Chatbot Outreach in Value-Based Preventive Care: Retrospective Analysis.

Area of Science:

• Health Services Research
• Digital Health
• Preventive Care

Background:

• Value-based care necessitates proactive strategies to close preventive care gaps.
• Patient engagement is hindered by logistical, behavioral, and socioeconomic barriers.
• Digital outreach, like chatbots, offers potential but requires comparative effectiveness studies.

Purpose of the Study:

• To evaluate chatbot outreach effectiveness versus traditional methods (phone, email, mail, multichannel) for preventive screenings and wellness visits.
• To compare compliance rates across different outreach modalities.

Main Methods:

• Retrospective study of 50,145 care gaps from 41,959 participants (2021-2023) in New York.
• Outreach methods included chatbot SMS, phone calls, email, and mail.
• Logistic regression and chi-square analyses examined associations between outreach, demographics, PCP relationship, and social vulnerability index (SVI).

Main Results:

• Phone outreach yielded higher compliance overall.
• Chatbots outperformed phone calls only for diabetes care in 2023 (OR 1.81).
• Primary care physician continuity strongly predicted gap closure; higher SVI quartiles generally correlated with lower compliance, with exceptions in primary care.

Conclusions:

• Outreach modality significantly impacts preventive care adherence.
• Phone outreach is generally most effective, but chatbots have targeted applications.
• Integrated, equity-informed strategies combining technology, patient preferences, and primary care are crucial for value-based care.