Why Is Finding Care So Frustrating?
Accessing quality healthcare can be daunting for patients today, with numerous challenges hindering their search for appropriate care, especially when they need it most. For most, navigating through a plethora of websites, sifting through reviews, seeking recommendations from friends and family, and consulting with their primary care providers are typically the initial steps. However, this often leads to the necessity of seeing a specialist, which introduces further complexity.
Firstly, the average consumer may not always know which specialties (and even sub-specialties) they’ll need and if they will need a primary care provider to make a referral, adding another layer of uncertainty to the process. Who knows which specialty treats stomach problems (hint: gastroenterologist), knee injuries (hint: orthopedics), or thyroid disorder (hint: endocrinologist or otolaryngologist if surgery is required) just to name a few.For patients with dedicated primary care providers (PCPs), it’s essential for them to loop back and keep them updated on any new treatment plans in the event there are multiple specialists involved. This uncertainty and runaround often results in patients either delaying care or seeking assistance from the wrong provider leading to lost time, inefficiency and higher costs for the consumer.
Secondly, consumers are increasingly prioritizing convenience and speed when deciding where to seek care. While traditional options like the emergency room (ER) or urgent care (UC) are well-known, there’s still widespread confusion about other, potentially more cost-effective alternatives. Options such as retail clinics or telemedicine services offer convenient and often cheaper options for non-emergency medical needs. However, many patients may not be aware of these alternatives or how to access them, contributing to the ongoing reliance on ER use.
Additionally, each health system has their own routing rules based on their services. Some health systems prefer that stomach problems go to internal Medicine providers first before escalating to a gastroenterologist while others may want to route stomach pain to primary care providers. Failure to adhere to these rules can lead to increased costs for healthcare systems and additional out-of-pocket expenses for patients due to unnecessary visits.
Moreover, the landscape of healthcare has evolved to offer various care options beyond traditional in-person visits, including telehealth, asynchronous care, retail clinics, pharmacies, labs, and digital programs and therapeutics. Today, managing conditions like diabetes, high blood pressure, maternity care, and receiving vaccines means understanding a wide array of available options. Patients must navigate multiple point solutions, portals, websites, and health lines just to learn more. As a result, they may not be aware of alternative, cost-effective, and convenient care avenues, leading to underutilization of available resources. In fact, it’s estimated that 40% of telehealth capacity within healthcare systems remains unused. This trend toward offering more services will persist, with federal programs mandating wait times and the imperative to provide virtual “Need Care Sooner” options to maintain compliance and meet consumer demands simultaneously.
Finally, the current search experience for care overlooks the comprehensive health record of the patient but it doesn’t have to! When two individuals search for “foot pain,” they receive identical care provider suggestions regardless of their medical history. However, for a diabetic patient, the optimal recommendation might be to consult an endocrinologist in addition to a podiatrist or for a patient with a family history of sinus surgeries to recommend a follow up visit with an ENT for a recurring sinus infection treated via telehealth. By integrating patients’ health records, we can offer personalized care recommendations tailored to their unique medical needs.
Can large language models (LLMs) be the solution to helping patients get the care they need, when they need it? The answer is a resounding yes.
LLMs Can Make Finding Care Easier
The healthcare landscape is evolving rapidly, with LLM solutions readily available to enhance patient experiences by making them more convenient and accessible. Take, for example, the b.well platform—a cutting-edge precision health solution that integrates LLM technology into its Find Care feature. This innovative capability enables patients to communicate in plain language, promptly identifies urgent needs, understands routing protocols, and thoroughly explores all available care options, ensuring best and most personalized patient experience.
- Using plain language: Patients can easily describe their condition, symptoms, or complaints in plain English, such as “I have stomach pain” or “My baby has a fever.” Our Find Care experience, powered by LLMs, swiftly matches them with the right provider based on their exact needs, all in simple language for seamless understanding.
- Detecting urgency: The Find Care feature is adept at discerning the urgency of a situation based on the patient’s inquiry. For instance, “I was in a car accident” prompts immediate routing to nearby emergency rooms, whereas “I have a headache” may lead to a referral to their Primary Care Provider.
- Routing rules: Matching patients with care providers relies on the routing rules of nearby health systems. Our LLM technology analyzes plain-text routing rules provided by the health system and learns from past patient routes to automatically guide the current patient to the appropriate care provider. For instance, in one health system, “I have stomach pain” may be directed to a gastroenterologist, while in another, it could lead to a primary care provider.
- Search all care options in one place: b.well consolidates all care options into a single, user-friendly interface that is surfaced through the “Find Care” feature. Patients can inquire about managing conditions like diabetes and instantly view all available options, from visiting an endocrinologist to scheduling a telehealth visit to accessing retail clinics or digital programs. By considering out-of-pocket costs and past outcomes, patients can make informed decisions for the most effective, convenient, and affordable care tailored to their needs.
The potential for LLMs in healthcare is limitless for visionary innovators who can harness it and think boldly.
There is clearly a lot of excitement about the potential for LLMs in healthcare. While a lot of the current focus is on how LLMs can be used to help doctors diagnose and document, we believe a bigger opportunity exists in helping patients and caregivers take a bigger role in their healthcare. With 500,000 primary care providers compared to 250 million patients and caregivers, even modest enhancements to patients and caregivers experience can yield substantial impacts on healthcare outcomes and engagement. Finding care powered by LLMs can empower patients and caregivers to find the appropriate care for their needs — driving self service and increasing access to services.
How to Incorporate LLMs into Healthcare
- Reference Architecture: The b.well solution is built using our reference LLM Architecture for Healthcare that allows us to leverage our existing investments in technology as well as to accelerate speed to market.
- Future-proofing and client choice: b.well’s LLM architecture is compatible with leading platforms including AWS Bedrock, OpenAI ChatGPT, Google Cloud, and Microsoft Azure AI. This versatility ensures the longevity of the solution, empowering clients to select their preferred platform based on their business preferences and needs.
- Managing hallucinations: Implementing safeguards against hallucinations is imperative for any LLM-based healthcare solution. At b.well, we adhere to an eight-step model meticulously designed to mitigate this risk. This process entails rigorous testing and feedback from internal teams of clinicians, limitations on the types of questions the LLM can address, stringent control over data utilization, vigilant detection of hallucinatory responses, and iterative refinement based on user feedback, ensuring the reliability and safety of our LLM.
- Controlled deployment: As with any technological advancement, we prioritize a methodical approach, placing a premium on user feedback. We’re gradually introducing our solution to a select group of users, diligently monitoring their responses to iteratively enhance our LLM technology.
What’s Immediately Next for b.well Harnessing LLMs?
Personalization based on the health record: By integrating patients’ health records to optimize their care-seeking journey, this advancement ensures that diabetic patients experiencing foot pain are directed to an endocrinologist rather than a podiatrist, maximizing the effectiveness of their treatment. Furthermore, for other patients, leveraging comprehensive clinical historical data enables us to distinguish between a standard headache and a chronic migraine, ensuring accurate and tailored care recommendations based on each patient’s unique medical background.
To understand enhancements in patient experience using LLMs when finding care, watch the demo below.
It shows how simple questions by patients go unanswered by their health system and their insurance provider today while the b.well Find Care powered by LLM is able to connect them to the appropriate care provider.
