Alyson Gagne

Problem Statements

Artera offers both automated messages that send based on triggers, for example, appointment reminders, and direct two-way text conversations between healthcare staff and individual patients. The second of these, the bidirectional messaging, is Artera’s differentiating feature on the market.

Without bidirectional messaging, Artera is basically a very complicated appointment reminder tool. There are many competitors on the market who offer very simple appointment reminders tools, often for much less. That means that any customer of ours who is not using and getting maximum value of bidirectional messaging should be viewed as a significant flight risk. Unfortunately, an unacceptably large percentage of our clients were either not using bidirectional messaging at all, or were severely under-utilizing it.

In the short term, our initial charter was to replace the legacy Artera inbox with a new interface that better served our customers’ needs. The legacy inbox was designed to work at the “practice level,” a data structure that made sense when it was designed, but over time no longer reflected how our customers used the inbox, or how their physical clinics were set up. The staff who manage the inbox typically work across multiple practices, and having a practice-level inbox means that those workers have to rotate through multiple different inboxes all day long, wasting their time and increasing patient response times.

However in the course of assessing our customers’ needs in the inbox, it became clear that there was much more that needed to be done. Because any customer who didn’t use the inbox was automatically a flight risk, the biggest problem we needed to solve was making bidirectional messaging and the use of the inbox the reason customers signed up for and stayed with Artera – not just a nice to have extra.

Assessment

I spent many months speaking to our customers about their use of the inbox heard several themes repeatedly:

• Quality control: A strong desire to control the quality and content of the messages that staff send, and a reluctance to allow staff to message without oversight
• Staffing: Using Artera requires either existing staff to have a new task added to their workload, or net new headcount hired
• Operationalizing: Once that staff is hired, it’s very difficult to train them, establish standards, and enforce those standards

At first I considered ways to make the inbox easier to operationalize and monitor. I considered enhancements like in-context training modules or audit tools. However after speaking to our customers, one thing became clear:

Using the bidirectional messaging features costs our customers money, above and beyond the contract itself. That’s because it requires them to either reallocate existing staff or hire net new headcount. What they need is not a way to make those expensive resources more efficient, they need a way to deliver the same value without requiring those resources at all.

That became our new “north star:”

A bidirectional patient messaging product that handles the high volume of simple, repetitive patient interactions via delightful automated processes, freeing staff to provide top-of-license care in the complex situations they can provide the most value in, resulting in patients having a higher quality communications experience that requires fewer total resources.

Actions

To achieve our north star, I spearheaded several initiatives:

• A new 0->1 inbox experience built on fresh tech stack, including a new underlying data structure (moving from practice level to enterprise level)
• New efficiency features in the inbox including “saved views” (i.e., “sticky filters”), bulk actions, and an enhanced keyword search algorithm
• An experimental “copilot” feature in the message composer that included several AI-enhanced tools such as language translation, message shortener and message summary tools
• Developed a vision and roadmap for an AI powered inbox, including features such as an autonomous digital agent and automatic responses.
• Built and launched a second, separate version of the inbox for a sensitive, high-profile federal client

Documents

All of the below documents were prepared by me in the course of assessing and evangelizing the inbox project. To protect privacy these documents have some information that is obscured.

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Outcomes

Although I was RIF’ed before I could see most of the fruits of this labor, the inbox will have the following impact:

• Leading:
  • Quantitative:
    • More clients actively using bidirectional messaging
    • Clients who are already using it, use it more
  • Qualitative:
    • Clients who are already using, use it for more practices and/or more use cases
    • Increased satisfaction with inbox product
• Trailing:
  • Quantitative:
    • More clients actively using bidirectional messaging
    • More clients using inbox from day one of launch
  • Qualitative:
    • Inbox is a leading sales incentive and/or retention incentive
    • Clients can use inbox with fewer staff