At the RACMA Conference Talked about how to use machine learning to improve patient feedback as well as building the rules engine to advise on patient experience improvement. Here are some of the slides and stories shared at the conference which seem to be received very well.
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AI & The Patient Experience
1. Dr Avnesh Ratnanesan Founder & CEO avnesh@energesse.com
AI & THE PATIENT EXPERIENCE
2. 2
OUTLINE
1.1 The AI Dilemma
2.2 Patient experience in healthcare
3.3 PX improvement technologies
4.4 AI in Australian Use Cases
5.5 Future AI solution – PXme
6.6 Trial opportunity
3. 3
LEADING SPECIALISTS IN PATIENT EXPERIENCE
CSIRO Health
& Biosecurity
Western Sydney LHD
South West Sydney LHD
5. 5
HEALTHCARE QUADRUPLE AIMS
1. Don Berwick et al Health Affairs 2008 Triple Aim, Insitute of Healthcare Improvement 2. Bodenheimer et al Annals of Family Medicine 2014
Health
Outcomes
Clinician (Staff)
Experience
Value
(Revenue/Cost)
Patient
Experience
6. 6
What shapes PX?
The sum of all interactions = Human + Environment + Technology experiences
9. 9Jiang F, Jiang Y, Zhi H, et al Artificial intelligence in healthcare: past, present and futureStroke and Vascular Neurology 2017;2:doi: 10.1136/svn-2017-000101
https://svn.bmj.com/content/2/4/230
AI UTILISATION IN HEALTHCARE
18. 18
FREE TEXT COMMENTS
“Nurse Sarah was pleasant but the doctor was very
rushed and I did not understand his advice.
The exit door slams all night, I haven’t been able to
sleep for 5 days since my operation”.
AI & Unstructured Datasets – Qualitative Patient Comments
24. Project Goal
Improve ACCESS to care for adult patients with
BACK PAIN referred to Westmead Hospital
Neurosurgical Clinics through a COST EFFECTIVE
PATIENT CENTRED service by August 2018.
26. • 62 year old with LBP pain > 2 years
• Currently unable to work
• GP referred to Neurosurgical clinics at
Westmead Hospital
REFERRAL TRIAGED
APPOINTMEN
T GIVEN
PATIENT
SEEN
FOLLOW-UP
CARE
PROVIDED
“No
communication
How long will I
wait?”
“No
communication…m
y
pain is increasing”
“Why do I
have to wait
so long in
clinic?”
“Has care been
organised for
me…when will
my pain
settle?”
27.
28. Number of
Responses
Kindness &
Respect
Involvement in
Care
Clear
Communication
Pre
Implementation
76 60 68
Benchmark 85 85 85
Patient Experience Heat
Map
“I wait for ever…
No customer care…
No one really cares”
29. 2) 15%
Out of Area
3) Only
1% RECEIVE
LETTER
for their appointment
4) 24%
of patients do not
receive a text
message reminder
5) Cost of DNA
$400 LOST per 15 min
appointment
“9 weeks to be
advised…
correspondence
rude”
31. Patient Experience Heat Map
April 2018 98 97 94
May 2018 87 87 100
June 2018 97 97 97
Kindness &
Respect
Involvement in
Care
Clear
Communication
September 2017 76 60 68
Benchmark 85 85 85
Post Implementation of Solutions
32. Questions 5: Did staff explain things in a way you could
understand?
PREMS Results
PRE POST
Improvement
by 50%
33. Questions 7: How likely are you to recommend the service?
PREMS Results
PRE POST
YES!
37. 37
TRANSLATE AI DATA TO IMPROVEMENT
Wisdom
Knowledge
Information
Data VOICE/ TEXT/ IMAGES
ACTIONS & INTELLIGENCE
REPORTS
OUTCOMES, EXPERIENCES
& VALUE
40. 40
PXme (PX MATURITY EVALUATION)
0% - 25% 25.01% - 50% 50.01% - 75% 75.01% - 90% 90.01% - 100%
Stage 1: Limited Stage 2: Ad-Hoc Stage 3: Organised Stage 4: Managed Stage 5: Leaders
No patient feedback
Very limited capability
and partnership with
consumers
Lack of leadership,
structure and KPIs,
Limited staff
engagement and
training
Undefined complaints
processes and service
recovery
Few improvements to
safety and quality, not
focused on PX
Ad-hoc, basic patient
surveys and
complaints process
Lack of capability and
little partnership with
consumers
Some PX initiatives
planned but lack of
PX leadership and
structure, unaligned
strategic plan and
KPIs,
Insufficient staff
engagement and
broad training
Few improvements
for safety and quality
and PX.
