Designing digital virtual agents into the healthcare workforce and into patient journeys offers a unique improvement opportunity to scale and sustain care coordination models for people with long-term conditions.

This is a pressing issue, as health systems globally are dealing with an unprecedented growth in patient populations presenting with one or more chronic long term conditions (LTCs) such as heart disease, diabetes and hypertension. There is an imperative to improve quality and experience, and manage the costs of chronic-care delivery, which represent 86% of all US healthcare costs 1, a percentage that goes even higher among Medicare patients.

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My prescription needs a refill.
I’ll submit the refill order, and don’t forget you have a doctor’s appointment tomorrow.

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Various approaches to population health management and coordinated care have been attempted, but many have failed to scale and sustain, as they are highly dependent on recruiting and training a workforce of care coordinators. This is a challenging prospect because of qualified workforce shortages in most parts of the world and/or the high cost of that workforce.

With Amelia, customers are taken on a guided journey from start to finish, even a journey that takes a customer down multiple paths.

One common response has been to invest in integrated care, where acute, community, primary and social care services join forces to create evidenced-based care packages organized around their patients 2. Such packages are arranged around care protocols designed to provide convenient and timely interventions, with the aim of maintaining health and preventing deterioration in the patient’s condition. However, they all have one major limiting constraint – not enough qualified people to support those with chronic illnesses with timely advice and care plan navigation.

Some organizations have broadened their definition of the healthcare workforce and sought to leverage a newly defined “human capital” in healthcare 3. This includes the mobilization of informal care-givers. While they certainly provide a critical value in empathy and proximity, and availability and affordability, informal care-givers need to be supported in their roles rather than burdened with the task of mastering various care protocols.

In the healthcare sector, there is very little margin for error. It is a very heavily regulated environment, an environment that needs fast action… It’s important to automate as much as you can to take human error out of the equation.

GERSON BENKER, VICE PRESIDENT OF IT OPERATIONS, CARESTREAM HEALTH, GARTNER SYMPOSIUM/ITXPO IN BARCELONA, 2017

Digital conversational agents can simultaneously augment the traditional care navigator workforce and enable these new informal care-givers. By assuming delegated routine tasks, digital agents free up human professional providers for high-touch patient care that only humans can provide, and for a larger number of patients. Moreover, digital agents enable a new workforce of informal care-givers 4 by being always available as their “whisper agent,” providing timely information and reassurance and, when necessary, escalations to human colleagues in the professional care team.

As for people living with LTCs, patients are increasingly encouraged (and often themselves request) to take more proactive responsibility for managing their own conditions. In turn, health systems are now looking to provide LTC patients with tools and resources so they can take on more responsibility, safely and effectively, by equipping them with care navigation tools. This often includes digital tools such as wearables and home monitoring devices. Virtual digital agents further empower patients by providing always-available, conversational access to tailored information, which can help them navigate their care options.

The growing success of patient navigator programs illuminates a path forward for the use of hybrid clinical + informal + digital navigator teams that make use of cognitive Artificial Intelligence-based conversational agents such as IPsoft’s Amelia.

What Amelia Can Do

Amelia is uniquely designed to act as a navigator in patient care. Navigators assess a variety of concerns, as stated above. Unlike basic digital interfaces such as low-skilled chatbots, Amelia is the only AI platform in the industry that possesses sophisticated psychological models, enabling her to accurately assess and effectively address a patient’s emotional state. Research has shown that positive customer experiences are directly related to empathetic support agents, and existing Amelia customer feedback consistently confirms those findings.

Our work with primary and acute systems has revealed a wide range of activities where Amelia, operating as a long-term care navigation agent, can support patients and their formal and informal care-givers. These include

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  • Appointment management: Booking and scheduling services across care settings (primary care and hospital clinics), and early engagement through pre-consultation screenings, questionnaires and information exchange.
  • Prescription management: Assisting patients with the ordering and collection/delivery of prescribed medications and other items, including top-up and refill prescriptions.
  • External test management: Providing patients with more control over the ordering, tracking and interpretation of their hospital and clinic tests, such as blood tests and echograms.
  • Condition advice and support: Offering condition-specific advice and well-curated health management tips, either on-demand or as part of a more structured education program, augmenting and extending the coaching provided by human care providers.
  • Submit and track home readings: Giving patients the ability to share blood pressure, pulse, peak flow and other readings from home with their providers, and engage in support conversations about the reporting and implications of these readings.
700EMPLOYEES SERVICED BY AMELIA IN HER FIRST THREE WEEKSSEB

In addition, Amelia’s conversational proficiency — ranging from simple to complex multi-turn conversational levels, with a rich ability to understand intent, context and emotion — is of unique value in handing a wide range of frequently asked questions in navigator sessions. These include questions such as whether to bring friends or family to an appointment, the length of a typical visit, the need for specific tests, and others. With her natural language capabilities, Amelia is able to manage complex phrases with ease, and can also capture conversational data transmitted data via multiple channels, including email, text, and voice.