Category: Industries

Category: Industries
West Corporation

Posted on August 17, 2015 by West Corporation 

The Call Center is Your Front Door

Imagine for a moment that you are a patient at your own health system, and you want to schedule an appointment, ask a question about your treatment plan, or request a referral. Visit the contact page of your health system’s website. What do you see?

Some of you will find a general 800 number that either routes you to one of those byzantine automated selection menus or leads to a call service rep or central operator who doesn’t know who you are, what you need, or how to route your query. Others will be faced by a webpage filled with a dense collection of numbers for a myriad of departments, professional practices, and clinics, leaving you overwhelmed and confused about who to call for what.

Now, pick up the phone and see if you get the information you need on the first try…

The point of this thought experiment is that you as a health system have made considerable financial investments in technology and training in order to create a patient-centric healthcare experience that provides excellent healthcare services spanning the continuum of care, but thanks to call center quagmires your patients are frustrated and dissatisfied before they even walk through the door.

Patient access centers are legitimate business departments and have an important role to play in the transition to value-based, patient-centric care. They have the potential to create new streams of revenue. They can engender loyalty to your brand. Most importantly, access centers are a critical first impression that ultimately determines whether a patient chooses to purchase healthcare services from your system.

Unfortunately, for too many health systems, access centers are an afterthought — or worse, completely neglected.

Patients are Consumers

Just like you, your health system’s patients are consumers who shop at Amazon, purchase airline tickets, and stay at hotels for business and pleasure. They’ve grown accustomed to a concierge-level of customer service, and this has altered their perceptions of what a high-quality healthcare experience should look like. The retail world has decades of experience with providing this level of service, and have leveraged modern technology to make constant improvements to help differentiate their brand, as well as retain and grow their customer base. The healthcare industry is just starting to catch on—not just because it makes good business sense, but also because they are now being incented/penalized to implement value-based care throughout the patient experience.

The modern healthcare consumer has more choices than ever before, and are seeking long-term relationships with their providers. The trick for health systems is finding an efficient and cost-effective way of:

  • Properly routing inbound calls using an intelligent, data-accessible system (patient-to-provider);
  • Determining patient communication preferences for outbound contacts (provider-to-patient).

‘Predictive Intent’

Hospitals and health systems have been doing scheduling and automated appointment reminders for years. However, these transactions only account for 20 to 30 percent of inbound and outbound calls.

The model patient access center should be doing a lot more than that. Your access center should drive revenue and patient satisfaction; reduce no-shows and time spent by caregivers on reaching patients; and eliminate the need for patients to fish around for answers to their questions.
If your airline carrier knows your preferred seating arrangement and upcoming flights; if your hotel’s concierge knows your preferred floor and newspaper, then why doesn’t your health system have access to patient data as soon as they call?

After authentication of the patient’s identity, an intelligent patient access platform should have, based on the health system’s defined business rules, real-time access to:

  • Upcoming and past appointments
  • Education and patient record materials in the system’s EMR and patient portal
  • Intelligent routing to be best available advocate, scheduling agent, care coordinator or case manager, based on patient data and what is known about that patient at that point in time
  • The patients’ preferred modes of communication (landline, mobile phone, text, e-mail, etc.)

Even if you don’t leverage live call center representatives, forget about automated menu options. Intelligent access platforms can emulate a live agent for many of these basic functions, leaving live agents to handle the more complex transactions, allowing them to maximize their value to your organizations and to the patients / providers they engage each day.

The goal of contact centers should be to make the patient experience as easy as possible through both personalization and self-service—striving for that perfect balance between automation and a live, human-touch interaction.

Your health system has invested considerable time, energy and money to provide value across the continuum of care. Why squander it over a bad first impression? The nature of each patient call may vary, but everyone is essentially asking one of two questions: will patients buy healthcare from your system or will thye buy healthcare again from your health system?

West Corporation

Posted on August 13, 2015 by West Corporation 

The new healthcare paradigm: “Think Whole Person”

The climate of healthcare is changing. The industry is moving away from the provider-centered approaches of the past to a more ardently patient-centered paradigm that is spreading fast in clinics and hospitals across the U.S. The passage of the Affordable Care Act and new Medicare reimbursement standards from CMS have set a new direction for care delivery aimed at improving patient experience and health.

