Healthcare Providers Embrace New Call Quality Monitoring Tools to Enhance Patient Care and Staff Engagement

Internal efficiency coupled with quality of patient care, customer service, and communications within a network of linked organizations are quickly becoming top objectives for healthcare insurance plan providers and care givers alike. Since overall quality scores will directly drive healthcare funding incentives versus disincentives, organizations face an urgent need to reevaluate their tools and processes for measuring and improving quality. And that must include a close look at monitoring of call quality and operational effectiveness in contact centers. These new priorities are driven by the fact that healthcare is undergoing a major transformation today. The purpose of the reformation is to address the many challenges including increasing costs and decreased, outcome-based reimbursement. Healthcare organizations are also grappling with internal pressures like spiraling out-of control costs, critical shortage of qualified healthcare workers and high employee turnover, combined with external pressures such as stricter CMS quality guidelines and pressure to achieve high star ratings to earn adequate funding, HIPAA compliance, increased insurance fraud and an aging population that is placing increasing demands on the entire healthcare industry.

Strikingly, only 5% of patients account for 60% or more of medical expense today, mostly due to high costs of managing chronic conditions – prevalent in our aging population. Out of the 3.8 million boomers aging into Medicare every year starting in 2011, 60% already have at least one chronic condition, so the pressure on healthcare insurance and care providers is about to grow even more dramatically. Amongst the many high level concerns to tackle, there are two significant concerns which keep healthcare executives awake at night and these are increasing operating costs and medical errors. Many leaders including federal, state and patient advocacy agencies have begun to address these critical issues by challenging previously held assumptions about these two factors. Evidence shows that elimination of errors alone leads to significant cost reductions. Therein lays the challenge to implement change to the patient experience. Historically, most efforts to manage the needs of these patients-customers have been stifled by a fragmented delivery system and lack of true care coordination. This simply will not be sustainable going forward. One of the areas that can positively impact this is at the contact center level which handles and serves patients, doctors and healthcare providers.

New call quality monitoring tools are helping contact centers within these healthcare organizations make a contribution to improve the overall experience of patients and healthcare network participants. They have helped to make significant costs reductions in training dollars through targeted coaching which helps the overall process improvement effort. All of these elements of patient care dictate renewed focus on the quality of communications among all parties – patients, healthcare plan providers, hospitals, specialty physicians, pharmacists, social services, home health, nursing homes, and a variety of ancillary providers. Periodic, intelligent capturing and assessment of information from patients, their employers, the insurance providers, the physicians and all other pertinent data sources leads to executive insights into operational effectiveness, as well as options for activities that would help address rising cost and eliminating defects. As a result, these healthcare providers are embracing innovative contact center quality monitoring tools that enable them to pinpoint critical business issues with laser-like precision. The latest-generation interactions recording and quality monitoring systems come with built-in analytics, which helps automatically sort out recorded communications according to their type and value – the financial value and the recording’s potential to provide insights into operational inefficiencies or errors. Gone are the days of hunting and pecking through all calls to identify issues.

This new generation of evaluation systems can present quality metrics automatically based on the multi-dimensional information that is automatically captured with each recording. Plus, they drive management attention to high value calls for detailed evaluation, while still providing objectivity for periodic evaluation of each agent. These systems can automatically trigger alerts or notifications when thresholds are crossed or errors occur – based on metrics that result from detailed quality evaluations, as well as data that is collected at the time of recording interactions. These early warning indicators could also be in the form of real-time dashboard graphs or desktop tickers that alert employees when certain thresholds are missed and targets are not met. Actionable nature of this monitoring system is further enhanced with automated training delivery. Coaching and E-learning content can be automatically assigned to the agents according to their individual quality scores, in addition to encouraging their progress with new learning opportunities. This has proven to help improve morale and increase agent satisfaction. These are some of the practical innovative solutions that help answer the very real challenge of managing healthcare contact center problems - in a systematic, disciplined, and productive way - the collective potential of individuals to continuously enhance the value delivered to patients, their families, and the communities in which they provide healthcare services.