Leveraging Call Centers for Better Patient Care

By Matt Phillion

The main operational goal of a traditional healthcare contact center is to handle a patient’s inbound call or chat as quickly and efficiently as possible. This is usually the best possible outcome: nobody really wants to spend extra time on a call resolving their healthcare questions or queries.

But what if there’s an opportunity to use those brief points of contact with the patient to address gaps in care, achieve better results for the patient, and let the organization go above and beyond the immediate need of the call? And what if that option also helped retain trained, skilled staff in an area of healthcare with high turnover rates and often low job satisfaction?

Organizations can take advantage of patient/member interactions to drive better results by taking care of important but routine additional interactions, notes Patty Hayward, GM of healthcare and life sciences with Talkdesk.

“Over the last few years, we’ve been getting better and better at doing more through automation, taking basic things off agents’ plates, and keeping them focused on conversations where they add the most value to patients,” says Hayward. “And it’s important to keep service agents focused on the more high-value needs, which are also good for retention. The turnover rate is high, and it takes a while to train patient access or revenue cycle agents. I talked with one organization who said it takes three months before their agents are online, but the average tenure is 18 months. And while your first instinct might be ‘How do we train them up faster?’ the alternate question is, ‘How do we keep them and increase revenue?’”

In talking with a counterpart in the retail sector, Hayward discussed a shift in philosophy for those call centers to be a source of revenue, such as having conversations about what the customer might have in their online cart, for example.

“A lot is happening in revenue in healthcare. We’re seeing record losses, operational issues, but at the same time we’re making this turn toward value-based care,” she says.

Concurrently, you have call center staff who want to do a great job, but for most there isn’t much of a career route unless they progress to manager.

“We know there are gaps in care for patients. What if we present this in a new way and enable real-time conversational guidance?” says Hayward. “The patient calls because they’re out of refills, and, using automation, the agent knows that the patient hasn’t seen their primary care physician in a year and a half, and they’re diabetic. Ordinarily, we have an outbound call center try to engage these patients, but we know those are minimally effective. What if you’re able to tick off four or five boxes while you have them on the line, and help them stay healthier, get earlier detections and hit our measures…it’s a win all around.”

Instead of outbound calls with the risk of being intrusive—or worse, ignored—the moment patients call in themselves, it’s “a golden moment,” Hayward says.

“Let’s get them to take care of all the outstanding things,” she says. “When they contact the call center, the goal is to answer the question asked. Often the patients themselves don’t know the things they need to do. So, it’s a chance to make an appointment for clinicians to reach out, or to get in touch with a pharmacist or physician if they’re not keeping up with a prescription because of side effects. We don’t want call center agents to have clinical conversations with them, but they can schedule those discussions.”

There’s no shortage of methods for enabling agents to help the patient in this way, Hayward notes, from large language models to active listening technology, it’s possible to offer the agents suggestions for what to do next and provide actionable next steps.

Improving quality of life—for patients and agents

Agents often come into call centers from backgrounds that have nothing to do with healthcare, Hayward says, so there’s a need to engage with education and training early on—and for those who stay, the career track can be very limited.

“The chance to more actively engage with patients offers a way for you to level up your employees,” she says. “You can take them from a basic knowledge to having deeper conversations and offer the opportunity to pursue certifications for better ways to have those conversations.”

Certifications offer a career track as their skill levels increase, removing that static nature of the job.

“If you don’t have much of a career ladder, you’ll have turnover as something more fulfilling catches the agent’s attention,” Hayward says.

While the technology is there for assisting agents to have these deeper interactions, a few barriers do remain. The EHR can be an issue depending on what kind of technology the organization uses—some are more ready than others, Hayward points out. Interoperability varies from resource to resource depending on how sophisticated an EHR the given organization is using.

“The tech is there, but we need to get those connectors in place,” she says. “The harder part is getting health systems to say yes, that’s the next level…Training and process management can be time consuming and challenging for even the best organizations.”

And then there’s the question of whether this is what the patient is ready to hear when they call in.

“How does this person know this stuff about me?” Hayward says. “But we can script our agents to talk about how we’re taking a more proactive look at your health to help you stay healthy, and that’s why we’re asking more questions.”

The hope and belief are that if you’re calling in to your health system, they already know things like the last time you saw your primary care physician. It’s a nuanced approach, knowing what questions to ask and which to simply schedule a clinician to talk with the patient about.

“Health information is very private and sensitive, but they already need to have access to what the patient is calling about, whether it’s a refill or paying a bill,” says Hayward. “I think we need to have sensitivity to these reactions, but on the other side of the equation, patients get frustrated if the agent doesn’t know enough about them. If we follow the laws, if our compliance is intact, these things should match up.”

Matching skillsets to patient needs

Another potential way to increase patient satisfaction and retain skilled agents is identifying strengths and playing to them.

“Routing is getting more and more sophisticated, and the more we can put rules in place, the better the patient’s experience will be. If you have an agent who is really good at having discussions with the patients on a live call, route them there, and if you have an agent who is very good at the written side of things, have them on the live chat,” Hayward says.

Those good conversations, whatever the format, get back to the crux of the issue: ensuring patients don’t have to call back as often.

“That’s the panacea we’re trying to get to,” says Hayward. “Being proactive rather than having them need to do things via multiple channels. If they have an outstanding order for an MRI, here’s how to schedule it right then and there.”

This actually goes against a common metric for call centers: the shorter the call time, the better. But if you’re engaging with the patient, the duration of the call isn’t as important as the effectiveness of the engagement.

“Our goal is to solve the problems so they’re not calling multiple times,” she says.

There remain some cultural and adoption pieces that need to be surmounted for this sort of interaction to come fully online, Hayward notes.

“If you look at health systems versus other industries, the latter’s entire goal is revenue generation, and their infrastructure is about doing that. But for health systems, the focus is on good clinical care—and it should be,” she says. “But they’re really focused on what happens inside those four walls. Once you’re there, you feel really good about the care you’re given, but it’s the outside looking in where the challenge lies.”

It’s an interesting challenge to strike just the right balance, Hayward says.

“This really is just around the corner, given how fast these models are evolving,” she says. “A barrier we face is [the] contact center is often thought of as a cost center, but what if we can improve and increase revenue by thinking differently and focusing on what’s best for the health system? We want patients to be healthy, and we want revenues to go up, and if we have better interactions with the patient, both will happen.”

Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.