Despite all the harm it did, COVID-19 also pushed positive change in healthcare from a digital information perspective.
This article was originally published September 9, 2021 on PSQH by Matt Phillion.
Digital transformation and patient experience have taken center stage in the present and future of healthcare. Telehealth, while not new, rose to prominence during the pandemic, and technology has gripped the attention of patients and providers alike: According to BDO’s 2021 healthcare digital transformation survey, respondents identified their top three areas of healthcare investment interest as telehealth (named by 75% of respondents, up from 42% in 2019), EHR interoperability (64%, up from 43%), and patient portals and digital messaging systems (56%, up from 50%).
Creating a positive, consistent patient experience is how healthcare systems can set themselves apart as we begin to see the world beyond the pandemic, says Greg Miller, vice president of industry strategy for healthcare and life sciences at Talkdesk.
“One of the things that has been consistent is the industry is slow to adapt,” says Miller. “It’s common to reference that healthcare lags behind by a significant number of years, but what frustrates me as a healthcare information junkie is people accept the status quo.”
Despite all the harm it did, COVID-19 also pushed positive change in healthcare from a digital information perspective. A recent conversation at a College of Healthcare Information Management Executives (CHIME) event noted that CIOs of healthcare systems were on a 10- to 15-year journey, but COVID sped up that timeline to more like 10 to 15 months.
“COVID cast a bright light on how siloed and fractured healthcare is,” says Miller. “Hospitals and health systems have processes and systems built around the physician, not the patient.” With the need for more active interaction with technology during the pandemic, though, “we’re starting to see innovative organizations talk about digital front door strategies.”
Talkdesk recently released a research report on the patient experience revolution in healthcare in which 78% of polled patients talked about wanting choice in channel.
“What that means is that they’re not willing to stand for the voice-only concept healthcare has been built on and still uses in the majority of its interactions,” says Miller. “We’ve accelerated, and I don’t just mean telehealth—it’s the natural winner in this space, but there are many forms of transformation.”
Healthcare needs to be ready to change and evolve as others get into the same space. Miller points to the recently launched Amazon Care, which focuses on telehealth and virtual primary care visits first.
“I heard an interview with a CEO of one organization, and they were asked: ‘Are you concerned about Amazon Care?’ And they said no,” says Miller. “This is how myopic healthcare can be. When Amazon got into bookselling, I’m sure Barnes & Noble said the same thing. A friction-free experience is something we need to bring into healthcare. It’ll change the game.”
What we’re doing right
The industry has made strides in this direction, Miller notes; not just in technology, but also federal laws, policies, and procedures. “Rules and laws were relaxed around doctors being paid for telehealth—previously they weren’t—and providing care across state lines,” he says.
We’re seeing new care models, some of which are wrapped around value-based care, and tech that is being purpose-built to help manage risk and promote engagement. “If you look at the industry, there are a gazillion patient engagement vendors trying to do their thing: texting, AI chatbots,” says Miller. “We’re going to see a massive consolidation of these.”
Interoperability of systems is also seeing a transformation in the industry. “Interoperability of healthcare data became federal law” this year, says Miller. “It’s just now getting to be mandated at the federal level that they [healthcare organizations] have to share information.”
CMS’ interoperability and patient access final rule took effect July 1, 2021, requiring all healthcare providers to grant patients access to their personal health information.
“If you show up at the emergency department and you’re unconscious, the ED doc needs to know your allergies and medications,” says Miller. “Without them, you could die. Making that happen is a combination of federal law and technology.”
Another step forward: more openness in terms of healthcare pricing. “One of the things that is super valuable—it might not be so much digital transformation—is the federal mandate around price transparency,” says Miller. He notes that this mandate came out in January 2021 but wasn’t enforced until May, and many organizations are still not meeting the requirements.
Miller mentions a company he stumbled across recently that uses technology to pull data from all price transparency tools on websites around the country. “If I need a hip replacement, maybe I want to go to Florida, for example, for a better price or quality,” he says.
Where artificial intelligence comes into play
When Miller started with Talkdesk, he tapped a number of CIOs about their involvement with the contact center. Most said they didn’t own it, but realized they did, in a way, because of the technology involved. Contact centers have proliferated over time, and many organizations have one for each of their clinics or departments.
“Almost all the conversations were identical,” says Miller. “There was so much opportunity for transformation.”
Typically, provider organization interactions are limited to voice conversations between humans, while in other parts of our lives, Miller points out, we’re comfortable having exchanges with virtual agents, chatbots, and other automated systems. “Healthcare is slow to adapt,” Miller says. “But this is the last mile of transformation to re-imagine the patient experience.”
Roughly half his organization is in research and development, and its entire platform is infused with AI. “We leverage AI to automate as many processes and interactions as possible,” says Miller.
An automated response could be the perfect fit for many incoming calls at a call center. “I did some market research, and the top reasons someone calls a provider are to schedule an appointment, refill a prescription, get directions, and inquire about transportation,” says Miller. “These are classic lower-value interactions that can be handled by a digital virtual agent.”
The virtual agent concept allows the patient or the patient’s family to interact with the payer or provider through the channel they choose, be it chat, voicemail, text, email, or some other method.
“AI plays a central role in that,” he says. The AI can be integrated on the back end with EHRs so when someone starts a chat, the AI surfaces who the patient is, authenticates their identity, sees the medications they are on, and can be proactive with the patient. “It’s a simple example of how AI can be super valuable. Patients don’t want to navigate a phone tree and sit on hold.”
AI also can help with one of the more frustrating parts of the patient experience: missed appointments. “The average revenue per doctor for a missed appointment is $200, and for the hospital it’s $500,” says Miller. “And people miss appointments for many reasons.”
By leveraging AI, providers can know which patients are scheduled for a procedure or appointment, communicate via an outbound text to confirm yes or no, or send a voice message as an appointment reminder. “I talked to one provider organization where the move to this kind of capability resulted in a 10% reduction in no-show rates,” says Miller.
This is huge, he says, because of the impact of no-shows: operating rooms that go unused, staff on hand who could be deployed elsewhere, and of course quality-of-life issues for patients who don’t receive their scheduled care.
For some organizations, AI didn’t work out in the past because there wasn’t enough data to properly train the AI. “You need a massive amount of data to train it,” says Miller. “Data scientists are hard to come by, specifically in healthcare—they’re hard to find, and healthcare can’t pay the salaries they can command in other industries.”
Talkdesk has developed a tool called AI Trainer that provides a click-based method for building AI models with a layperson’s technical understanding. “One of the next big playing fields is the democratization of AI,” says Miller.
Data has only become available digitally in recent years; prior to that, hospitals had no incentive to make the switch and remained on paper records. “We’ve been collecting data mostly for business purposes, and the payers use that data well,” says Miller. “But hospitals are still relatively immature in their ability to leverage it.”
The industry is making progress, but what are its next steps? “I think the patient has to be at the forefront and in the middle of every conversation around digital,” says Miller.
AI can be central to getting the patient in the conversation, though it’s not the only fix. Miller points out that the real goal is to identify a problem and use AI to solve it, not to treat AI as a panacea. “AI is everywhere. I think we’re going to see a lot more creativity in internet of things, and much more proactive care management than reactive or encounter-based.”
That change will have to be cultural as well as technological. “One of the biggest barriers to digital adoption and a patient-centric culture is the organization,” says Miller. “Changing the mindset of people is critical to shift to a more patient-centric viewpoint.”
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