Digitizing and Transforming the Patient Engagement ...montana.himsschapter.org/sites/himsschapter/files... · Developing insights from non-enterprise data and patient data Address

Bill Hughes, Associate VPSutherland Healthcare

Digitizing and Transforming thePatient Engagement Experience from an RCM and Access Perspective

2

AGENDA Topics and Concepts to Be Discussed

Evolution of Patient Engagement

Mass/Hyper Personalization

Propensity to Pay Analytics and an AI Driven Revenue Collection Ecosystem

Chatbots

Omnichannel

Future State – Healthcare Avatars

©2017 Sutherland, Inc. Confidential

\\ Sutherland Inc, Confidential3

Who We Are

1982FoundedHeadquartered

in New Jersey

75+ClientsAcross Healthcare

Continuum

Top

100Healthcare IT

Vendor by HCI

“Leader”

“High Performer”

“Major Contender”

Rankings by Everest,

Gartner, HfS

75%Revenues

Shared Risk-

Reward Contracts

URACAccredited

- Credentials

Verification

$150MIn Revenue

91+%Customer

Satisfaction

Score

28MAnnual Payer

Transactions

3.3MAnnual Provider

Credentialing &

Database

Updates

5,000Dedicated

Healthcare

Employees

$50B+Net Patient

Revenue of

Our Hospital

Clients

250KAnnual

Customer

Contact Center

Transactions

32K+Staffed Beds

Managed By

Our Hospital

Clients

15+Global

Healthcare

Delivery

Centers

9.5M+Annual

Charts Coded

800+Coders at

Sutherland

30KAnnual EHR

Installations

and Upgrades

MARKET OBSERVATIONS

Smarter customer engagement demands an understanding of every customer.

With a more effective wayto engage with them.

Yesterday - Limited Digital Access and Options and Enterprise Data (portal access)

Today - HCO Driven AI Engagement with Closed Cloud (multichannel access)

Tomorrow - Patient AI Driven Orchestration with Open Cloud (omnichannel and collaborative)

Patient Engagement Evolution

Ask, Discover, and Use your Organizations Stated ‘Digital Playbook’

• Digital Playbook Concept

• Key Questions• How outcome driven is your tech solution

• Capabilities and qualifications

• Viability – stakeholder engagement and strategic initiatives

• Feasibility – are API’s and required platforms available or do you need an RPA or Cloud strategy

• Other challenges to maximizing ROI• What to do when you prior investments have gone sideways

• How to salvage a bad decision


Digital Playbook

Technology Problem Impact

Expanding Data

Sources

Developing insights from non-enterprise data

and patient data

Address referral leakage and improve

care coordination

Propensity to Pay

Analytics

Increasing importance of self-pay collections

and maximizing collections

Improve collections and timeliness

Mass/Extreme

Personalization

Poor consumer engagement and market

reputation

Impact patient and staff behavior

Chatbots Administrative staff turnover and excessive wait

times for answering patient calls

Automate administrative tasks and

improve turn around time

Omnichannel Uncoordinated outreach, poor user experiences,

and lack of engagement modalities

Market perception and patient loyalty

Social Media

Monitoring

Poor market perception, especially for the

digitally connected

Improve market perception and early

intervention

Avatars Changing poor patient behaviors Improve collections, stickiness and

change behavior

RPA Staff turnover and high administrative costs Automate repetitive tasks and streamline

operations\\ Sutherland Inc, Confidential8

Pushing healthcare into a new level of Consumerism

In Pursuit of Retail (Happiness)

9©2017 Sutherland, Inc. Confidential

Extreme Personalization

Mass personalization

technologies once only

available to large

companies, e.g.,

Amazon, Google, etc.,

are now becoming

available at the

enterprise level!

