AI Technology’s Impact on Employee Burnout in Health Care Contact Centers

Patty Hayward, vice president of health care strategy, Talkdesk, describes how burnout among health care contact center workers affects costs and the care continuum, and the role technology will play in the future. 

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Welcome back to PopHealth Perspectives, a conversation with the Population Health Learning Network where we combine expert commentary and exclusive insight into key issues in population health management and more. In this episode, Patty Hayward provides insight on ways to address burnout among health care contact center workers.

I'm Patty Hayward and I run strategy here at Talkdesk for our health care and life sciences division. I've spent the last 25 years working for various health care IT vendors such as McKesson, I worked at Aetna, I've worked in a lot of population health spaces, et cetera. I've been at Talkdesk for just shy of 2 years now.

Can you discuss the factors leading to employee burnout among health care's contact center workers? What are some ways to address this?

I think we all know, what we just went through with the pandemic. A lot of providers found themselves with just crushing volumes of calls coming into their physician offices to health systems, et cetera, with lots and lots of questions and really found themselves unprepared to deal with the volumes. I mean, I've talked to some health systems where their phones just stopped functioning because they got so overloaded. And when you think about just that type of volume, and really, it's continued to be large because there's still a lot of questions as COVID-19 has continued to evolve and change. There's a lot of different things that people are talking about. Obviously, that's on top of all the other things that people put off and had to wait 6 months, 9 months for what was perceived as optional work, et cetera. So a lot of different things.

People are now kind of coming back and wanting to get in and do their regular sort of cadence of seeing physicians and doing what they should be doing to deal with their health. So there continues to be a large number and call volume. I also think that people are less tolerant these days it seems. There's a lot of talk about verbal abuse, things like that, that are going on. And all of these factors just lead to a really difficult time for folks who are dealing with answering and trying to help be caregivers and help navigate folks through the systems. Because our system is not easy to navigate. Let's just face that. And we also don't have systems that are advanced.

If you look at, say, if you were to call Delta Airlines, they know who you are as soon as you call, they know your status. They know if you've had a flight, they know if you've got lost bags. I mean, they pretty much know why you're calling before you are connected with an individual. We don't have those types of systems in health care. They're much more antiquated, and so there's not as much support for the agents. You're having to speak to an individual and you're usually having to do it between 9 and 5, and that just compresses the time. The thing that I always found funny was that when you're talking to folks who are just thinking of upgrading, their big thing they want is callback. Okay, but callback's not going to help your volume. Yes, it keeps you all from sitting on hold, but you're still having to wait that however long time it's going to take, and your agents still have to deal with that same volume. Really trying to put more automation in play is super important.

What are the easy things? Because obviously they aren't very sophisticated in a lot of this and on top of it, health care is very complex. When I talk to people who aren't specialists in health care, and I talk about appointment scheduling, it's not like you're going to get your hair done. These appointments can be really complex, especially if you're talking about specialists. It's not as easy as just, "Hey, I have 12 openings in the next 4 weeks and here they are." There are variables that need to be understood to make sure that they're slotted appropriately. There's a lot of complexity there that needs to be dealt with. I always coach people to start with what's easy and what can be done to offload some of those things.

A lot of things like just authenticating who the person is when they call in so that when the person answers the phone they know who they are, can see their record, and see what they may be calling about. That goes a long way to help. You can do things like allowing folks to have appointment reminders that are sent out that actually have some sort of interaction with them. They're not just dead end texts that then you have to call if you want to change something. They give you options to schedule and reschedule your appointment. They have options to get directions to get to the office. Some of those easier to do things. You want to start there and then you continue to evolve as you work with your staff members, your physicians, to look at how do you open up scheduling in those that make sense. Again, what are the easier appointments that you can offer automated scheduling for and continue to go through there. That's usually what I counsel folks to look at as they're starting to look at how to offload some of that volume from their human agents.

How does burnout among these particular workers affect the care continuum and costs? What are the ramifications without these workers?

Let me tell you a story because I think it goes to the ramifications at least to cost and to potential outcomes for patients. And then we can talk about the importance of the folks in a minute. I was referred to a specialist recently and I called every day for a week and they didn't even answer their phones. It wasn't even an option to speak to someone or wait on hold. It literally just went to a voice mailbox. And I of course got frustrated because I'm like, how is it that every day they don't have enough people to answer their phones? And so I left the messages, they never called me back, by the way. And I even left messages saying, "Hey, it's the third time I've called." Just to let them know you may want to call this person back.

And I was nice. I wasn't angry, I was just like, "Hey, just letting you know I'm really trying to get in here." And then a funny thing happened, I got a text message from them that said, "Hey, we received your referral, call us." So I laughed and I said, okay, let's see what happens if I try to interact with this text message. Because I'm like, I have been calling you. So I said, "I've tried calling," and I get back this bounce back that says, "I don't understand what you're saying. If this is an emergency, call 911. If it's a technical thing, call the company." I laughed, turned out it was a revenue cycle product and it made me think that these guys were actually really trying to deal with the problem that they knew they had, which was they're not getting their referrals because they're not answering their phones.

It occurred to me they were probably trying to solve the problem, but it wasn't connected to anything. I think that some of the ramifications of these things is that when something like that happens, a lot of times people just give up and they're like, "Is it really important that I go see a specialist for whatever it is?" I mean, depending on what it is. And so sometimes when people hit friction, they just stop acting. And that can have big ramifications obviously for the person's health, increased cost, increased complexity, things like that. Or it can just push out the appointments so far or maybe they put it off and they go back in a month and all those things.

