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Automating Conversation for Care Management: An Interview with Conversa's Chris Edwards

Chris Edwards is the Chief Experience Officer at Conversa. He has been at the forefront of technical change in healthcare from LASIK to EHR's and now to care management.

Conversa delivers 'automated, personalized doctor-patient conversation experiences that lead to more informed and meaningful patient relationships, effective population management and, ultimately, better clinical and financial outcomes.' Let's see what Chris has to say about his work and the future of care management...

Can you talk about what you’ve done previously and what brought you to Conversa?

Well I’ve been in health care technology for twenty years and actually grew up in the Bay Area, living in the .com area before Silicon Valley even existed. I always had an affinity for technology and trying to use it to better people’s lives, whether it was in oral care, vision care, chronic condition care or digital health and mobile health.

My journey has been all about that, and I’ve been doing strategy, marketing and sales development. I’ve always enjoyed running towards transformational businesses. So when new technology was coming out to help people whiten their teeth, I was doing that before it was popular. I helped people with a things called LASIK before people knew what that was.

Also got to be on the ground level for Electronic Health Records (EHR) and digitizing records to help patients have a better experience, and then to mobile health and then Conversa. And the thread that really ties these together is a better patient experience and a better consumer experience.

You know, this is the one industry that deals with life or death, and should have a phenomenal user experience at every single touchpoint but it really doesn’t.

What are you all working on at Conversa?

Well if you think about what’s going on in health care right now you see a huge shift in automated patient engagement. It’s becoming one of the most significant drivers in this transformation of health care. You have providers, you have patients and they’re really not talking. It takes 24 days average wait time to see a doctor and on the average visit you only actually see a doctor for 7-8 minutes, and it’s really not a great experience​​

So, here you have technology like Conversa that’s helping provide better communication and fuel patient-provider relationhships. You need communication around chronic condition management, pre-surgery, post-discharge from the hospital, medication adherence, and a number of these things.

So, what Conversa is becoming health care’s conversation platform. Accenture’s calling Conversa ‘Health care’s AI Orchestrator’, our clients are calling us ‘An AI Care Navigator’ because what we’re doing is we’re using our conversational AI to personalize and automate a patient conversation experience. They’re health and care chats to help health care organizations monitor and manage patient populations at scale more efficiently and effectively than ever before

We talk a lot about this type of technology and what we’re doing and our conversational AI that’s helping organizations like Northwell, Atrium Health, and Centura Health, and trying to think about new innovative ways to extend the communication and care that they deliver.

So does Conversa cover a suite of conditions?

Yep, we have an extensive library of about 350 conversation programs. Some include asthma, chronic obstructive pulmonary disease, congestive heart failure, diabetes, hypertension, joint replacement and many others. So a health system may have a certain population set, they’ll say ‘We want to better address our diabetes population, and we want to implement Conversa’s health chat to act as digital checkups and nice light touches’.

These health chats are becoming new innovative ways for health systems to communicate with their patients. One interesting example is Northwell Health, one of the 6 largest health systems in the nation. They may have people leaving the hospital, post-discharge from maybe a stroke or heart condition. They’ll say ‘Ms. Jones, we at Northwell care about your recovery and we have a new innovative way for us to communicate and care for you, and it’s called Northwell health chats’ and that’s Conversa. We’re powering that

Ms. Jones could receive this on here smartphone or desktop or email and she gets a link. It’s all secure, browser-based dialogue with structured responses that pushed to the patient.

"We’re seeing 80% plus of patients saying they feel more engaged in their care."

So there’s machine learning that’s taken place based on our branching logic and algorithms, that’s building out additional questions and queries. The key part of this is that these conversations will go back to the care teams at the health systems and they’re able to see the conversations and, based on the answers to the questions, a red / yellow / green clinical dashboard of which patients need what level of care immediately.

And is this integrated back into EHR systems?

