The Role of Hospital Call Centers

Medical call centers facilitate a multitude of different services, including answering the main switchboard, communicating critical information with patients and their family members, providing direction and support during emergencies, coordinating transport and dispatch, coordinating on-call medical staff and hospital communication, and providing 24-hour access to healthcare.

Because hospital contact centers are the communication hub for the hospital enterprise, they naturally have a role to play in nearly every area of a healthcare organization. Hospital call centers can improve patient and employee satisfaction, help reduce costs, and even provide critical communication tools within the hospital setting.

Influencing the Patient Experience

The call center functions as a virtual lobby for a healthcare organization, and patients’ experiences with call center agents play a critical role in their satisfaction with care access and the care they receive.

The American Medical Association (AMA) Journal of Ethics reports that the Centers for Medicare & Medicaid Services (CMS) can currently withhold one percent of Medicare payments – 30 percent of which are tied to HCAHPS scores. When Medicare and Medicaid account for more than 60 percent of all care provided by hospitals, the possible amount of dollars lost due to poor patient experience is a significant number. In 2017 alone, approximately $1.7 billion in reimbursements were withheld from hospitals.

According to the CMS, estimated US healthcare spending reached $14,423 per person in 2023, an increase of 7.5 percent for a total of $4.8 trillion—outpacing the projected annual gross domestic product growth rate of 6.1 percent.

However, hospital systems may receive less reimbursement for services because of poor patient satisfaction survey results. CMS administers the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to help health systems and governing bodies evaluate patient satisfaction through this national, standardized, publicly reported feedback that quantifies the patient’s opinion about the quality of care they received. This survey helps to calculate value-based payments.

Low HCAHPS scores can limit a hospital’s Medicare funding. For example, in fiscal year 2020, 55% of the approximately 2,800 participating hospitals received an estimated $1.9 billion in CMS value-based purchasing program incentive payouts, which roughly equates to $1.3 million per hospital. Systems with the highest HCAHPS scores received the most financial support, while those with exceptionally low scores received financial penalties.

[Related White Paper: What Healthcare Leaders Should Know About Contact Centers]

Call Center Software Improving Workflows in the Hospital

Research indicates that poor communication among healthcare staff is one of the leading causes of patient harm. Researchers of the “Improving Patient Safety Through Provider Communication Strategy Enhancements” study found that time spent searching for and contacting appropriate providers was a critical communication issue and averaged 10 to 40 percent of total communication time.

[Related Case Study: Providence Swedish: Improving On-Call Communication Delays and Code Call Workflows with Web-Based Platforms]

Staff in clinics and hospital rooms can leverage the software used by call centers to enhance workflows. The same communications integration engine software that incorporates personnel directories and on-call schedules used by a hospital call center can also integrate with nurse call and alert solutions, third-party devices (such as IP phones and mobile devices), and other applications to automate the handling and dispatching of messages and alerts.

Integration engines act as the “glue” that holds disparate IT systems and software together and translates a variety of different inputs to interpret data. These solutions appear as one seamlessly integrated system to the average end user, but behind the scenes, they handle the complex work of merging multiple systems into a single touchpoint.

Telehealth and the Hospital Call Center

The COVID-19 pandemic placed telehealth in the spotlight. Telehealth gained recognition as a critical healthcare tool to keep patients and medical staff safe and the public informed about health-related information via hotlines. Jennie McWhorter, IS Operations Manager for Ephraim McDowell Health in Danville, KY, said, “We were using the operators as a hub to our COVID-19 hotline so the community could dial the number they already knew and find what they wanted through our 24/7 operators.”

[Related Blog Post: Healthcare Call Centers Help Bring Care to the Medically Underserved]

Telehealth is an essential service because it overcomes barriers to healthcare. Hospital call center software and operators help bring care to patients with:

• Virtual Appointments – Patients can visit a doctor or nurse via web-based video conferencing.
• Medical Staff Consults – Telehealth is also used for patient/doctor communications. Doctors, nurses, and specialists use virtual consultations to coordinate care.
• Remote Health Monitoring – Communication between patients’ homes monitoring medical devices and their doctor.
• Non-Clinical Services – Remote, non-clinical uses such as administrative meetings, provider training, and education.

[Related Blog Post: The Benefits of Telehealth]

As needs arise and technology advances, the role of medical contact centers will continue to grow and become more complex.