As the pandemic grinds on, healthcare systems are looking for ways to adapt to the situation and better meet the new demands imposed by caring for COVID-19 patients. This includes improving how they handle their communications with patients. For example, at New Hyde Park, N.Y.-based Northwell Health, they’re planning to introduce robotic process automation to direct inbound callers to an appropriate level of care.
Other health systems, unfortunately, don’t seem to have gotten this particular memo. Part of the reason, I suspect, is that the leaders of these institutions haven’t tried to make an appointment with their own doctors lately. If they did, some would be aggravated or even horrified by the inefficiency and poor design within their interactive voice response systems.
Unfortunately, my personal experiences provide a good example of what can go wrong with IVR systems. Due to flawed IVR logic, scheduling a visit with a Johns Hopkins-affiliated doctor turned out to be something of, let’s say, an adventure due to its crazily disorganized IVR and telephony infrastructure. Even given my experience as an e-patient with chronic conditions, it took multiple calls to navigate to where I needed to be and at several points I almost gave up the fight.
My adventure began when I called the main Hopkins location in an effort to schedule time with a specialist. As I attempted to speak to someone in the right department, I hit a menu in which a computerized voice demanded that I input my Hopkins medical record number. Given that this was my first appointment, I obviously didn’t have one. I was able to move past this menu by strategic use of the phone’s zero key but there were more challenges to come.
After waiting several minutes to reach a person, someone finally responded and I outlined my needs. The call center employee asked me to hold while she found the answer to some questions I had asked. While I waited on hold, the call rolled over to a different extension and I found myself speaking to someone in a completely different location and department. (If I recall correctly, I was bounced to concierge services originally, then pediatrics the second time I called in, but I digress.)
Eventually, once I got to the outpatient clinic, I had a perfectly nice experience. However, my battle with the IVR all but prevented me from getting care, and if I weren’t such a stubborn, assertive patient I probably wouldn’t have gotten to the “make an appointment” stage. I’m sure that forcing potential patients to jump through extraordinary hoops isn’t quite what Hopkins is going for.
Some fairly straightforward lessons one can take from this case include the following:
- Health systems should identify and remove any choke points within their IVR tree. If patients reach a menu whose options don’t fit their needs or doesn’t offer a way to skip that stage, many will just bolt.
- If a patient’s call needs to bounce to another party while that patient is on hold, the logic behind the IVR could at least stay within the department in question. Otherwise, the patient might have to go through many minutes of additional wait time getting back to where they started, and again, many will just give up.
I think that AI to generate patient-appropriate ways to navigate the IVR tree might be the best solution to these problems at present. Like Northwell, health leaders can use AI to generate appropriate questions on the fly and move patients in the right direction based on their responses. This approach can be used for any type of care, but could have a particularly strong impact on COVID-19 care, given the need to triage and route patients as quickly as possible.
In any event, if a patient like me can barely make a routine appointment, imagine how many patients are being driven away completely. That certainly includes calls from COVID-10 patients who might end up fighting for life in your ICU if they don’t get timely care.
If you’re responsible for HIT within a health system, you should probably try calling in anonymously and see whether the IVR system creates roadblocks to making appointments — and by all means, follow through until the process is complete. While you might not like what you find, the exercise might be eye-opening.