By Patty Riskind, CEO, Orbita
LinkedIn: Patty Riskind
X: @orbita_inc
Over the past two decades, healthcare has emphasized two priorities that are sometimes at odds with one another: Reducing the length of inpatient stays (LOS) and decreasing the incidence of preventable patient readmissions.
In other words, caregivers are expected to get patients home sooner while making sure they are at low risk for a return visit. The reasons are sound: these efforts can improve both the patient’s quality of life and the organization’s financial well-being.
This has resulted in greater attention on the processes surrounding patient discharge, with specific activities emphasized at the time of release (e.g., patient education, medication reconciliation) and in the days immediately following hospitalization (e.g., follow-up communications, verifying that post-acute checkups are scheduled, ensuring prescriptions are filled and care plans followed). It is estimated that one in five patients experiences adverse post-discharge events such as infections or procedural complications within 30 days. The Agency for Healthcare Research and Quality recently reported a 14 percent adult readmission rate at an average cost of $15,200.
Increasingly, health systems turn to automated virtual assistants to facilitate higher levels of post-discharge engagement – particularly as they struggle with staff burnout, turnover and shortages. Well-constructed and well-trained virtual assistants can help ensure consistency, timeliness, accuracy and appropriate use of overextended human resources.
Four questions streamline post-discharge outreach
One large mid-Atlantic health system, for example, launched a pilot virtual assistant program to support post-discharge follow up in 2022. With nearly 2 million visits and surgeries in 2020, this busy provider found dwindling staff resources were overwhelmed by the volume of post-discharge follow-up required to achieve the organization’s LOS and avoidable-readmission objectives. Leadership had also discovered that, since the post-discharge nurses relied solely on phone calls, patient engagement was alarmingly low. As a result, patient questions were often unanswered, and the care team was unable to ascertain if recovery was on target or if intervention was required.
Working with a virtual assistant technology partner, clinical and IT teams developed a four-question outreach program, delivered at pre-determined times after a patient was discharged. The communication was cascaded over channels – text, email and voice – to ensure patients received the message and could engage in the manner they preferred. Patients were able to take action from a single point of contact, instead of needing to follow up with a phone call or log into another communication platform.
The questions were constructed to elicit information that would give caregivers a clear indication about the patient’s recovery process:
- Do you have questions regarding your discharge prescriptions?
- Are you having any new or worsening symptoms since discharge?
- Do you need assistance scheduling an appointment with your primary care provider?
- Do you have questions regarding your discharge plans?
Provider achieves 86% engagement across multiple communication channels
If patients answered “yes” to any of the questions, they were automatically connected with a staff member, who could ask further questions and determine the best next steps. Staff members had access to the patient’s condition, history and previous digital responses, so they did not need to re-gather information, saving time and frustration.
With the virtual assistant, this health system achieved 86% patient engagement. The cascading functionality – escalating the survey across channels if the patient had not yet responded – incrementally increased response 11-15 percent with each new channel. Ultimately, answers from two-thirds of the patients confirmed their recovery was on track, meaning staff had to conduct one-on-one follow up with far fewer patients than in the past (only one-third instead of all).
This health system’s post-discharge outreach program was highly successful because the virtual assistant was developed for this specific purpose, supported by tools that enabled the staff to adjust the program as needed. Natural language processing and conversational AI tools ensured communication was empathetic and adjusted for the patient’s communication style. Multilingual options were also available.
Value can span multiple use cases
Effective discharge follow-up is simply one example of the value automated virtual assistants deliver to healthcare. More and more, patients expect to interact with providers in the same, consumer-oriented manner as other areas of their lives. Unfortunately, healthcare has been slow to respond: While 80% of patients prefer digital channels to communicate with their healthcare providers (Dynata and Redpoint Global), 88% of physicians still rely on manual phone calls (Patient safety and Quality Healthcare).
Savvy healthcare leaders are exploring a variety of digital experiences that can help patients access and navigate their care, while augmenting staff in a way to improve efficiency and optimize revenue.