Category Archives: Articles

Articles from AnswerStat

Who Owns Me?

The Enterprise Nature of the Call Center in Healthcare

By Robert Kobek

Given two very long and I believe distinguished careers in the contact center industry and the hospitality industry, I’m not surprised about how little patient feedback information is shared between stakeholders in a company. Being new to the healthcare industry, I’m keenly aware of the requirement to survey for Medicare reimbursement. What about the rest of the journey?

Very few of us executives have the luxury of focus. We look at the entire landscape, ecosystem, culture, call it what you will. There are times when focus can be misunderstood. One specific example is the way an organization views its contact center.

It’s imperative to use horizontal/peripheral vision. This phenom is what will create an enterprise view of how your contact center remains a profit center. From appointment to billing, the contact center is the point of the spear in managing the relationships between you and your patients.

Later I will use three examples to show the impact of a contact center report on at least seven departments or silos in an organization.

And in the case of gathering patient experience for the contact center where there are at least two outcomes, enhancing the patient experience through process improvement. There is also a big difference between research and online feedback management where measurement of every key performance indicator is reported to more business silos.

Invariably, there is someone in the company who will treat a contact center like they are an orphan. Here is some guidance: Do what you can to help them understand what goes on in that critical, tip-of-the-spear part of the business. Contact centers are profit centers. Treating it any differently is a mistake.

Measuring the patient experience (PX) at the point of the omnichannel contact center/phone call has significant benefits when measuring the appropriate KPIs. Applying them to training, retention efforts, net promoter scores, customer effort scores, and a host of other important process improvement efforts, requires dedicated energy. With measurement, effort becomes a project, a project becomes executable. The beginning of the complete process to measure to enhance the patient journey has begun. The complete journey with qualitative and quantitative data, both structured and unstructured data (reporting).

What is particularly interesting (if you are anywhere near the data geek I am) about measuring the voice of the patient is how it compares with the way your dialing machine tracks a distinct set of KPIs. And, depending on your contact center stretch goals, there are comparisons between average speed to answer and a customer effort score (CES) question to the patient. Comparing those measurements with the disposition given by the agent and you have quantifiable evidence of a disconnect.

 A positive experience on the initial patient call sets the tone for the rest of the journey. Like the golf tournament precedes a trade show. With the enhancement of the patient journey at the contact center, the enterprise journey walks in step with the patient.

An example will help. The following comes directly from an NPS report.

In this case, there are several stakeholders inside your organization that can benefit from a customer comment. At a minimum:

  • center management
  • training
  • scheduling
  • patient experience professionals

This verbatim comment is the result of a patient responding negatively to one question “would you recommend us?”

Another example, and perhaps more important—the CES question. “Did xxx made it easy for me to do business?”

On a 7-point scale, one being they made it hard, seven it was easy, wouldn’t it be good to know why the scores from one to five were so low? Who should care?

  • accounting
  • marketing
  • training
  • center management

Then yet a third, the email delivery report. This one drills down on your ability to communicate effectively with the patient, at all levels. A clean list is a happy list.

Who benefits:

  • the patient
  • center management
  • IT—data managers
  • digital marketing
  • patient EX management

Who owns the feedback? Every stakeholder in the enterprise owns the obligation to enhance the patient experience.     

The lesson here: work with the patient throughout their journey by asking them about their experiences. Every stakeholder in your organization should play a part in deciding what the voice of the patient should be. Then use that information to enhance that experience.

There will be certain outcomes for sure. Your patient will remain loyal to you and in the event you are billing Medicare your star ratings will come in much faster and higher.

It will be an honor to work with you at your convenience.

Robert Kobek is the president of Mobius VP, LLC, and Patients-Count®.

Case Study: MD Anderson Cancer Center

The Technical Side of Operators Working from Home

By Nicole Limpert

The University of Texas MD Anderson Cancer Center is named after Monroe Dunaway Anderson, a banker, and businessman born on June 29, 1873, in Jackson, Tennessee. His family began buying and selling cotton in 1904 and in 1907 MD Anderson moved to Houston, Texas to grow the family business. Monroe established the MD Anderson Foundation in 1936 before his death in 1939. When the Texas Legislature authorized The University of Texas to establish a hospital for cancer research and treatment, the MD Anderson Foundation matched the $500,000 that was appropriated for the hospital which was then named for its benefactor.

MD Anderson is the largest cancer treatment center in the United States and ranks number one in cancer care by U.S. News & World Report. MD Anderson is also a degree-granting academic institution and research center. MD Anderson employs more than 22,000 people, including 1,788 faculty members, has more than 680 inpatient beds, several research buildings and outpatient clinic buildings, two faculty office buildings, a patient- family hotel, and other off-site facilities for clinical and research use, making it one of the largest cancer centers in the world.

The Road to Remote Operators

The askMDAnderson service, formerly known as the Welcome Center, was established to provide answers, resources, and expertise to people with a cancer diagnosis. According to MDAnderson’s website, askMDAnderson (askMDA) can help people:

  • Make an appointment
  • Understand treatment options
  • Learn about research studies
  • Navigate the MDAnderson website
  • Find out about patient amenities (such as travel and support resources)
  • Access prevention and screening services
  • Find accurate cancer information
  • Locate community cancer resources

When a pandemic was declared in March 2020, MD Anderson required non-direct patient care personnel to work remotely. This included the operators for the askMDA line. “Before April 2020, our operators had never worked remotely,” says Ninette Thomas, askMDA Operator Manager. “We began to look at the resources we already had to develop a hybrid remote call center and realized we were not harnessing the full capability of the technology available to us. That lead to a collaboration with a lot of other departments at our organization to establish our hybrid remote call center.”

