학술논문
Chatbot-Assisted Care Management.
Document Type
Academic Journal
Author
Schario ME; Mark E. Schario, MS, RN, FACHE, is the vice president, Population Health and President, University Hospitals (UH) Quality Care Network, UH Accountable Care Organization & UH Coordinated Care Organization. He leads the Population Health services for UH of Cleveland. Before joining UH, he has led clinical integration networks and accountable care, served as a vice president of operations/chief nurse executive, and senior field director for The Joint Commission. He is a retired lieutenant colonel with the U.S. Army.; Carol A. Bahner, BSN, RN, CCM, is the manager of care management in Population Health at University Hospitals (UH). Her 25+ years of nursing career at UH spans pediatric bedside nursing, home health care coordination, and care management in UH's Accountable Care Organization from its inception. She is passionate about helping people with chronic disease optimize their health.; Theresa V. Widenhofer, ADN, RN, CCM, is a nurse care manager in Population Health at University Hospitals (UH). Her nursing experience includes UH's transplant surgical unit. Before nursing, she was a product support analyst for a point-of-sale platform development company. She also works with Evolve Coaching, including its Arts for Autism and Joey Travolta Film Camp-Pittsburgh programs.; Joan I. Rajaballey, BSN, RN, CCM, is a nurse care manager in Population Health at University Hospitals, focusing on Medicare and Adult Insurance populations. She received her BSN degree from University of Central Florida. Her nursing experience includes ICU and home care coordination, and serving on the ADAMHS board for mental health and addiction services in Lake County, Ohio.; Esther J. Thatcher, PhD, RN, is a nurse scientist with Population Health at University Hospitals. A nurse since 2001, she has worked in primary care, inpatient, community outreach, and public health settings. Earning a nursing PhD in 2014, Esther's research focuses on population-level interventions for cancer and chronic disease prevention and early detection.; Bahner CA; Mark E. Schario, MS, RN, FACHE, is the vice president, Population Health and President, University Hospitals (UH) Quality Care Network, UH Accountable Care Organization & UH Coordinated Care Organization. He leads the Population Health services for UH of Cleveland. Before joining UH, he has led clinical integration networks and accountable care, served as a vice president of operations/chief nurse executive, and senior field director for The Joint Commission. He is a retired lieutenant colonel with the U.S. Army.; Carol A. Bahner, BSN, RN, CCM, is the manager of care management in Population Health at University Hospitals (UH). Her 25+ years of nursing career at UH spans pediatric bedside nursing, home health care coordination, and care management in UH's Accountable Care Organization from its inception. She is passionate about helping people with chronic disease optimize their health.; Theresa V. Widenhofer, ADN, RN, CCM, is a nurse care manager in Population Health at University Hospitals (UH). Her nursing experience includes UH's transplant surgical unit. Before nursing, she was a product support analyst for a point-of-sale platform development company. She also works with Evolve Coaching, including its Arts for Autism and Joey Travolta Film Camp-Pittsburgh programs.; Joan I. Rajaballey, BSN, RN, CCM, is a nurse care manager in Population Health at University Hospitals, focusing on Medicare and Adult Insurance populations. She received her BSN degree from University of Central Florida. Her nursing experience includes ICU and home care coordination, and serving on the ADAMHS board for mental health and addiction services in Lake County, Ohio.; Esther J. Thatcher, PhD, RN, is a nurse scientist with Population Health at University Hospitals. A nurse since 2001, she has worked in primary care, inpatient, community outreach, and public health settings. Earning a nursing PhD in 2014, Esther's research focuses on population-level interventions for cancer and chronic disease prevention and early detection.; Widenhofer TV; Mark E. Schario, MS, RN, FACHE, is the vice president, Population Health and President, University Hospitals (UH) Quality Care Network, UH Accountable Care Organization & UH Coordinated Care Organization. He leads the Population Health services for UH of Cleveland. Before joining UH, he has led clinical integration networks and accountable care, served as a vice president of operations/chief nurse executive, and senior field director for The Joint Commission. He is a retired lieutenant colonel with the U.S. Army.; Carol A. Bahner, BSN, RN, CCM, is the manager of care management in Population Health at University Hospitals (UH). Her 25+ years of nursing career at UH spans pediatric bedside nursing, home health care coordination, and care management in UH's Accountable Care Organization from its inception. She is passionate about helping people with chronic disease optimize their health.; Theresa V. Widenhofer, ADN, RN, CCM, is a nurse care manager in Population