Key Takeaways
- Implement robotic process automation for digital check-ins to reduce no-show rates, increase copay collections, and free front-desk staff for patient-facing tasks.
In the heart of South Carolina, a healthcare transformation is underway that challenges preconceptions about innovation in the American South. The Medical University of South Carolina (MUSC University), celebrating its 200-year anniversary, has emerged as a surprising leader in health tech adoption. Under the guidance of Crystal Broj, CPDHTS, Chief Digital Transformation Officer, MUSC has implemented a series of digital health solutions that are significantly reducing no-show rates, enhancing patient satisfaction, and improving clinical workflows.
MUSC University has positioned itself at the forefront of healthcare innovation and eHealth solutions. As the only comprehensive academic health center in South Carolina, MUSC serves 2.4 million patients annually across 16 hospitals, 2,700 beds, and 750 locations in all 46 counties of the state. It's also one of only two telehealth national centers of excellence in the country, showcasing its commitment to AI in healthcare and cutting-edge health technology solutions.
The Digital Transformation Office, led by Broj, is relatively new – just over two years old. What started as a one-person team has grown to ten members, including a fellow and three interns. "We're definitely into teaching innovation to the younger generations who are coming up through digital health and getting them involved early," Broj explained during a recent interview with the American Journal of Health Care Strategy.
Broj's background in computer science has proven invaluable in her current role. "Having that IT background lets me bridge the gap," she notes. "My sweet spot is taking business problems and finding technical solutions." This perspective has allowed her to bring fresh approaches to healthcare challenges, supported by strong leadership backing from the organization. MUSC's innovative work is often showcased at leading industry events like the HIMSS conference and VIVE Health conference.
One of MUSC's most successful initiatives involves robotic process automation (RPA) for patient check-ins through a partnership with Notable platform. This workflow automation system reaches out to patients before appointments, allowing them to confirm or cancel, while collecting demographic information digitally instead of using the traditional clipboard at the front desk. This digital front door approach has revolutionized patient engagement.
"We started with a very small project," Broj explains. "We wanted to outreach to our patients when they have an appointment and say, 'Hey Cole, you have an appointment in three days. Would you like to confirm it or cancel it?'"
The process began as a pilot in just five locations before expanding throughout the organization. The team continuously refined the system based on direct patient feedback, achieving a remarkable 98% patient satisfaction rate. Improvements included consolidating check-ins when patients have multiple appointments in one week and adding Spanish language capability.
The results have been impressive:
This time savings allows front desk personnel to focus more on patient interaction rather than paperwork. "That lets Sally actually be able to look up and go, 'Hello, Cole, how are you today?' Or be able to, when you get out of the office, schedule a referral or your next appointment," Broj says.
Moving beyond the frustration of traditional phone menus, MUSC introduced "Emily," a natural language processing voice AI for their patient access center. Unlike conventional systems that require callers to navigate through numbered options, Emily engages in conversational AI interactions.
"When you call, her name is Emily, you call and it says, 'Hi, I'm Emily. I'm your digital assistant. How can I help you?'" Broj explains. "It says, 'Well, I'd like to check on my appointment.' 'Sure. No problem.'"
After gathering necessary identifiers to access electronic health record (EHR) records, Emily can provide appointment information and help patients confirm, cancel, or reschedule. The team started small with just a few phone lines before expanding, and they're currently teaching Emily to handle more complex interactions like appointment rescheduling and Spanish language requests.
Perhaps the most transformative technology for provider experience has been the implementation of ambient scribing technology through Nuance Communications DAX. This artificial intelligence-powered solution records doctor-patient conversations and automatically generates clinical documentation, showcasing one of the most promising AI solutions in healthcare.
"No provider ever went to school to become a doctor, a nurse, or whatever and said, 'I can't wait to type into the EHR,'" Broj points out. "They wanted to help people."
The technology allows clinicians to maintain eye contact and focus on patients rather than typing into Epic during visits. After a year-long pilot that started with just a few providers, MUSC found that patients actually embraced the technology. More importantly, providers using the system effectively experienced:
While not ideal for all providers—particularly those highly proficient with Epic's smart phrases or those with established human scribes—the ambient scribes technology has proven valuable enough that MUSC is now rolling it out system-wide to all interested providers.
