Unity Health Network’s Centralized Contact Center


TriageLogic


TriageLogic Helps Unity Health Network Enhance Patient Care and Reduce Costs

In this issue of AnswerStat we’re spotlighting the largest independent physician group in Northeast Ohio: Unity Health Network. With more than one hundred providers in thirty-two locations, Unity cares for hundreds of thousands of patient lives. Unity Health Network is also a leader in the Ohio Independent Collaborative, a statewide organization that unites other large independent physician groups to improve care and lower costs in the modern world of on-demand medicine.

Like most independent practices, Unity Health Network frequently uses telephones to connect patients and providers. Recently Unity recognized these communication channels were due for modernization. As part of its initiative to provide patients with high-quality, improved access to care, the group created a centralized call center, called the Care Coordination Center, with the help of TriageLogic.

“TriageLogic’s call center platform allows us to help guide our patients 24/7, giving them improved access to the correct facility for the care they need,” said Lisa Kilway, manager of care coordination at Unity Health Network. “By using TriageLogic, we can take care of our patients at the best location for the lowest cost, which means we’re not only providing improved care, but we’re also doing it more efficiently.”

By implementing the TriageLogic platform at the Care Coordination Center, Unity Health Network is able to build the foundation for its patient communication strategy. Only one year into the new call center, Kilway said Unity has consistently exceeded its goals month over month. “Previously, patient calls suffered an abandonment rate well over 50 percent, but since we created our Care Coordination Center, that rate has dropped to less than 10 percent.”

In addition to the call center platform, Unity Health Network also implemented TriageLogic’s secure texting feature, which allows for secure texting to a physician – eliminating the need for archaic pager systems. Each text is accessible by the physician for ninety-six hours, so they can review the text and pass it along if necessary. On the back end, the nurse can view when the doctor has received and read the text. “With a page, many times we just sent it and hoped for the best. As a nurse, I really don’t like those loose ends. Secure texting ties them up,” says Kilway.

Unity Health Network developed some key initiatives for 2016. As a starting point, the physician group began providing access and appointments without waiting for a physician’s staff to check voicemails and return calls. “We’ll be moving to do the same with all of our specialties,” says Kilway. “Our goal is to get patients from their primary care physician’s office to the specialists they need to see – sometimes even the same day. We’re able to handle their care much more efficiently and seamlessly.”

According to Kilway, Unity Health Network has even more ambitious plans for the future with technology-driven healthcare. “We’re also piloting a high-risk patient management program, which will include patient advisors who will monitor the patient through telemedicine devices and direct patient care.”

The need for greater, more immediate patient access will continue to grow in the future, and Unity Health Network is committed to being on the forefront. By using the latest technology and efficient communication, Unity will continue to provide modernized, on-demand access to the best healthcare in Ohio.

TriageLogicTriageLogic is a URAC accredited, physician-lead provider of high quality telephone nurse triage services, triage education, and software for telephone medicine. Their triage solution includes integrated mobile access and two-way video capability. For more information visit www.triagelogic.com.

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Case Study: Saving Lives with Telephone Triage

By Charu Raheja, PhD, and Carla Price, RN, BSN

Numerous studies and countless articles have been written about the improper use of emergency rooms and the resulting high financial burden on the U.S. healthcare system. One study by the RAND Corporation indicates that unnecessary trips to hospital emergency rooms cost approximately $4.4 billion a year.

With the U.S. healthcare system in serious need of cost cutting, there is increasing pressure to minimize unnecessary use of the emergency room. In doing so, it is critical to ensure people who truly need care receive it in a timely manner, thereby reducing the potential for life-threatening conditions.

Over the years, telemedicine has been gaining acceptance as a means of lowering healthcare costs, and telephone nurse triage has become part of the telemedicine solution. By using standardized protocols to advise patients to get to the right place at the right time, telephone nurse triage can decrease unnecessary emergency room visits, resulting in significant healthcare savings annually.

However, one of the important aspects of nurse triage that is often overlooked is the profoundly human aspect of the service. Most callers are truly concerned, and having access to a triage nurse provides reassurance and guidance. It is difficult to put a price on peace of mind. In addition, several patients may not realize the severity of their situation.

This real life case highlights the importance of nurse triage in improving health outcomes.

Telephone Nurse Triage Case: It was a weekday morning when telephone triage nurse, Linda G. RN, received a call from the mother of an eight-week-old infant. The baby had been fussy for several days, was not eating well, and had a fever of 100.7. Nurse Linda used the Schmitt Thompson pediatric protocols, which prompted her to ask the mother if the baby had any recent immunizations.