Analytical Insights

Customer Profile – 360°view

Interaction Details

CEM solution to address

- Scheduling

- Referrals

- Consumer experience

Next Best Actions recommended from analytics

Seamless integration with case management - Data

and front end integration

Customizable and configurable for specific

healthcare organization specific sscenarios

11

The Petco Story: Example of Inbound Interaction

User

name

13

Extreme Personalized Patient Engagement


Social Media

Monitoring

Patient Responsibility

Management and

Collections

Unified Patient Access

Model

Care Coordination

Management

Phone Call, Text

Message, e-

mail, Portal,

App, Chat,

Social Media

NLP Engine

Text Analytics

Knowledge/Rules

Engine

Historical Data

360 View and

Unified Desktop

Omnichannel

Outreach

Use Case User Modalities Digital EcosystemEngagement

Solution

AI and ML

Personalizing your Patient Responsibility Collection Strategy

Digital Initiatives in the Market Place

14©2017 Sutherland, Inc. Confidential


Problem: People have different abilities and personal approaches to healthcare payments

Digital enablement promotes: Creation of different collections strategies and technologies based on capabilities and preferences

16

Propensity to Pay Analytics


Analytics


Predictive Analytics Driven Segmentation

Lo

w

ScoreLow High

Hig

hB

ala

nc

e

18

Predictive Analytics Driven Segmentation

Lo

w

ScoreLow High

Hig

hB

ala

nc

e

1.What is the target collection

amount when you touch the

patient?

2.What is the best payment plan that

is doable by the patient, but also

supports the collection process?

19

Financial Decision Support Grid Healthcare Organizations Rules and Policies


Patient

Category

Account

Balance

Target

Initial

Payment

Payment

Duration for

Balance

Avatar

Max

Duration

Other

Motivated <1,000 50% 6 months 12 months

Motivated >1,000 25% 12 months 18 months

Motivated >10,000 20% 18 months 24 months Representative Option

Gentle Nudge <1,000 40% 9 months 12 months

Gentle Nudge >1,000 25% 12 months 18 months

Gentle Nudge >10,000 20% 24 months 24 months Representative Option

Pulling Teeth <1,000 75% 3 months 12 months

Pulling Teeth >1,000 25% 12 months 18 months

Pulling Teeth >10,000 20% 18 months 24 months Suggest meeting with Representative

High Risk <250 100% 6 months 36 months

High Risk >250 Suggest meeting with a Patient

Representative and Support Services

20



Patient

Category

Account

Balance

Target

Initial

Payment

Payment

Duration for

Balance

Avatar

Max

Duration

Other













21



Patient

Category

Account

Balance

Target

Initial

Payment

Payment

Duration for

Balance

Avatar

Max

Duration

Other













22



Patient

Category

Account

Balance

Target

Initial

Payment

Payment

Duration for

Balance

Avatar

Max

Duration

Other













a

a

a

Digital Ecosystem

a

a

a

a

Digital Ecosystem

Chatbots = Automating customer happiness

AI has moved well beyond our home and into our work.

of customers now prefer bots for quick communication w/ brands.

of customer interactions can be resolved by bots.

80%69%Potential salary cost savings that bots could deliver .

$65Bof enterprises will spend more on bots than mobile dev by 2021.

50%

For the enterprise, conversational AI tech has begun impacting most functions

● More efficient engagement

● Market differentiation

● Improves patient loyalty

RCM“Conversational Marketing”

● Better Customer Experience

● Faster engagement resolution

● Lower cost for operations

Ops & Support“Conversational Support”

● Higher candidate engagement

● Faster candidate screening

● Brand differentiation

HR“Conversational Recruiting”

http://spotify-dev.suth.digital/






However, as companies begin to embrace AI - and specifically digital assistant solutions - they also face an increasingly complex ecosystem of solution providers.

Chatbot solution lifecycle - example.

End-to-End Solution & Service

1Live Transcripts

2Chat Analyzer

3Bot Flows

4Conversational

Design

5Chatbot Engine

6NLP Chatbot

Start the process with data gathering to scrub through all your customer data and touchpoints

Run chat-analysis algorithms to understand most common topics and opportunities.

Build out flows for each of the high-value use cases leveraging ML.

Develops scripts that align with brand tone and desired business outcomes.

Layer script and branded UI on top of NLP and additional enterprise integrations required for your particular business case.

Deploy, operate, optimize, and iterate on this process.

