Improving Care Management for Patients with Chronic Eye Conditions Using an AI-powered Engagement Platform

Lumata Case Study

Lumata Health has been supporting payers and health systems manage chronic eye diseases since 2017, including national insurance payers and several of the largest tribal health systems in the country. In 2021, they expanded their service directly to ophthalmology practices. Current partners include top 10 academic ophthalmology practices and private practices of all sizes and specialties across the US.

Lumata’s team of Certified Ophthalmic Assistants (COAs) provide a range of virtual eye care services to help patients manage their chronic condition throughout their care journey—including chronic eye care management, pre-visit intake, prior authorization assistance, and pre- and post-operative patient education.

Lumata was looking for a cost-effective way to engage patients remotely, monitor their progress with their treatment plan, and proactively intervene before the patient’s condition deteriorated.

The Solution

Lumata partnered with Wholistics to leverage our AI-powered Chatbot platform to design and develop a program of automated outreach to patients who had been recently diagnosed with glaucoma or macular degeneration, as well as post-op patients. Wholistics designed a series of text-based chats that were sent to patients  weekly via SMS, educating them with facts and tips about their condition and checking in on their vision status and medication adherence, such as eye drop usage. Those patients who were reporting discomfort, blurred vision or difficulty with their treatment plan were directed to a nurse via a one-click link, or could request a call-back.

The Outcome

After just three months piloting the Chatbot with patients, the program is already having a positive impact. According to Ashley Stanton, Director of Care Management at Lumata: “The Chatbot gives us the opportunity to engage patients outside of the clinical setting, on their terms. In addition to educating the patient about their condition through micro-doses of content and fun facts, we are now able to track medication usage, and whether patients are having difficulty, for example using eye drops, or whether they are seeing an improvement or deterioration in their vision from week to week. Those patients requiring clinical intervention can be directed immediately to a virtual or in-person appointment with a provider. In addition to generating opportunities for reimbursement on the provider side, we are also making the time spent with the patient more productive and efficient for the clinician, as they are now apprised of the patient’s condition in advance and have a better understanding of what the patient needs. The data we are collecting shows patient progress over time, and we are now able to intervene earlier if a patient is experiencing adverse effects or an exacerbation of their condition. Overall, the Chatbot pilot program has been successful-to-date and we are now looking at expanding this program across a wider cohort of patients including those with diabetic retinopathy.  Having spent the past 10 years building telephonic and value-based care management programs, I see great opportunities for using digital health tools like the Wholistics engagement platform to support longitudinal care management for patients with chronic conditions.”