Like I said, health care's really hard to navigate. We do not make it easy and we put it all on the patient. We don't make anything proactive. So it makes it a tough thing to navigate. The more friction you have, I think the tougher it is to navigate, which can have big ramifications for cost complexity and the patient's health. As far as how important these workers are, I mean, you can hear how important they are if you don't have someone that can help you navigate this system. We don't have automation in place. We don't have these systems in place to allow people to self-navigate. We rely on these folks and this is a high turnover center. I mean, think about it, you're answering phones.

It's important to support these folks with knowledge-based management, with less need to go into multiple systems and to do a lot of complex things. We need to guide and support them so that they have an easier time. The patient experience is important, but the agent experience is just as important. It's really, really crucial that we're supporting them so that they feel like they want to stay and as you train them up, you continue to have great folks that are staying. I mean those are all important pieces to this puzzle.

How will the growing use of technology and AI affect the payers, patients, and providers?

I think in two ways. I think we talked a lot about the option for automation. I think having that ability. So I started my morning at 7 on these calls and I do this all day, every day. Where I'm constantly on video calls, phone calls, et cetera because I work from home, I'm not in an office, it's hard for me to just break away and take a phone call. And typically when you have something like this, you're calling in, they're going to call you back. And guess what? I'm probably going to be on a call. So we're going to do this constant back and forth thing. The ability for me to be able to do that self-service aspect is important.

I think that as you look at what the payers are looking at, they're looking at a couple things. They're obviously looking at from their own perspective of, hey, I've got questions about a claim, I've got questions about different things like that. And our studies have shown that the biggest satisfier for a member calling into those payers is a knowledgeable agent. Because you can get your answers, you get your questions answered, you get things resolved in a quick period of time. A knowledgeable agent is the most important thing. So again, that how do we support those agents and make sure that they're answering the right questions, like listening to the conversation and offering suggestions of, I think the member's asking about this, here's the information. So you get a more consistent and a more correct answer into those agents so that they can then service the members that are calling.

On the provider side, I think when you're talking about a continuum of care and continuing to not only take someone from a primary care physician but into the specialty realm, possibly into the acute realm as well, is having some ability to not only self-service, but to do proactive outreach to these folks. So that text message I got would've been awesome if it had been connected to something that said, "Hey, here's a system where you can put your information in and we'll email you back with a couple of options for your schedule." That could have been done. That can be something that instead of having to deal, that way someone can do that in sort of less real time. They can do it in an asynchronous fashion that allows someone to, it's not self-service, but it allows them to have an asynchronous discussion. Because I think with new patients, you're not going to get automation. There's too much information that needs to be gotten and processed. But a current client, a current patient, you can do more things with.

So being able to authenticate a patient, being able to do scheduling online, to be able to do things from an app, to be able to do things from voice, because there are people that are just not going to get on the computer. There are people who are always going to want to call. And so to be able to have the ability to do chat bots is also important. Ones that actually work and that you're not screaming agent, agent, agent into every single time. I'm guilty of it. But it is important for them to be usable and to be integrated into the system of records for that EHR and to be able to invoke functions so that they can accomplish a task as well. I think those are all really important.

Thank you. What role do you think technology and AI will play in the future of health care?

I think it's just going to continue to get better and better because I continue to see all of the vendors pulling together more what we call APIs (application programming interface), which allow you to do things in real time so that you can say, "Hey, I want to reschedule my appointment," and it will pop up, here's the next 5 opportunities for you to reschedule for. So those are real time pieces. They're not storing a bunch of data or having to replicate databases. As we continue to evolve these APIs and allow there to be more opportunity to do those things, I think we're going to see a lot more self-service. I think we're going to see a lot more proactiveness as well.

Again, I talked about being reactive to everything. You get discharged from a hospital and you get referred to another physician. Usually you get a piece of paper with a name and a phone number and it's all on you to do. The guidance of these patients I think is important to the future of health care and where we're going. I think more holistic health too. There are some really interesting partnerships that are coming out too. So Walmart, United Health, really interesting combination there because if you think about holistic health, I think being able to help people if they're newly diagnosed, say with diabetes, how do we eat appropriately so that you're making sure that you continue to stay healthy and stay on your regimens. Medication, I think information about medication, Apple just came out with in their new iOS the ability to scan your medication and it pops up the information about the medication.

You can also, they've had it for a bit, you can actually keep your medication in your phone so that if you go to the doctor you can say, here's all the medications that I'm on. So there's a lot of things that I think are continuing to evolve and I think being able to share that information is really crucial. And I think being able to access that and being able to do something with it is how we're going to see things continue to evolve forward. And then care plans and how we automate people through different care plans. If you are say, going in to have an operation or a procedure done, there are things that you need to do or not do before you go in. You need to not eat and there's all these different things. How do we automate and help people understand these are the things they need to do and then continue to check in on them so that they know the day, hey, 3 days before you're supposed to take this, 2 days before you're supposed to do this.

And sending them reminders and doing these things and getting them on those care paths are super important. Because if you think about it, both from a patient and a health system perspective, if that person doesn't do what they're supposed to do before they come in, they're not going to be able to do the procedure. And usually that's a big revenue piece for the hospital. It's also a big piece for the patient's health. Bringing those things together and having those automations is going to also be really important. I see a lot of continuing evolving of these proactive outreaches as being crucial to how we move forward.

Is there anything else you'd like to add to the conversation today?

I think I added a lot. We went around a lot of different things. Yeah, I mean just I'm really bullish on where health care's going. I think there's a lot of really great things that are evolving. I think the health systems are really looking to adopt new technology, which is, the pandemic did a lot of things, but that's one of the things that I think it really helped us with, which is how do we adopt technology to move forward and to do things differently? And it really kind of, it was there before, but I think it turned up, I just use the analogy of a Bunsen burner, it turned on the Bunsen burner and made it start to go a little faster. I think that I see a lot of really great potential with a lot of the different technologies that are out there.

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This transcript has been edited for clarity.