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52% Positive
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#human#companies#pharmacies#customer#don#company#problem#need#product#account
Discussion (75 Comments)Read Original on HackerNews
First, The technology works, and it scales, but the whole bottleneck is domain expertise and implementation. These are expensive, and hard to scale. We hire pharmacists as project managers, that's how important domain expertise and implementations are.
Second, the amount of noise of "Voice AI for <industry>" is incredible. Most of them are completely clueless about the industry & basically "YC-striver" type who can only sell to other yc companies. They fail hard the moment they touch critical functions of the real world.
We have hundreds of pharmacies with us now and they mostly successful and happy. Our biggest friction is customers being burned by vendors like this and writing off AI altogether as "not ready".
This is such a great graph. Your company feels successful because your customer is happy yet the rest of the world would be just happy if your company died in a fire. This seems to also be just fine for companies like yours.
They literally lose money filling your branded prescription even with no labor baked in. We are their lifeline.
I know because I am not some spoiled tech worker who stumbled into this industry. I ran these pharmacies for over a decade before ever writing a line of code.
I know you're just trying to illustrate the real plight of your customers, but it's a bad illustration that confuses the discussion.
Second, out of sincere curiosity: what was the future of the industry -- and these particular pharmacies -- if AI hadn't arrived to offer salvation? The role they fill in society is non-optional, so how the market restructuring around these infeasibly narrow margins before?
Just because you think it is an amazing product does not mean the rest of us will agree with you. It's right up there with "I've never had a problem with it so anyone claiming to have a problem is wrong" mentality. It was your comment acknowledging the public does not like your product or products like yours. You just think your product is better than others. That may be true but it again does not mean it is so good that the public enjoys interacting with your product.
How happy are their patients?
People have no ideas have pharmacies work. Pharmacies don't control how much they pay for drug, or how much they get paid. The margins are terrible and you can't hire enough techs to answer the phone at peak call volume. So - most people experience are terrible as they wait on hold for a really long time.
EVEN if the AI is a little rough around the edges with relational calls, just solving for transactional calls with no hold is a massive win.
You keep saying that reducing call time is the "win." It seems like that the only metric you're measuring. If so, your product is a failure, not a success.
This is HEALTHCARE. You don't get to do "rough around the edges." You don't get to dismiss edge cases.
I also work in healthcare tech. My company doesn't permit such things because people die. I'll write it again because it's a point that tech fetishes can't get into their heads:
People die.
I suspect that applying an aerospace approach of dissimilar redundancy and root cause analysis to this will yield a much better experience for everyone (i.e. you, the pharmacies and the patients) than what would have been possible with humans alone.
I've ranted about this before, but medicine as it stands isn't a serious field. And I can say that with a straight face, because medicine has until now, been the only field of modern scientific endeavor (or rather cloaked under modern scientific endeavor) that has fought tooth and nail against gathering more data points for improving understanding.
More detail here, https://news.ycombinator.com/item?id=35762650
I'm glad that you're doing this!
I’ve been working with AI for years now and it’s not an easy task to get it right, but negative news go viral faster especially when it’s what people want to hear.
So I mostly avoid commenting on or pontificating about the value or lack thereof of AI, but the problem I have with companies rolling out "AI for whatever" isn't that sometimes AI gets "whatever" wrong, it's that the companies simultaneous gut the processes around correcting these mistakes.
I'm currently dealing with a months-long banking error where the bank has incorrectly linked my credit card account to my wife's account and/or an account of mine in a different region, so it variously doesn't show up in my online account, shows the wrong number, shows the purchases from the wrong account, etc.
Every time I call in in a 5-minute rigamarole of:
"Please describe what you're calling about."
"Representative."
"In order to connect to a representative, please describe what you're calling about."
"There's an error with my account."
"Would you like to know your account balance?"
"No, my credit card account is not correctly configured and isn't showing up in my online banking account."
"I didn't understand. Please describe what you're calling about."
Eventually the bot reaches some failure state and then allows me to wait on hold for an hour to talk to an actual rep.
When I eventually get to talk to a rep, I get "Yes, I see that your account isn't correctly configured, I'll submit a back-end ticket and it should get fixed within 5-10 business days."
The next week I check my online banking, my credit card still isn't showing up, and I call and repeat the entire process.
So yes, it's not AI that's directly causing this Kafkaesque nightmare, but it's AI that's empowered the leaders at every utility/retailer/bank/insurer/etc. that I deal with turn their support systems into this slop.
What you describe is an execution failure not AI, these are basic NLP systems that could be easily configured with some dataset to make them better, but i will make a wild guess that the bank has incompetent manager who was pushing for some numbers to put in a slide to say “I” did this.
Meanwhile you are royally fucking over the end user with your AI shit.
“You are absolutely right! You should indeed not give your 5 year old child 1000 milligrams of ibuprofen per hour”
I've seen AI used well in a few support situations, and it is great - faster to get to the answer vs a human (usually faster than even getting to a human, which is another issue)
When my case can be handled by the automated system, it is great, when it is not, it is usually misery, leading to anger at the customer and whatever company sold them that automated isht.
Especially for intelligent knowledgeable users of anything, by the time we call, it is an issue likely to need escalation.
So, the one absolutely critical factor for me and everyone I know is: how fast and easy is it to get to a human when we find the automated assistance does not work for our particular issue? It should be "I need to speak to a human now", and the immediate response should be "OK, let me get you one... Hello, this is [person], how can I help?" with the prior transcript already on the human's screen.
If this works, it is good because the humans are operating a level up, not having to deal with endless monotonous minutiae, and dealing with interesting issues all day, which means they get good at it and have a better attitude — a win for all.
