Patient experience begins well before a patient gets to the hospital. And if a patient’s experience trying to schedule an appointment isn’t a positive one, they may not make it there at all.

At the Cleveland Clinic Patient Experience Summit this week, Karen Applebaum, executive director of enterprise access operations and technology at Providence St. Joseph Health system, spoke about how her health system tackled that problem.

“It was really complicated,” she said. “[Patients] were making multiple phone calls; someone compared it to calling the cable company. This is not the personalized care experience that we wanted to offer.”

For one hospital, she said, 13,000 annual calls were going to an outsourced call center in Texas  — and only 28% of those callers were actually making appointments.

When Providence St. Joseph decided to tackle that problem, they did it in a fairly dramatic way: they created the Patient Engagement Center, an in-house call center with a focus on providing useful, positive assistance to anyone looking to engage with the health center. The staff there is backed up by a new technology platform, essentially a custom-made customer relationship management (CRM) platform.

With the new system, they’ve raised that 28% appointment rate to more than 70% today.

“Some of that involves actually training [call center operators] to exhibit empathy over the phone,” Applebaum said. “What’s the right thing to say? How do you say it? How do you convey the right tone and the sounds that you make on the phone? How do you problem solve? Someone might call with something obscure or something we don’t normally help with, but your job is to really help them and ease their way through that process. And then of course, how do you have a nice balance of interaction and transaction? You want them to have a good experience, but you also want to help them in the quickest way possible.”

The technology component was a challenge, Applebaum said, because in order to build a useful software they had to grapple with a lot of insufficiencies with their existing tech.

“One element that doesn’t get talked about is the provider directory, which sounds really basic, but it’s been an integral part of this journey,” she said. “I don’t think accurate online scheduling is possible without a really good provider directory. … We’ve got 25,000 physicians, and we found when we started that journey that less than 25% had what we called a complete profile.”

But the technology has paid off. Now, with a much more complete directory, the health system was able to build a CRM that allows for easy appointment scheduling and is even beginning to integrate with the EHR. It currently pulls information in from the EHR, but making that into a two-way exchange is a current development project.

The tool allows Providence-St. Joseph to collect data on what patients are having trouble making appointments, so they can, for instance, hire more specialists in a particular on-demand specialty.

Because the call tool is integrated in the way that it is, Applebaum shared, the Patient Engagement Center was able to save the life of a woman who called in with severe alcohol poisoning and wasn’t able to identify herself before losing consciousness. Operators were able to contact the local police to do a wellness check.

“When we talk about technology and CRM and this consumer platform, it can come across very much like a marketing tool,” Applebaum said. “We’re saying things like ‘new patient acquisition’ and ‘conversion rates’ and honestly all of that is very important and very true. But at the end of the day we see this service and this technology platform as an extension of how we provide care for the community.”