One good example of this trend is in Omaha, Nebraska where West Corporation is headquartered. A new physician-led practice called “Think Whole Person Healthcare” has recently been launched. The aim is to increase access to services and boost the patient experience while cutting the overall cost of care. The founders recognize that caring for a whole person requires much more than just a single doctor and, thus, have assembled teams of healthcare professionals who work alongside the physician to support their patients. The healthcare teams include pharmacists, physical therapists, nutritionists, case managers and others who coordinate to optimize all facets of the patient’s health. The facility is open extended hours, with some services available 24 hours, seven days a week. Teams function under one clinical leader and strive to deliver the highest quality outcomes.

This is a fascinating model of bringing everything a patient needs into one location. No more driving around town to get needed tests, to see different doctors or to pick up prescriptions. Everything and everyone you are likely to need are co-located in one building.

As the customer engagement model across this entire industry shifts, patients increasingly have an unprecedented amount of control over the way they find, acquire, access and value healthcare benefits and services. This shift is resulting in the “new healthcare consumer,” and those organizations that fail to provide a superior experience are at risk of getting left behind.

Even CMS recognizes the value of treating patients as consumers to improve experience and outcomes. There are several newly released billing codes, including those for Chronic Care Management and Transition Care Management, that now reimburse providers for patient care delivered outside clinical setting. With nearly half of all American adults suffering from chronic health conditions, delivering patient-centered, holistic care beyond the four walls will be critical to the long-term success of healthcare, and an organization’s ability to coordinate and orchestrate patient communications will be a key component of that success.

Whether inside a facility like “Think” or outside the four walls of the doctor’s office, the healthcare industry is experiencing the birth of a new paradigm. The focus on managing patients as customers means better care, improved quality outcomes, increased convenience and better overall patient experience.

To learn more about the West Engagement Center and other solutions focused on patient experience, visit the Healthcare section of the Website.

West Corporation

Posted on August 10, 2015 by West Corporation 

How do you connect with 67.2M people?

Just ask companies that partner with West. In the last month alone, they made 293.5 million automated connections with 67.2 million unique customers.

From these quickly resolved inbound calls to the IVR, to proactive voice and SMS/text notifications, customers got information they needed. They got it faster, on the devices they chose, and at the times most convenient for them.

It was easy for these 67.2 million customers to check order status, bill balance and hours of the nearest facility; prescription refill reminders, back-to-school updates, insurance claim progress notifications and severe weather alerts reached them at the perfect moments. These brands know what their audiences want, and used that knowledge to deliver a better customer experience.

But you know your customers, too, so, what’s the difference between their brands and yours? They show it.

Gathering preferences, predicting activity based on historical behaviors, recognizing natural language, relying on customers to provide their information as few times as possible, sharing visibility of customer interactions across multiple channels and business functions, issuing replies at appropriate times, and using data to make continuous improvements…

Intelligently integrated communication solutions can help you show customers that your brand is on their side. You share their sense of urgency, anticipate their needs, and want to engage on their turf. You are there for them and only them. And, along the way, you gain a business ally that helps save your business a boatload of time and money.

Imagine what your brand could do, listening to what your customers are thinking… Watch this video.

As if they’re reading our minds, “Delivering Great Customer Experiences at the Speed of Digital Business” is the theme of this year’s Gartner Customer 360 Summit. West will be there in San Diego, September 9-11th, delivering a presentation with American Express. Be sure to connect with us. #ExperienceConnected

West Corporation

Posted on July 29, 2015 by West Corporation 

Interoperable Sensors: The Key to Chronic Care Management

The subject of Chronic Care Management is getting a lot of attention these days, and for good reason. With the adoption of the Affordable Care Act and new Medicare reimbursement standards from CMS, the industry is moving away from traditional fee-for-service toward a more encompassing fee-for-value model.

As the management of the chronically ill transitions away from clinics and hospitals to become increasingly home-based, the use of electronic sensors that collect biometric data will be crucial for the next generation of Chronic Care Management. Devices like blood pressure cuffs, glucometers, and weight scales all can be equipped with wireless remote sensors that capture biometric readings and send them to a system that can then act upon the data; automatically issuing alarms and instructions if readings are out of range.

But despite the available technology, the fact is that most patients today are asked to collect and report their readings manually. As a result, patients often include incorrect data; sometimes by mistake, but often deliberately to make their health appear better than it is. Biometric sensors can change all that by automating the collection of data and ensuring more accurate patient information.

Sensors make the collection of biometric data more accurate and reliable, but it will take a higher degree of device interoperability to make it work for high-risk patients and providers. Consider a chronically ill patient with COPD that is on oxygen at home. They must provide oxygen level readings via an oximeter, as well as blood pressure readings and their weight. The sensors are separate devices and do not talk to each other, requiring the patient to collect and communicate each bit of information manually.

We need better industry standards regarding sensor interoperability. That is why West supports The Center for Medical Interoperability, an organization working to accelerate the seamless exchange of healthcare data and sensor information. Organizations like the Commonwell Health Alliance are devoted to making health data available to patients, clinicians and providers regardless of where care is sought or given. Groups like Health Level Seven International are focused on developing standards for data exchange and interoperability in Healthcare.

Interoperability is crucial for next generation Chronic Care Management and at West we are doing our part. We help organizations to better activate and engage patients beyond the clinical setting through a unique combination of patient-based technologies focused on delivering solutions that solve complex communication challenges. When it comes to sensor interoperability our ultimate success industry-wide depends upon making advances on a number of related technical fronts, including medical devices, electronic health records and the technical infrastructures powering our health systems.

West Corporation

Posted on by West Corporation 

Applied Lessons: How West Can Teach Healthcare How to Talk to Patients

In both mHealth and telehealth, efforts at reducing cost, improving quality and driving better consumer experiences will be increasingly dependent on technology integration and a unified engagement experience across the continuum of care and all communications channels.

Unless organizations start coordinating patient engagement modalities from portals to video calls to geographically distributed human resources, investments in these and other technologies simply won’t pay off. Why? Because patients may well end up suffering “engagement fatigue” from being over contacted, or they’ll lose confidence and tune out due to redundant or irrelevant information or their inability to reach the right human when they need one.

How do we know this? History. Thanks to value-based care, patient experience executives in healthcare are thinking more like their counterparts in retail, travel and financial services. Five years ago, those industries woke up to consumers who had, among other things, started Tweeting customer service requests, often because they weren’t getting the service they expected when they dialed the company’s 800 number. Many consumers even began showing a preference for companies who had “an app for that.”

Consequently, companies created Twitter and Facebook accounts and staffed them with social-savvy customer service folks. They built mobile applications. In pretty short order, though, companies realized that in their effort to respond to consumer demands, they had essentially created stovepipes of uncoordinated consumer engagement. The result: disjointed, redundant and often inconsistent communication from the company. Not exactly the outcome they wanted.

While many companies are still grappling with the archaeological record of those technology decisions, some are getting it right and making good strides in connecting the dots between channels of engagement, while also working toward creating more unified engagement environments.

In one example, West worked with Vanderbilt to improve appointment confirmation rates across the voice and text channels, simply by allowing patients to indicate their preferred channel for receiving the notification. In another example, West helped Utah Spine Care achieve a 500% increase in patient Portal registrations through targeted messaging of patients with upcoming appointments.

And finally, West worked with a top US airline to architect a customer-centric contact center solution that leverages a Natural Language speech application to handle inbound calls, provides intelligent call routing across three geographically distributed contact centers, and provides a CTI screen pop to pass data from the voice response system to the agent desktop. The solution decreased call handle time by 9 percent, meaning customers were able to get the information they needed much more quickly, and call abandon rate decreased by 60%, meaning caller frustration plummeted because they had greater confidence that they would be able to get their needs met.

Our hope is that by sharing the experiences we have gained, we can help patient experience executives in healthcare avoid unnecessary pain and derive the full value of their patient engagement technology investments.

West Corporation

Posted on by West Corporation 

Encouraging Patient Accountability in Prevention and Wellness

In this brave new world of value-based healthcare delivery, hospitals and health systems are focused on prevention and wellness as one of the primary goals for improving health outcomes.

The problem: patients often don’t heed doctors’ advice for following preventive-focused lifestyle or treatment plans. According to the Healthy World Report, “A Fragile Nation in Poor Health,” 83 percent of people say they don’t do what their doctors tell them. Moreover, a mere five percent of doctors said they would give their patients an A grade for following through.

Many patients, however, want to do better, as almost 40 percent say they would follow doctors’ advice if they got some kind of reminder or nudge from those doctors between their visits. Basically, patients are saying, “I am having a really hard time doing this. But, I would do a better job sticking to it if my doctor helped by reminding me and encouraging me along the way.”

The solution: stop being reactive. Health systems can proactively engage patients, but they need a systematic approach to do so – one that helps them assess a patient’s risk level and automate personalized communications so they can engage more, if not all, of their patients on a regular basis. Engagement communications can take the form of automated phone calls, text messages or emails between visits to keep patients on track with their treatment plans, prompt them to refill prescriptions or remind them to schedule preventive screenings and keep already-scheduled appointments.

Activating patients for wellness and prevention is easier than it sounds. Ochsner Health System, for example, is using its appointment reminder system to engage and activate patients to get the colorectal cancer screenings their doctors have ordered. The strategy is simple: send an automated phone notification letting patients know they are eligible and remind them to schedule the test. The results are impressive. In just two months, Ochsner scheduled 578 colorectal test screenings. More importantly, since there is an expected 25 percent pre-cancerous polyp detection rate, an estimated 145 patients benefited from early detection as a result of these exams. Not surprisingly, patients expressed appreciation for this outreach, saying if they were not nudged or reminded, they would not have completed this important preventive test.

Take a page out of the Ochsner book and get started by leveraging automated technology to successfully prompt patients to schedule important preventive screenings. Like Ochsner, the majority of health systems already have appointment reminder systems in place. Taking your program to the next level is a simple matter of maximizing that technology to engage and empower patients to take a more proactive role in their own prevention and wellness. Don’t wait. Start where you are, use what you have and do what you can. When you take that approach, everyone wins.

West Corporation

Posted on by West Corporation 

How Chronic Care Management is Like Going to the Gym

For people with chronic health conditions like Diabetes, Alzheimer’s and Cardiovascular disease, taking care of your health and following your treatment plan can be a matter of life or death. But don’t feel like you are alone. Nearly half of all American adults — about 117 million people—suffer from one or more chronic health conditions and all of them struggle with the enduring health challenges.

Whether it’s adhering to your medications, monitoring your personal biometrics, or attending regular doctor visits, effectively managing chronic health conditions requires coordination and discipline. But it’s easy to slip. Here are a few of the common excuses: “I’m too busy”…”It’s not convenient”…”I try, but I lose interest.”

Sound familiar? It’s a lot like going to the gym. We all start with good intentions to work out regularly, but it’s easy to find an excuse to not go. We all know we need to exercise in order to lose weight, stay healthy and relieve stress, but to achieve those goals you’ve actually got to get up off of the couch and get active.

Personal trainers understand this basic human frailty when it comes to working out and staying healthy. As a result, a number of techniques are commonly used to keep folks engaged and actively working on their fitness goals. Finding a workout buddy, journaling your workouts, and setting goals and rewarding your accomplishments all work to motivate and activate.

Accountability is Key

These same strategies work in Chronic Care Management as well. And it all boils down to accountability. CMS recognizes the value of accountability and incentives. As our healthcare transitions to value based outcomes, the healthcare industry will benefit by utilizing many of the same strategies used in the weight management and fitness industry. The workout buddy becomes a Care Coordinator. Journaling workouts becomes journaling biometrics. Setting goals and monitoring progress becomes a Care Plan. And finally, the incentives and rewards become value based outcomes.