IT Mobilization

“The very first step was to determine the feasibility of allowing our operators to work from home. Luckily, we were already investigating the prospect of working from home, but the pandemic fast-tracked all our ideas and testing for how operators could work from home. We knew it was a possibility and we needed to figure out a way to make it happen,” says Jeffrey Cain, Applications System Analyst.

Once the IT team determined it was technically feasible for the operators to work from home, they began preliminary testing. That was followed by a new hardware roll out, new software installation, technical testing, and regression testing. Jeffrey says, “We had a mixture of technical and regression testing. We simulated a remote workflow in our testing environment and included our regression testings and scripts to determine if we needed to change anything in our ANI (automatic number identification) screening table.”

Custom call center agent scripting guides operators through each call no matter where they are located. Remote operators are provided with the exact information they need to provide the best patient experience and reduce call center error rates.

Michael Wolf, Principal Applications System Analyst and Technical and Support Lead for the IT team that supports the operators adds, “As IT support we had been working remotely one or two days a week for years. So, for our ongoing support, we were already working remotely using our call center software for regression testing, developing new call scripts, and modifying call scripts. We were able to go through the entire workflow for a couple of years which helped us transition after COVID-19 hit.”

IT Challenges and Departmental Collaboration

One of the biggest challenges the team faced was that all their operators worked on-site and used desktops. The IT team replaced all the desktops with laptops for each operator for a total of twenty-two new laptops. Each laptop required:

  • A docking station
  • The hardware operators needed to use the laptops in their homes
  • Installation of all the relevant call center software used by operators and managers
  • USB headset, wireless keyboard and mouse, and a mouse pad

New hardware and applications had to be used and integrated to ensure the system ran smoothly, “The introduction of the other applications meant we had to familiarize ourselves with these applications that interface with our call center platform because they had become an integral part of the operator’s workflow,” says Jeffrey.

Testing, planning, and coordinating how to work from home wasn’t just for the askMDA operators. All of IT had to go remote in April 2020. This meant deploying thousands of laptops to people across MD Anderson’s institution to give them the ability to work remotely.

Michael says, “It was a huge undertaking with a lot of coordination between IT groups. A command center was set up in our main administrative building for people to come in and get any equipment they would need to work remotely. This took some work and collaboration between our colleges on the Voice Engineering Team and us on the Applications Support Team. We had to work out all the kinks, but it did work thanks to a lot of cooperation and collaboration.”

Remote Operator Setup, Training, and Support

Working remotely meant new workflows and procedures would be introduced. Operators had to be trained on using VPN access, two-factor authentication or Velo-Cloud, and establishing audio just to log in. Ninette comments, “We wanted to make sure our operators had the exact same setup they had at home as they did on-site. They also got a pager so when we have a situation like a code blue, they know it went through successfully even though they are at home.”

“The operators were using physical desk phones and their extensions are tied to the ANI screening table and the call center software. We needed to be sure that they could now transition seamlessly back and forth from their desk phone when they’re on-site to working from home,” says Jeffery.

Additional procedures were also established such as:

  • Following a specific login order to ensure nothing disrupted the system and it remained operable
  • Steps to be done when returning to campus
  • Using RDP (Remote Desktop Protocol) so IT can access the remote machines and make administrative changes

“Our training is 100 precent on-site because we want operators to be comfortable using all the applications before they go home. They are required to work 100 precent on-site for the first thirty days so they can ask questions,” says Ninette.

Remote Challenges

Web-based communication is fast, secure, improves communication times, adds efficiencies through remote access, and reduces the number of potential errors caused by miscommunication and absences. Yet, challenges still exist but they can be overcome with solid procedures and backup solutions.

Outages: Houston, Texas experienced a winter storm in February 2021 that essentially shut down the entire city. This demonstrated how important it was for MD Anderson to have remote procedures in place because some employees were unable to leave their homes. During and after the storm, many team members were without power which can be a downfall of working remotely. However, this organization has backup systems and procedures so communications could continue.

“We have backup procedures in case of a server or phone outage. There is a phone line that isn’t connected to our server so we can use that line for Code Blue and other emergency communications. If the phone system is down, we have landline phones that are hardwired into the building that are designed to work for codes,” says Ninette.

Staff management: Ninette comments, “We’ve been utilizing the reporting functionality of our call center software a lot more now that operators are remote. When we’re in the office and working together, I can hear my staff and know that they are working on calls. Now I’m using the reports a lot more than in the past to monitor productivity and availability. What was surprising to me was that I anticipated having a problem with performance when they went home, but what I found was that our productivity actually went up.”

Remote Benefits

MD Anderson had a separate “ride out” location in another building that was specifically designated as the location all the operators should go to in case of a disaster. The operators would relocate to this command center, which was outfitted with two desktop workstations and multiple open phone ports, where they could resume their normal workflows.

“We are now more prepared for hurricane season. We have less staff required for ride out because we have more people who are available to work remotely—provided they have power and internet. All we need is a power source to continue to work. We can literally work from anywhere,” states Ninette.

Michael adds, “Now that the operators have the ability to work remotely, the IT department has experienced benefits such as decreased overhead to maintain the equipment or perform quarterly tests and reduces our support time.”

Another benefit that came about with the operator’s ability to work remotely was schedule flexibility. After the thirty-day on-campus training, operators were able to go to a four-days-a-week/ten-hours-a-day schedule. The department originally offered only three shifts to cover their 24-hours-a-day, 7-days-a-week operation, but that has increased to seven shifts for more flexibility.

The team rotates the schedule so each operator is located on-site for only two days per week. This results in more flexibility for the operators, easier commutes, and they can limit the number of people on staff in compliance with their institution’s response to keep their employees safer during the pandemic.

Patient and employee safety are paramount. Even though between 82 to 91 percent of the operator staff work remotely per shift, there are still at least two operators in the building at all times in case there is a communication outage. Having a redundancy of operators on-site ensures normal operations without any interruptions.

