Overcoming Overutilization of Poorly Defined Healthcare Messaging Systems

3962189473d062fdc76ce9a07cbe89fd?s=47 Shahid N. Shah
November 29, 2017
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Overcoming Overutilization of Poorly Defined Healthcare Messaging Systems

The ultimate goals of healthcare messaging systems should be to increase patient education, answer questions in a timely manner, improve patient outcomes, reduce patients’ administrative burdens, and increase staff productivity by allowing staff to focus on communicating with the neediest patients.

The unintended results of many healthcare messaging systems have, unfortunately, been to accidentally increase staff workloads and reduce productivity for some because patients often chat more with staff willing to message with them.

The good news is that there are machine learning (ML) techniques available to allow machine responses with auto-triage and auto-escalation and simulate human responses so that some or many patient and staff communiques can be answered via chatbots and passing some or many messages to humans only when necessary. Join Shahid Shah, who’s built many healthcare chatbots and messaging systems, lead an interactive session on what works and what doesn’t.”

A summary of the event and a couple of highlights of my talk were covered by Andy Oram at http://bit.ly/2AaG9Fl

3962189473d062fdc76ce9a07cbe89fd?s=128

Shahid N. Shah

November 29, 2017
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  1. www.netspective.com © 2017 Netspective. All Rights Reserved. 1 OVERCOMING HEALTHCARE

    MESSAGING OVER- UTILIZATION HURDLES By Shahid N. Shah, Publisher, Netspective Media This Photo by Unknown Author is licensed under CC BY
  2. www.netspective.com © 2017 Netspective. All Rights Reserved. 3

  3. www.netspective.com © 2017 Netspective. All Rights Reserved. 4 WHY ARE

    WE MESSAGING? CONVERSATIONS MATTER OUTCOMES PRODUCTIVITY COMPLIANCE COSTS
  4. www.netspective.com © 2017 Netspective. All Rights Reserved. 5 WHO CARES

    ABOUT MESSAGING? PATIENTS HEALTH SYSTEMS PAYERS & INSURERS REGULATORS CARE PROFESSIONALS PATIENT’S CAREGIVERS THOSE THAT DON’T WORRY ABOUT UNCOMPENSATED CARE
  5. www.netspective.com © 2017 Netspective. All Rights Reserved. 6 There are

    no business models to do the “right thing” in healthcare. MESSAGING CREATES SIGNIFICANT OPPORTUNITY FOR UNCOMPENSATED CARE
  6. www.netspective.com © 2017 Netspective. All Rights Reserved. 7 Does messaging

    create “interruptions at scale”? MESSAGING CREATES SIGNIFICANT OPPORTUNITY FOR INCREASED UNNECESSARY INTERRUPTIONS IF NOT PROPERLY DESIGNED FOR WORKFLOWS
  7. www.netspective.com © 2017 Netspective. All Rights Reserved. 8 The ultimate

    goals of healthcare messaging systems should be to increase patient education, answer questions in a timely manner, improve patient outcomes, reduce patients’ administrative burdens, and increase staff productivity by allowing staff to focus on communicating with the neediest patients.
  8. www.netspective.com © 2017 Netspective. All Rights Reserved. 9 The unintended

    consequences of some healthcare messaging systems have, unfortunately, been to accidentally increase staff workloads and reduce productivity for some because patients often chat more with staff willing to message with them.
  9. www.netspective.com © 2017 Netspective. All Rights Reserved. 10 We should

    fear patient over- utilization of messaging when human health professionals are the only ones providing services. We need some fake humans (“chatbots”) in the middle. ☺
  10. www.netspective.com © 2017 Netspective. All Rights Reserved. 11 How do

    we create augmented intelligence messaging focused on what matters most to patients and caregivers?
  11. www.netspective.com © 2017 Netspective. All Rights Reserved. 12 How do

    we keep augmented intelligence in messaging out of the regulated space?
  12. www.netspective.com © 2017 Netspective. All Rights Reserved. 13 Insurer |

