Tag Archives: contact center case studies

Case Study: Hospital Uses Speech Recognition and Automation to Cut Costs and Improve Service

By Chris Heim

Southern New Hampshire Health System (SNHHS) serves Greater Nashua and 12 other communities across much of southern New Hampshire. The system is a fast-growing, 120-year-old provider, known for delivering exceptional health and medical care services. With 54 medical offices, a 180-bed community hospital, and more than 550 medical providers practicing in 59 different specialties, SNHHS is one of the largest healthcare groups in the state. With such a large network to support, the hospital’s call center is responsible for managing high volumes of calls and a broad range of information around the clock.

Due to the system’s continual growth and the broad diversification of communications technology, the SNHHS call center was becoming overwhelmed. Their team of call center representatives was receiving and connecting a dizzying number of both internal and external calls.

Managing on-call schedules was also handled by the call center using a paper-based system, manually updated as the staff received messages from the various departments, clinics, and individuals from across the system. Because of the complexity of the organization, this had become a challenge. The team maintained more than 75 different schedules using a printed booklet that became outdated almost as fast as it was created. This was becoming too cumbersome for the call center to manage effectively.

“Our management team knew we had to implement some changes to provide better support for everyone,” said Judy Mayopoulos, call center manager. “Since we also relied on a costly third-party firm to provide after-hours answering services for physicians’ offices, we felt we could manage our own answering service to improve customer service both internally and externally while providing better patient care.”

The Solution: Speech Recognition and Call Center Automation: Management at SNHHS developed a plan to bolster their call center with physicians’ answering services, operator console, speech recognition, Web-based on-call scheduling, and messaging capabilities. They selected Amcom Software’s contact center solutions to help meet those challenges and achieve their goals.

The speech recognition solution reduces the volume of calls handled by representatives. It allows callers to connect their own calls or access information by following voice prompts rather than using a representative’s assistance.

The speech recognition was initially rolled out internally to introduce it to staff and gain acceptance. “Our staff adapted to the speech recognition tool quickly, and they like it because they don’t need to be transferred multiple times in order to reach someone,” said Mayopoulos. After great success with the internal release of speech recognition, the organization rolled it out for external callers as well.

The health system also began using the system’s staff directory and on-call scheduling solution. Since the on-call schedules and directory are Web-based, each department can now manage and update their schedules easily and quickly. Call center representatives don’t spend time tracking down an individual only to find out they’ve contacted the wrong person. The on-call schedules are integrated with the organization’s operator console, so all the information they need is right in front of them.

The Results: Speech System Frees Up Call Center Staff – Enables Creation of Profitable Answering Service: Using speech recognition “has offloaded 55 percent of our live operator calls,” said Mayopoulos. “Our statistics also show that 97 percent of the calls that come through the speech system are transferred correctly. That’s a lot of efficient call processing without human intervention.”

Because they aren’t tied-up handling such a large volume of incoming calls, the call center representatives are now able to perform other duties, enabling the hospital to bring physicians’ answering services in-house. This service has become a new source of revenue for the hospital.

Management at SNHHS is pleased with the new in-house answering service because the call center representatives are familiar with working in the healthcare environment, which isn’t always the case with third-party answering services. SNHHS is able to accommodate each doctor’s unique protocols or requests, such as “only call a certain phone number after 10 p.m.,” or “after two tries, call this number.”

The Future: As Southern New Hampshire Health System continues to grow, the management and staff will focus on their promise to residents of the area to provide information, education, and access to exceptional health and medical care services. With the right combination of great people and the right technology, their contact center will have the capabilities needed to keep pace with the organization’s growing needs.

[From the February/March 2011 issue of AnswerStat magazine]

Case Study: Nemours Children’s Health System

By Mike Devine

New technology not only brings new opportunities but also new challenges to the healthcare contact center industry. Over the years, the number of communications systems and devices has exploded, resulting in a large amount of information for call centers to manage. Call center operators are now responsible for contacting staff members on a variety of communication devices that are continually changing. In the healthcare industry, having efficient and effective communications among the contact center and hospital staff plays a large role in achieving success.

Many hospital contact centers are currently running on a Cisco PBX, and the industry is seeing an increase in migration to this technology. It is important for hospitals to have call center solutions that integrate with their PBX to ensure a solid communications platform for mission-critical communications. This was the case for Nemours.

With facilities in Delaware, Florida, New Jersey, and Pennsylvania, Nemours is one of the nation’s premier pediatric healthcare systems and has made a promise to do whatever it takes to prevent and treat even the most disabling childhood conditions.  It’s a promise that extends beyond their clinical care to an entire integrated system of prevention, intervention, education, and research dedicated to improving the health of all children.

Nemours understands the role that contact center communications play in the quality of care provided to patients, and they are continually striving to improve efficiencies in their facilities. The Nemours call center management team in Jacksonville, Fla., was struggling with call volumes and utilizing insufficient methods to handle the demand. The facility employed four operators during the busy day shift and was using a paper-based system to manage on-call schedules for the various departments.

With Nemours being such a large and continually growing health system, the team knew something needed to be done to speed communication and reduce the communication burdens on the call center operators.

Operators Pick Software Operator Consoles for Critical Messaging: After careful selection, the Nemours Florida call center decided to implement a software operator console solution which equipped the operators with needed functionality, including the ability to message to a variety of devices and send messages directly to doctors through the console. “Our operators love being able to use [the system] to send quick text messages to doctors telling them to call a certain phone number,” said Lorraine Cann, call center supervisor for Nemours. “This eliminates the need for our operators to be a go-between and make numerous phone calls.”

Solution Ensures Consistent, Pleasant Greeting – and Cuts Workload: Nemours has also cut operator workload by using an automated greeting solution for callers. The application answers incoming calls with a pre-recorded greeting in the operator’s own voice. The “greeting solution reduces our call center noise dramatically, and operators love it because it saves them time and energy,” said Michelle Orr-Brown, switchboard operator for Nemours. It “ensures a consistent and pleasant greeting for all callers and gives them a good first impression of Nemours.”