“No,” she replied.

“When is the last time he saw the doctor?” Nurse Linda asked. The mother indicated that the baby had been to the pediatrician the week prior for vomiting, diarrhea, and fussiness, but no fever.

“Have you given him any medicines?”

The mother replied, “No.”

At that point, with the baby having been sick for over a week and now presenting with a fever, the guidelines recommended that Nurse Linda call the child’s pediatrician to inform him of the baby’s decreasing health status.

Concerned about sepsis and other potentially life-threatening problems, the doctor instructed the nurse to call the mother back and advise her to take the baby to the emergency room. The mother was genuinely surprised when Nurse Linda called back and relayed the pediatrician’s instructions, as she was completely unaware of the potential seriousness of her baby’s condition.

Without the guidance provided by telephone triage, protocols, and the nurse, the infant may have experienced delayed treatment, leading to potential increased morbidity, and even death, if the baby had been septic.

Life Saving Calls: As telemedicine continues to expand into new services, providing innovative and cost-effective care, it is important to remember the benefits reach beyond budgetary significance. Cases, such as the one described above, are a lot more prevalent than what one would expect.

For example, in a recent study, we found that as many as 7% of the patients who did not consider their case an emergency (and responded that they would have stayed home if they did not have access to a nurse) were actually told by nurse triage to seek emergency care. Even more alarming, about 1% of the patients who did not think they required emergency care were told to call 911.

This means that a large number of patients are at risk of serious health issues because of not receiving timely medical attention. Every call answered by Linda G., and other telephone triage nurses, may be the difference between life and death. Fortunately, for one eight-week-old baby who wasn’t feeling well, a telephone triage process was in place, and he received the care he needed.

Conclusion: While this is one case of many, a significant portion of the population does not have access to telephone nurse triage. Implementing telephone medicine to a greater population can save lives and improve health outcomes.

Charu G. Raheja, PhD, is the chair and CEO of Triage Logic. Carla Price, RN, BSN, is the nurse trainer for Triage Logic. For more information and related articles, email Charu.

[From the October/November 2013 issue of AnswerStat magazine]

Meeting Today’s HealthCare Challenges Through Contact Center Excellence

By Patty Maynard

Healthcare contact centers have been given an increasing amount of responsibility to help their organization meet critical goals related to health reform and patient engagement. With this added responsibility also comes an opportunity to shine – and play an even more valuable role in both your organization’s success and your community’s health. RelayHealth’s RelayCare™ provides the tools and technology to help contact centers achieve excellence in this expanded role.

The New and Expanding Role of the Contact Center: Last year, the Centers for Medicare and Medicaid Services (CMS) implemented its first round of reimbursement penalties for excessive readmissions, which led to more than 2,000 hospitals forfeiting about $280 million total in Medicare funds (Centers for Medicare and Medicaid Report, “Readmissions Reduction Program,” August 1, 2012).

As the penalties increase for excessive readmissions, contact centers can help solve this challenge. Leading healthcare organizations are taking positive steps to avoid CMS penalties and improve patient outcomes. Here’s one example.

Readmission Management Success Story: Wake Forest Baptist Health: Wake Forest Baptist Health, a nationally recognized academic medical center, had been making post-discharge calls to orthopedic patients for several years but saw the need for a more robust readmission management program. Beginning with general medicine and hospitalist patients, they later added cardiology and other patient groups.

The RelayCare Readmission Management protocol-driven workflows enable contact center staff to efficiently manage inbound and outbound readmission management calls, while giving patients a single access point for any questions or concerns. The surveys associated with each patient call are specific to his or her conditions, with an easy-to-follow interface that keeps users from having to scroll through questions that aren’t relevant. The workflow queues also include reminders for tasks, such as “Patient could not be reached; follow up again.”

Post-discharge patient outreach has added about 100,000 outbound calls to the contact center’s annual call volume. The thirty-nine full-time employees handle about 400,000 total calls. Overall, RelayCare facilitates easier, more consistent documentation across multiple touch points. Its reports track discharged patients through the readmission program and cross-references them against readmissions, enabling contact center staff and clinical leadership to view the program’s successes and identify areas for improvement.