Health at University Hospitals (UH). Her nursing experience includes UH's transplant surgical unit. Before nursing, she was a product support analyst for a point-of-sale platform development company. She also works with Evolve Coaching, including its Arts for Autism and Joey Travolta Film Camp-Pittsburgh programs.; Joan I. Rajaballey, BSN, RN, CCM, is a nurse care manager in Population Health at University Hospitals, focusing on Medicare and Adult Insurance populations. She received her BSN degree from University of Central Florida. Her nursing experience includes ICU and home care coordination, and serving on the ADAMHS board for mental health and addiction services in Lake County, Ohio.; Esther J. Thatcher, PhD, RN, is a nurse scientist with Population Health at University Hospitals. A nurse since 2001, she has worked in primary care, inpatient, community outreach, and public health settings. Earning a nursing PhD in 2014, Esther's research focuses on population-level interventions for cancer and chronic disease prevention and early detection.; Rajaballey JI; Mark E. Schario, MS, RN, FACHE, is the vice president, Population Health and President, University Hospitals (UH) Quality Care Network, UH Accountable Care Organization & UH Coordinated Care Organization. He leads the Population Health services for UH of Cleveland. Before joining UH, he has led clinical integration networks and accountable care, served as a vice president of operations/chief nurse executive, and senior field director for The Joint Commission. He is a retired lieutenant colonel with the U.S. Army.; Carol A. Bahner, BSN, RN, CCM, is the manager of care management in Population Health at University Hospitals (UH). Her 25+ years of nursing career at UH spans pediatric bedside nursing, home health care coordination, and care management in UH's Accountable Care Organization from its inception. She is passionate about helping people with chronic disease optimize their health.; Theresa V. Widenhofer, ADN, RN, CCM, is a nurse care manager in Population Health at University Hospitals (UH). Her nursing experience includes UH's transplant surgical unit. Before nursing, she was a product support analyst for a point-of-sale platform development company. She also works with Evolve Coaching, including its Arts for Autism and Joey Travolta Film Camp-Pittsburgh programs.; Joan I. Rajaballey, BSN, RN, CCM, is a nurse care manager in Population Health at University Hospitals, focusing on Medicare and Adult Insurance populations. She received her BSN degree from University of Central Florida. Her nursing experience includes ICU and home care coordination, and serving on the ADAMHS board for mental health and addiction services in Lake County, Ohio.; Esther J. Thatcher, PhD, RN, is a nurse scientist with Population Health at University Hospitals. A nurse since 2001, she has worked in primary care, inpatient, community outreach, and public health settings. Earning a nursing PhD in 2014, Esther's research focuses on population-level interventions for cancer and chronic disease prevention and early detection.; Thatcher EJ; Mark E. Schario, MS, RN, FACHE, is the vice president, Population Health and President, University Hospitals (UH) Quality Care Network, UH Accountable Care Organization & UH Coordinated Care Organization. He leads the Population Health services for UH of Cleveland. Before joining UH, he has led clinical integration networks and accountable care, served as a vice president of operations/chief nurse executive, and senior field director for The Joint Commission. He is a retired lieutenant colonel with the U.S. Army.; Carol A. Bahner, BSN, RN, CCM, is the manager of care management in Population Health at University Hospitals (UH). Her 25+ years of nursing career at UH spans pediatric bedside nursing, home health care coordination, and care management in UH's Accountable Care Organization from its inception. She is passionate about helping people with chronic disease optimize their health.; Theresa V. Widenhofer, ADN, RN, CCM, is a nurse care manager in Population Health at University Hospitals (UH). Her nursing experience includes UH's transplant surgical unit. Before nursing, she was a product support analyst for a point-of-sale platform development company. She also works with Evolve Coaching, including its Arts for Autism and Joey Travolta Film Camp-Pittsburgh programs.; Joan I. Rajaballey, BSN, RN, CCM, is a nurse care manager in Population Health at University Hospitals, focusing on Medicare and Adult Insurance populations. She received her BSN degree from University of Central Florida. Her nursing experience includes ICU and home care coordination, and serving on the ADAMHS board for mental health and addiction services in Lake County, Ohio.; Esther J. Thatcher, PhD, RN, is a nurse scientist with Population Health at University Hospitals. A nurse since 2001, she has worked in primary care, inpatient, community outreach, and public health settings. Earning a nursing PhD in 2014, Esther's research focuses on population-level interventions for cancer and chronic disease prevention and early detection.