    Payer Insurance Product 1 Insurance Product 2 Provider 2 Provider 1 Health Systems “Institution First” Messaging
  13. www.netspective.com © 2017 Netspective. All Rights Reserved. 14 How do

    we move from “institution first” to “patient first” or “patient centered” messaging? Hint: it’s not about patient engagement. It’s about outcomes.
  14. www.netspective.com © 2017 Netspective. All Rights Reserved. 15 Seema Verma

    Administrator Last week, CMS announced our new initiative “Patients Over Paperwork” to address regulatory burden. This is an effort to go through all of our regulations to reduce burden. Because when burdensome regulations no longer advance the goal of patients first, we must improve or eliminate them. … We’re revising current quality measures across all programs to ensure that measure sets are streamlined, outcomes-based, and meaningful to doctors and patients. This includes a review of the Hospital Star Rating program. And, we’re announcing today our new comprehensive initiative, "Meaningful Measures.” … “Meaningful Measures” takes a new approach to quality measures to reduce the burden of reporting on all providers…Meaningful Measures will involve only assessing those core issues that are the most vital to providing high-quality care and improving patient outcomes. … It’s better to focus on achieving results, as opposed to having CMS try to micromanage and measure processes. This will help two things: • Help address high impact measurement areas that safeguard public health. • Help promote more focused quality measure development towards outcomes that are meaningful to patients, families and their providers. “ ” SPEECH: Remarks by Administrator Seema Verma at the Health Care Payment Learning and Action Network (LAN) Fall Summit (As prepared for delivery - October 30, 2017) https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-10-30.html
  15. www.netspective.com © 2017 Netspective. All Rights Reserved. 16 There are

    enough chatbot engines and development tools (e.g. Microsoft, Facebook, Google) COMPLETE ENTIRE TRANSACTIONS DIGITALLY, NOT PARTIAL The patient to staff model will not scale – we need patient to machine to staff model. PERFECT THE PATIENT to MACHINE to STAFF INTERACTIONS What messaging measure will matter most for patient outcomes? MUST be OUTCOMES FOCUSED, not PROCESS CENTRIC AI and ML Drivers Focusing on better metrics and measure will drive AI & ML
  16. www.netspective.com © 2017 Netspective. All Rights Reserved. 17 Patients have

    no today in what’s targeted through messaging, how will we setup that feedback loop? HOW DO WE KNOW WHAT MATTERS TO PATIENTS and CAREGIVERS? VALIDATED “PROMS” (PATIENT REPORTED OUTCOMES MEASURES) What kind of telemetry and continuous learning can we put into place to know which are useful vs. not? How do we measure staff productivity through messaging? HOW DO WE KNOW IF WE ARE USING MESSAGING PROPERLY? Healthcare outcomes are notoriously difficult to determine, do we not measure process at all? WHO DETERMINES OUTCOMES FOCUSED vs. PROCESS CENTRIC? USE SAME APPROACH AS PROMS DEVELOPERS AI & ML Challenges Patient-centric and outcomes-focused easier said than done
  17. www.netspective.com © 2017 Netspective. All Rights Reserved. 18

  18. www.netspective.com © 2017 Netspective. All Rights Reserved. 19

  19. www.netspective.com © 2017 Netspective. All Rights Reserved. 20

  20. www.netspective.com © 2017 Netspective. All Rights Reserved. 21

  21. www.netspective.com © 2017 Netspective. All Rights Reserved. 22 DOES INCREASING

    MESSAGING TRANSPARENCY YIELD HIGHER QUALITY?
  22. www.netspective.com © 2017 Netspective. All Rights Reserved. 23 How can

    we help implement CMS’s new “Patients Over Paperwork” and “Meaningful Measures” initiatives?
  23. www.netspective.com © 2017 Netspective. All Rights Reserved. 24 THANK YOU

    Shahid N. Shah, Publisher, Netspective Media shahid@shah.org @ShahidNShah OVERCOMING HEALTHCARE MESSAGING OVER- UTILIZATION HURDLES This Photo by Unknown Author is licensed under CC BY