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Can We Chat? Using Automated Tools to Solve Some of Healthcare’s Biggest Challenges

Virtual companions boost efficiency, reduce costs and address gaps in care.

Have you tried resolving a customer service issue using the chat function instead of talking with a live agent? The chat was probably convenient, but there's a good chance it had limited functionality, and you left the encounter feeling frustrated and still needing answers. 

More payers are relying on virtual companions like these to address gaps in care, reduce operational costs and improve clinical outcomes. But, unlike the automated customer service chats your favorite retailer uses, healthcare’s chat-based tools can't follow a generic script. Given the complex nature and that every healthcare diagnosis is unique, virtual companions must be able to retrieve, decipher and distill information from multiple sources and deliver a care plan tailored to each member.  

In a recent webinar, Cynthia Horner, vice president for Amwell Medical Group, and Marie Renzi, director of digital care for Amwell, discussed incorporating chat-based tools into the care journey. From chronic condition management to maternity care to reducing emergency department (ED) readmissions, virtual companions can address gaps in care, boost efficiency, drive down costs and give members greater access to care. 

The Amwell ConvergeTM hybrid care enablement platform powers in-person, virtual and automated care. Embedded in the platform is a virtual companion, which pairs member information with data shared by payers to foster regular and customized interactions. Marie said the frequent touchpoints and high level of personalization are key reasons why the Amwell virtual care companion sees member activation rates that top 75 percent. 

3 Examples of Automated Care in Action  

During the webinar, Cynthia and Marie shared three real-world applications of how Amwell automated programs are helping payers overcome some of the biggest challenges in healthcare. 

Emergency Department Readmission Rates 

ED readmissions add $26 billion to the U.S. healthcare system each year. There's a significant opportunity to reduce costs in this area and to prevent patient over-use. 

Cynthia explained how the Amwell virtual companion helps members manage their health after a virtual visit and know where to go for appropriate follow-up care. Based on a member’s symptoms, the technology alerts the care team of potential risks and notifies clinicians of the need for a follow-up visit. In one example, the virtual companion, which has a 90 percent patient satisfaction rating, reduced calls by approximately 30 a day and generated $1 million in total cost reductions. 

Maternity Care  

With maternal mortality rates in the U.S. hitting 26 out of every 100,000, the Amwell virtual companion is a way payers can educate and remotely monitor women throughout their pregnancies. The chat-based tool works with a plan’s care management team to prepare women for what's to come from their first trimester through eight weeks postpartum. 

The technology captures real-time health data to provide tailored prenatal information. Members receive personalized materials about prenatal support, blood pressure tracking, fetal changes, birth plans, multiple births, and if applicable, in vitro fertilization. The virtual companion notifies the care management team when a mother's care should be escalated and scheduled for an in-person visit. 

The chat-based tool can also collect information about a member’s social determinants of health. For example, a mother may share that she doesn't have transportation. The payers’ care management team can then refer her to another resource, so she continues to receive critical prenatal care and doesn't fall through the cracks. 

Chronic Conditions 

For members with ongoing conditions like asthma, heart disease and high blood pressure, the virtual companion informs payers of how these members manage their medications, whether they're attending their medical appointments, and if there are significant changes to their conditions. In one instance, Marie shared how the virtual companion tool helped those with diabetes achieve better health, with nearly 10 percent of users reducing their A1C numbers. 

A Customized Experience for Every Member, Every Time 

For chat-based solutions in healthcare, the generic customer service interaction you may have had with your favorite retailer simply won't cut it. The technology must be able to collect and extract information from many sources and deliver a personalized care experience. Because when doing something as important as caring for someone's health, there isn't a standard script that clinicians can follow for every member every time. 

Watch this webinar to learn more about how chat-based solutions can help payers overcome some of healthcare’s biggest challenges.