It's about the people: Caring agents and satisfied patients are key to a successful healthcare call center culture

Article featured in Management in Healthcare - Vol. 6, 2 134-141 © Henry Stewart Publications 2056-802

Erinne Dyer

EVP, Growth, Envera Health, USA

Erinne Dyer is an Executive Vice President and Chief Growth Officer at Envera Health, where she works to assess organizational goals, build cross-functional teams and create multi-faceted engagement solutions. Before joining Envera Health, she served as a corporate vice president in corporate communications, marketing and outreach at Carolinas HealthCare System. Her responsibilities included managing 
corporate communications, marketing and community health for a system that included 900 locations, 7,600 beds and nearly 60,000 employees. Previously she served as director, corporate communications, for Cleveland Clinic. She graduated from Case Western Reserve University with a BA in psychology/
sociology. She earned an MEd in education, counselling and human behaviour at Vanderbilt University. She completed her executive MBA at Northwestern University, Kellogg School of Management.




Although healthcare is the fifth largest industry in the United States, it ranks 25th and last for simplicity of experience, according to the Siegel+Gale World Simplest Brands report. Wait times, paper forms, complex language and complicated insurance plans have created a significant gap between the engagement experience patients want as opposed to what they receive. As patients transform into demanding healthcare consumers, they expect the same experience from healthcare providers that they receive in other aspects of their everyday life. Patients become frustrated when they compare their healthcare interactions with the attention and ease of use they encounter with most online retailers. One recent study revealed that 75 per cent of consumers want the same experience in healthcare that they get from other industries. The key to providing the type of experience patients want begins on the front line — with the people at the other end of the phone who first engage with the patient. In many cases, this is the healthcare’s call centre agent, trained to help a patient that is looking for an appointment and could be anxious and in need. In the following paper, discover how to find, attract, train and retain the best talent for your healthcare call centre and understand why being able to do this consistently is a critical link to ensuring patient satisfaction and loyalty.




Although healthcare is the fifth largest industry in the United States, it ranks 25th and last for simplicity of experience, according to the Siegel+Gale World Simplest Brands report. Wait times, paper forms, complex language and complicated insurance plans have created a significant gap between the engagement experience patients want as opposed to what they receive.

As patients transform into demanding healthcare consumers, they expect the same experience from healthcare providers that they receive in other aspects of their everyday life. Patients become frustrated when they compare their healthcare interactions with the attention and ease of use they encounter with most online retailers. One recent study revealed that 75 per cent of consumers want the same experience in healthcare that they get from other industries.3 Now these same powerhouse companies like Amazon, Google and Apple are breaking into the healthcare space, providing significant new competition for health systems. However, healthcare providers are uniquely positioned to win for many reasons. Not only do they own the entirety of the care delivery system, but they also covet the most intimate of relationships with patients: the overall management of their health. The key to providing the type of experience patients want begins on the front line — with the people at the other end of the phone who first engage with the patient. In many cases, this is a practice operator or an agent, trained to help a patient that is looking for an appointment and could be anxious and in need. Despite the increasing reach and depth of technology into healthcare delivery systems, a personal touch from a well-trained, responsive, empathetic human is crucial for patient satisfaction. It matters what type of person is handling that call when interacting with often frustrated and anxious patients. Choosing the right person for this difficult job is critically important. Having people with the right skills and a positive mind set handling that first interaction is often the key to a successful patient engagement. Making sure the primary contact with your patients is successful requires having agents who are happy in their jobs and empathetic in their nature. To ensure you have satisfied patients, you need to have happy, caring agents.


The Challenge of Staffing A Healthcare Call Center

Recruiting qualified agents is a difficult and expensive process costing US$1,000-US$4,000 per person depending on your geographic location. Not only do you have to find people who can manage complicated software and perform complex workflows in difficult cases, but you also have to select individuals who are committed to getting patients the care they need. The staff you assemble must have the ability to manage the stress of a fast-paced environment and large call volume. According to a survey from ContactBabel, the average rate of call center agent churn is 33 per cent, spiking to 70 percent in large call centers. This compares to an average turnover rate across all industries of about 15 percent. The number can be even higher if you do not have tested processes to profile and select qualified, capable staff with the personality traits proven to contribute to success.