Source
Publisher: Lippincott, Williams & Wilkins Country of Publication: United States NLM ID: 101291585 Publication Model: Print Cited Medium: Internet ISSN: 1932-8095 (Electronic) Linking ISSN: 19328087 NLM ISO Abbreviation: Prof Case Manag
Subject
Language
English
Abstract
Purpose/objectives: Chatbots are automated conversation pathways that users can access through text message or email on smartphones or other connected devices. In care management, they can be used to monitor patients' health conditions or recovery from procedures. This article describes nurse care managers' experiences using chatbots in patient care, illustrated through two patient case reviews. Considerations for planning and implementing chatbot technology in care management settings are discussed.
Primary Practice Setting: This care management service is part of an accountable care organization that serves 582,000 patients in University Hospitals of Cleveland, Ohio. Care management focuses on patients with chronic conditions, recent hospital discharges, and other needs. Care managers comprise a centralized team as well as embedded staff in select primary care practices.
Findings/conclusions: The two patient cases are exemplars from the care management program serving patients recently discharged from the hospital with ongoing chronic conditions that increase risk for readmission. Use of chatbots helped overcome obstacles to conventional care management outreach and resulted in improved outcomes and strong trusting relationships with the care managers.
Implications for Care Management Practice: Patients who typically do not respond to other types of care manager outreach may respond to text message-based, asynchronous chatbot communication. Interpersonal relationships between care managers and patients can be strengthened by chatbot support. Chatbot technology tracks patients' progress and offers insights to patients and clinicians to facilitate earlier interventions when problems occur. Chatbots make frequent patient contact to collect and provide routine information, allowing care managers to spend more time on high-value interactions that require clinical judgment. Potential concerns about chatbots include effect on labor force, information security, health equity, and oversight of content.
(Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Primary Practice Setting: This care management service is part of an accountable care organization that serves 582,000 patients in University Hospitals of Cleveland, Ohio. Care management focuses on patients with chronic conditions, recent hospital discharges, and other needs. Care managers comprise a centralized team as well as embedded staff in select primary care practices.
Findings/conclusions: The two patient cases are exemplars from the care management program serving patients recently discharged from the hospital with ongoing chronic conditions that increase risk for readmission. Use of chatbots helped overcome obstacles to conventional care management outreach and resulted in improved outcomes and strong trusting relationships with the care managers.
Implications for Care Management Practice: Patients who typically do not respond to other types of care manager outreach may respond to text message-based, asynchronous chatbot communication. Interpersonal relationships between care managers and patients can be strengthened by chatbot support. Chatbot technology tracks patients' progress and offers insights to patients and clinicians to facilitate earlier interventions when problems occur. Chatbots make frequent patient contact to collect and provide routine information, allowing care managers to spend more time on high-value interactions that require clinical judgment. Potential concerns about chatbots include effect on labor force, information security, health equity, and oversight of content.
(Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)