Remote Workforce for Medical Contact Centers

By Jeff Forbes, CIO, IntelliCare

Fall, 2004

Not all technology promises come true, but for the medical contact center community yesterday's promise of a "virtual office" has evolved into today's distributed workforce.  Technology has brought down the geographic borders surrounding recruitment and enabled telephone-based centers to better meet demand for health advice and information, improve services, and manage costs.

The Benefits of a Remote Workforce for Today's Medical Contact Center: The images of a remote workforce have focused on the soft benefits for the home-based workers, such as wearing slippers while conducting conference calls.  The reality is that using a distributed workforce can help medical contact centers achieve greater efficiencies in delivery by enabling more scalable work shifts, better manage costs by reducing facilities overhead, and improve morale among the workforce.  But perhaps the most important benefit of using a distributed workforce in the medical call center is improved clinical recruiting.

As anyone in this field knows, the nursing shortage in our country has reached crisis proportions.  According to the American Hospital Association, there are 126,000 unfilled nursing positions in hospitals today and our educational system is not filling the pipeline.  The American Association of Colleges of Nursing estimates there are 21,000 fewer nursing students today than in 1995.  Hospitals and healthcare facilities will continue having a hard time filling clinical positions, so they must take advantage of any differentiator.

Offering nurses home-based shifts is one way to recruit in a competitive field.  Nurses burned out from 12-hour hospital shifts love the flexible hours offered by telecommuting.  Nurses that are no longer willing or able to meet rigorous physical demands can extend their careers and young parents can continue to fit in shifts around busy family schedules.  Without a commute, nurses no longer have to be tied to any particular physical site.  Nurses can be located anywhere, as long as they have voice and data access.

In addition to improved recruiting and workforce morale, the remote workers are more flexible, a crucial factor in managing call flow.  When demand spikes, remote workers can quickly log on without wasting time on commutes.  They also can just as quickly log off when demand slows, without working - or having employers pay for - a full shift.  Employers and workers both benefit from the flexibility.  Employers spend only what is needed to cover demand and workers can take advantage of extra hours when they're able.

Perhaps the most exciting part of building a remote medical contact center workforce is the ability to draw upon a large population to build centers of excellence.  Call centers that can recruit nationwide to build virtual teams and offer best-in-class services to their clients and callers.

How Do Remote Workforces Work?  The Technology Behind it All: Technology truly drives the distributed workforce and dramatic improvements in remote management and groupware-type products improve team building and management control.  But traditional phone lines, called POTS (plain old telephone service), still play an important role.

Telecommunications: Just as in traditional call centers, remote nurses need to communicate with patients via phone and access data and tools via computers.  While IP telephony enables both voice and data to share one line, there may be a preference to equip nurses with both traditional voice lines for patient calls and high-speed data lines for their computers.  This dual coverage provides redundancy in case of data-line outages; nurses can continue to take calls and track information manually.

Team building and relationship management: While remote workers deliver the same services as on-site nurses, avoiding a sense of isolation is a concern.  A number of key technologies can help overcome issues unique to the at-home agent.  With instant chat, help from a peer or supervisor is a click away.  Screen sharing allows supervisors to take over an agent's screen and teach, in real-time, how to best manage a call.  Instant meetings and white-boarding allow team meetings to occur regardless of agent location.  Computer-based training and distance learning permit everyone to complete training regardless of location or even time of day.  Training can occur in groups, individually, or even one-on-one.

Traditional email is in the mix as well - it supports team cohesion and informal learning within a work group.  Individuals can communicate with one another on a more casual basis, using the secure chat function, sharing screens, and even pushing websites to one another.

Remote agents do not need to feel alone.  With the appropriate technology tools, they can get real-time help, attend meetings, and take training whenever they need and wherever they are.  Technology enables the remote workforce to foster team environments and provide effective connections among peers and supervisors. 

Workforce Management: Even with the best telecommunications infrastructure and call management software, a remote workforce will fail without appropriate management.  Many managers' biggest concern about leading a remote team is that they think it will be difficult to ensure that people are actually working.  The solution to this dilemma is one part technology and one part recruitment: it's vital to find people who work well on their own.  Often, more mature nurses understand the level of availability required in order to be successful and can willingly contribute without excessive management.

Real-time call monitoring technology helps managers measure and monitor all of the statistics they track in brick-and-mortar call centers such as call handle time, ready-to-assist availability, post-call follow-up time, and other traditional metrics.  Because the statistics are available in real time, it's easy for a manager at any location to see who is working, who is on break, and the rate at which they are working. 

Making it Work: Our experience with building a distributed workforce model for our medical contact center services shows that the concept works.  It saves money, improves services, and vastly increases what has become a too small labor pool.  The contact center business is all about scalability and the flexibility of a remote workforce meets that need perfectly.  The telehealth business is also about appropriately managing demand - getting patients access to the right care, at the right place, at the right time.  With the ability to build virtual centers of excellence, the distributed model is the optimum choice.  Technology has enabled telecommuting to be a viable choice for telehealth, which is terrific for healthcare facilities, nurses, and patients alike.

Jeff Forbes is CIO for IntelliCare, a Portland, ME-based company that operates the largest network of medical contact centers in the United States, and develops technology that improves delivery of quality healthcare.  IntelliCare blends physical centers with remote capabilities to provide a range of coverage for their clients.  They have physical centers in ME, TX, MD, NY, MO, and TN, but 80 percent of their nurses are home-based throughout the country.  Reach Jeff at jforbes@intellicare.com.