Blue Cross Blue Shield--Rhode Island Improves its Bedside Manner

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  • Why CRM?
    Different areas in the organization had different information in different systems. We weren't getting good data, because it wasn't centralized in one application that would serve [several functions]. It had to let us gather information about our customers; improve what we do from a service experience; and look for opportunities to simplify our processes. We [also] needed to know the types of questions we were getting in the contact center to identify service-improvement initiatives.

  • What were your key criteria for selecting a CRM vendor?
    In 2003, when we chose Pegasystems, they had deep healthcare experience and a system we could easily implement in our organization. We didn't have to start from scratch. We tweaked it just a bit...to make it work for our business.

  • How did you gain executive and user buy-in?
    We were using just green-screen mainframe systems. Navigation to get to information was very difficult, and the training program was twelve weeks for new hires. We promised to improve upon the handle time for individual inquiries, to spend more quality time proactively resolving issues. That was the core of the business case we presented.

    To differentiate ourselves from our competition we have to have an edge on the service side. We needed to get our people the tools they needed, and to make it seamless to the customer. [The executive team] understood this was a priority; our CIO supported the project wholeheartedly.

  • What were the key challenges or obstacles, and how did you overcome them?
    We had all our resources focused on getting this done, and we managed our milestones very closely. That's where having a project management consultant really helped. We had a weekly project management meeting with all stakeholders, which kept us focused on important milestones--and kept us all honest. If there were any obstacles coming down the pike, we could mitigate them right away.

  • What were the main results and rewards of CRM?
    We reduced the time it takes to train a new hire to ten weeks--and we think we can reduce it even further. We're spending less time teaching them system navigation and more time focusing on quality customer-service interactions. In some cases we only have to teach them to navigate one or two screens instead of six or eight for the information they need, so we're able to cut back on the technical aspects of training to focus more on customer service soft-skills training.

    We saved a number of steps in workflows by automating processes the agents have to do on a daily basis, such as updating an address or requesting a member card. The system is automatically doing it for them. We saw a 17 percent improvement in call-handling times the first month after going live. We weren't really focused on reducing the talk time, but the time it takes to take another call after the first call's over.

  • What are your next steps?
    We're preparing to convert our back-end legacy system to a new processing system. We're going to have two separate systems for a while, but my folks will be shielded from that fact, [thanks to] a transaction router that knows which system to go to for information. We're working to get our service representatives access to an online reference library to replace the butterfly binders on their desks. The binders hold information [like] basic workflows and details around certain types of products that never resided in one system before. Also, we'll be building more workflow automation to reduce manual processes.

    Lessons Learned

  • Take your temperature first. The only way to gauge success is to take baseline measurements going in.
  • Don't be afraid of a second opinion. The right consultants know what they're doing--they've been through it before.
  • Minimize the impact. Too much change at once can be counterproductive. Retain as much as possible of what worked before.
  • Get regular checkups. Scheduled meetings to gauge progress help keep everyone in line.
  • Prescribe small doses. Break the deployment into manageable pieces to control the scope of your project.
  • Be proactive. Soothe the inevitable hiccups by showing people the benefits.
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