From Call Center to Care Center: How Hospitals Mature in Their Approach to Patient Experience

As an example, patient access is a strategic differentiator. Modernizing the call center isn’t just about operational function, but it allows healthcare organizations to see and engage with their patients. Patients should not have to wait months to be seen because there’s not enough support. The call center represents the largest volume of patient interaction compared with any other department of the hospital. That’s why this matters now.

Optimized care centers also have proven ROI. They can reduce emergency department readmissions. If a patient is discharged from the ED and comes back for the same concern within a month, insurance might not pay for that new visit, and the hospital may have to absorb the cost. An effective care center can help with patient outreach to reduce readmissions, which can also result in lower provider burnout.

The Difference Between the Call Center and Care Center

In a traditional call center or contact center, staff rely on a legacy phone system that routes calls manually through extensions. There are no integrated systems and no data captured beyond the call log. Getting information about the call means relying on the operator’s documentation. Ticketing is manual, as are agent transfers. The call center doesn’t have access to clinical systems such as the electronic health record (EHR), meaning that it can take staff longer to answer questions. 

The Level 1 call center is reactive, manual and voice centric. Ultimately, the healthcare organization doesn’t see it as a business value driver.

A Level 5 care center, on the other hand, is predictive, omnichannel and experience oriented. It has a fully orchestrated digital ecosystem including an integrated customer relationship management (CRM) system, EHR, AI and analytics. These tools allow staff to access the data needed when they need it.

The omnichannel portion means that there are multiple ways for patients to be helped, whether it’s self-help, a chatbot or a phone call. With integrated analytics, the healthcare organization can staff up or down based on anticipated call volume.

In short, a care center is an enterprise strategy that is completely aligned with the patient digital experience and facilities access to care. Since it’s focused on care outcomes and plays a major role in the patient experience, CEOs and boards begin to care about it and the value it brings the health system.

CHECK IT OUT: CDW's latest research report dives into how to build a frictionless enterprise.

What Technologies Are Needed for a Successful Care Center? 

There are several tools healthcare organizations should have in place to create a true care center. First is the actual telecommunications platform. There must be multiple ways for people to access the health system to engage in two-way communication: phone call, text messaging, chat, email or patient portal messaging. Intent detection and intelligent routing should be baked into those communication methods.

CRM and EHR integration play an important role in the predictive nature of a care center. The CRM helps manage outreach campaigns and social determinants of health tracking. It can also track patient preferences and communication consent, whereas the EHR enables staff to do scheduling, referral intake and eligibility and benefits verification. This can be useful if a patient calls to ask questions about whether generic medications are available. 

A unified data platform provides real-time data ingestion from the EHR and CRM. It can make identity resolution more efficient by creating a single, trusted profile. It also provides a longitudinal patient record, which tracks patient journeys over time, from first contact to ongoing care. These platforms also track triggers for outreach such as missed appointments, care gaps or ED visits, reducing manual intervention and increasing speed to action.

Interest in AI and automation is growing in healthcare, and call center use cases are among the most adopted. Natural language processing can be used for intent recognition in calls and chats. Predictive routing then gets the patient in contact with the appropriate person. Virtual agents can automate rote tasks, such as prior authorization workflows.

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Organizations also need to be mindful of how they are integrating care navigation and coordination into the care center. Enabling real-time collaboration with clinicians is key to meeting patient needs. For example, if a patient calls to ask if it’s ok to eat before a procedure, the contact center staff member needs to be able to connect with a clinician on the care team in real time to respond quickly, and that interaction needs to be documented.

Patient self-service is another important aspect of an effective care center. Patients should be able to schedule or reschedule their own appointments, pay bills, conduct previsit check-ins, upload documents and access referral status updates, lab or imaging results, and FAQs. Some people may still want to talk to a human being, but many would rather handle these tasks on their own time and at their own pace, assuming they’re getting the answers they need.

With all these different tools and processes in place, healthcare organizations must be able to measure their effectiveness. That’s where analytics and reporting come in. The data can show clinical deflection, or how much time a doctor gained back in a day because an operator had the tools and training to resolve the issue. This information can also be translated into dollars earned; if a doctor had more time during the day, that time could be spent on patient care, which translates to revenue for the health system. Those analytics represent an evolution from the traditional abandonment rate measured in a call center.

While not a patient-facing part of the puzzle, security, governance and compliance are equally important for a successful care center. Identity and access management, secure communication channels, protected health information–safe AI models, consent management, and role-based access to EHR and CRM data should all be accounted for in the care center.

READ MORE: Modernize healthcare contact centers for staff and patients.

How Can Healthcare Organizations Transition to a Care Center?

To make the transition from a call center or contact center to a care center, the organization must appreciate that there is more to it than a reactive approach to incoming calls. Rather, a care center should align with the health system’s clinical and financial goals for upcoming years. Does the health system want to achieve growth in ambulatory services, pediatrics, surgical services or the ER?

Second, what components of the operations are done today by more highly paid staff, such as doctors, nurses or pharmacists? This could even apply to people responding to insurance claims in the business center or taking care of billing in the back office. It’s important to identify the repetitive tasks done by people in these roles and determine whether they could be handled through automation or by an operator in a care center.

The last piece is figuring out what can be done better through technology. How can technology help make the operator more efficient.

The Importance of Partnership in the Care Center Journey

Healthcare organizations don’t have to modernize their call center alone. Working with a technology partner such as CDW gives them access to strategists with decades of healthcare technology leadership who understand the context of managing IT in a hospital.

CDW is also business- and clinical outcome-focused. We also have expertise in each of the areas mentioned above, from the CRM and EHR to governance and security. It’s not just one person involved in the process. 

As healthcare organizations consider how to optimize their contact centers, CDW can help guide the process to ensure workflows and technology are best configured to support health systems in meeting clinical and business goals.

This article is part of HealthTech’s MonITor blog series.