1. Thomas Morrow MD Author of Tomorrow’s Medicine Managed Care Virtual Health Assistants in Specialty Pharmacy

2. The Maasai Warrior in Kenya has better access to data and communication than President Reagan!

3. Disclaimer Dr. Morrow: is a full time employee of of a large biotech company but no company products will be discussed during this presentation. The opinions expressed during this discussion are his alone and do not reflect the opinions of his full time employer. has created this talk from his research concerning VHA for an article published earlier this year in Managed Care and again in ForbesManagedForbes

4. Natural Language Processing + Conversational Interface: Keys to Artificial Intelligence Artificial Intelligence The ability of a computer or other machine to perform actions thought to require intelligence. Natural Language Human written or spoken language as opposed to a computer language. Top Companies: – Next IT: focusing on the patient activation Next IT – Nuance/VirtuOz: focusing on medical records Nuance/VirtuO – Creative Virtual: no obvious medical focus Creative Virtual – IBM Watson: No commercially available products, Oncology/Cardiac physician decision support IBM Watson

6. Medical Decisions Occur in a Minute by Minute Basis Patients spend a few hours per year with their physician for a “specialty pharmacy” disorder. They spend 5000 hours per year making literally thousands of decisions that affect their health They need day to day decision support Natural language- driven virtual assistants can fill this need

7. Without a Relationship, There is no Influence We know that advice and guidance is much more influential coming from someone with whom you have a trusting relationship

8. The Virtual Health Assistant: Technology that extends the patient/provider relationship A New Definition of High Touch Fulfillment Needs Patient Education Disease Treatment Management Programs A New Level of Data Collection: Virtual Head-to-Head Trials

9. Reach and Influence Patients the other 5000 hrs. Virtual health assistants go far beyond reminders, and have been proven to make an emotional, social, and visual connection with patients

10. CharacteristicTraditional IVRTraditional Web ChatbotNext IT’s Multimodal Virtual Assistant InputVoice and DTMF tones input via keypad TextText, Talk, Tap Language ProcessingDecision Tree with limited FAQ based interactions Searchable FAQStochastic NLP engine with an intent based language model Logic ModelLinear with branches Typically 4x4 or 5x4 model Silo singular answer basedHuman Emulation – The model is a combination of decision tree, FAQ and intent model which also incorporates context like a human does. ChannelsPhoneWebPhone, web, SMS Text, mobile, kiosk, social media OutputVoiceText and sometimes voiceVoice, Text, Navigation often simultaneously based on channel Contextual AwarenessMinimal: Based upon account, user profile Minimal Based upon account, user profile or General Answers Page Awareness Conversational Awareness User Profile Every question is taken in the context of the entire conversation as well as other data sources Proactive EngagementNone Multiple options, dynamic, personalized language model size4x4 to 5x4200-300 in a basic FAQ mode10s of thousands of intents in a single model Where placed in organization IVR’s can be set up to support specific tasks in an organization Usually isolated to a section of a web site, not the entire site. Across the entire web site/portal and across multiple channels as well. Breadth/ Depthminimal on both since a human listening to the phone can only remember a small number of options Typically limited to either broad OR deep but not both Able to cover a very broad domain of knowledge while also having a great deal of depth where applicable. End PointSimple taskGeneral Answer to simple questionsTruly conversational Cost to Build$$ $$$ How builtVoice RecognitionSearch BasedChat Recognition Future enhancementsLimits reachedLimits almost reachedVirtually infinite Overall Long Term Value$$$$$$$$ Monthly Operational Cost to Organization $$$$$ (based on need to divert calls to Live Agent) $$$$$ (based on need to divert calls to Live Agent) $ (Virtually all calls can be handled by Virtual Agent limiting the number of live agents needed) Automated system choices available to an organization