What Should Healthcare Systems Consider When Modernizing Call Centers? Early Considerations From the Veterans Health Administration.

IF 1.7 4区 医学 Q3 HEALTH POLICY & SERVICES
Journal of Healthcare Management Pub Date : 2024-05-01 Epub Date: 2024-05-10 DOI:10.1097/JHM-D-23-00053
Caroline Gray, Barbara Lerner, Jacqueline Egelfeld, Jada Robinson, Tracy Urech, Anita Vashi
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引用次数: 0

Abstract

Goal: Growing numbers of hospitals and payers are using call centers to answer patients' clinical and administrative questions, schedule appointments, address billing issues, and offer supplementary care during public health emergencies and national disasters. In 2020, the Veterans Health Administration (VA) implemented VA Health Connect, an enterprise-wide initiative to modernize call centers. VA Health Connect is designed to improve the care experience with the convenience, flexibility, and simplicity of a single toll-free number connected to a range of 24/7 virtual services. The services are organized into four areas: administrative guidance for scheduling and general inquiries; pharmacy support for medication matters; clinical triage for evaluation of symptoms and recommended care; and virtual visits with providers for urgent and episodic care. Through a qualitative evaluation of VA Health Connect, we sought to identify the factors that affected the development of this program and to compile considerations to support the implementation of other enterprise-wide initiatives.

Methods: The evaluation team interviewed 29 clinical and administrative leads from across the VA. These leads were responsible for the modernization of their local service networks. PhD-level qualitative methodologists conducted the interviews, asking participants to reflect on barriers and facilitators to modernization and implementation. The team employed a rapid qualitative analytic approach commonly used in healthcare research to distill robust results.

Principal findings: A review of the early implementation of VA Health Connect found: (1) deadlines proved challenging but provided momentum for the initiative; (2) a balance between standardized processes and local adaptations facilitated implementation; (3) attention to staffing, hiring, and training of call center staff before implementation expedited workflows; (4) establishing national and local leadership commitment to the innovation from the onset increased team cohesion and efficacy; and (5) anticipating information technology infrastructure needs prevented delays to modernization and implementation.

Practical applications: Our findings suggest that healthcare systems would benefit from anticipating likely obstacles (e.g., delays in software implementations and negotiations with unions), thus providing ample time to secure leadership buy-in and identify local champions, communicating early and often, and supporting flexible implementation to meet local needs. VA leadership can use this evaluation to refine implementation, and it could also have important implications for regulators, federal health exchanges, insurers, and other healthcare systems when determining resource levels for call centers.

医疗保健系统在对呼叫中心进行现代化改造时应考虑哪些因素?退伍军人健康管理局的早期考虑。
目标:越来越多的医院和付款人正在使用呼叫中心来回答患者的临床和管理问题、安排预约、解决账单问题,以及在公共卫生突发事件和国家灾难期间提供辅助护理。2020 年,退伍军人健康管理局(VA)实施了 "退伍军人健康连接"(VA Health Connect)计划,这是一项旨在实现呼叫中心现代化的全机构计划。退伍军人健康连接 "旨在通过与一系列全天候虚拟服务相连的单一免费电话号码,以方便、灵活和简单的方式改善护理体验。这些服务分为四个方面:为日程安排和一般咨询提供行政指导;为用药事宜提供药房支持;为症状评估和建议护理提供临床分流;为紧急和偶发护理与医疗服务提供者进行虚拟访问。通过对 "退伍军人健康连接 "的定性评估,我们试图找出影响该计划发展的因素,并整理出相关的考虑因素,以支持其他全企业范围举措的实施:评估小组采访了退伍军人事务部的 29 位临床和行政负责人。这些负责人负责本地服务网络的现代化。博士级别的定性方法专家主持了访谈,要求参与者思考现代化和实施过程中的障碍和促进因素。研究小组采用了医疗保健研究中常用的快速定性分析方法,以提炼出可靠的结果:对 "退伍军人健康连接 "早期实施情况的回顾发现:(1) 截止日期证明具有挑战性,但为该倡议提供了动力;(2) 标准化流程和地方适应性之间的平衡促进了实施;(3) 在实施前关注人员配备、招聘和呼叫中心员工培训,加快了工作流程;(4) 从一开始就确立国家和地方领导层对创新的承诺,增强了团队凝聚力和效率;(5) 预见到信息技术基础设施的需求,防止了现代化和实施的延误:我们的研究结果表明,医疗保健系统将受益于预测可能出现的障碍(如软件实施的延迟和与工会的谈判),从而提供充足的时间来确保领导层的支持并确定当地的拥护者,尽早并经常进行沟通,并支持灵活的实施以满足当地的需求。退伍军人事务部的领导层可以利用这一评估来完善实施工作,它还可能对监管机构、联邦医疗交易所、保险公司和其他医疗系统在确定呼叫中心的资源水平时产生重要影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Healthcare Management
Journal of Healthcare Management HEALTH POLICY & SERVICES-
CiteScore
2.00
自引率
5.60%
发文量
68
期刊介绍: The Journal of Healthcare Management is the official journal of the American College of Healthcare Executives. Six times per year, JHM offers timely healthcare management articles that inform and guide executives, managers, educators, and researchers. JHM also contains regular columns written by experts and practitioners in the field that discuss management-related topics and industry trends. Each issue presents an interview with a leading executive.
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