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Entries in Patient Experience (12)

New England Baptist Hospital Hip Replacement- Patient & Caregiver Experience

June 9, 2021

Beginning Surgery ExperienceTwo weeks ago, Sam had hip replacement surgery at New England Baptist Hospital, a top nationally recognized orthopedic facility in Boston.

My experience caring for Sam has given me a close-up view into how his needs (and mine as a caregiver) were met pre-, during and post- surgery. I saw firsthand how effectively his hospital collaborated with VNA Care for follow up in home nursing and PT.

As a consultant in the healthcare experience space, I’ve gathered insights from patients and caregivers about their healthcare journey. Through this caregiver experience, I’ve learned the nuances of the hip replacement processes, evaluated communications, information and tools to engage Sam and his caregiver, and envisioned opportunities to enhance his preparation and recovery.

In this post, I share some key insights with many “Gold Stars” for experiences that met/exceeded our expectations and a few “Magic Wand Wishes” for ways the provider could have executed a better patient and caregiver experience. Since hip replacement is an increasingly common and costly procedure, it is in the health system's best interest to optimize the experience.

With New England Baptist’s reputation as a top orthopedic facility, it is easy to see how they have earned high patient experience ratings. Their care team delivered a highly orchestrated process which anticipated Sam’s needs and made him feel comfortable and well-informed. There were however, opportunities for New England Baptist and partner VNA Care to improve the patient post-surgery experience, and the entire caregiver experience. Keep in mind that it is the caregiver on the front line supporting the patient following discharge, which in our situation was the same day as the surgery.

Pre-Surgery

A few weeks prior to surgery, Sam attended a 3-hour preadmission screening appointment where he reviewed surgery details with different care team members and had x-rays taken. Sam was given a New England Baptist branded cinch sack with a checklist about what to pack for the hospital. According to Sam, this appointment was a thorough and efficient process.

Closer to surgery, Sam received an email invite to attend a virtual “Hip Replacement Pre-Operative Class". Since Sam encouraged me as the caregiver to join him, I attended this 90-minute session and Q&A with about a dozen others (Note: Not sure why the other patient’s names were displayed in the Zoom meeting given HIPAA). Sam also received a series of emails with video links to educate him about what to expect in the hospital, milestone steps for discharge and the recovery journey.

Gold Stars:

Orientation Timing: The virtual meeting was within a few weeks prior, so this gave us ample time to prepare in the days leading up to his surgery date.

Orientation Content: The hip surgery nurse specialist reviewed pertinent information about what to expect before, during and after the surgery. The follow up emails including “Planning for your Recovery” provided essential information to get Sam’s home ready for his return post-surgery, addressing fall risks.

Magic Wand Wishes:

Individual Patient & Caregiver Consultation: Since we had some questions that were specific to Sam’s situation, I wish that we had the option to schedule a virtual visit with the nurse to address our concerns in the days leading up to surgery. This would have reduced our anxiety around what to expect Sam to be able to do at different points of recovery.

Surgery

Discharge Medication informationDue to Covid, I dropped Sam off for pre-op with his crutches and cinch sack filled with paperwork and personal items for his stay. Several hours later, I was contacted by his nurse liaison about his status and about coming to his recovery room for a two- hour visit. It was not communicated to me or Sam if he would be staying over or being discharged. As 4pm neared, I asked about his discharge and the nurse moved quickly to get another PT session in to help Sam master stairs. The nurse went carefully through all discharge materials, answered all of our questions and then handed us the folder.

Gold Stars:

Nurse Liaison: As Sam went through pre-op, he texted me a contact card for the nurse liaison, which gave me reassurance that I had someone to connect with about his surgery status.

What to Expect Next Discussion: Instead of just telling us what we needed to do at home, the nurse walked us through the folder at discharge, reviewing each patient education insert so we understood what to do and where to go to re-read the information. This took the pressure off of us to remember everything that was mentioned during the discharge meeting.

