Bamboo Health

Today, we’re chatting about Bamboo Health (formerly PatientPing), and how it’s being used at your company. Before we continue, could you give a brief overview of your company and your role there?

I’m a product leader at a national virtual care provider that combines navigation with virtual care. We offer primary care, urgent care, behavioral health, triage, provider matching, quality rankings, and algorithm services. We aim to be the one-stop shop for our sets of members, and we’ve built a range of services to achieve this goal.

I’m intimately familiar with Bamboo; I helped purchase it and was involved in the original contract and all of the subsequent renewals.

What drove the need for a product like Bamboo Health?

We’ve been working with Bamboo Health for several years. We needed a new set of data to identify and enroll members in a specific population and gather some hard-to-find signals. Our goal was to find members in their moment of need and guide them in making decisions. Members often struggle to navigate the healthcare system and make decisions on their own, so we wanted to provide guidance during crucial decision-making moments.

To identify these moments, we developed a signal based on cases where patients were receiving in-person care at different hospitals. We matched this with relevant data to enroll patients in appropriate programs. Bamboo Health provided real-time pings on the presence of members at specific hospital facilities. They initially operated mainly in North Carolina and Boston but have since expanded their network to offer national coverage.

What were your specific requirements during the procurement process?

First, we were looking for a platform that could provide fast access to data; speed was important to us.

Coverage was also crucial. Most pings providers are integrated into specific hospital software or EHR systems and send notifications when certain data points are identified. We needed to make sure the provider we chose had broad coverage.

The other thing that was important was the entity resolution or the ability to identify specific sets of members.

Since we’re working with identified healthcare data, privacy was also a central concern.

Lastly, having condition-specific information was also important to us. We needed to understand why someone was seeking care and determine whether they were eligible for enrollment in our member program. That’s why we were looking for Bamboo Health and their Pings product to provide us with as much information as possible about each member, helping us make enrollment decisions.

What was the procurement process like? Were you evaluating other vendors, or had you already decided on Bamboo from the start?

We had zeroed in on Bamboo Health largely because we were piloting this particular product in a specific region, and Bamboo Health had the strongest coverage in that area. At the time, there weren’t many other ping providers available. Since then, several competitors have emerged, but at the time, it was difficult to find other products that provided real-time notifications and had the coverage we needed.

Now, after several years with Bamboo Health, do you feel there is real competition in the market for this type of product? Are there multiple vendors to consider?

There are certainly more vendors now, but I wouldn’t say there’s an abundance of them in this particular space. Bamboo Health is probably the national leader just in terms of its coverage. However, I haven’t conducted extensive research for a while; we may delve deeper into this when we approach our renewal period.

How was your experience with the sales process overall when dealing with Bamboo Health?

The sales process was relatively smooth. They started by understanding our use case and whether their solution was a good fit for our needs. They’re a volume-based business, so we had several discussions to determine the appropriate pricing, as well as the types of information we could obtain and how to achieve the desired coverage. Overall, I found the sales process to be relatively smooth. It wasn’t too lengthy; I think we were able to finalize the procurement within a quarter.

You ended up using the portal rather than the API. What led to that decision?

Bamboo Health has two facets to its product: it offers a patient portal where the data is displayed for users to access, and it provides an API for integration purposes. In our case, we had to evaluate the ROI and cost versus benefit of integrating the API versus maintaining a manual process.

We considered factors like the volume of people accessing complex care versus other places where our resources might be directed. Ultimately, we decided not to set up the API, and we still haven’t implemented it to this day. The time and resourcing cost of integration didn’t make sense for us; we chose to focus our product and development resources on other areas that provide higher leverage for our organization.

How does your organization use Bamboo Health now?

The primary use case for Bamboo Health is enrollment and intake in the product we’ve implemented. That’s still what we use Bamboo Health for to this day.

Which specific features or modules of the Bamboo Health product have you integrated into your workflow?

We use the PatientPing portal in Bamboo Health rather than the API. We don’t use the API, as it simply provides programmatic access to the same set of information as the patient portal (although there may be some additional data in the API that isn’t displayed in the portal).

