Everyone has waited for what seems like hours to visit a doctor or nurse practitioner, only to spend five minutes getting simple information on how to take a prescription. These routine visits—crucial to a patient’s health—burden the healthcare industry with enormous costs and can wreak havoc on a patient’s schedule.

According to a survey of specialty physicians in 15 major cities in the U.S., patients wait an average of 24 days to schedule an appointment with a doctor.

Some of the most frequent frustrations of healthcare, however, are changing thanks to what’s known as conversational AI (artificial intelligence), where computers communicate with patients via phone or text in a way that feels authentic, even almost human. Conversational AI is helping improve essential medical services like scheduling doctor's appointments, locating specialists, setting up referrals and managing ongoing care, often through a single virtual conversation.

The broad switch to technology-based solutions in healthcare setting is already underway: more than 90 percent of doctors and nurses will use mobile devices at work by 2022.

What makes conversational AI "smarter" is that it offers a more natural and intuitive method of communicating with customers. Traditional voice recognition systems are static: customers need to navigate multiple menus and options and usually end up pressing zero for an agent. A conversational AI system starts with the question and then routes the customer to the right answer or solution, eliminating the wait and frustration. It's also a better experience—instead of static dialog, conversational AI is able to handle a multi-turn conversation.

There are a variety of consumer cases that lend themselves to conversational AI.

Bloomberg News
Bloomberg News

Getting an appointment
With conversational AI, a healthcare vendor can install information and appointment assistants to help make scheduling appointments seamless. The text and voice-based services allow customers to schedule appointments based on criteria including location, doctor’s name and the nature of services. These “virtual medical assistants” will soon be available through channels such as Alexa, Google Home, Mobile App and Voice.

Managing healthcare maintenance
One of the biggest overhauls in medicine in recent years is the switch from a paradigm where patients sought help only at a crisis to a maintenance model where a crisis is prevented. Maintenance in many cases means a patient checking on how to take a medication or requesting information on starting an exercise program or eating better. As many as 30 to 40 percent of calls to the doctor are simple questions like: "Should I take my blood pressure medicine with food?”

Conversational AI will help overhaul and improve patient provider relationships and improve medication management. Health care providers will be able to automate simple queries and offer access to services like wellness program enrollments. Over time, this will mean increased patient satisfaction and a reduction in readmission rates. Conversational AI also has a huge upside for chronic conditions like diabetes: patients will be reminded to check their insulin and stay on top of their health issues. The possibilities are enormous: patients will be able to track both their condition and treatment, quickly access their health care records when considering treatment options, and eventually even report new symptoms or concerns to see if they should schedule an appointment.

Navigating insurance
Once a healthcare professional decides what they need to do to help improve your health the question becomes: who is going to pay? If you visit an emergency room or doctor that means taking out your insurance card. When you get home the real chore starts: repeated letters from your insurance company to either document your treatment or tell you about your deductible.

The process can be daunting, and many patients are left wondering what is covered and what will cost money. Conversational AI can help customers deal with the vagaries of employer-based and health exchange-based insurance plans, coverage exceptions and claims requirements. Coverage advisory services can help healthcare payers and providers by providing members a quick way of checking existing coverage, filing for claims, and tracking the status of their claims. Conversational AI is helping the claims process, particularly during pre-authorizations and billing inquiries, by helping customers learn about deductibles and network coverage using voice guidance.

The upsides of conversational AI in healthcare are enormous: quicker and easier access to both routine care and scheduling; curated and accurate feedback on handling chronic health conditions and an easier way to track insurance claims and billing. As AI becomes more commonplace and accepted in the healthcare field there will be more developments that improve and personalize healthcare. One possibility with significant potential is conversational AI that uses simple diagnostics to tell patients whether to pursue treatment at home or visit a doctor (and then book an appointment). Perhaps the most intriguing development overall is that artificial intelligence—often misunderstood or poorly explained—will be a conduit to obtaining personalized and ultimately more human healthcare.

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