Dr. Dowling is president of Dowling Medical Director Services, a private health care consulting firm specializing in quality improvement, clinical informatics, and health care policy affecting specialty care. He is the former medical director of a large,
Large or small, your ‘call center’ is essential to a good first impression.
Thank you for calling Urology Specialists of the Western Hemisphere. If this is an emergency, please hang up immediately and dial 9-1-1 or go to an emergency room. For prescription refills, please contact your pharmacy. Press 9 to…”
If this recorded greeting, which is unnecessary for most callers, sounds familiar, you may want to reevaluate how your practice manages the primary tool for patient engagement-the telephone call. Do you put your least experienced and lowest paid staff in this important role? Have you installed and configured phone systems that all but guarantee the first contact with the practice will not be a live voice or human touch?
These common responses to the pressures and pace of a contemporary specialty practice may ultimately shape the first impression of a patient or referring physician’s office, impact patient and provider satisfaction, and even determine customer loyalty. In this article, I will discuss the concept of a “call center” in a modern urology practice.
Call centers come in different shapes and sizes. If you have one or more employees answering the phone during business hours, then you have a call center-whether you call it that or not. After hours, your answering service may be your “call center”-responsible for representing your practice in a professional and reliable way. Some large practices with multiple offices have centralized routing and distribution of some or all phone calls by staff in a dedicated physical space-a physical call center.
Also by Dr. Dowling: How to set up e-prescribing for controlled substances
No matter the size of your practice or location of your “call center,” the needs of your callers are the same. One author summed it up nicely: “We want to be treated well, we want the human on the other end of the line to correctly pronounce our name, we want them to be friendly even when we're not, and (most importantly) we want our problem solved” (bit.ly/callcenterhistory). The goal of your call center is to get the caller’s problem solved in a dignified, professional, and respectful manner. The call center is the face of your practice.
How to measure call center performance
Where do you begin in assessing the efficiency and quality of answering phone calls in your practice? There are basic measurements that can begin to answer this question and get you started. Many phone or call management systems have reporting capabilities. If you don’t have such a system, you may have to manually audit or observe the number of calls, the average length and type of calls (appointments, refills, medical concerns), the category of caller (new patient, established, physician, hospital, etc.), how many calls per hour your staff is completing, how many callers reach a human, and how many calls are abandoned.
The electronic health record may be an important secondary source of information as it may measure messages by provider, tasks, or refill requests. Interview one or more of your staff who answer the phones and get their perspective on what’s working and what is not working. If you measure patient satisfaction, drill down on any information related to experience on the phone; if you don’t measure satisfaction objectively, ask your patients about their experience interacting with the practice.
Go online to ratings sites and see if people are talking about your customer service. Call your practice posing as a new patient and see what happens. With minimal focused effort, you should be able to get a clear idea of whether there is an opportunity for improvement and how to target the solutions.
How do you know what is normal performance for your call center? There are three common benchmarks or key performance indicators to use for comparison. First, the average abandonment rate is the percentage of calls that were disconnected before being answered. Second, the average time in queue is the amount of time after a call has been answered before the caller speaks to an agent. Finally, the average time to answer measures how long it took the agent to answer the call. According to one source, these benchmarks for health care are 13%, 2.5 seconds, and 3.2 seconds, respectively (bit.ly/callcenterbenchmarks). If you are far off these benchmarks-especially abandoned call ratio-then you may be losing business and not even know it.
Next:Three avenues of solutionsThree avenues of solutions
Once you have identified the opportunities, you can begin to apply targeted solutions.
Reduce inbound calls. The first-and often overlooked-category of solutions is to prevent inbound phone calls to begin with and reduce the load on the staff. Do you have a patient portal, online bill pay, virtual scheduling, live chat, secure email, or alternatives that can eliminate the need for phone calls? Are you anticipating questions in your patient literature, especially when preparing for a procedure? Are you accurately maintaining patient email and phone information so your patient reminder system actually works? Does your refill policy generate more daytime calls than after hours calls it prevents?
Also consider these questions: Are you returning morning messages promptly to prevent a second or third call back? Have you considered a dedicated phone number for physicians and hospitals, instead of routing it through the call center? Do one or more of your providers review their inbound lab results daily? Are you monitoring your failed outbound electronic prescriptions or faxes? Addressing these and other opportunities will return dividends in your call center performance.
Assess your technology. The second major category of solutions is technology. If you don’t have a call management system, examine the economics and see if it makes sense-the return on investment should be tangible and significant in a busy practice of any size. If you do have a call management system, be sure it is properly configured to monitor and report call and staff activity. Examine settings in your appointment scheduling software to ensure the staff can easily find available appointment slots. Are the interfaces between systems working properly, or do the staff have to waste time with dual entry? Does the staff have access to all the systems they need (the EHR, for example)? Involve your IT staff in ensuring that some chronic problems in technology are not directly impacting your call center staff and customers.
Evaluate your staff and training. The third category of solutions is human resources. Just as you would not let your nurse administer BCG without proper training, you should work to ensure that the face of the practice-the call center-is properly trained and supervised. Some phone systems allow supervisors to monitor phone calls to assess the quality of calls; are they doing that? Do your staff know how to get the answers to basic common questions such as, “How long has Dr. Jones been in practice?” or “Does Dr. Smith take my insurance?”
Are staff held accountable to some of the benchmarks mentioned above? Do you have the right people in the call center? The call center can be the nerve center of the practice, but may not be getting the attention it deserves.
Bottom line: The customer experience will increasingly differentiate high-performing medical practices, and the phone will be an enduring interface between your practice and your customers. Don’t assume that no news is good news-take a look at how your “call center” is working and see if you can answer some of these questions as well as your callers.