The Metric Challenge. Presenters: Kim Weir, BJC Call Center Kevin McAuley, UKHealthCare Patient Access Lori Bruelheide, UKHealthCare Patient Access

Size: px

Start display at page:

Download "The Metric Challenge. Presenters: Kim Weir, BJC Call Center Kevin McAuley, UKHealthCare Patient Access Lori Bruelheide, UKHealthCare Patient Access"

Silvester Long
8 years ago
Views:

1 The Metric Challenge Presenters: Kim Weir, BJC Call Center Kevin McAuley, UKHealthCare Patient Access Lori Bruelheide, UKHealthCare Patient Access

2 Call Center Support for the Physician Practice Class Registration Appointment Scheduling Outbound Call Campaigns Insurance Eligibility Determination Referral & Authorization Coordination Physician-to- Physician Phone Consults Prescription Refills Telephone Triage Hospital Follow-up Scheduling

Determination Referral & Authorization Coordination Physician-to-

3 Which Metrics are Most Useful? Day-to-Day Operations for Call Center Leaders Call Center Data Return on Investment for Executive Management Efficiency and Effectiveness for Physicians and Clinic Managers

4 Determining Value Traditional Call Center Metrics What Additional Information Do We Need in HealthCare? Total Calls Calls per Agent Abandonment Rate Transfer Rate Hold Time Queue Time Speed to Answer Talk Time Office Task Time Occupancy Rate Information Still of Value First Call Resolution Capture Rate Agent Adherence to Protocol Customer Service Quality Claim Denial Rates Customer Satisfaction Patient Physician Access to Care Answers to New Questions

Task Time Occupancy Rate Information Still of Value First Call Resolution Capture Rate Agent Adherence to

5 Communicating Effectiveness and Measuring Success Data Needs Context (Setting) to become Information Accumulated Information becomes Knowledge Does the data measure what we want it to measure? Just how many appointments? Or How many correct appointments? (right doctor, right location, right time) Wisdom Knowledge Information Data

what we want it to measure? Just how many appointments?

6 The Metric Challenge Metrics of the Future Kim Weir BJC Contact Center 6

7 BJC at the Commons 7

8 BJC Contact Center Services Current State Physician Referral Class Registration Consumer Marketing Support Nurse Triage Physician Exchange Physician to Physician Future State Transfer Center ACO Patient Notifications Post Discharge Calls Lapsed Patient Patient Access Center Daytime Triage Patient Portal Helpdesk Patient Care Navigator 8

Future State Transfer Center ACO Patient Notifications Post Discharge Calls Lapsed

9 Metrics of the Future Service mybjc Patient Portal New Metric First Call Resolution Patient Care Navigator Capture Rate Transfer Center Unplanned Transfers Access Center Patient Satisfaction 9

10 MYBJC FIRST CALL RESOLUTION 10

11 PATIENT CARE NAVIGATOR CAPTURE RATE 11

12 Metrics of the Future Service Nurse Triage BJC ACO Contact Center Lapsed Patient New Metric Under Referral Notifications Volume by service Total volume Appointment Conversion 12

13 REFERRAL TO APPOINTMENT CONVERSION 13

14 14

15 Metric to Outcome Metric ACO Notifications Outcome Support ACO physicians with tracking/coordinating their patients care Access Center Patient Satisfaction Navigator Capture Rate Patient retention Keeping the business in house 15

patients care Access Center Patient Satisfaction

16 Metric to Outcome Metric Transfer Center Unplanned Transfers Outcome Right care/right time/right place mybjc Portal First Call Resolution Patient using secure environment to message physician Nurse Triage Under Referral Assure delivery of safe and effective care 16

Resolution Patient using secure environment to message physician

17 17

18 Ch-Ch-Ch Changes Think in terms of cross-functional and cross-departmental work Be nimble and open to change Embrace new communication modalities a. Telemedicine b. Social media c. Secure messaging Decrease variation in practice standards across the Medical Group 18

communication modalities a. Telemedicine b. Social media c.

19 The UKHealthCare Patient Access Story Metrics in Action

20 2008 Patient Satisfaction with Access to Care 2 Description UHC Percentile Rank Target Ease of Scheduling Appointments 36% 90% 2 Press Ganey,

21 2014 Patient Satisfaction with Access to Care 3 Description UHC Percentile Rank Target Ease of Scheduling Appointments 81% 90% 3 CG CAHPS Retained Questions May

22 The Journey Begins Measuring Core Values with Traditional Metrics October 2009 Patient Access Center Implementation 22

23 Metric Evolution Asking the New Questions 23

24 Using Metrics for Remediation Building the Bridge As We Are Walking Upon It Process Evaluation Showed Declining Productivity Inaccurate Initial Projections Assumptions of 3-5 Years Experience Failure to Account Mathematically for Occupancy Volume Growth Lack of Standardization 24

25 25

Tips To Improve 5-Star Performance Ratings

Tips To Improve 5-Star Performance Ratings Two different patient surveys impact CMS Star ratings: 1. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, typically mailed to plan