The Emerging Importance of Care Management: While hospitals have a powerful incentive to reduce readmissions, a care management program is also important. Nearly 133 million Americans, or half the population, suffer from chronic diseases or conditions (Wu, Shen-Yi, et al, “Projection of Chronic Illness Prevalence and Cost Inflation,” RAND Corporation, 2000). Plus, their ongoing care management represents 85% of healthcare spending (Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2004). An outbound communication program managed by the contact center can yield many benefits:

  • Promote self-care and a more proactive role among chronically ill patients
  • Facilitate better care coordination
  • Support a patient engagement strategy
  • Reduce inpatient treatment when possible (to optimize utilization of hospital clinicians) by avoiding admission or readmission
  • Provide care management resources for patients, caregivers, and the community at large

Top healthcare organizations use care management software to engage with patients and help them better manage their health. In addition to improving patient outcomes, they are realizing cost savings through reduced readmissions and ED visits.

To read more customer success stories, visit the case study section in the resource library at www.relayhealth.com or learn more by contacting a RelayHealth solutions advisor at 888-743-8735.

[From the June/July 2013 issue of AnswerStat magazine]

Case Study: Medical TAS Advances

By Samantha Walley

Comcepts is a Mississippi-based answering service assisting physicians and their practices nationwide since 2004. The software we were using could not keep up with our company’s growth. In some ways, it was actually holding us back, designed with a limited, one-size-fits-all set of features. However, we take a very hands-on approach with our clients. We provide an answering service experience that is more like an extension of their office than a generic call center. Plus, each of our clients would like their calls processed in a different way.

A few years ago, we began searching for new answering service software. From the moment we saw the client screen of one particular system, we knew we were close. It already had many of the features we were seeking, customization was possible, and ongoing development meant new features and updates would be available in the future.

Getting Up and Running: We implemented a training program well before the cutover so operators would be familiar and comfortable with the system early in the process. With our database switched over and the equipment tested, it was time to cut over. I won’t lie – I worried a lot before the switch, but it proceeded as smoothly as I could have hoped. We sequenced down the old system, and the new one took over.

Features and Benefits: The fun part started when we were able to use the system, experience the features, and customize each client’s screen for their practice’s needs. All the information our operators need is right in front of them, leaving no need to search for information on other screens or in multiple documents.

This gives operators the ability to complete calls faster. The information our clients deem important is gathered and delivered in the manner they wish without putting a strain on our operation. The same number of operators can now complete a greater number of calls in the same time, which translates into happier callers, pleased clients, and a more prosperous bottom line.

We now have the ability to add new services and features, which gives us an advantage in winning new customers, as well as retaining the loyalty of current clients. We have since added nurse triage services to our business offerings, and these services have been integrated into the system.

About Comcepts: Founded in 1999, Comcepts began as a medical transcription company based on the Mississippi Gulf Coast. In 2004, a client expressed his desire for an answering service that served “physicians only.” After much research and plenty of dead ends with existing answering services in the area, we decided to fill the niche ourselves. Comcepts has grown from a husband and wife team working around the clock to a dozen part-time, full-time, and reserve operators working in our offices. The addition of nurse triage services complemented and enhanced our answering service operation and is seen as an “added value” by our clients. For the next step, we are testing some operators working from home.

Samantha Walley is the president of Comcepts, LLC, which uses nCall answering service software developed and supplied by nSolve.

[From the December 2012/January 2013 issue of AnswerStat magazine]

The Gift of a Lifeline

By Tony Stramandinoli

The mission of Julie Valentine Center, in Greenville, South Carolina, is to raise awareness and help victims of child abuse and sexual assault. Its staff of seventeen includes educators, therapists, advocates, and coordinators, which is further extended by volunteers and community partners. To say that the Julie Valentine Center relies heavily on its communications systems is an understatement. In fact, you could say that the community of Greenville and its nearly 500,000 residents rely heavily on the communication system at the Julie Valentine Center.

The Challenge: Voices Matter: Email and texting don’t cut it for crisis hotline communication, and missed connections are lost opportunities – and often lost lives. With families in need of help, hotline callers, donors, referrals, and volunteers, the Julie Valentine Center was struggling to keep their lines of communication open. “The phone system we were using was antiquated,” said Shauna Galloway-Williams, Julie Valentine Center’s executive director. “It was hard to use. There were frequent problems, none of which we could resolve on our own, so we were constantly needing to call the phone service company to reset it.”

“We were struggling with the system we had, but we weren’t shopping for a new solution; we had no budget for that,” she added. “We were fortunate to come to know Sean Robertson, who is part of the Leadership Greenville Alumni Board of Directors. He understood our needs and knew how to help.” Robertson knows telecommunications systems; he is the chief technical officer at a distributor of telecommunications solutions.

