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 Today on Newsday.

 We're not trying to stand in the way of anything. Sometimes you'll run into these systems and it'll be like, Are you really sure you want a person? We don't do that. in the business of removing friction, not adding it My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health. where we are dedicated to transforming healthcare, one connection at a time. Newstay discusses the breaking news in healthcare with industry experts

Now, let's jump right in.

(Main)  Alright, here we are in It's Newsday and we're actually on site. Scott D'Entremont with Parlance, yeah. Okay. Tell us what Parlance does again real quick.

Sure. We have a conversational AI platform that we use to support healthcare organizations. voice journeys really. Removing friction, as people are calling the healthcare system, is what we do.

we're actually gonna take two stories in that direction. I like this conversation We're actually at a 229 event right now. This conversation invariably will come up, where does generative AI fit? In this world especially with the call center and the care journey and the patient journey where does it fit? And the first story we have is McKinsey. Why IVR still matters in an AI world.

And I love the opening tagline. Want to know the biggest problem with generative AI chatbots? Your customers still prefer to call you. I know my parents do, my parents still prefer, and they're in that age group, that massive age group that's going through the health system right now, they still prefer to hear a voice on the other end.

Is that what the findings would tell us?

Yeah, absolutely. So 83 percent of is still coming to the healthcare system through the voice channel, statistically. And despite, billions of dollars of investment in patient portals, only 10 percent or so of appointments are scheduled via a portal.

So sometimes people are calling because they want to, sometimes people are calling because they have to, but the fact of the matter is, people are calling and everyone has accepted now that they're going to continue to call.

Yeah, The call center was one of the hardest things for me as a CIO.

you're sitting there, you're working with the EHR, and you're doing the ERP solution. You're doing all these, clinical workflows and all this stuff. And you're solving those problems. You're feeling pretty good about it. Then all of a sudden, out of the blue, somebody calls and goes, Hey, we've got a call center problem.

What's the call center problem? It's we have people getting transferred into Oblivion. We have people who aren't getting the service they want. We have. All sorts, it depends, the service level will depend based on which call center they go to and those kinds of things. When we talk about these solutions, what kind of project is it?

is it more like you have to get in front of what's the message you want and the routing and the, is it a pretty heavy lift from that perspective?

In relative terms, when you compare it to upgrading your EHR system, not at all.

Relative to many IT projects it's far less. But that's not to say that there's not some work for the system there. It really starts, I think, at the top, getting organized about what you're trying to accomplish, which we always suggest should include thinking about the brand and the consumer experience.

Healthcare systems haven't adopted the philosophy that, hey, I want it to be easy and consistent when I call. I don't know that I've run into one yet where it's the same, whether I call an ambulatory location or one of the acute care centers, that I get the same calling experience. And mergers have made it even worse.

Mergers have made everything a little at least from an IT perspective, it's just challenging. talking to a CIO the other day. Actually, two CIOs, and because of all the mergers, want to be moving forward, but they're constantly doing all that work to integrate and bring all those things together.

But part of that is care journey, and what we want to get to and where we're at are two very different things right now. reading this article and it starts talking about personalization. It's time to be personal. And that's one of the hopes for AI is that we can start to become more personal in our interactions.

How is generative AI changing that landscape?

It's just more powerful. So it used to be, we've been around a long time, Parliament's been around for 28 years, through many generations at this point, of speech based technology. And we, historically, have done a great job in a directed journey.

How may I direct your call? And, we'll put a directory of tens of thousands of places within the healthcare organization that we can send the caller to. The technology now, though, allows you to say, How may I help you? It and be much more interactive. And if it's an integrated system, it can say, hi Bill, how can I help you based on, the ante that you're calling from.

That sort of thing. I think it's a case of technology getting better and in the right hands. You can do a lot with it Now that you couldn't before.

We are spending a lot of money. I've had three conversations in the past week about patient portal.

It still amazes me. The amount of money we're spending on patient portals. I talked to one health system that had 65 people on a team that had developed their own patient portal. I had another one who had 45 people, and I had another one whose team is firmly ensconced with Epic MyChart, but another group is spinning something up because they're like, we're still not meeting the consumer's demands.