Web-Based On-Call Directories Speed Response Times: The operators gladly threw away the old on-call paper system when Nemours also implemented a Web-based on-call directory. It ties the on-call scheduling directly to the operator console system, providing operators with accurate schedules and up-to-date contact information. Each department enters their own on-call schedule into the system and can make changes when needed. Changes can be made by any credentialed user. This functionality reduces operator workload and allows the appropriate staff members to make changes at any time. The system is updated in real time, providing operators with accurate information, improving on-call response times because they are contacting the right people on the right device.

System Rollout: With these call center communication solutions, the Jacksonville call center management team was able to reduce the number of daytime operators from four to three. After seeing the success with the new systems in the Florida call center, Nemours decided to implement them in the Delaware facility as well. “The operators love the system and have adapted to it very well,” said Michael Kuck, application analyst, information systems for Nemours. “Having both call centers sharing one staff database and data center allows call traffic to be offloaded to one contact center if necessary.”  For example, if the Delaware area experiences severe weather, the Florida office is able to access the data for Delaware and provide coverage seamlessly for both locations.

Switch Integration: Nemours benefited from the software’s ability to integrate with its Cisco infrastructure. This means the organization is able to leverage capabilities inherent with the Cisco system in concert with the healthcare-specific the systems functionality needed to provide top-notch service.

Looking Forward: Being a technology-driven pediatric health system, Nemours continues to look for ways to provide patients with the best care through technology. They have already collaborated with the GetWellNetwork Inc., which provides interactive patient care information, including education about their health condition, entertainment, services, and Internet resources. In the future, Nemours wants to integrate the IP room phones, the new system, and the GetWellNetwork for a more interactive patient experience.

Another initiative for Nemours is to have the ability to track pages and messages sent out to caregivers on their smartphones. “Having the verification that a message was sent, received, and read would help our organization tremendously,” said Amy Ayers, communications manager for Nemours. “Managers are continually requesting this type of information and wanting to consolidate the number of devices their personnel carry.”

Many doctors at Nemours are moving to smartphones to consolidate devices, and technology management is evaluating smartphone messaging. This will allow hospitals to use BlackBerry, iPhone, and Android smartphones in addition to or instead of pagers and other communications devices for code calls, consult requests, and virtually any other type of messaging. The smartphone messaging software also maintains a complete audit trail of all communications, which includes messages sent and received, along with a date and time stamp.

Mike Devine, vice president of marketing for Amcom Software.

[From the December 2010/January 2011 issue of AnswerStat magazine]

Case Study: How Cleveland Clinic Provides Care Through Advanced Communications  

By Chris Heim

The most important part of any problem solving or improvement effort you may undertake is making sure you focus on the issues and ideas that will have the biggest affect on your specific goals. There’s never enough time or money available to fix everything, or even to try everything, so for today’s problems, make certain that you’re working on things you can best change with today’s top solutions.

The call center staff and management of Cleveland Clinic felt they could better manage the thousands of calls they receive and messages they transmit every day. As key contributors to their facility’s reputation for patient care, they recognized that the growing volume of voice and data traffic they handle could create unwanted complications in the hospital’s efforts to get crucial information to patients and staff, handle on-call scheduling activities, and manage emergency and medical alerts quickly and accurately.

Cleveland Clinic, located in Cleveland, Ohio, is a nonprofit, multi-specialty, academic medical center that integrates clinical and hospital care with research and education. Founded in 1921, the hospital’s vision is to provide outstanding patient care based on the principles of cooperation, compassion, and innovation.

U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best in its annual “America’s Best Hospitals” survey. Among the key factors in those rankings are improvements in staff efficiency, as well as excellent patient care, safety, and satisfaction – all significantly influenced by the quality and efficiency of their internal and external communications effectiveness.

Yvonne Parker, manager of Cleveland Clinic Health System (CCHS) Call Centers, wanted to ensure the group had the right tools and processes in place to support the organization’s mission. She led the team in a search for solutions that would enable the call center to eliminate redundant effort and use automation wherever possible to provide exceptional caller service.

Asking the Right Questions: Parker has always admired great thinkers, such as Albert Einstein, who said, “If I had an hour to solve a problem and my life depended on the solution, I would spend the first 55 minutes determining the proper question to ask.  For if I knew the proper question, I could solve the problem in less than five minutes.”  Her communications center team placed their focus on finding the right questions to ask, so they could go to work developing and improving on answers to the organization’s communications challenges.

Their questions included:

  • How do we continue to handle our growing call volume without “breaking the bank?”
  • Can we make on-call scheduling more accurate and efficient?
  • Can we make it easier for internal and external callers to connect with patients, staff, or departments?
  • Can we improve the way we handle directory look-ups and other searches?
  • How can we best deal with emergency or other medical alerts?
  • Can we do all these things without creating a bewildering maze of unrelated, competing systems that don’t “talk” to each other?
  • How do we introduce change without hurting our current success?

The Solution: After evaluating its options, the call center team selected key solutions from a single vendor to provide its communications backbone, which includes an integrated system consisting of operator consoles, online on-call scheduling capabilities, and voice recognition directory technology. Integral to the success of the system is that all applications pull information from a single database to ensure consistency and accuracy, as well as ease-of-use and administration.

The operator consoles direct call center staff through important tasks with easy-to-use screens that include all the information needed to process communications efficiently and effectively with just a few keystrokes. This includes automatic displays of incoming calls, single-button call transfers, conferencing, and speed dialing. Operators can quickly and accurately perform directory searches and code calls, as well as messaging sent to individuals, entire departments, and role-based groups.

Parker’s team added an automated greeting system to help operators minimize voice fatigue with pre-recorded introductory phrases. Operators can use call parking functionality to enable staff to learn the nature of a call prior to accepting it or returning it to the operator group to take a message.

An online directory with on-call scheduling capabilities was included so that any member of the hospital organization with the proper login information can make updates. This helps the clinic maintain accurate, up-to-date contact information and individualized communications preferences. Cleveland Clinic’s departments can also easily perform on-call scheduling tasks without running everything through the call center.

According to Parker, the on-call scheduling application took her primary call center team from paper to automation quickly with minimal stress and provided authorized clerical staff with unlimited immediate and future scheduling capabilities. “The application was an immediate hit with our operators,” she said. “They love that they no longer need to rely on a 15-page, hard-to-update document. It also provides our physicians and other hospital staff with access to needed information via a Web browser with or without operator support. This is a major bonus during low staffing periods and after regular hours.”

