Some of the most important technologies in health care are often the ones nobody notices. 

Every day, information moves among health plans, providers, care teams, and members. Behind the scenes, technology and artificial intelligence (AI) help health care organizations streamline processes, reduce administrative burdens, improve coordination, and lower costs. The goal is simple: help make members’ health care journeys less complex and easier to access the services and support they need.

The technology you never see

A smoother online experience. Faster access to benefits details. A customer service representative who already has the context to help. While these moments may seem ordinary, they’re often supported by technology working in the background to reduce complexity and improve efficiency. 

“Some of the most meaningful technology work in health care is intentionally invisible,” says Selma Ferhatbegovic-Fede, senior vice president and chief information officer at Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan.

“Members may not see the integration layer, the data platform, the cybersecurity controls, or the workflow automation behind an interaction — but they can feel the result when their experience is faster, clearer, more reliable, and less frustrating.”

Behind every claim, member service interaction, or provider transaction is a network of systems that must work together. As health care organizations modernize those systems, the focus is increasingly on creating experiences that feel more seamless, consistent, and connected.

Creating a more connected experience

Navigating care often means interacting with multiple organizations, from primary care providers and specialists to hospitals, pharmacies, and health plans. Keeping those touchpoints connected can be challenging, especially when different systems and processes are involved.

Technology is helping bridge some of those gaps by improving how information is shared and accessed. Better-connected systems can support more seamless experiences for members, providers, and service teams alike. In practice, that may mean quicker eligibility verification, more timely access to information, and fewer delays when coordinating care and administrative processes.

Ferhatbegovic-Fede says that technology alone won’t solve for fragmentation in health care, but it can create connective tissue to make the system easier to navigate. 

“The future we are working toward is one where members do not have to repeatedly explain their situation, providers have more timely information to support care and administrative processes, and our colleagues can see a more complete picture when helping someone navigate their health care journey,” she adds.

Using AI to reduce complexity

Disease detection, drug discovery, and scientific breakthroughs: AI’s potential in health care is vast, and much of the public conversation has centered around what’s ahead. Less attention has been paid to the current ways organizations are applying the technology to support the day-to-day work that keeps the health care system running.

“The biggest impact today is not in replacing clinical judgment or making autonomous decisions,” says Ferhatbegovic-Fede. “It is in helping remove administrative burden which lessens costs, improves accuracy, accelerates insight, and gives people more capacity to focus on higher-value work.” 

From document review and call summarization to claims analysis and workflow automation, organizations are using AI to support daily operations. While these functions may seem far removed from the member experience, they can help improve responsiveness, reduce delays, and give health care teams more time to focus on the people they serve. Greater efficiency can also help organizations better manage administrative costs, supporting broader efforts to improve affordability.

Innovation with a purpose

“While we always keep an eye on innovation, the most important question is not whether technology is the latest and greatest advancement,” says Ferhatbegovic-Fede. “It is whether it helps solve the problem we are facing and improves the experience of our members, providers, and customers. We start with the problem, not the tool.”

At Point32Health, that approach is reflected in efforts to modernize the digital experience for members and providers, improve how data moves across systems, and explore AI-enabled tools that can support operational efficiency. In addition to improving experiences, these efforts are designed to reduce unnecessary complexity, streamline operations, and create efficiencies that can help support more affordable coverage for members over time.

The organization is also working to enhance member and provider portals and advance data-sharing capabilities that support more connected experiences. These improvements are designed to make it easier for members to find information, complete routine tasks, and access support online, reducing the time spent searching for answers or contacting customer service. AI is being applied in practical ways as well, including areas such as document handling, analytics, and service interactions. These efforts help reduce manual work, improve consistency, and allow teams to spend more time on service, problem-solving, and personal connection with members.

Most people will never think about the systems, tools, and processes that support their health care experience. What they will notice is when interactions feel simpler, answers are easier to find, there is less administrative burden, and any issues are quickly resolved. As technology and AI continue to evolve, health care organizations like Point32Health are reimagining the health care experience, making it less complex, seamless, and easier for everyone to navigate.

Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, our purpose is to guide and empower healthier lives.