“As a team, we have the difficult task of balancing patient safety, employee safety, and employee satisfaction. We have made every effort to make sure we are not putting anyone in harm’s way by taking unnecessary risks. Implementing a hybrid remote call center in the middle of a pandemic was challenging. However, the collaboration between the different IT groups and the askMDA operator team have made this a successful transition,” says Ninette.

Nicole Limpert is the marketing content writer for 1Call, specializing in offering enterprise-wide communication solutions for healthcare organizations.

Multichannel Contact Center Scheduling

Staff Your Operation with Agents with the Right Stills to Work at the Time They’re Most Needed


By Peter Lyle DeHaan, Ph.D.

You run a multichannel contact center for the healthcare industry and have staffed it with well-trained agents. Some specialize in one specific channel, others can handle related channels, and some are cross trained on all channels. This is a great start. Now comes implementation; now comes multichannel contact center scheduling.

Schedule Channel-Specific Agents First

Start with the channel that receives the most interaction, and schedule agents for that channel. By way of example, let’s assume the majority of your contacts are via the telephone. Schedule telephone agents, across your hours of operation, to take a percentage of those calls.

If they can cover 50 percent of those calls overall, don’t schedule them to cover 100 percent on some shifts and ignore other shifts. Instead populate your schedule so that your telephone-only specialists can cover 50 percent of those calls throughout your hours of operation.

Repeat this for your next highest used channel.

Continue this process for each channel that has enough traffic in any given time slot to call for scheduling a specialist to handle it. As you work through this, you’ll find a particular time-of-day or day-of-week that doesn’t have enough traffic to keep one agent busy. Don’t schedule a specialist for those time slots. Instead move them to an area with enough work to fill their scheduled hours.

Schedule Partially Cross-Trained Agents Next

With your single-channel specialists scheduled, next fold in those who are trained on more than one channel. Let’s assume you have an agent trained to handle both text and email contacts. Place them on the schedule where there will be enough activity from one channel or the other to keep them busy.

Depending on the dynamics of your traffic, they could spend their shift bouncing between the two channels or primarily receiving contacts on one channel or the other. This is to be expected, and they need to be aware it could happen. The key is to not schedule them for shifts where there isn’t enough potential traffic in either of the channels they’re trained to handle.

Schedule Fully Cross Trained Agents Last

Once you have your channel-specific agents and partially cross-trained agents on the schedule, fill the remaining open slots with agents who are fully cross trained to handle any channel. This is the last step of multichannel contact center scheduling.

At minimum you should have one fully cross-trained agent on every shift throughout the day. They’ll serve as your buffer, able to pick up traffic from whatever channel has the greatest need.

Assuming you have enough staff, the fully cross trained agents will smooth out your schedule. They’ll pick up the slack on the channel where they’re most needed.

You can use these fully cross-trained agents in two ways. And their personality may align with one approach or the other.

Although able to take contacts on any channel, some agents will want to start on one channel and focus on those interactions until you move them to another channel—or until some preset condition exists, signaling them to make the switch themselves.

Other fully cross-trained agents are completely comfortable bouncing between channels from one contact to the next. They thrive on the moment-to-moment variability, which ideally positions them to pick up the moment-to-moment traffic changes that occur within any multichannel contact center.

Scheduling Tools

Knowing the philosophy of multichannel contact center scheduling forms the foundational understanding of what to do. Now comes the challenge of making it happen. For smaller operations with minimal channels, you can do this with some degree of proficiency on a spreadsheet.

A better solution, however, is scheduling software. But don’t try to use a single-channel scheduling package. Instead look for a solution that can take historical inputs from multiple channels and allow you to match agents according to the projected need.

Having a full-featured, robust scheduling solution will make the task of multichannel contact center scheduling much easier—once you’ve mastered the foundational staffing strategy.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat. He’s a passionate wordsmith whose goal is to change the world one word at a time. Read more of his articles or his book, Healthcare Call Center Essentials.

Addressing Healthcare Workplace Violence with Integrated Contact Center Software and Secure Messaging

By Nicole Limpert

When you think of the most dangerous careers in the United States, it’s understandable to think of farmers, loggers, law enforcement, and construction workers. But would you consider adding nursing to that list?

Violence experienced by healthcare workers in the United States has been a major concern for years and unfortunately, it is getting worse. The U.S. Bureau of Labor Statistics published a fact sheet about workplace violence in healthcare between 2011-2018 that showed the industry’s workplace violence was on the rise. It found that “healthcare workers accounted for 73 percent of all nonfatal workplace injuries and illnesses due to violence.”

A more recent survey from Perceptyx, an employee insight platform, found that over a 30-day period in early 2022, 92 percent of health workers experienced or witnessed workplace violence. It also reported that “Three in four (health workers) have also experienced verbal and physical assaults in the past month and almost half of them had to call security or a colleague to assist them.”

Understanding Healthcare Workplace Violence

According to research published in May 2022 by JAMA Network Open, patients and visitors were the most frequent source of violence towards healthcare staff. Occupational Safety and Health Administration (OSHA) includes the following reasons as risk factors that contribute to violence in a healthcare setting:

  • Working alone
  • Lack of means of emergency communication
  • Lack of training and policies for staff
  • Under-staffing in general, and inadequate security staff
  • Lifting, moving, and transporting patients
  • Presence of firearms
  • The perception that violence is tolerated, and reporting incidents will have no effect

There are numerous studies that show many incidents of violence are not reported by healthcare workers even though formal reporting processes are in place. Verbal abuse and bullying are especially prone to under-reporting.

Reasons for under-reporting include lack of faith in the reporting system, fear of retaliation, and because the people who have chosen healthcare as a career path feel they have an ethical duty to protect patients—even when the patients cause harm to their caregivers.