Finally, the system provides callers with an automated method of connecting routine phone requests, including directory assistance and messaging, without requiring operator involvement and with more ease of use than touchtone software. Call center staff can spend more time dealing with critical communications tasks, helping to ensure patient care and safety, enhancing staff satisfaction, and reducing the cost of operation.

According to Parker, the technology “has improved dial-zero calls to the operator by 75 percent, and that helps us reach our patient-first productivity goals.”  That is no small thing given the fact that the operators had been processing more than 55,000 dial-zero calls monthly. With ongoing system tuning for new names and phrases, the rate of properly connected calls is kept high, despite changes in staff or frequently requested information.

“Our operators are always prepared to support in-house calls from visitors, nurses, and physicians who need to reach a patient or have other critical needs, added Parker. “But in today’s busy inbound hospital call center, we need to maintain our focus on patient-first productivity, and getting the front door open as rapidly as possible is our primary objective.”

The Right Questions – Better Solutions: “Asking the right questions can simplify call center management,” concluded Parker. “With the right answers in hand, making well-informed choices and investing precious dollars where they’ll have the best effect becomes a much more frequent outcome. In our case, we could show that if we used Amcom Software applications and middleware, we could dramatically improve call center productivity and enhance critical patient care.”  At Cleveland Clinic, that meant the right answers to the right questions could help the call center team continue providing best-in-class service to their customers.

[From the October/November 2010 issue of AnswerStat magazine]

Case Study: Carolinas HealthCare System

By Chris Heim

As a vital support arm of Carolinas HealthCare System (CHS), TeleHealth Solutions provides a long list of critical call center services for CHS, and more than 120 physician practices in the 700+ Carolinas Physicians Network. Some of the healthcare-related services include nurse triage, appointment scheduling, after hours services, patient transfer, and critical code calls. Among TeleHealth’s support services are support for CHS marketing activity, outbound call projects, and serving as a CHS customer care line. As their quality reputation grew within CHS, so did the number of clients seeking their service.

The Challenge: TeleHealth Solutions, a medical call center based in Charlotte, N.C., has one of those “good problems to have”; it is growing. Quickly.

While the majority of TeleHealth’s clients are individual practices now benefiting from top-notch after hours support, another beneficiary of their vast services are the thousands of patients within the CHS network. The system, spanning both North and South Carolina, comprises 32 hospitals, including Carolinas Medical Center (CMC), approximately 200 physician practice locations, and more than 45,000 employees. According to Melissa Davis, assistant director of TeleHealth, “It’s our job to help patients navigate through our healthcare system to find the resources they need, 24/7.”

With three shifts running around the clock, TeleHealth’s clinical and non-clinical agents were processing more than 43,000 calls a month, a volume that continued to grow rapidly as more and more clients within the CHS network reached out to TeleHealth. To continue providing the dependable, quality customer service it was known for, TeleHealth needed to upgrade its technology and optimize automation.

The Solution: “Since we are adding many new initiatives and services, we needed a system that could support a wide variety and growing volume of calls,” said Davis, who was part of the TeleHealth implementation team. Knowing Carolinas Medical Center used Amcom Software’s operator console as the backbone of their communications system, and knowing it was supported by the system’s IT department, they jumped at the chance to standardize on this solution.

Not only could the system easily handle the call center’s volume and variety, but, as Davis noted, “of utmost importance, with [Amcom’s] MediCall we had a standardized communication backbone and could support fully integrated metrics and reports. Everything would be the same throughout the system.”

With an integrated communications system, TeleHeath Solutions was able to respond to more calls, assist more patients, reduce expenses, and most importantly, to continually introduce new ways to increase the value of their service.

The Results: The innovative console immediately reaped benefits for Davis and her team. With the system in place, TeleHealth has been able to successfully grow as a call center for Carolinas HealthCare System.

  • When a call comes in, agents instantly access individual client profiles, instructing them on how to process after hour calls, help determine if they need nurse triage, and highlight office hours, physician paging preferences, appointment scheduling guidelines, and other client-specific information.
  • For answering service clients, customized message pad templates ensure agents consistently and accurately gather the patient information deemed necessary by a particular physician client. For example, if answering for an OB/GYN office, the message pad templates prompt the agent to gather key information, such as how many weeks along the woman is with her pregnancy.
  • The system supports agents through the process of transferring critical patients into Carolinas HealthCare System – a process where speed and accuracy are paramount.
  • A group of agents relies on the system to send out alerts to necessary hospital staff when patients with heart attack symptoms need to be rushed to the cardiac catheterization lab for treatment. Such automation helps CHS stay under the 90-minute door-to-balloon time recommended by the Joint Commission. This means that a patient should be registered, evaluated, and ultimately receive potentially life-saving heart catheterization within 90 minutes.
  • A message reminder in the system alerts the operator if a patient call hasn’t been returned, helping to ensure quick customer service.
  • They can easily add remote agents during peak volume.
  • With a more automated triage service, TeleHealth Solutions supports CHS with several of its larger goals: keeping non-emergent patients out of the emergency department, enabling the ED to direct resources to true emergencies. TeleHealth can also assist patients who do not have a primary care provider to find a physician or medical home within the Carolinas Physicians Network.
  • TeleHealth has been able to add marketing services to its core offering, including a “new movers program” where every week agents pro-actively call new residents of Charlotte to help them find a new family physician.
  • Another service initiative involves calling patients who have a primary care physician but have not scheduled a preventative health visit in over one year.

All of these capabilities enable TeleHealth to offer their customers a service that is widely praised for alleviating the time pressures on busy clinical personnel. Physicians can rely on TeleHealth Solutions as a trusted partner to handle many of the administrative services that take away from the primary goal of patient care and safety. As Davis noted, “The primary reasons for physicians participating in our services are that the physicians see an improvement in their quality of life and increased family time while we extend accessible after hours services for patients.”

The Future: Looking forward, TeleHealth Solutions will continue to work with their call center vendor to help address some of Davis’ future initiatives. One innovative approach they aim to take in marketing to the community is to offer text-messaging capabilities, whereby a resident can contact the hospital to request more information about a particular CHS service. This text-based request would come into TeleHealth Solutions’ console and present as an incoming request call to the agent, much the same as a voice call. The operators would then have the capability to respond to the text message, providing the information requested by the prospective patient. “My generation has new methods of communicating,” said Davis.“We often would prefer to send a text rather than make a voice call just because it’s easier and more convenient.” Capabilities such as this, which focus on the increasing reliance on mobile devices, are now available.

