Streamlining Multifaceted Referral Intake with Intelligent Bots

About this project

Managing referrals from hospitals across 17 states, with over 50 distinct portals, presented a unique challenge for a large home health organization. Each branch had its specific payer relationships, adding another layer of complexity to the process.
Our mission was clear but demanding: Design a system that seamlessly automated the intake of these diverse referrals. Our solution? A team of bots trained to mimic human patterns and decisions. These bots were tasked with gathering referrals from myriad sources and funneling them, in a structured manner, into the organization’s electronic health record system. Beyond just gathering, the bots also standardized the data, preparing it for human review.

As an added layer of sophistication, we crafted algorithms to evaluate the capacity of each branch. This allowed for strategic decision-making based on resource availability at every branch at any given moment.

Domain & Technology
Our Services Include

Challenge

CHWE reached out to the Sobah team for this project after failing to get required delivery from 3 different partners in the past.

This problem involves data sources from over 50,000 different sources, where most of the data is unstructured.

Additionally, the user experience of the portal required encouraging citizens to be involved in their politics – a challenge that has eluded younger generations over the last few decades. Most importantly, the initiative is non-partisan and required completely neutral and data driven content to avoid any bias in the insights provided to the citizens.

Expectations

The client required our team to conduct a thorough and careful study of data sources, architectural choices and innovative search engine optimization techniques. Product involved a sophisticated phased roadmap required to be delivered over a period of years. The core requirement was to build a highly scalable, adaptable and agile product framework and architecture. We were also tasked with engaging content writers to deliver thousands of articles for educating citizens on various topics related with their politics and society. Product envisioned additional roles and content created for analysts and institutions that require bulk data and deeper insights using data analytics and AI.

Our team
Results
The introduction of the bot has significantly reduced manual efforts in referral processing. Its capability to seamlessly extract and integrate data into the EHR has transformed the referral intake landscape. In its next evolution, it will incorporate advanced intelligence to proactively evaluate patient eligibility across different payers. This will further refine the referral acceptance process, aiming to ensure that referrals accepted early in the process endure seamlessly through the revenue cycle management phase, minimizing rejections and optimizing operations.

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