Amid Competing Performance Improvement Dollars, Call Center Advancements Take Center Stage

Amid competing performance improvement dollars, call center advancements have moved center stage as health care organizations strive to improve patient access and experience. Reactive call centers, characterized by long wait times, complex navigations, and fully manual operations, can quickly morph into proactive “smart access hubs” powered by intelligent automation and artificial intelligence (AI). This transformation requires a new access strategy, one in which AI is a powerful tool to enable intelligent scheduling and coordination, not the entire solution.

A recent patient access survey of 100 health care leaders found that 47% ranked call center improvements as a top-three priority, and 15% put these investments in the number one spot. This should come as no surprise, as the US health care system still gravitates heavily toward traditional communication modalities such as phone calls, faxes, and postal mail. Despite untold billions spent on patient portals industrywide, new and existing patient experiences most often begin with the call center. Those interactions can shape everything from efficient care delivery to long-term patient loyalty.

As health care leaders work to remove barriers to access and create more seamless patient journeys, call center design must address the need to proactively connect patients to the right resource at the right time. Forward-thinking models will reflect a reimagined smart access hub that focuses on 3 key areas: intelligent scheduling, self-service automation, and call-deflection strategies that deliver conversational AI-enabled interactions.

Streamline Processes With Intelligent Scheduling

Smart access hubs are defined by intelligent workflows that align and anticipate patient needs, provider preferences, and clinical workflows. This goes beyond basic rules-based architectures to intelligence that is situational. For example, a simple rule may provide an avenue for appointment scheduling where the patient chooses a time or a provider.

In contrast, situational intelligence allows for more informed scheduling and care advancement. For instance, has this person been seen before? If so, have they completed any tests necessary for their next appointment? Is this part of an ongoing care plan or a one-off consultation? This type of deep contextualization allows organizations to schedule smarter, matching patients to the right provider and the right time, regardless of the modality used.

Pairing centralized scheduling with intelligent coordination and proactive tools reduces call handle times and enables more effective human-to-human calls. It also supports more consistent application of organization and provider preferences—a top scheduling challenge, according to 31% of executives surveyed by the Medical Group Management Association—particularly as staff turnover leads to loss of institutional knowledge.

Self Service and Automation Channels

Smart access hubs are designed to understand why patients call and then direct them to the best option. For many, self-service channels are the answer.

Nine in 10 patients want self-scheduling capabilities. When calls automatically guide patients to avenues for managing their own scheduling, the result is improved patient experience and operational efficiency.

Functionality should extend beyond scheduling and include value-added experiences such as simple opt-ins for waitlist management and communication preferences to deliver richer scheduling experiences along the full care journey. For example, a patient who is eager for a diagnosis and placed on a waitlist can automatically receive a notification when an earlier appointment becomes available. This minimizes the financial risk of late cancelations and other appointment gaps, while virtually eliminating manual and strenuous management of waitlists, further streamlining the scheduling process and strengthening patient satisfaction.

Finally, orchestrated rules should extend across multiple channels to reduce friction, whether patients are scheduling via phone, automated chat, or an online portal. This approach ensures that patients have the same options and experience at every point.

Call Deflection Strategies

Effective call-deflection strategies are a primary pillar of smart access hubs, providing the critical execution path to handle escalating patient demand and resource constraints. This requires intelligently routing patients to alternative, efficient self-service channels, which minimizes reliance on staff for routine inquiries and maximizes self-service availability. By not optimizing access, however, organizations risk allowing current challenges to translate directly into lost opportunities.

Self-service digital pathways can help bring balance by helping health care organizations manage demand without sacrificing human touch. AI agents are an important part of this equation in that they can send patients smart links to self-schedule and handle routine requests such as appointment confirmation and rescheduling requests. But one-size-fits-all solutions don’t adapt to organizational priorities, allow organizations to define for pace of adoption, or ensure the cultural balance between “high touch” and “high efficiency” is precisely dialed-in. It’s critical for organizations to maintain control of the “jobs to be done” with AI and with their highly trained staff. For complex or organizationally-designated needs, patients can still have access to a human agent, one who is freed to handle those specific interactions without the pressure of managing overwhelming call volumes.

The patient access survey revealed growing adoption of AI-based technologies in call centers: 37% of leaders reported investments in patient feedback analysis, 36% in agentic AI or voice AI agents, and 32% in intelligent call routing. Health care-specific voice AI solutions are uniquely designed to handle the nuances of Health Insurance Portability and Accountability Act (HIPAA) compliance and clinical workflows.

Recent analysis found that every call is intelligently routed, either resolved autonomously or transferred to the right staff resource. In some organizations, the voice AI was able to autonomously handle two-thirds of appointment cancellations and 72% of rescheduling requests to the voice agent.

Embracing the Future of Smart Access Hubs

Traditional call center operations defined by manual processes and heavy resource demands are no longer sustainable in today’s health care environment. Organizations must balance ongoing staffing challenges and rising expectations for better patient experiences, while protecting their brand promise and expectations of the patient populations.

The move toward smart access hubs represents more than a technology upgrade. It’s a strategic shift toward proactive, patient-centered access. It means every interaction is guided by intelligence that anticipates and adapts to patient needs. While AI has a role to play, it is a powerful tool to enable this transformation, not the total solution.

About the Author

David Dyke is Chief Product Officer at Relatient. He has over 25 years of product, R&D and commercial experience across many healthcare verticals, including patient access, revenue cycle, clinical research & health information management. David is passionate about helping healthcare organizations achieve their full potential while positively impacting the lives of people in their communities.