Optimize patient access with automation and technology

- [Eric] Good afternoon and welcome to today's program titled Optimize Patient Access with AI and Technology Best Practices. My name's Eric Wicklund, and I'm the Associate Content Manager and Senior Editor among other things innovation and technology for Health Leaders. And I'm gonna be the moderator for today's event. Now, our program is gonna be 60 minutes in length. Note that an on-demand version of this program will be available approximately one day after the completion of the event, and it can be accessed using the same login link that you used for this live program. Today's program is sponsored by Optum. Thank you to our sponsor and to you and our audience for giving us your time and attention. Before we get started, we've got a few housekeeping details. First, to ensure that you can see all the content for this event please maximize your event window and be sure to adjust your computer volume settings and/or PC speakers for optimal sound quality. Second, you'll find a resources list for today's webinar in the upper right corner of your screen. Here we've listed the webinar slide deck and other materials for you to interact with. And third, at the bottom of your console are multiple widgets that you can use. To submit a question and we will have a Q&A session at the tail end of this program, you click on that Q&A widget. It may be open already and appear on the left side of your screen. Now you can submit questions at any time during this presentation. However, please note that is likely those questions will not be answered until that Q&A portion at the tail end of this program. And should you experience any technical difficulties during today's program and need assistance, please click on the help widget, which is a question mark icon and covers common technical issues. Now at this time, it's my pleasure to introduce our speakers. We have Bill Trojan, COO of Delaware Valley Community Health, and Kara Carpenter, Vice President of Client Engagement at Optum. Thank you both for taking the time to speak with us today. And with that, the audience is yours.

- [Kara] Good afternoon and thank you for sharing this time with us and appreciate you coming today. Again, I am Kara Carpenter and I am the Vice President of Client Engagement for Optum RCM Services. A little bit of background about myself is that I have been in revenue cycle for 25 years, and I started my career at stock camp now here on working West Coast to the East coast front to the back end of the revenue cycle doing optimization projects and assessments. And then I moved into some senior operational leadership roles at healthcare systems based here in Minneapolis. And then I moved into running my own consulting firm doing revenue cycle optimization as well for about eight years, and came to Change Healthcare now Optum about three years ago. So excited to be here and I will turn it over to Bill for a brief introduction as well.

- [Bill] Thank you so much Kara. Hi, I'm Bill Trojan. Good afternoon to everybody. Just a brief introduction about myself. I have been at Delaware Valley Community Health for just a little over five years as the Chief operating Officer. And before that previously I was in the hospital world for about 17 years at multiple different health systems where I really got my experience for operations. And before that I was in IT as well. I got my master's degree at Temple University, Fox School of Business for Healthcare Administration. So been very familiar with the Philadelphia Area Healthcare System. Thank you.