Magic Wand Wishes

What to Expect Packet/Medication: As a caregiver, I was disappointed that there were several different inserts related to medication (Med List, Medication Guide). Although it was quickly mentioned at discharge, it was not documented which medications are to be taken together (i.e. laxative with pain management meds). This would have helped us follow protocol. There also wasn’t a "medication tracking form", so as the caregiver, I had to create my own to record the times that each medication was given and indicate when medications were stopped. There is an opportunity for the provider to gather templates like this from other caregivers and provide them within the discharge packet.

Post-Surgery at Home

Post surgery emails tied to surgery date As promised at discharge, Sam received a call from VNA Care to schedule nurse and PT appointments. During these visits, Sam learned how he was doing, what was normal and required a call to the surgeon’s office. These visits have continued over the past few weeks, with the PT providing additional exercises for Sam to do in home.

New England Baptist emails every few days to give us information about what to expect at that recovery point, which reduces our anxiety because we know what to look out for and how to respond.

Gold Stars:

Care Coordination: Sam felt relieved that his care was continuous and the instructions consistent from the hospital to home, the discharge nurse to VNA Care nurse.

Recovery perspective: Sam learned from his VNA Care nurse how he was healing relative to other patients. He felt relieved when he was able to master the PT exercises and he was off pain meds “much earlier than other patients” like him.

Home Health Patient Education and Education Workbook: During the first VNA Care visit, the nurse handed us a 94-page book and pointed out pertinent pages for Sam and for me such as medication categorization and fall preventiion information. This helped us to not feel overwhelmed by the big workbook of information, especailly in the first few days when we are trying to address everything we need to do.

Patient Education Journey: Sam and I find New England Baptist's post emails informative and relevent since they are tied to his surgery date and recovery milestones.

Magic Wand Wishes:

Caregiver Post-Surgery Communication: With Sam on pain meds following surgery, it would have been helpful to have all patient communications also pushed to me/caregiver. After he was off of the pain meds and cognizant of what needed to be addressed, Sam forwarded the emails to me. I realized that several would have really been helpful such as what to look for and what to do in the first few days following surgery.

VNA Visit Alerts: Although the nurse and PT mentioned that they were coming next Monday in the afternoon, it would have been helpful and expected for the patient and caregiver to receive a text reminder with the time range for their visit. Given that Sam is on crutches and often sitting with ice packs on his hip, I need to be available to answer the door for these visits.

VNA Virtual Visit: As a caregiver, I had questions that needed to be addressed in between the VNA nurse visits. Although I was encouraged to call VNA Care at any time of day or night, I wished that I had the option of a virtual visit to show the nurse Sam’s swelling and bruising. This would have made me feel relieved since the nurse could have seen his hip and leg to make the best care decision instead of relying on my words to convey what I saw.

Caregiver Experience Opportunity

Although many health systems are focusing on the “patient experience”, few are addressing the "caregiver experience". Instead, they bring in the caregiver during Family Advisory Council sessions to gather input on specific initiatives.

Caregivers need the necessary communication, information and tools to be successful in supporting the care of their loved ones.

The caregiver must be included in the patient communications (with the patient’s permission) from surgery planning through recovery to ensure that the patient is prepared and following care related directions, especially regarding medications and exercises. Caregivers need to have access to professional caregivers to address questions and concerns. And they need to understand the relationship (roles and responsibilities) of the care entities as context for their communications. Does the VNA share Sam’s recovery information with his surgeon? Why is Sam’s health plan nurse calling? Does she have access to Sam’s VNA info? What can she address that the VNA nurse or the surgeon’s office cannot?

From an information standpoint, caregivers need clinical guidance (i.e. what is normal with swelling and bruising) as well as insights from other family caregivers. While supporting Sam through his recovery, I devised a long list of short cuts to make each day easier; from leaving pillow cases by the freezer for ice packs to placing water bottles at all of Sam’s sitting and sleeping spots for hydration to tricks for putting his compression socks.

In addition to tips from others, Caregivers can benefit from tools to support the patient care journey such as templates (e.g. medication tracking, recovery milestone checklist, calendar of what to do/stop doing in days leading up surgery). It is often one family caregiver who needs to keep other family members updated and these tools would help us feel more in control as we manage the journey from preparation through recovery.

