, not just across providers, but also across payers as the member switches jobs and possibly moves from one payer to the other. Payers need to use USCDI for this exchange. 314e has invested heavily in FHIR to help payers power such an exchange. 

What 3-5 year goals do you have for the company?

At 314e, we are playing the long game; the infinite game. We started out as a few people helping a large IDN with data conversion. Then we got into staff augmentation on Epic implementations. But today we are true technology partners to customers across the healthcare continuum. Our goal is to become the go-to technology provider of services for cloud, analytics, integration, innovation, and automation for healthcare.

We want to do this by IP-led service delivery and products. We already have multiple products in the market, including one that we call Speki, which means “wisdom” in Old Norse. Speki is a content, help, video delivery platform with a SMART on FHIR launch. It is currently on the Epic App Orchard. We can take instructor-led EHR training, convert it into byte-sized chunks, and make that searchable and viewable from within the EHR.

Similarly we have a FHIR-based enterprise data lake product that we call Muspell. It supports archival and clinical data repository use cases and can be a data aggregation platform used by providers and payers. We run this on top of Databricks and it is available on both AWS and Azure. We have dozens more product innovations that we want to bring to market in the next 3-5 years.