Patient Relationship Management, add 3 parts technology and stir

Sometimes you need to break a few eggs to get to the root of the problem. Traditional approaches to improving the patient experience usually begin with the call center. Why is that? Maybe it has something do with the fact that a call center is tangible. Something you can observe and touch. Clearly, it’s something that can be measured. However, I think the real reason is that the number of call centers in any organization is finite. You know your number of call centers. It’s not about five, or as of yesterday morning we had three, it’s a specific number. As such, it’s a reasonable target. It’s a target that can typically be dealt with through the application of technology. There’s a handful of technology, which when applied to any call center in any location will, when measured against the typical metrics, enable the call center to be “better”. If someone’s marching orders are to fix the call center, those orders fit neatly with the application of technology.

Doing something to the call center is a shotgun approach to trying to solve a problem. It’s a recipe that is very repeatable; add three parts technology and stir. It’s almost guaranteed to produce measurable and visible results. It’s also almost guaranteed to not fix a single patient problem. The reason for that is that almost all of the technology deployed in call centers has nothing to do with addressing the reason the patient called. The application of technology for the most part has to do with getting the caller to the CSR more promptly.

The big distinction in dealing with patients versus dealing with call centers is that patient problems usually can’t be resolved via the application of a shotgun solution. Clearly, if every patient that calls about a billing problem is calling about the same billing problem then the application of technology could fix it. However, patients who are calling about billing problems are usually calling regarding a problem that is specific to them. There are two ways to address this type of problem. One way is to get a clear enough understanding of problem on the call and have the patient work with the CSR to resolve the problem. That type of solution puts out the fire. The problem with this type of solution is that it has to be repeated with the CSR every time that same problem arises. The other way, and by far a more proactive way, is to figure out what caused the billing problem and to correct whatever caused the problem thereby preventing it from ever happening again. Instead of putting out the fire, the hospital prevents the fire from reoccurring.

From my perspective this is one of the major differences between Patient Relationship Management (PRM) and Patient Equity Management (PEM). I’m not convinced that PRM actually exists, at least as relates to the acronym. I think it’s either call center management or patient account management, or some combination of the two. If it does in fact somehow manage the relationship of the hospital with the patient, it’s predominantly a one-way relationship, a push relationship from the hospital to the patient. PEM, patient experience management, patient expectation management, patient equity management, requires a two-way relationship, and requires knowing more about the patient than some profile developed through data mining. For PEM to be successful, the hospital must get to the root of why the patients are calling and what can be done to solve the problem in such a manner that the patient no longer has to call. It sounds like a lot of work. It is if you take a shotgun approach to it, sort of like trying to eat the elephant in one bite. I’ve found that if I break it down into manageable pieces, each of those pieces can be designed as a small project that can be solved.

The most difficult thing about trying to implement this type of solution is that it goes against everything that we’ve been doing. This can appear to be so far out of the box that you can’t even see the box. It requires you to think in opposites. The solution begins with how you phrase the problem. Instead of viewing the problem as, “How do we improve our call centers”, we need to be asking, “How do we improve our interactions with our patients?” We’re almost asking the inverse. In mathematics, that’s easy to do; you simply multiply by -1. Maybe that’s all that’s needed here.

Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy