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Overcoming Overutilization of Poorly Defined Healthcare Messaging Systems

Shahid N. Shah
November 29, 2017
130

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

Shahid N. Shah

November 29, 2017
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  1. www.netspective.com
    © 2017 Netspective. All Rights Reserved.
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    OVERCOMING HEALTHCARE
    MESSAGING OVER-
    UTILIZATION HURDLES
    By Shahid N. Shah, Publisher, Netspective Media
    This Photo by Unknown Author is licensed under CC BY

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    WHY ARE WE
    MESSAGING?
    CONVERSATIONS MATTER
    OUTCOMES
    PRODUCTIVITY
    COMPLIANCE
    COSTS

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    WHO CARES ABOUT
    MESSAGING?
    PATIENTS
    HEALTH
    SYSTEMS
    PAYERS &
    INSURERS
    REGULATORS
    CARE
    PROFESSIONALS
    PATIENT’S
    CAREGIVERS
    THOSE THAT DON’T WORRY ABOUT UNCOMPENSATED CARE

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    There are no business
    models to do the “right
    thing” in healthcare.
    MESSAGING CREATES SIGNIFICANT OPPORTUNITY
    FOR UNCOMPENSATED CARE

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    Does messaging create
    “interruptions at scale”?
    MESSAGING CREATES SIGNIFICANT OPPORTUNITY
    FOR INCREASED UNNECESSARY INTERRUPTIONS
    IF NOT PROPERLY DESIGNED FOR WORKFLOWS

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    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.

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    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.

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    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. ☺

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    How do we create
    augmented intelligence
    messaging focused on
    what matters most to
    patients and caregivers?

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    How do we keep
    augmented intelligence in
    messaging out of the
    regulated space?

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    Insurer | Payer
    Insurance
    Product 1
    Insurance
    Product 2
    Provider 2
    Provider 1
    Health Systems
    “Institution First” Messaging

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    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.

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    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

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    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

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    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

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    DOES INCREASING
    MESSAGING
    TRANSPARENCY YIELD
    HIGHER QUALITY?

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    How can we help
    implement CMS’s new
    “Patients Over Paperwork”
    and “Meaningful Measures”
    initiatives?

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    THANK YOU
    Shahid N. Shah, Publisher, Netspective Media
    [email protected] @ShahidNShah
    OVERCOMING HEALTHCARE
    MESSAGING OVER-
    UTILIZATION HURDLES
    This Photo by Unknown Author is licensed under CC BY

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