Road to Conversational Messaging: Full Panel

Alright, Pam. How about you? We know a little bit about you already. So what made your organization you know, move to conversational messaging?

Yeah. I’m gonna be really, kinda open here. I was a little, skeptical at first. Because we had put so many resources into building a contact center that we built the ground up, and we hired around behaviors.

And when I listened to the calls that our agents are answering and the way they do it with such kindness and empathy…

There are times I get a little teary-eyed when I listened through some of them, when somebody says, don’t worry. I know you’re nervous about the surgery. They’re gonna take good care of you. They’re really good there. And when people say things like that to patients, I’m like, you know what, I don’t want to lose that human touch.

And I also thought none of our patients are saying, “I want conversational messaging.”

Nobody has ever said that to me. What they do say is “I just need information.” I just need to get something done quickly and easily.

So if I can give our agents more time to spend with the complex care and the complex navigation and appointment scheduling that they do and offload some of those routine things, but still maintain that kind of empathy around that messaging –That’s when I said, okay. Let’s go off and begin this work. Because I didn’t wanna lose the goodness of what we had built for efficiency’s sake only.

We needed to make sure that they both hit, those models that they really were delivering, great care with heart.

Abdalla, what made your organizational organization move to conversational patient communication? What instigated it?

Obviously, you know, patients are calling to schedule, and we’re doing automated reminders as well, and patients were calling to reschedule. So we wanted to give staff another outreach tool to contact the patient. So if the patient would text in, you know, from an appointment, saying “I want to reschedule,” the staff would initiate that conversation and try to leverage the tool to reschedule the appointment. Now, it didn’t work in every case.

So sometimes you do have to get on the phone. And then as we progressed, it kind of modulated into a referral outreach tool. So that’s really what it’s being leveraged for now.

Cool. Awesome. Thank you. Carrie?
So I’m Carrie Davis Hanger Clinic. We started off with conversational messaging because we were listening to patients. We’ve been listening to patients since 2017 through Net Promoter Score.

And what they’ve told us is it needs it’s gotta be easier to connect with us. And so when we found Artera, we just thought the conversational piece was extraordinary in connecting people quickly and easily to care. So, that’s why we came out the gate with it. We just thought they want it easier, and we wanna make it easier for them.

Abdalla, why did you start here and how did you measure success?

It was Vellaire’s idea initially – it was her vision with this.

So we started with this. We had primary care and specialty care. One of the specialties was a gastroenterology group. And we rolled them out in a small – it was not very big in terms of the quantity – number of clinics, just to kind of gauge, you know, what the water temperature would be with, how would the staff be leveraging the tool? In addition, all tying back to having this as an additional outreach tool for the patient and for the staff. To use to kinda leverage all that, their appointment reminders, patient questions, and referrals.

So we started with that group, and then we measured with we measured success. Obviously, phone volume — Okay. — was one that we kind of tried to focus on. And we didn’t really see a dip there.

However, specifically with the digestive group, they really, really drilled down and started leveraging the outreach for referrals. And they saw improvements in their metrics. Velaire touched on doing all that as well during her just when she was speaking just now with the rheumatology group as well. That was they used the outreach for referrals, and they saw their phone service go up, and they saw the referral conversion also go up.

Which in turn obviously improves patient satisfaction and staff. And helps with revenue.

Pam, your organization also did a pilot. Right? You had twenty practices, a controlled patient access Center was involved and if we showed her there we go, we see her car. And it was mostly for appointment scheduling.

That’s right. Yeah. And so the same question, why did you start there? And how did you measure success at your organization?

So we measured success through no-show rates, everything that everybody talked about in the previous panel. We did the same things, but the one thing that I think that gets often forgotten about, and I think it might be a little PTSD on my part, is, we used the platform for, appointment reminders around COVID vaccinations.

And I will tell you something in New Jersey – those of you from New York and New Jersey, we got hit hard, we got hit fast, and we suffered for a long time. And at Hackensack Meridian Health, we decided during COVID that we were gonna stand up 23 vaccination clinics across the state, and we delivered vaccinations to a million people.