[From the June/July 2010 issue of AnswerStat magazine]

Preparing for the Pandemic: A Retrospective Review of a Call Center’s Vital Role

By Geri Hammes and Lora Foreman-Krall

The new 2009 influenza strain, H1N1, brought more than one challenge to those of us in the healthcare industry. Vaccine producers dealt with slow growth of cultures that delayed vaccine development and distribution. Populations more susceptible to the H1N1 virus seemed to be younger than those usually affected with seasonal flu in past years, necessitating different guidelines for vaccine administration.

These factors, combined with a strained healthcare system often strained by limited resources, made for an interesting test of our skills. At Franciscan Skemp Healthcare Call Center in La Crosse, Wisconsin, we saw the pandemic as an opportunity to demonstrate to both those within our facility and within the community we serve what an important role call centers provide. Call centers are capable of playing an indispensable role during times of healthcare crisis.


While no one can be completely prepared for an emergency, the influenza pandemic did give us a bit of warning as its spread was followed closely by the media and by the CDC (Centers for Disease Control). Our facility had a pandemic command center that discussed possible scenarios and ways to respond. As the number of influenza-like illnesses increased in our area, so did the call volumes.

While a steady increase would have been more manageable, we literally saw call numbers double and then triple in a matter of a few days. The clinic and emergency departments also saw an increase in their calls. We needed to address the concerns of our patients, manage the call volumes, and still utilize what resources we had available to us in a cost-effective way. We wanted to accomplish this while maintaining patient and staff satisfaction. As a team and working with other departments within our facility, we chose three primary areas in which to focus our efforts:

  1. Educate patients regarding the facts about the H1N1 virus and dispelling myths that were adding to fears. We wanted to offer them an opportunity to speak with a registered nurse, give them many opportunities to ask questions, and discuss their concerns with a real human voice.
  2. Prevent the spread of the illness. We wanted to keep patients who did not need to be seen home with reassurance and support 24 hours a day. This was vital to allow maximum use of healthcare resources and available personnel.
  3. Be mindful of containing costs and utilizing the resources available to us within the institution.

To accomplish this, our call center activated a reserve line, “Calls to Action” (CTA) that is used for time-limited marketing and educational events. We designated the CTA line as our flu hotline to specifically address calls regarding influenza and influenza-like illnesses.

Increasing Staffing

We increased our RN staff during regular business hours in order to offload calls from our clinic departments, as well as our after hours call center. By doing this, we were able to allow our dedicated call center staff the time to take the more complex calls that routinely presented after hours, in addition to the CTA/flu hotline calls.

We assimilated the new call center staff members from our PRN (the nurse pool) group of hospital nurses and then trained them according to guidelines we helped to develop using the latest information from the CDC, our state and county health recommendations, and our medical directors. Guidelines were specific for pediatric, OB, and adult patients. The goal was to make them easy to read and use no matter what RN answered the phone.

A phone script was also developed so nurses not familiar with answering the phone could have a guide as to exactly what to say. It was easily documented in our Cerner electronic medical record (EMR) system. The dedicated call center staff used the McKesson system for documentation, also part of the EMR system. This allowed each staff nurse to use their documentation system of comfort and still meet documentation needs efficiently and correctly. With some hard work and quick thinking, all of this was put into effect within a few days of the increase in call volumes.

As vaccine for the H1N1 arrived in our area, we were able to further utilize our call center. We advertised vaccination clinics using our already operational CTA line for scheduling of target populations. Callers were screened by an RN who answered questions regarding vaccinations. Then, callers were forwarded to arrange their appointments.

A secondary line dedicated to just patient scheduling of appointments was established. Those receptionists who took calls from this line knew patients had all their questions answered and were easily registered. By answering questions first and then scheduling appointments, we could assess patient needs and determine staffing and vaccine supply for all our vaccination clinics. We were able to adequately supply all our patients as the vaccine was made more available.

As the local influenza outbreak began to resolve, we were able to decrease PRN staff and return to our dedicated call center staff.  While this may look easy on the surface, this process was not without its share of problems.

First, all call center nurses needed to become subject matter experts very quickly. We had a core set of documents, and we all utilized the same approved websites. While our PRN nurses all had an extensive knowledge base of nursing skills, we had to provide education on phone use and how to follow guidelines, often with little or no training time. We utilized core staff as resource personnel, and they were instrumental in making PRN staff welcome into the department and call center routines.

Internal Communication

Another problem we encountered was related to effective communication. As new updates were made available, our staff had to make frequent changes, sometimes within minutes, based on the most up-to-date information. Communicating those changes to everyone in an efficient manner was difficult. We found direct face-to-face communications at shift change the most beneficial for staff within the department.

However, we also encouraged staff to check the CDC and our state health department websites specific for influenza updates because information was changing so rapidly. In addition, daily emails were sent by our supervisor with highlights regarding changes to protocols, target populations, and vaccine availability. All new updates were stored on our call center department website for easy reference.

Working with our hospital public relations department, we found having one centralized location with a small number of staff for communication allowed us to create a method to constantly assess what was happening in the public to better meet patient needs and modify processes based on those needs. It also allowed us to quickly identify problems within the system and make adjustments.  We could then disseminate that to our outlying providers, clinics, and the public.


The pandemic in our area could have been a real disaster for both our patients and our staff. However, because we quickly mobilized resources and utilized available staff – including our flexible call center nurses – we were able to educate our patients using the latest information, calm their fears, and provide them appropriate access to medical services.

By including staff not familiar with the call center into our department, we educated them to the role of the triage nurse.  They gained a valuable insight and appreciation for our role. We assisted other departments by taking the flu hotline calls and freeing them for patient care. To our entire facility, the call center became a resource for the latest information regarding the pandemic and vaccinations.

The Franciscan Skemp Call Center, while not in the forefront, became a central information location for both the public and our staff. Ultimately, it was the adaptability of our call center staff and the willingness of our organization to work as one team that made this entire event a success.

Geri Hammes, RN, BSN, is a call center supervisor and Lora Krall, RN, BSN, is a call center staff nurse at Franciscan Skemp Healthcare Call Center in La Crosse, Wisconsin.