Another beneficial tool would be a digital health app for the caregiver to track pain levels, swelling and other side effects, in between nurse visits to support interventions as needed. It is scary to be the one person who is responsible for noticing and responding to everything, especailly understanding how the symptoms are interrelated. Although the VNA Care nurse can address this when he is there, Sam's visits are only two times a week. What about all of the other days (and nights)? Yes we can call 24x7 but what if we miss sharing all pertinent information with the nurse?

Health systems can benefit from gathering information and tools from caregivers who have gone through the specific journey (hip replacement) and understand when these should be utilized and how they need to tie into the care flow with VNA Care and surgeon’s office.

Bringing caregivers into the communication loop and providing information and tools will empower them, save time and energy and generate both better outcomes and higher satisfaction ratings.

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UCSF's Comprehensive Co-Design Approach for Pediatric Patients growing up with Chronic Illness

April 27, 2021

The journey for pediatric patients with multiple co-morbidities can be complex, with some patients receiving care from 20+ providers. Jan Yeager, Service Designer, UCSF shared experiences co-designing a Chronic Illness Center with patients, caregivers, UCSF physicians and clinicians, and community providers at MadPow’s 2021 Health Experience Design Conference.

5 Questions in 5 mins, Interview by Sherri Dorfman, MBA, CEO Stepping Stone Partners

Q1. What are your stakeholder groups and how are they engaged in UCSF’s Pediatric Care Service Design process?

A1. Because this is a complex undertaking, we wanted to make sure that we integrated all of the key perspectives in our design process. We have a core team including myself, three providers and a program manager and then three formal workgroups. Two of the groups work fairly independently and are focused on two important facets of wellness, mental health and transition to adult care. The latter is critical to ensure the care ecosystem on the pediatric side can be replicated on the adult side. Our main working group “Clinical Care Delivery & Design Group” includes nurses, NPs, social workers, parents and young adult patients. We meet monthly to review our work in progress and collectively work through issues. We are also lucky to have access to the volunteer-based UCSF Youth Advisory Council and the Family Advisory Council which we tap into for input on aspects of our work.

Q2. What has been your biggest challenge working with these different stakeholder groups?

A2. It’s less of a challenge and more of a learning how to bridge different styles of communicating and working in the context of the design process. Physicians are excellent verbal communicators for example, while designers tend to communicate visually. Designers have a ‘try it out’ mindset, which can be uncomfortable in a risk averse environment. Not every tool we have introduced has been embraced, so that has been a learning too, finding the right way to situate a tool into the work.

Q3. How have you addressed this challenge, working together on defining a better pediatric patient experience?

A3. It’s mainly been through putting the tools into practice. For example, continually translating the dialog into visual models so that everyone can collectively view, reflect and discuss has helped shape the work. It’s becoming a familiar way to both communicate and work.

Q4. As you reflect on this Service Design process over the past year, what has been the most surprising?

A4. According to our initial plan introduced over a year ago, we would have been much further along in the design process. But we are essentially still in the discovery phase looping back continuously as we uncover a need for more data or to include a perspective we overlooked. This may be because of the complexity of the patient population we are designing for and as well as the need to collaborate with a large number of stakeholders as we weave all the pieces together.

Q5 Based on what you know now, what would you have done differently to guide this project?

A5. We would have started with a more formal orientation to Human Centered Design methods and tools. Some team members came into lead roles a few months into the project and we missed an opportunity to better align our roles and process. It’s been a continuous learning experience but we are beginning to see the foundation laid from the past year’s efforts.

UCSF’s Pediatric Care Service Design process benefited from input and guidance provided by patient -centric and patient representative stakeholders, creating a holistic and better care experience.

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Kaiser Permanente’s Reimagining Health Promotion & Behavior Change with Patients

April 26, 2021

As one of the largest metabolic and bariatric surgery centers in the world, Kaiser Permanente Southern California sought to reimagine how it prepared and supported its patients every step of their journey. Kelly Dumke, DrPH, Senior Learning Consultant from Kaiser Permanente’s Center for Healthy Living presented their Human Centered Design process insights at MadPow’s Health Experience Design Conference HxD 2021 within the Person- Centered Care Experiences track.