Include Contact Center Scripting in Emergency Action Plans

On June 1, 2022, a shooter opened fire in the Natalie Building, part of the Saint Francis Hospital in Tulsa, Oklahoma. The gunman was a patient who blamed his surgeon for pain following back surgery. He injured an unspecified number of bystanders and killed four people, including himself and three others who were hospital staff.

The U.S. Department of Homeland Security (DHS) states active shooter incidents are commonly over within 10 to 15 minutes. During the Saint Francis Hospital shooting, officers responded within three minutes when the initial call was received by 911. Their fast action undoubtedly saved more lives.

It is imperative that hospitals include their contact centers as part of their emergency action plan (EAP). According to the DHS, an effective EAP includes, “Contact information for, and responsibilities of individuals to be contacted,” and “an emergency notification system to alert various parties of an emergency.”

Handling calls quickly and correctly is of utmost importance. Scripting software can be customized to efficiently guide operators through scripts for any type of call, including emergency, crisis, and code calls. Contact center scripting software helps to streamline enterprise-wide hospital communications and processes by:

  • Speeding up call processing
  • Providing accurate information
  • Reducing operator errors
  • Improving efficiency and productivity
  • Supplying detailed call analytics and reporting

Integrate Emergency Notifications with Secure Messaging

Every healthcare facility has unique security risks that can affect patients, visitors, and hospital staff. Most organizations have a security management plan that is designed to identify and manage security risks.

Security teams manage and mitigate risks they find on a hospital campus and are supported by local police departments. The security teams often work together with a hospital’s telecommunication center because hospital call center operators also handle calls for security assistance and can monitor emergency phones and other security technology at the hospital.

When a security team needs to communicate an alert to the staff of a hospital campus, it is common for the hospital’s call center operators to send the notification because their call center software contains a complete personnel directory.

Contact groups are built in advance, so notifications occur with one click. Seconds matter and so do the number of keystrokes it takes for them to send out emergency notifications to multiple contacts and devices.

An efficient way to communicate these alerts is via the secure messaging app employees use on their smart devices for work. Many hospitals have replaced their outdated pager technology with secure messaging apps to improve notification speeds and response times. These apps are used by providers, lab techs, building maintenance, environmental services, contact center, security, and other departments within an organization.

Notification systems can integrate with a hospital’s secure messaging app and use automated notifications to communicate critical alerts and security instructions to reach more people in less time.

Some apps can also track message activity, complete with message histories, indicating whom messages were sent to and when messages were read so an organization can have confidence in knowing critical messages were delivered and read.

According to OSHA, healthcare workplace violence is preventable when an effective program is in place. They cite five key program components:

  • Management commitment and worker participation
  • Worksite analysis and hazard identification
  • Hazard prevention and control
  • Safety and health training
  • Record keeping and program evaluation

Technology used by a healthcare organization’s contact center should be included in a violence prevention program. As the hub of communication for a hospital system, their call center already has updated contact information for departments and employees and uses highly effective communication tools to get critical alerts to staff members.

Nicole Limpert is the marketing content writer for 1Call, a Division of Amtelco.

Vendor Case Study: LVM Systems’ SOC 2 Type 2 Examination

LVM Systems Completes 2022 System and Organization Controls (SOC) 2 Type 2 Examination

By Jake Johnson

LVM Systems’ successful completion of its 2022 System and Organization Controls (SOC®) 2 Type 2 Examination affirms that our practices, policies, procedures, and operations meet the SOC 2 standards for security, availability, processing integrity, and confidentiality.

Completing this examination demonstrates LVM Systems’ commitment to the security and integrity of our platform. LVM Systems selected 360 Advanced to perform the demanding third-party examination.

Throughout the examination, 360 Advanced audited LVM against the AICPA Trust Services Criteria. The examination’s outcome ensures that the company’s controls meet the criteria of the selected trust services.

These trust services criteria encompass the following five categories:

1. Security

Protects data and systems against unauthorized access, disclosure, or damage.

  • LVM has a security team that includes a security officer, a compliance officer, and an incident response team to ensure LVM is up to date with current security best practices and that LVM complies with its security policies and procedures. In addition, LVM performs annual risk assessments, evaluating every aspect of the organization for improvement and ensuring LVM policies and procedures align with current regulatory requirements.
  • Background checks are performed on all prospective employees. New employees must review and sign the LVM security agreement, ensuring employees maintain a high level of security integrity. In addition, before working with LVM systems or processes, new employees must receive mandatory security training.
  • Quarterly security training ensures employees understand LVM security policies and procedures and are vigilant about new security threats.
  • Third-party systems monitor vulnerability and penetration testing to ensure systems remain secure.
  • Development teams undergo ongoing training on secure software development lifecycles and secure coding. In addition, third-party security code analysts review the software for known vulnerabilities to ensure LVM development teams use current best practices.
  • LVM utilizes encryption standards to ensure all private data access or storage is secured.
  • For hosted solutions, LVM utilizes Microsoft Azure as the preferred cloud provider. Microsoft Azure has a security team of over 3,500 members, over ninety security certifications, and has invested over $1 billion in security R&D to ensure client systems and data are protected.

2. Availability

Information and systems are available for operation.

  • System monitoring ensures systems are running smoothly. If anomalies are detected, appropriate LVM resources are notified.
  • Backup, redundancy, and recovery standards follow industry best practices.
  • Disaster recovery development and testing ensure LVM can rapidly recover systems.

3. Processing Integrity

System processing is complete, valid, accurate, and timely.

  • Development processes include rigorous quality assurance (QA) reviews to ensure processing integrity within LVM’s software. QA utilizes automated testing tools, manual test scripts, and data comparison tools to assure all areas of code are thoroughly tested.
  • QA also tests the latest operating system patches to ensure compatibility.
  • Security and information technology (IT) teams ensure the processing integrity of LVM’s hosted solutions.