There was no way we were going to be able to handle the inbound phone traffic for a million appointments. There just was no way, so we had to create this online solution, and we needed this texting solution to remind people about these appointments that they were so desperately looking for.

And so that’s that was when our aha moment was very early on. Doing the practices that all made sense, you know, as, you know, as people that work in the digital space, it’s intuitive. It makes sense to us all. But the aha moment was when we could deliver, good information, the right information at the right time, in a really scalable, critical way.

The reason we started in these different areas of our business, so our national contact center, eight seven seven four Hanger, it’s a toll-free line that patients can call. I’ve personally wanted to see if patients would text in. And I manage this team, And, so we started there just to see what kind of traction we’d get. In the patient care centers, we started there because we have You know, I don’t know about y’all, but, our office administrators have a very hard job.

They are the first person that, encounters our patients. Right, when they either walk through the door or they get on the phone, and we’re burning them out with the telephones. And so we wanted to not only give our patients a better experience and ease of access, but we wanted to make their jobs and their lives easier.

And then we also, put it into our other, department of financial counseling. So a lot of times, you know, we would require that our financial counselors would call a patient. And to everybody’s point, nobody answers the phone. It’s an eight five five phone number. Forget about it. I might even try to block it. Right?

But when we gave this tool to them, and they’re able to send a secure message introduce themselves as a human, attach an invoice to it, and say, would you like to have a conversation about your bill? If not, click here to pay. Like, not everybody wanted to have a conversation. So we were able to see, like, okay, we don’t have all our people on the phone counseling our patients, some people just wanna click and pay. And our click rate was just huge and the quantity that we were collecting the average went up, you know, so over the phone, we may collect, you know, two hundred dollars, and patients click to pay, and they may pay four hundred dollars.

So that’s why we started out there, just creating ease everywhere. And then the way we measure success, same, you know, decrease in no-shows, call volume. But we also did a survey with our office administrators.

Again, some of the most important people in our organization said, prior to launching the pilot, said, tell us about, you know, how the phone impacts your joy.

And, we went live in our pilot for ninety days, and we went back to those office administrators and said, tell us how Artera has impacted your life. And I found out last night, one of our office administrators printed out a bunch of “I Love Artera” signs because they were afraid that in the pilot, you know, this was just a testing ground, and we were gonna take it away if we couldn’t prove its value. So he posts all these pictures of I Love Artera. I sent it to Artera reps, and it went viral in Artera.

I heard. Yeah. I’m sure you, Artera people have seen it. That’s Lucas Shaw. Anyway, but we asked them “did this improve your lives and your job?” and overwhelmingly, they said yes.

So that’s how we measured.

From the rollouts and all the go-lives, I have probably three takeaways: The first one is having a streamlined process to get users into the platform which would tie into the training. So once they complete the learning module online, making sure that the users know This is not something you access through Epic. This requires you to access it through a browser and making sure they know how to submit that request to our ISD team.

The second takeaway, I would, in addition to obviously having resources and stuff, you know, folks to click on and learn. The second takeaway is in terms of the rollouts, So if you’re currently using Artera just for automations and you’re just firing off reminders and no one’s in the platform, There’s a big difference once users get in the platform. So once actual end users are in the platform, that’s when general tickets are gonna start generating. That they may not understand something that may think something is wrong in the platform or resources assigned incorrectly.

So where do those tickets go? They go to your ISD team or your IT team. So you gotta make sure they’re dialed in and looped in, you know, ensure that they’re aware that these go-lives are coming.

And the third item is – It may be a large ask – but I know if I have a clinic reach out to me directly and they want a more hands-on approach, I take it upon myself and I’ll meet with them one on one and walk them through the platform myself and show them, you know, how you can really leverage this And this is after the go lives. We’ll still have groups reach out. You know, they just wanna understand it better.

So, yeah, make sure Users know how to access it and log in. That’s number one. And then number two, have your IT support team who’s here today, and I thank you guys very much for all the work you do dialed in. And then the third item would be, like, a hands-on approach.