In this new model of healthcare, everyone wins, even physicians. CMS recently released the new CTP code 99490 that provides a financial incentive for physicians to take care of comorbidity patients outside of traditional office visits. The new code allows payment at an average of $40 per beneficiary per month for services performed for Medicare beneficiaries. The practice must implement an ongoing care plan and a clinical staff member must spend at least 20 minutes during a calendar month coordinating care and communicating with the patient.

Moving Forward

West Healthcare Practice has several tools and services available to help physicians and clinics take advantage of the new CMS reimbursement – like our technology enabled communications, automated notifications and case management tools, and supplemental services that make a difference. In whatever way you move forward, look for providers and partners with the right combination of capabilities, vision and experience that will help you employ meaningful strategies regarding Chronic Care Management and CPT 99490.

West Corporation

Posted on by West Corporation 

Challenges of Chronic Care Management Factored into CPT Code

Half of all American adults — about 117 million people—suffer from one or more chronic health conditions. Indeed, seven of the top 10 causes of death in the U.S. today are a result of chronic conditions like Diabetes, Alzheimer’s and Cardiovascular disease. As a result, Chronic Care Management (CCM) has taken the spotlight in the healthcare industry and new Medicare payment guidelines reflect the new focus on CCM.

CPT Code 99490

The Centers for Medicare and Medicaid Services (CMS) recognize CCM as a critical component of primary care that contributes to better patient health while reducing healthcare costs overall. So beginning in January 2015, CMS established CPT code 99490 as an incentive to foster CCM and to help cover the costs of chronic care management. The new code allows payment at an average of ~$40 per beneficiary per month for services performed for Medicare beneficiaries.

The good news is that CPT 99490 will significantly broaden Medicare payments for remote patient monitoring of chronic conditions. In order to be eligible the patient must have two or more significant chronic problems that pose a real risk to the patient’s health and well-being. The practice must implement an ongoing care plan that addresses these conditions, and a clinical staff member must spend at least 20 minutes during a calendar month coordinating care and communicating with the patient.

Historically, Medicare has provided limited coverage for this type of service and the new code could result in a profitable advantage for providers, especially smaller physician practices and / or community-based facilities that work with chronically ill patients. These providers now have a financial incentive to promote CCM among their constituents and to retain "control" over those patients; once they refer on to an enterprise healthcare system they stand to potentially lose control as the PCP.

But there is some bad news, too, which is that CPT 99490 may unwittingly provide a disincentive for larger enterprise healthcare organizations when it comes to CCM. Most hospitals and clinics are considered a “facility” and, therefore, are not eligible for payment under the new code. Complex billing systems can work around the red tape but it’s a nightmare to administer. The fact that many physicians are actually paid employees of the enterprise works to cloud the administrative waters even further. The truth is that it would be more profitable for these larger organizations to simply release the patient and readmit if/when the condition recurs.

Moving Forward

If your practice is a direct, patient-centered practice that is already providing case management for a group of chronically ill patients, you are in a great position to benefit from the new CPT 99490 code.

It will take more time to sort out the implications of the new code for larger enterprise organizations, however; and more thoughtful and technology-enabled strategies will be needed in order to use the code advantageously. In the meantime, look for providers and partners with the right combination of technologies, capabilities, vision and experience that will help you employ meaningful strategies regarding Chronic Care Management and CPT 99490.

West Corporation

Posted on by West Corporation 

Helping Patients Graduate to Good Health

With high school graduation season in full swing, many seniors are turning their attention to college. While most college freshman successfully make the transition, nearly a third don’t—many of those return home and create a sometimes stressful and financially burdensome situation for the family. Those students who fail to make the leap to college often underestimate the transition or don’t receive the right support to get there.

Making the Transition

Transitioning from high school to college is not unlike medical transitions of care. When patients are discharged from the hospital or other institutional setting, many handle the transition to self-care just fine. But one in five underestimate the transition and are readmitted within 30 days of discharge. For them, making the change from an environment where medications and meals are administered on schedule and visiting hours are structured around rest and recovery proves too difficult. Medication errors, missed follow-up appointments and gaps in self-care are all major contributors to readmission and higher costs.