4. Confidentiality

LVM protects information designated as confidential.

  • LVM follows a data retention policy and conducts activity tracking.
  • LVM maintains an asset inventory and destruction policy.

5. Privacy

LVM collects, uses, retains, discloses, and disposes of personal information following industry best practices.

  • Notices and communication of objectives
  • Choice and consent
  • Collection, use, retention, and disposal
  • Disclosure and notifications
  • Monitoring and enforcement

As caretakers of our customer data, and as security concerns grow, healthcare organizations choose LVM Systems as their core platform and engine of growth.

Jake Johnson is the CIO of LVM Systems.

Vendor Spotlight on Patients-Count: Measure to Manage the PX Journey

By Bob Kobek and Michael W. Hill

The patient experience (PX) journey all starts here, right here. The opportunity to establish trust and begin the patient journey with them starts at the contact center, the point of the spear. It’s the first step in a patient’s journey with your healthcare organization. It’s the first voice, the expediter, the listener, the innovator, the loyalty builder, and the expectation setter for the rest of the journey.

This is where measuring to manage your internal ecosystem begins, taking you from the first touch point through to the Customer Assessment of Healthcare Providers and Systems (CAHPS) survey, if needed.

The practice of measuring to manage is simplest when you incorporate it as a matter of process in your healthcare call center. The contact center is by far the most accountable product or service deliverable.

Every event in the log in time of your agents is accounted for. Given today’s automation, everything you do—whether it be full-tilt call center management to your customer relationship management system—should be designed to measure and report.

Let’s start with the agent disposition of a call. The internal measurement tools are sophisticated. You have the ease of reporting on key performance indicators (KPIs) that are all instigated from the first incidence of an agent hearing a dial tone. The good old dials, contacts, completes (DCC), leads per hour (LPH), and sales per hour (SPH) will never go away. They’re still the best measure of the hourly outbound performance of your center.

Average speed per answer (ASPA), number of calls taken per hour, number of calls per resolution, and customer effort score (CES) are a few standard measurements for your inbound center.

These are important metrics. They establish benchmarks and performance. Some are even meant to do a better job of managing the process. The best call centers use some of that data to gamify the performance.

But, what about the people?

There are two areas of management measurement that typical contact center software does not address: patient experience (PX) and employee experience (EX). These relate to contact center performance, which are both related to your Medicare reimbursement score via the CAHPS survey.

Mobius Vendor Partners has launched a new product, Patients-Count®, entirely aimed at measuring and improving patient and employee experience to help you meet your strategic goals.

Let’s break the measurement of customer experience (CX) and employee experience (EX) down, with the understanding that they relate to patient experience (PX).

Patient Experience (PX)

You can use a typical set of questions to measure the impact of each patient contact with an omni contact center agent, whether inbound or outbound. These questions measure the key performance indicators (KPIs) of most agents—as a group and individually—through the lens of the patient.

If those patients have an affinity toward their experience—be it good, bad or indifferent—you can expect a response rate as high as 40 percent. A minimum response rate should be 10 percent, which is still enough to deliver actionable data.

Here are some KPIs to consider and remember. These are measured from the voice of the customer (VOC):

  • friendliness
  • innovation
  • knowledge
  • courtesy
  • listening skill
  • solution

All these KPIs can reflect a relationship between agent disposition and patient experience.

One question with some variation, is particularly relatable between the agent and the patient: the customer effort score (CES) and the employee effort score.

For example, “ABC made it easy for me to handle my issue” is directly relatable to the supervisor score. Another is “My supervisor helps me perform to the best of my ability.”

Both are on a 7-point scale, relatable, and can inform strategies to help you improve both patient and employee experience at the same time.

Employee Experience (EX)

Satisfied, engaged employees make sure their customers are satisfied. To measure the employee experience, your organization should survey employees in those areas that relate to their overall performance about their job responsibilities.

A good example is measuring the statement, “My supervisor helps me perform to the best of my ability.”

Let’s look at some sample results. Over half (21 out of 36) of employees surveyed don’t “strongly agree” that their manager helps them perform to the best of their ability.

These are common results, in which supervisors aren’t taking the time to work with their employees to help them perform at their best. So, what can a company do with this information?

First, ask the employees more questions about what areas of their job they could use support or guidance in. Then plans can be put in place to give the employees the requested training or support.

After that is implemented, survey the employees again in three to six months to see if there has been an improvement in the score.

Mobius Vendor Partners sees a direct correlation between the willingness of employees to help their customers have a positive experience and employees having a positive experience when their supervisor helps them perform at their best. Employees that receive help are then employees who will help others. That in turn increases contact center productivity.

Specific questions about the KPIs (friendliness, innovation, knowledge, courtesy, listening skill, and solution) that are of interest to you and your employees can be developed for your call-center personnel.

Bob Kobek (bobkobek@mobiusvp.com) is president of Mobius VP, LLC, and Patients-Count. Michael W. Hill (mikehill@mobiusvp.com), is senior employee experience consultant at Mobius VP, LLC, and Patients-Count.

Consider reaching out to www.Patients-Count.com, a professional firm specializing in surveying to help your company improve the performance of your employees and enhance the patient journey, simultaneously.

Cross Channel Training

Consider the Optimum Strategy for Your Contact Center Staff


By Peter Lyle DeHaan, Ph.D.

At one time healthcare call centers handled calls and nothing else. They had one channel. That was it. Now most call centers handle more than just telephone calls. They’ve become multichannel. Contact center is a better name for them.

Along with phone calls—which is still the predominant channel at many operations—we’re now seeing text chat, web support and assisted browsing, email response, and a multitude of social media platforms to monitor and engage. In addition to these is a possibility of handling two older channels: mail and fax.

