Laura Clemons

Improving Patient Experiences and Reducing Cost Through Process and Technology: A Case Study

by Laura Clemons | Apr 29, 2021
Prior to the pandemic, the University of Miami Medical System was experiencing a surge in ambulatory and acute care visits. The contact center in place was developed more than 10 years prior to these circumstances and therefore not designed to accommodate the over 1500 healthcare providers and their respective patient networks effectively and efficiently on a yearly basis. Consequently, the UM Medical Center's annual capital outlay for the additional hardware and required software upgrades in order to achieve minimum standards in its mass patient communications and appointment setting systems was in the millions of dollars. The consensus among the UM Medical Center administration was that this expenditure was excessive in light of an ever-increasing call abandonment rate and average call-wait time, and the percentage of no-show appointments showing no improvement for a number of years. As one of the country's top academic medical centers, the need to re-evaluate its contact center operations to optimize communications between patients and providers was well apparent.


The solution required the UM Medical Center administration to engage outside professionals, Precision Point Partners (P3), in the evaluation and redesign of the existing contact communication systems and processes, and the implementation of streamlined technological solutions such as Voice, Omnichannel and integrated SMS (short message service). Identifying and evaluating the elements of successful medical contact communication systems included focus on positively impacting the patient experience and developing a comprehensive understanding of the potential cost savings. Several elements were readily established as integral to an effective redesign: 

1. Development of robust remote work capability processes and training.
2. Driving efficient workforce management in areas such as scheduling, RTA (real-time adherence) and forecasting.
3. Implementing a comprehensive quality-control management strategy via coaches and coaching agents.
4. Providing advanced voice appointment reminders through SMS.
5. Initiating a well-defined performance management structure, utilizing analytics to drive positive behaviors and outcomes.

The University leaned on P3 to spearhead the RFP process, recommend the finalists, and manage the transition from on premise to Contact Center as a Service (CCaaS) implementation, including developing new processes, training, Quality and Workforce Management. UM's internal resources stayed focused on current needs to minimize any gap in service delivery during this time. 

Pre-Pandemic Results
The build of a cloud-based CCaaS system provided immediate relief from the challenges that were negatively impacting the patient experience and the increasing costs arising from call abandonment and no-show appointments. An integrated EPIC EHR and NICE inContact platform allowed for an effective migration from UM Medical Center's outdated contact communications system.  

Many other benefits came from the migration to this cloud-based system. The P3 team integrated a Workforce Management platform that improved forecasting, scheduling and performance management processes, resulting in a 13 percent improvement of agent utilization.

In addition, the team implemented a text to chat to voice component. This was important to the overall experience because a patient’s response to a text could now be converted to asynchronous chat. This allows agents to chat from the NICE inContact platform while the patient is on a mobile device.

This overall implementation led to a cost reduction of over 30 percent in the first year. Additionally, average handle time (AHT) was reduced by approximately 25 percent within the first 6 months of the deployment.  In addition, abandon rates were reduced by astonishing numbers, and average speed of answer improved greatly. These metrics delivered the strong ROI that the University was looking for and truly elevated the patient experience exponentially.  

And Then There Was COVID
It was extremely forward thinking of this organization to begin their digital transformation well ahead of the pandemic. According to Deloitte, business entities’ digital forecasts and planning have leap-frogged three to five years from where they were pre-COVID. These accelerated investments in IT are providing the opportunity to help organizations investigate and analyze the pivot from a pre-COVID existence to the current COVID reality, and the post-COVID future. 

The foundation for the University of Miami was in place, and the pandemic underscored the importance of this strong base.

The move to a work from home environment developed from this spontaneous emergency need required an immediate reaction. Although the foundation was properly set, the University needed to evaluate if it had the correct tools- people, process, and technology- in place, to drive the work at home environment and optimize the experience. 

Operating in a cloud-based environment eased the execution challenge when they needed to pivot from a brick-and-mortar facility to a work at home environment. Call center agents were able to log on to their systems with a laptop that had a Google Chrome browser. The cloud-based solution provided them access to a secure (certified under federal guidelines) web RTC environment (Real Time Communications) via a NICE inContact platform integrated with an EPIC EHR system, and a virtual phone on their laptop. This replaced the usual VPN (Virtual Private Network) environment and ensured that they will always operate with the most up-to-date, secure solution as long as a strong internet connection is accessible.

When the University of Miami moved their 1,000+ agents to a work at home model, so did the rest of the world. The University of Miami did not lose ONE call during this time. 

The strain on internet bandwidth was a very real problem at the beginning of the pandemic. By operating in a cloud-based environment, they had multiple data centers, fully replicated from one another, establishing data redundancy through these various secure locations. This allowed for real-time data back-up. In the eventuality of an internet interruptions, they had back-up DSL connections as local redundancies and emergency options.

Telehealth considerations were included in the first phase of the project, but no one could have predicted their true value until the pandemic struck. Systems were established to send Telehealth patients reminders 15 minutes prior to their appointment, register them, and place them in a virtual waiting room. The system informed the provider that the patient was ready for their appointment. Both the patient and provider communications are delivered using the APIs provided by the SMS solution implemented pre-pandemic. This system allowed for an incredibly seamless transition in the Spring of 2020 when the vast majority of appointments moved to this telehealth model, giving more patients life-saving access to their providers through this operational efficiency. 

UM Associate Vice President, Cary Danner commented, “COVID-19 brought many challenges to the healthcare industry. Moving all our agents away from the contact center was not one of them. Together with the P3 team we were able to transition hundreds of agents to their homes in less than 72 hours without service interruptions to our patients.”

Once the switch was made to a work at home environment with a reasonable amount of success, it became imperative to take a step back and regain proactive footing rather than remain in a reactionary stance. This included reengineering some of their standing practices to ensure they aligned well with this new work from home model, as well as other training, culture, and patience experience enhancements that were identified as part of the world's new normal.

Miguel Ramos, P3 President, added, “The project with UM was a great example of timely innovation that made a huge impact for every aspect of the patient journey, and a great model for exemplary  contact center performance for healthcare systems to follow.”  

What's next? Further enhancements in Cybersecurity, more complex call routing given the number of provider specialties, advanced speech recognition and Chatbots to provide a seamless transition from traditional touch tone routing, increasing routing accuracy and greater patient satisfaction.

Life will never be the same for any human on this planet after this pandemic, and healthcare contact center leaders know this better than anyone. A revised standard has been set for patient communications in this new world we are living in, and the importance of maintaining superior communication flows into and within medical systems will remain a top priority for the near and distant future. The University of Miami Health System team continues to experience the benefits of their forward-thinking investments into the call center. These investments in operational efficiency are providing unimaginable value as they navigate the vaccine rollout to their patients, serving patients, providers, and their community at large—an invaluable benefit. 

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