Alvee’s AI Data Platform Gives Payors & Providers Tools to Advance Health Equity
Founder Nicole Cook is building on 15+ years of leadership experience at the intersection of health equity and EHR interoperability to create an AI data management tool that predicts patients’ social determinants of health. Seamlessly integrated with EHRs and CRMs, it promises workflow automation and greater visibility for health disparities amongst vulnerable patient populations.
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Challenge
Maria arrives in an emergency room with a bone fracture. After a quick examination and glance at her chart, a physician attends to Maria’s injury, rates her pain, and makes a treatment recommendation, sending her home with a prescription for painkillers.
What the physician doesn’t know is that English is Maria’s second language. Most of the treatment instructions were lost on the Spanish-speaking patient. Additionally, Maria doesn’t have a car to get to and from her follow-up doctor’s appointments or ample insurance to cover the cost of the prescribed pain meds.
But what if the doctor was able to intuit Maria’s potential barriers to care? In the physician’s hustle between tending to patients and required EHR documentation, what if they had immediate access to carefully mined data that painted a picture of Maria’s needs beyond the ER or doctor’s office? To take it a step further, what if the physician was equipped with recommendations for Maria based on her social determinants of health (SDOH) — her need for transportation or a Spanish-speaking medical assistant?
Origin Story
While the scenario above is a blend of common SDOH case studies, the ‘what ifs’ are more than wishful thinking. With Alvee they are a reality. Founded and helmed by CEO Nicole Cook, Alvee equips payors and providers with an AI-driven workflow automation and data management tool that provides real-time patient-specific notifications about health disparities, SDOH, missing demographic information, and chronic conditions.
Cook is something of a native to the world of health data and interoperability. She spent seven years at Epic supporting the go-to EHR system’s early implementation in hospitals. She joined Epic on the heels of the passage of the HITECH Act in 2009, the Department of Health and Human Services legislation that pushed the medical community to adopt electronic health records. In her time there, she saw the healthcare software company grow from 3,000 employees to 10,000, an experience she likens to the often rapid evolutions of startups.
Cook was Epic’s boots on the ground, a conduit between the providers using the system and the software’s mothership. As such, she was often on the receiving end of the providers’ frustration with the system. It’s a common trope that Epic and large EHR systems like it introduced extra clicks and computer time, taking away from (rather than adding to) attentive patient care. She saw firsthand the physicians struggling to keep pace with the new requirements to document a patient’s health journey in the system.
From Epic, Cook pivoted and joined the startup world, serving as VP of Client Relations at SameSky Health. There, she worked closely with the company’s CEO & Founder Abner Mason, leader of multiple high-profile organizations committed to advancing health equity. It was at SameSky that Cook observed how disparate health databases and inconsistent measurement of health disparities created obstacles to stratifying health conditions by race, ethnicity, gender, or sex.
“It was frustrating to sit on the sidelines and see the lack of data keep payors and providers from taking action to improve health equity,” she said. “If you can’t measure health inequity, you can’t improve it.”
Cook envisioned a tool that would fill in data gaps when it came to demographic data collection and serve up health equity reports to keep healthcare organizations accountable for improving health equity amongst their patient population. In July 2021, she launched Alvee.
Under the Hood
Cook is a self-proclaimed data nerd, someone who has always loved all things magic and fantasy and was known to host Star Wars marathon parties as a kid. She nerds out over the “magic” of Alvee’s AI and machine learning technology in its ability to leverage APIs to pull in data from external sources like the US Census Bureau, CDC, FDA, and CMS.
“This is missing in EHR systems today,” Cook said. “We have a patient’s medical history and visit information but nothing that says based on where this person lives, this person may be at risk for having food insecurity or access to care issues.”
Alvee’s tool equips providers with a frictionless and discrete way to ask patients about possible barriers to care and offer recommendations. Alvee successfully completed their first platform integration with Salesforce Health Cloud at the beginning of the year. Without changing any part of a user’s workflow they can see health equity alerts specific to each patient for confirmed and possible barriers to care — such as food insecurity, lack of transit/transportation, disability, and language — all alongside the patient’s clinical appointment data and member plan details.
Take the scenario with Maria. In the brief few seconds that the ER physician would have to glance at her patient record, they might see “Possible Barriers to Care” alerts for “Food Insecurity” and “Transportation.” Drilling into the transportation barrier to care alert would yield resources to connect Maria to transportation benefits. What they wouldn’t see is Alvee’s backend data crunching — generative AI, predictive analytics, and machine learning models — to produce Maria’s real-time, patient-specific alerts.
Or, perhaps Maria speaks to a member service representative following her ER visit to inquire about billing. In that conversation, the representative would have the ability to conduct a social needs assessment with Maria to confirm information like her English proficiency, household size, or housing situation. The assessment is one more layer of Alvee’s tool. Responses to this assessment would automatically update ICD-10 codes, the common language for recording health data in a consistent way between hospitals and countries.
“We integrate like a data fabric, weaving SDOH and health information together to provide insights,” Cook says. “Alvee makes the invisible barriers to care visible.”
Much of the tool’s wizardry is behind the scenes. Cook prefers it this way. For her, designing points of Alvee brand recognition into the EHR and CRM interfaces is not as important as seamlessly fitting into providers’ existing care workflows. Their brand value rests in the health equity insights they provide — a health equity score to measure and track the organization’s performance quarter over quarter, health disparities by location, and health equity reports to determine high-risk members or where data gaps exist for language, race, and ethnicity.
After a year of bootstrapping the company, Cook is seeing a modest and steady revenue each month. With a proven solution in hand, she is focused on Alvee’s go-to-market strategy. The company is initially targeting healthcare organizations utilizing Salesforce Health Cloud as they can implement their solution in less than a week. The solution is built to be EHR/CRM agnostic and they will add additional integrations in the months to come.
Our Take
Cook’s digital health startup has emerged at a time when health organizations are incentivized to integrate health equity data solutions like Alvee’s. COVID laid bare the pervasive health inequities across racial and cultural lines. In response, health disparity legislation increased considerably. For example, the 2022 National Committee for Quality Assurance (NCQA) Health Equity Accreditation now requires payors and providers to track proof points of their ability to offer quality care to diverse populations and attract opportunities to reduce health inequities. Alvee’s health equity tool can help them make good on the healthcare needs of patients with barriers to care.
Additionally, as a Health Transformer playing at the intersection of health equity and data management, Cook has the holy trinity of experience. She understands what EHR interoperability should look like (and not look like), knows how to account for data privacy in emerging technologies like AI and machine learning, and has an intuitive sense of how the right data architecture can bring accountability to centuries-old systemic health disparities.
Please join us in welcoming Nicole Cook and the rest of the Alvee team to the StartUp Health global army of Health Transformers.
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Published: Jul 13, 2023