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Staff Shortages: Automation of Clinical Care the Only Option

Unless you believe demand for healthcare will fall or nurses will stop retiring, there is no other option.  Yes, you can automate back-office functions.  Yes, AI can do lots of ‘sexy things’ such as reading x-rays more accurately and discovering new medicines faster.  However, consider chronic disease and mental health totaling 90% of all healthcare costs in the US. 

The challenge with chronic care is two-fold:  We need to (i) reduce clinical inertia and (ii) empower and drive patient self-management harder.  At the heart of this is automation of routine clinical care and automated patient engagement that is accessible to all patient groups. 

With over 200,000 patient successes, has proven that Automated Clinical Conversations via Text powered by Evidence-Based AI is effective.  Validated studies show 64% less nurse-time required while improving A1c by one point, 70% reduction in emergency admissions for COPD patients, and a pharmacist team managing 10-times more patients for hypertension medication titration.  Further details at the end of the blog.


Clinical Inertia: Slow-Motion, Avoidable Deaths

Clinical inertia refers to the failure of healthcare providers to initiate or intensify treatment despite recognizing the necessity for such actions based on clinical guidelines or a patient’s health status.

The research is clear: Clinical inertia leads to a large number of avoidable hospitalizations and deaths; the challenge is typically divided into diagnostic, preventive, or therapeutic inertia. 

In contrast to adverse events, clinical inertia is not visible minute to minute, but is a drawn-out process often lasting weeks or months.  Clinical inertia is avoided by good standard of care with appropriate care plans executed day in, day out…ideal for Automated Clinical Conversations.

Staff Shortages: Compounding Clinical Inertia

What happens when an organization is short of staff?  Doctors and nurses typically go beyond the call of duty when dealing with an emergency. But humans find it almost impossible to do ‘important tasks’ that are ‘not urgent’ during a prolonged crisis.  Enter clinical inertia; the silent killer of patients with chronic conditions or frail patients recovering from surgery at home. 

How can automation work?  Take hypertension.  Imagine a digital nurse reaching out to at-risk patients to ensure they measure their blood pressure at home to get an accurate diagnosis (multiple readings, avoiding white coat syndrome).  The digital nurse then summarizes the data and exports it to the EHR where a doctor or pharmacist makes decisions on medication. The digital nurse then, once again, ensures patient progress is monitored, and flags up issues such as failure to take medication or an out-of-range reading.

Now imagine that the digital nurse can support medication adherence for diabetes, the taking of rescue medication for COPD or asthma, and ensuring a patient is fully prepared for surgery.

Staff Shortages: Reducing Interaction, Lowering Patient Engagement

Healthcare workers are increasingly experiencing burn-out by ever-increasing demand and a sense that they are not ‘doing enough’ for patients.  Even the most dedicated doctor or nurse will find it hard to systematically make follow-up calls or medication reviews per SOC or pathway guidelines during a crisis, or when feeling completely overwhelmed… ‘OK let’s do that next week.’

The result is less interaction with patients and fewer opportunities to engage and nudge patients towards healthier behaviors, consistent medication taking, etc.   

How can automation work?  Imagine a digital nurse texting the patient daily to check in, offer personalized health advice, capture readings and providing immediate feedback.  Little and often personalized interaction is proven to empower patient self-management: Better for the patient and better for the healthcare team.    

Automation:  Always On, Always to Protocol, but Personalized 

It is undisputed that clinical variation or variation from SOC/agreed pathway is both bad for clinical outcomes and drives cost.  From chronic care to surgery, less variation is better and safer.  One benefit of reducing variation is that you collect better data which points to further improvements more easily and effectively.  If there is too much variation, it is near impossible to gain insights from the data.

Impact of automation? After saving staff time, the biggest benefit with automation is ‘machine driven’ implementation of best practice.  The digital nurse will neither take a short-cut nor change the standard of care.  This does not mean every patient is treated identically: Firstly, the patient is assigned to a relevant patient cohort.  Second, the combination of individual settings and the use of AI delivers highly personalized care (the digital nurse has access to relevant context).   

Automated Clinical Conversations via Text…It Works!

Florence, our digital nurse, started life as an R&D project in the UK’s National Health Service (NHS).  The challenge was ‘how to develop a simple, highly scalable solution that can reach all patient groups?’  The solution was ‘Automated Clinical Conversations via Text’ powered by Evidence-Based AI.

Florence is now hard at work 24/7 in England, Scotland & Wales, Australia, and across the US.  Over 200,000 patients have been successfully managed by Florence with success in all chronic conditions and in pre/post operative patient management.

Lindsey, a nurse practitioner in Newport, Maine, describes Florence as a ‘personable robot that holds patients to account’, that will ‘check in with you [the patient], see how you are feeling, that you are taking your meds or whether you need a dose change’.  One of the patients describes Flo as ‘a regular doctor, that is why I like it’.

Examples of Flo success in improving outcomes and saving clinical time includes:

  • Diabetes: 64% less time spent, A1c reduced by 1 point
  • Heart failure: Hospital admissions reduced by over 65%
  • Hypertension: 50% fewer appointments, sustained improvements
  • COPD: 70% reduction in emergency admissions

We are on a Mission to Create 1 Million Nurses

Contact us for further details




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