It is no secret that many healthcare organizations were on a long trajectory to evolve into digital-first companies, operationally and strategically. Transforming the member and patient experience with digital innovation was considered a necessary investment for a somewhat distant future. The COVID-19 pandemic has shown healthcare leaders that the future is now. Nearly overnight, the digital needs of members and patients have been dramatically accelerated. And many questions remain about the future of healthcare CX and what it will entail.
Sheila Curr, general vice president of healthcare at TTEC, and Tim Keefe, client partner at TTEC, share their insights into the trends that were spurred by the coronavirus that are reshaping the healthcare landscape and what is needed to meet the needs of members and patients in a new reality.
JA: What were the CX priorities of healthcare organizations before the pandemic and what was the mindset in terms of digital experiences?
Sheila Curr: Prior to the pandemic happening, the mindset was really around the basic minimums around meeting members’ or patients’ immediate [digital] requirements or needs. Post pandemic, we've seen a big change in that process. There is much more emphasis around wellness—both mentally and physically—for their patients and for their members and the ability to show empathy across those digital channels.
Tim Keefe: Prior to the pandemic, many of the electronic channels or digital channels were still really viewed as new or we're getting there, or that's kind of next phase of development. Suddenly, of course, we had to go from, you know dominant inbound voice contacts into traditional call centers to essentially everybody's working from home. People are coming into hospitals, people are avoiding clinics and all of these electronic channels and remote and virtual tools went from nice to have to essential to your business. And I think that's really the amazing social experiment that we're seeing here, which is how are these things going to carry forward into the new world?
JA: In terms of making fast adjustments in response to the pandemic, what worked and what didn’t?
TK: Well, I think we saw a lot of companies where their basic culture was reflected in how they responded to the pandemic. Companies that had a culture that was agile and rapid to assess problems and make decisions have done reasonably well. To speak specifically to our capabilities at TTEC, we moved over 30,000 people from center-based work to at-home in two weeks, which is, I mean, that's a phenomenal effort by any organization. But it would not have been possible if we didn't already have a culture of agile thinking and had demonstrated the capability to support at-home employees for very long time. It's been a significant part of our business for at least a decade.
And then the other the other piece of it, of course, is we had competitors and in some of our clients that did not have that flexible environment; did not have that forward-looking business continuity planning and they've suffered quite a bit. And we know we're jumping in to help them wherever we can. But it really is interesting to see how organizational culture and core leadership values show up in events like this.
JA: What do you see changing moving forward?
SC: Well, I think we've seen a huge shift from the regulatory mindset of healthcare providers previously to the fact that it had to be brick and mortar, and there was nothing outside of brick and mortar that they would feel comfortable with. This has been a great social experiment, not just in how we service our clients, but how our clients service their members. I don't think they thought that we would be at a point where we are now talking about bringing a lot of their business to work at home—not just the business that we moved, but new business that they're bringing to us. I think it's a monumental shift in the way our clients think about the business and think about how to service their patients or their members.
TK: You know what happens in a crisis often is that rules are allowed to be bent or sometimes, really revisited in terms of how they're looked at. And I think some of the policies that have been written over the past decade 15 years around HIPAA and private health information, while coming from a point of great security, also now have to be flexible. For example, there is going to be new movement for online security to move toward asynchronous communication channels that are encrypted end-to-end to allow for more effective remote or virtual telehealth programs or tele-wellness programs.
But there's also, I think, now really a sea change in, for example, telephone appointments or video appointments, which were kind of early phase for many practitioners. We’re just starting to get to a point where the insurance companies would pay for those appointments and pay for those events that are now going to be the norm.
Also, leveraging commercially available medical devices like Apple Watch capabilities to help primary care physicians work more effectively with a patient or a member who they will see much less often. So I think there are some very, very fascinating changes. And then with that come in some ways, new opportunities and new work that has to be done in support of the pandemic and I think we'll go beyond that, such as the whole tracing program, etc.