Building on their RPA success, MUSC has expanded intelligent automation to tackle prior authorizations. Previously, staff would need to manually enter information from Epic into payer portals, wait for authorization codes, and then enter them back into Epic—a process taking 15-30 minutes per authorization.
With automation, this has been reduced to approximately one minute. Currently, about 40% of authorizations flow through the system without human intervention, allowing staff to focus on managing denials and exceptions rather than routine data entry. The result is faster patient care—patients can get their MRIs and other services much more quickly without waiting for administrative processes.
MUSC's digital transformation journey hasn't been without challenges. One significant hurdle was change management, particularly with front desk staff. "We found that they, that our front desk people were telling people not to use the software," Broj admits. This resistance, combined with high turnover rates, required developing comprehensive training programs and continuous reinforcement to improve AI literacy and facilitate AI integration.
Getting physician buy-in for new technologies like ambient scribing required understanding provider concerns about looking incompetent with new systems. "Nobody wants to go in, no matter what system it is, you don't want to go in in front of other people and not look smart," Broj explains. "I mean, they went to school for 12 years, for Pete's sakes."
Her strategy involved:
Another significant challenge has been reconciling IT's traditional waterfall project management approach with innovation's more agile methodology. While IT teams typically work with precise timelines for Epic updates, innovation projects often require frequent pivots as new technologies are refined. "It's sort of the gift that keeps on giving—smaller, like, 'I need an API guy for like two hours this week and then to validate for an hour next week,'" Broj explains.
With these initial successes, MUSC continues to expand its AI initiatives and health technology solutions. Current projects include:
The organization is also developing an innovation district that aims to become a tech hub combining technology and healthcare. "Our innovation district that's coming that you'll keep hearing more and more about at MUSC, we're really building out to be a tech hub to do really cool things with combining technology and healthcare," Broj shared. This initiative explores cutting-edge concepts like generative AI in healthcare, LLMs, and AI agents to further enhance patient care and operational efficiency.
Despite all the technological innovation, Broj emphasizes that the goal isn't to replace human interaction but to enhance it. The time saved through automation allows staff to focus more on patient needs rather than administrative tasks. Front desk personnel can engage more meaningfully with patients, providers can concentrate on clinical conversations rather than documentation, and the entire care process moves more quickly.
As Broj puts it, "I think at the end of the day, the relationship game is one of the biggest pieces that you can have—being trustworthy and showing that trust and earning the trust of people."
<p>I think at the end of the day the relationship game is one of the biggest pieces that you can have is you know being trustworthy and and showing that trust and earning the trust of people and that does not come right [Music] away hello everyone this is Cole from the American Journal of healthc care strategy joined by a really special guest today uh Crystal uh of MUSC Crystal bro Crystal please introduce yourself and your current role um thanks for having me first of all and Happy New Year it's good to talk to you again um I'm Crystal Bry I am the chief digital transformation officer here at the Medical University of South Carolina based in Charleston um it's a very new role um we've only had a digital transformation office for a little over two years um started the role two years ago um with just a team of me um but we've grown into a team of 10 now who are doing some really amazing things and I think we're going to talk a little bit about that today thank you so much again for coming on you know people think of the South and South Carolina they kind of think of it as like a slower not as technologically advanced region I'm from Raleigh and I I've had a lot of friends uh who are going to MUSC whether for school or for fellowship and I've been hearing from them I've been hearing on the news that it's actually doing a lot more Innovative things than what at least I've seen even up in the north which is what people assume is the Innovative area and so I was excited to bring you on board to the podcast and really discuss and showcase the high level of innovation that's going on there um and like you said it's a new team and now it you said there was 10 team members now yeah we have 10 team members um uh including we have a fellow and uh three interns so um definitely into that you know teaching Innovation to the you know younger Generations who are coming up through uh digital health and and getting them involved early which is amazing that we have those programs our Innovation District that's coming that you'll keep hearing more and more about um at MUSC we're really building out to be a tech Hub to do really cool things with uh combining technology and uh Healthcare um so keep a lookout for that too but we have been doing some really great things in the past two years um with with digital things um do you want me to just start on one or two where would you like to start yeah no I think I I would really love to hear also for people who do not know what is the scale of MUSC look like how many kind of hospitals and and what does that look like so we are