Like, if you have the capacity to do that. And then it’ll pick up steam. So right now, we have thirty two at the end of the month. We’ll have, like, forty seven, and then there. So by the end of the year, I’ll have a hundred and fifty practices, across a multitude of specialties, all primary care women’s health, primary pediatrics, ortho-neuro, urology, urology is complete right now.

But what we did is we took it a little bit differently. It’s not just about using the carer program. When we bring you in, we bring you into the pack and our patient access center, but we also say, and now you’re on patient texting, and now you’re on online appointment scheduling, including like our oncology department does online. And so we’re not saying Oh, here’s just this one piece. We’re saying we’re gonna look at your entire Access Center.

And access points, whether it’s through text, through email, through the web, through the phones. And so we bring all of that up together. So it takes us a little bit longer but we do it’s one change for the practice, one change for the division, one change. So it’s for us easier to manage.

Our governance around that is, I said earlier, we go to an executive strategy council. They’ve blessed the strategy.

And all the stakeholders are there. But I actually work with a real group of dedicated and talented people from our medical group who are, you know, side by side. I’ve got clinical leader side by side who sit down with us and say, this is how we’re gonna put all the pieces together and how they set the priorities. So for instance, our orthopedics practice came to us and said, we’re bombarded, our whole division.

And we’re like, well, we can help, but to help, we need you to do visit type standardization, template redesign, online appointment scheduling. How many of you are like, oh, I feel that pain. That’s like, yeah. I can hear it.

They’re like, oh, you mean one appointment type for all new net new patients? Well, yes, yes, I do mean that. And, so, so that’s the kind of work that we do. So it takes a little bit longer, but we bring up the full package at once.

Yeah. We learned the importance of training and, connecting people on the platform with other people so that they could learn from each other. That was a big learning. We just went live with a hundred and seven offices today.

Great timing. Oh.

Yeah.

We have nine hundred, and we have a very aggressive and optimistic, twelve-month rollout, but my team’s group has been just going bananas today, with questions. But it’s great because they are all now connecting together and figuring out and talking about the best ways to optimize. And so, but for us, we really learned how important training was.

And what we did recently is I filmed a video with our senior leadership team. And, you know, we’re dealing with a lot of change management. Right? Yep.

We have a new CEO. We have a new president. We have a new thing. In our era that we’re asking people to do. And some people think what’s just another thing you’re asking us to do. But what we did with our senior leadership team in this video that I interviewed them. We defined, okay, what is Artera?

Why are we asking you to do it? How is it going to impact your job, and how does it align with our strategy?

And so when we spell those things out from the senior leadership team, in direct, you know, video eye contact to the office administrators, they can digest that and then go, okay. And part of it was we listened to you, and you told us you hate the phones. So we’re gonna do something for you. So it’s not just, you know, only about patients.

It’s also about you. And, then I did a video with some of our pilot users and Those happy people. Those happy people. I picked the happiest and, got them on a video too, and, you know, ask them questions like, how did this impact your job?

Were you scared at first? You know, and so then those so that’s the first training module that our new users see. It’s like your senior leaders support you, your colleagues, have done it. They love it.

Welcome aboard. And I think that that has been very helpful and something that we learned out the gate months.

Like I said, it’s not a roadblock, but it was a challenge – bringing the voice of the office administrator to our senior leadership team, and saying ‘they love it.’ Our patients love it and we showed some conversations.

We were talking about this at dinner last night you know, to the point, like, can you do you feel empathy through a texting platform? Do you we had this one patient, and I love to go in – I’m just a voyeur. I’m just looking at conversations all the time.

Yeah. And, this one patient, he’s like, I just, and this was around Christmas time. He’s just like, “Merry Christmas to you all. I just am so grateful that you’ve you know, shown me so much love and compassion, and he really changed my life.”

Right? He texts this in.

And So our office administrator, oh, you know, mister so and so, we so appreciate you as our patient. We think of you as family. You have a happy holiday. His response, oh my gosh.

I didn’t know actually people responded to these. Like, there was a person behind. Yeah. Like, he was just so grateful.

He just thought he was texting in ether, you know, just my gratitude.