- [Kara] So a few of the learning objectives for today are, first of all outlining the key. So key issues associated with the patient access function. Obviously we know, and we'll talk about this later, how important that function is. It's really the entrance, the first impression for the patient and leads to so many different impacts, whether it's your revenue, whether it's your reputation, your the overall experience from the front to the back end. And again, looking at both financial and the clinical metrics used to evaluate those issues. Secondly, describing the technological advances that can help speed the patient access journey. So we can talk a little bit about that, whether it's telephony versus AI, versus just the process for the staff, improving patient access, efficiency, retaining patients within your network, obviously impacting and looking at revenue leakage. And then improving overall patient satisfaction. Lastly, developing a plan of action for outsourcing patient access call center operations with clear ROI. And we'll talk about different options on how that outsourcing can work to really compliment your healthcare system and your goals. So again, today the agenda is the introduction. We walked through that, we'll talk about the labor challenge and impact. And then third, the case study, which Bill will walk through the experience of his healthcare system. So again, the approach and solutioning. So again, probably something we can all relate to here is the workforce challenges and the impact. Obviously we've had a couple of challenging years, so we're gonna talk about where we are today, where we were previously and going forward some of the ways that we're addressing that. So we're gonna start with the polling question. And so I will go to the next slide and this is where you can have an opportunity to share your challenges from your perspective at your healthcare system or places that you're working with. So first of all, the question is how would you rate your organization's patient access staffing challenges? A, very difficult recruiting, educating employee retention take up most of my week. B, difficult, we feel the labor shortage but it hasn't reached crisis levels. C, average. D, not very difficult, we're having no trouble finding talent. Or E, not a problem, we're having no problem finding and retaining team members. So if you can go ahead and share your answer on that, I'll give you just a few, about 30 seconds to answer. Hopefully we can try to hit 25% of the attendees answering. All right. So thank you for those who answered and shared your current situation. So 24% answered very difficult, which I have heard from a number of our current clients as well as prospective clients overall in the industry that it's been very difficult, 40% that it's difficult. So they're feeling the labor shortage, but it's not the crisis level. 32% average, and 4% not very difficult, which that matches my experience as well. You know, obviously sometimes it's tapered off a little bit, but just with the remote workforce and other challenges, we're finding it more in that difficult category. Thank you for sharing your answers. So when we look at labor challenges overall, I think they really fall into three categories. We've got the staffing shortages, we've got the rising cost of labor, and we've got the uphill battle of the thin margins. And according to a 2022 American College of Healthcare executive survey, labor shortages are the number one concern of hospital CEOs. The first time since 2004 that CEOs didn't cite financial challenges as their top concern. And I'm sure many of you can relate to that as well. Again, too closely related items are staff shortages leading to increasing wages and signing bonuses, putting pressure on slim hospital budgets and margins. And according to our recent report, more than half of all hospitals had negative margins last year. Research shows that on average outpatient volumes have not yet recovered to their pre omicron levels. So with that reduction in hospitalizations as the omicron surge continues to recover, volumes are down on average across the country. And again, going along with that is the impact on financial performance. So there's really four different pieces that we're hearing across the market and I'm sure all of you are hearing as well. Again, nearly half of CFOs and VPs are saying the revenue goals are behind because of those workforce challenges. I've heard quotes from some CEOs and CFOs and COOs that their labor costs have doubled in some areas. Labor expense per adjusted discharge is up 17% compared to 2020. 2021, the median rate of turnover in hospitals which was 23%, which is definitely been higher, and the vacancy rate was around 10%. And despite even the corporate layoffs in early 2023, the unemployment rate remains at a 50 year low. So again, putting that all together, these issues are impacting that patient access fund function, which is that, again, as I mentioned earlier, really that first crucial interaction a patient has with a provider organization. How many of you have been calling to make an appointment and you're on hold for 10 minutes to schedule an appointment? That happened to me recently. Or you get transferred over to another area and you finally give up and you abandon the call. And again, that's impacting the revenue leakage. A positive patient experience can boost patient experience scores, which Bill will share later through his Pres Ganey scores. And a negative patient experience, as you all know, a negative can stay with you and you'll remember it three times as much as that positive patient experience. So again, every moment that patient's on hold, someone's in the waiting room. And again, it's a domino effect negatively impacting that patient perception of their care. Whether it's the scheduling, whether it's that check-in, whether it's pre-registration, all those pieces together can have either a very positive experience or a very negative experience. Effective patient access can really help reduce those unfilled appointment slots. I know Bill's looked at that as well as you know, some of our other clients where we're looking at how can we really increase all those slots that are unfilled for different reasons, improving the collection of co-pays, co-insurance, self-pay dollars. As we see more and more patients with high deductible plans, how do we collect that upfront? Ensuring that claims are cleaner, cutting denials and reducing costly post-treatment rework. Again, we've all seen the increase in denials come through the backend and then trying to get paid on some of those claims. Helping set realistic patient financial expectations and avoid surprise billing. Helping to retain patients in network again, making sure they're educated on the process and setting that foundation for really an outstanding patient experience. Whether that's, you know, all the way through the scheduling process and again, having that survey at the end to make sure that you're collecting the... That they are