Once staff is in place, at an average of US$45K per person, initial training (roughly another US$1,250 each) and management are crucial to operate a healthcare call center. Best practice ratios call for about one supervisor for every eight agents, and, at about US$50K per supervisor, staffing a large health system’s internal call center can average as much as US$2.6m annually. These costs are daunting but is the price you must pay to build and manage a staff capable of providing patients with the care they need. Many healthcare providers are now choosing to outsource their patient contact needs to third parties rather than drain resources from their main mission — caring for patients. Dedicated virtual call centers like Envera are increasingly being chosen to handle patient needs, freeing up valuable internal resources.


Importance of Satisfied Agents

Whether customer contact is handled in-house or outsourced, the key to success of  healthcare call center remains the same — it is all about the people.


Correlation between employee and customer satisfaction

The theory that customer satisfaction relies heavily on the satisfaction of an organization's employees is an idea that is now widely accepted. This is especially the case when it comes to employees who interact directly with clients.

A Gallup survey revealed that companies with employees in the top quartile of employee satisfaction and engagement outperform bottom quartile companies by 10 percent. The reason for this correlation is simple: Satisfied employees are more motivated to perform well and understand they are a key component in the success of their organizations. This leads to their desire to increase client loyalty by providing outstanding service.

The importance of employee satisfaction is particularly critical in a call center environment where poor performance can have a severely negative impact. Maintaining a high rate of engagement, however, in the difficult environment of a call center is challenging.


Evolution of healthcare call centers

Nearly two thirds of all U.S. hospitals use call centers for multiple purposes, and the number is growing steadily. Healthcare call centers no longer simply schedule appointments but instead are evolving to create greater consumer experiences and meeting patients where they are.

This shift in focus is happening to accommodate the growing need for communication between patients and providers. In a recent Spok survey, half of responding organizations said they have had a call center strategy in place for one to five years, while nearly 20 per cent have had such a strategy for over five years. Nearly two thirds said they have done so to respond to new organizational goals.

The 2020 COVID-19 pandemic has illustrated the importance of having a highly functional call center. Patients scrambling to get tested in the early days of the crisis and then desperately seeking to obtain a vaccine later in the year have stressed call centers across the healthcare industry. As healthcare call centers evolve, they need to be able to handle a growing number of services, develop multi-channel communications and maintain continued engagement with patients — especially during transition in health events.


Benefits and outcomes of effective agents in healthcare call centers

The interaction with the call center agent is the first stop in the consumer/patient experience and sets the tone for the entire engagement. Effective agents can use this opportunity to create a positive communication experience that can lead to patient satisfaction and ultimately patient loyalty.

A study from Solucient suggested that an effective call center team can also deliver a significant return on investment (ROI). The study determined that call centers generate an ROI of at least three to one and are ‘an essential driver of hospital revenue, profitability, and patient loyalty.’8

Reaping these benefits, however, depends heavily on having a staff of well-trained, knowledgeable agents who can quickly understand patient needs and go above and beyond to take care of them. Agents who gain satisfaction from helping patients and feel they are making a contribution to their organization are key to a successful healthcare call center.

The Happiness Advantage
Shawn Achor, a speaker and author, has written a book called The Happiness Advantage that highlights the importance of having happy employees. The book talks about how having a happier and more positive mind set can help people excel in a world of increasing workloads, stress and negativity. Some of the key points made in the book that relate directly to healthcare call center 
work include:

  • ‘Happiness is not just a mood — it’s a work ethic.’

  • ‘Organizational psychologists have found that even brief encounters can form “high-quality connections,” which fuel openness, energy, and authenticity among co-workers, and in turn lead to a whole host of measurable, tangible gains in performance.’

  • ‘The most successful people, in work and in life, believe that their actions have a direct effect on their outcomes.’

  • ‘Martin Seligman, the pioneer in positive psychology, has broken happiness down into three, measurable components: pleasure, engagement, and meaning.’

  • ‘People with a calling orientation not only find their work more rewarding but work harder and longer because of it.’ 

Keys to building a caring call center team

There are a number of important steps a healthcare call center must take to ensure that the team is made up of caring individuals dedicated to helping patients. Three important aspects stand out: creating the right environment, hiring the right people and training them to effectively handle often stressful patient calls.


