Challenges Mount in Healthcare Contact Centers: Managers Look to Technology to Connect with Patients and Improve Customer Satisfaction

By Victor Morrison

When it comes to augmenting a successful contact center, many organizations think the answer is to do more of the same by increasing human-to-human interaction. That, however, is not typically the case. While customers appreciate and value talking to a person, it’s a costly approach that leaves companies searching to find a scalable and more cost-effective solution to interact with their customers. Other industries have faced this challenge for years, but the traditional hands-on, in-person structure of the healthcare industry never forced it to truly consider such a strategy.

Today’s Challenges Are Tomorrow’s Crises: The healthcare industry is bracing for a major onslaught in regards to customer service:

  • The Association of American Medical Colleges (AAMC) has projected a shortage of 150,000 doctors in the next 15 years.
  • Nearly 70 million baby boomers are set to collide with the projected decline of physicians.
  • As a result of the Affordable Care Act, the number of insured is growing by the day.

With fewer physicians, more insured individuals, and an aging baby boomer population, healthcare contact centers (for both providers and insurers) can expect a sizeable increase of inbound call volume. Coming with it is the challenge of providing exceptional care and overall customer service across multiple channels.

Years ago, patients judged the quality of their healthcare experience primarily on interactions with their doctor. Now the total healthcare experience extends beyond office visits to include patient interactions with online resources and call centers. According to Pew Research, 80% of Internet users have searched online for medical information on specific diseases or treatments.

This means that opinions about the quality of care hinge not only on a doctor’s ability, but also on experiences with newer, non-traditional healthcare channels. Organizations need to equip those channels with the technology to handle the continuing shift in how patients access healthcare.

The physician shortage will put even more pressure on alternative help channels that are readily accessible and easy to use and understand. According to, nine out of ten adults have difficulty using everyday health information available in healthcare facilities, retail outlets, media, and communities. This limited health literacy can be tied to poorer health outcomes and high healthcare costs.

As healthcare facilities and in-person care options are stretched to their limit, health literacy will be further impacted, resulting in worse health outcomes and further skyrocketing healthcare costs. To combat this, organizations can and should implement technology that effectively communicates an individual’s health options, while, in turn, controlling call volume and allowing customer service representatives (CSRs) to invest more time in complex inquiries.

One such example of this is found in the healthcare provider, Aetna. The organization implemented an intelligent virtual assistant (IVA) named Ann to engage with online users and address issues regarding high inbound call volume. Ann and IVAs like her are able to answer tier-1 and tier-2 questions that may bog down a CSR’s queue and lead to service delays.

Now, as in-person visits with physicians become less accessible, contact centers can expect to play a more vital role in health delivery. CSRs will need to field more medically complex calls, requiring them to invest more time and energy into each interaction. To best serve the patients’ needs and to enable a CSR to do this, basic-level questions need to be handled more efficiently. This means empowering patients to engage with technology, such as an IVA, to make better use of the health information that is already available to them via the Internet.

Technology to Increase Favorable Patient Outcomes: Technology offers richer benefits than simply lightening the load of a CSR. For the past ten years, Dr. Timothy Bickmore, faculty member at Northeastern University, has studied the effect IVAs can have on building trust and compliance with patients. Called “relational agents” in his work, the technology is fueled by natural language understanding and enables the machine to ask and answer patient questions while building a rapport. Dr. Bickmore found patients who interacted with an IVA versus an actual doctor or nurse:

  • More accurately reported their health information to the virtual character
  • Preferred the simulated character because patients don’t feel rushed or talked down to
  • Were more likely to know their diagnoses and make follow-up appointments with their doctors

These results prove IVAs can increase contact center efficiencies by reducing the number of basic incoming calls. The technology is also capable of being a personal guide, coach, and assistant, with a singular focus on connecting with a patient in a meaningful way and empowering them to effectively manage their health.

Based on the ability to connect with a countless number of users at a fraction of the cost of a live CSR, IVAs can help establish a scalable and consistently high-level means of revenue-enabling customer intimacy. In fact, IVAs are showing such promising results that Gartner predicts by 2020, customers will manage 85% of their relationships with enterprise organizations without interacting with a human.

Bringing Relational Agent Technology to the Contact Center:  Relational agents or IVAs can offer huge benefits to hospitals and healthcare facilities, particularly in delivering highly efficient administrative support. But, the needs of a healthcare contact center are unique, which is why the current generation of IVA deployments are evolving into virtual health assistants (VHAs). Next-generation VHAs fill the void for more proactive engagement, with the ability to:

  • Proactively engage the patient via their smartphone to facilitate the most appropriate intervention at any given moment
  • Stage and proactively collect granular patient-generated health data from the patient and deliver it to the electronic health record (EHR), including answers to well-being and quality-of-life questions and disease and therapy related information
  • Seamlessly escalate to a live representative when interactions become too complex

These features and other future developments will bring healthcare contact centers to the next level in customer service. As CSRs manage more complex inquiries, VHAs are put to work collecting valuable information for providers and patients to stack alongside EHR and remote-monitoring device output.

While capacity is still a mounting problem, with the brunt yet to come, healthcare providers are looking to equip contact centers and the rest of its organization with the technology needed to effectively service all patients. IVAs and VHAs give healthcare contact centers the capacity to continue excellent health delivery without draining resources.

For over 22 years, Victor Morrison defined a vision for pharmacy and specialty pharmacy interaction with Teva Pharmaceuticals. With that knowledge and perspective, Victor is now working with Next IT to bring the benefits of IVA technology to the industry and its patients.

[From the October/November 2012 issue of AnswerStat magazine]