the um we're just celebrating our 200y year anniversary um we just had our uh our anniversary dinner last week um so so we're one of the oldest medical colleges in um the South um the only Comprehensive academical Health Center in South Carolina um 2.4 million patients served annually um 16 hospitals across the state 2700 beds 750 locations we serve every County all 46 of them in the state of South Carolina we are one of two telea Health national teleah health centers of excellence in the country one of two um we have uh a little over 3,000 students um 22 faculty and Physicians um six colleges in the Medical University side 42 degree programs um about 5.9 billion total Enterprise operating budget and a 10 billion um estimated economic impact to the state of South Carolina so while you know we might be looked at as small down South we have we have big numbers um we're also awesome with uh clinical trials we get a very large amount of research funding about 300 million we have almost 1,200 clinical trials going on at once down here so so all over the place lots of really really really cool things um 55 active faculty startups 33 products in the market um f 595 International and US patents so lots and lots of of innovative thinking and processes here in South Carolina and and you originally got a degree in computer science right way back so has that helped you to to be Innovative because I guess one of the things I'm wondering is how do you find yourself in a role where you're overseeing the organization that's essentially responsible for medical Innovation throughout the whole state um so yeah I was a programmer back in the day when I when I first graduated college so I think that helped help me because um having that it background lets me bridge the gap and in my sweet spot for personally the what I love is taking business problems and finding Technical Solutions and as I grew up in my career so to speak I went from programming to business analysts to managing to directing those types of things not just in um and I started Healthcare much later I've only been in healthcare for about five years but in uh manufacturing and financial and insurance um and and solving those kinds of problems and bringing Technical Solutions to them so so learning Healthcare from the outside in has been very interesting it also allows me to bring some some new ideas um to the Forefront and new ways of doing work so it's not the same old same old and uh MUSC really really Embraces that and uh I have really good support from leadership which is amazing yeah that that leadership support is is a key thing and I think some of the projects that you've talked about working on as well when the audience hears about them really require that support from Enterprise so yeah please share what are some of the the Innovative things you're working on I know we discussed a couple of them last time and I'm really excited to go a bit more in depth yeah we have we have some really good uh projects and and good outcomes with them now we started with um robotic process automation which is you know if you think about AI this is sort of the the easy part of AI it's it's uh just literally um having Bots do work that people do so we started with a very small um project to start with we wanted to Outreach tore patients when they have an appointment and say hey Cole you have an appointment in three days would you like to um confirm it or cancel it um I need some demographic information stuff that you used to put on the clipboard the the awful clipboard that you get at the front desk right so now we can collect that we collect it on your phone you put in all that information and then it goes automatically into our electronic health record which for us is epic um and it's it's very seamless it can you know take a picture of your insurance take a picture of your driver's license all of that goes over um and so we started a pilot with with our partner notable um who we used for that and we did it for five sites you know as as we talked about we have 700 plus sites across the state started with five sites just to just to start to work with it um and then we rolled up to some more sites and then we rolled out to some more sites um and we added new features along the way because one of the things that we did was we captured you know how's this experience for you thumbs up thumbs down and then a whole you know comment section and very amazingly a lot of people gave us a lot of comments 98% patient satisfaction with the experience which I think is amazing um but even so they'd be like this is great but I have three appointments in one week and I'm getting three emails or texts from you that's a lot that's a lot to have to do why can't I just check in at once why can't they check in at once we looked at it we changed it so now if you have more than one appointment in a week you get it on Sunday and you're checked in for all your appointments during the week you know we'd really like to have it in Spanish we put it in Spanish we got all kinds of comments from from from our Spanish speakers here in South Carolina which is the second language in South Carolina by the way um and uh they they love it they love to be able to do it they love being able to do it at home or when they're on the go and not have to sit in a doctor's office and be filling out all those forms the other thing we do is you know well we fill this up before why do I have to do it again well we pull the information that's in Epic so you can just validate it where you can't do that on a clipboard and you know the people at the front desk are not going to print it out and go show me make sure this is all correct right so so we're able to do that we did have some bumps in the road because you know being iterative and changing things along