(Example of Conversa's Clinic-Facing Dashboard, taken from their website)

Yes, it is. It’ll bring in patient generated health data from a patient’s weight scale or connected blood pressure monitor and bring that data into the conversation. It can say ‘Hello Ms. Smith, I saw your weight has fluctuated up 10lbs last week, let’s talk about that.’ And there are a couple of things there: Firstly, the patients can always escalate to the care team if they need. Secondly, the care team members, whose case loads may be thousands of people, can quickly analyze using our risk colors the level of severity of patients, and be flagged by our systems for the patients they need to speak with. So these interactions are happening with the care team on their time.

How frequently does your AI fail and conversations need to be elevated to a care team member?

The system is doing really well, we can take a look at all the things being said in the marketplace like Accenture and Caremark combined with some of our metrics. We’re seeing 80% plus of patients saying they feel more engaged in their care. One client they found that with a particular population that 29% of the time they were able to discover that patients were off their plan. That’s a big deal! Especially considering the millions of dollars they may be spending.

"We need to know what needs to be asked of these patients and so we have medical directors but what’s also important is the way to do that, and layering in the behavioral science there."

We helped the hospital intervene, and if Conversa doesn’t exist then these people stay off their health plan and a negative event occurs and they may have to rush into an EHR or something else down the line and spend a lot of money.

There’s been a whole growth of companies that are developing ‘digital therapeutics’ to handle chronic conditions, for example Omada or Livongo for diabetes. Does this overlap with what Conversa’s working on?

Well, Frost and Sullivan did some work analyzing this market and found that we are an important fit in this market and actually compliment those other services. We’re really the last mile in that patient experience. One of the things we are focussed on is the ongoing and continuous conversations.

For example, if you’re diabetic you might need frequent touches whereas if we’re just surfacing nutrition advice for employers for a wellness program that’s not going to happen every day.

Conversa also integrates data from wearables and other biometric devices, how does that fit into the rest of Conversa and does that drive value for the clinics?

Yes, so like you mentioned we do integrations with the EHR and we do that with many of the major EHR systems. Part of our key mantra is creating automated, personalized digital conversations experiences. So the personalization part is a really big deal because we know that bringing in and leveraging things found in the patient record as well as patient-generated health data will allow the system to deliver a better personalized experience that can address more parts of a patient's profile. This is something that’s very important to our value proposition because we’re trying to drive better insights to the care team and so combining the clinical data with patient-generated health data, like from devices or wearables

That’s why we designed this not to be another app. No one wants to download another app! You would have your FitBit app and the health system app and that’s just not a good experience, we try to keep the patient experience at the forefront of this.

"Patients need something ubiquitous with on-demand access, and they need it in health care."

Another thing I would mention is the focus on conversations: we’re also approaching this a lot differently than anyone else does in the marketplace based on the content we develop. We have content staff writers creating the conversations.

And these people are from major consumer brands, used to building consumer trust and being engaging and surprising and delighting and motivating. This is really important because using specific phrasing and icons and emojis combined with Self-Determination Theory, a behavioral-change framework to maximize positive motivation around autonomy, competence and relatedness.

We need to know what needs to be asked of these patients and so we have medical directors but what’s also important is the way to do that, and layering in the behavioral science there.

Where do you see Conversa going in 5 years?

What we’re hearing from clients and market analysts is that we play well in the fee-for-service and the value-based-care space. Because all these other industries have been thinking about customer experience and having conversations and customer relationship management, and you Conversa is right there, regardless of fee-for-service or fee-for-value. We really want to continue to be positioning around this consumer value

Improving care coordination, patient engagement, population health, marketing engagement, customer retention, brand experience, these are all tactics and initiatives that health systems, pharma and payers need to do. So we’re able to help across patient care and marketing initiatives. We live in a conversation economy with Facebook and Snapchat and so patients need something ubiquitous with on-demand access, and they need it in health care.

What's one thing about healthcare that young people interested in the field should know?

The healthcare industry is made up of a group of passionate people who truly care. It's unlike any other industry out there. From doctors to care teams to strategists to technologists, the people in healthcare are special. And the stories they folks have of these are fantastic. If you are interested in entering the field, ask someone already there about their story. They'll have one.

Up Next:

A series of interviews with startup founders at HLTH: Stay tuned for the CEO of OrangeTheory, Dave Long, describing the role of fitness + data in healthcare.