Colorectal cancer is highly preventable, and when detected early survival rates are over 90%. Nevertheless, screening rates are far below clinical recommendations. Almost one-third of eligible adults regularly go unchecked, and more than 55,000 people in the U.S. are expected to die from colorectal cancer in 2026, according to the American Cancer Society.
Leaders at Atlantic Health in Morristown, New Jersey recognized that improving screening rates was not a matter of simply scheduling more procedures. It was about providing patients with support during the often complicated, inconvenient and unpleasant process of preparing for a colonoscopy.
“We wanted to improve the overall experience for the patient,” said Ravish Parekh, MD, a gastroenterologist with Atlantic Health. “We also wanted to minimize cancellations and improve workflow for operational staff, which led us to explore the possibility of using AI in our colonoscopy program.”
Atlantic Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
To address the challenge, Atlantic Health partnered with Artera, an agentic company strengthening how healthcare professionals communicate and care for patients, to create an augmented intelligence (AI)-powered patient communication program to make the overall process of undergoing a colonoscopy easier.
Standardizing a complicated process
Existing barriers included general confusion and unanswered questions about preparation, which led to a disproportionate number of cancellations. In turn, that caused downstream problems. Last-minute cancellations make it impossible to schedule another patient in that timeframe.
The burden of dealing with the situation fell largely on schedulers and operational staff. The call volume of patients with questions about their instructions, and the necessary follow-up calls, could be enormous. The additional workload for staff could, at times, make an already problematic patient journey even bumpier.
For the most part, the colonoscopy itself is not uncomfortable or debilitating. The problem for many patients is the preparation. It involves getting a prescription for the preparation medication and filling it, sometimes confusing instructions, following dietary restrictions and completing bowel preparation.
“In every practice and with every human, there’s always some variation in how the prep instructions are given,” said Dr. Parekh. “AI has standardized all of this so there is one set of instructions and one way of explaining things to patients.”
Creating consistency in patient communication
Atlantic Health focused on making patient communications consistent to ensure that every patient received the same clinically approved information regardless of where they sought and received care.
Historically, preparation, instructions and reminders were delivered manually in the office or by a person on the phone. Now, an AI-driven outreach program delivers uniform, standardized telephone messages to patients.
The system pulls from a proprietary knowledge base created and approved by clinical leadership and built around the most frequently asked questions physicians and other health professionals receive about colonoscopies. That distinction is critical to maintaining Atlantic Health’s oversight of every answer given via a large language model’s “conversation skills.”
“It’s trained only on what we tell it,” explained Dr. Parekh. “It was also very important to us that it understand tone and demonstrate empathy so it could carry on a conversation and answer any questions that patients have.”
Answering questions before they become barriers
The AI agent contacts patients by phone one week before their colonoscopies, verifies their identities and then proceeds to “talk” with them. The agent confirms the appointment, encourages patients to read and understand the preparation materials and reminds them to pick up their prescription from their pharmacy.
Patients are also invited to ask questions. The AI agent has been trained to respond to more than 80 frequently asked questions, mostly about preparation and the procedure itself. Most importantly, it evolves. Atlantic Health reviews the patient interactions to spot new questions to promptly expand and refine the system’s knowledge base accordingly.
“Sometimes it’s things we didn’t even think about, like whether patients can wear their dentures or their hearing aids,” Dr. Parekh recounted.
The system is also multilingual, which eliminates one very basic barrier to accurate understanding because it speaks the patient’s preferred language. All activities are documented within Epic, so care teams know who has been reached, what they asked and who needs follow-up.
Early results show signs of success
Atlantic Health is also rigorously evaluating the program's effectiveness. Rather than deploying the AI agent universally right away, the health system established a control group as part of the pilot. About half of scheduled colonoscopy patients received AI outreach calls, while the remainder were reached through the standard process.
“We were able to analyze the incremental impact of these agents versus the traditional approach before we launched the program,” explained Dr. Parekh. By comparing outcomes between the two groups, Atlantic Health is able to accurately measure the technology's impact on patient engagement, cancellations and operational efficiency.
Positive and measurable results were observed almost immediately. In the first 30 days after launch, 43% of patients contacted by the agent answered the call and confirmed their identities. Thirty-nine percent confirmed their appointments and 18% asked questions. Patients were doing more than simply answering an automated call. They were actively engaging with this technology and using it as a source of information and guidance.
“We were genuinely surprised that so many patients engaged with the agent. We didn’t expect that,” admitted Dr. Parekh. “We thought they would just confirm and hang up, but now 18% of the patients contacted by the AI agent ask questions.”
Not only are patients taking the opportunity to understand their own responsibilities and obligations better, but cancellation rates have also fallen too. Evaluation is still underway, but early results indicate that standardized, “intelligent” communication processes and messaging are helping patients stay on track for scheduled procedures.
Operational benefits emerge
Atlantic Health estimates that the amount of time that teams spend managing outreach calls has been reduced by 39%, with a corresponding uptick in the amount of time that care teams can spend on more complex patient needs and scheduling activities.
The initiative has also established consistency throughout Atlantic Health’s open access colonoscopy program, which includes several hospitals and outpatient locations. Historically, each site had slight variations in how information was communicated, but now the AI platform has established uniform messaging throughout the organization and its various facilities.
Improved efficiency has a positive impact on every aspect of care, including the most important: the patient experience. In fact, indications are that some patients are more comfortable discussing certain topics with an AI agent than an actual person.
“Patient satisfaction with this form of AI has been pretty amazing,” said Dr. Parekh. “We notice that some patients with uncomfortable questions are more likely to interact with the agent precisely because they’re not discussing potentially embarrassing topics with a human. They don’t feel the same way with AI.”
Looking beyond colonoscopy
The colonoscopy initiatives created by Atlantic Health represent the beginning of even more exploration of the benefits of AI-enabled patient engagement.
“There are so many other aspects within GI beyond colonoscopy itself,” said Dr. Parekh. “If we can have AI make sure that the patient is prepped and confirm their appointment, we can do postop calls for patients too. They often have questions or issues that come up after the procedure, and right now the processes for handling those are still manual. This can certainly help”
The potential extends beyond gastroenterology as well.
As health systems continue working to close preventive care gaps, technologies that improve communication, increase adherence and reduce operational burdens may play an increasingly important role. For Atlantic Health, the pilot has already demonstrated that AI can help patients navigate a complex healthcare process while supporting physicians and operational teams.
Most importantly, it has shown how technology can be used to remove barriers that prevent patients from completing one of the most effective cancer screening tools available. By combining clinically validated information, personalized outreach and operational efficiency, Atlantic Health is working to ensure that more patients reap the benefits of undergoing a procedure with such high potential to not only spot and treat cancer but save lives.
For strategies on ensuring the responsible and effective use of AI in practice, check out the AMA STEPS Forward® “Governance for Augmented Intelligence” Toolkit.
From AI implementation to digital health adoption and EHR usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors. That includes the AMA Center for Digital Health and AI, which works to ensure physicians help shape how AI is developed, implemented and regulated across the healthcare system, with patient safety and physician-led care remaining at the center of those efforts.
