Q&A: Proactive Engagement Centers: How Scripps Health Transformed their Traditional Call Center to Deliver Customer-Centric Experiences

Engagement Center RepToo often call center representatives lack context to why a consumer is calling and are forced into a reactive—rather than proactive—position. This creates a disjointed, impersonalized, experience. Because a strong patient-provider relationship is central to this strategic market shift from “volume/episodic” care to “value/relational” care, health systems now need to capitalize on every patient and consumer interaction—from fielding the first inquiry to actively supporting proactive health, ongoing care, and recovery —to achieve a “trusted provider” status in the eyes of the “shopper”.

To respond fully—and to optimize every consumer or patient inquiry—health systems need to speak with a unified voice and deliver consistent, positive experiences with every interaction, both in the physical world and online.

Enter the call center.

Call centers were created to handle everything from switchboard/call-routing to appointment scheduling, pre-registration, and billing questions, as well as physician referrals, nurse triage, and marketing response. In reality, though, many call centers today are falling short on optimizing every patient inquiry and delivering the exceptional, positive experience that every patient expects.

In a recent webinar hosted by Becker’s Hospital Review, Don Stanziano, Corporate Vice President, Marketing and Communications at Scripps Health and Rachel Neely, Senior Healthcare Consultant at Evariant discussed how Scripps implemented a marketing call center to capitalize on every customer interaction to build deeper, more personalized relationships with their prospects and existing customers.

Let’s take a look at some key takeaways and questions asked during the webinar:

How easy is it to integrate all customer data – online, call center, clinic visits, etc.? What is needed to pull all activity together?

To be honest, it really is not that easy. Anything worth doing well is not an easy process, but is very important and strategic work that must be done. Priority number one would be to make sure you have internal buy-in. This means that Marketing has to be committed and willing to work with many departments throughout the organization including, but not limited to, the Call Center, IT, IS, Finance, Clinical Operations, and Compliance. Once you have this necessary buy-in, the process is much more manageable.
In addition to this, if you are working with a vendor, the vendor should guide you through connecting all of your critical data points. You may have data from different sources – which is entirely fine – but the data needs to feed into one centralized location.

Who are your call center representatives? Can you describe their level of education and experience?

Our call center representatives have a variety of skillsets, but most of them come from clinical operational roles with some understanding of healthcare and experience in a clinical setting. The representatives absolutely need to have some level of comfort with data as they are responsible for gathering and interpreting data. Their responsibilities are much more than just answering a telephone. Although it is not required, it is helpful to have a nurse navigator on the team in the engagement center to provide light cross-selling and upselling to the callers.

Why the emphasis on Twitter? The majority of people use Twitter in really unproductive ways, like tweeting about what they had for lunch or what shoes they’re wearing that day. Why would people take seriously what they tweet about their healthcare experiences that they have very little knowledge about? Also, isn’t the impact of a tweet completely dependent on how many followers and what types of followers someone has?

We can start by saying that Scripps Health does not put a lot of emphasis on Twitter – but more so – on social media in general. The most engagement comes through Facebook; however, it is important that we monitor the entire social media presence. Because customers are on social media, we need to actively listen to their feedback, complaints, and experiences and make it known to them that we are present and we do care about every individual we engage with. If Scripps is being talked about on social media in a negative way, we need to address that and work with Operations to resolve the issue.

How are the various inquiry platforms routed to specific campaigns? Is the campaign guru then monitoring all incoming platforms?

At Scripps Health, a small, core team monitors, in real-time, all of the leads being brought in. All leads are gathered through a CRM platform. Depending on how the lead was sourced, it then follows a patient journey and is routed appropriately to receive an automatic trigger which can include a nurture email, and event invitation, etc. This blog post dives into how patient journey maps are used for ongoing preventative nurturing and cross-selling.

What is the full-time employee size of the Scripps Health call center and do they operate from a centralized location, decentralized location, or home approach?

This entirely depends on the organization and volume of calls and the other types of work that the call center representatives are engaged in. Scripps Health has multiple call centers with a variety of functions from billing to schedule to marketing. We can speak specifically to the Marketing Call Center. The Marketing Call Center at Scripps is centralized and everything routes through a 1-800 Scripps phone number. The team of 12 is connected to the CRM database and to the online and offline marketing efforts. They have access to a certain amount of information in the EMR.

Are interstitial pages one of the categories of web design that Google is targeting and downgrading in their index?

This penalty only impacts intrusive interstitials that happen directly after going from a Google mobile search result to a specific page. It does not impact or penalize pages after that. You can read more about this topic here. Basically, if you have an intrusive interstitial that comes up later in the click path on your website, this won’t impact it – it only looks for the intrusive interstitial after the click from the Google search results page.

Do you have ROI calculations?

Yes. For the campaigns that the Engagement Center is a part of, we absolutely calculate the ROI for both the technology investment and the marketing investment. To calculate these metrics, we look at call activity, we can track leads into the call center by campaign (i.e. through cardiovascular efforts or bariatrics, etc.) and how much engagement happens with online vs. call center tactics. We cannot accomplish what we are trying to do without being able to show ROI and Don actually reports to his board on a monthly basis with how the campaigns are performing.

