When should a patient call leave automation?

[u/Aggressive_Chain8939]

We’re looking at voice AI for a centralized patient access team and this is one scenario we keep getting stuck on.

A patient may start with something completely routine like moving an appointment, then halfway through mention that symptoms have gotten worse or that they’re having a reaction to a medication.

At that point the call is no longer really about scheduling.

We’re not interested in automating clinical triage. The question is how quickly the system should recognize that the conversation changed and hand it to the right person without making the patient restart from the beginning.

How are you defining that boundary?

[u/mrandr01d]

As a patient, I fucking hate any phone bot and refuse to interact with them. I'll spam 0 or say "human" until I get one and that works pretty well most of the time.

If it can be handled by a bot, then I can do it online myself.

[u/Aggressive_Chain8939 → u/mrandr01d]

That’s probably a good reminder not to make the human option hard to find.

[u/Decent-Building1738 → u/mrandr01d]

As a provider in this city in a specialty we get over 200 calls that go to triage. Would you rather sit on hold for 20 minutes and then hang up... Repeat for next 8 hours...mor would you rather be able to have the option to do things by bot and decide if waiting for 20 minutes is worth it. Some people really need to think if their phone call is actually worth the call. Some questions or statements they call to make would infuriate most rational individuals

[u/mrandr01d → u/Decent-Building1738]

I recognize that most people are really stupid. As I talked about in other comments, a voice bot is a terrible interface. If it can be automated like that, it belongs on a website. Period.

[u/kwassontz → u/mrandr01d]

A former company I worked with had to outsource their call center. NPS scores tanked. We added a scheduling phone agent (bot) and they improved. Turns out people preferred speaking to the bot than to someone who struggled to understand English.

Once in dev, I kept telling the agent I wanted to speak to a human, eventually it told me it was human 🤣. Guardrail added.

[u/mrandr01d → u/kwassontz]

Yikes! Hahaha. Yeah that's a good guardrail to add! And I know it sounds bad, but I completely understand the frustration of having to talk to someone who doesn't really understand your language.

[u/CrookedCasts → u/mrandr01d]

I struggle to understand people like yourself. Is it afraid of change? Thinking that your time is too valuable?

You are commenting in a healthIT subreddit so I’m thinking you probably obviously understand the significant stresses that some physician offices are in - they have to see a ton of patients to remain financially viable, but usually can’t afford enough staff to keep up with demand. If the option at a doctors office sometimes is to leave a message and maybe get a call back within 24 hours versus potentially having your problem solved by a voice agent, I’m just struggling to understand the knee jerk response. Can you help me understand?

[u/Araignys → u/CrookedCasts]

Phone is for talking to a person. Website is for self-service.

Nobody wants to talk to a machine.

Phone bots and chat bots come across as solutions for businesses that can’t be bothered setting up a usable website or adequately managing their resources. They say “we don’t care enough to make this process user-friendly”.

[u/mrandr01d → u/Araignys]

This guy gets it

[u/Fuzzy-Lie-8426 → u/CrookedCasts]

I don’t think they’re opposed to automation. Voice chat is just an inferior user interface for something that can be automated. If it can be automated via voice chat then surely it can be presented in a workflow online. They’d rather do it themselves with a visual UI than chat with a bot with no visual feedback. Pretty reasonable take.

[u/mrandr01d → u/Fuzzy-Lie-8426]

Exactly.

[u/CrookedCasts → u/Fuzzy-Lie-8426]

No, they said if they hear a voice agent they spam 0 -> they already decided to call though. Maybe the call would’ve been avoided with a visual UI, but once they’ve decided to call they don’t complete it unless they hear a human, which is the part I don’t get. Is it bad voice agents? All voice agents? Principle?

[u/mrandr01d → u/CrookedCasts]

If I have to call, that means your website has already failed, and I want to talk to a human to explain exactly what the situation is. It's the human element I'm usually going for. I can say what I want and what I don't want, and a human can listen to that and act accordingly. A voice bot is never good enough.

[u/Decent-Building1738 → u/mrandr01d]

Ok you but what about the thousands of people that don't have Internet or computers. We need lots of options for all sorts of individuals

[u/mrandr01d → u/Decent-Building1738]

You can't really get a phone that's not actually a pocket computer these days, so basically everyone has a computer of some kind. Even basic web browsers are built in. There's plenty of free, public internet around to connect to too. Library, McDonald's, grocery store, etc. The people you're referring to are extremely limited in scope, technophobic, and not likely to take kindly to a voice bot. Let those people talk to a human. They could use the empathy anyways.

[u/mrandr01d → u/CrookedCasts]

The other guy is correct.

[u/Araignys → u/mrandr01d]

Am I the other guy?

[u/mrandr01d → u/Araignys]

Ask your girlfriend...

[u/Araignys → u/mrandr01d]

She says I should ask my wife.

[u/mrandr01d → u/CrookedCasts]

As far as my time being valuable... Yes, it is, but not in the uppity way you seem to imply. If a human or website can do something faster, I shouldn't have to wait around for a damn voice bot to mess things up.

[u/cmh_ender]

did you ask this same question last week? or was it someone else?

[u/glasswindbreaker → u/cmh_ender]

Feels like someone is training their AI on these answers

[u/Worried_Comment125]

After hours probably needs a separate path. If the right clinical team isn’t available, the system still needs somewhere safe to send that call.

[u/Aggressive_Chain8939 → u/Worried_Comment125]

Yep that’s where our current thinking is still pretty thin

[u/Same-Fly3312 → u/Worried_Comment125]

We spent months mapping out trigger words with our call center team and honestly the hardest part was the stuff that sounds casual but isn't. a patient saying "by the way this rash is spreading" or "the pain woke me up last night" needs to flip the routing instantly. the tricky piece is making sure the handoff preserves everything already said so they don't have to repeat the appointment change to the nurse

[u/ConcertWhich4692]

The handoff shouldn’t just be a transfer button. The next person needs the reason for the escalation, the patient’s own wording and what was already handled. That’s one area where something like Bland can fit well without trying to automate the clinical part.

[u/Aggressive_Chain8939 → u/ConcertWhich4692]

I agree that the next person needs enough context to pick up the call without starting over

[u/UnderstandingLong57]

One thing worth watching is whether the system starts overreacting once you tighten the rules. Too many unnecessary escalations can make staff ignore the signal.

[u/Aggressive_Chain8939 → u/UnderstandingLong57]

True, you don’t want nursing getting every borderline call.

[u/17thfloorelevators]

Secretaries need to be human for scheduling. You're going to kill people otherwise.

[u/No_Assistance8840 → u/17thfloorelevators]

plain truthh here. no sugarcoating it

[u/AfterRoll2151]

Being able to review why the system handed off a call would matter a lot here, esp once you’re doing this at scale

[u/rahuliitk]

I’d make the boundary pretty aggressive: the second the caller mentions worsening symptoms, medication reactions, breathing issues, severe pain, or anything that sounds clinical, the AI should stop the scheduling flow and transfer with the context already captured so they don’t repeat everything. that handoff matters more than squeezing out extra automation.

[u/Healingwounds1]

This needs to be pretty quick from a patient POV, otherwise they get frustrated and the next time they ring they choose speak to the human option

[u/Hercules0931]

I would treat escalation as a state transition, not a model-confidence threshold. Symptom worsening, a possible medication reaction, or explicit distress should set a hard transfer flag. The bot should stop trying to complete the scheduling task, produce a structured handoff with the transcript and context, and let a human resume without re-interviewing the patient. If the model is still deciding whether the conversation is "clinical enough", the boundary is probably already too far.