Healthtech RISA Launches AI Platform to Optimize Healthcare Prior Authorizations

January 17, 2024 9:40 PM EST

The RISA Multi-Agent System brings a new level of sophisticated decision-making and coordinated action, transforming prior authorization tasks into a model of efficiency and precision.

RISA, envisioned by serial entrepreneurs who scaled Urban Health, a mental wellness and sleep platform to over a million users, now targets the heart of healthcare's inefficiency. Kshitij Jaggi, Founder and CEO, recounts the thought behind this vision, “The healthcare system is at a breaking point. With a staggering $950 billion funnelled into administrative costs and $265 billion of that lost to inefficiencies as reported by McKinsey, our focus was clear: we needed to rebuild and innovate.” 

With a deep understanding of the health-tech space, the three founders turned their focus to healthcare's most pressing challenges, harnessing state-of-the-art AI. Thus, RISA's vision shaped itself, aiming to break down the barriers of administrative inefficiency in healthcare and allow providers to reclaim their time for exceptional patient care.

Kshitij Jaggi, Founder and CEO, reflecting on RISA's journey and its inaugural solution suite, emphasizes the deliberate choice of targeting the prior authorization workflow: “We specifically chose prior authorization as our initial focus due to its historical status as one of the most tedious and least automated processes in healthcare operations. The integration of our Multi-Agent System (MAS) brings a new level of sophisticated decision-making and coordinated action, transforming this traditionally cumbersome task into a model of efficiency and precision.”

RISA's Multi Agent Team of Prior Authorization specialised in different tasks

The manual nature of the prior authorization process, required for procedures or new medications, involves a detailed review of medical records against care guidelines. This process, which includes sifting through various types of information such as test results and doctor's notes, is not only time-consuming for healthcare staff but also causes significant delays and anxiety for patients, adversely affecting their healthcare experience.

Dr Ruchi Garg, a Senior Surgeon and National Program Director of Gynaecology Oncology at the City of Hope, Atlanta, and a member of RISA's medical advisory board, highlights the specific challenges: “Prior authorization is riddled with issues, from ever-changing payer guidelines to managing multiple documents. These contribute to its complexity and inefficiency, which RISA aims to address.”

The strategic decision to focus on prior authorization impacts several facets of healthcare. Kshitij Jaggi added: “Prior authorization affects both providers and patients. It not only impedes physicians' clinical time but also burdens health systems with increased expenses, leading to lower patient satisfaction due to care delays and complex billing. Additionally, the extensive manual work involved causes burnout among clinical and administrative staff, diminishing operational efficiency.”

RISA is redefining the prior authorization process in healthcare, skillfully merging its innovative Multi-Agent System (MAS) approach. Kumar Shivang, the Co-Founder and CTO of RISA, sheds light on this groundbreaking development. "Our MAS isn't just a collection of AI agents; it's a symphony of specialized capabilities, with each agent teams focusing on a unique aspect of prior authorization workflow, working in tandem to simplify and expedite the authorization process," he explains. This system goes beyond the conventional use of AI, thoughtfully integrating human expertise at pivotal decision-making moments. This integration ensures a perfect equilibrium between the precision of AI and human oversight, akin to the philosophy behind Microsoft’s co-pilot design. The result is a decision-making process that is both technologically sophisticated and acutely sensitive to the complexities of human input.

Complementing this technological marvel is RISA's commitment to an intuitive user experience. Rishabh Sahu, Co-Founder of RISA, elaborates on this aspect. "We've designed our platform with the end-user in mind. Our simple-to-use UI, accessible via a Chrome plugin, seamlessly integrates with existing EHR systems, embodying our 'click less, do more' philosophy. This ensures that healthcare professionals can adopt our system with minimal disruption to their existing workflows," he states. This design choice not only underscores RISA's user-centric approach but also eliminates the need for new dashboards or extensive retraining. Furthermore, RISA's adaptability is a key differentiator, enabling it to evolve in tandem with changing medical guidelines and EHR system updates, setting it apart from more static AI solutions in healthcare.

The implications of RISA's innovation extend beyond mere process optimization. For Chief Medical Officers and Care Teams, the value proposition of RISA is clear: it liberates them from the clutches of administrative overhead, allowing them to dedicate more time to patient care. This shift not only enhances the quality of healthcare delivery but also boosts the morale and job satisfaction of healthcare professionals.

For CEOs and CFOs, RISA's impact is quantifiable in economic terms. By reducing administrative overhead and streamlining processes, Dr. Shelby Kutty, Director of Taussig Heart Centre at Johns Hopkins & Medical Advisor at RISA, mentions, “RISA directly contributes to cost savings and operational efficiency. The estimated financial impact is significant – for every 500 physicians utilizing RISA, the potential savings range between $4.5M to $6.5M, a testament to the efficiency and effectiveness of RISA's MAS-driven approach.”

RISA is proving its system's effectiveness on openEMR (Open source electronic medical record), with plans to expand to major Electronic Health Records systems with initial partners. Starting with individual physician practices, RISA aims to collaborate with larger health systems strategically, leveraging its early successes. Additionally, RISA plans to form the “MASTERY” Team (MAS Talent to Expedite Research by Years), comprising top AI talent dedicated to healthcare innovation.

As RISA continues its journey, the potential for transformative change in healthcare administration is immense. With its cutting-edge technology, user-centred design, and a profound understanding of the challenges facing healthcare today, RISA stands not just as a solution provider but as a pioneer, ushering in a new era of efficiency, care, and wellness in healthcare.

About the company: About RISA Based out of Palo Alto, RISA Labs is an "AI Research group" streamlining healthcare operations using multi-agent systems, starting with prior authorization. The goal is to make healthcare admin more efficient, serving clinics and health systems of all sizes. By merging the intuitiveness of human care with the precision of artificial intelligence, RISA labs envisions to build the world's largest AI Factory for Healthcare Operations.

Contact Info:
Name: Bilal Mahmood
Email: Send Email
Organization: RISA

Release ID: 89118992

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