Creating the right environment

One of the areas that client surveys consistently address is the type of environments in which the agents are asked to work. It is important to create an inviting setting where agents can feel part of a team. An open workplace that facilitates good two-way communication can be extremely beneficial. A work environment that helps keep people satisfied and more engaged with the work they do can be an important differentiator between having just an adequate versus a superior healthcare call center.

Providing a satisfying environment that translates when agents are speaking with patients is a priority. Creating a warm physical environment for employees is an important way to ensure that they find joy in helping patients during their moments of need.

When the pandemic hit, the shift to a remote workforce brought forth a new challenge when it comes to creating the right environment. Instead of focusing on the design of a physical workplace, the goal became how to accommodate a growing virtual workforce. This is done through providing advanced communication and collaboration tools along with offering flexible work hours to allow agents to meet the needs of work and family during a time of quarantine.

Whether physical or virtual, the goal is always to support the team by offering feedback opportunities through employee polls, a culture and communications committee and ongoing focus groups.


Hiring and vetting the right people

Ensuring call centers have caring agents begins long before they ever begin taking patient calls. The process begins at the hiring stage, where it is critical to find the right type of individual that is capable of not only handling the stress of call center activity but also displaying the empathy needed during patient interactions.

One call center stresses that:
it is important that the call center trains its agents to treat callers with compassion by balancing quantitative metrics such as call length and the number of calls processed with those that indicate the quality of the interactions, such as first-call resolution, abandonment rates and quality of patient engagement.

Another medical call center says that one of the key traits for an agent in the healthcare field is empathy. ‘The callers should not be pitied; instead, agents should listen and ask questions to understand what the callers are experiencing.’

There are many candidates applying to be call center agents, but the difficulty is in culling the group down to the ones who display the right aptitude and attitude for a healthcare call center. High performers display a greater level of openness to experience and agreeableness when compared with the overall population. Successful agents also require high levels of empathy and flexibility, which are crucial traits in a healthcare environment.

Openness to experience is highly correlated with intelligence and creativity. This is particularly emphasized because creative problem solving is important when talking to patients over the phone without visual cues. The agents have to be nimble when listening to what patients are saying and what those words may be indicating in terms of their health situation.

Agents open to experience tend to learn about the person on the other end of the phone as opposed to judging what they are saying. This naturally creates a rapport that allows the patient to share important information, which then enables the agent to better guide the patient on next steps. Finding people with these attributes can be challenging.

Tips for building a caring call center team

  • Leverage a holistic approach to hiring and vetting that includes behavioral interviews, skills-based testing, cognitive ability testing and other assessment tools.

  • Look for prospective employees who seek satisfaction, meaning and purpose from helping others and have a deep aspiration to improve the world.

  • Seek out people who exhibit curiosity, openness to experience, friendliness and agreeableness.

  • Perform extensive research to help identify characteristics like empathy and flexibility.

  • Conduct assessment tests and those who score high in several key categories should make the cut to the next stage of the hiring process.

  • Establish a goal of choosing people who are likely to stay with the company for the long term.

  • Establish strict retention goals that are tracked and reported at the company leadership level.

  • Make directors, managers and supervisors accountable for creating and managing a culture that all employees will want to embrace.

Below is a chart showing the personality traits of effective call center agents from one successful healthcare company (Figure 1).

The Impact of Self-Transcendence
The people most likely to succeed in a healthcare call center value self-transcendence more than the general population. Self-transcendence is the concept of rising above and relating to what is greater than self. Agents with this trait do not necessarily have to be highly educated, but they understand the importance of helping others. Agents in an environment that welcomes and nurtures self-transcendence often feel like a true professional for the first time and find joy from being able to help people.

Other aspects of self-transcendence include strong spiritual beliefs, which help them engage with patients and do the best job they can by helping them. People with the self-transcendence trait are perfect for the job because they care about helping others.

personality traits-1

Figure 1: Personality traits (average)


Figure 2: Typical values of effective healthcare call center agents

Successful healthcare call center agents tend to value self-transcendence, which reinforces their ‘in-service-to-others’ mind set (Figure 2).