having a positive experience and they're giving that feedback as well. Patient experience, again, it directly impacts the revenue cycle. So as I've mentioned already, it's really a circular experience around the patient experience because of the referrals that drive volume growth, that positive patient experience drives better revenue collection, financial experience impacts patient satisfaction. And again, that experience is gonna drive a higher likelihood that patient's gonna come back. So again, it's making sure that you have the appropriate staffing in place, that they have the appropriate training. Again, what's their experience? There's everything from the training of the staff to the tools that they have and the support that they have overall. So we have another polling question for you here. How many team men... And I will go to the next page to go through the answers as well. How many team members does it take your organization to clear each patient for care? A, three or fewer. B, four to eight. C, nine to 15. D, more than 15. Or E, not sure. If you can start submitting your answers, that would be great. All right, keep it open for 10 more seconds and then I will see what the outcome is. Alright, thank you. So again, this is not all too surprising. I think everybody thinks about clearing a patient in a different way. Obviously you want to make sure that you have the right registration information, the right insurance information, demographics, insurance, understanding who their physician is, what type of appointment they want to make sure that they're clear to be seen. Again, the answer is three or fewer are 25%, four to eight is 33.3%, nine to 15 is 6.3%, and more than 15 was zero, and 35% we're not sure. And again, it can be broad across patient access or registration. So a lot of hands and a lot of people and sometimes they're not all tied together with the workflow to make sure that the handoffs happen in appropriate way. But again, it does take a lot of people to clear the patients. Next we're gonna talk about the case study. So what is that approach and solutioning that is right for your organization? Everyone's organization is a little bit different and today we're gonna talk a little bit about Delaware Valley, but first really kind of putting in perspective from a CIO, the quote was, which I thought was appropriate because I do think the landscape is changing in healthcare. "Now it's about the shift towards consumerism. "We are all being measured publicly "and it's publicly reported "on how good our patients feel after exposure "and experience with us as a health system." So it is truly about the patient impression, what their experience has been and whether they come back again with choices. So again, patients are shopping around, they're looking for how they can get the best care, but also looking at what makes sense financially. So getting that quick access at a reasonable and getting good medical experience at the same time. So talking about, again, the patient provided relationship is really comprised of those varying interactions. But communication is mostly managed separately, which I think is one of our challenges. So again, that greatest impact on the patient provider relationship is truly, it's divided between administrative, there's the financial and the clinical. So you have the doctors or the nurses, the providers, the folks that are caring for all these patients on a daily basis. And then we have have the financial piece and the administrative piece. So again, trying to tie those together to make sure that the patient is educated and informed, but also getting the care timely and the access timely. So again, 7% of decision makers say personalized communications are important to strong RCM, yet there's little coordination between the clinical and the financial messaging. How many times have you had someone order MRI or order another visit for you and you didn't have the realization that may potentially that would cost another certain dollar amount or that that would be outta network for you. So again, connecting that between the clinical and financial and 79% of healthcare organizations manage clinical and financial patient communication via multiple technologies really without that holistic strategy. Again, staffing challenges that really the biggest ones happen to be, you know, they are linked so that really it's between three different categories. So again, challenges that keep RCM for being patient focused. Pain points heard directly from patients and pain points faced with current RCM tools. So again, none of these are probably likely a surprise. It's just how do we really make it easier and more patient centric for the patient? So again, poor patient adoption of the portal. So again, the MyChart, the other tools that are out there for patient portals, 32%, that's really one of the big challenges 'cause not enough people have embraced that. Lack of staff expertise, lack of budget to hire more staff. Pain points heard directly from patients. Too many forms to complete. How many times have you completed a form online and then you have to complete it again in person. Difficulty understanding bills. Having to input same info multiple times. Pain points faced with current RCM tools, the lack of workflow automation capabilities, lack of visibility into data, lack of patient self-serve options. And you know, I think you have to also make sure that you're thinking about what demographic do you have. You have a group that will really welcome those self-service options and then you have the group that will really want that phone call. So balancing it and making sure that all those options are available. So the status quo of management patients takes a lot of time. So we looked at really the average healthcare organization and on average they clear 40 patients in the typical day. It takes one day, one plus days really if you're factoring in authorizations and other things to clear each patient, and they employ on average 20 healthcare workers to schedule, register, financial clear each patient for their appointment. So we have another polling question about what we just talked about. Really what is the greatest current patient access challenge? Is it A, labor shortage. B, suboptimal workflows. C, lack of automation. Or D, all of these. So if you wanna go ahead and submit your answers, that will be helpful. Alright, I'll give it five more seconds and then I'll see what the outcome is. Alright, all of these it's not overly surprising. So first of all, we've got 17.4% that had labor shortages at the hop. Suboptimal workflows at 9.3%. Lack of automation, 8.1%, or all of these at 65%. Which really, that's what I see across the board at healthcare systems is really, and that was my own experience when I ran a call center as well is just all three of those together really hit hard, whether it was one versus the other contributing. Alright, I will turn it over to Bill to walk through an overview of Delaware Valley as well as his experience here. Bill.

