Chatbots Manage Scheduling with Customized Two-Way Communication

Asparia (formerly SimplifiMed) in October launched the first conversational platform using chatbots embedded into electronic health records (EHRs) to automate administrative tasks to improve consistency and reduce staff burden. Chatbots are computer programs that conduct conversations via voice or text. They are designed to convincingly simulate how a human would behave as a conversational partner.

With Asparia’s chatbot, patient access functions can be automated with customized two-way communication that improves adherence to appointments, check-ups, and preventive screenings, according to the company.

“Automating these activities with smart technology is a major step forward in improving patient care and alleviating the issues in patient access,” says Amanda Heidemann, MD, from CMIO Services, a healthcare consultancy. “Asparia will enable healthcare delivery organizations to achieve higher efficiency and reach quality and population health goals.”

While automation can increase adherence to patient treatment plans and improve patient outcomes, it also boosts efficiency and financial performance, Asparia states.

The cost of missed appointments to medical offices is roughly $150 per no-show, but in reality it is much higher and devastating, says Kamal Anand, MS, MBA, CEO of Asparia.

“No-shows erode the patient-care team bond and as a result reduce clinicians' influence to change patients' behavior. Knowing that some patients will not show up, clinics overbook. So, when a sick patient seeks an appointment, she does not get one for several days. Moreover, when she does show up, she has to wait for a long time in the lobby due to overbooking,” Anand says. “As the patient did not get timely care and had to wait in the lobby, her relationship with the clinic gets dented. It’s no wonder that when the physician asks the patient to take medications as prescribed or get preventive care, the patient often ignores that. These patients then end up going to the ER or have to resort to expensive procedures.

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“Most of the reminder systems today require patients to call the medical office or clinic to cancel or reschedule,” Anand adds. “However, patients either forget or do not call because they remember that when they called to schedule the visit, they had to wait on the phone for a long period of time. Moreover, patients know that medical offices overbook and assume that even if they do not show up, another patient will fill that slot. Still, at the heart of the problem is a lack of a real relationship between the patient and clinician. Each no-show only further erodes the relationship.”

Just because a chatbot can hold two-way communication does not mean that it is able to reduce no-shows by itself. To make an impact on the no-shows, the chatbot needs deep integration with the EHR so that it can work almost like a human in managing the complex scheduling rules practices have, Anand says.   

“The biggest benefit of using a chatbot is to strengthen the patient-clinician bond. Under the value-based care model, this bond is of paramount importance,” he says. “Not only does the patient get care when she needs it, medical offices’ quality score improves. This improvement in quality is reflected in better payments.”

Health and hospital systems, medical groups and Federally Qualified Health Centers use Asparia. The company claimed these healthcare delivery organizations reported increases in patient response and engagement, lower no-show rates, and higher consistency and adherence to preventive care check-ups.

Response rates to notifications about vaccines went from 5% to 70% at a medical group in Arizona, says Brett Swanson, MD, a primary care physician from Scottsdale.

The chatbot can be embedded in EHR systems such as Epic, Athenahealth, NextGen, Centricity, and DrChrono.

“(With the chatbot,) an average multi-specialty medical group should see an immediate drop in the no-show rate and increased availability of same/next day appointments,” Anand says. “In the mid- to long-term, as the patient-clinician bond matures, they should see higher patient loyalty, higher clinician satisfaction, and higher revenue under risk-based contracts."