By Charu G. Raheja and Ravi Raheja
The landscape of medicine is changing. As healthcare dollars become less available or are distributed differently, hospitals and organizations are consolidating their practices to create a network of primary care physicians and specialists. Larger groups provide economy-of-scale, a good referral source, and established branding in the community.
However, an increase in size presents a challenge in terms of providing a uniform patient experience throughout the system, as well as helping callers navigate the system effectively. Organizations want to help patients as much as possible on the first phone call, regardless of the reason for the call. Patients may call to talk to a triage nurse about a symptom, an appointment for a physician referral, a medication refill, or a billing question. How do you manage these requests without transferring the caller three times only to be sent back to the initial operator?
Call center consolidation and cloud-based technology may be the answer.
What Is Cloud-Based Technology? The cloud is simply the latest term for a concept that has been around for a while. Web-based email and online banking are examples of cloud-based technology.
Cloud refers to applications, services, or resources made available to users on demand via the Internet from a provider’s servers. Companies typically use cloud-based computing as a way to increase capacity, enhance functionality, or add additional services on demand without having to commit to potentially expensive infrastructure costs or increase or retrain in-house support staff.
Providers can offer end users immediate access to new, always-on features from nearly any device in any location. They also provide the business with a predictable, subscription-based, pay-per-use way to fund IT.
So How Does This Apply to a Healthcare Call Center? Imagine this scenario. A diabetic patient is concerned because he has high blood sugar readings even though he has been using his medicines as directed. He has a primary care physician, an endocrinologist, and a cardiologist. He has the number for the cardiologist handy, so he calls him first. Near the end of the day, the office calls back and tells him to call the endocrinologist instead. He calls, but it is already late and he gets the answering service. The patient may have to wait until the next day to get a response to his medical question.
Now, what if patients could call a single number for all their providers? The operator taking the call could see that a patient has a medical symptom – in this case, high blood sugar. The operator puts the caller in touch with a triage nurse who determines that the situation is not an emergency, but the patient needs to be seen in a week. The nurse can see that the patient has an endocrinologist, a cardiologist, and a primary care physician. The nurse makes an appointment with the endocrinologist and advises the patient about what to do while he or she is waiting for the appointment. A triage note is put in the system for the primary care physician so he or she knows the patient called and has an appointment with the endocrinologist. The nurse triaging the patient can also see that the patient has a cardiologist, but it has been a year since the last visit. She schedules a cardiology appointment as well and emails the patient information about nutrition classes provided by the hospital.
Is This Technology Available Now? The answer is yes. To reach this level of service, the organization needs:
- A Single EMR System: A single EMR system lets providers and operators across the system access the entire patient chart to provide coordinated care. Many EMR systems are Web-based (that is, cloud-based) and can be accessed securely from multiple locations and devices.
- A Centralized Call Center: There should be a single point of entry into the system, where the operators have scripts and training to handle a variety of caller needs and can answer questions or direct callers to the most appropriate person.
- Cloud-Based Call Center Technology: Web-based systems have a more flexible design to interact and exchange data with other Web-based systems. The traditional call center platform with a single vendor may no longer be the most efficient way to get the functionality required to perform all operations. The call center can build a robust platform by obtaining components from multiple vendors with specialized products and have them work together. This approach enhances functionality because the most appropriate product can be selected for the organization. Components can be changed or added over time, depending on the evolving needs of the call center.
Conclusion: Coordinating healthcare among different providers has been a struggle and an issue for several decades now. New, cloud-based technology along with a centralized call center is a viable solution to help providers and patients stay coordinated, while at the same time improving patient care and decreasing costs.
Charu G. Raheja, PhD, is the CEO and chair of TriageLogic. Ravi Raheja, MD, is the COO and medical director of TriageLogic. TriageLogic is a URAC-accredited company offering Web-based telephone triage software and nurse triage services. With a national footprint, TriageLogic has been providing affordable triage solutions for almost ten years for use in institutions and private practices.
[From the June/July 2014 issue of AnswerStat magazine]