Customer Outcomes: The Healthcare Journey

Customers expect a brand to continue a conversation seamlessly, following the customer across devices swiftly without dropping important information. When the service relates to a customer’s health – if the customer is a patient, that is – then the stakes become higher for the provider’s ability to keep up.

Aetna continues to optimize its customer experience for patients through the Aetna One Advocate (A1A) platform it rolled out last year, with SaaS CX support from customer tech specialists Topbox.

The Aetna approach employs a team of advocates – yes, humans – who use their healthcare expertise to manage multiple patients. Communications go both ways. Patients couldn’t be expected to master the complicated journey through services and benefits, in sickness or health. The advocate can advise Aetna members by drawing on local nurses, pharmacists, dieticians, social workers, doctors and network specialists.

According to Jason Clement, vice president of Aetna One Advocate, patients respond well to the proactive approach advisors take in reaching out to communicate with them about benefits. This informed communication is data-driven, supported by Topbox technologies that pull together and analyze patient contact from all of Aetna’s channels.

“We want to ease members’ burdens of managing their health and their benefits,” Clement explained. “We also want to learn more about what concerns members, frustrates them, delights them and most importantly what’s missing. Topbox offers capabilities that allow us to analyze and deliver a unified view of all member interactions, from contact center calls, emails chats, feedback on the website and surveys.”

He added, “Topbox technology helps us identify recurring service requests or concerns, and pinpoint their root causes, more quickly. As a result, we can continue to improve the overall customer experience.”

Topbox CEO and co-founder Chris Tranquill summed up what businesses want to solve with his company’s solutions: why are customers calling us?

“There’s a better way to do this, to collect and analyze all the ways that customers talk about companies, or to them, today,” Tranquill stated. “Through chats, emails, SMS, product reviews, in-app chat, social media, there’s all that amazing unstructured data sitting in databases that just can’t be normalized in an efficient way. We pull that data together and normalize it and really understand what customers are saying.”

Tranquill wants clients looking beyond surveys because, in his view, a low percentage of customers take surveys – two to five percent, on average – and those customers who do complete them tend to be compelled to do so because they are at the extremes, in terms of their responses, feeling either enthusiastic or strongly discouraged about their experience with the company. “We want companies to think outside of surveys,” he said. “Every single channel matters, and we’re seeing that more and more. The average customer uses three or more channels now (for a specific customer issue).” Aetna’s A1A program aims at getting ahead of these issues by helping advisors meet customer demands proactively and “educating customers on how they should be using Aetna and other available resources.”

One key metric the Topbox team accounts for is the channel through which the customer sends their message.

“There are two major things that drive choice of channel,” said Tranquill. “The first one is the complexity of the problem. If there is a detailed fix, you’re not going to send an email because it’s better to explain over the phone. The second one is the demographics (of the customer) and what channels they use for convenience and speed. You’re just going to get more of the conversation on the phone. On native chat channels, text, SMS, it’s going to be more direct because it’s a (simpler) secondary or tertiary issue. There’s a lot of good data there, too, but not in the detail of a phone conversation.”

Topbox director of marketing Jonathan Moore said, “The business will learn different things based on the customer’s choice. Consumers are more candid through indirect channels like web forums.” He added, “The best way to gauge consumer response to what you’re doing, in business support, customer success and tech support, is to get it from consumers in their own words.”

Thus far, Aetna reports positive results from its users. “Findings from Topbox have helped the A1A team ask and learn more about members’ personal preferences and goals, barriers, cost, site of care, and community resources,” Clement said. “Several members have told us they were surprised by the depth of support and delighted to have someone proactively looking out for their best interests. By building relationships with members, advocates help address customary issues such as improving medication adherence and coordinating member care plans, including disability. Many times, however, the advocates provide members with help they didn’t know they needed or had.”

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