Driving Continuous Improvement in Healthcare Cloud Contact Centers with AI

In our last blog, we explored AI and Automation: The Secret to Boosting Employee and Customer Satisfaction in Cloud Contact Centers.

Today, we are taking it a step further. We’re exploring how AI and EDCi’s Continuous Improvement (CI) model can revolutionize your operations, enhance patient experience, and boost your bottom line.

To truly transform your healthcare contact center and patient experience, you need a culture of continuous improvement. This means constantly analyzing performance, identifying areas for enhancement, and implementing changes that drive better outcomes. In healthcare, for example, it’s not just about speeding things up or making things easier, though that’s certainly part of it. It’s about achieving better outcomes for patients, providers, and the entire system.

So, how do we bring continuous improvement into the world of cloud and AI solutions?

Platforms like Genesys or Microsoft, for example, are not just about providing tools; they’re about giving us the power to drive real, meaningful change—delivering smarter, more efficient solutions that ultimately lead to better healthcare experiences. 

We all share a common goal in healthcare: to improve quality and effectiveness, ultimately achieving the best possible outcomes for patients and keeping them healthy. To measure progress, there are 90 + quality measures in place—things like screenings, processes, and outcomes that track how well we’re doing.
‍

Let’s breakdown a standard healthcare procedure:

Scenario: Jane (the patient) needs a mammogram. Her health organization is being measured on whether it provides this screening, which is a preventative measure that can catch health issues early, reducing long-term healthcare costs.

Step 1: Identifying the Need
How do we know that Jane needs a mammogram? This information comes from your software, integrated with the Quality Assurance (QA) data source. The software alerts you that Jane is due for this test.

Step 2: Communicating the Need
How do we get the message out once we know Jane needs a mammogram? It’s not just about informing Jane; we must notify her primary care provider and someone from the scheduling department. This could be done automatically through a screen pop or an alert sent to a mobile device, ensuring all the relevant parties are notified quickly. This is your automated outreach process.

Step 3: Getting Jane to Schedule
Now, how do we get Jane to actually book the appointment? This is where your automated workflow comes in—sending reminders, prompts, and follow-ups to encourage her to schedule the mammogram.

Step 4: Documenting and Submitting the Screening
Once Jane gets scheduled, you need to ensure the process is correctly documented. The system needs to capture the correct coding, showing that the mammogram was performed for proper claim submission.

Step 5: Measuring Effectiveness
Now, we measure the success of the entire process—did Jane get her mammogram? If she didn’t, we need to go back to the beginning and address the care gap. This is the Care Gap Measurement step, where we ensure that no patient is overlooked and that any missed steps are quickly addressed.

So, the entire process—from identifying Jane’s need for a mammogram to ensuring she gets the screening, and it’s documented properly—is a cycle of continuous improvement. Every time you evaluate this process, ask yourself: How can I leverage my cloud solutions and AI to make it smoother, faster, and more efficient?

The goal is to close the care gap and improve quality scores. The process might look different in each organization, but the fundamental steps are the same: identify, communicate, schedule, document, measure, and improve. And each time, consider how cloud-based or AI-driven technology can help streamline the workflow and enhance patient care.
‍

Creating a Roadmap to Maximize Cloud ROI

When beginning to implement CI within your organization, creating a roadmap that maximizes Cloud ROI is important. Often, we break out these goals into four main categories that allow us to push toward Continuous Improvement.

1. Quarterly Reviews: Analyze performance, tune AI, measure results, and report progress.
2. Ongoing Analysis: Continuously assess KPIs and performance to ensure goals are met.
3. Feature & Release Planning: Align capabilities with business goals and plan upcoming releases.
4. Technology Training: Stay up to date with evolving tech to apply new solutions to business needs.

In the graphic below, you can see commonly taken actions in relation to each of the four main categories.

Continuous improvement is all about staying agile—being ready to pivot and adapt at any moment. But when you're working with technology and going through the implementation process, it’s a big undertaking. Getting approval can take time, and the actual implementation might stretch out even longer. Your goals might have shifted by the time everything is ready to go. Staying flexible and adjusting on the fly can be difficult in that kind of cycle. That’s why we’ve seen huge success in Continuous Improvement; thanks to continually evaluating our goals, staying flexible, and implementing automation, organizations can optimize processes, achieve cost savings, enhance agent satisfaction, and improve patient engagement in their cloud contact centers.

Recent Continuous Improvement Success Thanks to Automation:

‍
Efficiency and Cost Savings:

By automating transactions, a small to mid-sized user saved approximately $100,000 per quarter.

Answer Rate for Account Services:

For a financial service industry company, Continuous Improvement increased the ability to answer calls by 18%, turning each call into a valuable sales opportunity.

Cost of a Customer Interaction:

The cost of customer interactions was reduced by 20%, allowing the organization to repurpose the saved money to more impactful areas.‍

Contact Center Results:

-      Reduced Average Handle Time (AHT) by almost 3 minutes per call

-      Reduced Average Speed of Answer (ASA) by 55%

-      Reduced abandon calls by 50%

-      Reduced transfers by 40%

Reducing Abandoned Calls:

Even a 5% abandonment rate (which may seem low at first glance) can mean 10,000 missed calls. In one case, a patient called to schedule an appointment with her primary care provider. The agent transferred the patient to Nurse Triage due to “trigger/red flag” words. By the end of the interaction, they believed they had potentially prevented a suicide attempt. This goes to show that every call is crucial; this could have easily been one of the 10,000 missed calls.

Transform your Healthcare Contact Center Today

The future of customer service is here, and it’s powered by cloud, AI, and continuous improvement. By implementing Continuous Improvement, organizations can optimize processes, achieve cost savings, enhance agent satisfaction, and improve patient engagement in their cloud contact centers. Ultimately, the goal is to improve quality and effectiveness, achieving the best possible patient outcomes and keeping them healthy. 

EDCi’s CI model is a subscription-based consulting and engineering service offering 24-hour support, ensuring you’re never alone in a smarter, more agile future. Let’s embrace the power of AI and Continuous improvement to transform healthcare contact centers and deliver exceptional patient care.

‍