By Richard Stier

You are your health network’s senior leader for access with direct responsibility for the contact center. This morning your CEO asked you a question that has dominated your thoughts. “We’re taking a hard look at the budget,” she said. “The contact center represents a significant line item. Can you help me understand if, or why, the call center is vital to us? Why should it remain in our budget?”

How would you respond? Three key criteria provide the foundation for your effective reply.

Criteria 1: Structure the Framework: Align your contact center’s priorities with C-suite imperatives.

You have an ongoing conversation with your vice president about the organization’s driving priorities, and you’ve focused your contact center to support three of them:

1. Reduce avoidable readmissions to eliminate a recent fine from CMS,
2. Improve CAHPS scores for patient satisfaction to improve reimbursement, and
3. Fill practices of newly employed physicians to accelerate the revenue cycle.

Because reducing preventable readmissions is an organization-wide priority, you’ve made it a contact center priority. At discharge, a contact center ambassador asks patients for permission to contact them and their caregivers when coordinating follow-up appointments. Your contact center receives discharge reports every morning from each member hospital. The ambassador calls, emails, or texts the discharged patient and the authorized caregivers to coordinate a day and time for the follow-up physician appointment.

After the scheduled day and time, a contact center ambassador calls the physician office to see if the patient kept the appointment. If the appointment was not kept, they reconnect with the patient or the patient’s approved caregiver to reschedule.

The results have been substantial. The readmission rate declined from 25 percent to 15 percent, and a fine from CMS was reduced by two million dollars over the past two years. Kept appointment rates for post-discharge physician visits have climbed to over 85 percent.

You’ve used tools in your contact center software to document and improve first experience satisfaction scores, and your overall CAHPS scores have been steadily rising. And, you have documented the stream of patients for whom the contact center has made appointments with newly employed physicians at eight practices.Your healthcare contact center is the virtual front door for personalized support and referrals. Click To Tweet

Criteria 2: Place the Rebar: Hardwire your contact center to strengthen your organization’s patient experience (PX) advantage.

You’ve shared with internal colleagues that healthcare currently has a 29 percent patient experience failure rate (per research by Hospital Compare). Only 71 percent of inpatient patients report they received the “best possible care.”

You’ve challenged your peers to ask, “In what universe is a 29 percent failure rate acceptable? Could we miss our revenue projections by 29 percent? Be over budget by 29 percent? Could we even conceive of missing our quality metrics by 29 percent—we only drop 29 percent of newborns, so we meet the standard?” Seriously.

You’ve communicated your belief that “best possible care” experiences begin before a patient receives care and continues after the patient returns home. You explained that your contact center is uniquely positioned to serve as the virtual front door for personalized support and referrals—whether on the website or on the phone—before using a clinical service and for individualized follow-up and coaching after discharge.

You’ve taken several actions to strengthen patient experience advantage:

• You now include patient ratings and comments in your online provider directory. This key information for prospective patients increases the probability of a good match with one of your providers. Better alignment between patients and providers results in higher patient satisfaction.
• Your contact center conducts pre-CAHPS patient satisfaction surveys to identify areas for improvement before the CAHPS surveys are conducted. The contact center leverages relationships with callers as a conduit of opportunity to improve CAHPS scores across the enterprise.
• You place contact center ambassadors in your emergency department to capture patients without a primary care physician. This has resulted in less congestion in the ER, patients being re-directed to more appropriate sites or levels of care, and incremental patients being referred to in-network providers.
• You have a pre-admission patient hotline where contact center ambassadors work with patients to keep them in-network, secure financial clearance, and arrange for a deposit prior to their visit. Ambassadors add value by providing patients with information about directions, location, and parking.
• You shift your team culture to celebrate “phone hugs,” redirecting the focus from processing transactions to building relationships with patients through empathic conversations.
• You launch digital patient experience journey mapping to document experiences from patients’ perspectives starting with the first online or phone contact to handoff of care to post-discharge connections.
• You recognize the maturation of contact centers to require super agents whom you call “senior ambassadors.” They serve as indispensable personal coaches. They have a proven ability to calm difficult callers and help them with their most challenging situations. For example, they may coordinate pre-visit scheduling for multiple tests that need to be completed before the patient has their physician appointment.
• You’ve integrated your contact center’s provider data into a single master provider database as a source of truth. The benefits include a comprehensive and more accurate database, reduced data errors, greater data security, increased provider satisfaction, and an improved caller experience.
• You took two important steps to strengthen your organization’s patient experience advantage:

1. You recognize your contact center’s role to deliver differentiating, memorable first experiences. In collaboration with your chief patient experience officer, you pulled together a team of first touchpoint and access leaders to multiply your impact.
2. Your first touchpoint team understands the first three seconds of that initial interaction influences hospital selection and preference (SHSMD 2012). The team identified a shared metric for targeted improvement: first experience satisfaction score. You regularly monitor this and have ongoing first touchpoint team challenges across several departments to improve it. Your first experience satisfaction score has moved from 58 percent two years ago, when you implemented this initiative, to 84 percent last quarter. Future metrics considered by your first touchpoint team are: improved CAHPS scores and improved patient satisfaction with specific handoffs of care targeted for improvement.

