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How Conversational AI is Changing the Patient Experience

We’ve all sat for hours in the less-than-comfortable chairs, watching people who came in after us mysteriously be beckoned back to see the doctor in the incorrect order. That mild ping of confusion and anger lingers in our minds for a while, before finally hearing our name called unceremoniously. 


This frequent frustration is the bane of many who seek routine medical care. In the United States, access to timely, qualified healthcare is reaching a borderline-crisis status. As patients are being forced to spend more and more money out of pocket for their medical care, the demand for high-quality, efficient service is higher than ever. In fact, according to the 9th Annual Vitals Wait Time Report, the average star rating of a doctor’s office decreased linearly as wait time increased, with 1-star doctor’s offices boasting a 34+ minute wait time. The report also found that an alarming 30% of patients have walked out of an existing appointment due to overly-long wait times. 


As the federal government shifts Medicare dollars away from fee-for-service payments, the model of how patient care is handled needs to change in turn. Medicare and most private insurers are moving to alternative payment models, which emphasize primary care professionals. However, for these models to work, patients still have to get in to see a primary care physician, where the key bottleneck exists. The process leading up to the appointment can include navigating outdated call center infrastructure, long waits to reschedule, and higher-than-expected insurance premiums and deductibles, all making for a truly frustrating experience that most patients avoid at all costs.


As healthcare firms begin to re-focus on improving the patient experience, incoming technology is taking the rightful front-seat in many business leaders’ minds. In fact, over 90% of healthcare CSO’s believe that new technology (including AI inclusion) will completely upend their industry over the next five years. In stark contrast, only 13% of the same CSOs believe that their organizations are adequately prepared for these changes.( One such technology that has become top of mind in improving customer self-service and experience is conversational AI. With its unique core competencies to provide factual, quick information to patients, conversational AI is poised to be extremely valuable to improving the patient’s lifecycle. 


Here are a few solutions where Avaamo’s conversational AI has impacted our healthcare clients, and where your organization can see applications as well:


Discovery & Scheduling 
Scheduling an appointment is a well-known headache, but that inconvenience extends beyond the customer’s experience. Nurses and PA’s can spend up to an hour a day attempting to facilitate a patient’s next doctor’s visit. With top-to-bottom integrations into service directories and providers, conversational AI solutions are able to mitigate wasted time by connecting the right patient to the right doctor in a single conversation. 


Care Management
Instead of worrying about the financial impact of hospital readmission rates or deductible payments, conversational AI has the potential to manage the patient’s recurrent care needs at-home, without the need of a doctor. With proactive engagement and pertinent reminders, these solutions improve the patient experience, while saving both the patient and the doctor’s office time and money. 


Coverage & Claims 
Can you list all of your employer-provided coverage exceptions and rules right now? If your answer is no (which it likely is), conversational AI can help. Instead of searching through files of paperwork and insurance details, our technology has been used to build intelligent virtual assistants that provide accurate, quick coverage advisory services to patients. Whether it’s checking existing coverage options, filing claims, or tracking the status of active claims, conversational AI can provide a hassle-free solution.


Prescription Refills and Pre-Authorization 
Conversational AI technology is helping doctors and physicians simplify the pre-authorization and billing inquiries process by initiating conversations with patients based on their previous chat history to reduce blockers caused by verification delays. Removing the need to progress through multiple steps in order to get important medical information and refills reduces the headache on the medical staff, and gets patients what they need faster.


While all of these areas of opportunity seem enticing, it is important to plan for success with your new conversational AI implementation. To get started properly, there are a couple of key strategies to keep in mind. The first of which is proper prioritization, which comes through developing your strategy around the largest bottleneck to your current patient experience. Adopt a third-party mindset and identify what areas of your operations require the most care, whether it be general scheduling, account servicing, or other key aspects of business operations. After your team has determined the most critical need for AI, you can move forward. Secondly, ensure that your integrations are set up for success. Your team’s new conversational interface will loop in directly to your back-end computer systems, so ensuring that your solution provider has access to these data permissions is crucial to success.
It is critical to find a provider that boasts a wide range of integration options to allow the highest degree of flexibility within your data processing. Equally important in your conversational AI implementation is your change management strategy. Without proper education and advertisement of your new, exciting methodologies, your strategies and the undoubtedly expensive new tool will likely fail. Setting up programs and communication paths to educate your patients and employees alike will assist in wide-spread adoption and acceptance of your AI solution. The last key starting point for your AI journey in healthcare should be to ensure that your compliance and security standards are properly established. It is imperative to select an AI provider that is certified-HIPAA compliant and is capable of protecting your patient’s highly confidential data.


As time progresses, AI assistants and integrations are becoming more and more ubiquitous in the healthcare landscape. Adopting a conversational AI solution for your healthcare organization can feel like a daunting task, however, the benefits of such an implementation become apparent almost immediately. While the growing fear and hype-cycle of automation everywhere persists, applying artificial intelligence to the healthcare space is poised to become a conduit for improved, more humanized healthcare, not less.
Prachi Pandey