Healthcare AI: How one hospital system is using technology to adapt to COVID-19

TechRepublic’s Karen Roby spoke with Jay Roszhart of Memorial Health Center’s Systems Ambulatory Group in Illinois about artificial intelligence (AI) in hospitals. The following is an edited transcript of their conversation.

Karen Roby: The American Hospital Association estimates that hospitals have lost more than $200 billion because of the COVID-19 pandemic. Hospital leaders are always looking for ways to get patients back into doctors’ offices and the hospitals in a safe and secure way. 

SEE: TechRepublic Premium editorial calendar: IT policies, checklists, toolkits, and research for download (TechRepublic Premium)

Talk a little bit just to start us off here about the population that you serve there in Illinois.

Jay Roszhart: We’re in Springfield, Ill. We’re serving around half a million to a million people across 9 to 27 counties, depending on if you’re looking at our primary or secondary service areas. We do that with five hospitals, as well as a physician services group. We’ve got well over 200 providers. It’s physicians and advanced practice providers now, as well as a home health organization, home hospice, durable medical equipment, behavioral health, etc. We’re a large integrated system. About $1.4 billion in revenue when we don’t have a COVID-19 year.

Karen Roby: It’s been a challenging year, to say the least.

Jay Roszhart: It has. The very first month of the pandemic, we saw our volumes decline about 40%. We actually saw about $100 million loss in one month, which is a larger loss than we’ve ever had in our history. Primarily, that is due to having to shut down things like clinics, having to shut down some of our more elective procedures, and figure out the processes that we needed to keep people safe so that they could still get the care they need, but in a safe way.

Karen Roby: Talk a little bit about the AI-based program and how that’s helping you achieve just that.

Jay Roszhart: We’re actually back to about 100% of our pre-COVID volumes in our ambulatory areas—that’s our physician clinics. Primarily, we do about 300,000 of those a year. And the way we’ve gotten back is by making it as safe as possible. One of the things we’re doing is rolling out a chatbot to actually be the virtual waiting room. The good silver lining in this pandemic is it’s forced hospitals, health systems, physician practices to innovate and to try to think a little bit more consumer friendly and a little bit more technology-forward.

We’ve always been technology-forward on the direct care giving side, but this is more on some of the other things. You ever go to a physician office and you have to fill out 15 forms? And think about all of the waste that is being consumed during that period of time that you are checking in, scheduling an appointment, giving them your insurance card. Somebody is entering that manually into a system. Somebody is then billing for it. Somebody is then coding for it. Somebody is then adjudicating that claim on the insurance side. There is all kinds of waste and all kinds of manual process that really is not related to actually a physician giving you care. We’re using AI to try and automate that. We’re using a chatbot to try and automate as much of that manual process as we can.

SEE: Natural language processing: A cheat sheet (TechRepublic)

Karen Roby: There’s one thing that that the pandemic has certainly taught companies, and school systems, and health systems is where they’re lacking when it comes to technology. So many have moved really down the line with digital transformation, whereas others are way behind and having to pick back up. Talk a little bit about, for a patient now, what they see when they’re interacting now. What is the message that’s being sent is now you can come in safely to the hospital or to the doctor’s office. What does that look like for the patient?

Jay Roszhart: To keep people safe, what we’re doing is we’re doing as much as we can outside the physical four walls of the hospital. Whether that is telehealth visits through a platform like Zoom that we’re on right now, or whether that’s through in-person visits. But moving as much outside of the four walls of the clinic or the hospital as possible. Right now, what a patient would experience is they would actually get a text message saying, “Hey, you’ve got an upcoming appointment. Click on this link.”

It would confirm who they are, and they would actually go through their phone … their cell phone device, to actually complete all of that paperwork that they would normally complete sitting in the waiting room to do all of the registration, all of the check-in, to get the information on their insurance. It would also give them reminders about the day of in terms of, “Hey, your doctor’s running a little bit ahead of time. If you can be here early, great.” Or, “Hey, your doctor might be running a little bit late. If you want to push back your arrival time by five minutes, that’s fine.” And essentially all the way to the point where as soon as the patient’s ready to be seen, they can walk straight into the office, bypass the waiting room, go straight to the doctor, and be seen by the doctor. That’s the goal of this.

Karen Roby: How do you see long-term that things have changed or will change as a result of the last six months?

Jay Roszhart: I think long-term, first of all, the social and financial implications of COVID-19 are going to be long lasting. They really are. From a financial perspective, hospitals, health systems, everywhere are going to be looking for ways in which they can reduce costs, improve efficiencies, and attract and keep patients loyal to their health systems, and loyal to their physician practices, and loyal to their primary care panels.

SEE: AI on the high seas: Digital transformation is revolutionizing global shipping (free PDF) (TechRepublic)

One of the ways they’re going to do that, it’d be more consumer-focused and a little bit more in touch with what a consumer and an individual who is seeking healthcare in the local community wants. In our local community, one of the things that we know they want is a little bit more technology, but they still want that personal touch. One thing that our solution has done in partnership with LifeLink, the company that’s helping us develop the chatbot in the AI solution, is ensure that personal touch. They use a term called a “person in the loop AI,” which means that if the AI or the chatbot ever gets to that point where it doesn’t understand something, you can link up to a real person.

You can really get up to that real person who can intervene in the real time to assist that individual, and still have that personal touch, and still have that personal interaction. For our patients, that’s really important. It’s really important that they feel that local face. It’s also really important from our safety standpoint that we can continue to deliver the care we want to deliver and the care patients need, but in a way that does not jeopardize their safety during a pandemic when we should be social distancing, and we should be masking, and keeping people out of waiting rooms, etc.

Karen Roby: Obviously no one could anticipate where we would be right now if you asked in February where we’d be in August or September. But do you feel like you guys have moved through the most difficult part of it now, things are coming together, and the technology is starting to work to the benefit of your patients? Do you feel like you’ve made it through or over those speed bumps?

Jay Roszhart: I sure hope so. But hope’s not a strategy. We are continually developing strategies to ensure if we do have any more speed bumps or if we do see the positivity rate grow, that we know what we’re going to do next. I will say we’re in a much better position now than we were back in March when this was really developing and starting to heat up. And that’s despite our positivity rate being a lot higher than it was back in March. Not only nationally, but here locally. To me, that’s a testament to some of the work that we’ve done. It speaks to our ability to really adapt much more quickly in the future. That adaptation is going to have to continue to come. Because regardless of what happens with the positivity rate, I think the financial and social implications that have occurred are going to force that adaptation even quicker.

Also see