Quality Customer Service in Healthcare is Critical: Secrets to Building a Customer-Driven Service Platform

By Joe Caliro

Many companies in the retail industry include a variation of the statement “provide world class service” in their mission statements. These same companies have well-planned business strategies and comprehensive marketing strategies. But ask them about their customer service strategy and you’ll find it’s often nothing more than a bullet point in their mission statements.

The need for quality customer service in any industry is evident; in the healthcare industry it is especially critical. Unlike call centers where retail products are being sold, medical call centers are dealing with people’s health – and quite possibly their lives. Consequently, it is crucial that the quality of customer service, including the operation of the call center, which often deals in life and death emergencies, be as high-level as possible.

It’s important to remember that the call center in a medical environment can be established to perform a wide variety of functions, perhaps more than in any other industry. These include conventional answering services for physician after-hours call coverage, nurse triage/health information, community nurse lines, emergency department advice calls, and home health calls, both inbound and outbound. What’s more, the settings in which the call center can be located are almost endless: hospitals, doctor’s offices, medical practices, hospice care, home health care, and long-term care service providers. Generally speaking, the pressure placed on a call center by a physician or other health care professional is far greater than the pressure put there by the executive manager of a typical retail business.

When establishing a consumer-driven service strategy in a medical facility, the task is to look at how customers (that is, callers and patients) are represented in your organization. This data is collected in many ways, for various reasons, and by different departments. Unfortunately, there usually is not a single department responsible for pulling all the data together. There are four key types of data required for a well-built customer-driven service platform:

  • Customer feedback data
  • Employee feedback data
  • Behavioral / monitoring data
  • Operational daily metrics used to run the business

In many medical organizations, various departments access this data through static daily or weekly reports. Nowhere does this data meet both analytically or operationally to show the cause and effect of major business actions. Because the data is not linked, it’s difficult for a company to see how the different aspects of operations are affected by one another. In reality, each of the four data points reflects effective “levers” that can be pulled to affect business or marketing efforts. Over time, these four key data points can be tied to financial fluctuations and true Return on Investment (ROI) analysis.

Data Rules: It has been said, “He who has the data rules.” But in many medical organizations, the four key data types are owned by or kept in separate silos or departments that have formed strong “fiefdoms.” Unfortunately, fiefdoms tend to protect “their” data and can be unwilling to share or allow other departments to control the analysis, impeding the development of a customer-driven service platform.

While other departments can and should take an active role in the collection and interpretation of data, only one department should be responsible for linking all the data that will feed the customer-driven service platform: the quality department. If fiefdoms exist or the quality department does not have the analytical power to build the linking service platform, organizations should consider outsourcing the task to a quality company that specializes in building customer service measurement platforms.

The four primary quality operations to consider outsourcing include:

  • Monitoring and evaluation of calls, chat, email, and customer comments coding
  • Customer and employee surveys
  • Advanced satisfaction/loyalty modeling
  • Continuous quality improvement efforts

There are a number of reasons to outsource the monitoring and evaluation function. Much of it has to do with the type of monitoring model that your call center employs, usually either a traditional monitoring model (multiple quality assurance monitoring (QAM) teams operating within the center), or a decentralized monitoring model (a QAM team accomplished by coach-driven monitoring with no internal QAM team).

The challenges raised by these two models are similar: they are costly, consistency in calibration of accurate standards is difficult, and the objectivity of the reporting is suspect and not effectively used by the center or the organization. The emerging centralized monitoring model provides a highly viable alternative. This model is actually a hybrid of the traditional and decentralized models and allows organizations to replace the internal QAM team of the traditional monitoring model and outsource the required base call monitoring and evaluation requirements for coaches in the decentralized monitoring model. Besides reducing costs, the emerging model puts actionable data in the hands of management and coaches, allowing them to focus on improvement efforts and targeted coaching.

In the emerging centralized monitoring model, an objective, third-party company evaluates call centers from one core calibrated group of employees. This group is directly calibrated by company program managers and reports results on a reporting platform that allows anyone in the organization to track quality trend by all levels of the entity, including at the individual employee level. This model can eliminate the need for a large headquarter QAM team, as there is no need to “check the checkers.”

Feedback is Predictable: Of course, regardless of the model used, an organization cannot begin to understand the effects of its operational and marketing plans – not to mention procedures, policies, systems, products, and service – without an actionable and accurate customer and employee feedback loop. Every organization should have at minimum two types of surveys: relationship and transactional.

For budgetary reasons, many only use relationship surveys. Relationship surveys certainly have value, tracking the brand image in areas such as price, value, advertising, customer service, and billing. However, surveys are given at random to the customer base with no point of reference to business activities. Thus, a customer may have interacted with your organization one week ago or one year ago. With no point of reference to time or possible recent interaction, customers draw their answers from collective memories, their experiences, or what they remember from advertising or word of mouth. Consequently, relationship surveys are bad for managing the day-to-day business decisions affecting customers.

Conversely, transactional surveys measure customers’ experiences within a given time frame of their interaction with your organization, permitting sufficient time to complete their interactions and form opinions. A good transactional survey breaks down these interactions into key elements of the experience. With the proper analytical modeling, an organization can survey and track which aspects of the customer experience are causing the customer to be satisfied, or dissatisfied, with the outcome of the interaction.

