The primary challenge identified within the platform’s workflow was the significant time burden associated with the in-home medication assessment process. This inefficiency limited the number of members that could be served, hindering the program’s ability to scale and deliver a cost-effective solution to its managed care partners. The high degree of manual data entry not only impacted user efficiency but also diverted valuable clinician time away from direct member care, creating a barrier to a more seamless and effective user experience.
To address the core operational challenges and provide a scalable, value-based solution, the client required a platform that could fundamentally transform its in-home medication assessment workflow. The key requirements for the new platform were:
To resolve this critical workflow bottleneck, a comprehensive, multi-faceted solution was developed. The team integrated advanced AI capabilities, including optical character recognition (OCR) for document-based data extraction and speech recognition for hands-free data capture, directly into the assessment process.
This solution was delivered through a new, intuitive mobile app interface, which allowed providers to:
- Quickly Scan Labels: Use the device’s camera to scan medication bottles, automatically populating the member’s record with drug names, dosages, and other key information.
- Dictate Notes: Use speech-to-text functionality to record notes and observations during the assessment, eliminating the need for manual typing.
- Automate Data Entry: Directly link the captured data to the backend system, streamlining the entire workflow.
The implementation of the AI-driven solution yielded significant, measurable results that directly benefit managed care operations:
- Reduced Per-Member-Per-Month (PMPM) Costs:Clinicians saw a considerable decrease in the time spent on administrative tasks, which translates directly to a lower cost per member served and more efficient care delivery.
- Enhanced Risk Stratification:The use of OCR minimized human error associated with manual data entry, leading to a more reliable and complete member record. This improved data quality allows for more accurate risk stratification and proactive care planning.
- Increased Operational Efficiency: The platform maintained all evidence—including scanned labels and dictated notes—within a single, easily accessible record. This eliminated the need for manual retrieval of information, allowing pharmacists and care managers to complete their medication reviews significantly faster and more efficiently, reducing overhead.
- Proactive Vitals Monitoring:The integration of IoT devices (e.g., blood pressure cuffs, glucometers) enabled automated, real-time vitals capture. This provides clinicians with continuous member data, allowing for early detection of health changes and proactive interventions, reducing expensive emergency room visits and hospital readmissions.
- Cost-Effective Remote Care:The platform was expanded to include a secure, in-app telehealth feature. This allows pharmacists and clinicians to conduct remote video consultations directly with members, facilitating follow-up discussions and medication counseling without the cost of an in-person visit.
- Increased Scalability for Growth:By streamlining the assessment workflow, the platform was able to handle a higher member volume without a proportionate increase in staff, enabling the program to scale efficiently to meet the needs of larger managed care contracts.
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