And then when he found somebody was, like, on the other side, you know, I could just, like, you, I just could feel it. And I was just like, wow, this is, this is pretty great. So we shared those examples with our senior leadership team too. That’s nice.

I’m gonna steal that one. Yeah. Take it. Alright. Yep. Pam, how about you? What about roadblocks or less than So, actually, I don’t think that we experience so much roadblocks as, just getting organized around the work and who you have to have involved from your internal teams.

That was really because once we identified who for my, you know, who from IT needs to be involved, who from the consumer experience team needs to be involved, and who from our physician groups need to be involved.

Once we identified that and got organized around the work, we kind of got in place. But here’s what the learning that I that came out of that. One, it wasn’t that we had roadblocks, but I really appealed to we’re not taking away from something you’re doing. Mhmm.

And we’re not adding more work. What we’re doing is we’re making things better for our patients. And I appeal to their sense of that’s what they all want. That’s what the people that we work with, our colleagues, they just wanna do what’s right for So I try to appeal to their inner angels and just say, this is this is gonna be good stuff.

I found from the IT folks though, They really like working on this kind of stuff because it’s modern, relevant, and contemporary technology.

That excites them. More than some of the stuff that they have to deal with, like, you know, I don’t know. I don’t know. Does anybody still work on UNX?

I don’t know. But that’s who I am. You know, that, oh, it’s just another, you know, I, I, I need to turn out another report in Tableau or BI, but this is something that’s like, oh, This is something that patients actually want, use, and need, and it’s new technology. Let’s get in on it.

And they wanna participate.

Are you mixing it, or is it all staff that are answering these things? And We’re definitely mixed at UNC. So, like, our appointment reminders trigger from automation. So does some of our referral outreach However, we still leverage referral outreach for conversational.

But it’s definitely mixed, I would say.

the line share is automation, and we try to trend as an organization towards automation to, you know, lessen the workload on the staff. So Other because, yeah, I think we are, we’re a mix for sure. And if you look at our car down there, the things that we are thinking about next, it’s going to be a mix.

Still, I think there’s a great balance to, to be had with AI and with human.

So I I don’t think that we should scale back on one and tip the scales towards the other. It it feels so natural you know, inside the platform, and I know efficiency is really important, but our people want to connect with people too in this way. So I don’t wanna take that away from them, you know, to, to push more AI. The, the human element is so important, and it it’s really tender when you look at the conversation.

But what about the fact that that human element are people that are used to doing it on the phone and how do I convert them to the now. That’s the other question I get. I get that a lot. And I bet you others in the audience are going, yep, that’s what we want to figure out.

What about that? So we’ve done a couple of things on that one. First of all, we have built some scripts for the agents to be able to use as templates. To to be able to do that.

And so we’ve built some scripts. That’s been helpful. We’ve actually invested in some extra training for some of them to be able to do that. But we’ve also put them through a skills based test to make sure that they can do this work.

It’s not, you know, some people are great on the phone, but, you know, doing the written word is just a whole different ball game. And so we test them and see, you know, what? You’re really good here. But we’re gonna have other people who maybe are gonna be better, in the conversational work.

A little bit better. And so we do it that way.

Skills based testing, extra training, some scripting, And we have a QA department that does listening to, you know, when we say this call is being recorded, we’re recording everything but not only recording the call or the conversational text, we’re recording the screens. And so that we can see what happened where things were going awry.

Like, oh, she didn’t know to click on that. Tab, that would have given her the answer. So let’s go back and give her some new education and some training around that one. So we do a lot of that with all of our agents. Those are really great insights. Mhmm. Really great insights.

As you got to stop three in this whole journey or as you’ve evolved with expansion and so forth, Did you get any additional value that you haven’t mentioned yet? Any other kind of outcomes that, as you’ve gotten Yeah. We’ve seen, instances of patients able to convert their in, in person appointment to a virtual.

There was one instance that comes to mind was an oncology patient. Their car broke down, or they had something going on with their vehicle.

And they text in the clinic, I’m not gonna be able to make it to my appointment. My car broke down, and the staff responded, okay, do you wanna convert this to a virtual appointment? And they’re able to still be seen. Right.