Roberston’s relationship with the Julie Valentine Center began in 2010. “I became involved while acting as a mentor for one of last year’s Leadership Greenville service project groups. This group was remodeling the exterior and entranceway to Julie Valentine Center’s building, so I was onsite with them for their meetings a couple of times a month,” explained Robertson. “During that time, Joyce Smart, their development director, asked if I could take a look at their phone system because it was failing to route calls properly some of the time and was difficult to use.”

The Solution: Round the Clock Reliability – and Usability: Crisis lines have to be available 24/7. There’s no way around that. Robertson’s company, CTD (Computer Telephony Distributing) took up the cause. They approached LG-Ericsson, USA, who agreed to provide the telecommunications system. And their Greenville reseller, Atkins Data and Telephone Services, would help with installation and setup. All three companies worked together to make things happen for the center with an installation that included the central unit, digital phones for every desktop, and IP phones for remote use.

Moving to the new technology was easy. “The transition was our smoothest technology move ever,” said Galloway-Williams. “It took just a couple of days to set up – and, with no break in service. The new phone system was easy to get used to.”

There was not a lot to worry about in making the switchover. All of the information programmed up-front. Not only was the transition smooth, but also the new system is easier for the staff to use, which makes the center more accessible to those who need of help. “For example, we can easily set greetings and other outgoing messages – whether universally or individually – and we were easily able to ensure that our hotline rings in two locations: here and in another after-hours location with no gap,” concluded Galloway-Williams.

The fact that the system “has full-function digital and full-function IP phones meant that we could use their existing infrastructure and provide them with the remote phones and other IP functions that they needed to further enhance the services that the offer to their clients,” added Robertson.

The Results: Enhanced Communications: The new system solves the Julie Valentine Center’s telecommunications problems today by providing an easy-to-use, easy-to-manage, and reliable voice communication with all of the functionality of a traditional PBX. It manages calls within the walls of the Julie Valentine Center, out to clients, and to the 24-hour crisis line’s after-hours call center. Some of the new features include unified communications for voice and video conferencing, data collaboration, remote and roaming user support, and scalability. These serve to deliver a seamless communication experience for the Julie Valentine Center now and hold the potential to enhance their communications options in the future.

The results were that the Julie Valentine Center was able to enhance their telecommunications issues so that they can continue to provide an important service to the community. All of the enhanced functionality, usability, and reliability of their new phone system comes without any increase in ongoing cost-of-use, making this a winning solution for the Julie Valentine Center and the Greenville community.

Tony Stramandinoli is vice president of LG-Ericsson USA.

[From the August/September 2012 issue of AnswerStat magazine]

Resurrection Health Care Tracks Revenue and Demonstrates Contact Center Value

By Patty Maynard

As hospital contact centers are tasked with being more accountable to their healthcare systems, measuring return on investment (ROI) becomes a necessity. A contact center with built-in accountability can show its worth to the organization through demonstrating its ability to generate revenue and increase market share.

For Resurrection Health Care in Chicago, change has come in the shape of hospitals bought and sold, staff realignments and reductions, and a merger with Provena Health in November 2011 that formed Illinois’ largest Catholic healthcare system. Throughout these changes, Resurrection Health Care has operated its contact center with RelayHealth products for marketing campaign management and triage since 1993. In 2007, Resurrection added RelayCare Revenue Tracker to help the contact center determine the effectiveness of these campaigns in generating revenue.

With Revenue Tracker, organizations can measure the revenue impact of direct and indirect services and calculate the financial impact of selected programs or the entire contact center. It also features intelligent technology that helps reduce the effort required to confirm partial matches and reduce the number of duplicate records.

Key Contributions and Compelling Numbers: Call Center Director Cheryl Dusenbery has worked at Resurrection for sixteen years. With Revenue Tracker, the center can follow a patient’s path from first contact to any financial service in the hospital and credit the revenue generated to the correct marketing campaign.

“If someone calls in looking for a doctor and gets a referral, for example, and nine months later they’re back in to deliver a baby, we’re able to match our call records with the hospital’s financial records and reconcile the revenue,” Dusenbery said. “Without RelayCare Revenue Tracker, it would be a totally manual process, and it would be nearly impossible.”

In fiscal year 2011, $32 million in incremental revenue at six hospitals could be correlated to contact center calls. This is an increase in revenue of approximately $330,000 per hospital when compared to the $35 million in revenue generated in fiscal year 2010 over seven hospitals.

“The average revenue per call for fiscal year 2011 was $925. That’s a nice thing to be able to say to a CEO, and it helps them understand the contact center’s value,” Dusenbery said. “They see the value in what we bring to the table. It brings credibility to the marketing team and the contact center.”