Established survey
and complaints
process
Some partnership
with consumers
PX initiatives planned
but requiring
formalised PX
leadership, structure,
& metrics, some
targeted training
Some staff
engagement and
pockets of
accountability
Increasing
improvements to PX
but not hardwired into
culture as yet.
Strong PX
measurement
platform enabling
deep insights that
guide targeted
improvements, highly
defined complaints
process
Strong consumer
partnership,
formalised PX
structure and
leadership, strategic
plan and PX KPIs
High buy-in, staff
receive targeted
training, are engaged
and ‘own’ the PX.
PX is hardwired into
culture and is
sustainable.
Strong PX
measurement
platform enabling
deep insights that
guide targeted
improvements
Industry leaders in PX
and consumer
partnership, best
practice PX structure
and highly engaged
leadership
Staff are highly skilled
in PX and ‘own’ the
PX, with full
accountability.
PX is hardwired into
culture and
improvements are
sustainable.
41. 41
PX MATURITY SCORE
www.energesse.com
o The Overall PX Maturity Score is
56.97%.
o This places the organisation at the
Early Organised (Stage 3) stage of
maturity.
42. 42
IT RECOMMENDATIONS: MAPS PX GAPS TO APPS
Internet of Things (IoT), Artificial Intelligence (AI), Augmented & Virtual
Reality, Big Data, Blockchain & Mobility
Slides will be available through the college portal
1
Slides will be available through the college portal
1
Case Study
When Western Sydney began to accelerate the patient experience improvement 3 years ago, we initially started the journey by measuring all the strengths & gaps using an earlier version of the PX Maturity Model.
In the last 2 years of working together, they have been gradually been addressing the gaps and have improved their district wide patient experience score from 72% (based on similar qs in the BHI survey) to 87% (May 2018). These results were published in this article earlier this year, so imagine if a strategic methodology can help an entire health district of 5 hospitals, numerous clinics and 9000 staff make a positive change, imagine what this methodology can do for your organisation.
Requires a ‘Systems Thinking’ approach
Structured Data
In the Net Promoter Score philosophy,
Only delighted and excited customers become promoters, for you to grow your business and customer base, particularly by word-of-mouth. This is even more importantly now that customers are becoming less loyal to brands, unless they feel an authentic connection.
How do we do that with all the ‘noise’ in the digital world
PanSensic has algorightms that can analyse keywords and phrases
This could also be seen readily in another question of how likely patients would recommend this service pre and post implementation of solutions with an alomost 30% increase in patient likelihood.
1
I often find that clients feel like if they’re measuring patient feedback well, and their surveys are thorough and statistically significant, then they’re improving the patient experience. This couldn’t be further from the truth.
The problem is many managers want to do something quick and think to tactically, sometimes just to please their supervisor. The knee jerk reaction is therefore to conduct a survey, because that’s what everyone else is doing. The truth is conducting surveys or collecting patient feedback or stories in real-time is only one part of an overall patient experience improvement program. In fact, it is only 1 of 6 major parts in an improvement program.
Therefore just measurement is NOT improvement.
While they have all the supporting structures to gather data, they are often challenged with how to manage the data – they don’t know what to do with the data, how to get buy-in to the data, how to action the data into strategies and solutions. Data needs to be actioned into clear, structured and targeted improvements to make an impact.
Energesse has developed a guiding framework called the 6Es. Borne through 6 years of R&D specializing in this field to address this challenge for clients.
But you’ll hear more about that later on.
Slides will be available through the college portal
Lead them down one funnel which leads to one solution only. If they have to choose between too many things its too hard.