While automated symptom checkers and other chatbot technologies have become common, most are not directly connected to the overall patient journey. By incorporating chat-based interactions that can escalate patients to the appropriate level of care when needed, healthcare can be more personalized, empathetic, cost-effective and scalable.
In an October Becker's Hospital Review webinar sponsored by Amwell, Murray Brozinsky, chief strategy officer at Amwell, and Sue Voltz, administrator of the telehealth program at Nemours Children's Hospital (Del. and Fla.), shared why automated care is needed and how it works.
Four key takeaways were:
1. Healthcare is in desperate need of change. Reasons why change is needed include rising healthcare costs, labor shortages and poor patient experiences. According to Mr. Brozinsky, one out of every five dollars spent in the U.S. is on healthcare, systems are short 400,000 nurses and 81 percent of patients are not satisfied with their healthcare experience. "Our whole health system is struggling with quality and outcomes," he said.
2. Amwell has developed a two-way automated companion that can deliver a personalized, evidence-based patient experience. Amwell offers an automated companion designed to extend existing trusted provider relationships. "We want to listen to patients' wisdom while collecting evidence-based data on their current health and care status," Mr. Brozinsky said. "The trick is to reduce variability of care, which is what evidence-based care is about, while increasing the variability of experience, which is what personalization is about."
When patients are enrolled in a particular automated care program, they have access to a personalized virtual companion. "If the patient is having issues, we'll reach out more frequently," he said. "It'll dial back if the patient is doing well. The tool is asking questions and can incorporate connected devices if they're relevant for a specific program. It then takes the patient's responses and makes a real-time decision as to whether or not that patient is on track."
Patients doing well are provided supporting education and information; others might be nudged to get back on track. "And if they breach a threshold that's determined by the care team at the health system, then they are intelligently triaged to the right level of care," he said.
3. Spectrum Health has reduced cost of care by automating emergency department (ED) discharge. After implementing Amwell's ED Discharge Program, Spectrum eliminated 30 calls per day received by nurses or social workers and reduced ED readmission by 5% and total cost of care by $1 million per year. At the same time, 90 percent of patients were satisfied.
4. Nemours is leading automated care adoption first by focusing on reducing telehealth no-show rates and improving engagement. "We started with an automated chat to prepare patients for telehealth visits," Ms. Voltz said. "Our no-show rates for video visits were high, so we wanted to ensure that families were better prepared for those visits."
The number of no-shows dropped from 15 percent of patients to only 5 percent, after patients completed an Amwell automated care chat one day prior to their appointment. In addition, more than 75 percent of families said they were satisfied with their chat experience.
"Our clinicians have also liked developing the program and thought they could reduce some of the return visits to the ER," Ms. Voltz said. "It helps reduce misunderstandings that can occur post-op and ensure that parents know how to care for their child after they leave the hospital."
Automated care programs are currently active for patients being treated for tonsillectomy and appendectomy, as well as to help patients with pre-telehealth readiness and post-virtual urgent care.
By combining automated care programs with human interaction in specific practice areas, health systems can become more proactive instead of reactive, and can scale and personalize healthcare to improve engagement and reduce costs.
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