Bobby Guelich
CEO, Elion
Clare Frye
SVP Operations, UpLift
AUTHOR
Bobby Guelich
CEO, Elion
Clare Frye
SVP Operations, UpLift
Guide

Contact Center Series – Part 1: An Overview

A brief primer on contact centers in digital health

This is part one of our four part series, “The Digital Health Operator's Guide to Contact Centers” — access parts two, three, and four.

Healthcare is a services-driven industry. Patients interact with providers, pharmacies, and health plans along their care journey. These same organizations interface with one another to enable patient care. And despite the push to automate elements of the process, the personal and sensitive nature of delivering care means person-to-person interaction will continue to play a central role into the future.

As a result, regardless of where you sit in the digital health landscape, chances are you will need a contact center function within your organization — and possibly more than one. 

To meet the demands that accompany growth, externally-facing teams are necessary to enable everything from sales to customer service to care navigation. Thus, learning to build, scale, and manage effective, large service-oriented teams (aka contact centers) is a core component of most — if not all — successful digital healthcare startups. 

To help digital health companies better understand how to build these critical teams and avoid the common pitfalls, we are kicking off our “Digital Health Operator’s Guide to Contact Centers” series with a rundown of what contact centers do, the most common types, and how to figure out your contact center requirements.

A quick primer on contact centers in healthcare

What is a contact center?

The term contact center refers to any team whose primary responsibility is to manage high volumes of interactions with external stakeholders. In the healthcare industry, these stakeholders typically include patients, prospective patients, or another third-party critical to your business (e.g. providers that are part of an insurance company’s network). 

Contact centers can take many forms (as you’ll see shortly), but most are large, people-driven teams like customer service or sales. Key attributes of contact center teams include:

  • A high volume of interactions, frequently across multiple communication channels including phone, email, live chat, secure messaging, and text
  • Highly standardized workflows
  • Large headcounts

Common types of contact centers

Contact centers show up in a variety of contexts within healthcare organizations. The table below reviews the most common types of contact center teams; whether they predominantly handle inbound contacts, outbound contacts, or both; their primary responsibility; and specific examples of how they are used in the healthcare industry. 

Contact center type
Contact type: inbound vs. outbound
Responsibility
Healthcare examples
Data Exchange
Customer service (CS)
Networks / Solutions
Inbound
Format
Receive and address inquiries from patients
Relevant Vendors
• Health plan member service
• Pharma / med device CS
• General product support
Data Exchange
Sales (B2C, B2SMB)
Networks / Solutions
Inbound and outbound (varies by team)
Format
Close sales
Relevant Vendors
• Healthcare SaaS sales to small clinics
• Health insurance agent sales (web / phone based agencies)
Data Exchange
Enrollment & engagement
Networks / Solutions
Outbound
Format
Activate and engage patients
Relevant Vendors
• Activating and enrolling potential patients from an employer / health plan provided list
Data Exchange
Onboarding
Networks / Solutions
Outbound
Format
Ensure patients onboard efficiently and can use the product or service
Relevant Vendors
• Digital health patient onboarding team
Data Exchange
Navigation
Networks / Solutions
Inbound and outbound
Format
Help patients find appropriate, high-quality care
Relevant Vendors
• “Front door” companies
• Health system navigation teams
Data Exchange
Care team
Networks / Solutions
Inbound and outbound
Format
Manage longitudinal relationship with a patient
Relevant Vendors
• VBC provider care teams
• Health plan care teams
Data Exchange
Process-driven team
Networks / Solutions
Inbound and outbound  (varies by team)
Format
Execute a people-driven process critical to business operations
Relevant Vendors
• Health plan network management
• Prior authorization management
• Bill collection

Defining your contact center requirements

For operators who have never worked with contact centers before, it can be difficult to know where to start. What technology do I need? What should I look for in potential hires? How do I define success for the team?

In our experience, we’ve found that the core requirements for any contact center team are largely driven by two factors: 

  1. Where your business needs fall on the spectrum of inbound to outbound contacts
  2. The maturity of your operation

The inbound to outbound spectrum of contacts

Each type of contact center has its own specific needs related to its function within the company. 

Some handle mostly inbound calls, such as customer service inquiries. Others are more focused on outbound interactions, such as sales calls. Or maybe the needs fall somewhere in between, like a care team that is doing both proactive outreach and reactive issue management.

Where you fall on the inbound/outbound spectrum will drive many of your specific requirements, including your technology, the team members you hire, and what you measure to assess performance. We’ve highlighted some examples of how this can vary in the table below:

Team type
Tech purchasing priorities
Competencies to recruit for
KPIs to track
Data Exchange
Inbound-focused teams
Networks / Solutions
• Service-focused CRM
• Integrated phone system→focus on interactive voice response (IVR), call routing and skilling
• Knowledge management solutions
Format
• Service orientation
• Empathy
Relevant Vendors
• Efficiency (e.g., calls/day)
• Satisfaction (e.g., customer satisfaction, net promoter score)
Data Exchange
Outbound-focused teams
Networks / Solutions
• Sales-focused CRM
• Integrated phone system→focus on outbound efficiency
• Sales acceleration software
Format
• Salesmanship
• Ability to handle rejection
Relevant Vendors
• Sales
• Close rate
Data Exchange
Inbound and outbound teams
Networks / Solutions
• Sales or Service CRM (depending on the team)
• Care operations platforms
• “Next best action” workflows
• Automations
Format
• Clinical expertise
• Empathy
Relevant Vendors
• Varies by team

Maturity of operations 

The maturity of your operations also plays a critical role in determining your contact center’s requirements. For most early-stage healthcare businesses, you can break this down into two stages: defining the work and scaling the team.

Phase 1: Getting started — defining the work

At this stage, you’re typically so early in the evolution of your business that you’re still figuring out exactly what needs to happen to deliver your product or service. The theme here is flexibility. You want to build your team, technology, and processes in a way that quickly and easily accommodates any necessary change as you learn more about your business and your customers.

Phase 2: From startup to growth — scaling the team

After you have a solid understanding of the work your team needs to perform, the focus shifts to preparing to scale. The themes of this stage are efficiency and quality. Your energy will be concentrated on further solidifying your processes, technology, and organizational structure — and, if the company is growing, rapidly expanding the team.

These stages are likely familiar to founders, as they apply to much more than contact centers — but understanding where you are in this evolution is integral to building your contact center processes and teams. The next two installments of this series explore each of these stages in greater depth, offering actionable advice on technology, people, and operations. Finally, we wrap up the series with a deep dive into the best practices for managing outsourced contact center teams. 

Read next: Contact Center Series – Part 2: Getting Started

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