Post on 25-May-2020
Bill Hughes, Associate VPSutherland Healthcare
Digitizing and Transforming thePatient Engagement Experience from an RCM and Access Perspective
2
AGENDA Topics and Concepts to Be Discussed
Evolution of Patient Engagement
Mass/Hyper Personalization
Propensity to Pay Analytics and an AI Driven Revenue Collection Ecosystem
Chatbots
Omnichannel
Future State – Healthcare Avatars
©2017 Sutherland, Inc. Confidential
\\ Sutherland Inc, Confidential3
Who We Are
1982FoundedHeadquartered
in New Jersey
75+ClientsAcross Healthcare
Continuum
Top
100Healthcare IT
Vendor by HCI
“Leader”
“High Performer”
“Major Contender”
Rankings by Everest,
Gartner, HfS
75%Revenues
Shared Risk-
Reward Contracts
URACAccredited
- Credentials
Verification
$150MIn Revenue
91+%Customer
Satisfaction
Score
28MAnnual Payer
Transactions
3.3MAnnual Provider
Credentialing &
Database
Updates
5,000Dedicated
Healthcare
Employees
$50B+Net Patient
Revenue of
Our Hospital
Clients
250KAnnual
Customer
Contact Center
Transactions
32K+Staffed Beds
Managed By
Our Hospital
Clients
15+Global
Healthcare
Delivery
Centers
9.5M+Annual
Charts Coded
800+Coders at
Sutherland
30KAnnual EHR
Installations
and Upgrades
MARKET OBSERVATIONS
Smarter customer engagement demands an understanding of every customer.
With a more effective wayto engage with them.
Yesterday - Limited Digital Access and Options and Enterprise Data (portal access)
Today - HCO Driven AI Engagement with Closed Cloud (multichannel access)
Tomorrow - Patient AI Driven Orchestration with Open Cloud (omnichannel and collaborative)
Patient Engagement Evolution
Ask, Discover, and Use your Organizations Stated ‘Digital Playbook’
• Digital Playbook Concept
• Key Questions• How outcome driven is your tech solution
• Capabilities and qualifications
• Viability – stakeholder engagement and strategic initiatives
• Feasibility – are API’s and required platforms available or do you need an RPA or Cloud strategy
• Other challenges to maximizing ROI• What to do when you prior investments have gone sideways
• How to salvage a bad decision
\\ Sutherland Inc, Confidential7
Digital Playbook
Technology Problem Impact
Expanding Data
Sources
Developing insights from non-enterprise data
and patient data
Address referral leakage and improve
care coordination
Propensity to Pay
Analytics
Increasing importance of self-pay collections
and maximizing collections
Improve collections and timeliness
Mass/Extreme
Personalization
Poor consumer engagement and market
reputation
Impact patient and staff behavior
Chatbots Administrative staff turnover and excessive wait
times for answering patient calls
Automate administrative tasks and
improve turn around time
Omnichannel Uncoordinated outreach, poor user experiences,
and lack of engagement modalities
Market perception and patient loyalty
Social Media
Monitoring
Poor market perception, especially for the
digitally connected
Improve market perception and early
intervention
Avatars Changing poor patient behaviors Improve collections, stickiness and
change behavior
RPA Staff turnover and high administrative costs Automate repetitive tasks and streamline
operations\\ Sutherland Inc, Confidential8
Pushing healthcare into a new level of Consumerism
In Pursuit of Retail (Happiness)
9©2017 Sutherland, Inc. Confidential
Extreme Personalization
Mass personalization
technologies once only
available to large
companies, e.g.,
Amazon, Google, etc.,
are now becoming
available at the
enterprise level!
Analytical Insights
Customer Profile – 360°view
Interaction Details
CEM solution to address
- Scheduling
- Referrals
- Consumer experience
Next Best Actions recommended from analytics
Seamless integration with case management - Data
and front end integration
Customizable and configurable for specific
healthcare organization specific sscenarios
11
The Petco Story: Example of Inbound Interaction
User
name
13
Extreme Personalized Patient Engagement
©2017 Sutherland, Inc. Confidential
Social Media
Monitoring
Patient Responsibility
Management and
Collections
Unified Patient Access
Model
Care Coordination
Management
Phone Call, Text
Message, e-
mail, Portal,
App, Chat,
Social Media
NLP Engine
Text Analytics
Knowledge/Rules
Engine
Historical Data
360 View and
Unified Desktop
Omnichannel
Outreach
Use Case User Modalities Digital EcosystemEngagement
Solution
AI and ML
Personalizing your Patient Responsibility Collection Strategy
Digital Initiatives in the Market Place
14©2017 Sutherland, Inc. Confidential
\\ Sutherland Inc, Confidential15
Problem: People have different abilities and personal approaches to healthcare payments
Digital enablement promotes: Creation of different collections strategies and technologies based on capabilities and preferences
16
Propensity to Pay Analytics
©2017 Sutherland, Inc. Confidential
Analytics
\\ Sutherland Inc, Confidential17
Predictive Analytics Driven Segmentation
Lo
w
ScoreLow High
Hig
hB
ala
nc
e
18
Predictive Analytics Driven Segmentation
Lo
w
ScoreLow High
Hig
hB
ala
nc
e
1.What is the target collection
amount when you touch the
patient?
