Modernizing Patient Communications for World-Renowned Care: The Brooklyn Hospital Center and Cisco Contact Center Story

Cisco Americas

The Brooklyn Hospital Center was founded in 1845. It’s safe to say that we are a fixture in the community, but being an historic institution doesn’t mean we’re old fashioned. In fact, we’re a modern teaching and research hospital that operates dozens of clinics at our Downtown Brooklyn campus, our eight satellite sites, and many private practices and doctors' offices.

At TBHC our mission is to be a destination provider of top-quality and compassionate healthcare to the people of Brooklyn and Greater New York. The core values that drive our work are community service, respect, efficiency, accountability, teamwork, and excellence. We serve a large and diverse population in terms of age, ethnicity, socio-economic background, sexual and gender identity, and other demographic factors.

This diverse population interacts with the hospital in many ways, but often that interaction begins in one area: our contact center. 

Struggling with an Obsolete Contact Center

We strive to provide the best and most up-to-date care to every patient and member of the community we serve, but an organization as big as ours sometimes falters. We recently realized that our contact center was not providing an acceptable level of service to our users.

It wasn’t for lack of trying. TBHC's 20 contact center agents are a team of dedicated professionals, but they were working with old technology. They were not equipped to handle the needs of the patients who were calling into schedule, change, and cancel appointments. It was a mess for both our staff and our patient population.

To start, the hospital as a whole was using seven different phone systems which were impossible to manage all at once. We were spending all of our collective time putting out fires instead of helping users communicate efficiently and accurately with our various clinical areas and our patients. The core of this system was a legacy Nortel telephone system that amounted to 3,000 wired phones, all of which were 20 to 30 years old.

Multiple systems means IT spends their time putting out fires instead of enabling your workforce. @CiscoCollab

This was the same gear we had in the contact center. It lacked sophistication having no way to see where call traffic was coming from or where to route it to. This missing information lead to redundancies and wasted resources. For example, at that time our agents handled scheduling for dozens of clinics and specialists but had no way of knowing the person a caller was trying to reach and thus had to answer with a generic, “The Brooklyn Hospital Center” greeting. This wasted time, prolonged the interaction, and didn't provide a personalized experience for our callers. 

There wasn’t even a simple way to route callers based on their language preference. This was particularly troubling when one considers the diverse population we serve. Sometimes a call would come in to an English-only agent from a Spanish-speaking patient. After a mutually confusing initial encounter, the agent would put the customer on hold and yell across the room for someone who speaks Spanish to pick up the call. It was just as frustrating and disruptive for agents as it was for patients. We knew that we had to prioritize patient experience and that our contact center needed to be the starting point for those efforts.

Finding a Solution that Better Serves Patients and Contact Center Agents

As The Brooklyn Hospital Center's Director of Technical Services, it was my job to find a solution that would improve the situation for both our patients and our contact center team. We had several priorities in view, with patient experience top of mind. It was simply unacceptable that patients were put on hold without knowing the length of their wait time. It was even worse when calls were dropped. Also, we needed a call flow that routed patients to an agent who spoke their language and who already knew what clinic, department, or specialist they were calling in to. 

Proper call routing = unparalleled customer service. Stop guessing, start serving. @CiscoCollab

In terms of the installation within the contact center, we wanted a centralized solution that was easy to use and maintain. Our hardware was ancient. With our previous setup, agents could only retrieve voicemail by picking up the handset on their desks. And they only knew of a message if they were sitting at their workstation. There was zero flexibility.

A final consideration was avoiding cost overruns. Our contact center is a 9-to-5 operation that mostly handles scheduling. Still, our previous setup made it impossible for our agents to handle all the incoming and outbound calls, and we had to outsource some of their work. We had to resort to third-party overflow vendors who charge by the minute. Let me tell you; it was starting to add up.

"It was simply a matter of getting our leadership's approvals to switch to a new infrastructure and then adopt a solution we already knew and trusted." Cisco @CiscoCollab

The right solution was staring us in the face. We were already using Cisco Unified Communications Manager in our IT department, but the contact center was still running on old Nortel/Avaya PBX equipment. It was simply a matter of getting our leadership's approvals to switch to a new infrastructure and then adopt a solution we already knew and trusted.

A Speedy Transition to our Cisco Contact Center Architecture

Using Cisco Unified Communications Manager in-house for our IT team was one thing. Deploying the solution to meet the needs of patients calling into 40 different clinics, departments, and specialist offices was another. We knew what we wanted, but we didn’t have all the answers lined up.