the way occasionally things didn't work right at the beginning and so some of those early offices were like oh that doesn't work or somebody would come in and go what what is this thing that came to me is this real and they' be like yeah no no just come and see me Susie at the desk and I'll give you the clipboard and then you can fill it out um and so then we found that they that you know our front desk people were telling people not to use the software which um is kind of not what we were hoping for so we you know we did some training on that and then we know too that front desk people turn over right and so then the new person didn't know what this notable thing was and so they kind of ignored it and so we had to put together you know do a lot of change management put together training programs so every time somebody gets on board they learn what notable is so they understand um but we've gotten some really really good numbers out of this too um we now uh at time of service get copay collections they're up almost 20% from before we had this um our no-show rate are down almost 4% um which is great because we also use epic Fastpass so if uh you cancel your appointment for Wednesday um and I'm on the waiting list it'll automatically notify me and say hey do you want to take Cole's appointment at 10 o'clock and uh then I get in and get my service done faster um but the biggest change was that our previsit check-ins um went up almost 67% so people really were using the software to to get that along um so very excited we handled about a 100,000 um monthly digital registrations and for the front desk people it saves 3 to five minutes um so if you average that over all of our front desks we're saving about 500 hours a month um which is amazing now that does not mean that we let Sally go on Fridays um because we need those people still at the front desk um but instead that lets Sally actually be able to look up and go hello Cole how are you today or be able to when you get out of the office schedule a referral or your next appointment in or whatever right there and really focus on taking care of what we think is most important which is the patient yeah that is and and like I was I appreciate you giving us the scale because people you know they'll say Okay 60% 4% Etc but when you're looking at a system that serves millions of people I know at Jefferson we have about 4.8 million outpatient you know 4% of that's 200,000 appointments so that's a big deal right you know being able to gain 200,000 appointments back a year by reducing noow rate by only 4% that pre-check in is so important again I want to talk about that referral process real quick because I think that's like a big hidden value is when they get that time back you're now doing inline referrals they're going to be referring usually within the organization that's going to allow them to I'm assuming check in again on Epic when they get that referral to a new appointment and so it just creates a continuity of of care that we've been working on for a while yeah and the other thing too is that we really needed to build trust in the system so once we knew we could do our pay with this now we've added on and so this year our big um thing is is part of that referral process starting with prior authorizations um right now um you get it on Epic you have to type it into the payer portal and then wait for the referral code and then type it back into epic that can take anywhere from 15 to 30 minutes per authorization so if you need an memorize somebody's actually doing your lookup to make sure your insurance will cover it now using uh Bots going from 30 minutes to about a minute it'll automatically know and nobody has to type and so then they process the ones that get denied or they're doing that kind of stuff so that happens a lot faster which means that you can get in to get your MRI faster you can get treated faster so we're working on that right now um again it's a bot training thing about 40% are actually going through right now not being touched by a human um which is amazing um and so we're continuing to scale that um and now we're looking at working on referrals because if we're in a health system and referrals are phone calls but they're also faxes believe it or not and one department will fax to another department and then it goes to the patient access center and then somebody has to type it into epic and then it goes into a queue and then somebody calls and says Cole do you want to schedule your appointment and so we're trying to automate some of that process too so again we can serve the patient quicker and get them the care that they need how did you or I guess the other the probably better question is how long was the process of getting that executive Buy in from when kind of the team was founded to where they're letting you or or encouraging to take up bigger and bigger project right because I know from a CFO perspective in can be kind of scary in some ways because a lot of CFOs have said it's like putting money into a black box where you give money to an innovation team and you have no idea what they're doing with it yeah you know I'm really lucky because Innovation is one of the the key things that we lead with and our CEO is very very supportive of this work so when I came in we had just started with this notable project they were just getting ready to launch the five and they sort of you know let me take and Lead it and then you know Build It Up over time and make sure that it was successful and spend the time and care that it needs because a project like that you can't just expect a vendor to do it plug it in and it be done all that change management the training the support the making sure that that's working is something that's very very important to make these types of projects in