Automation has a major role in transforming the healthcare experience. For example, many hospitals and health systems use automation to ease the burden of staffing shortages and effectively manage and triage patients at scale.

One type of automation is chatbots and related technology that can automate the triage and symptom intake process, along with surfacing education and discharge materials.

For example, Northwell Health implemented health chats with its patients. The health system saw a 94% engagement rate among oncology patients, and 83% of clinicians say the health chats extend the care they can deliver, reported the health system's chatbot technology vendor, Conversa Health. Care navigators also commented on the additional peace of mind they had as a result of being able to see patients responding through the chats.

Healthcare IT News sat down with Murray Brozinsky, CEO of Conversa Health, which now is part of telehealth vendor Amwell, to discuss how chatbots and automation tech can ease the burden of staffing shortages; how the tools can help with patient education and discharge; how the technologies can be used to combat clinician burnout; and the potential importance of combining chatbots and similar technologies with virtual and in-person care.

Q. How can chatbots and automation tech ease the burden of staffing shortages and potentially manage and triage patients at scale?

A. Even before the pandemic, a UCSF study projected a global shortage of 2.5 million healthcare workers by 2030. Now, as the pressures of delivering care during the pandemic prompt one out of five healthcare workers to leave the profession – and with primary care physician retirement rates set to increase dramatically by 2026 – the future of care delivery, patient experience and health outcomes will increasingly depend on automated support.

Healthcare organizations will reimagine care management, transitions of care and care coordination using data-driven technologies that help care teams treat patients proactively and help patients perform more – and more informed – self-care.

A good example is Northwell Health, a health system in New York that uses automated chats to help their care teams stay closely connected to patients during their recovery after hospital discharge.

Patients interact with a digital companion that frequently checks in on them on behalf of their care team. It asks questions about their health status and care progression and can also capture biometric readings from devices.

It analyzes these responses in real time and recommends what the patient should do next to improve their likelihood of recovery. If the companion determines the patient needs more help, it guides them to the appropriate care venue by notifying the care team to call the patient, escalating the patient to a telehealth visit or scheduling an in-person appointment.

Intelligent automation tools like this empower care teams to focus on activities that provide the greatest value for their patients. They optimize resources and system utilization.

They also support the delivery of more personalized care, which enhances the experience for both patients and clinicians – while reducing costs. And it's what patients and providers want: Research shows more than half of patients (54%) and physicians (56%) expect smartphones to become their touchpoint with their health system.

Q. How can chatbots and automation tech help with patient education and discharge materials?

A. More than half of U.S. adults live with a chronic condition such as diabetes, heart disease, hypertension or asthma, and one out of four face multiple chronic conditions, federal data shows.

Education and care plan adherence are extremely valuable levers to help patients manage these conditions and live their best lives. Health systems and other care providers that use automation to frequently monitor their patients – collecting and analyzing qualitative and quantitative patient data – identify when they are off track and provide relevant, personalized, evidence-based guidance just at the right time and have an enormous opportunity to pull these levers.

These technologies also help health systems develop deeper patient relationships by increasing the number of empathetic, helpful, trusted touchpoints they have with their patients, which strengthens loyalty and retention – critical at a time when competition for healthcare consumers is skyrocketing from traditional and nontraditional providers.

Automated patient engagement enables healthcare organizations to harness the wisdom of patients to improve better clinical, operational and financial outcomes. They give health systems a powerful mechanism for initiating ongoing discussions with their patients – at scale – and with the frequency needed to avoid unnecessary health complications.

With this information in hand, care team members can intervene earlier and help patients avoid adverse events and unnecessary hospital readmissions. They can also provide the coaching needed to keep low-risk patients from becoming rising risk or high risk.

The potential for automated engagement tools to drive improved outcomes following a hospital stay is substantial. Nearly 20% of patients experience an adverse event within three weeks of hospital discharge. In three out of four instances, these complications could have been prevented or ameliorated.

Care teams can work in partnership with automated virtual care technology to continually assess patient status before and after hospital discharge and provide relevant education, nudges and guidance to keep them on track. And if and when they go off track or require a necessary readmission, the technology can flag them sooner for appropriate intervention.

Q. How can chatbots and automation tech be used to combat clinician burnout?

A. The pressures of COVID-19 pushed clinician burnout to new heights – one out of five physicians and two in five nurses say they will leave their profession within two years because of it, an American Medical Association study shows.

It's estimated that physicians spend as much as 49% of their day on desk work. Corroborating this, a Medscape survey found that 59% of physicians cite bureaucratic tasks – such as electronic health record charting and paperwork – as the major contributor to burnout.

Chatbots and data-driven technologies can ease the burden on physicians, nurses and other frontline health workers by automating tasks that are better suited for a computer while freeing up care teams to practice at the top of their licenses.

Automated tools and chatbots serve as a 24/7 extension of the care team. They can reduce patient stress and anxiety by making patients feel less isolated and by providing education and answers to questions. They help ensure necessary tests are not only ordered, but that patients complete them.

They guide patients to take the best next step for them in their care journey, whether that be taking medications, showing up for appointments or having necessary screenings. They help patients stay on top of their health and better position clinicians to stay on top of their caseloads.

The data collected from these technologies – patient-generated health data – is a motherlode of intelligence for care teams and health systems alike. In a pilot project we conducted, 82% of physicians said they would recommend the use of health chat technology to a colleague. And 83% reported that health chat technology extended the care they deliver to patients.

University Hospitals in northeast Ohio is using an automated tool for COVID-19 screening and triage, which enabled the health system to rapidly respond to patients with COVID-like symptoms as well as keep its employees safe. UH's "Employee HealthChecks" tool remotely screens 29,000 employees every day for COVID-19 symptoms, reducing pressure on its overextended clinicians and staff.

Q. Can you elaborate on the importance of combining chatbots and similar technologies with virtual and in-person care and making that into a seamless experience?

A. Patients want – and deserve – access to high-quality affordable care when and where they need it. Health systems and other providers need to meet patients where they are – which is increasingly in their homes – with consumer-worthy experiences while reducing variability of care and improving health outcomes. And they need to accomplish this with acute health worker shortages and pressure to reduce costs.

In order to do this, we believe care delivery will increasingly blend physical, virtual and automated interactions. The key is blending the right amount of physical, virtual and automation to maximize patient experiences and health outcomes, while optimizing resource utilization.

This leads inexorably to data-driven platforms designed to help health organizations orchestrate care for every patient along each step of their health journey.

A critically important data set in this equation is patient-generated health data: the vital data that patients carry around with them about their health and care status that exists nowhere else. This includes patient-reported outcomes, biometric data, social determinants, behavioral data and other data that changes over time.

If you could afford to send someone to sit in a patient's home every day and ask them questions and take vital signs, you could use this information to inform the care they need. Since no health system can afford that – nor would a patient want it – automated systems using chatbots will become the faithful patient companions of the future.

They will do the heavy lifting – collecting vital patient-generated health data, combining it with other patient data, analyzing it and recommending next best actions to help orchestrate the right blend of care for each patient.

We'll know we've succeeded in making this a seamless experience when instead of referring to a blend of physical, virtual, and automated experiences, or hybrid care, we simply call it healthcare.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.