Generative artificial intelligence (AI) arguably is the hottest topic today in the world of business and technology. With the ability to create content such as text, images, audio, and video, generative AI algorithms are being tested for use cases in marketing, finance, education, and healthcare.
ChatGPT and other generative AI platforms have tremendous potential to transform healthcare and other industries. But the current inherent limitations of generative AI introduce compliance and ethical risks that healthcare organizations must navigate before integrating this technology into clinical processes.
Specifically, ChatGPT and other generative AI tools that have become popular in the last year can suffer from accuracy problems, often inventing facts that don’t exist in the real world. Factual errors make generative AI poorly suited for physicians to rely upon at the point of care. Further, patient privacy issues and lack of governance are challenges for healthcare organizations seeking to use generative AI for clinical use cases. These issues are not unsolvable, and generative AI is only at the early stages of exploration in healthcare, but it means that these clinical use cases will take time to develop and deploy safely.
Fortunately, there is one area of healthcare where generative AI can help providers and payer organizations today: the contact center. Both providers and health plans can use generative AI to assist customer support agents and enhance patient/member support and self-service.
Customer experience is critical
Contact centers are key to delivering a superior customer experience (CX) – the kind of experience that influence loyalty to healthcare providers and health plans. Patients and members rely on the healthcare contact center to set up appointments, request information, check on prescriptions, pay bills, and more.
Consumers often have more interactions with the contact center than individual clinicians or plan representatives. While these interactions are often more transactional, the total experience with a contact center can be the determining factor in whether a person remains with a provider group or health plan.
Unfortunately, too many healthcare organizations struggle with problems that inevitably undermine the CX. For starters, there continue to be high levels of turnover among contact center workers across all industries. In a 2022 survey of contact center professionals by the International Customer Management Institute (ICMI), 57% of respondents said turnover was up over the previous year.
Contact center workers also struggle with burnout from a combination of chronic understaffing and the already intense pressure of dealing with high volumes of calls from patients and plan members, many of whom are coping with serious health issues and are anxious, frustrated, and possibly in pain. These patients and members may be seeking important test results, asking about insurance coverage, or trying to schedule an immediate appointment with an oncologist or cardiologist.
For relatively low-paid contact center workers, that’s a lot of pressure. It doesn’t help that many of these agents are forced to rely on technologies that make their jobs even harder, such as poorly designed user interfaces, as well as inefficient workflows. How many times can customer service representatives scroll through multiple screens to find medical or insurance information for a distraught patient/member waiting on the line – with the call backlog growing by the minute – before they find a different job?
Another way limited technologies impact the CX is through a lack of channel options. Not every patient/member wants to talk to a support agent on the phone. People may prefer email, text, or even a chatbot. In the digital age, the lack of omnichannel options is a deal-killer for consumers. And even if a healthcare organization offers multichannel support, information found in other channels may not be accessible to a contact center agent on a call with a patient or member.
How generative AI can help
For contact center workers, successfully assisting patients and plan members is fulfilling because they know they are providing the service that people need. ChatGPT and other generative AI platforms are tools that can be used now to make healthcare contact centers more efficient and effective.
Combining AI with automation both eases the agent burden by removing tasks from their plates and helps to create a frictionless experience for patients and plan members. For example, generative AI could be used to 1) craft email replies to patients/members who have questions or need specific information, and 2) summarize discussions and setting dispositions.
Generative AI also is well-suited to enabling customer self-service. Patients and plan members could interact with a generative bot, say, to find available appointments and book time slots, to clarify post-op instructions, or to get advice about the next steps in their care journeys. Generative AI could then route the patient or member to the right agent, department, or web page.
When contact center agents are on calls with customers, generative AI can provide them with succinct, well-organized summaries of relevant information. This spares agents from the time-consuming burden of searching for answers in a knowledge center.
Calls with patients or members often can be long and unfocused. Generative AI can be used to summarize patient/member support calls. And if the caller wants to schedule an appointment with a specialist, generative AI can provide agents with parameters for scheduling that account for facility availability, patient transportation limitations, and other variables. This is especially helpful for newer agents, for whom scheduling can be extremely challenging.
Conclusion
It may be some time before generative AI can be deployed reliably in a clinical setting. Today, however, generative AI platforms can be used by providers and payers to increase patient/member loyalty by improving the CX and allowing agents to be more helpful and productive, improving job satisfaction and reducing burnout and turnover.
About Patty Hayward
Patty Hayward, GM of healthcare and life sciences at Talkdesk, has over a quarter century of industry strategy experience, including at organizations such as McKesson, Medicity, and Humedica. She is an expert in HIE, population health, pharmacy, process redesign for healthcare systems, and increasing access to patient information.
