Driving Digital Transformation With AI, Voice Bots, and the Power of Starting Small
In a recent episode of The Big Unlock podcast, Crystal Broj, Enterprise Chief Digital Transformation Officer at the Medical University of South Carolina (MUSC), shared a compelling account of how her team is reshaping healthcare delivery through AI-driven innovation. Crystal talks about how MUSC is transforming healthcare through AI-powered voice bots, ambient listening, digital front door innovations, the challenges and successes of implementing a new patient check-in system and deploying an automated AI agent in their patient access center.
From piloting intelligent automation to enhancing patient access and provider efficiency, MUSC’s digital journey offers valuable lessons for any healthcare leader navigating transformation.
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Start Small, Scale with Purpose
One of the biggest lessons Crystal emphasized was the value of starting small and scaling smart. MUSC began its digital transformation journey with a pilot using Notable to send appointment reminders to patients at just five clinics. After carefully evaluating feedback, the initiative expanded across the organization. This phased approach allowed MUSC to iterate, build internal trust, and grow digital capabilities with confidence.
“One of the biggest lessons learned is yes, start small and then move forward,” Crystal explained. “We didn’t try to make everything perfect—we added little pieces thoughtfully.”
AI Accelerates Access and Reduces Manual Burden
A standout success story is the implementation of an automated AI agent to handle prior authorizations. This task—once requiring 15 to 30 minutes of manual data entry and payer coordination—is now done in about 30 seconds by AI.
“We have about a 37% accuracy on this agent, and it keeps learning all the time. That means almost 40% of the ones we send through are done without any human intervention.”
This innovation not only accelerates care for patients but frees up staff time for more complex needs. By automating a time-intensive administrative process, MUSC improves both efficiency and the patient experience.
Voice Bot Redefines Patient Access
Another game-changing technology has been the deployment of a voice bot named “Emily” in MUSC’s patient access center, which handles 42 phone lines and approximately 150 agents.
Emily uses natural language processing to greet patients, validate appointments, and provide key information—all without involving a human agent. The bot now deflects 17% of incoming calls, reducing wait times and call center volume while allowing staff to focus on more complex patient concerns.
“We’re not getting rid of jobs,” Crystal clarified. “But our access reps can now handle more complex questions. Our hold times have gone down, and hang-up rates have dropped.”
Beyond regular business hours, Emily also provides 24/7 support, and she is being trained to handle appointment rescheduling and Spanish-language interactions. With plans to roll Emily out to additional departments like revenue cycle and pharmacy, the bot is poised to become a foundational tool in MUSC’s digital infrastructure.
The Importance of Testing and Change Management
Crystal stressed that rigorous testing and thoughtful change management are critical to successful implementation. When deploying voice tech like Emily, MUSC took the time to train the bot on regional accents, common phrasing, and different user needs to ensure a seamless experience.
“Testing is really important—getting the people who are going to use the software to test it helps us understand what patients are actually hearing.”
Equally important was managing the human side of change. Staff had to be retrained, new workflows created, and consistent communication ensured. For example, front desk teams were used to handing out clipboards for patient check-ins—now they needed to trust the technology and guide patients through digital check-in instead.
Real Metrics, Real Impact
MUSC rigorously tracks key performance indicators (KPIs) and return on investment (ROI) across its digital initiatives. These include:
- $1.4 million collected in copays through pre-visit engagement,
- $1.9 million in open balances recovered via automated tools,
- 98% patient satisfaction with the Notable platform,
- 37% reduction in “pajama time” (after-hours charting) for doctors using ambient AI documentation tools,
- Over 1.7 million reminders sent to patients since June.
These metrics are reported monthly to business and clinical leadership, demonstrating tangible value from the digital investments.
Transparent Scheduling and Digital Front Door Improvements
To improve access and meet patient expectations, MUSC has also implemented DexCare, a natural language-powered “Find a Doctor” tool integrated into their website. Patients can search using everyday terms (e.g., “elbow pain”) and immediately see available appointments—both in-person and virtual.
This initiative has already resulted in 200+ self-scheduled appointments in its first week, even without promotion. Crystal believes this level of transparency will be vital in shaping the modern digital front door.
“Our patients are asking for access. Now they can see what’s available and take action right away.”
Challenges on the Road to Transformation
Of course, transformation is not without its challenges. Crystal pointed to IT staffing limitations, the need for ongoing support from cross-functional teams, and the unpredictability of integrating with legacy systems. Agile planning, flexible timelines, and close collaboration with vendors and internal partners have been key to overcoming these hurdles.
Crystal also highlighted the need to address provider resistance, particularly with ambient AI documentation tools. While the tools helped reduce after-hours work and accelerate documentation, some physicians were initially hesitant. MUSC had to adjust its communication strategy, provide more hands-on support, and build confidence over time.
Looking Ahead: A Seamless Experience for Patients
When asked about the future, Crystal envisions a healthcare experience where digital tools support seamless navigation before, during, and after a patient’s visit.
MUSC’s digital transformation journey—under Crystal Broj’s leadership—proves that healthcare innovation doesn’t have to start with massive disruption. By starting small, tracking real outcomes, and scaling intentionally, the organization is using AI and automation to solve real-world problems, improve care access, and empower its workforce.
For healthcare leaders navigating similar paths, the message is clear: start small, measure impact, and move forward with purpose.
A Pediatric-Centric Approach to AI
Pediatric healthcare comes with its own unique challenges—fewer available data points, smaller population sizes, and higher sensitivities around communication and consent. This makes the responsible use of AI even more critical.
Dr. Morse noted that solutions must be designed with children and families in mind, not simply adapted from adult care settings. Whether deploying ambient tools, summarizing clinical notes, or streamlining administrative workflows, every use case must prioritize trust, safety, and patient experience.
