The Role of AI in Tackling Inefficient Pathways
By Jonathan Carr Brown, Managing Director at Healthily
In today's healthcare landscape, the burden of demand is not only straining health insurance margins but also overwhelming healthcare providers. However, rather than viewing demand as the primary issue, it's crucial to recognize that the root cause lies in inefficient resource allocation across both private and public sectors.
As the Managing Director of
Healthily, the world's foremost health navigation platform and a non-executive of a British NHS Integrated Care Board, I firmly believe that the key to addressing excessive customer demand lies in effective health signposting powered by Artificial Intelligence (AI).
Our Dot™ platform stands out for its unique ability to navigate healthcare choices based on personal risk and appropriateness at a service level.
The unholy trinity of bad appointments that are eroding health insurance margins comprises:
1. Unnecessary Pathways
One British study found that a significant portion of appointments with family/general medical practitioners — between 10% to 20% — are for self-care or self-limiting conditions that could be managed independently.
Imagine the savings and efficiency gains if even a fraction of your members realized they could manage such conditions without an appointment. Not only would this save personal and corporate time, but it could also lead to reduced premiums.
2. Inefficient Pathways
A considerable portion of virtual consultations or face-to-face visits are taken up by patients who would be better served by specialist care from the outset. For example, over 20% of presentations to family doctors in the UK are for back complaints that could initially be addressed by a physiotherapist.
Additionally, approximately 40% of appointments are related to mental health conditions, where personalized triage could expedite and improve treatment outcomes.
3. Duplicate Pathways
The rise of virtual consultations has brought convenience but also inefficiencies. Research suggests that 25% of individuals using virtual services are immediately referred to face-to-face appointments, indicating suboptimal triage.
Moreover, redundant appointments occur when patients require tests for a formal diagnosis, despite the possibility of self-referral with appropriate information. This paradigm shift mirrors the evolution seen in pregnancy care, where self-administered tests have become standard practice.
It's evident that tackling these inefficiencies requires a holistic approach focused on the introduction of automation in the triage process. Given the complexity of the task, the ideal, if not the only, solution is to resort to the use of advanced (and more importantly safe) AI healthcare navigation.
Our Dot™ platform offers tailored solutions to optimize resource allocation and improve patient outcomes in a fully automated way which does not require any human intervention.
Inefficiencies in pathway selection represent a significant challenge for both health insurance providers and patients alike. However, by leveraging AI-driven solutions like the Dot™ platform from Healthily, we can revolutionize the way appointments are triaged and managed, leading to substantial cost savings, improved patient experiences and, ultimately, better health outcomes.
Join us in embracing the future of healthcare efficiency.
Explore how the AI-powered solutions from Healthily can transform your organization's approach to appointment management and resource allocation.
Together, let's build a healthier, more streamlined and cost effective healthcare ecosystem for all.
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