digital successful um and you know being able to show success there then allows you to go okay yes let's do this now um I started while I was doing that putting together a whole digital roadmap of the types of things we wanted to do um and so I started in October our road map was done by talking to Stak what do you need how can we help you that kind of stuff um my road map was done in about June and so then I had this beautiful plan of the work we're going to do over the next three years um and then that November chat DPT became crazy busy and all of a sudden it was buzzword by December somebody's like hey let's look at ambient technology for scribes um and so that just like my scale of a plan went off the wall right because now it's like okay we're going to move this out we're going to move this out so we have time to do this and we partnered with our Solutions team um to bring in actually the ambient scribe and that is um um we're using nuance stxs and so we started with a pilot we started with just a couple of providers to start with and then we grew the pilot and we decided we were going to do it for a whole year so we really really knew what was going to um what we were going to work on and if it was going to work for our our providers and we found out a lot of things um we thought patients might not use like it we thought patients would be very adverse to having that in room and the opposite from our surveys and things patients actually love it they were really excited with the experience because instead of having to type into epic the whole time which by the way no provider ever went to school to become a doctor a nurse or whatever and said I can't wait to type into the EHR right they want to help people and so so this gets them out of that and being able to look at you and say they're GNA take the notes for me and then I'll review them is that okay when you get the patient consent then you are actually able to look at your patient in the face and have a really good conversation that's great for the doctor it takes the stress off of them and it's great for the patients um and what we found was you know when the providers used it and used it well um they were 33% less time outside of their scheduled hours trying to finish those charts and even better 25% of what we call pajama time which is nights and weekends went down so they got their their lives back their personal lives back um which was great but also because we were closing the sooner for our revenue cycle friends um we dropped our our chart leg by about 35% so things were getting closed things were getting taken care of faster um and that was absolutely I mean those are great numbers and great statistics we were very pleased with it but there are some doctors that this did not work for um there's a thing in Epic called smart phrases where you can schedule things and it just it does all kinds of stuff for you right and and the more Adept you are at that the more you can customize it just for Crystal and some doctors have that down to a tea that it's actually slower to be able to have to talk and then read it than it is to do that um some doctors with uh human scribes just really are in sync with their human scribe and they can just look and that they know so again it doesn't work for them so it's not something that works for everyone but for those that spent the time in it um they found that it was great um but we had to remind people to use it and we had to you know really onboard them and engage them and keep them engaged so they didn't like oh I'll use it on Monday then I don't want to bother with it um to really get that you know that Cadence of using it using it well and it was a new tool I mean remember this came out right after GPT was was going on and so throughout the year of our pilot Microsoft was also changing it and and adapting it and making it smarter and smarter so the people who started with the pilot by the end they're like this has changed so much and it's so much better of a product it was when we started um and overwhelmingly we decided to expand it throughout the whole system um this year so starting in January we're now starting to roll it out to all of our providers that would like to use it you since you you're not a clinician I think one of the important questions as also somebody who is not a clinician um I've I've spoken with a lot of doctors about this and and there's a kind of a tremendous amount of fear because epic was supposed to or not epic but EHR EMR was supposed to improve everything especially about primary care and I think it has improved a lot I think efficiency is up I think doctors earn more for the hospital for sure now but a lot of doctors feel kind of like they got the short end of the stick and so when it comes to new technologies they're already like in a bit of fear right they have especially in primary care a lot of doctors in their 40s are saying you know I have I have this loan debt I have this huge patient burden I don't really see this light at the end of the tunnel and then the administrators like ourselves are saying we have this AI technology that could really help but there's this hesitancy do you have any strategies for helping you with that yeah I think you know one of the things we can't just put technology for technology sake like Dax is cool right it is very cool when it works um but you know you have to make sure that the doctors really get comfortable with it um and that they that so that they don't because nobody wants to go in no matter what system it is you don't want to go in in front of other people and not look smart I mean they went to school for 12 years for p sakes they're smart people so and they're very confident um but you don't want to give them a tool that makes them not feel that way so you want to make sure