Hospital call centers lack automation, hurt patient satisfaction

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Hospitals are looking for ways to improve patient experience, and one popular approach is to offer online appointment scheduling.

However, those efforts are likely to overlook the sizable percentage of patients who still use their phones to connect to a health system call center to find the right provider for their needs and schedule an appointment.

Many call centers are missing the mark when it comes to giving a good patient experience, says Julie Yoo, chief product officer and co-founder at Kyruus, a vendor of software enabled call centers. The company recently called 40 hospital call centers and measured their ability to accommodate patient scheduling preferences and how long they waited on hold, among other metrics.

The assessment found that 40 percent of call agents could not meet half of patient preferences for being matched with a specialist, and 82 percent could not book an appointment directly over the phone. Some 60 percent could not match the patient with a provider of the patient’s preferred gender, and half could not find a provider at a location convenient for the patient. Further, about 75 percent did not find an appointment for a patient with an appropriate provider within a three-week timeframe.

Many call centers lack an electronic infrastructure that can link to accurate provider data and identify an appropriate physician at a convenient site whose expertise aligns with the patient’s clinical needs, primarily because call centers typically still rely on paper-based physician directories.

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The information to match providers to patients, however, is easily available electronically in the hospital’s clinical and administrative information systems, which call centers may not have the ability to access.

With that access, EHR and claims data can be pulled during a phone call and used to match the right provider to a patient, and also to better inform the provider about the patient being seen. A cardiologist seeing a new patient, for instance, may not know the patient also has kidney disease or diabetes unless EHR and claims information is passed on by the call center to the provider in advance of the visit.

Providers need to analyze the distribution of their physicians to understand if they have an appropriate amount of the right physicians with the right expertise to meet patient demand, Yoo says. And they need to partner with their insurers to get access to extensive data on specific types of insurance that patients have.

A patient may be covered under Aetna, but the plan has many different types of policies, and call centers may not know the specific plan that the patient is in. The call center may validate the insurance and the service will be done, but the policy validated may not be the right one, and the claim will get denied.

For patients, however, the most frustrating moment when talking to a call center may come at the end, when everything is set and the patient then is told that the appointment will be in four months because the doctor is booked until then. “You lose the loyalty of your patients,” Yoo says. Kyruus’ report on call center experiences is available here.

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