Patient outreach automation is an AI voice agent that calls patients, instead of waiting for their calls. It reminds them about a check-up or a test that is overdue, and it follows them up after they leave hospital. It is the same kind of agent as the AI medical receptionist, working in the other direction. This kind of product is sold mainly to clinics and health plans in the United States.
A missed check-up or test is called a care gap. For instance, a person with diabetes should have an HbA1c blood test, which shows the average blood sugar over the last three months, at least once or twice a year. A woman above a certain age should have a mammogram, an X-ray that screens for breast cancer, every one or two years. When such a test is overdue, there is a gap in that patient's care.
Why do clinics and health plans care so much about these gaps? In the United States, health plans are scored on how many of their members get these tests on time, and the scores affect how much the plans are paid. Many plans pay clinics a bonus for closing gaps. A yearly visit also lets the doctor record each of the patient's long-term illnesses. That record is used in risk adjustment, which pays a plan more for members who are sicker.
Take, for example, a clinic in Michigan with 1,200 patients who have diabetes. The agent finds 340 of them with no HbA1c test in the last 12 months. It calls all 340 over three days. One of them is a 62-year-old retired bus driver. The agent tells him that his test is overdue, and offers him a slot at the clinic's lab on Saturday at 9 a.m. He accepts, and the agent books it. Of the 340 patients, 210 answer the call and 150 book a test. The other 190 get a text message, and a second call a week later.
A clinic could make these calls with its own staff. But 340 calls would take an employee several days, and many calls would reach voicemail. The agent can call each patient at the time when that patient usually answers.
The calls follow a planned sequence: first a call, then a text, then a second call. Planning such a sequence for each group of people is called journey orchestration. After a hospital stay, the follow-up is often run by the hospital's patient engagement platform, which this agent can work alongside. Like the receptionist, the agent is one kind of AI customer service agent.