Conducting effective training

Finding the people with the right outlook is an important first step towards an effective healthcare call center staff. Getting them to be effective in helping patients requires comprehensive training. One healthcare call center says training is a key differentiator:

A new agent coming out of training needs to feel comfortable and well equipped with the knowledge that they have the support of an entire team. Knowledge takes some time, but agents need to show their great customer service skills on each and every call. That’s engaging with the patient and understanding what they’re going through, whether it’s a wellness visit or a patient with stage 4 cancer. The agent needs to connect with patients and be caring.

People who reach out to the call center often are not well, so agents need to make sure they are listening closely and responding with empathy. Agents have to be trained to listen to what the patient did not say and probe when necessary to identify a greater patient issue. It is also critical to identify the patient’s tone to uncover a potentially escalating safety issue.

In addition, training should be focused on the technical side to help agents understand how to use the system. They also need to learn to follow the protocols and guidelines that may be different for each provider.

Since the healthcare industry has not yet gone through the business process engineering that has resulted in standardized processes in other industries, there tends to be a variety of approaches in the customs and nuances of how providers want to handle the patient engagement process. This means agents must be trained in the wants of each provider, service line and patient.

Tips for developing an effective training program
  • Approach training in a unique way, without focusing strictly on handle time, that is, how long it takes for the agent to speak to the patient

  • Identify the reasons for long handle time

  • Focus your training on having agents take the time they need on every call

  • Make sure agents are identifying and addressing every patient need without the pressure to cut the conversation to meet a target handle time

  • Real-time feedback to easily identify opportunities for improvement

  • Recordings and automation for content storage

  • Caring agents and satisfied patients are key to a successful healthcare call center culture


Creating the right incentives

Employees in every organization and industry need incentives that can raise morale and increase job satisfaction. The right incentives can lead to higher performance, better retention and lower absenteeism. Finding the right incentives for healthcare call center staff is particularly critical because of the importance of the work they do.

Establishing the right incentive program in a healthcare call center is difficult because of the variance in client programs that each requires very different tasks. One program may require 25 steps to finish a task while another may require only two. Comparing agents who are working on the two different programs is inherently unfair. This can lead to metrics that do not come out equally, making it difficult to measure one person versus another.

Healthcare call centers in general tend to lack the metrics that are in place in centers in other industries. There is usually little data available on call activity, service level, abandoned calls and agent productivity because they do not have the systems in place to capture those data.

Tips for creating effective incentives
  • When designing your incentive program, look for things that are within the agent’s control that can be normalized regardless of the program.

  • Consider quality of calls as measured by quality teams and patient surveys.

  • Stress being able to adhere to staffing schedules.

  • Create a scorecard with appropriate metrics on each agent’s performance to identify trends by type of issue and identify outliers, both good and bad.

  • Focus on the quality of conversation without making errors from a patient perspective.


The power of a virtual healthcare call center

Because of the pandemic, the past year has seen many healthcare call centers going virtual, having agents work remotely and hiring from a wider geographic area. Hiring agents from different regions in the country makes it much more effective in offering providers coverage in all time zones.

Recruiting from a much wider talent pool enables a company to significantly raise the quality of people joining the staff. A virtual model offers flexible hours at any time of the day or night, allowing for the addition of experienced individuals who must work from home but who still want to contribute to the greater good.

This model is particularly attractive to healthcare professionals who no longer want to work in practices, but still have a burning desire to help patients. According to one report, one of every ten healthcare workers have resigned a job since February 2020. An additional 12 percent of health care workers say they have considered leaving their current role for another position in the industry. These individuals are perfect candidates for positions as call center agents.

Ultimately a wider reach and higher staff level means a better experience for the patient, more cost-effective patient interaction solution and higher customer satisfaction scores for your organization.



Ensuring patient satisfaction is the key to a successful healthcare call center. Blending caring and compassionate people with technical innovation and new ways of thinking, understanding client needs and tailoring customer programs to meet those needs are important elements that lead to that success.

The essential component is the agent, the individual who is actually handling the patients’ needs. That is why focusing on the agent is crucial. In the final analysis, well cared-for agents result in well cared-for patients.






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About Envera Health

Envera Health provides comprehensive engagement partnerships for healthcare organizations seeking to transform the patient experience and simplify the care deliver y process. Supported by a unique CRM-driven engagement center, we other a complete suite of patient engagement solutions custom-designed to improve operational efficiency and enable steady growth.