JA: What types of demands do clients have about being able to rapidly scale contact tracing and testing?
SC: There's a lot of demand out there. We have roughly 300 million folks in the U.S. and currently in the marketplace. There's roughly about 150 million tests with that we have multiple layers of how to get that testing out to the individuals who need it. We have a couple of clients that we're talking to around doing appointment setting within their retail stores. In addition to that, you have the three biggest states by population, California, Texas, and Florida also doing free testing within certain counties in their states. So, there's a broad range of how do we test and, by extension, how do we track for people that are test positive? How do we track?
There are two schools of thought around that. The first one is tracking through a digital mobile app in the respect that there is outreach to all of the people who a patient has come into contact with there's verification done digitally. That's one process. And there are certainly a lot of folks looking at that process.
There's also some technology that's out there from different companies, Google being one of them. But in addition to that, there is a school of thought that these are very complex situations and there's a lot of discussion that needs to be had with these individuals as opposed to taking a five questionnaire test on a mobile application. So, our company is talking to both sides, both from a digital standpoint and from, how can we help to do that tracking and tracing when in the more complex format in a call center environment?
JA: Another hot area is what to do about healthcare fraud. Tim, what are you seeing in terms of what companies can do to combat it moving forward?
TK: There are a variety of things that fit into the fraud management perspective and these are no different than a lot of the work that chief information security people have been pushing for years. But one of the things is, are there technologies that can better identify or match a caller or a contact digital or voice that I can absolutely be assured that this is who they say they are?
We're moving beyond passwords and PINs into voice biometrics or tools that leverage the biometrics off the originating device like an iPhone or an Android phone. There are tools that also monitor the communication between an agent and a caller and generally use algorithms to identify patterns that could be flags for potential fraud or abuse of a particular program. Some of this is involves mapping caller information like IP addresses or phone numbers back in the bad actor databases. So it's a combination of direct technology and indirect technology like a bad actor and database checking. Also, another component of it is strong training for the individuals who are working with people to identify fraudulent behavior like social engineering, attempted phishing, etc.
JA: What impacts are you seeing in health insurance enrollment?
SC: Well, health insurance enrollment is still a concern for our clients. Health insurance enrollment may be smaller than what it typically is for the season this year. And there are a few factors that are impacting that. First of all, we're at roughly 30% unemployment in this country. It now impacts not just the individual on an exchange for small business owners or individual consultants that are not employed by a company, but it also impacts both small and large group enrollment. So we are having conversations around what that will look like.
Interesting enough, we believe that open enrollment for group and individual groups will probably be much smaller than what we've seen in previous years. There will definitely be an impact to it. We do think, however, that from trends that we're seeing that Medicare actually might have an uptick and that is consistent from what we're hearing from a couple of our clients as well.
JA: What will the healthcare landscape look like moving forward?
SC: We are currently talking to all of our customers as far as what their roadmap looks like. And it is changing on a daily basis as we moved all of our clients to work at home, and we literally emptied out our call centers and our brick and mortar sites. Our thought was there will be a period of time in that we would have them at work at home and the clients’ expectation would be, “Okay, let's get back into brick and mortar.”
There's been a few of our clients who have already talked about when do we start the thought process around bringing it back in house. But I would say the vast majority have gone the other way, they're asking us to build out plans for bringing their business potentially 100% work at home ongoing. I think there is a lot of fear, across the board, within the industry of how long the pandemic will last.
And as we know that will be attributed to testing, but also attributed to having the ability to get the testing done and also having the ability to have a vaccine. Depending on who we listen to, the vaccine is anywhere from 18 months to five years out. So I think the goal now for most of our clients is to look forward to ensure that they have continuity in their business. So, to Tim's point earlier, I believe that the mindset of our clients is changing. They are now looking at this as a viable option for ongoing service. They are opening up budgets to engage technology to expand those capabilities for work at home service.