I'm not sure that surprises me but guess what does surprise me is How much money we're spending there, on the phone. And the phone is still a very important thing, but as I tell my staff a lot of times, it's you realize that phone actually does call people as well.

But I think because of our thinking our thought process towards automation and those kinds of things, we're constantly thinking, hey, self service is the way to go. We want them to just boom. But you can still do self service. via voice. Yeah, totally.

our argument is that the sort of best version of service today is not a live answer or direct to a person.

It's getting where you want to go as quickly as possible. And if you need help, that person should be available. So we're using technology to self serve simple and routine things. I want to cancel my appointment. Thousands and thousands of calls come in to confirm my appointment. Where is it?

What time is it? Simple questions. Where do I park? Things that people don't want to wait in a queue to ask an operator for. And many of these contact centers are staffed by professionals, nurses, navigators, that make a lot of money. So the ROI on, using automation in those simple, cases is pretty big.

The ROI on the clinics though, to me was the most amazing when we were doing this kind of project and we were saying we actually have nurses answering phones and doing all this stuff. And when we looked at those workflows and we looked at what we could automate, we looked at what we could do.

I'm like, man the return is significant. Yeah, it really is. And they're like but that's part of the nurse's jobs. I'm like. That's not why they went to school. That's not what they wanted.

Yeah. Yeah, and when you go, maybe they're describing where to park, right? That's really not a win.

So this is interesting because it has wave one, wave two, wave three.

I want to go through this. So wave one, use advanced analytics to determine the breakpoints in the current call flow where customers give up and seek help from an agent. This gives companies a list of potential adjustments to the system that allows them to implement quick design changes to tackle Some of the top sources of user frustration.

Then it goes wave two, wave three, and I'll go through those in a second. I think we've all experienced that. That's when you call in and essentially you're like, I give up. Zero. Get me out of this loop. do we get around that?

I think you have to have a direct quick path. You can't have, a 30 second message.

Thanks for calling. Our options have changed. We'll have some customers that have literally a 30 second message on the front. And almost before they even think about it, people are like, Okay, and they're going to hit zero. The statistic nationally is about 12 percent of people utilize the complete IVR.

Everybody else. Because each time

you touch a button, it's friction. Button friction, all the way down. we want the IVR that feels like Google. When Google first came out, we were just like, what? People don't even remember what Yahoo looked like. there was a whole bunch of options and that kind of stuff.

Google just put that box up there and said, tell us what you want. I think we want IVR to do the same thing. We want to call in and say how can I help you? No big long message, or just, welcome to St. Joe's, how can I help you? I have an appointment for today that I need to cancel. Okay, great. Let's take a look at the information.

We want it to be a dialogue. Are we getting closer to that? Yeah.

We're there now. Keck Medicine of USC has an 800 number, believe it or not. One of the only ones we've seen be successful all around the country. So they can actually use it to promote system and obvious for their community where to find them.

It's 1 800 USC CARE. You can call it and say, how can I help you? And it says, how can I help you? And it can be anything from what times the cafeteria open in Glendale to I need to confirm my appointment. And of course the system needs to say at which location, what kind of an appointment, all that sort of thing.

And then it, does it route to it? So it knows when to say, okay, we're going to put you through to a human.

Yeah, absolutely. And you can ask for a human too. We're not trying to stand in the way of anything. Sometimes you'll run into these systems and it will, it'll be like, Are you really sure you want a person?

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 Wave 2, redesign customer journeys. spent a lot of time on this actually at St. Joe's. It was interesting. Because when we started mapping them out, it was, as long as this table, we had these journeys, and we were looking at it going, oh my gosh, I can't believe we do this to people.

And it was all well meaning, you created this little tree to handle people that had very specific care needs, or this one for that, and it was also a point in time with this is what the technology could do. And so you have these journeys, and these journeys still exist in every health system.

And when you finally take the time to map them out, you go we can do better. And then when you realize the technology has come so much farther. I'm going to go on here. Wave 2 redesigns customer journeys for the priority call types identified in Wave 1. The Wave allows companies to apply user centric design principles from a clean sheet.

It also is an opportunity to integrate available new technologies such as call flows that adapt based on context data from the customer. Activity outside the Have you come across clients that start with a blank sheet of paper?

