Healthcare’s complexity often begins with the patient's intent and ends with the care the patient receives. The journey from initial symptom recognition to appropriate treatment can be fraught with uncertainty, misdirection, or inaction.
"It's easy for us to forget that the most important diagnostician is not a clinician, but the patient," said Michael Turken, a physician and health tech entrepreneur. "If they don't think their symptoms are worth worrying about, we may never see them until it's too late."
To better understand this dynamic, Clearstep conducted a comprehensive pre- and post-intent study using anonymized data from a health system customer and compared it with our own findings.
Clearstep's Pre-Intent Study
In our study, which involved approximately 5,000 patient conversations, we aimed to assess patients' initial care intents and how often these intents were redirected to more suitable care endpoints.
The findings revealed that 73% of patients were rerouted to a care setting different from their original intent. Furthermore, 67% of these rerouted patients were directed to lower acuity care settings, highlighting a prevalent trend of patients overestimating the severity of their conditions.
Comparative Analysis with AI-based Virtual Triage Study
The findings from Clearstep's study align with those of a 2024 study titled "Using AI-based virtual triage to improve acuity-level alignment of patient care seeking in an ambulatory care setting."
This study by Reliant Medical Group analyzed 8,088 encounters and found that virtual triage technology significantly influenced patient care behavior. Virtual triage (VT):
- Reduced face-to-face visits by 12.5%
- Reduced self-care engagement by 8.2%
- Increased virtual care by 19.1%
One-third of patients changed their care-seeking behavior to align with VT recommendations, indicating the tool's effectiveness in guiding patients to appropriate care levels. Additionally, VT led to 12.0% of patients de-escalating care acuity and 21.2% escalating it, with high compliance rates.
Customer Data Insights
Using Clearstep APIs, our customer, a large health system in the south, implemented a robust system to manage patient flow and balance supply and demand across care settings. Faced with same-day and near-day primary care capacity challenges, the customer added custom routing logic to direct patients to telemedicine or urgent care when immediate attention was needed. The results were impressive:
- 97% de-escalation from patients intending to go to the ER
- 40% de-escalation from care-constrained primary care
- 36% increase in patients going to less-constrained urgent care locations
- 130% increase in patients going to virtual care (less-constrained resource)
These figures demonstrate the effectiveness of Clearstep's routing logic in optimizing care delivery and reducing strain on high-demand resources.
Several key themes emerged when comparing our customer data to Reliant Medical Group's study and our broader study. Both datasets indicated a significant rerouting of patient care intent, with a common trend of de-escalation to lower acuity care settings. This alignment suggests that Clearstep's routing logic is universally effective across different healthcare systems and patient populations.
For instance, for our health system customer, the most frequent re-directions were:
- Office visits: 43% de-escalated to virtual care
- Urgent care: 25% de-escalated to virtual care
- Self-care: 9% escalated to more structured care
- Emergency department: 6% de-escalated to lower acuity settings
Similarly, in the AI-based virtual triage study, a substantial portion of patients initially seeking emergency care were successfully redirected to less urgent settings, ensuring that high-acuity resources were reserved for those truly in need.
Custom Business Rules and Outcomes
A notable finding from both studies is the impact of custom business rules. By integrating additional routing logic tailored to specific system capacities and patient needs, healthcare providers can significantly enhance patient outcomes. For example, our customer's custom rules led to a 97% de-escalation from the ER, a vital metric for maintaining emergency care efficiency.
Additionally, these outcomes were achieved regardless of the delivery method of the clinical logic—whether through APIs or white-label implementations. This consistency underscores the robustness of Clearstep's algorithms and their adaptability to different healthcare environments.
Enhancing Healthcare Delivery through Efficient Resource Management and Patient-Centered Care
Clearstep's routing logic emerges as a flexible and powerful tool for improving healthcare delivery. By understanding and addressing patient intent, healthcare systems can better manage resources, reduce unnecessary high-acuity visits, and ensure patients receive the right care at the right time.
The comparative analysis between our customer's data, our own findings, and the AI-based virtual triage study highlights the universal applicability and effectiveness of virtual triage solutions such as Clearstep. As healthcare systems continue to face capacity challenges and strive for efficiency, these tools offer a pathway to not only meet but exceed patient care expectations.
If you think your healthcare organization could benefit from Clearstep's virtual triage solutions, let's chat.