The main feature we rely on is the patient portal queue, which displays a list of patients along with the location where they’ve sought care and relevant identifying details. When we identify members who match our eligibility criteria, our clinical staff members assess the information, which includes important features such as ICD codes and CPT codes. These features help us determine whether a patient is a suitable candidate for enrollment, and we then proceed with our internal setup processes.

Essentially, this is where Bamboo Health’s capabilities for our use case end. We mainly use the patient-related information available in the portal to ensure that we’re accurately identifying people and staying compliant with HIPAA regulations. We also use the ICD and CPT codes, along with any accompanying notes that might be present.

What works well about the Bamboo Health product?

I have to say that the completeness of the notes and the accuracy of provider information can be inconsistent. This is an area where Bamboo Health could improve. If they offered more complete notes and contextual information explaining why a patient visited a particular location, it would enhance the effectiveness of their product for our needs. Their pings reflect when a person shows up and checks in at a particular in-person care location, but that doesn’t always link to the patient record and the underlying reason for their visit. This contextual information is crucial when your aim is member enrollment.

This is a difficult challenge to solve, given that this information comes from add-ons that integrate with various EHR systems across different healthcare networks. They’d have to go from hospital to hospital, or network to network, to install these different add-ons to get access to this data. As useful as those enhancements would be, the inherent complexities of this problem make it challenging for any company in this space to fully address.

I’d say there are two distinct classes of data: Tier 1 data indicates when a patient checks in or is transferred or discharged (ADT), and Tier 2 data includes both that ADT information and visit data, including the specific reason for the visit, along with any accompanying notes and CPT codes. Coverage for Tier 2 data is less comprehensive than that of Tier 1.

How much of the data you receive from Bamboo Health is Tier 1 data versus Tier 2 data?

I’d estimate that around 30–40% of the data falls into the Tier 2 category, while the remaining 60–70% fits into the Tier 1 category. If Bamboo Health were to enhance its product, investing in improving the data coverage and reliability in the Tier 2 category would be the most significant area for improvement.

I’m curious about the coverage of the so-called Tier 1 data, specifically the standard ADT (admissions, discharges, and transfers) data. What is the coverage like across different states or nationally?

We also get ADT data from different sets of insurance carriers, so the Bamboo Health product is an external resource designed to get us faster access to that data.

The healthcare system has largely shifted away from variable payments based on the length of a stay. Instead, they now offer a lump sum payment, and the provider bears the risk if they keep the patient longer. As a result, insurance companies no longer care about the specific timing of admissions and discharges; they’re just paying a lump sum.

Against this background, the ADT data is comparable to the data we receive from Bamboo simply because payers don’t seem to prioritize these details anymore, and there’s no enforcement mechanism that requires providers to supply this type of data.

It sounds like the primary value being provided by Bamboo is low latency. How does the latency of Bamboo’s product compare with that of a carrier network?

Bamboo Health is significantly faster. With Bamboo’s product, we receive pings within minutes on the same day. With a carrier network, the best-case scenario is a one-day lag, but more commonly, data takes a week or two to reach us. ADT is definitely better than claims data, which can have a lag of up to seven weeks to allow for full adjudication, but it’s still significantly slower than Bamboo Health. You do sacrifice some extra context and information for the sake of speed, though, so there’s a trade-off.

Does Bamboo Health have any other strengths or weaknesses that you’d like to highlight?

As for strengths, one aspect that I find helpful with Bamboo Health is its coverage map. The key factor here is how many systems they can access and retrieve data from. For example, Georgia is a Kaiser Permanente state, and it can be extremely difficult—if not impossible—to access Kaiser’s data due to their closed-loop systems in certain areas. So, in my opinion, network coverage is really crucial.

In regard to weaknesses, if Bamboo Health can improve the quality of the data they provide and reduce the cost per ping, I believe those would be valuable improvements.