[From the April/May 2010 issue of AnswerStat magazine]

Call Center Case Study: Sometimes Time is the Best Medicine

By Eric Camulli

While several variables often factor into the purchase of healthcare coverage, strong customer service can be a true differentiator in the marketplace. Blue Cross of Northeastern Pennsylvania (NEPA) has never been afraid to try new customer service strategies, especially if it creates happier, more loyal customers. For seventy years, the company has been at the forefront of healthcare insurance, finding new and better ways to provide the best choice of coverage, with the largest network of healthcare providers.

In implementing technologies to improve the customer service experience, they have found that incremental improvements can really add up. In fact, for Blue Cross NEPA members, these improvements have added up to more than four years of recovered time.

Raising the Bar:  Bob McDonald, the director of service operations for Blue Cross NEPA, has set a goal to create a customer service environment where everyone has a positive experience. In order to meet this goal, he is using technology to address some of the most common sources of frustration.

One challenge is ensuring that no one has to wait on hold for more than sixty seconds. McDonald also strives to empower members to decide when they want to talk to a customer service agent, rather than dictate to the member when an agent is available. With more than 800,000 calls annually, on three different types of coverage (HMO, PPO, and traditional), meeting these goals has been no small challenge.

“With nearly 600,000 members, our phones are always going to be ringing,” said McDonald. “We can handle the call volumes, but we also want to let our members know that we understand how valuable their time is.”

In 2007 and 2008, a change in claims systems triggered an influx of questions from Blue Cross NEPA members and providers, resulting in a significant increase in call volume. While agents were committed to helping members understand the recent changes, the member experience was not at an acceptable level to meet Blue Cross NEPA’s internal standards.

All three queues were experiencing hold times in excess of acceptable levels for the organization, and some callers were met with a busy signal, which caused frustration among both members and agents. The rate of abandoned calls also increased.

“I wasn’t sure how we could decrease hold time while meeting some of our other goals, such as maintaining a 60-second average speed to answer, with a less than five percent abandon rate,” said McDonald. “During our peaks, we were having trouble staffing; we needed to find a way to even out the call volumes without forcing people to sit on the phone waiting for an agent.”

McDonald discovered the concept of virtual hold. “The idea that we could actually call our members back was exciting to me,” said McDonald. “And, I could see the immediate impact on customer satisfaction, which is ultimately our top goal.”

No, Really, We Will Call You Back: To address its immediate issues related to hold time, McDonald first rolled out call back technology across its three lines of business. “For us, it’s important that our callers have the same experience, no matter which line of the business they contact,” McDonald said.

When hold times are under 120 seconds, callers simply stay on the line and are transferred to a live agent quickly. At peak times, or when hold times go beyond 120 seconds, the caller is given the estimated wait time and offered two options: stay on hold or hang up the phone and receive a call back later, in the same amount of time as if they had waited on hold. Forty-six percent take the callback option. As callers acclimate to the option, usage has increased over time.

For McDonald, allowing members to use their time productively, rather than force them to wait on hold, was an immediate success. Members complimented the company on its use of the new technology, and abandon rates dropped. “Our members trust us to call them back in a timely manner,” he said.

As more callers took advantage of the callback option, average speed of answer improved by 19 percent. This allowed McDonald to better match staffing levels to call volume and offer agents a safety net for unanticipated peaks. The improved call distribution helped increase job productivity and satisfaction. In addition, staff complaints dropped and  work-related stress was reduced.

“We eliminated that first 30 seconds or so of some calls where the caller would sometimes vent about how long it took for us to talk to them,” McDonald said. “It makes calls easier for the agents. Anything I can do to reduce tension between agents and members is a good thing.”

Since the call back is presented as a normal inbound call to the agents, it requires virtually no agent training. “Our agents don’t have to do anything different. We just let them know it was happening,” McDonald said.

Empowering Callers: While he was addressing the hold time issue, McDonald was also implementing new options for customer callbacks. Now Blue Cross NEPA members can schedule a return call for up to seven days in the future, which allows the caller to define when the customer service interaction will take place. On the agent side, the technology works the same, automatically placed at the requested time.

The technology also provides an after-hours service – a feature McDonald is in the process of implementing – allowing callers who try to reach an agent outside of business hours to immediately schedule a callback time during normal business hours. This puts the responsibility on Blue Cross NEPA to make the return call and allows the member to move on with other activities.

While the contact center is meeting its metrics (see sidebar), McDonald is most proud of the impact it has had on Blue Cross NEPA members. “We get comments from members all the time – they’re surprised that we have this capability, and they love the fact that they can go about their business,” McDonald said. “We saved so much time for our callers – in 2008 alone, we reduced member hold time by fifty-six percent.”

Helping Members Stay Healthy: McDonald isn’t done yet. One of the ways Blue Cross NEPA can improve the health of its members while reducing member costs and premiums is for members to keep up with preventive healthcare. To encourage members to schedule check-ups, they manage outbound reminder campaigns.

The company has been testing an application with a recent campaign reminding women over 40 to schedule their annual mammograms. The system is set to contact members and play automated reminder messages upon making a live connection or accessing a voicemail system.

Reminders were sent to more than 2,000 women during the mammogram campaign. Although McDonald is still tracking response rates, early indications show that this is a viable tool for other outbound reminder campaigns, such as flu shots, colon screenings, and PSA tests.

“We want to be a resource for our members,” said McDonald. “And that includes helping people proactively take care of their health, not just answer questions about their insurance.”

As Chief Technology Officer of Virtual Hold Technology, Eric Camulli is responsible for leading the direction and architecture of solution development to ensure that VHT’s virtual queuing solutions meet the needs of a diverse client base. With more than a decade of experience in the telecom and contact center industries, Eric combines technical expertise with an understanding of the challenges facing today’s contact centers.

[From the February/March 2010 issue of AnswerStat magazine]

Call Center Case Study: excelleRx

By Eric Camulli

Established in 1996, excelleRx provides medication counseling and pharmaceutical distribution services for 70,000 hospice and chronic care patients throughout the United States. To support its 800 client hospice organizations, excelleRx employs 645 team members, including 250 pharmaceutical care representatives who are highly trained pharma­cists and pharmacy technicians.

