On-demand digital tools lead to better health outcomes, lower costs, study finds

Many patients are seeking help for the prevention and management of health conditions outside of normal working hours, especially for chronic conditions, according to a recent study. Therefore, these findings support the integration of artificial intelligence (AI) tools to extend after-hours patient care.

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“AI-powered programs can enhance primary care by improving efficiency, increasing patient engagement, and providing timely support,” the researchers wrote. “While there is considerable speculation about why digital programs are used and growing evidence of their benefits, there are gaps in understanding how these programs are used.”

This cross-sectional study published in JAMA Open Web, aims to use real-time behavioral data from AI-powered programs to demonstrate when patients are most likely to seek support among an insured population.

Data was collected from 79,437 members who participated in 1,464,752 unique coaching sessions from January 2023 to April 2023 using the AI ​​platform Lark, which offers chronic disease prevention and management programs to insured patients. The platform includes support for diabetes prevention, diabetes management, hypertension management, heart health and general health.

The researchers examined the percentage of coaching sessions conducted during Monday through Sunday hours, categorizing coaching by business hours (Monday to Friday between 8am and 5pm) and out of business hours (Monday to Friday outside of 8am to 5pm, and holidays). Additionally, the researchers assessed differences in on-hours and after-hours coaching by age and gender.

The mean (SD) age of the 75,161 members who provided their age was 47.5 (11.5) years, and 75,648 (73.6%) of the members who provided their gender were female. However, members rarely provided information on race and ethnicity, so it was not included in the survey.

Regardless of age, members demonstrated similar behavior and sought support in the evening hours, with 35.2% of all sessions occurring during working hours and 64.8% occurring outside of working hours. Adults aged 50 to 64 had the most after-hours sessions (65.4%), compared to adults aged 18 to 34 who engaged the least after-hours (62.1 %). This division between business and after-hours does not differ by gender (P = 0.68).

Additionally, the mean (SD) session duration was 4.78 (0.01) minutes. Members aged 75 and over had the highest mean (SD) session duration of 5.71 (0.20) minutes (P = .01 relative to those aged 18-34; P = .009 vs. those aged 35-49; P = .03 compared to those aged 50-64). Female patients had longer sessions (vs [SE]4.79 [0.01] minutes) compared to male patients (avg [SE]4.43 [0.02] minutes).

However, the researchers acknowledged some limitations of the study, including the fact that these changes reflected only the average behavior of the members; factors such as seasonality and program length can help understand whether usage patterns for these platforms change over time. Additionally, the researchers note that future studies should assess the effects of employment status on usage behavior.

Despite these limitations, the study suggests a need for on-demand prevention and management support for chronic disease patients who often seek these resources outside of business hours using digital health tools and platforms.

“Digital solutions cannot answer all health care problems,” the researchers wrote. “However, personalized on-demand support for the prevention and management of chronic conditions can address problems before they occur, leading to better health outcomes and lower costs.”


Graham SA, Pickus SK, Lockwood KG, Buch LS, Dunn P, Paruthi J. Business versus after-hours use of an AI-based digital health platform among insured patients. JAMA Netw Open. 2023;6(9):e2333511. doi:10.1001/jamanetworkopen.2023.33511

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