Customer service drives new radiology call center

Plan is to double volume in three years

A beautifully designed, state-of-the art facility for imaging services is the centerpiece of a group of previously independent sites now being served by a new radiology call center.

The idea behind the call center — the joint venture of a New York City health system and the medical school associated with it — was to market the five sites as one entity while upgrading the technology supporting them and enhancing customer service, says Gala Prabhu, a New York City-based senior manager for Accenture who served as project manager.

"Some of the five different facilities had specialties," adds Prabhu. "One just did MRIs and another just ultrasound and bone density scans, and two had larger repertoires. The new facility — a spectacular space — also had a PET scan."

"We wanted to create a call center that would serve all five sites, use the staff who were already there if possible, and make sure the level of service improved 100%."

Logistical concerns were "not a big deal," she notes, as service sites are all within 10 blocks of each other. "The same physicians could have patients receiving an MRI on different streets."

When the call center was set up — in a separate, nearby location — all the schedulers who had been onsite at the five service facilities moved there, Prabhu says. As the call center startup was in conjunction with the opening of a new service site, she adds, there was no reduction in the number of full-time equivalents.

"In fact, the plan was to increase staffing, as they hope to double their volume in terms of procedures in the next three years," Prabhu says.

One of the main intentions of the project — with several sites in such close proximity — was to make sure no one seeking an appointment was turned away, she says. If someone called for an appointment at one site and found no availability, Prabhu points out, the individual could always be scheduled at another location a short distance away.

As she observed existing operations at the sites, Prabhu realized that staff tended to be focused on one service line. "There were schedulers who knew how to do mammograms, and others who did MRIs.

"In one of the areas, the level of service was horrendous," she says. "They had lost some staff and the phone was not being answered." Patients in that neighborhood expected a high level of customer service and didn't hesitate to let their dissatisfaction be known, she adds.

Once the call center was up and running, no schedulers remained at the service sites except those who handled breast biopsies, Prabhu says. "A biopsy for breast cancer is so 'high touch' that we wanted [staff in that area] to work all the way through [the process] to make sure patients felt comfortable. There is a lot of information they have to give the patient and in a call center you are not able to provide that high touch."

'Really good scripts' needed

What stood out in the course of designing the call center was the need for "really good scripts" to guide conversations with patients, Prabhu points out. "People who are coming in for a bone density scan need to be told very clearly, for example, that they can't have calcium that day. There is a very rigid protocol."

In the past, staff had learned the protocols through word of mouth, Prabhu says, and were pretty good in their own areas but not across the spectrum of services.

Her biggest and most lasting contribution to the call center, she says, was the creation of a detailed script for each service line. "I did some 35 scripts by the end of the project. Most of it was in their heads. It was just a matter of getting it on paper.

"The chairman and administrator of the radiology department wanted [the communications] for each area to be very scripted, very polite, very professional," Prabhu says. "They wanted staff to say the same thing and follow the same protocols." (See script.)

Crucial to the success of the project, she notes, was the fact that the health system had just moved to a new scheduling system that allowed staff to schedule across multiple sites.

The scheduling software, the radiology module of GE Centricity, has highly refined specifications, Prabhu says, allowing users to build in such questions for the scheduler as: Did you prep the patient? Did you tell her to bring her old [mammogram] film? Did you ask if she was breast feeding?

Because the radiology department was using digital images, rather than film, the majority of tests already were stored on-line, Prabhu notes, "so it was possible to view [images] without moving them" from place to place.

In order to create a call center of this type, she emphasizes, "you have to have the technology to support the whole idea."

Knowing preferences important

Another challenge addressed via technological innovation, Prabhu says, was that while schedulers at the individual sites had developed good relationships with the physicians they served, those relationships did not exist across the five facilities and the various specialties served by the call center.

"Before, [a scheduler at a certain site] would know Dr. X's preferences, and physicians like that," she explains. "They don't like repeating themselves. They don't want to have to tell the scheduler every time, 'I want Dr. Y to read this.'"

With the computer telephony integration software planned for the radiology call center, Prabhu says, "caller ID triggers where the call is coming from, [so the scheduler] can say, 'Oh, Dr. X, I already have Dr. Y reading your film.'"

The best example of how the system works, she notes, is the Chinese restaurant where the employee answering your call says, "Do you want your usual order?" Both are based on telephone ID, Prabhu adds, and require building a database.

While the system at the Chinese restaurant basically includes your address and last order, the radiology call center database has the answers to such questions as: Who's the office administrator? Who does the physician want the test read by? Where does he or she normally send patients?

The scheduler having this information in advance of the call "makes the physician feel absolutely fantastic," Prabhu says, "and the schedulers have less stress and no sticky notes everywhere."

A staffing initiative pushed by the radiology department chairman focuses on recruiting undergraduates who want to go to medical school to work at the call center so they could get a better understanding of what that part of the health care industry entailed, Prabhu says. His other rationale, she adds, was that if you're spending a lot on technology, you want an educated, articulate individual to go along with it.

"My concern was that you're getting 20- or 21-year-old kids who have no working experience, so we had to make sure they were very well scripted," Prabhu says. "It will be interesting to see how this would work out in the long run."

What she pointed out to the department chairman, she adds, is that opportunities for career advancement are limited for call center representatives. "They can move to another level, as a manager, or you can make sure you have incentives for them."

The quality and productivity measurements necessary to create such an incentive program involve yet another type of technology that is important to the call center operation, Prabhu notes.

Using technology such as the Nortel Telephony System, she says, call center managers can rate staff performance by measuring, for example, how many callers are waiting in the queue and how long they've been waiting, and by alerting supervisors so they can jump in and take a call when necessary.

"You need technology to support a call center," Prabhu emphasizes, "especially with highly specialized areas like radiology that have detailed prep instructions. You need the knowledge and the joint effort to build all your databases. You need to have that information supplied to schedulers so they can provide it to patients."

(Editor's note: Gala Prabhu can be reached at sumangala.prabhu@accenture.com.)