Not really. It's pretty confusing. Oh, really? To start from

a blank piece of paper is really hard?

Yeah. Yeah,

can see that. The other is really confusing too. When you start to map it out and you're just like, wow. I'm not sure how they end up at the right place. And the reality is they don't end up at the right place a lot.

Most of the time, yeah. I think, for our company, and it's a managed, it's a managed service, so we're constantly working with people to iterate.

But I think, as much as bringing new technology to the table, we're bringing the experience and expertise of how to design these call flows and the voice part of the journey to support it being easier for patients to get where they need to go and reduce, on the agent side, the simple questions and, Just make it better on both sides. And I think it's important to think about both sides, both the agent and the

And this is where you guys live. Wave 3 is applies machine learning, AI technologies, additional technologies on top to add predictive and conversational capabilities to the IVR.

Exactly. There is a lot of work that gets done before you just go, there's the technology magic. Although, what's interesting to me is when we talk to people who have implemented Epic or a solution like yours, a lot of times they'll say, Yeah, we didn't see it as the magic bullet, but it was the impetus to do all the other work that we needed to do.

Yeah, exactly. Alright, so that's article number one. Let's take a look at article number two. This one is Bain Consulting, beyond hype, getting the most out of generative AI in healthcare today. Did you have a chance to read this article?

Yeah.

I want to give you a broad, open ended question which is essentially, jumps out at you this article specifically?,

I think it's very consistent with what we've found. And that is to say that everyone's excited about AI and the promise is real. And it's going to make a huge difference in all of our lives. But at the same time there's just a lot of people looking at things and trying to figure out where it fits in and not always doing a lot.

As we get involved with new engagements. There's now an additional committee that's looking at AI things and things like that. It's interesting to start thinking about, okay, knowing that AI is real and here, how do we apply it today?

So we can just do this by graphics.

In the near term, generative AI can reduce administrative burdens and enhance efficiency. And, which use cases for generative AI have the highest priority for your health system in the near term? And charge capture and reconciliation, structuring and analysis of patient data, and then workflow optimization and automation.

And that's where we're sitting right now and having a conversation. Which use cases for generative AI are the highest priority for your health system, but in a long term category? And it's all the clinical stuff. And it's because of the risk associated with that's why that remains.

And so that's pretty obvious to a lot of people. And what do you see as the biggest barriers to implementing generative AI in the health system? Resource constraints, lack of technical expertise, and regulatory and legal considerations are the top three on that. It's interesting because as we talk about AI, one of the things that I hear from these CIOs in these meetings is, it's just coming. We're not selecting it or choosing it, it's just, not coming in as a new application that we select, it's coming in as a feature of stuff that we've had. almost like they don't have to go out and find it, it's finding them. Yeah, exactly. Somebody who's had your technology, you guys have been around for a while, are they seeing that kind of thing?

Hey, it used to be this, now it's this. Because you're constantly bringing new technology into it. Yeah. Is that a pretty seamless migration or is there Yeah, it

is. It is. We're able to change people from how may I direct your call to how may I help you. And the difference there is now the system is able to answer frequently asked questions.

And that's a huge advantage. AI. So I

could just feed a bunch of facts into it and it can just get them back out there, which is what are the hours of operation? Oh, it's this to this.

Yeah, exactly. What insurance do you accept is one. And then you can get a little bit more granular, so it's a physical therapy practice.

What should I wear for my appointment? That sort of thing.

What should I wear for my appointment?

Yeah, that's one that we've heard several times.

S. hospitals are desperately searching for margin improvements. let's talk about the investment and the ROI on this. ROI is one of the most misunderstood terms I think I've heard. But if we made it real simple, like the amount of the investment to the time that money is returned.

That's essentially the definition of it. think the confusion is in how do we measure it and those kinds of things. do the cost savings come with a really well designed system that utilizes on the voice side.

It's a hard one for us to say, too, because the sort of the arithmetic a CFO in a healthcare system loses is different than what we feel like is the real effect.

The real effect, we think, is in what's the soft ROI, which is, you are in a competitive marketplace, and if it's really hard to call and you can't get through, you're going to do that knee replacement. the competitive hospital and somebody lost a case in a piece of revenue that's really hard.