Improved Transition Care Management

Readmission rates highlight the opportunity to improve the quality and effectiveness of Transition Care Management and reduce the cost of avoidable readmissions. One way to do that is to simply do more patient outreach after discharge. But that is not always easy, and only fairly recently has there been a financial incentive to do so. In October,2012, Medicare introduced “the stick” by levying hospital readmission penalties. Then, in January, 2013, Medicare applied “the carrot” by offering reimbursements to providers for eligible Transition Care Management services (in the range of $172.66 to $243.60) billed under CPT codes 99495 and 99496. And still, relatively few provider organizations are capitalizing on it.

Many practices lack the resources to perform even the most rudimentary transitional care activities. But over the last 24 months, companies like West have recognized the need in the market and are working hard to deliver solutions that combine patient engagement technology with the human touch to enable providers and their networks to quickly and cost-effectively deliver more robust transitional care services.

Incentives to Improve

With CMS expected to spend well over $1 billion annually on Transitional Care Management payments, the potential up-side incentive for providers working to improve transitional care is significant. But the downside for those who do not is also very real. CMS is ratcheting up readmission penalties to 3% of payments this year and organizations are finding it increasingly difficult to ignore the call.

If you’re the parent of a graduating senior attending college this fall, best of luck in this exciting time of transition! If you’re also responsible for the successful transition of patients from one setting to another, you have your hands full, but perhaps there’s more help out there than you thought. Click here to learn more about West Engagement Center solutions which are focused on patient engagement and activation.

West Corporation

Posted on July 13, 2015 by West Corporation 

Insurance Claim Spin Cycle

My washing machine croaked. It wasn’t one of those slow and reasonable deaths we saw coming; it was a sudden, painful and sopping wet mess. 

The machine filled for two full hours, flooding the laundry room and kitchen. A slow trickle into the basement didn’t seem like a tremendous deal until, hours later, hanging pictures crashed, revealing just how saturated our drywall had become. Dirty clothes, ripped up flooring and industrial-strength fans haunted us for weeks; getting a new machine was the least of our problems.

This all went down months ago, but I can’t rinse away the memory because my insurance company seems to be taking us for a spin: We filed a claim. We followed up on the claim. And we waited for a response. And we had our house put back together. And we followed up. And we paid bills. And we worried. And we followed up. And weeks passed; our lives went on. And we got frustrated enough to follow up again… The saga repeats.

I won’t throw this company under the bus because it’s an all too common story. Ten years ago – even two years ago – we wouldn’t have expected anything different from an insurance provider. However, brands selling everything from pizzas and pharmaceuticals, to air travel and package delivery, have upped their game in our modern, consumer-driven world. Customer service isn’t only immediate, it’s proactive. Before I even think to check in for my flight, a notification that things are on schedule is sent straight to my cell phone. I’ve been programmed to get what I want when I need it, and now I count on it.

So what do I want from my insurance company? Immediate, frequent and accurate interaction, via the channels I’ve selected. I want peace of mind and reassurance for my family.

Speed and transparency of the claims process are top-level concerns among policyholders; and research shows that our propensity to switch providers jumps nearly 20% just by submitting a claim. Meanwhile, steep competition in the marketplace makes that likelihood tough for most insurance companies to stomach.

Although it sounds like insurance companies face an uphill battle when it comes to claims, there are strategic solutions to automate more of the customer care experience.

Smart, automated self-service has been shown to vastly improve companies’ productivity, profitability and customer satisfaction – increasing the frequency of interaction, while exponentially decreasing the money and human resources allocated for it.

Check out this infographic about boosting the success of your IVR with a few best practices from West:

  • Incorporate data to heighten caller authentication and verification, trimming time and frustration.
  • Integrate proactive SMS/text notifications to preempt inbound customer calls and decreases repeat calls.
  • Empower customers to help themselves 24/7×365 with user-friendly interfaces on multiple channels
  • Enable callers to speak naturally and self-serve more quickly with speech recognition applications.

Give your customer experience a boost. Get claimants like me out of the self-service spin cycle. Experience Connected.