- [Bill] Thanks Kara. So just let me briefly describe to you about Delaware Valley Community Health. We are a multi-site, fairly qualified health center. We are located in the Delaware Valley region, but most of our sites are located in Philadelphia. We have nine sites. Three of the sites I would say are rather large sites, and then about four of those sites are mid-level size and then just two of those sites are satellites. We serve about 47,000 patients, unique patients per year. We had 116,000 in-person clinical visits in 2022, and we had 43,000 virtual visits, and I'm sure that that number it's continuing to drop a little bit. I'm sure as you all know, we're kind of coming outta the pandemic and that number was a lot more in 2021 and obviously a lot more in 2020, so that number is starting to go down. But we still have a fairly decent amount of virtual visits that we do telehealth with as well. So being a fairly qualified health center, we provide mainly primary care services. So most of our sites will we have adult medicine, or for that matter, family medicine. We have dental in three of our sites. We have behavioral health in six of our sites and we do OBGYN in three of our sites. So you can see there what's listed as far as some of the more specialty types of services like HIV care, hepatitis care, podiatry, optometry, even though these are, they're still kind of considered primary care services, obviously they're not, the traditional types of pediatrics, family medicine and so forth. So that's just to give you an idea of the type of care that we provide to our patients. Next slide please. And just to give you an idea of our patient population and our payer mix. You know, we are mostly inner city, so obviously that is reflective of the huge population of Hispanic Latino patients at 66%, and at 22% we have African American patients, and then this year basic white patients at 8% and 4% at other. And that's not untypical of most inner city based FQHCs. As far as our payer mix, this is also a very typical payer mix for an FQHC. We're heavy on Medicaid because we're in FQHC, we obviously receive a lot of revenue funding through HRSA. So we have a fairly large uninsured population at 25%. And then we have a private pay at 12% and Medicare 9% and CHIP, which is our children's insurance plan that's offered to all children who come into our sites through the county of Philadelphia. Next slide please. So to just kind of go over some of the challenges that Kara had mentioned earlier and had alluded to. This is something that we were going through when we were first deciding on what we wanted to do as far as as how we can increase access, and being in FQHC access is our number one goal. We are always looking to make sure that access is something that we are constantly looking at trying to address and trying to make sure that our patients have access to care because obviously that is one of the biggest social determinants is one is not being able to get that care and so forth. So obviously the challenges that we had to face was staffing. We were hearing from our patients that they couldn't get through on the phones and we couldn't hire staff and keep staff to be able to answer phone calls. And not only that, but we had a fragmented sort of call center. We had one fairly decent sized cohort of phone operators at one site and each of the other sites had their own operators, two to three operators answering the phone calls for each of the sites. And it just was not a great solution. If somebody was out, we had the pool staff to cover and training was always an issue trying to keep folks trained on the different types of protocols that we had for scheduling and so forth. So that was a difficult task to stay on top of. I think the limited resources because you know, we try to hire from our communities and we try to represent our communities when we do hire and that has always been sort of a limitation, but nonetheless it is something that we try to do at our organization and obviously that is very limiting as far as your pool of being able to get operators and so forth. So we looked at trying to get a couple different vendors or partners for us to be able to provide a more centralized call center service. And to be honest, we were not very quick to jump into this scenario. And I think one of the things that Optum was able to offer us was really a proof of concept to help us make sure that this was the right decision for us. So we entered into an agreement with them and worked with them to implement one of our sites that had the most challenges as far as as access and that site, as you'll see, I'll give you some results in a few minutes here, but that really helped us to provide access, to provide a better service, to create a better patient experience. And our providers we're hearing it from our patients that I tried calling but what we couldn't get through, the phone just keeps on ringing or somebody picked up the phone and hung up on me. So again, this was a big challenge for us and this was something that our management team had to fix. So one as we looked at trying to implement and outsource call center, Optum was there to help us provide that service and since then we we're working on trying to incorporate some artificial intelligence, some AI intelligence and technology to help improve that experience as well. Which Kara and I will get a little bit more into later. So what were the results? As of right now, four of our nine locations are now with opt-in services. They do I think a really great job of trying to standardize our protocols and they have a great training and technology program to help us really separate what are the protocols for each of the sites and how their agents are able to decipher which site is calling and what protocols they're using for scheduling these patients and so forth. This has helped our no-show reducing our no-show rates, it's helped to increase our patient satisfaction, and again, our main goal was to improve access. So that was one of the things that it really helped to do. And as well, it helps our revenue when we can fill our schedules and get patients in to see our providers as well. Next slide please. So just to give you a little bit of an idea of what those efforts did for our patient experience scores. We basically saw almost double digit improvement in our patient experience scores, especially we use Press Ganey for patient experience survey and we saw in the areas of ease of scheduling appointments improve, we saw ease of contacting our sites improved, and then just overall access improved for all of our sites. And then in the one site you can see the percentages at 16% double digits improvements. So the proof was in what our patients were telling us and that was what we were looking for and that was enough to give us this proof of concept that we were looking for and hence why we had expanded it from one site to now four sites and looking to continue to expand even more. Next slide please. So back to you Kara.

