Call centers may change the face of access

Telephone triage as a way of managing demand in health care — by screening medical complaints and directing callers to the most appropriate form of care — is just one element of the bigger concept of "decision support" that could completely change patient access and customer service, says Thomas J. Heatherington, MHA, MBA, manager with Andersen Consulting’s Global Care Delivery Solutions Team.

"All the clients I’m working with believe there’s a huge, huge potential here that’s untapped. Even some of the most evolved systems have not tapped anywhere near the target," says Heatherington, who works out of the firm’s Pittsburgh office and is a member of the faculty of the University of Pittsburgh’s Graduate School of Public Health.

Meeting patients’ needs over time

The potential, he says, is in two areas: demand management, which involves putting in place sophisticated information pools and support systems to apply a "longitudinal" rather than "episodic" view of a patient’s health; and differentiation, which has to do with knowing and meeting the needs of different segments of patients or health plan members.

"Industry has segmented its customer base for years now — identifying yuppies and matching them with the right car or credit card," Heatherington says, "but that’s largely untapped in health care." He gives this example of that kind of customer differentiation: A patient dials the health system’s call center. The person who takes that call — perhaps an access services employee — accesses the caller’s account and sees that he is a "worried well" — concerned about his health, which generally is good. Using a customer-friendly approach, the health system sets up a plan for dealing with that type of person — calling to check on him periodically, for example.

"Customer service-oriented segmenting is knowing what’s important to different segments [of the patient population] and then tailoring the first contact, which is [via] telephone," he adds.

Rising above the rest

The implication for access management, Heatherington says, is to differentiate your health system through superior customer service, which "starts in a big way with the telephone. The challenge is how to weave new capability into the telephone process so you can demonstrate that superior differentiation."

The telephone has a key role in the move toward integrated delivery systems — how people are transferred around the health system, for example.

"If I get a call for a pharmacy refill, do I transfer that person to a pharmacist, who gets all the demographic information again, or does the pharmacist just say, ‘I see that you need a refill on your antibiotic.’ Or do I even need to transfer that call —can I just leave a message for the pharmacist saying that Mr. Jones needs this antibiotic?"

A recent article in the Harvard Business Review, Heatherington says, concluded that customers who defect are "satisfied" — "very satisfied" customers don’t leave. "How to get those [‘satisfied’ customers] to stay — for me, that’s telephone access."