that the training and that they have support and that there is a phone line or a textt number that they can get instantaneous support so they feel very comfortable um and to explain the why and what's in it for them and what it's going to do for them I think is the bigger picture piece that you have to say this is why you want to do it because it will make your day go faster it will give you time back um and and try to do that the other thing we used was as physician Champions um there are some you know Physicians that are just like this is the coolest things and I want the new stuff I want the new stuff and then to be able to tell because I'm Tech girl right so you know that's nice that you're the digital girl and you're telling me this is a new tool but you're not a provider you're never going to be a provider you do not understand a provider's life and so getting Partners on that side that try it and say yeah look this is really cool look what I can do look what I've saved get the true people that do are doing the same job as you saying this will work for you is so much more important than anything being pushed from it or digital over um and so those Partnerships are very important that's really uh that's a so just to kind of resmar because it's really important it was physician Partners which uh I mean that's that's really an excellent way I know techie Physicians as well and you can see they always have the newest stuff so that's a key one um but then again like you said it's kind of understanding trying to understand their workflow understand what the value is but I really like the point about that knowledge because you're right doctors they do rely on their their kind of confidence for for patients to listen to them and accept their care and I know in Primary Care especially with gap closures with preventive care they really do need to rely on that expertise and and that confidence in the situation so that's that's really key do you think that like or I guess the question is how did you learn that was it through experience that you learned how to reach out to Physicians how to identify their struggles because it's somebody who's early in my career right when it comes to working with Physicians I'm still nervous when it comes to working with them um yeah I think it's just a matter of having the confidence in what you're doing and and reaching out and explaining you know this is this is what I know I don't know everything but you do can you partner with me and help me accomplish this task or going to we call them ice Chiefs exper you know they're the ones that that run that department um to go what is the you know who should I talk to who would be somebody that I could partner with on your team you know so that I can you know try this thing or do this thing and and who would maybe be interested and then you know trying to build those relationships I think the end of the day the relationship game is one of the biggest pieces that you can have is you know being trustworthy and and showing that trust and earning the trust to people and that does not come right away I mean even being a newcomer here um you know people are very nice and and they want to help but they're like oh yeah you know we've we've tried these things before it's not going to work right so you want to make sure that you know well well let's can you partner with me and let's see if we can make it work this time and maybe for now it's a pilot sometimes it's okay for a pilot to fail um and you have to be willing to let that go too because you can spend a lot of time trying to make a pilot work and just be stuck in Pilot mode forever and it never actually launches and it never gets anywhere and so um there's there's a part of pilot you be like okay this is the stop end if it doesn't happen by this date or if we don't get this functionality by this time then we have to look for another vendor or move on to a different project yeah that's important because I agree and especially we learn that in project management but sometimes we forget it because we want especially being new organization I'm sure you know you want things to work because it you know your name is kind of writing on that so I appreciate that a lot uh so we we've discussed the bot we've discussed uh kind of the the the Dax co-pilot what was that third one that so this is something that's a little more and it came after chat dy2 as well but we we launched a voicebot um for our patient access center and so everybody goes oh yeah I hate voice Bots it's awful right and so what they're thinking about is Hell love you reached n USC press one for Orthopedics press two for Primary Care or whatever you know and it's that you're stuck in the loop and you're like on your cell phone and you're like oh my gosh I have to chck like wait no I've got to go back to the number pad so I can push in a three then you're like yes it doesn't answer yes um but that's not what I'm talking about I'm talking about a full natural language processing voice spot so when you call her name is Emily you call it says hi I'm Emily I'm your digit digital assistant how can I help you it says well I'd like to check on my appointment sure no problem they get some information because it has to go into epic so it has to get your name and mother Keith goes oh yeah I see that you have an appointment on Tuesday the 21st and Thursday the 23rd which one would you like to talk about um the one with Dr Smith sure no problem that's Thursday the 23rd at 1 pm um do do do you want to still keep that appointment do you want to cancel it do you want to reschedule it and she can do that just speaking out um oh yeah and then I also have one for Dermatology later in the month and she can switch gears and also go to that um and so that is super exciting again we started