- [Kara] Thank you Bill. Thank you for sharing. So really looking at, when we talk about labor shortage, we look at how do we protect revenue, but also how do we retain employees who wanna be here? So a couple of things that we have continued to focus on that I think are important for a strong patient access team is really those bonuses for the frontline team members based on the performance, looking at it from a geographic perspective. So I think one thing that Bill mentioned is just if you are limited to a certain geographic location, we always look at hiring from the current location but also looking at if you can hire across the US it does open up the possibilities much more or potentially even globally as well in some instances. So I know Bill and Optum have started to go down of that nearshore capability and a lot of healthcare systems have found a lot of good success on it, especially looking at if you have different needs around languages such as Spanish, it does really support that initiative as well, having those bilingual staff. So that is something that we've looked at as well, where you get really an advantage on looking at it geographically across the US and then also in some instances from an offshore perspective or onshore, or nearshore. And then again contingency arrangements with partners. So it depends, but depending on what service anything from looking at it from a contingency perspective to make sure that the collection is happening, you're moving those patients over to Medicaid eligibility or whether they're getting scheduled timely. There's a lot of different arrangements that can be made there to make sure that you do have the revenue protection. And again, this is really important. I know we use this on a daily basis and I think it's part of the, some of the challenges that the audience spoke to earlier was just the workforce and predictive analytics. So again, that operational efficiency. Can you manage staff to patient care needs? When are your highest intervals of calls? Are you staffed appropriately? Do you have staff that are cross-trained, cross skilled? And again, that's part of the solution that we were able to bring to the table for Bill and Delaware Valley. But just making sure that you have the right analytics and reporting to support that. So you're really staffing to win your highest volumes are, maybe it's 10:00 AM to 2:00 PM. Maybe it's 5:00 to 7:00 PM. It really varies by client and the different kind of demographics or the different, depending on what you're looking at there. Staffing effectiveness. Do you have a repeatable and sustainable way to match staff with the patient demand? So again, it's that scripting, it's making sure that the staff, again, back to that retention, making sure that they have the right training from a compassionate perspective. Are they able, it's back to language, just making sure that the right access and they're trained in the right way depending on what kind of appointments you're scheduling as well. And then lastly, just really the emerging care models. Can you design and support emerging care models that play staff in that lower cost care setting? So again, having that workforce management to help align with what your volumes are. Obviously it fluctuates. It could be higher after a holiday. It's always higher on a Monday, right? So there's definitely different dynamics that are important as you're looking at what your patient access model should look like. Again, looking at that AI piece that Bill mentioned earlier, this is I think it's balancing the AI experience with that conversational. How do you cut down that call time? But as probably a lot of you prefer, and a lot of our patients prefer that you speak to someone because you want to understand maybe there's an appointment that's earlier. So again, we're really blending the AI with and being able to use a virtual agent, an agent assist where it integrates the desktop using AI to augment agent interactions with customers. So that intro piece of the call, and again, giving greater availability as well to answer calls from patients coming in. And then insights. So using that natural language to identify the call drivers. So what kind of and sentiment, what words are they using? Speech analytics is something that we use frequently and just looking at what types of words are they using, is that a positive patient experience, one that where it can improve. And so using those tools to train staff as well. And then having those voice bots and those chat