Pager Health, a virtual care navigation system, has developed three new enterprise applications employing Google Cloud generative AI technology to enhance its assistance to payer partners. 

These tools include chat summation, sentiment analysis and a frequently asked questions bot. The chat summation tool provides summaries of member interactions, giving clinicians notes and streamlining documentation processes.

Nick D’Addezio, VP of strategy at Pager, remarked, “If an encounter takes 10 to 15 minutes, there’s always five to 10 minutes of documentation time that person has to do in another system of record. In the chat summation tool, it goes down to one minute.”

The time saved by these tools enables clinicians to dedicate more attention to tasks that require a more human touch. Considering that there are approximately one million doctors in the U.S. responsible for caring for over 300 million individuals, any increase in efficiency is crucial. However, concerns remain that these tools might be used by payers as an excuse to downsize staff in pursuit of greater productivity.

The FAQ bot, developed on Google Dialogflow, also contributes to reducing call center interactions by enhancing responses to common health and benefit inquiries.

The sentiment analysis, powered by Google Vertex AI, evaluates a member’s emotional condition and tracks the progression of interactions. It analyzes chat responses, including word choice, tone, and response speed, to check whether a member is experiencing happiness, frustration, or anxiety. This data is then provided to payers, enabling them to train their staff and enhance interactions. In the future, this tool may even prompt suggested responses based on common engagements, as noted by D’Addezio.

Pager Health announced its collaboration with Google Cloud last year, positioning itself among the tech giant’s 40 healthcare independent software enterprises. Google recognized Pager’s growth potential, particularly as its platform gained popularity during the pandemic. Additionally, the company is exploring the utilization of Med-PaLM 2, a large language model tailored to the medical domain.

Pager has chosen Google over other AI companies due to the tech giant’s capacity to fine-tune models to particular client data, thus preventing data leakage into the general dataset used to inform the foundational algorithm. This approach instills a greater sense of security among payers.

The company primarily collaborates with 10 Blue Cross Blue Shield plans and major insurance players in Latin America. Additionally, Pager is engaged in discussions with other national plans. D’Addezio anticipates that the new tools may offer capabilities to function within more direct provider models.

The advent of highly efficient administrative tools raises familiar questions within the health tech sector. While efficiency is highly sought after by payers, providers, and employees alike, what are the implications for call center staff and other affected employees?

These plans must adhere to medical loss ratio floors, which necessitate efficiencies and cost savings on the administrative side to meet regulatory requirements.

Pager views AI tools as instruments that significantly enhance productivity. Doctors, call center agents, care managers, and physicians will all have access to “superpowers,” that will help them manage patients more effectively.

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