Survey Says…Human Factors to Consider

Survey Says…Human Factors to Consider

/ People, Performance Management
Survey Says…Human Factors to Consider

A recent survey of healthcare contact center professionals sheds light on people management challenges.

This article is part of Kathleen Peterson’s continuing series on the requirements that business leaders must address to get the strategy “right” in healthcare.

This installment of Healthcare Corner summarizes the remaining survey questions posed to participants at the June 2017 Healthcare Call Center Times Conference in Salt Lake City. Hundreds of healthcare professionals gathered to learn about and discuss contact center strategy, management and technology. The survey was conducted to glean insights into the state of affairs of today’s healthcare contact centers as we watch this industry grow and face similar challenges as those in other industries.

The following are six questions that we asked participants. The responses reveal valuable information and shed light on the people/human factors aspects of the contact center industry.

Do your people feel valued by the enterprise?

Only 7% responded that they “always” feel valued and only 3% said “not at all.” A stunning 77% reported that they “sometimes” feel valued (See Figure 1). This is understandable since obviously their organizations value them enough to fund the trip to the conference! When asked about the criteria for feeling valued “sometimes,” the response was that either the operation was closely linked to strategic objectives or to some version of “when they want something.” Feeling valued “sometimes” in any relationship represents opportunities for improvement. In healthcare contact centers (and in others) the contact center must identify where the “value gaps” are and work on closing those gaps!

How do you handle physician-to-physician calls?

We asked this question because this is always a “prickly” issue in centralized scheduling environments. I say “prickly” because there are no standards, not unlike other developing processes in healthcare contact centers. Physician-to-physician calls represent one of the contacts requiring very careful attention, negotiation and ideally elimination of the need for “doc2doc” contacts—beyond genuine medical emergencies.

Only 18% of respondents said that they use “telephone encounters,” an EMR function allowing messages to be sent to the practice where they can be triaged by a nurse or medical assistant for fulfillment (see Figure 2). This is essentially what happens when the call is “transferred to the practice” to be handled (39%). Centralized scheduling centers that “do not handle” physician-to-physician contacts generally offer a “backline” or cellphone for access.

What KPIs are utilized in your contact center?

Key performance indicators (KPIs) fall in along the lines of non-healthcare operations; hence, the cautions are the same. Contact center leadership must be clear on what these measures are and what they mean.

Service level (X percentage of calls answered in Y seconds) is used by 90% of respondents (see Figure 3). The question is, “How is it being used?” Sadly, far too many use service level simply to evaluate yesterday’s performance instead of evaluating the effectiveness of a plan where service level is the backbone. This often occurs when those thrust into managing an operation have not benefited from effective operational contact center management training!

Average abandon rate is used by 90% of respondents. This is relatively easy to understand at first glimpse; as a result, AAR is often considered to be of utmost importance. But keep in mind that abandonment is a response to a condition. IT IS NOT a condition in and of itself. “Fixing” abandon percentages will be the result of contributing factors. The number one factor is a delay beyond the caller’s tolerance; often when you can fix that you can fix abandon.

In my opinion, a 34% response for “calls per hour” is too high. This is a throwback metric typically found in high-demand environments, such as operator services. This is where a “catch-and-toss” model has emerged… that is, answer and transfer as fast as possible. This often leads to misdirected calls, but with metric measures met. In more complex business operations, calls per hour is relatively useless as a means to evaluate any meaningful quality, accuracy or experience factors, and it is deadly when used to forecast staffing. These types of measures can lead to agents literally hanging up on people just to meet the objective. This creates a condition in which the metric accomplishment is more meaningful than the experience. It is why we recommend the Contribution to Capacity approach.

Contribution to Capacity means that agent performance is evaluated via a time-spent analysis. This is the percentage of time spent in the various “states” available—talking, after-call work, available and other. When this data is presented in a bar chart with each agent represented, it is relatively easy to see how each individual is “contributing.” (For more on this topic, read “‘Contribution to Capacity’… A Transformational Term,” on our website:

Average handle time (AHT) is used by 75% of respondents to measure performance. Caution is also required here due to the fact that many healthcare contacts are complex (perhaps complicated is a better word) interactions of varying duration. When measuring AHT, it is best to use a set of control limits determined by statistical analysis (X-Bar R Charts). It may be easier to simply graph your average AHT; you will visually see the upper and lower control limits or the “range” of acceptable “performance” at the agent level. AHT also represents process; system response time and navigation as much as individual competency. Keep in mind that AHT is not any indication of quality; recordings and QA must validate the performance within AHT.

What type of ongoing training is provided at your contact center?

There is no more important factor in today’s healthcare contact center than training, and it is far too often given short shrift. New-hire training programs are largely the focus of in-person learning (82%) (see Figure 4). But how the material has been designed, developed and delivered determines its effectiveness.

