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Healthcare CX's New Reality: What to Expect

May 7, 2020

How will healthcare CX evolve in a world that’s been changed by the coronavirus? TTEC’s healthcare CX experts Sheila Curr and Tim Keefe share insights on opportunities for healthcare organizations to better meet their members’ and patients’ needs from a digital-first approach. They also discuss strategies for quickly scaling contact tracing and testing efforts as well as combatting healthcare fraud.


Key Takeaways

  • More and more healthcare organizations are planning to make telecommuting a permanent part of the workplace.
  • New skill sets and training requirements are being asked of agents that will last beyond the pandemic.
  • Health insurance companies are bracing for a sharp reduction in open enrollment rates while preparing for a potential uptick in Medicare enrollment.


Judith Aquino: Welcome to the CX pod, I'm Judith Aquino and today we'll be talking about the customer experience in healthcare. What does healthcare look like in a world that's been changed by the coronavirus and what can healthcare organizations do to support their members and patients moving forward? Joining me in this discussion are Sheila Curr, general vice president of healthcare at TTEC, and Tim Keefe, client partner, also at TTEC. Thank you both for speaking with me.

Sheila Curr: Thank you, Judith.

Tim Keefe: Judith. Happy to be here.

JA: So I'd like to start with talking about what things were like before the pandemic started. Sheila, what would you say the CX priorities were of healthcare organizations before the pandemic and what was the mindset in terms of digital experiences?

SC: Yes, thank you. Prior to the pandemic happening the mindset was really around the I would say the basic minimums around meeting their members or patients immediate requirements or needs. Post pandemic, we've seen a big change in that process. There is much more emphasis around the wellness both mentally and physically for their patients and for their members and the ability to show empathy across those digital channels.

JA: So making a human connection has become more important.

SC: Exactly, yes.

JA: And Tim is there anything you'd like to add?

TK: And again, I think this would be reinforcing what Sheila was just saying I think 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 and then suddenly, of course, we had to go from, you know dominant inbound voice contacts into traditional call centers to what and of course of 48 hours essentially suddenly everybody's working from home.

People are coming into hospitals, people are avoiding clinics and suddenly 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, but it was a dramatic change.

JA: Can you talk more about that, about in terms of transitioning to more electronic channels. What worked really well and what could use more work?

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 really phenomenal effort by any organization, but 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, you know, 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's, it really is interesting to see how organizational culture and core leadership values show up in events like this.

JA: So one of the things that has often been said about healthcare is how it's such a highly regulated industry that companies are slow to move on adopting change and digital transformation. So I'm curious, what do you see changing moving forward and what areas are healthcare organizations likely to continue to be more flexible around?

SC: Well, I think we've seen a huge shift from the regulatory mindset of health care 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 as Tim has said.

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.

As Tim said based on some of the competitive landscape changing and some of those folks either shutting down facilities, that we have a few companies that may not be here at the end of this. So 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, you know, 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 flex. So there is going to be new movement for its online security to move towards an asynchronous communication channels that are encrypted end-to-end to allow for more effective remote or virtual telehealth programs or telewellness programs.

I think we've all experienced that ourselves in our day to day lives over the last five weeks or seven weeks it's been that we've veen in shelter in place in California. And you think about things that really had become the new normal in a very short period of time.

The elements of that are specifically related to the pandemic and we'll talk more about that in a few minutes. But there's also, I think, now really a sea change where, 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.

Leveraging commercially available medical devices like Apple Watch capabilities to help primary care physicians work more effectively with a patient or a member that they will see much less often. So I think there is some very, very fascinating changes there 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: Right and so speaking of that, I'd love to hear more about what you're both seeing out there. Let's start with contact tracing. What types of demand or effort are you hearing about from clients to be able to rapidly scale contact tracing?

SC: There's a lot of demand out there. As you know, this plays into not just the contact tracing but testing and how to get testing out into the marketplace quickly. We have roughly 300 million folks in the US 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 that need it. We have a couple of clients that we're talking to around doing appointment setting within their retail stores.

Because now, as of April eighth, the National Health Association has provided access to pharmacy retail organizations to order the test directly, they did not have that ability to do that, prior to April 8. With that it comes the challenge of do you have 500 people walk into a retail store to get tested.

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 Judith.

The first one is tracking through a digital mobile app in the respect that there's a reach out to all of the people that 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 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, 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: And when it comes to training how extensive is that how much do people need in order to be a high functioning associate?

