Use Skills-Based Routing to Invigorate a Healthcare Call Center

By Matt Everly

As a representative of a healthcare call center equipment vendor, countless times I have talked to a healthcare organization where the staff claims that they don’t have a “call center,” and I guess technically, they’re right. They don’t have a single place where calls come into that are then routed to operators. They may have something that’s far worse, dozens of small call centers being managed by departments independently. This kind of independent, disjointed scenario may lead to inefficiencies, duplication of efforts, low caller satisfaction, loss of revenue, redundant, unnecessary equipment purchases, and preventable errors.

The calls that hospital operators deal with every day include patient information calls, code calls, appointment scheduling, directions to a facility, triage, paging, who’s on-call information, accounting, physician referral, directory assistance, dial zero, housekeeping, room reassignments, directory update calls, and many more which are related to the health of people in, or soon-to-be in, the care of your healthcare organization. These calls range from “information only” to potentially “life and death.”

A medium to large-sized healthcare facility can handle millions of transactions every year, including inbound and outbound calls, pages, and a rainbow of codes. As in most industries, some calls can be very short and handled quickly by any operator. Others, like nurse triage and appointment taking calls, require an operator with different skills. That’s why skills-based routing makes sense in designing or redesigning your healthcare organization’s PBX console or call center operations.

Understanding the business of healthcare, and in particular your healthcare organization’s business, is the first step in implementing skills-based routing. This knowledge of your business allows you to determine the answer to the question, “Why is this caller calling?” Other important call information includes which number was called, the caller’s ANI or caller ID, whether it’s an internal or external call, if the call came from an automated announcement, or any information you can obtain about the calling party. TARP, a specialist and an innovator of in the measurement of customer satisfaction and loyalty, has determined that handling a call on the first contact will deliver 10% higher customer satisfaction while lowering costs by 50%. So implementing some level of skills-based routing is a win-win for the caller and the organization.

In a nutshell, skills-based routing takes all the information gathered about a particular incoming call and connects it to the operator that is most likely to provide the service the caller needs. An example of a call that would fit well in a skills-based routing environment is a caller that dials the main line number of your healthcare facility, the operator asks the caller for personal and insurance information, and determines that the caller needs to speak to a pediatric nurse in the triage center. What happens next?

Without an integrated CTI, ACD, and database system, the operator would manually send a call to a group of nurse triage operators that may be part of an ACD group with little or no caller information, and without knowing how busy those nurses/operators are. After that transfer, the initial operator is out of the loop, and the caller is left at the mercy of how the nurse ACD group is designed. If the call is answered by a nurse, then a higher paid nurse  has to re-question the caller, about who they are and type of insurance before servicing the customer. If the call is not answered, any number of things could happen: voice mail, dead air, or the caller may be routed back into the main queue. To a healthcare facility, this can be disastrous both financially and legally.

An integrated multi-tiered call center, using skills-based routing would allow all or most of the calls to be routed to first-tier operators (PBX or call center) or second-tier nurse operators if a DNIS “nurse triage” number was published, or if the call data indicated that the second-tier nurse operator was the best choice. Supplementary telephony systems also play a major part in creating effective skills-based routing plans. IVR, speech recognition, voice mail, and auto-announcement systems are extremely important tools when used correctly.

In the nurse triage call scenario, first-tier operators will take information immediately while determining where the call should go. Information including person calling, address, social security number, member number, and so forth can be input into the database. Once the first-tier operator determines that the caller needs to speak to a second-tier nurse operator, the call can be sent within the system along with the data collected by the first-tier operator to the second-tier nurse/operator ACD group. Along with receiving the call, the second-tier nurse/operator will already have the information input by the first-tier operator, which can be automatically imported into the specialized nurse triage database. The higher-paid second-tier nurse/operator can immediately begin to help the patient without asking them for the same information again. Functioning as a single, integrated, multi-tiered healthcare call center, the healthcare organization can read incoming call information and route calls appropriately, collect information as the call progresses from tier to tier, control what happens to the call in every stage, view all tiers and ACD groups “real time” at all levels, route the call efficiently without bouncing a call from system to system, record the call at each stage, and track the call and everything that happened to that call during its life cycle.

The nurse triage call scenario is one of dozens of call types fielded by healthcare call center operators. In a healthcare environment, seconds count, and the ability to deal with multiple languages, fluctuating call volumes, integrating to healthcare databases and IT systems, alarms, codes, and natural disasters is paramount. By using skills-based routing effectively, a healthcare system has the ability to improve efficiency, save money, eliminate errors, improve caller satisfaction by immediately recognizing where a call should go, and distributing the workload more intelligently and equitably.

Matt Everly is the Marketing Manager for Amtelco’s 1Call Division, which offers products to streamline communications at healthcare and higher education organizations. You can reach Matt at 800-356-9148 or

[From the December 2005/January 2006 issue of AnswerStat magazine]