One thing I’d like to mention is how their product works and the integration process. Even if you’re setting up their patient portal, there is a small integration required where you need to provide them with a roster of individuals along with the relevant information. This does take some time, but they have a good support system in place that is well-ticketed and monitored. While I’m not sure if they have official SLAs, I have never experienced a response time of over 48 hours. So, they are quite responsive when it comes to addressing any issues or loading specific data. One of the integration capabilities you would need is the ability to regularly send a roster via data. We have data systems in place that enable us to automate this process, so it’s not a manual process for us.

When it comes to stability, have you found Bamboo Health to be reliable and relatively bug-free?

They’re definitely reliable in terms of what they deliver; the main concern is how much rich information they are able to provide rather than any bugs.

Do you trust the data provided by Bamboo Health, or do you require a certain level of validation?

During the initial pilot phase, we conducted a thorough validation process. We compared Bamboo Health’s data to the ADT feeds that we received directly. Bamboo Health actually had access to more pings than the ADT feed itself, which allowed us to identify certain information that wasn’t being captured by payers. That was a positive outcome for Bamboo Health.

In terms of the amount of information available, the payers ended up having slightly more information than Bamboo Health, but the difference was minimal. I would say that data quality is about as high as it can be. In order to incorporate more data, Bamboo Health would need to engage in significant deal brokering for investment or revenue-sharing agreements with hospital systems to get to a point where they could incorporate more of that data.

How would you describe the overall usability of the system?

It’s fine; it’s functional and serves its purpose. I wouldn’t say that I was blown away, as a product person, but at the end of the day, it’s a user interface for displaying a database, and in that regard, it works.

How would you describe your experience with account management and support from Bamboo Health overall?

I’ve had a positive experience with support from Bamboo Health. They are responsive when needed.

Their account management is pretty standard. Since their integration into Bamboo Health, the company’s approach to expansion involves offering an additional suite of products. As a result, our account management tends to focus less on our specific use case, unless we are discussing renewals. Instead, they tend to offer product enhancements or new offerings they want to sell, which is understandable. However, I haven’t come across any solutions that have directly addressed our specific use case. While there’s nothing particularly outstanding about the account management, I also don’t have any major concerns or anything negative to say; it’s been a fairly standard experience overall.

Looking back, do you feel that you made the right decision in choosing Bamboo Health at the time?

Yes, but I would also say that our ROI is decreasing with them. A couple of things are causing this: the cost-per-ping structure is changing, which is raising the cost, and the number of members we can enroll has not gone up, which reduces the ROI that they produce for our organization. For me, that’s why our likelihood of renewal is moving closer to 50/50. Our intent to renew is still technically positive, but it’s becoming less obvious that they’re giving us good value. The question we’re now beginning to ask is whether the pings are worth the investment given the level of enrollment we’re securing and whether it generates enough value for our business. For now, the answer is yes—but honestly, barely.

Do you have any advice for the team at Bamboo Health?

I think improving the data fill rate would be great. If they could increase the number of Tier 2 Pings they provide, that would be tremendously valuable. However, there are also external pressures and threats to consider. Health information exchanges like DirectTrust and Carequality can move faster and offer richer sets of data in a standard format, which may pose an existential threat to Bamboo Health.

The key areas where Bamboo Health could potentially compete with health information exchanges are by offering better quality data and having a broader network. I don’t think speed would be the place to compete. Another potential strategy could be positioning itself as a low-cost provider, although it would be difficult to outperform the likes of DirectTrust and Carequality.

They can also improve by growing their network, which would be a crucial value-add for them. When you use health information exchanges, they are fast, but it depends on the degree of participation, which is key. I expect that legislation will mandate participation over time, which will require PatientPing to establish a different competitive advantage.

Do you have any advice for buyers who are currently considering their ADT data strategy?

It will depend on the use case, but a lot of ADT data and enriched data strategies are ultimately focused on identifying and enrolling members in a particular plan. I would encourage buyers to thoroughly consider what information they need to know in order to take the next action. It’s important to establish exactly what you need to know in order to take your next action and then evaluate whether you have the necessary data to support that action.