That's really hard to quantify. We all know it's there. The direct arithmetic is in hiring avoidance, where you're having fewer FTEs. In most cases, these are open recs that people can't fill. We'll often be engaged with people that are trying to hire seven people and you hire Parlance for the cost of a couple of them and you've saved the amount of five of them.

The other place is in just deflecting the work from verifying who's calling. So the system will go, hi Bill, and get some other, demographic information from you, birthday, etc. and hand that call to the agent. That's 40 to 45 seconds. When you multiply that by millions of calls, that ROI story is pretty immediate and direct.

It's interesting to me. labor shortage is real. It's only going to get exacerbated. The need for intelligent health systems is real. As I look at it and I think about all the different, How do we make sure that call doesn't get to a nurse unless it really needs to get to a nurse?

Or a doctor unless it needs to get to a doctor? or never get to a person if it never needs to get to a person? How do we make sure that we're not transferring the person ever? Let alone two, three, four times? How do we make sure that they feel like they are known by the health system? Nothing's more frustrated than the third time you get transferred and you talk to somebody and they say what's your name?

Are you kidding me? I've said my name now three times. You should That happens a lot. Yeah, you should know my name. You should know, the screen pop should be right there. You should know who I am, why I'm calling, and all those things. I think if we look at the labor shortage, we look at the cost pressure it's going to be imperative to create a smart health system.

And part of that has to imagine all the different ways that you interact with a patient. They do this, I've been in a lot of different industries, they do this in every other industry. They're like, okay, how is a customer going to come to us? They come to us through this point. Okay, there's a digital journey.

But that digital journey could become a physical journey so that we have to think about the transition to the physical journey. We have to think about the journey after they've had the experience and how do we measure it? How do we make sure that the next one, how do we encourage the next one? And we don't think that way in healthcare because we're sick care right now.

But, a lot of this technology is very much in use in the payers. And, enough, they are in the wellness care. They're the ones trying to keep people from going to the hospitals. And the idea that we can direct people to healthier outcomes has always been the promise of this technology. Let's get in front of it.

I don't know. This isn't a Newsday episode. As I think about this, I think this is one of the areas where generative AI is really going to play a role, but there's still an awful lot of work to be done. That we have to do on the back end to understand the workflows, understand the processes, understand how people move through the system, and redesign that stuff.

A hundred percent. So we always engage idea that it's going to be a phased approach. So you start with navigation. Get the calls to the right place. And we start out by having a huge directory. Which you don't think about that necessarily, and if you have a traditional IVR mindset, it's got nine places you can send a call.

And then it's to the next tree and then the next tree. So by having, a directory, in many cases, our customers will have tens of thousands of potential either people or departments that a call can be transferred to. So once you have that mapped out and some frequently asked questions mapped out, you can start thinking about, okay, what do we do in the appointment space now?

So confirming and cancel appointments, that's pretty straightforward, although not as easy as you think even to do that. When you're looking at setting appointments The workflow work that health systems need to do there is incredible. I have a customer that's what else can you do for me? And she's right, you can't do that much more yet, because I have 78 different templates, literally 78 different templates, that we're supporting in order to make these appointments.

What we'll do is, as we clean some of that up and get some consistency, we'll have you guys start doing appointments for those things. And of course, at the same time, those ones then. can be added to the portals.

that's a heavy lift, but that's really valuable work. Yeah. The standardization, the simplification and standardization of those processes give us the ability to ask simple questions in the process, pre fill those forms and make it really easy to them.

you ever link between the voice and the portal, like you create an experience that links all the way across the digital journey? Yeah.

We do on the chat side, so you can reach out on the chat side or the voice side. Yeah, that's how we do

it. That's interesting. Scott, that's about it for today.

We just made it through two stories, but love this topic, because I think more and more we're talking about the financial challenges that healthcare systems are facing, and I think there's a lot of opportunity here if people will mind this area. Yeah, thanks. Thank you. Appreciate it. Appreciate it.

 Thanks for listening to Newsday. There's a lot happening in our industry and while Newstay covers interesting stuff, another way to stay informed is by subscribing to our daily insights email, which delivers Expertly curated health IT news straight to your inbox. Sign up at thisweekealth. com slash news. Thanks for listening. That's all for now