By using a file extract from an organization’s financial system to match revenue against contact center encounters, Revenue Tracker can assist contact center managers as they:

  • Generate reports showing gross and net contribution
  • Demonstrate financial value and impact resulting from contact center operations
  • Report against multiple time periods with criteria to account for multiple variables

“When I talk with other facilities, I stress how important it is to position the numbers as a correlation,” Dusenbery said. “If someone fills out a card to get a thermometer, or if you’re trying to track what you get from a physician’s lecture, that’s incremental revenue that demonstrates the effectiveness of a marketing campaign.”

Revenue Tracker has also helped with resource decisions in the contact center. Staff can be added during hours when call volumes or the average revenue per call are higher or reduced when they are lower.

“We can track callers by outcomes, by the number of calls taken by nurses or representatives, or by the percentage that generate revenue,” Dusenbery added. “We’re able to decide by looking at the results whether it’s more cost-effective to have nurses go out into the work force or to other call centers.”

Conclusion: Whether demonstrating or determining its worth to the organization, Resurrection Health Care’s contact center has received the help it needed from Revenue Tracker. Tremendous amounts of data have been processed during the time that RelayCare has been in use at Resurrection Health Care. In that time, it has also added and removed hospitals from its roster. Through it all, RelayHealth has been a partner in keeping the information flowing.

“Every time we added a hospital, we wondered, ‘What’s going to happen now?’” Dusenbery said. “Each one is a giant influx of data, and we worked hand-in-hand with RelayHealth to make sure we could handle it.”

Patty Maynard is the solution line leader for RelayCare.

[From the June/July 2012 issue of AnswerStat magazine]

Marie Curie Cancer Care Transformed its Nursing Referral Center

By Clare Dorrian

Marie Curie Cancer Care is a UK charity, which provides end of life care for people with terminal illnesses. The organization is best known for its network of 2,700 nurses and healthcare professionals caring for terminally ill patients in their own homes or in one if its nine hospices across the United Kingdom. Last year, Marie Curie cared for 31,000 patients, with each patient referral requiring an average of 25 minutes to complete.

Management knew that it needed to overhaul this referral system to keep pace with the current demand and meet the anticipated growth for services. The revised system needed to reduce the time and effort that it took employees to match each patient with a nurse who had available time, as well as geographical proximity, and the necessary skills for that patient’s needs. In addition, the upgrade to its contact center, called Patient Connect, should:

  • Be able to support the amount of care provided, with the planned increase in services, while maintaining costs at current levels.
  • Provide increased and better information to the Patient Connect staff, nurses, and patients in a very timely fashion.
  • Improve the Marie Curie Patient Connect system’s rate of employee satisfaction by driving significant efficiency and productivity gains.

After reviewing a number of systems, Marie Curie selected a vendor who worked closely with their business and IT teams in the design and rollout of the re-vamped business processes and system. The benefits were quickly noticeable.

In the first six months after the new system was operational, Marie Curie was able to decrease the time it took to get patients matched with nursing staff to improve patient service levels by 20 percent. In addition, the training time for new coordinators in the new system decreased by 80 percent, from five weeks to five days. Also, the system allowed faster response times, which combined with the improved efficiencies in the call handling and call response times, resulted in a more powerful communication vehicle that can handle one-third more first-time call requests.

The most important and influential change in the Patient Connect system is the increased efficiencies in getting nurses and patients connected. The average referral and nurse assignment procedures have decreased 75 percent, from an average of 25 minutes to six minutes. As a result, Patient Connect now functions as a key communication hub for Marie Curie, allowing for quick, streamlined communications and logistics coordination among the center, the staff, and the patients.

“The founders of Marie Curie pioneered hospice and home-based nursing care in the UK way back in 1948,” said Susan Munroe, director of nursing and patient services for Marie Curie Cancer Care. “We were able to take that vision to a whole new level, providing our staff, nurses, and patients with a level of customer care efficiency that truly affects lives. Within the UK, research shows 65 percent of people would choose to die at home. While we now care for 50 percent of all cancer patients that die at home, we are constantly striving to increase that number across terminal cancer and other illnesses. And these system led efficiencies are a significant enabler towards achieving this strategic objective.”

Clare is EMEA marketing champion for Sword Ciboodle and responsible for marketing strategy, marketing programs, and client engagement in UK and Europe, as well as Global Industry Analyst Relations. Clare joined Sword Ciboodle in 2005, bringing a wealth of experience in the contact center sector through her previous positions at Intelligent Finance, Halifax Bank of Scotland, and AMAZE Consulting.

