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Navigating AI in Healthcare: Elevating Quality and Patient Experience

With AI rapidly advancing, healthcare organizations are under pressure to integrate new technologies while maintaining high-quality care. Striking this balance is crucial for improving organizational efficiency and patient experience.  

This series explores the core challenges healthcare organizations face when adopting AI, essential considerations for implementing AI solutions, and Authenticx commitment to delivering responsible and reliable AI solutions tailored to the unique challenges of healthcare. In our previous blog, we discussed the gap between expectations and reality with AI in healthcare. Today, we’ll explore how AI can measure and improve quality at scale, consequently elevating the patient experience.  

The Challenge: Ensuring Quality in Every Conversation

Measuring agent quality and patient satisfaction at scale is a significant challenge. Realistically, not every patient conversation can be reviewed by a human. Even if it could be, you would then face the challenge of personal bias and human error. So, how can organizations measure quality at scale, empower agents to provide excellent care, and offer a better patient experience? Let’s dive in.

Automating Quality Assurance with AI

Quality assurance begins with listening at scale. Today, many organizations rely on humans to listen to call recordings for quality assurance, which is naturally limiting.  Humans can only listen to a limited number of calls in a day and their judgment can be influenced by various factors, such as their mood, personal biases, or relationships with agents. By leveraging AI alongside human review for quality assurance, organizations can obtain a more objective picture of an agent’s performance over time. This combination enables the identification of trends across multiple teams, highlighting whether an individual agent needs improvement, if certain conversation topics were not adequately covered in training, or if there is a broader systemic issue. 

AI is a phenomenal tool for analyzing vast amounts of data, making it possible to scale listening efforts, automate quality assurance, and monitor agent performance efficiently and effectively. AI can streamline listening efforts by summarizing conversations, aggregating key themes or topics across thousands of interactions, and capturing sentiment at scale while minimizing the risk of human error or personal bias. However, AI does not replace human judgement. Authenticx AI monitors key quality metrics with both AI and human evaluation. Conversations where compliance or adverse events are detected are flagged for human review. 

Leveraging AI to monitor key quality metrics offers visibility into how agents are upholding brand standards. Agents benefit from visibility into their skills scoring which empowers them to take ownership of their development. This transparency encourages agents to make real-time adjustments and continuously improve their communication style. Regular performance feedback allows agents to proactively identify areas for improvement and make adjustments. With Authenticx, agents also have the ability to dispute scores, which triggers a custom workflow for review and ensures a fair and accurate assessment. Managers can provide feedback to individual agents or teams with Authenticx Agent Coaching Notes.  

Limiting Bias in AI

Authenticx Founder and CEO Amy Brown said it best: “Building ethical algorithms takes time. Models that were built quickly are more likely to have ingrained bias while lacking the necessary guardrails in place to keep them from causing unnecessary damage. If done in haste, or done poorly, AI models have the potential to cause real harm in certain sensitive industries, such as health care.” 

Authenticx is committed to mitigating AI bias in our platform with preventative measures. Our approach is healthcare-specific and human-led. We build and train our AI in-house, using healthcare-specific data. In addition to traditional data scientists, we leverage the expertise of nurses, case managers, social workers, counselors, and fluent Spanish speakers to help train our models on some of the known biases, gaps, and other issues that can lead to patient friction. These healthcare professionals label the data that is used to train our AI in identifying various conversation components such as sentiment, compliance issues, adverse events, and more. Feeding the model high quality, contextually relevant information ensures a more accurate output.  

To maintain accuracy and reliability, we continually evaluate, test, and re-train our models. With strong security and governance procedures, we maintain high standards of AI ethics. Partnering with global pharmaceutical companies and their governance boards helps us refine our platform to meet and exceed industry expectations and reinforces our commitment to providing accurate and unbiased insights that enhance patient experiences.  

Adopting an AI solution can help healthcare organizations to scale their listening efforts, automate quality assurance processes, and offer valuable feedback to agents – ultimately elevating the patient experience. Authenticx AI can help organizations improve and maintain high quality care with models that are built by healthcare professionals, for healthcare professionals. Curious about how this works in practice? Next week, we’ll explore the practical applications of the Authenticx platform and how your organization can elevate quality assurance and patient experience.

Catch up with this blog series:

Data-Backed Storytelling | Authenticx

Intelligent, immersive, and personalized data-storytelling.

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About Authenticx

Authenticx was founded to analyze and activate customer interaction data at scale. Why? We wanted to reveal transformational opportunities in healthcare. We are on a mission to help humans understand humans. With a combined 100+ years of leadership experience in pharma, payer, and healthcare organizations, we know first-hand the challenges and opportunities that our clients face because we’ve been in your shoes. In 2023, Authenticx was ranked No. 349 on the Inc. 5000 recognized as one of America and Indiana’s fastest-growing private companies.

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