Case Study: Conversational AI in Healthcare

Intelligent Patient Triage System for Regional Healthcare Network

A mid-sized medical service provider serving 2.3 million people across the Southwest was drowning in administrative overhead and patient wait times. Their call centers handled over 8,000 daily inquiries, with staff spending countless hours on routine scheduling, symptom assessments, and insurance verifications. The organization needed a solution that could streamline interactions while maintaining the human touch. Read our Conversational AI in healthcare case study to the end and explore how we transformed their patient experience!

The Challenge:

How did we help reduce administrative burden and improve access to care, maintaining clinical accuracy?

Our client, the healthcare network, faced mounting pressure from multiple directions. Patient volume had grown 42% over three years, but staffing remained flat due to budget constraints and the ongoing talent shortage. Reception staff were overwhelmed with appointment requests, insurance questions, and basic medical inquiries that could be handled more efficiently.

Meanwhile, patients grew frustrated with hold times averaging 12 minutes and often abandoned calls entirely. The organization’s existing phone system couldn’t distinguish between urgent medical concerns requiring immediate attention and routine administrative requests. This created dangerous bottlenecks where clients with serious symptoms waited alongside those simply needing prescription refills or appointment changes.

Clinical staff found themselves pulled into administrative tasks, reducing time available for actual patient care. The network’s leadership recognized they needed a smarter approach—something that could handle routine inquiries automatically while ensuring complex medical situations received appropriate human attention. And this is where they contacted Master of Code Global for comprehensive
healthcare AI consulting services
.

What We Created:

Master of Code Global developed an intelligent patient communication platform that serves as the first point of contact for all clients’ interactions.

Our Conversational AI development company built an all-in-one intelligent solution that handles communications across multiple channels. The platform integrates seamlessly with the network’s existing electronic health records (EHR) system and appointment scheduling software, creating a unified experience.

This custom AI assistant conducts initial screenings using clinically-validated triage protocols. When people call or chat, the system asks targeted questions about symptoms, medical history, and urgency level. Based on responses, it either schedules appropriate appointments, provides relevant health information, or immediately transfers high-priority cases to medical professionals.

For routine administrative tasks, the system accesses patient records in real-time to handle appointment scheduling, prescription refill requests, and insurance verification. Now, their medical clients can modify existing appointments, request medical records, or get directions to clinic locations without human intervention.

The platform we built from scratch includes a sophisticated escalation engine that recognizes when conversations require human expertise. Complex medical questions, emotional distress indicators, or ambiguous symptoms trigger immediate transfer to appropriate clinical staff, ensuring patient safety remains paramount.

Technologies We Used:

Rasa NLU
Node.js
Amazon Transcribe
AWS EKS

Services We Performed:

Clinical Workflow Analysis

Mapped existing communication processes and identified automation opportunities

Medical Triage Logic Development

Created decision trees based on established clinical protocols and emergency medicine guidelines

EHR System Integration

Built secure connections to Epic and Cerner systems for real-time patient data access

Multi-Channel Deployment

Implemented the AI across phone, web chat, and mobile app interfaces

Staff Training Programs

Educated healthcare workers on AI-assisted workflows and escalation procedures

Compliance Certification

Ensured full HIPAA compliance and implemented necessary security measures

The Results:

63% Reduction in average wait times from 12 minutes to 4.5 minutes

89% Patient satisfaction score for AI interactions, with 94% saying they would use the system again

47% Reduction in abandoned calls due to decreased wait times and improved service options

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