[From the April/May 2012 issue of AnswerStat magazine]

Case Study: Valley Health – Winchester Medical Center: Using Automation to Improve Patient Care by Monitoring Pain Pathwaysal Center

By Laura Alt LaLuzerne

Valley Health is a not-for-profit organization serving the healthcare needs of residents in Virginia, West Virginia, and Maryland. Valley Health provides outstanding care to their patients through a system of six hospitals and related facilities, offering patients convenient care that is close to home. One of the Valley Health locations is Winchester Medical Center, a 411-bed Level II Trauma Center located in Winchester, Virginia. Winchester Medical Center is a resource for 400,000 residents, offering diagnostic, medical, surgical, and rehabilitative care, along with advanced critical care services in heart, neurosurgery, oncology, trauma, and neonatal care.

A Unique Approach: Helping patients manage their pain is important to every healthcare facility. Being able to monitor and record each patient’s pain level on an ongoing basis can be challenging, as it takes a large amount of a nurse’s time. According to Lorraine Leake, director of the transfer center and communications at Valley Health, the ongoing charting “takes away time from the patient, so anything we can do to help the nurse, so they are doing more bedside, that is our goal.”

Integrating Two Systems: Leake looked at the various systems available in their facility, trying to find a way to make it easier for the nurses to monitor pain levels. The facility’s call center system streamlines enterprise-wide communications by providing patient room information and on-call scheduling information. A separate system allows patients to enter their pain level with their TV remote control. Leake began working on a plan to get the two systems to work together. Lorraine presented her ideas on merging the data in these systems to the respective vendors, 1Call and GetWellNetwork. The two companies then worked together to integrate the two systems.

How the Pain Pathway Process Works: To start the pain pathway process, a nurse scans a medication given to a patient. Fifty minutes later, the patient is asked on their television to rate their current pain level on a scale of 0 (low) to 10 (high). The result is sent from the GetWellNetwork to 1Call’s on-call scheduling module, which keeps track of the nurse responsible for that patient’s room and pages the appropriate nurse with the result.

Impressive Results: The integration of the two systems was implemented in November 2009. “It is used in every inpatient area, except for the critical care area. It is on 335 beds out of our 411,” Leake stated. Early results showed a 48% average response rate from patients. A time study revealed that checking on a patient takes a nurse nine minutes. Susan Clark, RN clinical manager for the Float Pool at Valley Health, commented, “For a pain scale of 0 to 3, when the nurse doesn’t have to do anything since the patient’s pain is being controlled, it saved 69,066 minutes in a two-month period, which turns out to be 1,151 hours. For a pain scale rating from 4 to 10, where the nurse would have to do something, it saved 74,988 minutes, basically 1,249 hours within a two-month period.”

Meeting Joint Commission Standards: During a recent visit, the Joint Commission staff was impressed with how the pain pathway was set up at Valley Health. The Joint Commission would like all healthcare facilities to have 100% documentation of pain scores. Valley Health’s scores were “originally around 59% and went up to 89% in documentation with the pain pathway. The scores have gone up to 92% with this system in place,” according to Leake. Valley Health quickly found out what an effective process this was. When the schedules for the nurses covering the patient rooms weren’t copied by several departments, the scores went down, giving them a way to prove that the pain pathway process is working.

Benefits of the Integration: Even though the process is automated, Valley Health still knows when something isn’t functioning exactly as they would expect it to. If a patient doesn’t respond to the pain level request, perhaps because their television is off or the patient was asleep, the nurse receives a page that the patient did not respond so the nurse can go check up on that patient.

Although there were mixed reactions to this new process among the nurses – with some of them loving it and some not liking the many pages that they receive – the benefits for the nurses make it a very worthwhile process. “They don’t have to go to the patient’s room, then get the medications, and then go back again. They are there one time, and that saves them a lot of steps,” said Leake.

Fine-Tuning the Process: At first, Valley Health wasn’t planning to use this system in the pediatrics department because they were worried the kids wouldn’t understand it or think it was a game. The pediatric nurses, on the other hand, wanted to have this available for their patients. When it was implemented, it worked very well.

Red Alert Integration: Valley Health also uses an alert notification system. “We are sending reminders out through Red Alert every so many hours, reminding the nurses ‘to chart your medications,’” Leake said.

Clark added, “That has brought up scores on some of the floors that are very busy and always turning over beds and patients.”

Future Plans: This process is currently used with the alphanumeric pagers that the nurses carry, “but our system is set up to send a page to a BlackBerry®, or a cell phone, or any device,” Leake stated. Also in the future, Valley Health plans to use this process to page nurses when patients have finished watching a video or completed educational materials about a particular medication. “We are trying to improve our patient satisfaction scores, our HCAP scores,” Clark commented.

