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From Patient Records to Patient Engagement: Speech Recognition Branches Out
By Juliann Schaeffer

Speech recognition in the healthcare sector may be more commonly associated with doctors populating patient records, but now the technology is branching out to interact directly with patients in an effort to engage consumers and help improve overall health outcomes.

Developed by Eliza Corporation, the Eliza health engagement management platform engages patients with automated multimodal communications, using speech recognition over the phone and other communication channels to aid hospitals in reducing readmissions and increasing medication adherence while helping health plans increase members’ preventive screening rates.

What Is Eliza?
Initially founded as a research and development entity, Eliza Corporation decided in 1999 to focus its efforts on the healthcare market, according to company founder and CEO Lucas Merrow.

Because no other such speech recognition programs at the time were engaging patients in this manner, Eliza’s team had to learn from experience, “building the speech recognition engine’s capabilities with each call and developing best practices designed to encourage people to talk about their health with an automated system,” Merrow says.

The company has since built programs that include automated calls, e-mails, text messages, mail, and social and mobile healthcare interactions specifically designed to manage diverse patient populations, Merrow says.

“As one can imagine, outbound calling for health topics offers a unique set of challenges,” Merrow says. “We often encounter people with health conditions that present vocal challenges, such as emphysema, cerebral palsy, and/or artificial larynxes, that our technology is able to recognize, often to patients’ delight.”

In general, the technology seeks to do the following:

• extend the reach and effectiveness of doctors, clinicians, nurses, etc in ways that create healthier outcomes and greater value;

• engage individuals with their health and healthy behavior; and

• point to resources and automate tasks and workflow.

Reducing Readmissions and Improving Care
Eliza’s Readmission Reduction solution attacks hospital readmissions in particular.
Aimed at easing the transition to outpatient care by quickly following up with members who have recently been discharged, the Readmission Reduction program seeks to reinforce discharge instructions and provide patients with additional support and resources based on their individual risk profiles.

Not only can the technology proactively follow up with patients postdischarge, but it also collects information to gauge readmission risk (by assessing whether patients have all the tools necessary for successful recovery) and then connects them with additional resources when necessary.

And it’s working. According to Merrow, “Patients receiving follow-up outreach after hospital stays are 25% less likely to be readmitted within 30 days of discharge,” which reduces not only the readmission risk for patients but also the extra costs these added health stays mean for hospitals and health plans.

Compared with having an actual person follow up, Merrow says many patients actually prefer the anonymity the automated technology allows, especially for certain healthcare patient populations.

“We’ve seen that with more sensitive topics [such as colorectal cancer screening and antidepressant medication adherence], people actually are more likely to engage in an automated call than with a live agent,” Merrow says. “It’s the concept of perceived anonymity that makes people feel more free to share their real barriers to a health behavior without feeling the need to please the person on the other end of the line or say the things they think the agent wants to hear them say.”

Eliza technology learns by experience and has used that experience to cater its language to different patient populations and drive engagement. “We’ve learned over time that different conditions have different ‘personalities,’ so to speak,” Merrow says. “The more impactful a disease is on a day-to-day basis, the more open to engaging on the topic is the individual. For example, we’ve learned when talking to a young adult about asthma to presume the individual sees the asthma as a side situation, not a main event. An individual suffering from coronary heart failure is another story—[these patients are] often eager to really dig into the challenges associated with managing the condition because talking about the situation validates how impactful it can be.”

Improving Screening Rates
Not just for hospitals, Eliza also has been effective in increasing preventive screening rates when health plans have utilized the technology for their members. “When done well, proactive outbound healthcare notifications have been shown to improve health outcomes and reduce healthcare costs,” Merrow says.

He says inspiring positive health behavior with quality technology does two things: “First, it supports people in doing the right thing—whether that’s getting a flu shot, a preventive screening, filling their prescription, etc. Second, these health behaviors have proven to dramatically reduce long-term care costs because it’s preventive care. Therefore, the individual wins by making better health decisions and the provider wins by reducing the longer-term care costs of that individual. It not only saves money but also improves patient satisfaction.”

According to Merrow, Eliza’s automated outreach has seen the following results:

• a 76% increase in the number of patients who get their recommended diabetes screenings;

• a 137% increase in colon cancer screening rates in a Medicare population; and

• a quadrupling in participation in an online smoking cessation program.

One example of its success is a partnership between Eliza and Medical Mutual of Ohio (MMO) that targeted health plan members eligible for breast, cervical, and colorectal cancer screenings. After Eliza’s interactive, automated outreach, “The mammography rate of MMO members who received a combined outreach regarding both breast and cervical cancer was 45% higher than the rate of those who didn’t receive the calls, and the cervical cancer screening rate was 53% higher. Meanwhile, the colorectal cancer screening rate of members who received the Eliza outreach was 35% higher compared to those who didn’t get the call,” Merrow explains.

“This collaboration is proof that by simply improving the methodology, we are bringing about both member engagement and behavioral changes,” says Paula Sauer, senior vice president of care management and pharmacy at Medical Mutual. “In this situation, outreach technology plays a major role in driving engagement and ultimately results in positive health outcomes.”

— Juliann Schaeffer is an associate editor at Great Valley Publishing company.