Hospice Pharmacia, the primary business unit of excelleRx, aims to change the way medication is deployed so that patients receive medications based on objective information instead of just habit or personal prefer­ence. More than just empty words, this dedication drives excelleRx to combine technology and clinical expertise to ensure that patients receive the appropriate medication for their unique situations.

Challenge: The mission is to provide the best care and support to the nurses who use Hospice Pharma­cia customer service. This involves making sure that nurses speak to the right representative at the right time. Many call centers have seasonal spikes, which can be easier to staff for, but Hospice Pharmacia experiences spikes in call volume differently.

“Because our nurses are mobile, we see call spikes in the morning, at noon, and at the end of the day,” said excelleRx Vice President of IT Steve Lemak. “When nurses call, it’s vital that they speak to an expert, not just a warm body. Our pharmaceutical care representa­tives are highly specialized technical experts, so it isn’t easy to find temporary help – es­pecially without overstaffing for the rest of the day.”

For a mobile workforce of nurses and other caregivers providing care to patients, being tied to a phone for even five minutes is unacceptable, so how can operations be optimized without sacrificing quality of service?

Solution: A custom callback solution from Virtual Hold was implemented for Hospice Pharmacia. The callback solution virtually eliminates caller hold time. If there is a call queue when a nurse calls, the system informs the nurse of the estimated wait time and offers a choice: either wait on hold or receive a callback when a pharmaceutical care representative is available.

If a callback option is selected, the nurse’s place in line is maintained. The nurse hangs up and can move on with a busy day, secure in the knowledge that Hospice Pharmacia will call back when it said it would.

Results: High-tech, high-touch applications, like the callback solution, enable Hospice Pharma­cia to provide quality medical management services to its mobile workforce of nurses and caregivers. With this technology, they can ensure that nurses speak to the right person the first time, within the time promised. Moreover, even though it can be dif­ficult to estimate how long nurses will have to wait, the estimated wait time calculations result in callbacks that are on time 99% of the time.

As nurses become more comfortable in receiving a callback, utilization of the system continues to improve. In 2007, a callback was offered to 44% of callers and more than half of those opted for a callback. In 2008, nearly 72% of callers who were offered a callback accepted it, which is no surprise given how busy nurses are.

It “is a great product that’s really helped us out,” Lemak said. “A nurse’s time is very valuable, and we could be losing more than business when they’re on hold.”


  • 2 million minutes of hold time avoided
  • 54% boost in service level during peaks
  • 58% reduction in abandons during peaks

System Profile:

  • Nortel Symposium
  • Nortel MPS 500 IVR
  • Nortel IPML CTI
  • Virtual hold technology: Concierge
  • 2 locations
  • 2 queues
  • 250 representatives for 17,000 callers

As Chief Technology Officer of Virtual Hold Technology, Eric Camulli is responsible for leading the direction and architecture of solution development to ensure that VHT’s virtual queuing solutions meet the needs of a diverse client base. With more than a decade of experience in the telecom and contact center industries, Eric combines technical expertise with an understanding of the challenges facing today’s contact centers.

[From the December 2009/January 2010 issue of AnswerStat magazine]

Presbyterian Health Transforms the Customer Experience in Healthcare

By Joe Heinen

Presbyterian Health in New Mexico has made customer service the focus of a transformational effort that may serve as a model for similar enterprises throughout the country. Presbyterian Health is New Mexico’s largest provider of healthcare, a private, not-for-profit healthcare system with annual revenues of over $2 billion. Founded in 1908, it operates seven hospitals, 25 clinics, and serves more than 700,000 customers. In addition, Presbyterian Health also offers a healthcare insurance plan.

The medical care provided by Presbyterian has been consistently rated top notch by independent rating firms who regularly survey consumers on their preference of hospitals, doctors, and facilities. But medical care is only a part of the customer experience. In delivering customer service, Presbyterian faced challenges that are not limited to the healthcare industry. These included multiple organizations and difficulty in navigating a complex set of organizational silos, such as navigating insurance, scheduling, billing, and appointments. Presbyterian wanted to improve the level of its customers’ satisfaction when they interacted through its contact centers and throughout the customer experience. This meant taking a fresh look at all aspects of the process.

“In healthcare there is a great deal of built-in complexity and a variety of programs, such as Medicare and Medicaid, that require certain training and skill sets, so it is challenging to be able to quickly route inquiries and consolidate customer service to make it easy for the consumer,” said John Johnson, director of customer service for Presbyterian Health. “When our members think of Presbyterian, they value the community aspects of healthcare, including local staff and doctors. But we also wanted to create an environment where the customer experience was the same across the entire enterprise,”

Presbyterian had many different locations where calls were handled, which created a fragmented service experience. A single call might require multiple transfers or the customer calling back in. Many inquiries would require help from different functional areas, such as billing questions, scheduling appointments, and coverage issues. Their goal was to centralize customer service where appropriate but to retain local access for tasks that were best handled outside of the contact center.

Through its contact center, Presbyterian has a staff of 130 representatives across multiple centers. With locations around the state of New Mexico, Presbyterian has regional hospital facilities and primary care clinics with staff located in smaller communities. And with regional sites, which are community-based, it is important to members to have staffing from their community handling their calls.

Presbyterian took a complete view of service center improvement as part of an enterprise transformation effort, including such key technology-driven efficiencies as enabling multiple contact channels, proactive customer contact, leveraging virtualization, and driving business process improvements. In assessing itself, Presbyterian found that one of its biggest challenges was to create a single customer service system that supported a variety of customers needs, including flexibility, simplicity, personalization, and efficiency.

“Our intent was to create a more seamless, ‘One Presbyterian’ view of customer service so the customer didn’t feel they were dealing with so many different organizations,” Johnson explained.

Within the Presbyterian customer service center, they undertook a project to integrate three main areas that comprise about 75 percent of the customer service volume coming into any customer service area in the company:

  • Patient financial services, which handles physician and hospital billing
  • Member services, which supports members from the health plan that is owned by Presbyterian
  • Primary care scheduling for primary care clinics

Even in areas where they sought to increase the use of self-service and automation, Presbyterian focused heavily on improving the customer experience and access at the same time. All of its efforts followed a rigorous Six Sigma design process, with closely monitored and measured results.