Laura Alt LaLuzerne has worked in the telecommunications industry since 1987. She has also worked as a training specialist traveling throughout the U.S. and Canada, a documentation writer, and is currently the 1Call marketing coordinator. You can reach Laura at 800-225-6035 or laura@amtelco.com.

[From the August/September 2011 issue of AnswerStat magazine]

Case Study: Reducing Patient Appointment No Show

Capital Health is Nova Scotia’s largest provider of health services. They operate hospitals, health centers, and community-based programs throughout Halifax Regional Municipality and the western part of Hants County. Capital Health is 12,000 employees, physicians, learners, and volunteers providing medical and surgical care, mental healthcare, community health programs, addiction prevention and treatment, and environmental health services.

As an academic district, Capital Health helps educate tomorrow’s healthcare providers and administrators and engages in research into new treatments, cures, processes, and practices. Capital Health serves the 500,000 residents of the district and provides specialist services to the rest of Nova Scotia and Atlantic Canada.

Each day, thousands of Capital Health patients have scheduled appointments. Until recently, patients received reminders about upcoming appointments only occasionally. According to Betty Bouchie, the senior systems analyst for Capital Health Voice Services, “The staff was doing some calls, but it was very sporadic. When they had a break from people coming and going, they would take a list and try and call people.”

Reducing No Shows: When a patient doesn’t show up for a scheduled appointment, a number of things happen. There is a loss of productivity for the nurses, doctors, and technologists scheduled to work with that patient, a loss of utilization for the equipment allocated for that patient, and the patient has to be rescheduled, or in some cases, put on a wait list.

For these reasons, the Nova Scotia Breast Screening Program approached the Capital Health Voice Services call center because they realized the value of reminding patients about their upcoming appointments. “They had identified that making calls made a big difference,” said Bouchie. “So they approached us to say, ‘We need help. We need this done. We cannot do it ourselves, and we thought people who worked on the telephones would be the best people to do it.’”  The call center agreed to make reminder calls for them as a manual process, in order to see how much of a difference it would make. The appointment reminder calls made such a substantial impact that Capital Health soon saw the need for an automated system. They selected the 1Call Pro Show Automated Appointment Reminder Solution.

The Initial Results: “Once we got up and running, we actually dropped their no-show rate from nine percent to one percent. When we started doing calls for them, their average wait list was about nine months. We dropped it down to about six months with manual calls, and it’s three months now,” stated Bouchie.

Natalie Klaus, Capital Health’s manager of communication services, voice services, commented, “We currently process approximately 11,000 automated calls per month, which is maybe one percent of the total number of appointment reminder calls for Capital Health.”  This number includes reminder calls only for the Nova Scotia Breast Screening Program and for some of the diagnostic imaging program.

“The second that the word got out of the impact we had made, we had people lined up down the block,” added Bouchie. “They want the same thing.”

Hospital-Wide Benefits: The primary benefits that Capital Health has noticed are the significant reduction in the no-show rates and the reduced wait list time. Another benefit of the automation is freeing up staff. According to Klaus, “It’s mainly the no-show rate, and it’s also about redeploying current resources to do other tasks. So if you had a person assigned to make calls all day, now you can have them complete other tasks.”

An unexpected benefit of appointment reminder calls is related to the wait list. Because patients get the reminders in advance, if they do need to cancel, they can call to reschedule, and then a person from the wait list can be placed in that appointment. Since the appointment time can be scheduled with a wait list patient, it is not lost on a no-show who would then also need to be added to the wait list.

Perfecting the Process: Bouchie and Klaus have learned several key things about appointment reminders. They have found that calling three days before the appointment is optimal. Four to five days is too long, and the patients forget about it. However, any less than three days is too late, and they may not reach the patient. They also found that using a unique caller ID number for each department or group makes it more likely that people will answer the call. “Since we display a number, people are very likely to pick up,” said Bouchie.

Each patient appointment is set up to try as many as six times to leave a reminder message twice each day, morning and evening, for three days before the appointment. They’ve found that they typically reach the patient on the first call.

The messages that patients hear are customized, depending on the specific needs of the department or group. They have included important reminders, such as a facility being scent-free, and also reminders that the patient should arrive fifteen minutes before their appointment time.

Each group has a unique callback number if patients need to reach them.  The system does a look-up to determine if the number called is local for the patient; if it is, then a local callback number is provided. If the number called is long distance, then a long-distance callback number is given.

