policy automation: automating policy compliance in personalized

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Policy Automation: Automating Policy Compliance in Personalized Customer Engagements

Davin Fifield, VP Oracle Policy Automation Jan Guzik, Product & Service Development, KP OnCall Sheri Hastings, Software Architect, Perficient April 2nd, 2015


Spread the Word about the Event!

#ModernServExp


Agenda

Who needs Policy Automation?

What is Policy Automation?

Customer case study: KP on Call

Summary

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Challenges in service delivery

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of companies say inflexible technology prevents adapting to new ways of doing business.3

46% 29% of customers say their 1st choice is something other than the phone2

of issues that end up as a call didn’t start that way1

60%

1 Sales and Service Excellence, Effortless Experience, Nick Toman, 1 Oct 2013. 2 CFI Group, Contact Center Satisfaction Index 2013. 3 Oracle CX Study, February 2013,

How quickly can you adapt to change?

Do you offer multi-channel service for complex inquiries?

Are your customers able to self-serve effectively?

http://www.cfigroup.com/downloads/CFI_contact_center_satisfaction_index_2013-eo.pdf

http://www.oracle.com/us/corporate/features/cx-survey/index.html


Modern service delivery requires many types of policies

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Government Policies

Regulations

Product Decisions and

Eligibility Rules

Organizational Best Practices

Service and Advice Rules

Legislation


Organizations and IT struggle to adapt to policy changes

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Inconsistent policies impact the organization

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34% of organizations say inconsistent policy implementation caused poor customer satisfaction

of organizations state that policy change remains predominantly manual

95%

Sources: Economist Intelligent Unit Survey


Objective: Use policy automation to automate high value business functions

The service automation spectrum

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Anonymous Browsing

View Personal Information

Find General Answers

Update Personal Information

Initiate Complex Transactions

Get Personalized Answers

Complete Complex Transactions

Fully Automated Service Delivery

Low Complexity, Low Benefit

High Complexity, High Benefit

Traditional Development, Static Forms Policy Automation: Dynamic, Policy-Based

Typical Benchmark


Higher Education

Policy Automation has customers in almost every industry Financial Services Social Services Tax Administration

Health and Insurance Media and Utilities Mfg and Retail Justice and Licensing


Agenda




Summary

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Cross Channel Contact Center

Knowledge Management

Web Customer Service

Policy Automation

Service Cloud Platform

Field Service Management


Managed, Interactive Policy Models

Sources

Product and service definition rules

Regulations

Company policies

Self-service, mobile

Chat

Call center

Any other apps

Deployment

Policy Automation enables consistency and agility Deploy up to date policies directly into service experiences


Policy Automation for Oracle Service Cloud

Microsoft Office

Policy Modeling

Customer Portal or

any other web site

Policy Automation Cloud Service

Agent Desktop

Policy Experts

Agents Customers

Model policies and end user interviews in a business-friendly desktop experience

Manage the policy lifecycle with streamlined cloud-based administration and deployment

Provide personalized web-based advice for customers and agents


Policy Automation for Oracle Service Cloud Intuitive, personalized guidance

Deliver clear, transparent and personalized advice

Increase customer satisfaction and reduce call center volume

Provide documents that record and explain decisions

Reduce the number of escalations and appeals


3x Up to 3x improvement in case handling success

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Source: Oracle customer surveys. Most cases resolved in one contact down from three. Error and appeal rates halved.


Policy Automation for Oracle Service Cloud Agile customer service

Up-to-date

advice

Update with Oracle Policy

Automation

Policy change

Deploy

Policy modeling with

Microsoft Office

Business-friendly policy authoring experience

Respond quickly to changes in legislation and policy

Rules match the language and layout of source material


Policy Automation for Oracle Service Cloud Easy to use experience that makes it easy to engage policy experts

Intuitive Interview Design Experience

Rules Modeled in Natural Language Word and Excel Documents


30x Policy and rule changes are 30x faster on average when using Policy Automation

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Source: Oracle customer surveys. When compared to traditional scripting and code-based approaches.


Decrease errors and training costs

Consistent, personalized cross-channel guidance

Can also integrate policies via standard web services

Policy Automation for Oracle Service Cloud Enable Cross-Channel Consistency

Customer Portal

Agent Desktop

Knowledge Base

Your Web-site / Application

Policy Automation Interviews


Policy History Tracking

• Empower agents to explain why a decision was made

• Avoid customer complaints

Handle New Obligations

• Easily manage changes using the structure and wording of the source material

Decision Audit Reports

• Empower auditors with detailed explanations of how each rule was applied for every customer decision

• View easily in a report

Build Trust through Transparency Policy Automation simplifies compliance reporting


12x Agent training costs are reduced up to 12x when using Policy Automation

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Source: Oracle customer surveys. When compared to traditional form-based data collection by agents.


