How Conversational AI Can Solve the Patient-Reported Outcomes Puzzle

When CMS announced its first-ever hospital patient-reported outcome-based performance measure (PRO-PM) in 2023, it was more than just a new measure in the growing list of Inpatient Quality Reporting (IQR) program requirements. It was the beginning of a new generation of regulatory expectations around healthcare quality.In just three short years, that first measure, the THA/TKA PRO-PM, has been versioned out for the outpatient and ambulatory surgery center settings. A new PRO-PM, the Information Transfer PRO-PM, is already in its voluntary reporting period. And of the seven quality measures that make up CMS's new mandatory framework for acute care hospitals, the TEAM model, both measures made the cut.

But if PRO-PMs are a critical player in the future of healthcare quality measurement, the methodologies that healthcare providers rely on to power them are woefully stuck in the past. Think: paper surveys sent to patients via snail mail, emailed links to web-based surveys that may or may not land in the patient's spam filter, and overworked staff members manually abstracting whatever survey data they do manage to collect as quickly and as accurately as possible in order to meet the measures' complicated requirements and timelines. It's a lot of hurdles to clear, and yet just one mistake or missed deadline can result in a penalty.

At Medisolv, we believe the answer is one solution that clears all of those hurdles at once: Conversational AI.

What is Conversational AI?

Conversational AI is technology designed to talk with humans in a natural, back-and-forth way; the same technology behind ChatGPT, Siri, and the AI copilots embedded in many of the tools you already use. It combines natural language processing to understand what someone is saying, machine learning to improve over time, and large language models to generate human-like responses.

How is Conversational AI Different than a Traditional Chatbot?

Early chatbots were basically decision trees in disguise: press 1 or press 2. Conversational AI understands context, learns and adapts, and can handle open-ended questions without getting lost.

Businesses across every industry are already using it to scale customer engagement without scaling labor, create personalized experiences at volume, and turn static touchpoints into dynamic conversations. Healthcare providers need to do the same, and there is no better starting point than PRO-PMs.

Using Conversational AI to Take Control of PRO-PMs

In March, Medisolv joined forces with Lilac Software, an innovator in AI-driven predictive analytics and Medicare Advantage Stars performance, to launch our first conversational AI solution in our newly enhanced PRO-PM Module.

The solution automates PRO-PM survey collection, primarily through conversational AI-enabled phone calls. The AI voice agent calls the patient, walks them through the survey questions, and collects their responses: just like a human representative would, but at scale and without the staffing burden.

Here's what our research, product testing, and customer results have shown us.

Higher patient engagement rates

Conversational AI drives better engagement throughout the survey collection process. Our studies show that 71% of people who engage with an AI voice agent complete the purpose of the call. And it works across patient populations — including older audiences. 93% of seniors we surveyed said they are comfortable speaking with an AI agent about medical topics, even sensitive ones.

Richer survey responses

Patients know there's no human on the other end of the line, and that changes what they're willing to share. "It's private and calm," said one patient. "You can be honest because nobody's reacting on the other end." The result is richer, more detailed responses — especially to open-ended questions — compared to written surveys.

Multi-channel optimization

Medisolv's PRO-PM module meets patients where they are. In addition to phone surveys, we administer conversational AI surveys via SMS and send traditional web-based surveys via email or text. The module learns which channels work best for your specific patient populations and optimizes accordingly.

Reduced administrative burden

Not enough staff, not enough hours: that's the biggest barrier to successful survey collection for most healthcare systems. Conversational AI removes it entirely, allowing organizations to expand survey volume without adding headcount or burdening existing staff.

Medisolv's module goes a step further, combining data processing with AI to auto-abstract patient responses into a standardized, submission-ready format. We even handle submission. It's a fully automated solution from the first pre-op survey to the final measure calculation.

The Promise of AI Beyond PRO-PMs

It goes without saying that PRO-PMs are just one small starting point for healthcare teams that are looking to integrate AI into their quality improvement efforts. Ultimately, AI-powered quality intelligence will be the difference-maker between healthcare systems that thrive in the increasingly complex world of value-based care and those that merely survive.

Improving Patient Engagement Everywhere

Beyond PRO-PMs, quality improvement often comes down to getting patients to act: schedule a follow-up, book a screening, refill a prescription. Most of that coordination is still happening manually across provider groups, pharmacies, and payers — and not as successfully as it should be. AI-driven engagement will give healthcare systems the scale and timeliness they need to drive real compliance and care coordination.

Turning Clinical Data Into Action

From Medicare Advantage Stars to MSSP, healthcare organizations have more quality data than ever. But it's fragmented, and most treat it as a report card on past performance rather than a tool to drive future performance. AI and predictive analytics change that — enabling organizations to identify care gaps earlier, coordinate outreach faster, and align clinical metrics with financial performance in ways that weren't possible before.

Step One is Knowing Where to Start

The Medisolv and Lilac partnership is built to address exactly these needs. By integrating clinical quality intelligence with predictive analytics and AI-driven workflows, healthcare organizations can move from retrospective reporting to proactive performance improvement.

But as with all transformational change, the shift to AI-enabled quality improvement and value-based care will not happen for healthcare organizations overnight. What's important is taking the first step, and PRO-PMs are the perfect place to start. I invite you to schedule a demo of our conversational AI-driven PRO-PM module to see the difference.