Another helpful feature is automated data importing. The process of receiving different types of data from the various groups is automated and is scheduled every night. Data is imported five days in advance so if a problem does occur receiving the data, several people are alerted via email. When this happens, the cause can be investigated and fixed before there is any impact to the reminder calls.

Adding More Services: Capital Health started handling appointment reminders for two of the most complex groups. They continue working to offer these services to more departments and groups. Currently, patients only receive phone calls for appointment reminders. This is primarily due to patient privacy. Capital Health is discussing adding email reminders, but they will need permission from patients to do this. “We want to make sure we have our processes in place and everything thought through before we start rolling it out with email as well,” stated Klaus.

More recently, reminder calls for the Department of Medicine have been added. “They love it. We did a pilot of four groups, and it went great,” Bouchie said. “They want to add the rest as soon as possible.”  This “is a great product.”  Bouchie added. “It has made an impact just in its beginnings, and it will make a huge impact as we go forward.”

[From the April/May 2011 issue of AnswerStat magazine]

Case Study: Hospital Uses Speech Recognition and Automation to Cut Costs and Improve Service

By Chris Heim

Southern New Hampshire Health System (SNHHS) serves Greater Nashua and 12 other communities across much of southern New Hampshire. The system is a fast-growing, 120-year-old provider, known for delivering exceptional health and medical care services. With 54 medical offices, a 180-bed community hospital, and more than 550 medical providers practicing in 59 different specialties, SNHHS is one of the largest healthcare groups in the state. With such a large network to support, the hospital’s call center is responsible for managing high volumes of calls and a broad range of information around the clock.

Due to the system’s continual growth and the broad diversification of communications technology, the SNHHS call center was becoming overwhelmed. Their team of call center representatives was receiving and connecting a dizzying number of both internal and external calls.

Managing on-call schedules was also handled by the call center using a paper-based system, manually updated as the staff received messages from the various departments, clinics, and individuals from across the system. Because of the complexity of the organization, this had become a challenge. The team maintained more than 75 different schedules using a printed booklet that became outdated almost as fast as it was created. This was becoming too cumbersome for the call center to manage effectively.

“Our management team knew we had to implement some changes to provide better support for everyone,” said Judy Mayopoulos, call center manager. “Since we also relied on a costly third-party firm to provide after-hours answering services for physicians’ offices, we felt we could manage our own answering service to improve customer service both internally and externally while providing better patient care.”

The Solution: Speech Recognition and Call Center Automation: Management at SNHHS developed a plan to bolster their call center with physicians’ answering services, operator console, speech recognition, Web-based on-call scheduling, and messaging capabilities. They selected Amcom Software’s contact center solutions to help meet those challenges and achieve their goals.

The speech recognition solution reduces the volume of calls handled by representatives. It allows callers to connect their own calls or access information by following voice prompts rather than using a representative’s assistance.

The speech recognition was initially rolled out internally to introduce it to staff and gain acceptance. “Our staff adapted to the speech recognition tool quickly, and they like it because they don’t need to be transferred multiple times in order to reach someone,” said Mayopoulos. After great success with the internal release of speech recognition, the organization rolled it out for external callers as well.

The health system also began using the system’s staff directory and on-call scheduling solution. Since the on-call schedules and directory are Web-based, each department can now manage and update their schedules easily and quickly. Call center representatives don’t spend time tracking down an individual only to find out they’ve contacted the wrong person. The on-call schedules are integrated with the organization’s operator console, so all the information they need is right in front of them.

The Results: Speech System Frees Up Call Center Staff – Enables Creation of Profitable Answering Service: Using speech recognition “has offloaded 55 percent of our live operator calls,” said Mayopoulos. “Our statistics also show that 97 percent of the calls that come through the speech system are transferred correctly. That’s a lot of efficient call processing without human intervention.”

Because they aren’t tied-up handling such a large volume of incoming calls, the call center representatives are now able to perform other duties, enabling the hospital to bring physicians’ answering services in-house. This service has become a new source of revenue for the hospital.

Management at SNHHS is pleased with the new in-house answering service because the call center representatives are familiar with working in the healthcare environment, which isn’t always the case with third-party answering services. SNHHS is able to accommodate each doctor’s unique protocols or requests, such as “only call a certain phone number after 10 p.m.,” or “after two tries, call this number.”

The Future: As Southern New Hampshire Health System continues to grow, the management and staff will focus on their promise to residents of the area to provide information, education, and access to exceptional health and medical care services. With the right combination of great people and the right technology, their contact center will have the capabilities needed to keep pace with the organization’s growing needs.

[From the February/March 2011 issue of AnswerStat magazine]