A Large Healthcare System in Minnesota

A Large Healthcare System in Minnesota

Client challenge

The client has set out to transform the health system’s ‘access to care’ operations into a centralized, best-in-class Customer Experience Center that will provide a streamlined, convenient and central point of access for connecting patients to the clients diverse service offering.The main goals of the project were to optimize access and growth, increase consumer retention and enhance the overall patient and consumer experience.

With these goals in mind, in late 2017 the client engaged with RelateCare to initially perform a diagnostic investigation of the clients decentralized patient access and contact center sites, i.e. a Current State Assessment (CSA), in order to fully understand the current state of the clients patient contact operations and lay out a series of recommendations to support the centralization project.

The RelateCare CSA involved a team of patient access consultants and subject matter experts going onsite to perform a deep-dive analysis to uncover opportunities from a people, process and technology perspective as relevant to best-in-class patient access models and the organizational goals. Also included in the scope of investigation were the main campus, northern region and southern region contact centers.

RelateCare’s Partnership Approach

Following the CSA, the RelateCare consultancy team met with the clients leadership and presented the findings of the deep-dive analysis.

We recommended several key areas of improvement:

  • Key Performance Indicators: The establishment of a comprehensive suite of best practice KPI metrics to measure the project’s impact and performance on both a quantitative and qualitative level.
  • Workforce Management: Creation of a robust workforce management initiative to elevate contact center performance through data analysis, forecasting and real-time management of resources.
  • Technology and Telephony: Through the increased integration of existing Telephony and Electronic Health Record systems the client would have the functionality to improve the patient experience and allow for more data-driven and informed decisions.
  • Leadership and Training: Through the implementation of training initiatives, the client would observe an increase in employee engagement, consumer satisfaction and consumer retention.
  • Quality Assurance: Enhancement and expansion of the Quality Assurance program to provide regular call monitoring and analysis through which agent performance is measured against industry standard best practice, supported by timely and effective feedback for an elevated patient experience and a culture of continuous improvement.

After delivering our findings and recommendations RelateCare were invited to partner with the client and sit on the ExecutiveSteering Committee already in place for the Consumer Experience Center (CEC) project. This involved updating the group on project progress and providing input and guidance on challenges faced as a result of centralization efforts.

Strategic Outsourcing

RelateCare also offered a “build or buy” option to the client where they had the option to build services in-house or outsource them to RelateCare. While the client opted to improve and optimize certain internal processes and operations, they also opted to outsource a number of services to RelateCare’s best-in-class patient access centers.  It was agreed that the client would outsource Out of Hours Primary Care Nurse triage, Scheduling Support, Workforce Management, and Quality Assurance.

Out of Hours Nurse Triage

The client and RelateCare have implemented a new after-hours Registered Nurse (RN) Triage Team for established and potentially new patients phone calls for after hours, weekends and holidays. The new service took its first calls in June 2018.

So far, this program has been an incredible success. The most significant impacts have been the reduction in the number of calls that the clients providers and physicians must take afterhours, which allows them to focus on working to the top of their licensure. Furthermore, there has been an impact on provider satisfaction and the volumes of patients that are diverted from unnecessary Emergency Room care, (a

The RelateCare team has the infrastructure and expertise to handle these calls from their state-of-the-art contact centers. This includes 100% call recording.

The program is outlined below:

  • Trained RN’s, dual licensed in MN & WI respectively, answer inbound patient calls redirected/warm transferred from the client After Hours Contact Center to RelateCare’s US operations.
  • Approximately 4000calls are forwarded from the client Contact Center (ACC) and managed monthly by the RelateCare RN’s.
  • Quality Assurance is completed by a dedicated RN.  Overall, this RN team has continuously exceeded the target of 92% compliance.

RelateCare was asked to also provide an outsourced solution for Appointment Scheduling services for the client. This program involved the creation of a team of dedicated and trained Patient Service Representatives working from RelateCare’sPatient Coordination Center in Cleveland OH, scheduling calls for the clients patients across their various clinics. The solution first commenced in May 2018.

We originally provided overflow support to specific clinics with their scheduling calls. This involved an original scheduling team of 10 Patient Service Representatives (PSR’s), with average monthly call volumes of 7000 inbound calls. Following on from early implementations, RelateCare now provides scheduling support for 6 clinics, with plans in place to expand further in the near future, increasing the number to 30 Patient Service Representatives with average monthly call volumes increasing eventually to over 20,000 calls per month.

Scheduling Figures:

 KPI’sNovember (2018)December (2018)January (2019)
Total Scheduling Calls Offered (Client & RelateCare)289712546630,069
Calls Offered to RelateCare147721535416,196
Total Calls Answered (RelateCare)14,18114,81715,111
Avg. AHT4:3004:2704:4803:55
Avg. Aban. Rate<5%4.1%5.6%6.7%
Service Level (30 sec)70%73.43%71.25%70.08%
Reported Scheduling Errors<1%2.15%1.25%0.88%
Workforce Management (WFM)

A large portion of theWorkforce Management function for the client has been outsourced to RelateCare. The solution will be operated offsite during the clients standard hours of operation by RelateCare staff who are trained in Forecasting/Scheduling and Real Time Management. RelateCare is also working with the single existing WFM Resource at the clients to train and upskill the resource in the Forecasting and Scheduling of the resources across the current and future sites. The use of WFM reporting allows the leadership of the sites to determine appropriate staffing and shift patterns, which will ensure there are enough agents always available to manage call volumes both predicted and unpredicted. The implementation of a WFM function has a direct correlation with the achievement of Key Performance Indicators.

Quality Assurance

A Quality Assurance Program, which is currently in development, ensures that patients and providers alike receive a consistent standard of service when they connect with the client. The goal of the the client QA Program is to provide continuous assessment of soft skills, knowledge, technical skills, compliance and accuracy of individual agents, teams and lines of business against agreed Best Practice Industry Standards. Through a robust analysis and reporting methodology, the patient/caller experience will be monitored and areas for improvement will be captured and reported to the clients leadership. The QA enhanced program will create equity and greater synergy throughout the different business units within and will also provide consistency in the clients caller experience through timely and focused agent feedback.