In the webinar, you gave two different scenarios/personas – Harry, the patient that wants to talk to someone on the phone and Sally, the patient that only wants digital communications. When Harry received a phone call, who was it that was calling him?

Engagement Center Use Case

In this case, the person calling Harry is a Marketing Call Center representative. Harry instigated activity online (presumably searching for a phone number) and that information was fed to the Marketing Call Center. The representative then called him.

How do you capture online activity unless they register/identify someway?

This information is captured in two ways. The first is through registration from an online web form. The second is through integration with a Content Management System (CMS). With a CMS, we are able to track who is hitting the website and when.

Does the Engagement Center have the capability to send reminders for upcoming appointments? And if a patient is a no show/missed appointment, can the Engagement Center representative coordinate a call to the patient to reschedule?

Provided that the Engagement Center is linked to the CRM system so that data is being fed from the CRM, then absolutely!

Does the Engagement Center integrate with the health record?

The Engagement Center does integrate with the health record in a very secure fashion. The Engagement Center representative can see limited, basic information about the caller including: online activity with the health system, campaign and event activity, as well as basic encounter information such as the last date seen and first visit with the health system. There is no HIPPA sensitive data that is stored on the platform – it’s more based on the consumer interest vs. clinical.

Is the CRM available only on outbound calls? How would one navigate both on cold calls?

The Engagement Center product can be used for both outbound and inbound. Scripps Health primarily utilizes the inbound function. Outbound is possible, but adds another layer of clinical skillset through clinical discharge or a nurse navigator. The exception to the rule is simply doing outbound call reminders such as appointment reminders and outreach based on online activity and clinical intent.

What product and vendor do you use for CRM and for your Engagement Center?

Scripps Health has utilized Evariant for both CRM and the Engagement Center for over three years. In this short video, Don talks more about why Scripps selected Evariant and the transformation that their marketing department has had at Scripps to enhance their patient engagement strategy.

How are physicians partnering and do you have any specific experiences you can share around this?

Scripps has seen a number of physicians that have become interested in what the Marketing team is doing. The physicians are interested because they want to know how this will impact them. The Marketing team educates the physicians about the software and the overall strategy to have a more digital focus. The Marketing team has greater control around guiding the consumer to the physician and can direct the incoming patients to the appropriate physicians based on the location the caller is coming from or if there is a specific request to see a physician. In this case study, we talk more about the data-drive approach to marketing that Scripps has taken and how they have been able to execute successful campaigns.

How would the Engagement Center interface with a telehealth platform?

Telehealth calls are sourced typically through transfers from your call center or through a direct call to a specific number. Several Evariant clients use the Engagement Center solution to give patients the option to schedule a face-to-face meeting within a period of time or be transferred to a provider that can speak to them immediately. The interface with the telehealth solution can be through APIs or other types of integration. We have seen different variants/use cases on the above as well.

What was the biggest challenge when going through this transformation?

The biggest challenge was getting internal alignment and resources – from IT to the executive level – committed to the project. Everyone needed to be on board and understand the benefits and the goals on implementing the Engagement Center solution. The Engagement Center is not just a technology, but is actually building the patient experience.

How did you get internal buy-in to make the investment in an Engagement Center solution? Where did you start in this process?

The Engagement Center solution was part of an overall marketing strategy. Three years ago, Scripps was using a traditional call center software, but it was out of date and the current vendor was not supporting it. It was opportunistic that Scripps was considering a CRM and Evariant had an Engagement Center solution that could solve the gaping call center issue.

There was a great deal of socialization to get this process started. Again, this included getting internal teams aligned – working with IT, Compliance, and Finance – and making sure that they understood the need for a CRM and Engagement Center solution.

What type of feedback – internally and from patients – have you received since implementing the Engagement Center?

From a patient perspective, satisfaction is high. Patients feel like they have a “one stop shop” when calling the Scripps Engagement Center vs. being rerouted. Don receives emails almost daily from the call center leader with feedback from callers that are happy with the service and complimenting the callers. The patients appreciate that the representatives know a bit about the callers when they call in. With the representatives knowing more about the callers – such as an event the callers attended last month or their last visit – they can have a more engaging conversation. The callers are not just waiting for the phone to ring, but are being proactive.

From an internal perspective, there is increased interest in the Engagement Center solution. Other departments want to know how they can be part of our vision and how we are able to show a concrete, tangible ROI.

Final Thoughts

In order to provide their patients with the highest quality care, Scripps Health recognized that they had to improve the customer experience and provide proactive service starting with the first encounter. With an Engagement Center solution, Scripps Health arms their call center representatives with the right context and talking points to provide a personalized, more informed customer experience resulting in more proactive population health management.



Evariant provides a leading healthcare CRM solution suite designed to help health systems transform the healthcare experience for their consumers, patients, and physicians. Built on the Salesforce Platform, our solutions foster richer consumer/patient engagement and tighter physician alignment. Powered by cutting-edge data and analytics, Evariant enables health systems to effectively communicate care options that increase revenue and market share, while optimizing network utilization. Many of the top health systems have selected Evariant to thrive in today’s hyper-competitive and rapidly changing environment.