What We Faced
Challenge
A healthcare provider based in New York needed to streamline processes for their call center. The ultimate goal was to improve the customer experience through increased first call resolution (FCR) and improve employee satisfaction through process simplification.
The company needed a more efficient way for their ~250 call center agents to manage calls. The company had multiple service offerings, each with its own source systems. Customers engaged with multiple services had personal data in multiple systems. When receiving a call, the agent would first need to identify which services the caller receives then search and review multiple systems to satisfy HIPAA verification, and then address the caller’s request. Some agents needed to access over eight different systems to address a single call.
This was a cumbersome process and led to long hold times and some calls not being resolved during the first call (FCR), which is a driving customer satisfaction metric for call centers. The provider wanted to find a solution that would become a central hub of data where agents could access patient and member data, and also log and track calls. The solution also needed to control access to disclosure of protected health information (PHI), while enabling call center agents to effectively help callers.
Implemented Technologies
Salesforce CRM (Service Cloud and Health Cloud) with Five9 Computer Telephony Integration (CTI), Salesforce Shield, and MuleSoft.
What We Did
Solution
MRE Consulting implemented Salesforce Service Cloud and Health Cloud as a customer relationship management (CRM) system for the call center. In addition, the solution included Five9 integration with Salesforce for inbound/outbound calling, Salesforce Shield for data encryption and event monitoring, and MuleSoft as an integration layer to access data from other systems. This enabled multiple benefits for the call center team as they now had visibility into all interactions and patient data, all in one place.
Data from 10+ legacy systems were virtualized in Salesforce to avoid storing extensive amounts of data within Salesforce which would have been costly and create risk for exposure. The user interface made the data accessible in Salesforce on the Contact, but the system was doing a callout to the company data warehouse to surface the needed information at the time of requesting it. This solved not only the data storage issue, but also kept the visibility of PHI data to an as-needed basis.
The system also needed to satisfy compliance requirements set forth by the Department of Health, which regulated what information should be accessible based on both the patient or member’s plan and the agent’s role and responsibility. To support these requirements, multiple profiles were created based on the call center agent’s role and responsibility with custom, role-based access which limited what information agents could view for a patient or member.
Salesforce Shield was also implemented for audit tracking and event monitoring. MRE built a solution to extract and save the Salesforce Shield data daily to Amazon S3 Cloud storage for long-term audit compliance beyond the system’s non-configurable 30-day purge period.
What We Delivered
Results
The Salesforce CRM was rolled out to the 250+ call center agents. The system allowed for the streamlining of key business processes:
- Improved the call center agent experience and efficiency with call handling by consolidating data into a single system. The solution was designed to simplify the steps an agent needs to perform resulting in a quicker result for the caller.
- The profile of a caller would be automatically loaded when a caller’s phone number matched that of a profile already in the system, saving considerable time for each call. Previously, agents would need to search for the caller’s profile in multiple systems, based on what services they received from the company.
- All data that is eligible for HIPAA verification was centralized and available to the agent on one screen, facilitating quick identity validation. Previously, this data could have lived in multiple systems, requiring the agent to toggle between systems. One agent stated that this change alone could save up to 4 minutes per call.
- A person’s profile featured member and patient data sourced from 10+ systems, enabling quick visibility of the consumer’s full history with the company. Quick and easy access to this data would enable agents to provide an improved experience to callers. This data was virtualized for data security.
- Supervisors and call center leadership had access to Salesforce Reports and Dashboards which provided information about calls/cases, open cases, case types, aging cases, and performance by team.
The team is excited about the new capabilities and are already discussing additional systems for data integration and visibility.
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