Criteria 3: Pour the Concrete: Confirm your contact center as an investment, not an expense.

Expenses are cut. Investments are funded. You understand that if your contact center is perceived as an expense, you must be prepared for tough questions.

You’ve collaborated with your CFO to develop and publish a quarterly one-page contact center executive dashboard report for your leadership team. The metrics in this report are reviewed with your CFO annually and revised as needed.

Your contact center executive dashboard report includes three columns:

1. Executive Briefing on Strategic Priorities: The left column includes a bulleted list of metrics aligned to support Criteria 1 priorities.

In this case, you’ve provided a list of indicators under heading “Reduce avoidable readmissions.” Those indicators include: baseline, target, and current readmission rate; baseline, target, and current kept appointment rate; and baseline, target, and current percentage of PCPs with patient follow-up appointments within seven days of discharge.

The next indicator in the “Executive Briefing on Strategic Priorities” column is improve CAHPS scores. Your indicators are baseline, target, and current score for first contact satisfaction, and the number of pre-CAHPS patient satisfaction surveys completed by the contact center.

The third indicator is “Fill practices of newly employed physicians.” Indicators are baseline, target, and current number of referrals and appointments made to employed physician practices and the baseline, target, and current number of referrals and appointments made to all participating physicians for this quarter.

2. Strengthen PX Advantage: The center column includes metrics aligned with Criteria 2 priorities. Your indicators include: number of click throughs on patient ratings and comments in the online provider directory; number of unattached ER patients referred to in-network PCPs; number of patients served this quarter with the pre-admission patient hotline; and baseline, target and current patient satisfaction with handoffs of care from the contact center to employed practices.

3. Contact Center Investment Summary: The right column metrics support the priorities in Criteria 3. Indicators include a bulleted list of metrics after contact center interactions and clinical triage such as inpatient admissions, outpatient visits, ER visits redirected, total physician referrals, total physician appointments, incremental gross revenue, estimated net contribution (supported with attached detail), and estimated ROI.

When you meet with the executive team, you have three additional categories of metrics available to discuss, in anticipation of questions.

1. The first is priority service line measures with indicators for each clinical center of excellence such as referrals resulting in inpatient admissions and referrals resulting in outpatient visits.
2. You have also identified metrics for integrated access centers such as number of switchboard calls, call length, total handle time, abandonment rate, caller satisfaction, appointments scheduled by clinical service and practice, number of transfer center transactions, number of physician-to-physician consults, and gross revenue from physician-to-physician consults.
3. Finally, you are prepared to update the group on contact center operation indicators such as total website conversions, total appointments scheduled, kept appointment rate, average seconds to service, and call abandonment rate.

Your reply: As you mind concludes this mental review, you take a breath and hear yourself respond to your CEO’s question with confidence.

“I believe our contact center is essential to our ability to achieve our strategic imperatives. We intentionally support our priorities to reduce avoidable readmissions, improve our CAHPS scores, and fill the practices of employed physicians. Our contact center strengthens patient experiences as our competitive advantage, beginning at the important first point of contact—whether online or on the phone.

“Importantly, our contact center delivers a tangible return. Our Executive Dashboard Report documents an ROI of three to one. That is, we get three dollars returned for each dollar invested. In summary, our contact center delivers a solid ROI while improving patient satisfaction.”

As your organization’s leader for access, you made the shift from managing transactions to delivering transformative experiences. The contact center team you lead builds competitive advantage by ensuring extraordinary patient experiences at the critical first touchpoint and beyond. Your contact center is vital to your organization’s mission-critical priorities.

Richard D. Stier is vice president marketing at Echo, A HealthStream Company. He is a results-proven proponent of delivering transformative patient experiences. Echo, a HealthStream® Company, delivers enterprise-class, innovative solutions to optimize patient experience contact centers. Echo’s solution for hospital-based contact centers, EchoAccess, enables your organization to deliver intentionally memorable experiences that mitigate risk, solidify loyalty, and reduce unnecessary readmissions.

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