How, and how well do you handle that situation — how close are you to the proper response I described?
Is your pharmacy one of your customers? Do you use your own product regularly?
Our user base skews elderly. Going in, I was really skeptical about how much engagement and value we could provide to these older patients. I'm blown away how well it all turned out and how valuable it's been for our patients and client clinics.
For example, we were able to reduce no-shows for some high-cost appointments by 80%. Turns out that the reasons why people don't show up are a complicated and diffuse — everything form anxiety, to not speaking english, to being confused about how to get into the building — and properly configured LLM-based systems are really, really good at dealing with exactly this sort of problem.
Like they don’t even say the full name of the prescription they just tell you the first three letters and they’ll say “for the patient born on…”
Current pharmacy IT systems are currently almost 100% automated so how are you claiming it’s the first use?
Even worse is that the human is usually just as worthless because the problem is often upstream at the insurance provider or regulation
This is something I’m finding with people complaining about AI systems the AI system in this case is not any worse than the previous IVR system was it just expanded the use cases and now people say oh it doesn’t work for those expanded use cases
There’s no mention whatsoever of the current absolute devastatingly bad state of all software across the world
It’s like people are mad when there’s an application that already sucks, someone attempts to use genAI, that fails and then they blame AI
The whole thing is absurd
In many ways this is a repeat of the India call center train wrecks of the 00s. On paper, letting someone in Bangalore vs onshore handle incoming customer service calls looked like a path to amazing savings. In practice the customer experience was horrendous and companies CTRL-Zed these decisions and rapidly brought customer service back onshore again. AI is just that story of shortsighted decisions by weak leadership playing out all over again.
https://arstechnica.com/tech-policy/2024/02/air-canada-must-...
> Air Canada essentially argued that “the chatbot is a separate legal entity that is responsible for its own actions”
Yeah, if I'm calling or chatting with a company, I expect them to stand by whatever commitments they make, and I will judge them harshly if they don't. This is true whether an AI or a human is speaking on the company's behalf.
Set up whatever online portal or app you want. I’d prefer to just sign in and click a button.
If I’m picking up the phone or sending an email it’s because I have a weird problem and I need to talk to a person.
You don’t need a cookie banner for functional cookies, and opt out should be a single button.
I think we need to take a good hard look at what we want out of this world and ask ourselves. Do we really need to automate this? Like really. What benefit does the world receive having an AI chatbot tell grandma the wrong doage for her meds? This is the naked extraction of value from a service that's already been offshored. Companies like these are gleeful to make their service as shitty as they can because they know their users are doing so against their will. Infact, that's become the goal.
BS. How is the AI touching that information?
Prescription notification is outbound communication. It’s almost a recorded message. A little text to speech if it is supposed to read the drug name.
Wrong dosages?? This must be handled by the “enroll a new scrip” functionality, right? So basically B2B doctor interaction. You let AI touch that? Aren’t the vast majority of the costs from customers not doctors? None of this makes sense.
But the biggest problem is ASR. WER is still atrocious even with SOTA models. When you add drug names and regional accents, it's a recipe for disaster.
WER = Word Error Rate
Too many acronyms; not everybody is in your field.
And the patients generally don't have a pronunciation key. Doctors prescribing might not, either.
It ends up being quite a lot of variation.
As some examples: Wegovy, Ixempra, Qvar, Keflex
The biggest problem with AI customer service is that a human employee would've let a minor issue slide without escalating it. But a chatbot often inflames the situation, and by the time the customer reaches a human agent, they're already furious.
Most people aren't rational or logical. Non verbal feedback, like acknowledging someone's anger and showing empathy, is incredibly important.
At the time, they had a real person handling their support. The real person told me this was just a glitch and that my correct address was on file and everything is fine.
That wasn't actually true. A new debit card to replace my expiring one ended up being sent to the old address a couple of months ago.
So I go back to the website to try to edit it one last time. Same problem.
I call them and get their fucking stupid AI slopbot.
Still, I explain the whole situation:
> I'm trying to update my address on the website. When I click the edit link next to the old address, it shows my new address instead. I need to remove the old address.
What did the slopbot decide to say? Oh well, I should go on the website and edit my address of course! I gave it two more chances by trying to explain it a different way and how this didn't work.
Did it accept that and escalate the issue to a human? No. It kept telling me to go to the website.
I had to say
> Hey you fucking bitch, how many times do I have to tell you that doesn't fucking work? Escalate this to a fucking human before I get the attorney general involved.
to finally get a live person to fix it (I actually had to do this twice, the first set of fucks, the slopbot forgot what problem I was having and needed a refresher!). Suffice it to say, I will never trust any large amount of money with this bank again. I'm highly skeptical of any company using AI CS now, because this is one of my many experiences where the slopbot is incapable of recognizing a complex situation outside of its capabilities.
I mean look at this situation: their AI slopbot turned this one mistake into 5 mistakes instead of just allowing it to be one that another human corrects.
It's gotten to the point where whenever I see someone lauding AI customer support, I just assume they have an investment/job that hinges on people liking it and/or their only experiences are using it as a glorified refund button.
We need to fight the talking point that open source is bad!
AI couldn't do this job with a checklist. It would forget the entire checklist after two responses, then get fixated on the words that the customer used to complain about how dumb the AI was and loop until they hung up and called back to hopefully clear the context.
edit: Unless Kinney had been sold a product that used caller ID to carry over context, then the customer's best chances would be to scream "Agent!" over and over again (to get put on hold for 45 minutes, then transferred to the most screamed-at Philippine minimum-wage gig worker on the planet), or to show up to the drugstore and start screaming at people.