2.What is the best payment plan that
is doable by the patient, but also
supports the collection process?
19
Financial Decision Support Grid Healthcare Organizations Rules and Policies
©2017 Sutherland, Inc. Confidential
Patient
Category
Account
Balance
Target
Initial
Payment
Payment
Duration for
Balance
Avatar
Max
Duration
Other
Motivated <1,000 50% 6 months 12 months
Motivated >1,000 25% 12 months 18 months
Motivated >10,000 20% 18 months 24 months Representative Option
Gentle Nudge <1,000 40% 9 months 12 months
Gentle Nudge >1,000 25% 12 months 18 months
Gentle Nudge >10,000 20% 24 months 24 months Representative Option
Pulling Teeth <1,000 75% 3 months 12 months
Pulling Teeth >1,000 25% 12 months 18 months
Pulling Teeth >10,000 20% 18 months 24 months Suggest meeting with Representative
High Risk <250 100% 6 months 36 months
High Risk >250 Suggest meeting with a Patient
Representative and Support Services
20
Financial Decision Support Grid Healthcare Organizations Rules and Policies
©2017 Sutherland, Inc. Confidential
Patient
Category
Account
Balance
Target
Initial
Payment
Payment
Duration for
Balance
Avatar
Max
Duration
Other
Motivated <1,000 50% 6 months 12 months
Motivated >1,000 25% 12 months 18 months
Motivated >10,000 20% 18 months 24 months Representative Option
Gentle Nudge <1,000 40% 9 months 12 months
Gentle Nudge >1,000 25% 12 months 18 months
Gentle Nudge >10,000 20% 24 months 24 months Representative Option
Pulling Teeth <1,000 75% 3 months 12 months
Pulling Teeth >1,000 25% 12 months 18 months
Pulling Teeth >10,000 20% 18 months 24 months Suggest meeting with Representative
High Risk <250 100% 6 months 36 months
High Risk >250 Suggest meeting with a Patient
Representative and Support Services
21
Financial Decision Support Grid Healthcare Organizations Rules and Policies
©2017 Sutherland, Inc. Confidential
Patient
Category
Account
Balance
Target
Initial
Payment
Payment
Duration for
Balance
Avatar
Max
Duration
Other
Motivated <1,000 50% 6 months 12 months
Motivated >1,000 25% 12 months 18 months
Motivated >10,000 20% 18 months 24 months Representative Option
Gentle Nudge <1,000 40% 9 months 12 months
Gentle Nudge >1,000 25% 12 months 18 months
Gentle Nudge >10,000 20% 24 months 24 months Representative Option
Pulling Teeth <1,000 75% 3 months 12 months
Pulling Teeth >1,000 25% 12 months 18 months
Pulling Teeth >10,000 20% 18 months 24 months Suggest meeting with Representative
High Risk <250 100% 6 months 36 months
High Risk >250 Suggest meeting with a Patient
Representative and Support Services
22
Financial Decision Support Grid Healthcare Organizations Rules and Policies
©2017 Sutherland, Inc. Confidential
Patient
Category
Account
Balance
Target
Initial
Payment
Payment
Duration for
Balance
Avatar
Max
Duration
Other
Motivated <1,000 50% 6 months 12 months
Motivated >1,000 25% 12 months 18 months
Motivated >10,000 20% 18 months 24 months Representative Option
Gentle Nudge <1,000 40% 9 months 12 months
Gentle Nudge >1,000 25% 12 months 18 months
Gentle Nudge >10,000 20% 24 months 24 months Representative Option
Pulling Teeth <1,000 75% 3 months 12 months
Pulling Teeth >1,000 25% 12 months 18 months
Pulling Teeth >10,000 20% 18 months 24 months Suggest meeting with Representative
High Risk <250 100% 6 months 36 months
High Risk >250 Suggest meeting with a Patient
Representative and Support Services
a
a
a
Digital Ecosystem
a
a
a
a
Digital Ecosystem
Chatbots = Automating customer happiness
AI has moved well beyond our home and into our work.
of customers now prefer bots for quick communication w/ brands.
of customer interactions can be resolved by bots.
80%69%Potential salary cost savings that bots could deliver .
$65Bof enterprises will spend more on bots than mobile dev by 2021.
50%
For the enterprise, conversational AI tech has begun impacting most functions
● More efficient engagement
● Market differentiation
● Improves patient loyalty
RCM“Conversational Marketing”
● Better Customer Experience
● Faster engagement resolution
● Lower cost for operations
Ops & Support“Conversational Support”
● Higher candidate engagement
● Faster candidate screening
● Brand differentiation
HR“Conversational Recruiting”
However, as companies begin to embrace AI - and specifically digital assistant solutions - they also face an increasingly complex ecosystem of solution providers.
Chatbot solution lifecycle - example.