First, they gathered customer feedback of expectations. The customer needs were straightforward and included requests such as:

  • “Answer my call quickly.”
  • “Let me choose how I contact you.”
  • “Have the right person answer the call the first time.”
  • “Don’t waste my time when I call.”

After its initial assessment, Presbyterian identified dozens of areas for potential improvement. For example, while much of its brand promise to consumers was based on the idea that there is “One Presbyterian” that can meet all of their healthcare needs from insurance to medical care, they had grown to have more than 100 unique phone numbers that their customers needed to navigate depending on their needs.

Presbyterian wanted to simplify matters and create a single point of access, incorporating the Web, self-service, and assisted service which could operate as part of an integrated system. To do so, they catalogued each of the business processes associated with hundreds of customer interactions.

After capturing and categorizing their business processes, Presbyterian used software to create business rules for virtually any contact type, including eligibility, claims, physician assignment, plan questions on over 100 plan types, co-pays, scheduling physician appointments, payments, balance inquiries, and physician inquiries. To ensure consistency, each business process could be deployed once but would drive interactions across multiple customer systems, from the Web to voice self-service. After that, the team re-designed many of the processes and was able to reduce the number of steps by 46%.

Presbyterian also implemented workforce management to ensure that its staffing was optimized across 25 different sites. Using skills-based routing, they were able to identify the right resource for each incoming call and route the caller accordingly. In addition, if hold times grew too long, Presbyterian offered any incoming caller the opportunity of automatically scheduling a return call, which allows a customer to choose the time and location where they want their call returned.

A proactive contact capability can initiate outbound voice calls, such as issuing an appointment reminder. Using IP technology, Presbyterian can use a single platform to route calls anywhere, as appropriate.

The results were so strong that Presbyterian Health was chosen as one of the world’s top innovators in customer service by an international group of industry experts in the fourth annual Customer Innovation Awards, sponsored by Genesys, an Alcatel-Lucent company. Presbyterian was selected because it had one of the best customer responses and, at the same time, produced tangible business benefits. The result was an integrated customer care system that brought together a complete range of technologies, including the Web, live agents, automated voice, patient options for scheduling proactive call-backs from key contacts, and business processes.

The panel of analysts judging the awards noted that Presbyterian had one of the strongest improvements in customer satisfaction, as well as showing significant business benefits through ROI and efficiency. For example, while seeing a 218% increase in self-service options and an 8% increase in uptake for automated systems, Presbyterian also saw customer satisfaction increase by 44%. Overall they saw an 18% increase in efficiency, taking into account both assisted and automated assistance. Along with the increase in customer satisfaction, Presbyterian has seen significant cost savings because of efficiencies and business process improvements.

While the improvements to its system cannot erase the challenges in healthcare, they can still have a huge impact on customer loyalty and satisfaction. Presbyterian’s experience shows that with the right blend of technology and initiative, any organization, even one under tight cost constraints, can dramatically improve the customer experience while still showing cost savings.

As vice president of marketing at Genesys, Joseph Heinen is responsible for corporate branding, marketing communications, and public relations, as well as strategic ROI and benchmarking programs. Prior to this, Mr. Heinen held positions in the company as vice president of strategic marketing, vice president of product marketing, and vice president of vertical markets.

[From the December 2009/January 2010 issue of AnswerStat magazine]

Advocate Medical Group Improves Customer Service Through Call Recording and Monitoring

By Chris Heim

Advocate Health Care, based in Oak Brook, Ill., is a faith-based, not-for-profit health system. It is the largest healthcare provider in Illinois and is recognized as one of the top 25 integrated healthcare systems in the country. Founded in 1980, Advocate Medical Group is one of the leading medical group practices in Chicagoland, with more than 700 physicians providing a wide range of medical and surgical care. Advocate Medical Group physicians are affiliated with Advocate Health Care Hospitals and provide outpatient care and diagnostic services at more than 80 locations.

The Challenge: The 100 staff members in Advocate Medical Group’s Patient Care Express Contact Center represent the hub of communications activity for this large, integrated health system medical group. When Advocate Medial Group began acquiring new physician practices, the ability to provide detailed records and a better audit trail became essential for building trust, as well as establishing and maintaining quality service standards not only for the patients, but also for internal customers. These 24/7 services included appointment scheduling, messaging, physician pages, appointment reminders, and medical advice provided to patients through the nurse line. The ability to easily access recordings of these calls was essential to validate and improve the quality of all communications.

The administration team was using call recording software and had even used handheld recorders at one point to capture this information, but they needed better ways to store and retrieve these important files. “The systems in place did not provide us with the right amount of clarity in the recordings or the detail needed to store and retrieve the files when needed,” said Karen Baker, administrative supervisor for Advocate’s answering service department. “We needed to find a better system that simplified the process and also provided a standard training tool for our team.”

The Solution: Advocate selected MediaSTAR™ call center recording solution from Amcom Software. A long-time customer for operator consoles, as well as emergency and incident notification and management, Advocate decided that a complementary solution from an existing vendor would be the best option.

Advocate Medical Group is now able to record and archive calls to its network for easy retrieval. They can now capture all calls in the following areas:

  • Physician pages, including at-home conversations
  • Patient appointment reminders
  • Appointment scheduling
  • Centralized messaging
  • Nurse triage advice

Advocate Medical Group is also using call recording for quality management. “With the volume of calls we handle, sometimes an agent may present an adverse tone or step outside of protocol. [Call recording] is an essential asset with coaching, mentoring, and working on ways to improve the exchange of information. When people hear how they sound to a customer, they’re often amazed. It’s an incentive to hear how you come across. We like to use it as a motivator. When we get a compliment on how a call was handled, we always send it to the associate to let them know,” Baker said.

Supervisors will randomly ask associates if a call can be monitored in real time, then the results are discussed in a positive format that points out what’s being done correctly and what needs improvement.

Advocate Medical Group’s Patient Care Express will soon begin using the system as the single tool for employee call scoring and quality assurance. This will enable a supervisor not only to review calls but also to grade them on quality aspects, such as how clearly words are spoken, use of proper medical terminology, pace, and so forth. Call scoring will allow for more in-depth reporting across the team, as well as clear categories for associates to consider when on calls. It will enable the contact center to measure the adherence to policies and standards, as well as the agent’s soft skills in a consistent, formulated manner.