bots to automate the customer interactions where we can. So I think that's really important. But also balancing it with the patient satisfaction and what your patients are looking for. Again, successful integration, execution, excuse me, can drive value for the patient and the provider, but really it requires that modified engagement. As Bill mentioned, you can pilot, you could use the outsourcing for just overflow calls. You can use it for certain clinics where you're challenged, or we obviously have many healthcare systems that choose to centralize it all into one so that patient's getting the same experience every single time. Again, it's that value for the patient experience. So it's improving the patient satisfaction and the quality that reduced wait time. I think that's really, really significant as Bill mentioned in his examples. That can be the biggest complaint and we probably all have an example of our own that we can remember maybe yesterday, maybe last month, scheduling appointments that take quite a bit of time. A 24/7 availability, rapid patient call resolution. And then again that provider is important because that's an improved patient experience and retention for the provider and it's that reduced overall cost for the patient access services. And again, successful implementation. You have to make sure that you're looking at the requirements. So what is that direct connectivity to the EMR for realtime exchange of the records, and making sure that you're having the realtime appointment data available accurately. Identifying the patient quickly, improving that voice bot accuracy and that predicting the caller intent, and then training that conversational AI model. Really incorporating all of those pieces together is really important for that patient experience. But also streamlining and making sure that you're staffing appropriately. So what does that look like for the transition management process? The probably the least amount of time it would take rapid deployment would be about 90 days. And I say that only because you need to obviously look at your current state review and workflow, what's working well? What needs to continue to happen? What can we tweak? Creating that workflow that makes the most sense between your telephony platform if you have one. Looking at the scripting, looking at the workflow that interface with your EMR. And again, like I said, building that customized script is really important because obviously that impacts the patient experience, how they arrive. And there's obviously nuances to each healthcare system. The connectivity as I mentioned earlier with the IVR. So again, making sure that you are understanding how that interface is today, is that something new that's coming to the table. And I think part of this as well that really isn't added in here as well is change management. If it's all decentralized today and you're moving to a centralized model, it is obviously a significant change. So again, understanding what is the ask. 'Cause there's obviously many customers within a healthcare system from the physicians to the providers to the patients and across the board. And then really the testing is very important to make sure you have a successful go live and having that appropriate staff, and the time to recruit those staff is essential along with the training overall. Whether it's training in your provider and/or the scripting training and the overall workflow training. So we have our next polling question and if you can, I'll go ahead to the question here. If you can share your answer, that would be great. What are your top patient access priorities in the next 12 to 18 months? A, patient scheduling. B, patient registration and benefit verification. C, prior authorization. D, patient liability estimation collection and financial counseling. All right, I'm gonna close out the poll. Great. So it does seem to be the top challenge, which is not surprising is patient scheduling 37.7% and patient registration and benefit verification 17%, prior authorization 22.6%, and patient liability estimation collection and financial counseling 22.6%. Thank you. Scheduling has definitely a lot of nuances in it and depending what you incorporate into it, obviously there's always challenges, but definitely that first impression for the patient. All right, I think we have hit the time for Q&A. I appreciate everyone participating today and I hope we can go through some questions here, but thank you again for your time and the opportunity to speak today.

