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How Accolade Transforms Member Care with AI-Driven Personalization

How Accolade Transforms Member Care with AI-Driven Personalization

Healthcare can often feel impersonal and overwhelming, so Accolade is on a mission to change the experience.

Healthcare can often feel impersonal and overwhelming, so Accolade is on a mission to change the experience.

Since its launch in 2007, the company has grown from startup to a healthcare innovator with more than 14 million members. Its secret lies in combining technology and data insights with a personalized approach to healthcare access and management.

Based in Plymouth Meeting, Pennsylvania, Accolade partners with employers to oversee their employees’ healthcare needs. At the core of its operation is a contact center where about 1,500 skilled professionals—including Care Advocates—provide support tailored to each member’s unique needs. They handle everything from benefits enquiries to virtual primary care and expert medical opinions.

“We’re the number on the back of a member’s card, their first point of contact,” explains Ardie Sameti, Accolade’s Senior Director of AI and Automation. “Our Care Advocates are very knowledgeable about healthcare, claims and benefits, client support services, and provider services.”

Enhancing Care Delivery

As Accolade expanded, it faced the challenge of maintaining operational efficiency without compromising its hallmark personalized care.

“How do you scale a business where trust, relationships, and empathy are at the core of everything? So, the technology we’ve built and the partnerships we’ve formed are anchored around this principle,” says Sameti.

This includes the strategies Accolade has adopted for notetaking and call summarization by Care Advocates. Traditionally, this was a manual, time-consuming task that often led to inconsistencies in note format and content.

As Sameti notes, “It’s important for us to efficiently and accurately capture information from member interactions, so we save time and ensure the high quality of our care.”

Streamlining Notetaking with Generative AI

Recognizing an opportunity for improvement, Accolade explored using generative AI to automate this process. It realized that by reducing hold and wrap-up times, it could streamline its operations while maintaining service quality.

“So, we said, ‘Let’s take our existing Observe.AI platform that’s already listening to calls, already doing natural language processing, speech analytics, and transcription, and have it produce a summary after every call’,” says Sameti.

His team collaborated with Observe.AI to develop a “golden model” for note quality.

Using Observe.AI’s Summarization AI, this model prioritized clearly defined data points, values, and next steps using a templated format. Iterative testing and safeguards ensured that AI-generated notes were consistent and actionable.

Reduced After-Call Work, Increased Engagement 

The impact of this innovation was significant: the time spent on after-call tasks decreased by more than 50%, reducing Care Advocates’ administrative duties. 

“We returned the time that Care Advocates spent taking notes during and after interactions back to the business, specifically to our Care Teams and operations’ leadership,” says Sameti. “This allows them to decide how they want to use the time, whether for training, taking another call, or any other purpose.”

With this shift, Care Advocates can focus more on engaging with members.

“Our Care Advocates report that it’s much easier to talk to members and stay present,” adds Sameti. “This ability to better engage and drive member satisfaction is the perfect outcome for us.”

Better Productivity and Quality Assurance

Accolade’s move to AI-driven notetaking has also led to cost savings and increased productivity.

“When you reduce post-call activities, you’re essentially getting more out of your Care Advocates because you’ve removed some administrative work off their plate, which allows them to perform with higher productivity,” says Sameti.

By automatically generating call summaries and integrating them into its CRM system, Accolade ensures each member’s record contains a concise yet comprehensive overview of their interactions. This streamlines record-keeping while enhancing quality assurance and regulatory compliance.

“These safeguards are in place to make sure that if there are discrepancies in the notes, you can actually listen to or see the interaction for yourself, and that’s all in the CRM system.”

Expanding Possibilities with AI

With its sights set on future innovations, Accolade is exploring new AI-powered capabilities for its contact center.

“We’ve been discussing two exciting areas with the Observe.AI team,” Sameti shares. “First, there’s potential in conversational AI and looking beyond agent-centric solutions to deliver better services to our customers. Also, we’re interested in predictive modeling to gauge our customer satisfaction and net promoter score. It’s a promising direction we’re eager to explore further.”

Discover how Accolade’s innovative approach can transform the healthcare experience. Read the full customer success story.

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Sharni Medina
Director of Customer Marketing
LinkedIn profile
June 18, 2024
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