SC: I believe it will be a very different skill set than some of the programs that we currently have today, it will be a lot of coaching and counseling of the patient to extract that information. We are still building out those requirements, this is fairly new, as we all know it's really come to the forefront within the last two to three weeks. So we will be developing those skill sets and requirements over the next week or two, but it is a much more complex and longer phone engagement, than we would typically do on some of our programs.

JA: So another I guess hot area is what to do about health care fraud. Tim, what are you seeing in terms of what companies can do to combat it moving forward?

TK: Yeah, so fraud has obviously been a growing problem in a number of industries and with healthcare now and $3 billion of money being poured into the economy, you can just imagine the amount of bad actors that are jumping and trying to take advantage of that.

So, you know, 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.

You know, 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. The other big thing of course is the same tools are there. 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, you know, caller information like IP addresses or caller 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 and also another component of it is strong training for the individuals that are working with people to identify fraudulent behavior social engineering attempt phishing, etc.

So it's, it's got to be three pronged. And it's got to be constantly reinforced and I think the problem is going to get bigger before it gets in smaller with this, but it's one of the things that we take a lot of pride in that we want to allow technology to fill in the blanks for our for our agents, but we also train our agents very well to fill in the blanks for technology.

JA: Right. It sounds like another example of something that started out as maybe a temporary digital fix that now is going to become mainstream.

TK: Yeah, very, very true. And I think we've got a lot of experience with it. And, you know, unfortunately, and the financial services clients that we serve, because this has been a huge problem for them for many, many years and we've worked with them to build programs that leverage both human and technology solutions to reduce fraud dramatically.

JA: And so I want to go back to just talking a little bit more about what will the healthcare landscape, in terms of CX, look like moving forward. Sheila, what would you say some of the key takeaways should be?

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 how do we look forward to ensure that we have continuity in our business?

I'm looking into the landscape and not knowing where it will be, so right now I think the approach will be let's look at a work at home environment. Let's look at perhaps enhancing technologies around that work and home environment and how that experience will impact either their members or their patients. TTEC has done a phenomenal job of moving business to work at home and really not having any hiccups through that process.

So to Tim's point earlier, I believe that the mindset of our clients are 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.

JA: And since what you said just reminded me, in terms of mindsets changing, is it changing fast enough for safe health insurance enrollment?

SC: Well, health insurance enrollment is still a concern for our clients and for us here at TTEC. Health insurance enrollment may be smaller than what it typically is for the season this year. And there's 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 both groups, small and large 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: Oh, interesting. And I guess time will tell.

SC: Exactly. We wish we had a crystal ball to forecast. We are all trying to figure it out in this new world.

JA: And Tim, what key takeaways would you say our listeners should come away with?

TK: Well the biggest ones are, you know, things that were considered future activities like higher digital engagement work at home and more effective self-service and bot driven programs are now the mainstream very suddenly.

And I think what all of our clients need to do is recognize that this is here to stay. How can they step in and take advantage of the situation? There are positives, right, we're reducing some of our overhead for running our business, are giving employees now more flexible staffing models and where they can live versus where they work.

These can all be great ways for us to improve the quality of the teams that serve our members. And then as we leverage the digital channels, we have this opportunity to not only bring on members in a more effective educated way leveraging, you know, highly proactive, highly personalized engagement, but also from the membership behavior as well and moving more toward wellness and ongoing engagement.

I think one of the really interesting things is the number of “I just want to check in on you” emails that are coming out from almost everybody, right, from within my own employer, and from vendors that I do a lot of business with.

And I think some of that will stay, and that we are really going to shift to, again, a community catering model. And I'm not trying to be political here. But when I, when I say that, I don't think it's 100% of the world. But I think a lot of people stepped up and showed their true colors with what's been going on. And these are the people who show up every day to deliver food. And these are mostly minimum wage people and the people that get out and bang on the pots and pans every night at seven o'clock to say thank you.

So that's the community that I think we need to be aware of. And that's the community that if there's a positive out of all of this that has come so much to light.

SC: And if I could add to that quickly, our clients are now coming to us and asking us to be trusted advisors in helping them with their business strategies throughout COVID and I think it will ultimately make stronger partnerships for TTEC and our clients going forward. So to Tim's point, there's a lot of goodness, you know, coming out of the silver lining of this pandemic.

JA: Right. Yeah, it really sounds like we're suddenly entering this new reality, but it's good to know that there are a lot Of opportunities and a lot to be hopeful about.

SC: Absolutely.

TK: Agreed.

JA: Just to let our listeners know you can find more information about what Tim and Sheila were discussing in our Strategy Guide, “Healthcare Experience Moves Home,” which is on our website TTEC.com. Thank you both so much for your insights.

SC: Thank you.

TK: Thank you for the opportunity.