- [Eric] Okay, thank you Kara, thank you very much. It was a very informative presentation. I think it's kind of highlighted the fact that... A lot of the questions are looking to summarize some of the biggest points you made, you and Bill have made during the last 45 minutes. We do have, actually, we have about 13 minutes left in the hour, so anyone who wants to submit a question please click on that Q&A widget and send them in. I'm gonna start right now with the first question. You've got a health system that wants, that has made that decision to outsource patient access call center operations. What are the top three items on the to-do list for them?

- [Kara] I think the top three to-do items and Bill, feel free to chime in here because you've been through this process. But I think understanding your volumes and your biggest pain points. Secondly, understanding, are you open to centralization or are you looking for more of a pilot program? And third, what is your goal with the patient experience and scheduling?

- [Bill] Yeah, Kara, so I can jump in and I can tell you that for Delaware Valley Community Health, I mean one was really having the right partner was important and we looked at several different organizations that could provide this service to us and ultimately we went with Optum. But I'll tell you, it has to be a partnership. It can't just be this vendor relationship. And I feel strongly that Optum is held up and then they share a lot of what they do with us to help us and you know you don't typically see that type of partnership with just, I think any organizations. And I think that having an organization like Optum help make you a better organization as far as trying to define your KPIs and how you do things and how you standardize things from a process perspective. I think that was really important for us when we had decided on who we wanted to partner with.

- [Eric] Okay. Let's move on to another question here, and I know there was some discussion before some of the technologies put into play here, both established and some new and upcoming. What technologies or applications are having the most impact accelerating the patient access journey or supporting patient satisfaction? And are any of these technologies surprising you as to how popular they are?

- I think from my perspective the biggest ones that are having an impact is really, it's the type of telephony platform that you have and what those capabilities are. I think with that, I think the second piece is that the appointment reminders and the automation of those I think are really a very, it's creating a lot of efficiency for the provider to make sure that patient will be showing up that that information is collected prior and that's interfacing back to the EMR itself. And I think overall the AI piece, I think with the conversational, the AI bots, the chat bots and being able to really streamline that patient experience with still the ability to talk to a live agent, I think is definitely keeping the abandonment rate lower as well as that wait time. So that connection is happening sooner. I think it's that balance between not automating the whole process but creating that balance knowing that you've got many different generations that are your patients.

