By Matt Phillion
According to a recent American Medical Association survey, employee burnout in healthcare has become endemic. Many of the factors impacting physicians and nurses are also hitting healthcare contact center support agents. These agents are often the first point of contact for patients who reach out during times of great stress looking to get answers about insurance benefits or coverage, to schedule an appointment, or to address other core parts of their care.
While many of the headlines during the pandemic have focused on clinical staff burnout, studies have found that nonclinical staff, especially those who deal directly with patients, are falling prey to the same burnout.
“We have to face it: Call centers are always a tougher area for burnout,” says Patty Hayward, vice president of strategy for healthcare and life sciences at Talkdesk. “It’s a lot of the same pain points over and over again. There are challenges there to recruit, engage, and retain the same people and get them trained up.”
Patient satisfaction with a call center experience hinges on the knowledge and temperament of the agent they deal with, Hayward notes. “If you get a response, if that person is knowledgeable, and they can engage with and solve your problems, you’ll come away more satisfied,” she says.
A call center without enough staff to comfortably handle the volume of callers makes it less likely a patient will get that engaged, invested agent on the other end of the phone. But in healthcare—and in most industries, to be fair—call centers were understaffed even before the pandemic hit. “The number of calls versus the number of people manning the phones was always askew,” says Hayward. It’s a consequence of the business model: If an area of operations doesn’t bring in significant revenue, that area is going to be understaffed.
“But when the pandemic hit and nobody could come in, everybody just called,” says Hayward. “Yes, there are patient portals, but really if you want an answer to a question, it’s all about voice.” Contact through a portal is asynchronous compared to the immediacy of a phone call, and a sick patient is going to want an answer as quickly as possible—creating a perfect storm for call centers when COVID-19 arrived.
“We’ve talked to a lot of organizations, and their systems were not designed to handle the volume and just went down,” says Hayward. Other verticals, like retail or travel, had ways to deflect customers from human interactions with more self-service opportunities like chatbots or website interfaces. But these options were never fully adopted in healthcare.
“It’s still very challenging,” says Hayward. “Asking ‘Where is my order?’ is a lot simpler than ‘Hey, I have these symptoms.’ There’s a lot of liability there.”
Getting patients to use portals has always been a problem, but in part, patients continue to desire a human interaction because of healthcare’s very nature. “There’s nothing more personal than healthcare,” says Hayward.
Technology already exists to help with some functions, such as a “call you back” feature commonplace in other verticals. But that doesn’t help with call volume. There still must be appropriate levels of staffing to make those return calls.
Adapting and adopting technology
Hayward offers a firsthand experience with identifying technology gaps for call centers and adjacent patient interactions. She was recently referred to a specialist for a follow-up and wasn’t able to get through to the specialist’s office, with the line going directly to voicemail.
“I tried at different times, thinking they’d be less busy, but no!” she says. “I then got a text message saying they’d received a referral, which included the same phone number. I thought ‘Let me try something’ and responded to the text, but got an error message.”
The text was likely part of a revenue cycle product to identify lost referrals.
“I thought ‘They think they’re adopting technology to help, but it’s not,’ ” she says. “They only sent one text message, and it didn’t help me at all. I went to their website, which only had office hours and a phone number. All roads lead back to a voice connection.” These disconnected pieces put up roadblocks to better patient encounters.
“Look at tech that is synchronous, that can work with your voice technology,” says Hayward. “There are lots of ways you can alleviate challenges, so when you get to a human, the human has more time and space, and this enables a more empathetic journey.”
For example, patients often repeat the same interaction with a chatbot, then a chat program, and then a voice connection. Technology offers options for authenticating the patient’s identity without violating HIPAA so that the connection carries over between interactions, rather than needing to start from scratch each time.
“There’s opportunity with integrations to evoke better functions. Say you’re an existing patient who has a physical coming up you need to reschedule,” says Hayward. “You should be able to check if the doctor has opened the schedule to that sort of thing, offering alternatives like a waitlist.”
Although EHRs are designed in different ways and with varying functionality, some already have waitlist options. And these baseline interactions don’t necessarily require a staff member to facilitate, meaning that when you do reach a voice-to-voice connection, it’s more meaningful. “If you do these things, it helps mitigate employee burnout,” says Hayward.
When repetitive tasks take up a staff member’s time and energy—tasks that technology could handle—it’s harder for them to have a good conversation with a patient. And often the patient is depending on that good conversation. “If you’re in a call center and you get someone anxious or upset, the biggest satisfier for that patient is connecting with someone who is knowledgeable and empathetic,” says Hayward. “It’s a difference of night and day.”
However, there’s a disconnect between existing, widely used technologies and more advanced options that can offer suggestions or port over a patient’s previous interactions. “A lot of organizations have different vendors for different technologies,” even voice technologies, Hayward explains—an artifact of silos between various departments. “Often they can’t even transfer you, so you have to call somewhere else yourself.”
Patient-centric versus physician-centric
What has held healthcare organizations back from implementing newer, more interconnected technologies? Certainly, privacy laws come into play, but Hayward adds that healthcare can be conservative when it comes to adopting new technology—rather than focused on the patient’s convenience.
“Traditionally, healthcare has been designed around the physician, not the patient,” she says. “Everything has been about the practicing physician and the patient working within the parameters the provider sets.”
But the industry is recognizing the need for a change. “We don’t move fast in healthcare, and we can’t adopt different models all the time, because it puts people at risk. There are a lot of reasons for moving slowly because of what’s at stake,” says Hayward. “But the thing I love about healthcare is that people have the best intentions about wanting to care for other human beings.”
The rules that have slowed adoption of new technology have value because they’re in place to protect the patient—but there’s reason to change as well. For one, call agents should be empowered to practice at the top of their roles, just like any other staff member in the healthcare continuum.
“We talk about being able to offer new folks information, making suggestions, reducing the number of technologies they need to interact with during a call, and being able to automate tasks so they offload pure volume and enable more meaningful interactions,” says Hayward. “The satisfaction of being able to solve more complicated problems can help productivity go up and make the job better.”
The future of contact centers
Hayward would love to see the industry automating more of those easy-to-automate tasks. While scheduling in healthcare is notoriously complex and will always need some level of human interaction, unburdening the staff members who answer patient calls can help prevent burnout and talent loss.
“Using digital and voice to perform those automated tasks, we can free up more time so people can interact in an empathetic way,” letting them work at a higher level, she says.
Hayward predicts that we’ll see these advances, but they might be concentrated among larger healthcare groups and organizations with the resources and funding to put them in place. “There’s a big disparity between the haves and have-nots,” she says. “But as we continue to see consolidation in the industry, those who can make it happen will do it. I don’t think we can afford not to, but it takes a good push to get these things adopted.”
Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at firstname.lastname@example.org.