5 Questions in 5 mins, Interview by Sherri Dorfman, MBA, CEO Stepping Stone Partners

Q1. As a “non-designer”, how did you learn to approach this member program through a new lens?

A1. At the very beginning of this initiative, the Human Centered Design (HCD) at Kaiser Permanente Training taught me how to use the core tools and practices of human centered design and also gave me coaching as I learned to apply it. Their model of both practicing HCD and spreading the mindset and methods throughout Kaiser Permanente is truly inspiring. Overall, human centered design empowered me to embrace designing WITH patients (and not just for them) and it makes my job more fun and (hopefully) much more impactful.

Q2. You mentioned working with your clinicians to identify patients either going through or considering going through the bariatric program. Your data indicated that there were disparities in outcomes. How did you capture insights from patients who were not successful?

A2. Our clinicians gave us names of many patients who had gone through our program, but we found that those who were willing to talk and join our codesign sessions were typically successful with the surgery. We were not getting the perspective of those who were not as successful or struggled along the journey. We realized that we needed to do a set of ethnographic interviews to understand their specific situations to uncover barriers. We also interviewed caregivers to gain insight into their support system.

Q3. What was the biggest surprise that your team uncovered about these bariatric patients during the “Understand Phase”?

A3. We had a patient tell us “I had surgery on my stomach, not on my mind”. We realized how important it was to design this program not only to prepare a patient, but to address and support their mental and emotional health before and after the surgery. Many patients also disclosed experiences with trauma in the past that may play into maladaptive coping mechanisms that contributed to weight gain.

Q4 While imagining solutions for your patients, you invited the staff to be join the process. How did their perspective enhance the design process?

A4. We invited our staff to observe the patient’s co-design to hear needs firsthand. Then we asked the staff to participate in a co-design session and brainstorm solutions and ideas together with patients. For example, one operational issue that surfaced was that some patients did not even feel comfortable coming into our medical centers that didn’t have furniture that could accommodate different body types. Together, we explored solutions such as larger more comfortable chairs for patients in the waiting area.

Q5. How did your project team use the patient centered design insights to build a stronger understanding between patients and providers?

A5. During workshops, we devised eleven personas to define different reasons why patients were in the program such as losing weight to get other surgeries or improving their health. By sharing these profiles with the staff, we helped them better understand the differences in patient motivations for the surgery. We also created a top 10 list of what patients want you to know up front when considering surgery, which enables the staff to more effectively set expectations with patients at the start of the program.

Notice how Kaiser Permanente has co-created with patients and staff to design a better care experience at every journey step, across different channels, from in- person appointments to digital patient education tools.

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Ochsner Health System’s O Bar & Digital Medicine Program Success & Expansion

October 27, 2020

Ochsner Mobile O BarOver five years ago, Ochsner Health launched their O Bar (Apple genius-like concept) to support patients getting started with digital health tools. Today, Ochsner has nine physical O Bars located in the bottom floor of their health centers and one mobile O Bar.

Although any Ochsner patient can visit the O Bar to begin using a curated set of digital health apps and devices, patients who are invited to join a digital medicine program can go to the O Bar to get set up with selected digital tools to manage and monitor their health journey. Digital medicine program participants have the option to have their digital tools sent via the mail, without going to the O Bar and can call their program tech support for any assistance. Pre-Covid, about 5-10% of patients chose to receive their digital health tools by mail. During the pandemic, it is mostly all mail.

Ochsner Hypertension Digital Medicine ProgramTo date, Ochsner Health is offering digital management initiatives for hypertension, diabetes, pregnancy and the latest COPD program. Patients do not need to have access to WIFI to participate, just a smartphone or tablet. Less than 5% of patients participating in the digital medicine program use the tablet and instead have their apps downloaded to their smart phone.

“Our digital medicine programs are realizing 2-3x better outcomes rates than the standard of care”, explains Dr. Richard Milani, Chief clinical transformation officer and innovationOchsner Medical Director, Ochsner Health. “In order to understand how these programs were designed, it is important to take a step back and think about how we need to help patients manage their chronic condition(s). First, we need more frequent data to know at any point in time if their chronic disease is under control. Second we must make sure individuals are prescribed guideline-directed pharmacotherapy. With the number of new medications coming onto the market and medical research about the profile of patients experiencing the best outcomes, we must be sure patients are having the best chance to achieve an optimal outcome. Finally, we need engage our patients on the “right behaviors” (e.g. nutrition, fitness, stress reduction).”

