146 VIEWPOINT “ Healthcare organisations run on slim margins, increasing their need to use AI to find cost savings and revenue opportunities” Precision and timeliness can be a matter of life or death. That’s why the healthcare sector faces the dual challenge of improving operational efficiency while driving down costs. Organisations run on slim margins, increasing their need to use AI to find cost savings and revenue opportunities. Four startups – Humata Health, Octagos, Outbound.ai and Raapid AI – are all helping healthcare providers and payers overcome these specific challenges. Each company brings a unique approach to using AI and agents for improving efficiency and reducing costs, and together they represent a promising vision for the future of healthcare management. Humata Health seeks to automate the preauthorisation process for providers and payers, reducing the time spent waiting for approval and ensuring patients receive faster access to necessary treatments. Delivering completely ‘touchless’ authorisations, clinicians can use Humata Health solutions by simply entering an order for a procedure into an electronic health record (EHR) and receive prior authorisation from payers without any other human intervention. Humata Health’s AI system integrates seamlessly with existing healthcare systems, analysing documentation and payer requirements to generate preauthorisation requests and decisions. This not only enhances efficiency for both providers and payers, but also improves the patient experience, enabling care delivery to proceed without unnecessary delays. By addressing one of the most time-consuming aspects of healthcare administration, Humata Health exemplifies how AI can transform cumbersome processes into streamlined interactions. Meanwhile, Octagos helps healthcare organisations enhance both operational and financial efficiency. The volume of data generated by remote patient monitoring, such as patients wearing implantable and wearable cardiac devices, has created significant operational and financial strain. Most transmissions are non-actionable, requiring timeconsuming manual triage, which adds to the administrative workload and delays clinical care. Octagos addresses this challenge through an AI-powered platform that combines high-accuracy data analysis with expert clinical validation. Its machine learning engine identifies meaningful cardiac events with over 94 per cent accuracy, significantly reducing unnecessary data review. Certified cardiac specialists then validate the findings, ensuring both clinical efficiency and diagnostic integrity. For high-risk populations, such as heart failure patients, Octagos enables near-real-time transmission review, supporting proactive care strategies that can prevent hospitalisation and reduce costs. By aligning clinical efficiency with financial sustainability, Octagos exemplifies how targeted AI integration can advance both quality care and cost-effective operations. Outbound.ai, on the other hand, is on a mission to improve the human work experienced in healthcare. Its AI SALLY ANN FRANK: MICROSOFT Startups are using AI to transform healthcare operations – from automating administrative processes and analysing remote patient data, to streamlining revenue cycle management and simplifying complex claims AI: a unifying force for healthcare efficiency
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