End-to-End Solution & Service
1Live Transcripts
2Chat Analyzer
3Bot Flows
4Conversational
Design
5Chatbot Engine
6NLP Chatbot
Start the process with data gathering to scrub through all your customer data and touchpoints
Run chat-analysis algorithms to understand most common topics and opportunities.
Build out flows for each of the high-value use cases leveraging ML.
Develops scripts that align with brand tone and desired business outcomes.
Layer script and branded UI on top of NLP and additional enterprise integrations required for your particular business case.
Deploy, operate, optimize, and iterate on this process.
Examples of Chatbot Success Stories
Internal HR300K+/yr Candidates
100K+/yr apps automated
Support100K+/yr cases resolved
$600K+ savings/year to Sony
Sales Qualification180K leads/year automated
28% conversion gain
Fantasy SportsOver 60K sessions / day at peak
24% contact deflection
\\ Sutherland Inc, Confidential31
Case Study: Chatbot Solutions reduced live contact volume annually by 36%
for Sony PlayStation Vue
Results: 180K Customers Served via Automation
CASE STUDY
Supporting Sony Playstation Vue subscriber growthKPIs affected by automation
● 36% live chat deflection rate
● Approx. $630K saved annually
● Consistent CSAT levels before and after chatbot
● Total of 180K customers serviced via the Vue chatbot
Live Production Link
CustomersCustomer
Care
AI-Enabled Chat Deployment Model
Website
Sutherland Chatbot
Chat
Voice Knowledge Base
CRM
Page 33 | Sutherland, Inc. Confidential | Digital Transformation
Salesforce Integration (Live Agent)
34 \\ Sutherland Inc, Confidential
● Manages session + resume handling
● Manages API calls & security handling
● Stores custom application logic (rules,
lead scoring, workflow management) &
admin tools
Custom Middleware Layer
● Brand-ready integration
● Mobile-optimized
● Flexible deployment and activation
behavior
\\ Sutherland Inc, Confidential35
● Integrated hosting included
● Supports Github for version control
● Python-based
● Analyzes for customer intent
● Supports over 30+ languages
● Machine-learning powered
Bot framework & IDE platform
Natural Language Processing engine
Omnichannel message delivery/distribution
Website/Mobile App
TLS
/SS
L
Analytics/Reporting
● Powers HTML web messenger widget
● Connects to major social networks,
including Facebook, Twitter, Slack, etc.
● Integrates with Zendesk, Stripe, etc.
● Optional telephony and SMS
connectivity through Twilio or other 3rd
party service
Engagement Chatbot
AWS Cloud Channels
● Supports major platforms, including
Google Analytics, Mixpanel, Adobe
Analytics/Omniture, etc.
Reference Architecture - example
● Manages session + resume handling
● Manages API calls & security handling
● Stores custom application logic (rules,
lead scoring, workflow management) &
admin tools
Custom Middleware Layer
● Brand-ready integration
● Mobile-optimized
● Flexible deployment and activation
behavior
\\ Sutherland Inc, Confidential36
● Integrated hosting included
● Supports Github for version control
● Python-based
● Analyzes for customer intent
● Supports over 30+ languages
● Machine-learning powered
Bot framework & IDE platform
Natural Language Processing engine
Omnichannel message delivery/distribution
Website/Mobile App
TLS
/SS
L
Analytics/Reporting
● Powers HTML web messenger widget
● Connects to major social networks,
including Facebook, Twitter, Slack, etc.
● Integrates with Zendesk, Stripe, etc.
● Optional telephony and SMS
connectivity through Twilio or other 3rd
party service
Engagement Chatbot
AWS Cloud Channels
● Supports major platforms, including
Google Analytics, Mixpanel, Adobe
Analytics/Omniture, etc.
Reference Architecture - example
Use Cases:
• Find a provider
• Schedule an appointment
• Cancel an appointment
• Reschedule an appointment
• How much will this procedure
cost
• How busy is the ED/Urgent
Clinic right now
• Can I pay just part of my bill
• What are the visiting hours
• Where do I park
• Is this procedure covered by my
insurance
• Can I bring my pet
• …
Omnichannel emergesinto Healthcare
Virtual Assistant Digital Ecosystem
SO
UR
CE
DA
TA
Omnichannel
Social
Biometric
Clinical
Claims
Pharmacy
Ambulatory
Economic
Content
Action & Rules
Engine
User
Experience
Personalization
Integrated
Data Hub
Design Thinking
Agents
Text
Social
Portal
Visualizing Payment AvatarsA day in the life
41
Virtual Assistant Concept Demos
©2017 Sutherland, Inc. Confidential
Example Capabilities of Virtual Assistants
• Update Personal Info
• Request an Appointment
• Manage My Account
• Make a Payment
• Find a Provider
• Cost Estimator
• Clinical Summary
• Wellness Avatar
• Ask a Question?
• Directions
Questions?
How will you give your customersa better experience?
Contact Information
Bill Hughes
Assistant Vice President, Digital Portfolio
Sutherland Healthcare
Phone: (206) 849-2715
Email: Bill.Hughes@Sutherlandglobal.com