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Five ways AI can provide better patient experiences in healthcare
by Jason Ronczka

Tech journalists and market analysts are obsessed with how artificial intelligence will revolutionize healthcare in the years to come. Their enthusiasm is justified – there are many incredible breakthroughs happening in the field every month. Whether it’s robot doctors performing surgery or programs identifying chronic diseases before they fully manifest, the future of healthcare is a bright and exciting one.

These innovations seem like science fiction playing out in reality, but it will be many years before such technologies reach mainstream potential. The first broad usage of artificial intelligence in healthcare will be more subtle. It will center around providing great customer service for patients while reducing costs for providers and payers.

Here, we reveal five improvements that AI can assist with right now to create better patient experiences in healthcare.

1. Prescription refill and delivery management

By using the data available on how much medicine a patient has, and how often they should be taking it, pharmacies can use proactive conversational AI to remind them to renew when their prescriptions are running low. The patient could be contacted using any method they prefer – such as email, text, or phone – which will result in higher response rates and better medication adherence.

Missed prescriptions are a big problem in America. Two thirds of Americans take at least one prescription medication. On average, each person is on four prescriptions, which means it can be hard to keep track. An Express Scripts study of 600,000 patients found 10% of people procrastinated on refilling their prescriptions, resulting in missed medication, while 20% simply did not renew them on time. These issues are compounded in specialty pharmacies where the cost of drugs is much higher and the waste that occurs from unfilled or undelivered medication creates more pain for both the pharmacy and the patient.

Using AI in these conversations, pharmacies can gently nudge their customers to ensure orders are placed on time. Refills can be arranged for either collection or delivery using the communication channel the patient is most comfortable with.

2. Patient post-op follow-ups

When a patient is discharged from the hospital, they are likely processing a maelstrom of feelings and emotions. The last conversation they have with medical professionals before being discharged – containing critical details about their aftercare – may be blurred by these thoughts. Using conversational AI, hospitals can give patients continued support in a way that works for them.

Patients can receive their discharge instructions by text or email and then opt in to receive post-op advice on an ongoing basis. AI can check in to see if the patient is progressing as they should. If they’re not, it can connect them with a medical professional or schedule an appointment depending on the severity of the situation.

Ensuring patients progress as they should after a procedure is a crucial challenge for the healthcare industry. Take the 300,000 hip fractures that happen in the United States each year, usually occurring among those aged 65 and older, and usually following falls. These individuals typically have a higher level of mortality in the years after, not only due to the elevated risk of blood clots and pneumonia that come with hip fractures, but also the more general health risks created by reduced mobility. Healthcare professionals do not have the capacity to check in on these and other patients as often as they should.

Conversational AI can keep tabs on how a patient progresses after surgery – every day if necessary – in a way that human workers simply do not have the time or resources to do.

3. Patient medication regimen reminders

Every year, 125,000 Americans die prematurely due to not taking their medicine, or by taking it incorrectly. Express Scripts’ study found 39% of their sample simply forgot. It’s a problem that over-indexes among patients with mental illness (up to 60% have poor medication adherence) and the elderly (55%). It’s also a very expensive problem, costing the US healthcare system $300 billion a year and the global pharma industry $637 billion.

What if proactive conversational AI can reduce non-compliance by 1%? What if it can reduce it by 10%?

It's a simple user journey. Participants receive instructions about their medicine or regimen using their preferred channel of communication. They then receive reminders at times they are most likely to act. If a participant has general questions or concerns about the regimen, the AI can respond and guide them towards the correct information, escalating more serious matters to a healthcare provider or even emergency care.

4. At-home care management

No-shows cost the US healthcare industry $150 billion a year. Providers visiting a patient’s home only to find they’re not in because they’ve forgotten about the appointment or that they can’t conduct the care because an essential caregiver isn’t available is a colossal waste. The provider, the payer, and the health system overall lose out on time and money while the patient becomes more likely to suffer downstream impacts on their health. These missed opportunities for care often end up in the emergency room.

Again, proactive conversational AI can raise completion levels. Patients and their caregivers can receive scheduling information and coordinate confirming or changing an appointment early enough that the provider visit is not wasted. This is all done using the communication channel the patient and caregiver are most likely to pay attention to. They can then receive pre-visit instructions and a final check-in on the day of if appropriate.

After the session, the patient will be encouraged to take a post-visit satisfaction survey, giving the healthcare provider unrivalled insight into the quality of their appointments.

5. Aid payer delivery of value-based care

It’s not just providers that can benefit from proactive conversational AI. Payers can too. Value-based care models bring payers and members into much closer relationships where the payer must address the social determinants that impact member health and create obstructions in adherence, coverage, and utilization.

AI allows payers to have conversations with providers and members about things like whether home delivery is covered for a patient whose circumstances make it difficult to arrange transportation for prescription pickup. Members can also gain access to tailored digital conversations about whether their coverage is adequate based on the usage data in the payer’s systems.

Payers can also use AI to reach out and encourage members to utilize benefits such as annual wellness and eye exams or dental screenings, benefits which are designed to stave off more serious and more expensive healthcare services down the line. AI also gives payers the ability to influence gaps in medication adherence by reaching out to their members about medication refills with information on copay reduction programs and other benefits designed to help ensure that prescriptions are filled.


Using AI now to improve patient experience in the healthcare sector is essential for getting the public to buy into the future applications that may seem more like ‘science fiction’ at the moment but are closer to reality than some may think. Customers must first trust AI to manage their appointments, benefits, and prescriptions before they trust AI to give them open heart surgery.

The five cases outlined here represent some of the biggest potential wins in healthcare. Currently missed appointments and prescription non-adherence cost US health providers more than $1 trillion a year. If conversational AI can recover some of those losses, that’s a significant amount of money that could be reinvested in giving patients better service and higher qualities of care.

ContactEngine specializes in increasing engagement and driving human action and has been successfully addressing difficult challenges for a broad range of commercial industries across millions of journeys for more than a decade. American patients expect the same high standard of customer service in healthcare that they receive in other sectors like their internet and utility providers and the organizations they do financial business with. ContactEngine can help bridge that gap and save providers and payers money in the process.

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