really small with just a couple of lines the first day but it took a while because it's it's a voice spot right so and it's natural language processing which is a much that higher point of AI that we're getting into as opposed to the Bots because now we're talking about a large language model Etc and so on and so we did find some problems because he say okay what what's your name it's Crystal Bry oh Bry b r y like no no no no no B OJ and she goes oh your last name is no no no no B OJ cuz she's still a computer yeah no B is in boy R is in Roger and she like so your name is B is in boy RS and you're just like no learn learn it's like okay well we loaded in the top 10,000 last names in South Carolina so she learned a little bit and then we loaded in okay well what if they say as in and we use the NATO alphabet alpha bravo and that's great and yes that's one way for her to learn but I'm in the South so you might say be is in Bourbon and you just never know what you're going to get the next time so we realized that that even you know the the natural language processing and the picking up of it is good but it's not necessarily great yet it's still learning and so we decided after getting you know only about 50% of people coming through that way and being able to confirm we we started with another identifier that would work better for people that is easier to use um we may go back to the other one eventually um but we're also Now train that to be able to reschedule appointments which is harder than just looking up an appointment and canceling an appointment because then you have to offer up times and understand a lot more about uh do you have anything Thursday at four o'clock no not anything else at four o'clock time frame next week and she has to be able to understand that and work with that so we're training her on that now training her on Spanish again for our Spanish speaking friends um so that's coming out and we're working on a chat bot that will mirror some of the things that she can do on the phone on our website that's really smart so you'll have both and then what just for the audience what identifier did you end up going with um it's a standard epic identifier so if you work in Epic you can tell I don't want to just announce that over right right so one of the one of the ones in the uh within epic is this this a proprietary technique that you've discovered is what you're saying yeah well it's EP it depends on how you have epic setup and what things you allow to go through the security oh very impressive very impressive so this is a Col you can't just do this on your own you have to collaborate with the Epic team with the data team it it's not something that you you can just establish by creating an innovation team and saying here you go no no we really had to partner and that was a very interesting challenge because a lot of these Innovations like I've talked about we started small and then we opened like the Emily The Voice spot we started with four lines and then we expanded and then we expanded and so um it is used to having things very waterfall right because their teams have been doing epic installs or epic updates or other big big system updates so they're very big and very grownup so they're very established so they know that there's going to be a go live date on June 30th so 30 days before that they have to finish testing and get the environment ready for the move and talk to everybody and then 30 days before that they're looking at the release notes and you know they know exactly what needs to happen with Incredible Precision um a vendor who's doing a new technology is very agile and so you may be doing something and this piece doesn't work so then they're like oh no the API that we wanted to do to do the confirm or the cancel or whatever that's not working product we need a new API and so that means then you have to go back to you know they thought they're done with their piece they set up the API for you I done no no no we have to try something else or we need a report to validate this or now we're moving on to the next five sites or whatever so we need to download of those five sites so it's sort of the gift that keeps on giving smaller like like just I need an API guy for like two hours this week and then to validate for an hour next week but really really hard to staff and um trying to partner with it and get a get a Cadence going so that they would understand what we're going to need and how that can fit in with the rest of their department has been something that over the past few years we've worked on partnering with and I'm so thankful for our it leadership that that they have um had the grace to put up with some of the changes that and the disruption that we bring to their Department um just by the sake of the innovations that we're doing and you know having all these different vendors that we're working on they're basically hitting the same resources because basically it's epic Cadence it's the API teams it's the reporting teams um that we need certain things from at various times throughout the year but it's sort of much more sporadic it's not a scheduled thing yeah and I it's important I appreciate you kind of sharing insight into the problems as well because there are so many different things like you said that kind of how patients are going to identify themselves on the phone and like you're saying it's not something you can just solve by coming up with an easy alternative and none of these things really are you have to talk with Physicians you have to talk with the the patients so it's all really important um again thank you so much for coming on crystal I really appreciate your time and I hope we can have you back on again I would love it thank you so much</p>
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