Although there may be some overlap, each channel requires a separate set of skills, which means supplying channel-specific training. Do you want to cross train all contact center agents so that any employee can handle any contact, regardless of the channel and when needed? Or do you want specialists that excel in one area? Or is a mixture of both approaches the best strategy for your operation?

Here are some considerations about cross channel training:

Specialists

Contact center specialists, such as telephone agents or text chat representatives, handle communications through one channel and one channel only. Because they specialize in that channel, they excel at it and can serve customers with greater effectiveness, proficiency, and speed. A specialist will be more efficient in their channel than a generalist.

This is ideal for some operations, and its ideal for some agents. These employees relish consistency and find comfort in knowing what they will do at work each day, each week, and each month. For them, they counter the repetition of their work by embracing the unexpected variety from one call to the next or one text to the next.

For agents who like a variety of tasks, specializing in one channel is a horrific prospect. If you don’t offer a way to counter their boredom, they’ll leave as soon as a more suitable job becomes available.

Generalists

Contact center generalists receive instruction on how to handle communication on each channel your operation offers. This means that every employee receives cross channel training. They relish the opportunity to learn and master each channel. They have a flexible mindset and see benefits of enjoying a varied workday.

Having a contact center staffed with generalists provides the most responsive configuration, with any agent able to handle any channel at any time. This is ideal for time-critical communications that don’t tolerate interaction delays, such as the telephone, text chat, and web support. (Having a delayed response with email, social media, mail, and fax isn’t an issue, providing they’re handled in a reasonable time.)

Selective Cross Training

The discussion between contact center specialists and generalists, however, isn’t an exclusive one. You can have a mixture of both. You can even have partial cross channel training where an agent receives training on some channels but not all.

For agents who want to handle the same type of communication, let them specialize. Don’t force them away from something they like into something they don’t want to do by cross channel training them. All that will do is taking a successful agent who happily serves you well in one channel and turning them into a disillusioned employee who seeks a different job.

Other agents, however, will clamor for the opportunity to receive training on and handle every communication channel you offer. And they’ll be the first in line to explore opportunities with new channels.

There’s a middle ground, however, where agents may want to and benefit from receiving cross channel training on specific channels with similar skill sets. One example might be the text chat and email channels, which both need quick and accurate typing skills. But they may shudder at the idea of talking on the phone. Conversely a phone agent may also enjoy text chat, as both have back-and-forth interaction with the contact.

In these cases, let agents select which channels they want to receive training on. Be sure, however, that cross channel training is optional and not expected. Embrace those employees who want to remain one-channel experts.

Cross Channel Implementation

Regardless of the degree of cross channel training in your contact center, there are two implementation strategies for your cross-trained agents.

One possibility is with agents assigned to a particular channel for the day, with the understanding that you may reassign them to another channel as traffic warrants. This switch may be for an hour or two or for the rest of the day. Regardless, staff always begins the day on a scheduled channel.

The other approach is a universal distribution of contacts, with any customer communication going to any agent regardless of the channel. This makes scheduling the easiest and offers the most responsiveness to customers, but it may come at the cost of optimum efficiency.

Conclusion

If your healthcare call center handles other communication channels, or is thinking about it, consider how you want to approach it. You can adopt a specialist mindset, pursue a generalist tactic, or embrace a mixture of the two.

The point is to consider the cross channel training strategy that’s ideal for your operation, your customers, and your staff. Balance their needs to provide the best outcome for all stakeholders.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat. He’s a passionate wordsmith whose goal is to change the world one word at a time. Read more of his articles or his book, Healthcare Call Center Essentials.

How Hospital Contact Centers Help Organizations Achieve Their Frictionless Patient Experience Goals

By Nicole Limpert

Patient satisfaction is different from patient experience. While research from the NRC Health’s 2019 Healthcare Consumer Trends Report indicates that 85 percent of patients in the United States are satisfied with their care team, the data also indicates that patients encounter points of friction along their care journey that may result in them choosing a different healthcare provider in the future.

In today’s world, patients are also consumers. Healthcare contributes more than $1.2 trillion to the Gross Domestic Product (GDP) and is the fifth biggest industry in the United States. Healthcare systems strive to supply a frictionless patient experience to not only provide better care, but to also earn their patient’s loyalty for future healthcare needs.

A recent Kaufman Hall survey of 200 hospitals and healthcare executives found that 90 percent of respondents said improving patient experience is a high priority.

Start at the Beginning

Before a patient can appreciate all the innovative technologies and exceptional care their clinicians provide to them, they must navigate the early phases of a care encounter which can be confusing and overwhelming. Their beginning journey often starts with calling their provider or contacting them via web chat, to get answers to their questions.

These communications are often routed to an organization’s contact center and are the first basic steps of a patient’s journey. The interactions are important because they start to form a patient’s impression of the entire experience and of an institution.

Medical contact centers serve as a virtual lobby and communication hub of an organization and effectively become an extension of a hospital or clinic’s operations. It’s imperative that operators begin a patient’s journey with a frictionless experience and are consistently delivering that elevated level of patient-first service.

The NRC Health’s data supports this reasoning. In the database of patient comments, the routine parts of a patient’s experience, such as appointment-setting, wait times, and registration staff courtesy, dominated patient concerns.

An astounding 60 percent of patient comments were related to these everyday experiences when obtaining healthcare access.

Contact Center Scripting for Seamless Interactions

Healthcare contact centers are tasked with being front door of an organization. Every phone call or web chat interaction is an opportunity for the agent to uphold an organization’s patient-first values and offer a frictionless experience.

Scripting tools and protocols can help operators provide a unified experience across all care settings for patients, their home caregivers, and their professional care staff.

Scripting helps operators seamlessly guide patients through interactions by using programmed scripts that prompt agents to ask the right questions, give the right answers, and direct the patient to the right person or department.