The Results: The staff greatly appreciates the new system. “Today the team is able to extract a recording file easily for a given communication to provide an audit trail when necessary,” Baker added. “All of our calls are stored and retained for the required amount of time to comply with both Advocate and industry policies.”

Having easily accessible recordings of calls has proven extremely helpful in resolving issues, miscommunications, broken processes, and clarifying disputes. “The level of performance, quality, and loyalty has improved across the team and across the system with the ability to listen to the interaction taking place during our calls,” Baker said.

Additionally, call recording has increased focus on training efforts, helped to identify process improvement opportunities, and facilitated employee development. “Call monitoring is inarguably one of the best methods of improving call quality and service delivery,” said Baker. “Our professionalism, efficiency, and overall customer experience have definitely benefited. Advocate Medical Group’s Patient Care Express has realized significant improvements in call quality, customer satisfaction, associate performance, and overall contact center performance. We have been able to identify improvements in our clinical quality and safety outcomes by the ability to conduct and report in-depth root cause analysis on adverse events and incidents. This makes Advocate Medical Group a safer and more responsible organization.”

“Call quality monitoring allows Advocate Medical Group to be reflective of the customer’s value and expectations,” added Tina Kennedy, director of Patient Care Express. “It empowers the contact center with the ability to truly measure the customer experience. This is the competitive edge and the customer value-added focus that sets Advocate Medical Group apart from other organizations.”

Chris Heim is CEO of Amcom Software in Eden Prairie, MN. For more information, call 800-852-8935. Sixteen of the top nineteen hospitals in the U.S. rely on Amcom Software to run their mission-critical communications. Solutions include call center communications, emergency management, mobile messaging middleware, and paging, as well as the above-mentioned MediaSTAR.

[From the December 2009/January 2010 issue of AnswerStat magazine]

Case Study: Regina Qu’Appelle Health Region

When an emergency call comes in at the communications center of the Regina Qu’Appelle Health Region in Regina, Saskatchewan, it could be originating across the hall – or from hundreds of miles away. The Regina Qu’Appelle Health Region is the largest health care delivery system in southern Saskatchewan. In diverse communities stretching across the region, nearly a half-million residents call this 52,000 square mile area home. Communities range in size from tiny Fleming, population 95, to Regina, at around 200,000.

Serving the communications needs of the organization is a challenging task. Regina’s Regional Communications Centre does that and more, as it also provides emergency dispatch services to their region and three others. From their facility in Regina, the unit answers approximately 150,000 requests for service annually, including more than 42,000 calls for emergency services. The four communications specialists at the center launch communications that deploy 40 ambulance services, 76 fire departments and 80 first responder teams, serving more than 130 communities in southern Saskatchewan.

This was all made possible in 2006 when the management team in the Regional Communications Centre determined that they needed to reassess their role in the region, including the possibility that the growing demand for emergency call services might force them to roll back service availability to parts of the region. By analyzing the trends they were seeing – a growing number of calls, compounded by expanding communications technologies such as cell phones and the Internet – they realized that the call volume in their center would continue to be a challenge.

“The ability to quickly summon help, made possible by the explosive growth of cell phones and other technologies, is having an amazing, life-saving impact on millions of people,” said Chris Heim, CEO of Amcom Software. “On the practical side, it also adds to the huge increase in calls going through emergency call centers. I don’t think anyone would be able to handle this kind of fast-growing call volume without the use of technology. The only alternative is to add personnel at a pace that no health system could ever afford.”

The Solution: Rather than reduce critical services to the region, Kim Gutwin, superintendent of the center, led a team that explored changes that would save time and cost. Their search led them to implement Amcom e.Notify and Smart Console software in their communications center. The center’s network takes advantage of nearly every imaginable communications technology: pagers, telephones (both home and business land lines, including TDM and VoIP, as well as cellular), text messaging, email, and public address included.

When an emergency call comes in, the communications specialists initiate a notification message that immediately alerts all local emergency response teams in a pre-determined call-tree fashion on their preferred communication device. Instead of relying on humans to call, text, or page emergency response teams, the system automatically handles it. The software’s two-way alert and confirmation technology also automatically initiates escalations or backup calls as needed, leaving nothing to chance.

All of the communications specialists are certified by the International Academy of Emergency Dispatch (IAED). They are trained to determine the needs of each caller, deploy the appropriate resources, and if necessary, provide communications support during the emergency to ensure the best outcome.

“Now e.Notify helps our network of more than 200 call groups, each with 20 to 30 responders, get emergency care to anyone in our cities or out in the rural areas of our province more quickly, more reliably, and more efficiently,” Gutwin said. “The notification system has allowed many of the communities we serve to provide 21st-century services to their residents. We’ve had fantastic results.”

The Results: Since implementation of the system, Regina’s key performance indices show significant improvement in the center’s ability to reach, direct, and manage responses from their vast coverage area and diverse set of responders. “Our activation time – the time it takes from when we receive a call until we initiate an emergency response – has dropped from an average of 5 to 10 minutes before we had the system to about 40 seconds,” explained Gutwin. “That’s a dramatic improvement in our ability to handle emergency situations. It gets emergency teams moving faster, and it allows our communications specialists to handle the next situation much more quickly.”

The center’s 911 answer time – the amount of time before a call is picked up – has improved as well. With a goal of 90 percent answer time within 60 seconds, the staff quickly rose from 80 percent success to 91 percent. Gutwin predicts further improvements as communications specialists become even more proficient and experienced. “We’ve been able to maintain and improve on our key performance indicators, despite a dramatically increased call volume and the same number of human resources. These improvements are operationally huge.”

There is broad agreement across the area served by Regina Qu’Appelle that these tools have proven their value in ways that go beyond the usual improvement and efficiency numbers. “It’s allowed us to communicate with our rural emergency service providers, especially the small fire departments and first responders, in ways that just wouldn’t have happened before. They simply couldn’t afford sophisticated communications systems – they’d still be trying to use radios, and they’d be on their own,” concluded Gutwin. “So what we’re seeing is the survivability of an essential service, because if we couldn’t provide this, I don’t know what they would’ve done.”

For more information about Amcom Software, call 800-852-8935.

[From the August/September 2009 issue of AnswerStat magazine]