"We set up our digital medicine programs to be supported by a dedicated team who interacts with and manages the patient’s condition(s)”, shares Dr. Milani. “Their doctor invites the patient to join the program, but it is a digital medicine team who responds to the incoming data and alerts from the digital health tools.” Ochsner’s digital medicine team consists of a pharmacist/APP to help the patient with the “right guideline-directed medicine” and a health coach to provide guidance on lifestyle decisions using behavioral health science techniques. Patients that are on two of Ochsner’s digital medicine programs engage with the same pharmacist/APP and health coach, creating a holistic approach to patient care.

Patients access all of digital health tools in the digital medicine program area with their patient portal. A patient logs in to access patient education information (videos), communicate with her team by scheduling a phone call or sending asynchronous messages and view monthly reports which shows how she is doing, and progress made over time. The patient can also contact the digital medicine team for technical support for their digital tools, which is rare because these connected devices are easy to use for even less tech savvy patients.

Ochsner Connected Mom Pregnancy Digital Medicine ProgramIn addition to appropriate connected devices given to patients to capture and transmit key measures (e.g. diabetes/wireless glucometer, hypertension/ wireless blood pressure cuff, COPD/wireless inhaler and pregnancy/ wireless blood pressure cuff & wireless scale), patients receive texts to capture changes in condition (e.g. COPD severity level), track self- efficacy measures or to be notified of a health concern (e.g. warning about the poor air quality level). Patients have the option of connecting in and sending more information such as weight measures from their own digital scale or steps from their fitness tracker to share with the digital medicine team.

Program Success Measures & Expansion Plans

Ochsner has enrolled more than 15,000 patients across their digital medicine programs.

Over the past 5 years, Ochsner has received positive feedback from their digital management team (e.g. Pharmacist, Health Coach) and from patients in the program.

“The role of a clinical pharmacist isn’t always to add more medicine. We work with each person to incorporate lifestyle changes and medications that are right for them. This includes stopping or decreasing medicine doses when lifestyle changes lead to improved health.” -- Carrie, Clinical Pharmacist

“I work with individuals to make small, achievable goals that will not only improve their health, but ultimately improve the way they feel mentally and physically. This allows the patient to feel confident in themselves to make healthier choices in any situation.” – Christina, Professional Health Coach

“I like that it is private. I don’t have to take a blood pressure reading at a Walgreens or CVS. It’s encouraging to know that the lifestyle choices I’m making as well as my compliance to my drug regiment is having a positive effect.” – Alan, Digital Medicine Hypertension Program

“For anyone who has doubts about joining the program, I would say step out and take the journey.” – Lance, Digital Medicine Diabetes Program

“You get a lot out of Ochsner Digital Medicine. You get a family who is by your side every step of the way.” - Gaylan, Digital Medicine Hypertension Program

In addition to patient and staff feedback, Ochsner uses a set of quantitative measures to evaluate success. Dr. Milani is proud to share the Net Promoter Score of patients in the digital medicine program of 87.5, which indicates a high level of recommending the program to others.

Dr. Milani explains, “the key success measure is the reengineering of chronic disease care into a new model of care delivery. Our metrics of success are control measures for the disease (i.e. better blood pressure control, better diabetes control, etc.).”

Ochsner has plans to grow their digital medicine programs in 2021. “We are expanding the population we currently serve and will be adding more disease categories (like lipid management and others). We look at the prevalence of disease burden and the opportunities for better control when deciding on new digital medicine programs,” Dr Milani concludes.

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Providence Health’s Bot Grace engages and guides patients to the digital front door for care

February 25, 2020

According to the 2019 Accenture Digital Health Consumer Survey, patient’s expectations are increasing for providers to offer digital capabilities. Patients value convenience (appointment times, location) and are increasingly considering “non-traditional” service channels such as retail clinics and virtual care.