Examples of Chatbot Success Stories

Internal HR300K+/yr Candidates

100K+/yr apps automated

Support100K+/yr cases resolved

$600K+ savings/year to Sony

Sales Qualification180K leads/year automated

28% conversion gain

Fantasy SportsOver 60K sessions / day at peak

24% contact deflection




Case Study: Chatbot Solutions reduced live contact volume annually by 36%

for Sony PlayStation Vue

Results: 180K Customers Served via Automation

CASE STUDY

Supporting Sony Playstation Vue subscriber growthKPIs affected by automation

● 36% live chat deflection rate

● Approx. $630K saved annually

● Consistent CSAT levels before and after chatbot

● Total of 180K customers serviced via the Vue chatbot

Live Production Link

https://support.us.playstation.com/articles/en_US/KC_Article/PlayStation-Vue-Support

CustomersCustomer

Care

AI-Enabled Chat Deployment Model

Website

Sutherland Chatbot

Chat

Voice Knowledge Base

CRM

Page 33 | Sutherland, Inc. Confidential | Digital Transformation

Salesforce Integration (Live Agent)

34 \\ Sutherland Inc, Confidential

http://www.youtube.com/watch?v=Vj1WrWmKw9o

● Manages session + resume handling

● Manages API calls & security handling

● Stores custom application logic (rules,

lead scoring, workflow management) &

admin tools

Custom Middleware Layer

● Brand-ready integration

● Mobile-optimized

● Flexible deployment and activation

behavior


● Integrated hosting included

● Supports Github for version control

● Python-based

● Analyzes for customer intent

● Supports over 30+ languages

● Machine-learning powered

Bot framework & IDE platform

Natural Language Processing engine

Omnichannel message delivery/distribution

Website/Mobile App

TLS

/SS

L

Analytics/Reporting

● Powers HTML web messenger widget

● Connects to major social networks,

including Facebook, Twitter, Slack, etc.

● Integrates with Zendesk, Stripe, etc.

● Optional telephony and SMS

connectivity through Twilio or other 3rd

party service

Engagement Chatbot

AWS Cloud Channels

● Supports major platforms, including

Google Analytics, Mixpanel, Adobe

Analytics/Omniture, etc.

Reference Architecture - example

● Manages session + resume handling

● Manages API calls & security handling

● Stores custom application logic (rules,

lead scoring, workflow management) &

admin tools

Custom Middleware Layer

● Brand-ready integration

● Mobile-optimized

● Flexible deployment and activation

behavior


● Integrated hosting included

● Supports Github for version control

● Python-based

● Analyzes for customer intent

● Supports over 30+ languages

● Machine-learning powered

Bot framework & IDE platform

Natural Language Processing engine

Omnichannel message delivery/distribution

Website/Mobile App

TLS

/SS

L

Analytics/Reporting

● Powers HTML web messenger widget

● Connects to major social networks,

including Facebook, Twitter, Slack, etc.

● Integrates with Zendesk, Stripe, etc.

● Optional telephony and SMS

connectivity through Twilio or other 3rd

party service

Engagement Chatbot

AWS Cloud Channels

● Supports major platforms, including

Google Analytics, Mixpanel, Adobe

Analytics/Omniture, etc.

Reference Architecture - example

Use Cases:

• Find a provider

• Schedule an appointment

• Cancel an appointment

• Reschedule an appointment

• How much will this procedure

cost

• How busy is the ED/Urgent

Clinic right now

• Can I pay just part of my bill

• What are the visiting hours

• Where do I park

• Is this procedure covered by my

insurance

• Can I bring my pet

• …

Omnichannel emergesinto Healthcare

Virtual Assistant Digital Ecosystem

SO

UR

CE

DA

TA

Omnichannel

Social

Biometric

Clinical

Claims

Pharmacy

Ambulatory

Economic

Content

Action & Rules

Engine

User

Experience

Personalization

Integrated

Data Hub

Design Thinking

Agents

Text

Email

Social

Portal

Visualizing Payment AvatarsA day in the life

41

Virtual Assistant Concept Demos


Example Capabilities of Virtual Assistants

• Update Personal Info

• Request an Appointment

• Manage My Account

• Make a Payment

• Find a Provider

• Cost Estimator

• Clinical Summary

• Wellness Avatar

• Ask a Question?

• Directions

Questions?

How will you give your customersa better experience?

Contact Information

Bill Hughes

Assistant Vice President, Digital Portfolio

Sutherland Healthcare

Phone: (206) 849-2715

Email: [email protected]

mailto:[email protected]

Documents

Digitizing and Transforming the Patient Engagement ...montana.himsschapter.org/sites/himsschapter/files... · Developing insights from non-enterprise data and patient data Address