To ensure best practices, and the selection of the appropriate components, we sought out a Cisco partner who specialized in contact center solutions, and found one in ShoreGroup. They helped with project management and designed the solution that best suited our needs. The process was streamlined and relatively swift with respect to projects of this scope.

We signed off on the design in mid-January 2018, and work started in February. Three months later, the Cisco Contact Center was up. We went live in August and spent the intervening months vetting call flows and integrating apps that would expand our capabilities.

We added Acqueon to manage outbound multichannel communications, and Twilio to leverage an SMS gateway. Finally, we integrated EPIC EMR to tie our scheduling system into the hospital’s patient records system. This integration was one of the key reasons we went with Cisco. Integrating our EMR and scheduling systems was a game changer.

I have to say that ShoreGroup and our on-site team at TBHC were stellar. We were dealing with several vendors in different time zones, but the IT department put all of our resources behind the project. We did a lot of testing and then rolled out the new solution.

I was shocked at how quickly our contact center staff picked up the new system. I thought it would take longer, but within two weeks everyone was comfortable and using the technology. Our agents knew they could look at the screen and see where the call was coming from and where it was going. It was that easy.

It All Adds Up

With any new implementation, there will always be a few surprises and lessons learned. One of the issues we spotted immediately was our inability to move ahead with Twilio SMS campaigns. It wasn’t a hardware or software glitch, but an oversight in our previous contact center procedures. Simply put, we’d never asked our patients for their cell phone numbers. We’d put in phone numbers, of course, but we’d never required patients to specify whether these were landlines or mobile phones.

What had been a minor oversight in the past ended up having huge implications for our new system. Now our agents always ask callers for their mobile numbers. This means we can also take advantage of that Twilio integration.

We’re not only taking appointments with our new Cisco Contact Center solution, but we’re also moving into exciting new communications channels that will generate new business opportunities for TBHC. We’ll be doing things like annual health checks by messaging patients on their birthdays to remind them to come in for a physical. We can remind mothers when their newborns are due to be vaccinated, or send out alerts about flu shots. We can do this through voice and SMS messages.

We also have at-risk patients who need to keep up with their medications. We can send them reminders to pick up their prescriptions at the pharmacy. We can automate callbacks and feedback mechanisms. The potential is huge from both a patient care and business perspective. We’ve only begun to scratch the surface.

In terms of watching over all of this, we’ve also installed Calabrio workforce management software. Our supervisors can listen-in on calls and then coach agents to ensure an optimal patient experience. They can also monitor the hold queue and even set staffing levels according to call volumes. These are very simple things on their own, but taken together they greatly enhance the power and flexibility of our contact center operations. It’s incredible that we now have a call center solution that integrates so well with other providers. 

Lessons for the Future

Our next step is to expand Cisco and IP telephony to the entire hospital. We’ve already gone from seven telephone systems to two. Next, we’re putting together a business plan and a capital campaign to extend our deployment of Cisco Unified Communications Manager throughout the main hospital. In the future, who knows, maybe we can add a system that recognizes voice commands using technology like smart speakers.

No matter what happens, our ultimate goal is to provide the necessary tools to our staff so they can then provide the best experience for our patients. But as we found out, technology isn’t always the only answer.

We also set a goal of increasing appointments by 5% while simultaneously decreasing no-shows by 5%. We then discovered that our Cisco Contact Center solution had zero impact on these two targets simply because it didn’t need to. With the insights provided through the contact center, we saw that we were already efficient. We didn’t have to make a push for these arbitrary goals. Instead, we could focus on maintaining that efficiency while always keeping the patients top of mind. 

New IT solutions won’t solve all of your problems. You still need great people behind that technology. @CiscoCollab

It was a valuable learning experience. New IT solutions will resolve many issues by simplifying and speeding up processes, but they are only part of your journey. You have to be prepared for the surprises that they may uncover.

In the end, everything comes down to providing a superlative patient experience. All other metrics and outcomes are secondary. I could go on for hours how Cisco transformed our contact center operations and how smoother things have become on our end.

However, the only thing that really matters is that it is now easier for our patients to talk to The Brooklyn Hospital Center, and play a more active role in their healthcare. We can also respond to them in meaningful and nuanced ways. What better way to give everyone in the community the quality healthcare they deserve?