Agenda




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Problem – What we want to solve

Cost of Care + Availability of Care

• Health Care is expensive

• Average Nurse Salary/year (CA): $91K(BLS, 2011)

• Average Physician Salary/year (CA): $183(BLS, 2011)

• Health Care is hard to find

• patients and resources

Solution

Minimize in person care unless essential

or desired by patient

Offer remote care (telephone appointments, video)

Remote care still requires the most expensive resource (Nurses, Doctors, and other professionals)

Web Self Service & Nurse Chat

The Web Self Service & Nurse Chat project empowers members

with a choice of self assessment versus waiting to speak to a

nurse on the phone or go in for an appointment.

UTI Web Self Service Use Case

Cindy thought she had another Urinary Tract Infection (UTI). She remembered that when she suffered the same symptoms a year ago, she called the nurse triage service. She was treated over the phone, but it was embarrassing to talk about her symptoms at work and she had to wait a while for the nurse. Today when she called, she was

asked to if instead of talking to a nurse, she would rather go to a secure web site and fill out a questionnaire. Cindy liked that option, so she

decided to try it. Once on the website, she answered a few questions and received instructions that a nurse practitioner would notify her via

email about the status of her request. In just a few minutes, she received an email telling her that she had a prescription ready to be

picked up. The nurse practitioner also included some instructions on how she could avoid a future infection.

Member Experience

How does it Work?

Member Survey

LOVE It!

“This was definitely awesome. I would use it in a

heartbeat. Loved the live chat option even if I didn't use

it, it was nice to know that it was there to answer any

questions. Kaiser goes above and beyond when it comes

to reaching its patients in a variety of ways. A++++ to you

Kaiser!!!!”

Did you prefer filling out a questionnaire versus talking to a nurse?

Would you use this service for different symptoms? Comments

“Great service, readily accessible and private with fast and efficient response. I'll be sharing with other members.

“The systems was easy and user friendly. I didn't have to wait for a nurse to call me back or send an email to my primary provider. I like the easy route and fast service.”

“Super quick and easy – this is why I love Kaiser so much. Everything is streamlined and easy for the

patient. Thanks!”

8%

29%

63%

Yes

No

NoPreference

Would you use this service again for UTI ?

6%

94%

Yes

Unsure

11%

3%

86%

Yes

No

Unsure

3%3%3%

9%

82%

Very Easy

Easy

SomewhatEasy

Difficult

Very Difficult

How easy was it to use the app?

Member Survey - Specifics

$$$$$ Benefits Is there ROI? – Yes, it will free up nurses to work with other members

25% 50% 75%

UTI Calls/Mo 3200 3200 3200

Pt Accept WSS 800 1600 2400

FTE 1.6 3.2 4.8

Cost Avoidance/Yr $ 263,080.00 $ 526,160.00 $ 789,240.00

Utilization


Agenda



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Summary

Use Oracle Policy Automation to

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Improve customer satisfaction with accurate personalized advice

Increase transparency and agility

Understand the impact of new policies and changes before deploying them

Ensure policy compliance


Want to know more?

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Learn about industry applications

Policy Automation Industry Examples: http://t.co/zU3GXIm3lm

Try the Policy Automation app

iTunes: http://apple.co/1EQUxze Google Play: http://bit.ly/1EQUW4N

Engage socially Watch YouTube videos

https://www.facebook.com/ OraclePolicyAutomation

https://twitter.com/OracleOPA

http://www.youtube.com/user/OraclePAVideos

http://t.co/zU3GXIm3lm

http://apple.co/1EQUxze

http://bit.ly/1EQUW4N

https://twitter.com/OracleOPA

https://www.facebook.com/OraclePolicyAutomation




Be Sure to Attend: Public Sector Vertical Breakout April 2 – 2:00 – 4:00 p.m. Join your peers within the Public Sector to hear three presentations around the "HR Modernization Story Benefiting Generations of Airmen", "Improving Citizen Service Experiences with Oracle Policy Automation", and "A Modern Citizen Experience: The Next Generation of 311/CRM Systems". We will also discuss the challenges and opportunities in delivering great experiences for your constituents