Call flow scripting can automatically detect call flow and determine scripting options for operators based on an organization’s protocols. Scripts for appointments, physician referrals, prescription renewal, scheduling, research, crises and emergencies, facility directions, and much more, help to personalize each patient communication while aligning with an organization’s messaging goals.

Supporting Frictionless Patient Experiences with Technology

Healthcare organizations want to provide a frictionless patient experience while advancing the physical, mental, social, and even economic health of their communities. Some of them will have to overcome added barriers like care deserts and poor care access.

To ensure that every pathway is clear for a patient to connect with an organization, they must have the right foundational technology to create and provide a consistent, seamless, frictionless patient experience.

As technology grows, so does the consumerization of healthcare. Consumers now expect speed and convenience in healthcare. Digital devices have normalized videoconferencing, wearable health tech, telehealth, and online access to lab results.

Contact Center Software for a Frictionless Environment

A hospital’s contact center software can help with an organization’s innovation strategy to improve efficiency, patient experience, and help provide a frictionless environment.

Hospital Stay: After a patient has been admitted for a hospital stay, they may be moved from one room to another for tests, procedures, and during recovery. Call center software can assign a fixed phone number to each patient that will follow them for the duration of their stay.

Associating each patient with one phone number helps to streamline care communications and ease the stress of the patient’s family and friends who are trying to find their loved one after they are transferred to a different room.

Secure Messaging: Healthcare organizations can seamlessly integrate secure messaging apps with their call center software and different communication systems (such as nurse call, alarms, security, building maintenance, lab results, and housekeeping) to receive notifications faster.

Remote Patient Monitoring: Contact center software can help manage and respond to data collected via remote patient monitoring (RPM). For example, if a high-risk patient experiences an adverse change in vital signs, their wearable health monitor can send an alert to the healthcare’s contact center, triggering the software to connect to a member of the patient’s care team or dispatch paramedics to the patient’s location.

Smart Paging: Care staff can use smart paging to instantly find another member of their team using the hospital call center’s directory to send them a message using that individual’s preferred contact method.

Workflows: The same communications integration engine software that incorporates personnel directories and on-call schedules used by a hospital call center, can also integrate with nurse call solutions, third-party devices (such as IP phones and mobile devices), and other applications to automate the handling and dispatching of messages and alerts to enhance workflows.

The Importance of Empathy in a Frictionless Environment

While technology is crucial, the most important ingredient in the secret sauce that results high-quality interactions and a frictionless environment is empathy. If an organization has understanding as one of its core principles, it can discover deeper truths about the experiences of their patients.

Cultivating a patient-first culture based on empathy takes time. It must be built, retained, and continuously improved upon. It should be foremost at all levels of an organization, and ideally, begin at the hiring process.

A frictionless environment is the natural result of this kind of foundational approach to improving the patient experience through empathy. This environment draws patients in, earns their trust, and keeps them coming back for future care.

Empathy in the Call Center

It is important that agents who work in a hospital call center understand the value their organization places on empathy, and how they play a key role in conveying that care to callers. Leadership can help build empathy in their contact centers by:

  • Including empathetic statements in scripting protocols.
  • Reviewing speech analytic reports to identify words and phrases that indicate an operator should use empathetic language or to trigger empathy statements in the script.
  • Training agents to carefully listen to callers and to not be afraid to ask callers to clarify any questions or requests they have.
  • Including empathetic role playing when training a new operator.
  • Using visual cues to remind agents that they are speaking to real people. A quote or image that is displayed on the screen or in the agent’s work area helps to humanize the caller.

Patient experience leadership should involve their contact centers when planning frictionless patient experience goals. The technology already being used in their call centers, along with well-trained, informed agents, can be used to help the entire enterprise achieve their patient-first goals.

Nicole Limpert is the marketing content writer for 1Call. The 1Call Division of Amtelco is a leader in developing software solutions and applications designed for the specific needs of the healthcare call center marketplace. 1Call features a complete line of modular solutions specifically designed to streamline enterprise-wide communications, save an organization’s limited resources, and make them tremendously efficient, helping them bring wellness to their members and their bottom line.

Checklist to Ensure Patient Care Quality in Nurse Telehealth Triage

By Ravi K. Raheja, MD

How do you ensure patient care quality when it comes to nurse telehealth triage? Whether you use an outsourced nurse triage service or want to license software and use your own team, follow this checklist when addressing every patient caller.

Not only do these important items minimize liability with remote care, but they also ensure a high quality of care for patients and a decrease in overall healthcare costs. We’ve seen firsthand how successful these items have been in our own nurse triage call center, which is why we want to share them with you to improve your own patient health outcomes.

Develop Detailed Nurse Triage Training

To be effective at telehealth triage, nurses must remain focused on each patient’s needs, obtain the appropriate information about their symptoms, know how to handle difficult calls, and document all information thoroughly.

At TriageLogic, we use a 10-step approach to training nurses, which can be found in our learning center course: “Critical Steps to a Triage Call.” You can also read a related article on training triage nurses.

Broadly speaking, when it comes to triaging patients over the phone, nurses must remember to smile, show empathy, and remain calm and confident while they are addressing patient questions and concerns. They must also use three types of listening—active, reflective, and empathetic—to fully understand each patient’s symptoms and guide them to the appropriate care.

Along with the potential for angry or distressed callers, triage nurses must also know how to handle patients whose symptoms call for emergency services.

Use National, Standardized Protocols

Nurse triage protocols developed by Drs. Schmitt and Thompson are the gold standard for patient care quality. When integrated with nurse triage software, they provide the most intuitive means of establishing caller dispositions by using yes/no questions to determine symptom severity.

A group of independent medical professions review these protocols annually and update them during important health-related events (like the COVID pandemic).

