Patient communication follows an unwritten rulebook. A delicate balance of efficiency and empathy that's developed over decades.

Many industry experts will tell you that patient interactions are too nuanced, too human to be effectively automated. Conventional wisdom suggests that technology and compassion exist in opposition.

But the data and learnings we’ve experienced automating patient communications at scale tell a different story.

After automating more than 50 million healthcare calls, we've uncovered patterns that weren't visible at smaller scales. It's like the difference between observing a few dozen birds and tracking entire migration patterns across continents. At this scale, surprising truths emerge.

1. The trust paradox

Think about the last time you answered a call from an unknown number. You probably didn't. Few of us do anymore. But here's where it gets interesting: patients desperately want to hear from their healthcare providers, just not from strangers.

This paradox became crystal clear in our work with MemorialCare. When designing their 24/7 caller experience, it was crucial that the AI voice conveyed trustworthiness. That's why we custom-designed a voice persona named "Mila" specifically selected to be "confident, calming, and efficient,” qualities that immediately put patients at ease despite interacting with an AI system.

2. The archaeological dig of healthcare systems

You are probably familiar with how archaeologists carefully excavate ancient cities, layer by layer. That's remarkably similar to what happens when you integrate with healthcare infrastructure.

This archaeological reality hit home when we partnered with a large decentralized physician organization spanning multiple states. Their leadership described their challenge perfectly. They were trying to transform "a confederation of hundreds of small businesses into a singular brand promise.” But first, they needed to understand what was actually happening beneath the surface.

We deployed our Illuminate diagnostic across 29 practices in 5 states, recording over 80,000 calls in a two-week period. Layer by layer, we uncovered the hidden reality:

• Half of calls were lost in initial IVR or after operator transfer.
• 38% of callers never successfully reached staff.
• Illuminate discovered operational issues like infinite loop IVRs that meant patients calling a speciality clinic couldn’t schedule and that 90% of callers couldn’t reach the billing department.

In some instances, the IVR systems were broken. But mostly they had accumulated layers of configurations and pathways that no longer served patient needs.

This layered complexity was even more pronounced at a leading health system with 250+ locations. Because the health system was the result of mergers and the practices were largely independent, the patient experience was fragmented across what was supposed to be a unified brand.

Each location had its own processes, terminology, and routing rules – artifacts of years of independent operation. By establishing a centralized telecom leadership team and standardizing these archaeological layers, we transformed the experience across 10 million annual calls while saving the equivalent of 230 full-time employees of effort.

3. The invisible infrastructure of knowledge

There's a fascinating phenomenon in healthcare: the most critical operational information often exists nowhere and everywhere simultaneously. What patients need, how calls should be routed, when exceptions should be made – this knowledge typically lives in the minds of experienced staff rather than in documented systems.

We encountered this invisible infrastructure firsthand while working with a leading non-profit health system.

On the surface, their challenge seemed straightforward: they were receiving nearly 150K ambulatory calls monthly. But the invisible complexity became apparent when we discovered how prescription renewals were being handled. Staff needed to verbally verify patient information and confirm details for each call, a process that existed primarily as institutional knowledge rather than documented workflow.

By making this invisible knowledge visible and then integrating directly with their Epic EHR system, we created something transformative: a prescription renewal system that doesn't require patients to remember their medical record number or password. Crucial for patients who struggle with portal access.

The system could automatically identify callers and their prescription history, handling what had previously required valuable staff time better spent elsewhere. The result?

• ActiumHealth deflected 68% of inbound calls away from staff.
• For those callers identified with prescriptions in their EHR, we automated the renewal process for 95% of them without requiring any staff intervention.

This work of mapping the invisible connections between phone systems, EHRs, and human workflows formed the foundation of success, turning undocumented institutional knowledge into systematic, scalable processes.

4. The multi-dimensional success matrix

Typical call metrics are like trying to describe a symphony by only measuring its volume. They miss the richness and complexity of what's actually happening when patients and healthcare systems interact.

This limitation became evident when working with a leading academic medical center handling 2.7 million calls annually.

Traditional metrics only tracked basic call handling statistics – volumes, duration, abandonment rates. But these one-dimensional measures failed to capture the transformative impact of automation.

Our more sophisticated analytics revealed that by reducing call volume to hospital operators by 65%, we weren't just saving time. We were enabling a complete role transformation. Staff weren't just handling fewer calls. We freed up 60 FTE of capacity that could be upleveled to manage more complex patient needs, turning what could have been a story about reduction into one about enhancement and growth.

The multi-dimensional nature of success was even more apparent in our partnership with Virtua Health to identify high-risk patients.

By analyzing medical records, ActiumHealth and Virtua were able to identify the patients with the greatest need for the finite care delivery capacity. By creating targeted campaigns, Virtua generated over 25,000 appointments with 66% leading to necessary procedures, ultimately creating more than $25 million in revenue with a 21x ROI. This comprehensive measurement framework reveals the outcomes that genuinely matter to both patients and health systems.

These examples illustrate why successful healthcare automation requires moving beyond simplistic metrics to understand the full ecosystem of impact. Not just what happened during the call, but how it transformed patient care and organizational effectiveness afterward.

5. The resilience requirement

Behind every successful healthcare automation system is a complex balancing act between technical capability, operational flexibility, and human-centered design – what we call resilience.

Perhaps the most demanding resilience test came with implementation timelines. When a leading health system told us that long calls during busy periods could cost them $10-15 each (even those ending without resolution), we knew that traditional months-long implementations wouldn't work.

At MemorialCare, we demonstrated this operational resilience by answering 100% of calls within 8 weeks of contract signature – a speed of deployment that protected staff from burnout during critical transition periods.

True resilience isn't just about technology that works – it's about technology that works consistently, across languages, volumes, and implementation challenges, without compromising the human experience.

6. The human amplification effect

The most surprising discovery were the ways that systems were able to work and create opportunities that simply weren’t possible before. While providers and health systems go to great lengths to encourage patients to get needed care - a mammogram, a referral to cardiology - half of open orders sit unfilled, leading to gaps in patient care and missed revenue opportunities.

At a leading regional health system, we deployed AI agents that could automatically reach out to patients identified in an EMR worklist, identify the patient, remind them of the open order, understand if they were still interested in scheduling and if not what the barriers were, engage in natural customer conversations, and then transfer callers to a human agent as needed.

This resulted in staffing going from 15% of their calls reaching an interested patient to 100% of the patients being interested to schedule, 37,000 new appointments scheduled per year, and $11 million in additional revenue per year.

The pattern became unmistakable across implementations: successful automation creates a virtuous cycle where technology handles routine tasks, humans focus on complex problems, patients receive better care, and the entire system becomes more effective.

The technology doesn't replace human capabilities – it amplifies them, creating continuous improvement that would be impossible with either technology or humans alone.

The big picture

What does all this tell us? That successfully automating healthcare communication isn't primarily a technical challenge – it's a human one. Understanding the social, organizational, and behavioral dimensions matters as much as the AI itself.

The new entrants entering this market with impressive demos aren't wrong about the technology's potential. But they're missing the hard-earned wisdom that comes from navigating the messy reality of healthcare at scale.

After 50 million calls, we've learned this truth: lasting innovation doesn't come from disruption alone, but from the patient, meticulous work of translating technological possibility into human reality, one conversation at a time.