Providence Health’s Innovation team continuously monitors these trends to identify ways to deliver a better patient care experience. “With the tremendous growth of chatbots and voice assistants, we decided to develop a virtual health assistant and begin to understand how to support the patients in their search for care”, explains Maryam Gholami, Chief Product Officer at Digital Innovations, Providence Health.

In fall 2018, Washington State based Providence St Joseph started developing and testing Grace, a chatbot which asks the patient about their symptoms and based on their location, time of the day and scope of services provided in various care options (virtual, clinics, or At Home) directs them to the best care. Eventually Grace was enhanced to also address frequently asked questions by patients.

Since the healthcare system is complex for consumers to navigate, Providence Health designed their digital tool to provide answers and guidance to help the patient find the right care and make the best care decisions. For example, a consumer may not know which modality of care to use (e.g. Emergency Room. Urgent Care, Retail Clinic, Virtual/Telehealth) or what symptoms trigger an immediate visit.

On the consumer side, Providence Health wants to stay aligned with their patient’s increasing expectations for service on demand. Consumers are already using digital assistants for shopping, banking and travel 24x7.

“From a business perspective, we want to provide accessible, convenient and affordable care. Therefore, we need to improve operational efficiency, free-up professional caregiver capacity for the right care and tasks, while increasing the care options and quality for consumers. We want to have our virtual health assistant take on the administrative tasks so that our clinical staff can focus on patient care. For example, Grace conducts a virtual patient intake to schedule a visit, collecting information such as reason for the visit, demographics, insurance and payment details”, explains Maryam. “This digital health assistant also assesses the best modality of care based on patient’s input and availability of care, matching the right resource to meet each patient’s needs. With this type of service navigation, Providence Health can ensure that the required license level is designated for the visit, reducing care cost and ensuring availability of providers for the appropriate level of care. Healthcare is supply-constrained, so this is a very important value.”

Patient Experience with Grace Bot

Providence Health has worked closely with the patients to design the Grace bot. Here is a look into the patient experience.

Patient Patricia who lives in Washington State, types her symptoms into Google to figure out what she has and where she can get care. Within her search results, Patricia sees a Providence Health website link and then meets Grace, a pop- up text chatbot ready to help her.

The Grace bot helps Patricia in two important ways:

1. Care Navigation: Given that Patricia needs “same day care” and has a low acuity health problem, she types into the Grace bot that she has a fever and sees that Grace has recommended a virtual visit or a same day clinic appointment. Patricia provides her zip code, chooses the clinic near her house and schedules an appointment for 7 PM that evening.

2. Customer Service/Concierge: Patricia has questions about whether her insurance is accepted and types in “what insurance do you take?” Grace provides a list of insurance options. Patricia can also ask for information to read about her health problem before her visit.

Patient Experience with Grace Bot

The Grace bot was designed for patients by patients. Throughout the development process, the product team at Providence Health worked closely with patients to understand the “tasks they were trying to complete” and defined how Grace needed to guide them through these steps. During testing, the team monitored where patients dropped off and tuned the messages to “optimize” their care journey.

“We are digging into the questions that our customers ask so that we can improve our knowledge base. This enables Grace to better respond to our patient questions”, Maryam explains.

With ongoing patient feedback, Providence Health has identified and has been addressing several areas to improve the patient experience.

Chatbot Persona: Maryam shares that “we used emojis to make the digital interaction more casual and friendly. Our patients did not like the emojis because they felt emojis do not convey trust which is essential when communicating health information. Patients also needed to feel comfortable that the responses and recommendations were not coming from a human. We are working on the right persona for Grace and defining the best interaction”.

Chatbot Behavior: Providence Health’s product team is determining when Grace needs to confirm information with the patient so that it accurately reflects her needs. There is a fine line between repeating back to be sure and being annoying to the patient who is looking to quickly complete her task (e.g. set up a visit). However, there is a risk of sending the patient to a modality that does not meet her needs (i.e. she needs to see a doctor and not an RN). “We need to understand the clinical operations from end to end so that we can define the business rules to successfully guide the patient interaction”, Maryam comments.

Consumer Adoption: Some patients are pleasantly surprised about what the Grace chatbot can do for them. Others may not understand what to ask her. Health organizations will need to educate consumers on the types of questions to ask so that patients can gain the most value when engaging with the bot.