Give Answering Service Operators Their Own Protocols

Answering service operators (ASOs) are the first people to interact with callers on a nurse triage line. Their purpose is to greet patients and ask them about why they’re calling.

This helps identify urgent versus non-urgent issues and passes each caller’s request along to the right triage nurse. However, it’s become clear that ASOs also need their own protocols to avoid delays in patient care.

Why?

ASOs don’t always ask detailed questions. For example, if a patient calls for a medication refill, the ASO should verify if the patient has also started to experience any withdrawal symptoms, rather than simply assume the request is non-urgent.

Establish Average Patient Callback Times

When a call comes into an ASO, they will pass those caller requests along as emergent, urgent, or non-urgent. Each of these groups come with different requirements on how soon triage nurses should call them back.

A quality nurse triage program should have established time limits. Sticking to these time limits is vital to patient care quality.

For emergent, that’s five minutes or less. Urgent requires fifteen minutes or under. And non-urgent should be within thirty to sixty minutes.

Staggering calls in this manner not only prioritizes patients based on severity, but it also avoids overwhelming your triage line depending on how many nurses you have scheduled.

Record Calls for Quality Assurance

Recording your nurse triage calls is an important part of any quality assurance program. Doing so keeps your nurses accountable and less likely to deviate from using the Schmitt-Thompson protocols.

It also mitigates liability against your nurses. In case of a poor health outcome, these records corroborate the actions a nurse took, the reasons why, and whether those were correct.

Finally, recorded calls provide oversight and identify potential training needs. Evaluating them will indicate whether a nurse is struggling in a particular part of the triage process and allow managers to create opportunities for improvement.

Implement Secure Texting

Secure texting is an HIPAA-compliant option that allows nurses to chat with doctors without having to download an app or additional software. Nurses send messages to doctors’ phones over browser encryption, and doctors are required to click a link to acknowledge each message before accessing patient data.

This ensures patient confidentiality and speeds up responses from doctors depending on the severity of each patient’s symptoms—all of which leads to greater patient care quality. All messages are then documented in the patient’s file for reference.

Ravi K. Raheja, MD is the CTO and medical director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC accredited, physician-led provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. Their comprehensive solutions include integrated mobile access and two-way video capability.

Contact them if you have questions regarding any of the items from the above checklist or you’d like to discuss how to implement them within your own nurse triage.

Decrease Patient Liability Using Nurse Triage Software

By Ravi K. Raheja, MD

Patient phone calls, and questions about whether symptoms require an office or emergency visit, are part of every busy medical practice. However, how do you train nurses to ensure that they give the appropriate care advice every time, while documenting caller information, symptoms, and dispositions?

If your team wants to decrease liability on these calls, implement software with medical protocols that document all this information. Choose a solution that employs time-tested protocols. This helps ensure each patient caller is directed to the appropriate level of care in an appropriate window of time, regardless of when they call.

Effective triage software is an easy-to-use solution for nurses that includes standardized protocols to address any patient symptom. It also includes thorough documentation with timestamps and the ability to customize triage and care instructions based on the needs of the practice. The information should be integrated with your EMR or able to be simply copied to an EMR file, ensuring continuity of care.

Documentation

When it comes to avoiding liability as a triage nurse or healthcare provider, documentation is everything. Consider the following example of a doctor who took a patient’s call while out of the office. He couldn’t notate his care advice to the patient in their chart. In fact, the only option available to him was to scribble his notes on a napkin.

That patient went on to experience a medical complication, then subsequently sued the doctor by disputing what the actual care instructions were during their call. Thanks to that napkin though, the doctor had proof of what he’d said. Thankfully, nurse triage software is far more thorough.

Standardized Care

Seek a solution with protocols that are easy to follow, are updated regularly as new healthcare issues develop, and can be customized with instructions specifically for your practice.

In turn, this ensures that nurses are prompted with the best questions to ask patients based on the severity of their symptoms and allow those nurses to document their thought processes as they triage each call. With this, all their interactions are recorded and easily accessible for reference.

The results? Nurses can shift their attention to their patients, and patients receive the correct outcomes, no matter which nurses they speak with. Another advantage is that all incoming calls receive the same quality of care or advice regardless of which nurses answer them.

Patient History

Along with symptom severity, effective triage software allows nurses to record relevant patient history so that their dispositions for care are based on all their potential health factors. Nurses must be mindful of addressing callers objectively, avoiding stereotypes, and using their listening skills to evaluate symptoms in their entirety.

Timestamps

Triage software should include timestamps for pivotal moments recorded on nurse calls. These include when calls are received, when they’re returned, and when they’re completed.

Consider that the biggest threat to nurse triage is delayed patient care. As such, it’s critical that your nurses correctly address patients’ symptoms in a timely manner, advise them to seek care from the appropriate medical professionals, and have the documentation to back up their work.

Clear Dispositions

Part of the nurse triage process is providing clear dispositions and follow-up instructions. If a patient’s condition suddenly changes, a nurse’s notes should reflect this change, as well as the triage advice they offered.

When patients are referred to providers, this documentation should also be easy to share with them. If it is, those providers can address those patients immediately and maintain a continuity of care, especially when their patients’ needs are urgent.

If a patient’s health begins to deteriorate, triage software should have instructions for the responding nurse to know how to expedite assistance from a referred provider. This should include a secure texting and chat option that lets nurses contact physicians, update them on the conditions of their patients, and close the loop on care.

Conclusion

Triage software can help ensure patients are directed to the appropriate level of care in an appropriate window of time. This decreases provider liability and improves patient care.

Ravi K. Raheja, MD is the CTO and medical director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC accredited, physician-lead provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. The TriageLogic group serves over 9,000 physicians and covers over 25 million lives nationwide.

Contact them to schedule a demo and see how TriageLogic’s MyTriageChecklist solution can benefit your patient callers and their dispositions.