- [Bill] And I just have to say that I agree with Kara that we're really looking forward to seeing where the AI technology can take us and how we can improve the patient experience through the AI technology. I think that you've seen it in so many other industries and I can just tell you that having someone or having your call answered even if it's through an AI bot or conversational bot and being able to get something done it's so much more satisfying to me as a customer when I know something is getting done instead of just waiting on the phone, waiting for a live person to come on to be able to assist me. A lot of times you don't need a live person to just verify an appointment or to cancel an appointment or do certain functions. And that's really where I think AI is gonna take us and where I think we could find advantages in creating a better experience for the patient as well.

- [Eric] Okay, very good. We have another question here, a little bit more specific. What is the provision for an unusual situation, something that may need to be elevated back to the practice?

- [Kara] So in most instances we develop that with each practice because it might be different, it depends on... I'm trying to think of a good example where maybe if the patient is very upset, then they may want to speak to someone directly to get an appointment sooner. So we would escalate in that scenario. If there was an error found, we would escalate that back as well. There's sometimes certain types of scenarios or instances where the practice wants to know that appointment was being scheduled or if there's a certain type of appointment that is being scheduled then we would escalate that. But we usually develop those protocols and workflows so it might depending on a clinic for certain types of pregnancies or genetic counseling, I know in some dental practices there are certain instances where we would escalate it and go back to the provider to make sure that that patient has the appropriate follow up. With a call or an in basket message depending on what type of workflow they have set up.

- [Eric] Okay. We got another question here. This one's very interesting because there's been a lot of talk of it now with the introduction of new cultures, new people. It's not always English that we're talking about when you're dealing with AI. How is AI technology evolving to accommodate languages other than English and bringing in certified interpretation services to assist patients in their primary language?

- [Kara] So AI, we have been working through developing it in at least the, you know, more... Again, it depends on the healthcare system as Bill shared, he has more heavy Spanish speaking and it varies by healthcare system on what they're looking for. We have clients in New York City, it just depends on kind of what the ask is. But we've been able to adjust it based on language, but we obviously always have the option to use the language line as well. So if we need to route that call so it goes to the language line for interpretation, we can do that as well. So there's a couple different options depending on what language that client is asking for.

- [Bill] We are actually getting ready to test out Spanish speaking bots with Optum now. So that's one of the things that we're in the process of doing and trying to implement a Spanish speaking bot for our organization. So I think that's the sort of next phase of this as well.

- [Eric] Alrighty, then we've got time for one more question. So let's look a little bit ahead to the future. How do you see this platform evolving? What more might you wanna do with it or what other new technologies might you wanna bring into it?

- [Kara] I think it will continue to evolve where I think the platform itself will continue to be more and more, I think user friendly. It'll be more... It will have the ability to connect to a live agent more quickly. I think the AI agent will, again, we're continuing to work on the words that we're hearing from the patient, what are the common themes, but also that AI agent and how we can connect it with the telephony, but also connect with patient collections. Whether that's POS collections, co-pay, co-insurance deductible. I think there's some opportunities from a financial perspective as well and making sure that the patient has the right options. So I think we're continuing to hone in on the patient experience, getting their feedback on the actual experience and making sure that it's routing to the whether that call needs to go to a clinic or other avenues, but I think it'll continue to evolve as we continue to use this more and more.

- [Eric] Alrighty. Bill, any last words about what you wanna see happen in the future with this type of technology?

- [Bill] Yeah, I think definitely the evolving of different language and the evolving of the functions that you can use AI for and how it can be used for not only insurance verification, but just other things that it just takes a person to do. And hence a patient could be waiting and waiting and waiting and we don't want that, and we just want to make the patient experience better. So I'm really looking forward to where this technology can lead us and how it's gonna make it better for everybody in the process.

- [Eric] Okay. Thank you. Thank you Kara and Bill for a great presentation today. Excuse me. That's all the time we have for questions. And I wanna thank our presenters once again for an excellent presentation. I'd also like to thank our sponsor Optum, for making today's program possible. Finally, thank you to you and our audience for participating today. We hope you'll join us in the future for another Health Leaders webinar. This concludes today's presentation.