Provider Adoption: Providence Health is working on enabling the Grace bot to support virtual care. Grace can engage with the patient to capture information prior to the telehealth visit. However, we need to ensure that this is designed and implemented in such a way that clinicians can properly review all of the information captured before the visit begins and that we are not increasing provider burn-out. It needs to improve the experience for both patients and providers.

Patient Representative Experience: When the Grace bot “hands off” the patient for the scheduled visit or for further follow up, it is important that the representative knows that patient just engaged with the Grace chatbot, has the context and the information already collected and can address the patient accordingly.

Chatbot Success Evaluation

Maryam shares some key success measures for the Grace bot. “We currently know that over 42% of our patients who engage with Grace get answers to their questions or get help navigating to the right modality of care. 18% of these engagements result in completion of appointments booked with one of our ExpressCare Clinics (Urgent Care). We are also learning which questions Grace doesn’t know how to answer or which tasks she can’t currently complete. This learning is very important to help us with our future product direction and iterations”.

Patients interacting with Grace can navigate to Providence Health’s ExpressCare options based on a chief complaint or use a symptom checker before choosing recommended ExpressCare options. Providence Health is seeing a 90% accuracy rate for patients that have been directed to ExpressCare from the patient’s chief complaint.

According to Maryam, there are weekly meetings with the product analytics team to understand how patients are using Grace so that they can enhance the patient experience. “We measure every interaction in the funnel to understand if we’ve helped users complete their tasks. Some of these measure include # of click rates, # of patients questions answered, # of appointments booked, # of visits completed along with type of visits, and chatbot engagement when the customer support center is closed”, describes Maryam.

At the end of each interaction, Grace asks the patient if he is satisfied with the task – “Was I able to address your needs today”? According to Maryam, about 40% indicate that the Grace bot met their needs. Providence Health is closely listening to patient feedback to increase the satisfaction percentage.

Providence Health has received insightful patient feedback about the Grace bot experience:

“This was the first time I’ve seen something like that, I thought it was extremely helpful. It asked a lot of good questions to get me the right help.”

“I felt like it was really easy to get an appointment. Very quick automated responses got me to the right place.”

“I thought it was excellent. I research a lot of my own health issues, so I’m excited about this. Anything that can help me learn about my symptoms and what to do about them, I’m excited for it.”

“For me, it was kind of cold. If it could change the wording to make it more human it would be better. I’d prefer a more human touch to it. I think in this field personality is important, so work on making it more warm, caring, and friendly.”

Future Plans with Grace:

Providence Health is committed to enhance the Grace virtual health assistant experience for patients by:

Expanding the patient journey: Currently, Grace is available more in the discovery phase, when patients are searching for care options. “Next, we are incorporating Grace into the Virtual waiting room to gather intake information before the patient participates in the telehealth visit. Our goal is to have Grace available when/where appropriate to help consumers navigation through health journey”, Maryam adds. “We are looking to move beyond low acuity to helping patients find and book PCP and Specialty appointments”.

Increasing the personalization: While Grace currently does some personalization based on consumer’s location, time and symptoms. Providence Health believes there is still a great deal of opportunity to leverage various sources of data including patient records. They will proceed carefully given the consumers’ data security and privacy needs.

Improving the High Tech & High Touch Collaboration: “We view our virtual assistant as an augmentation tool for our professional caregivers. We are working on creating a warm hand off to human caregivers with the conversation context. We are designing these tools so that based on consumer’s choice, human caregivers can step in to assist our patients”, explains Maryam.

Providence Health’s clinical and business leaders believe that offering these virtual health assistants are essential to delivering the best care experience for the patient, today and in the future.

“We are levering technology to connect the consumers to the right place for care with the right service and providers at the right time. AI is going to help us to improve the seamless experience.” Thanh Nguyen, Executive Director and Chief Clinical Officer of Express Care

“AI-powered virtual assistants will have a significant impact on healthcare by engaging consumers through voice/chat, a more natural way of interaction, and by intelligently automating mundane tasks and simplifying complex ones at scale.” Aaron Martin, EVP, Chief Digital Officer

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