There is widespread agreement in healthcare that intelligent automation technology is key in bringing about better patient and member experiences. The challenge now is to overcome the hurdles to implementation.

Consumer expectations for better, faster customer service experiences are being defined by innovative leaders like retail giant Amazon with their automated yet highly interactive applications that can bypass human involvement. Witnessing the benefits and increasing acceptance among consumers, multiple industries are following suit, embracing things like natural language processing, digital assistants, and machine learning - the intelligent, automated solutions behind the well-favored digital tools such as chat bots, mobile apps, and virtual agents.

In healthcare, patient and member centricity are becoming the norm and implementing this kind of intelligent self service is turning out to be advantageous. The advanced technology can not only replace current models of patient/member administrative experiences for more personalized approaches, but it also shows promise for impacting preventive health measures with predictive analytics by leveraging the right data.

It is plain to see how these outcomes can lead to a greater competitive edge for healthcare companies leading the intelligent automation charge. Yet, putting this technology into practice is proving to be more complex. Thus, their implementation is taking longer than expected. Healthcare payer organizations poised with the right data infrastructure and in-depth planning experience a faster, more agile go-to-market for intelligent self service (ISS) technology.

Here we interview industry expert, SoftServe VP Healthcare John Edwards, to gain more insight as to how healthcare payers can utilize ISS to create better, more personalized member experiences, and how they can move more quickly to market with these solutions.

GP: Why is it important for healthcare payers to prioritize technology that enables intelligent self-service solutions?

JE: Meeting consumer expectations with a simple, convenient way for members to get answers to questions from one’s mobile device related to things like health plan coverage and claims payments is a great leap for the industry with the support of intelligent self service technology like robotic process automation (RPA) and artificial intelligence (AI). It is also a considerable time saver for both the member and the payer’s contact centers. Reduced call time with chat bots for quick administrative tasks opens the door to greater value from a payer’s contact center investment by saving human interactions for more thoughtful, complex member concerns.

Let us take this a step further. Imagine leveraging intelligent automation to learn more about the member with each interaction, and then develop a process that empowers your contact center team to respond appropriately with the right approach, the right information, and connect them to tailored health offerings, even offering to schedule their next appointment. By getting to know the member, being informed about their care team, and integrating both clinical and electronic health information exchange (HIE) data to form a 360-degree view, a payer can take on a more proactive role to support current and potential needs. This creates the opportunity to build a trust-based relationship that places the member’s needs at the center of the payer’s offerings.

GP: Why is it taking longer than expected for payers to implement this technology?

JE: Some companies struggle to realize the possibilities from their ISS technology implementation and unleashing the potential later in the process can be met with bottlenecks and delays from limited planning. Legacy technology can often be a barrier to implementing smart approaches to member service and unclear priorities as well as internal resistance to making changes – not disrupting the status quo - also create their own challenges as it is important for an aligned and unified front to implement large-scale technology solutions. The consumer driven, ‘always on’ paradigm is driving payers to reimagine how they engage members and intelligent self service is moving from ‘nice to have’ to critical priorities for payers looking to differentiate the member experience and reduce cost.

GP: Where should a payer start?

JE: A payer can start by examining current contact center call volumes, reasons for the calls, and the types of self-service solutions that are currently being deployed. A model for expected return by implementing additional types of self service should be developed and a plan should be created to monitor and celebrate successful implementation and adoption of these capabilities. This kind of planning should precede technical development and deployment which results in a clear business vision and expected value that will guide the overall implementation activities.

GP: Can you share some considerations to think about for payer-specific use cases?

JE: As you are deciding where to start with ISS technology – Robotic Process Automation (RPA) and Automated Intelligence (AI) - in your contact center, consider the following questions:

How can we better service our members and reduce the time of resolution for each call by automating time spent by associates who typically must enter multiple systems to gather information needed to answer the common types of questions?

Where can we increase the job satisfaction of our associates and reduce attrition by eliminating some of the repetitive tasks (range from 20%-80% of an associate’s time) and provide the associates with opportunities to add greater value?

Which processes are prone to errors (typically rates of error range from 2-4% in contact centers) where preventing these errors will improve the quality of services we offer and reduce rework costs?

What additional value can be delivered by our contact team by up leveling the capabilities and confidence of our associates and support them to offer distinct types of services?

RPA can be 3x-20x faster than an associate. Where can we find areas to speed up our service and streamline our associates’ work?

With an industry average of 75%, how can we increase first call resolution and eliminate callbacks reducing our total call volume?

Where can we increase self-service and containment of the call using RPA and Chat services?

Key to the success of implementing RPA and AI is assembling the right team to support your project. This technology requires a blended team of contact center associates, business analysts, technical engineers, project management, data scientists, and AI engineers. To get optimal impact also consider including strategy associates, customer experience associates, and change management professionals.

GP: Thank you for taking time out to share your insights with us, John.

If you want to learn more about how the HUMAN360º Healthcare Digital Experience Platform can move your healthcare organization forward, watch our in-depth overview of the platform’s capabilities in our on-demand recording, or request a demo.

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