Coaching was deemed as the primary vehicle for training by 90% of respondents. Again, this is a slippery slope. It has been my experience that the coaching role is often a shared responsibility assigned to supervisors or team leads who themselves may possess little if any actual skill (training) in being a coach! This reality reduces the effectiveness of the program; in fact, there may be little semblance of a “program.” Coaching programs need to include individual agent development plans based on objectives and performance. Coaching is best utilized to enhance skills and not to deliver them fresh. The effectiveness of coaching is based on coaches being skilled in utilizing a program that clearly identifies approach, standards, criteria, timeliness, and is ultimately effective. It must be backed up by performance evidence.

E-learning, deployed by 59% of respondents, is evolving. The trick to E-learning is the same as in coaching. It must be relevant and actionable; otherwise, it is a waste of time, resources and money. Far too often isolated skill-based training is presented via an E-learning “capsule” that lacks any real connection to actual job tasks, brand or strategy. It leaves the learner to assimilate and apply the material to their own job. The question is, “How motivated or capable are agents to assimilate the material?”

What contact types does your contact center handle?

There is no surprise here. Voice contacts are handled by 100% of participants; emails come in second at 70% (see Figure 5). Voice is still a very strong channel in healthcare contact centers (and in many others). The demographic range is wide and it is only in recent years that healthcare has begun to manage ways to utilize additional channels. HIPPA concerns have kept many systems from adopting a broader spectrum of alternative channels. The next frontier for healthcare is text. The next generation wants to interact using their devices more than any computer. Although chat is at 25% and text 15%, we see more systems looking to ramp up digital device interfaces. The adoption of video in healthcare contact centers is low (7%), as it is in other industries.

The addition of what systems would provide the greatest benefit to your contact center?

Contact centers utilize multiple systems to manage the operational demands of the center. Interestingly enough, the No. 1 response to this question was CRM (customer relationship management) at 69% (see Figure 6). What does that really mean? It appears that what contact center leaders want from CRM is articulated in two ways. The first is to “pop the record.” The second is to have the patient’s contact history be available, allowing agents to see the entire contact history. Unfortunately, CRM may not be configured, capable or integrated in a way that delivers these functions. CRM systems are often purchased by marketing; making the contact center an “add-on user.” In the case of the “add-on” user, the primary purchaser becomes the information architect and will plan for marketing’s needs and NOT necessarily those of the contact center. A clear set of requirements must be crafted by the contact center; then the type of system(s) can be determined.

According to 61% of respondents, investment in workforce management tools yields significant benefits. And they do as long as the data is accurate and the need clear. Workforce management systems for fewer than 30 agents in contact centers that operate within regular business hours and are staffed with entirely full-time employees may not benefit as much as they would hope. This investment is constrained by operating hours and the FTE model. However, growing operations considering an investment in these systems must also invest in acquiring the skills required to optimize them.

Multimedia intelligent routing (57%) is a system that delivers significant benefits. All data for all channels now resides within a single “engine” that is able to intelligently distribute the load. This certainly enhances distribution; agents no longer have to log in and out of various queues. However, the most compelling advantage gained by intelligent routing is that the data for demand is in one place and reportable! This makes many other objectives easier to achieve. The single engine is necessary to provide the desired contact history, allowing the agent to build rapport and enhance the experience by knowing what their journey has been like so far! Intelligent multimedia also enhances efficiency by improving agent utilization.

Finally, quality recording and business analytics (52%) definitely provide benefits. The benefits are totally dependent upon the structure and effectiveness of the overall quality program. Historically, quality assurance has been thought of as listening to recorded calls and providing feedback/coaching. The trend today is to enhance the use of these recordings via the use of speech analytics. The analytics function extracts information from conversations (voice or text) to identify trends (e.g., why patient is calling, the cause of the contact).

These insights expand the power of the quality program to look beyond the benefits of improving performance on an individual basis to improving performance on a center basis by fixing chronic problems. For example, suppose the analytics engine tells us that some percentage of contacts are asking clarifying information on directionsparking. This indicates definitively that our alternative channels (recorded directions, website) are failing. Therefore, fix the issue and eliminate the contact. This is what analytics is all about. Far too often analytics are applied to individual agents rather than on systemic issues plaguing the entire population. Focus on tools that identify obstacles within the patient journey—the practices, policies, procedures, processes and systems that get in the way. The elimination of obstacles via intelligent analytics impacts positively the customerpatient experience and efficiency.

As you can see, the landscape of healthcare contact centers is not terribly different than other industries. These findings demonstrate that this industry is on its own journey of discovery.

Kathleen Peterson

Kathleen Peterson

Kathleen M. Peterson is the Chief Vision Officer of PowerHouse Consulting, a call center and telecommunications consulting firm.
Twitter: @PowerHouse603

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