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November 26, 2018
HOW ARTIFICIAL INTELLIGENCE HELPS PUT PATIENTS FIRST
By: Kelli L. Bravo, Vice President, Healthcare and Life Sciences, Pegasystems

Exploring the possibilities of the new wave in healthcare technology

Artificial intelligence (AI) has quickly become lauded as promising technology that can help those in the healthcare field improve decision making and take cost out of the system by predicting illnesses or health trends. AI is “always on,” so there is certainly tremendous potential to mine data and identify what’s wrong. But what if we look at the data to see what’s right—or what’s possible?

There is a place for AI to help predict health trends and illnesses, but it can also improve care management, patient outreach, and customer service. In the near term, the real value of AI comes in analyzing vast amounts of data and leveraging the resulting insights to personalize interactions. The healthcare industry is home to amazing stores of data that cover health history, claims filed, IoT data, program preferences, and socioeconomic factors (such as access to transportation and financial services information). But right now, that data exists in disconnected silos. AI enables us to connect and interpret all of that information, building a profile so providers and payers both get a singular, vibrant view of each patient–and can then select a next best action unique to that individual’s needs.

Know more. Do better.

AI can process vast amounts of data in real time; providing new and more contextual levels of insight. Imagine helping clinicians to better prioritize and personalize the guidance they give their patients to help them get more engaged in their own health. Before even seeing a patient, AI can process data about the patient’s history, complications and socioeconomic factors. Having that consolidated, comprehensive view of a patient may lead a clinician to recommend to the digital-savvy senior a new mobile diet-tracking tool for diabetes. Or, a doctor might recommend a meal delivery service for an elderly, chronic kidney disease patient with no access to transportation.

Health plans can also be more personalized and relevant in their interactions. For instance, being smarter about what messages go out—and when. A health plan member who has just undergone a double mastectomy should never receive a reminder to book her mammogram. However, a patient recently diagnosed with cancer should definitely receive information about a wellness program supporting patients who are undergoing chemotherapy. Knowing what information to send, to whom and when can help health plans to save time, reduce costs and help patients to live better lives.

AI can also assist across channels. Call center staff—whether at a hospital or health plan—can be better equipped to assist people when guided by AI. When a patient calls and the data shows that person was recently diagnosed with COPD, the representative might simply ask, “How are you feeling?” and then offer COPD educational materials or programs.

If the dashboard shows that a patient is enrolled in three different wellness programs within a health plan, the customer care representative shouldn’t waste precious time asking standard, repetitive enrollment questions. Instead, that patient should be guided immediately toward the types of high-value content most likely to promote positive outcomes for both patient and payer – like information on wellness programs, Medicare Advantage enrollment or claims assistance.

Getting up to speed

Other industries such as banking and retail have been using AI to better serve customers for years. It’s time for healthcare to catch up. Healthcare organizations have a lot to learn about their customers—and AI can help. Using AI to connect with and personalize interactions with individuals (not just segments) can build trust, further patient engagement and improve outcomes while driving down the cost of care. Let’s make it possible.

For more on AI, read Citizen AI in the 2018 Digital Health Tech Vision.

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