Yeah. So there’s like, you know, little bright spots like that. We’re anticipating a ton of value you know, again, we had twenty nine offices. We’ve got one hundred and seven going live today.

But we when we worked with our sales, agent, Kevin, and when we got with Lauren and Reed, we were just like, we are gonna suck everything out of this platform than we possibly can, and we’re gonna look at all kinds of ways we can use it. We’re gonna be launching a program around discharges for, patients from one of our hospitals to see if we can reduce readmission rates and using conversationally, and we’re doing it at the end of the month. And, we sat down with our clinicians, and they walked us through what the script, you know, over a period, these, a series of texts over a period of thirty days, what would they would look like?

And when it kicks over, then, over to the clinician, when the clinician needs to nervine. Otherwise, they keep going through that. I’ll be really interested in that because in the end, that’s the holy grail. Can I help somebody using technology get better and stay better?

That’s right. And that’s, you know, that’s the one where I think that if we prove this one out, we could take throughout the whole house. But can we really find out easily, you know, Did they re did they schedule with their PCP? What is their pain level like?

Do they need help getting their prescriptions filled? How many of us in our clinicians struggle with that when our patients are discharged?

Also really curious to learn You know, everybody talks about content, you know, like, woah, we’re we set them home with that big folder full of content of all the line drawings and how you’re supposed to clean your wound and stuff. And I’m like, does anybody ever does this stuff work? If we if we add content to these things, does it work. Mhmm.

Does it make a difference? I don’t know. And so I’ll be really interested in the next iteration to figure out that next piece. That’s where we’re gonna go.

How are we using it to, improve the care?

We have a few use cases that are new that came in, One was specifically around using conversational messaging, to prevent patients presenting themselves to the ED, that that was brand new that just came in.

And we are currently also using it and expanding it. For I’m sure all of you are familiar with this, the No surprises Act, no surprises billing. So the patient, you know, needs to know upfront about their bill.

We’re using that tool.

We have an automation that fires to the patient, letting them know that they have an estimate created.

But the patient access team is in the platform itself interacting with the patients back and forth. And that was a small I think it was it was a very centralized approach. Now they’re expanding that. Now the scope of that, I’m not sure, but that’s the two main pieces that come to mind off the top of my head.

We’re going to continue our rollout in the next twelve months. And really, we were focused and have been focused on the administrative element of it.

And then we are moving eventually into adding the clinicians. Like, right now, the office administrators, we’ve gotta get them to it. And so we’ve had patients that will send photos or, you know, of a wound and say, is this normal?

And, and then they can take that to the clinician, but we want to move to the place where we just at mentioned the clinician and the clinician can pop into the conversation. And that way, we don’t have to have our patients download an app to send a message to their clinician. It’ll just go right to the office, get, you know, sent to the clinician.

And just keeping it simple. That’s what we wanna do. Perfect. Perfect.

So, I’m really focused on making it easier to access care. And besides the continuing of our rollout to all our by the end of twenty twenty four, we should be done.

But, also, I really we’ve started to use it around. We did a test a few months ago. I was like, why aren’t we using this for? Because we sent out four hundred texts to patients who were due for colonoscopy.

Mhmm.

And forty people called and made appointments.

And four people found out that they had cancer.

And as hard as it is to, you know, for those four folks, it is encouraging that it was a simple text that got them into care and got them into care early.

And so we’ve and so I’ve said, that’s it. Every care gap goes in here. Reminding people because we all know people delayed care for two and a half years.

Every mammogram, every annual physical, every single colonoscopy. But so for instance, we went live with mammograms last week, And the beauty of that is I have online scheduling for all screening mammograms at all eight of our sites that do it. So not only they don’t have to call like they did for the colonoscopy.

Nope. You can you are due. Click here. Pick a slot, we’ll get you in. You’re confirmed. And you stay in that experience.

And so that’s why I’m looking at So now primary care will be complete this afternoon with all our primary care sites. So I’m like, all annual medic Medicare visits for those sites automatic text campaigns go out and say, you’re due. Schedule now. Here’s the link.

And that’s the kind of thing that I’m really focused on.

Getting people into care.