Transactional surveys also drive operational changes. Because they are relevant to a specific experience at a precise point in time, it is possible to tie survey results to customer satisfaction as it relates to weekly internal metrics and financial performance. When building a customer-driven service platform, an organization should consider linking all data from transactional surveys to both daily operation metrics and relationship data in order to track the correlations to financial fluctuations in the business. Once this link has been established, the organization can have a service strategy that drives the business from an end user’s perspective.

A “Blueprint” for Customers: In order to ensure that relational and transaction surveys are asking the right questions, start with an “ideal customer blueprint map.” This is a total exploration of the ideal customer experience in your industry. The mapping includes focus group benchmarks for industry norms and breaks down each aspect of an organization’s service delivery cycle. It explores the articulated and unarticulated needs of customers and tries to define expectations within their service experience. The final blueprint can then be applied to an organization’s current business model to determine where there are weaknesses and points of competitive advantages.

From the ideal customer blueprint map, an organization can then design a “blueprint survey.” In this process, a comprehensive life cycle survey is created to capture every critical aspect of an organization’s service and sales delivery. Through advance modeling techniques, an organization can determine the impact of key business activities from a customer’s perspective. The blueprint survey lays the foundation for developing an ongoing customer satisfaction/loyalty survey, which is a far more effective tool than a generic survey.

The outcome of a blueprint survey is easy to translate to management and employees because they can see it came from customers’ input, and the results will help show who is responsible for each action that drives satisfaction. Once an organization has built an actionable and accurate customer survey process, it will then have the foundation to replicate the same process with agents and other employees. The right modeling can quantify the ROI of a pay increase, commission increase, adjustments to employee benefits, or changing other aspects of an organization’s culture.

Don’t “Dummy Down” Data: Even with a well-designed survey, some organizations “dummy down” the customer satisfaction data that they collect. In fact, some market research companies admit there are better ways of interpreting customer data, but the entities they serve don’t have the discipline to understand and work with higher-level analytics. Recently, this has led to much “buzz” about how a company only really needs one question to run its business.

One of the most common ways to “dummy down” customer satisfaction data is by looking at only the “top two / three box” responses to key questions. This is where the business reports only the percentage of responses to the 4 and 5 scores on questions with a scale of 1 to 5. When reporting top box response in this way, the claim can be made, for example, that “85% of all customers are satisfied or very satisfied with our service.” Unfortunately, this is not an accurate or actionable reflection of true performance.

Top box reporting also does not reflect the total effect of changing performance within the top boxes as well as downward movement of customers in the bottom two boxes. Any negative movement, regardless of which box the customer rates, is information the business needs. It is critical to know how all customers are evaluating the organization and how all customers are fluctuating both in positive and negative directions.

An organization that wants to build a customer-driven service platform must employ an index methodology for analyzing and reporting customer and employee survey results. The index methodology survey process calculates multiple critical survey questions into a single number that, when operational, will ensure that customer feedback becomes an integral part of any organization. In addition, the indexed approach allows tracking of performance to many national syndicated surveys like JD Powers and American Customer Satisfaction Index (ACSI).

The final level of higher analytics involves bringing all the data together to track and predict financial impact on operational and marketing efforts. Using a variety of advanced analytics and predictive modeling techniques can determine where you are losing money or brand position due to poor performance. This modeling and analytics will determine your strategic plan’s driving issues and will quantify losses or potential growth opportunities. All analytics will be actionable, quantifiable, and measurable.

Putting Theory into Practice: Imagine you want to reduce the wait time for callers because you believe they are waiting too long and are dissatisfied with their experience.  If you have a robust, customer-driven service platform in place, you would be able to analyze your data and come up with something like this:

  • To increase the speed of answer, you will need to link wait time and agent headcount to the cost of X. In this example, $650,000 would give you a 1 point improvement in handle rates.
  • This handle rate increase will give your company a .12% increase on your overall customer satisfaction index.
  • With the customer-driven service platform, you would know that a .12% increase in satisfaction will net a .25% decrease in lost customers
  • With a net present value calculation, you could determine that this .25% decrease in lost customers translates to a net contribution of $3.2 million to your bottom line.

In the boardroom, the question would be asked, “Who wants to invest $650,000 to make $3.2 million?” The answer would be clear. Think about how this debate plays out on other issues such as: What is the cost of lower customer service from an offshore center versus an onshore center? What is the right wait time for a phone call? What effect is an IVR system having on caller satisfaction?

Healthcare organizations of all types are consolidating and often losing money as a result. One way to help stem the tide of this negative financial performance is to provide customers with consistent, quality information and customer service through the call center and throughout every aspect of the entire enterprise. Customers must be made to feel that they are truly the key to a medical organization’s success. Presenting any other appearance can put the fiscal health of a medical facility into serious jeopardy.

It will not be the panacea to the financial woes facing the healthcare industry, but it could mean the difference between keeping the doors open – or closing them forever.

Joe Caliro is the Executive Vice President of Quality at HyperQuality and responsible for launching and managing Professional Services, HyperQuality’s new, full-service customer quality consulting arm. Joe can be reached at joe.caliro@HyperQuality.com.

[From the October/November 2007 issue of AnswerStat magazine]