Patient Access: The First step on the journey
During medical school, my responsibility as a physician-in-training was to show up, see the patient in the room, and make sure I was providing the best care possible.
However, when I moved into residency, and subsequently moved into a role as a faculty member, I noticed that the process for getting the patient into the clinic was just as important as the care they received once there.
The Importance of the Healthcare Contact Center
It was this realization that led to my interest in the healthcare contact center.
A patient’s journey within a healthcare system begins in the contact center— it sets their expectations for future interactions. Ensuring a positive patient experience, and genuine patient engagement, starts before the patient even arrives in the clinic. The call center agents provide a positive, uniform experience to patients, setting the tone for the patient’s experience within the wider healthcare system. Optimizing call center protocols and processes to the highest quality standards is critical to ensure efficient clinical flow, appropriate provider utilization and optimal patient care.
Consumerism in Healthcare
The importance of the healthcare contact center has become even more pronounced in recent years due to a cultural shift that positions patients as consumers. Highly effective call centers are not only essential for high-quality patient care, they also pay a vital role in the “business of medicine”. Often patients have multiple options on where to seek healthcare. Reliable, efficient between-visit communications are vital to ensure a positive patient experience and minimize patient leakage. Robust, well-managed contact centers with well-trained agents create shorter hold times, quicker first call resolution (eliminating the need to make multiple phone calls), better call routing and more accurate scheduling.
The Physician Champion
Whether you are creating a completely new center or transforming a current, less functional one, the successful creation of an optimized contact centers requires a Physician Champion. As anyone who has tried to implement systematic transformations can attest, change is hard. This is particularly true when changing a system that has been in place for many years. For many physicians, letting go of well-established processes can be difficult. While physicians may view centralized contact centers as loss of control, involving them in creation of processes and protocols actually gives them control on an even greater scale.
What is a physician champion?
Becker’s Hospital Review, defines a physician champion as a “physician leader who coordinates improvement efforts between fellow clinicians and administrative staff”. They provide clinical input to the project team and communicate key clinical changes to the rest of the physician group. Not only are they able to provide essential clinical insight when developing new protocols and templates, their presence also ensures that the physician group’s input as “front line clinicians” is incorporated into changes.
Physician involvement in developing, and then monitoring, scheduling ensures that physicians are part of change management, providing them the widest breadth of control to ensure their patients receive the most appropriate appointments.
Trust & Credibility
Physicians listen to and trust other physicians; often, more weight is given to information from a fellow physician because of their shared experiences. Because of this, change management within a clinical practice often will hold more weight when it is communicated between peers. By being “in the trenches”, a physician is able to offer more insight and more buy-in than an outsider or non-physician.
Physicians regularly talk to patients and are able to provide their observed feedback—the patient perspective can otherwise be difficult to gauge, relying on lengthy and delayed experience surveys.
In my own experience, physician and patient feedback led to multiple changes in our scheduling protocols. Additionally, because of the physician buy-in we had, the provider group was willing to pilot ideas as they felt comfortable knowing that their feedback would be listened to and implemented if the process went poorly.
4 Requirements of a Physician Champion
- Presence: Consistent, active participation and regular attendance at team meetings.
- Time, time and more time: being a physician champion takes a significant amount of time, especially at the onset of a project and during go-lives.
- Thick skin: Change is hard and comes with inevitable roadblocks and challenges. Being the physician champion makes you an easy target for complaints. It is essential that you can listen and not take things personally.
- Commitment: It’s a really rewarding job—eventually most people come around and you can see really big impact on patient experience practice-wide. It really is a great way to affect patients outside of the ones you see in clinic.
Case study: RelateCare and SLUCare General Internal Medicine
My first experience in the physician champion role occurred at the SLUCare General Internal Medicine (GIM) Clinic.
As the physician champion, I wanted to ensure the clinic perspective (represented by patients, physicians and staff) was clear to the project stake holders.
Key to this approach was engaging the services of RelateCare to consult and advise on the project. We approached our work with RelateCare as a partnership. They didn’t show up, give us stock answers and leave. Rather, they came into our clinics, spent time with our staff, listened to our physicians and worked WITH us to create solutions that would fit our needs.
The physician champion was the springboard for much of this collaboration—their knowledge of clinical operations, staff resources and the consultant’s expertise created a foundation for both groups to assess strengths and weaknesses and how to leverage them to make the most impactful changes.
Finding the right partner in RelateCare, in conjunction with engaged physicians, meant that we were able to utilize our scheduling agents to optimize our patients’ access. For example, we used our scheduling guidelines and guided scheduling questionnaires to direct patients to providers who have more access. This was a win-win-win: the practice wins because they are getting more patients scheduled; the providers win because their schedules are filling, allowing them to meet productivity targets and, most importantly, the patients win because they are able to get a provider who has the time and space to meet their needs. We have rapidly grown our new providers’ panels while allowing more senior providers to focus on their long-time patients.
Through schedule template optimizations, we increased our arrived patient appointments without adding any additional appointment slots—we connected patients to the appointments already on the schedules that were previously going unused. Not only did this improve our access, it also ensured that the time our providers were spending in clinic was used efficiently rather than asking them to add more sessions.
We implemented an interactive voice recording (IVR) to streamline incoming phone calls. Since initial implementation we have used patient and provider feedback to move through several different iterations of the IVR to ensure we are best meeting our patients’ needs.
First call resolution has improved, dropping our call volumes by over 50% and decreasing our call abandonment rate from 40-50% to less than 10%.
Feedback, Communication, and the Physician Champion
Feedback was key to this project’s success. No matter how small a change was, after it was implemented the project team actively sought provider, clinical staff and patient feedback. We were open to hearing everyone’s opinion and the more feedback was incorporated, the more people were willing to share. This cycle allowed for multiple, rapid simple pilots to allow tests of change.
Having a dedicated Physician Champion is an essential ingredient if you want to embark on any transformational project, but particularly so when it comes to the healthcare contact center.
Dr. Jennifer Schmidt is Chief Medical Officer of RelateCare. She also serves as an Assistant Professor of Internal Medicine and the Section Chief of Ambulatory General Internal Medicine at Saint Louis University. Dr. Schmidt majored in biomedical engineering at Marquette University and has a green belt in Six Sigma. She completed her medical degree at Saint Louis University School of Medicine and her Internal Medicine residency at the Medical College of Wisconsin in Milwaukee, WI. She currently co-directs the Internal Medicine Residency Continuity Clinic experience and has been published in the New England Journal of Medicine Catalyst.