At Kore.ai, we imagine AI ought to scale back friction—not add to it. That’s very true in healthcare, the place legacy processes too typically delay care, frustrate sufferers, and drain sources. I just lately had the chance to talk with two leaders deeply invested in fixing that: Michael Duke, Lead Accomplice at Guidehouse, and Dr. Anthony Chang, pediatric heart specialist and Chief Intelligence and Innovation Officer at Youngsters’s Hospital of Orange County (CHOC), and founding father of the American Board of AI in Medication.
Collectively, we explored how healthcare organizations are utilizing conversational and agentic AI to not solely optimize operations, however to basically reimagine affected person and member experiences.
The Hidden Value of Monetary Clearance
Guidehouse companions with a supplier that was spending greater than half-hour per name to confirm insurance coverage protection, receive pre-authorizations, and validate service areas—work usually dealt with over the cellphone with payer representatives.
The end result? Escalating operational prices, staffing challenges, and avoidable write-offs from missed authorizations.
“Our individuals had been doing their finest, however the quantity and complexity simply didn’t scale,” Duke shared.
Automating the Drawback—with Empathy
To deal with the difficulty, Guidehouse deployed a Kore.ai-powered voice-based assistant—a well mannered, persistent digital agent able to:
- Navigating complicated IVRs
- Ready on maintain (typically 20–45 minutes)
- Talking with payer reps to retrieve protection particulars
- Logging the outcomes routinely
In early phases, the assistant dealt with 4,100+ calls, achieved an 85% success price, and saved over 15,000 employees hours yearly—with out displacing a single worker.
“The reps didn’t even notice they had been talking with a bot,” Duke mentioned. “Some even complimented its Southern-style politeness.”
To take care of scalability, Kore.ai will introduce multi-persona capabilities—giving the bot names like Mary, Emma, and Bob—and embedded generative AI to dynamically adapt to altering IVRs and perform extra pure conversations.
From Name Automation to Full Workflow Intelligence
As we speak, these assistants go far past the decision. With Kore.ai’s AI for Course of, they:
- Pre-orchestrate outreach methods
- Seize structured knowledge from conversations
- Auto-document ends in EMRs
- Set off downstream workflows with out human enter
This degree of orchestration ensures compliance, reduces handbook work, and accelerates time to decision—liberating up medical and administrative groups to deal with higher-value duties.
AI’s Subsequent Leap: From Insights to Autonomous Motion
Dr. Anthony Chang supplied a broader medical lens on what’s subsequent. He categorized the evolution of AI in healthcare as:
- Well being AI 1.0 – Conventional machine and deep studying
- 2.0 – Generative + agentic AI (what he calls convolutional intelligence)
- 3.0 – Cognitive AI, that includes digital twins, autonomous brokers, and true precision care
In a single state of affairs, he described a pediatric discharge expertise the place generative AI interprets directions into Spanish, personalizes them for youngsters, and creates partaking storybooks. Agentic AI then handles scheduling, medicine logistics, transportation, and even alerts clinicians if a wearable indicators threat.
“Generative AI supplies insights. Agentic AI takes motion,” he defined. “When mixed, the influence is geometric—not simply additive.”
What This Means for Healthcare Now
At Kore.ai, we’ve spent years creating enterprise-ready conversational AI Brokers. Now, we’re increasing into medical determination enablement and government-scale deployments—partnering with organizations like Guidehouse to enhance entry, scale back price, and streamline operations for suppliers and payers alike.
What excites me most is how these programs are evolving to really feel extra human, whilst they deal with extra complexity. With the correct mix of expertise and empathy, AI might be each scalable and supportive—making care extra accessible, extra responsive, and extra private.
Ultimate Ideas
Healthcare is below strain from each course. However with the correct AI programs in place, we leap forward. We will take away the delays, bottlenecks, and inefficiencies that get in the best way of nice care.
When you’re able to discover how conversational and agentic AI can elevate your group, let’s speak. The way forward for healthcare isn’t simply coming—it’s already in movement.
Watch a recording of the speak
