By Ravi K. Raheja, MD
Triage call centers have experienced significant advances since they first started over twenty years ago. The standardization of protocols and improved training and experience of triage nurses has created a system that ensures high quality care, standardized outcomes, and cost-effective use of resources.
So what are the next steps in the evolution of the clinical call center?
The answer is found in the latest technology. Nurses are already very effective at using the triage protocols and their nursing judgment to take care of patients. However, the new technology resources available today have created an opportunity to improve the efficiency of nurse call centers and provide new features that will benefit providers, patients, and nurses. Here are some of the new features that should become standard in any call center software platform in the near future:
Doctors and triage nurses will be able to send secure text messages without using an app: Providers with smartphones need secure text messaging to comply with HIPAA requirements when they receive patient data from the call center. Currently, many platforms require doctors to download a specific app to receive secure text messages. From an operational perspective, each provider must set up the app on his or her individual smartphone, and the apps must be kept up-to-date across all operating systems and devices.
We are now reaching a point with new technology in the market that can allow providers to receive text messages and patient data on their smartphones without having to use an app. It works universally across all smartphones and requires no set up from the end user.
Secure chat functions with the call center is also possible without using an app.
Patients will be able to request a nurse call directly from their phones without speaking to an answering service: Consumers (patients) are increasingly accustomed to using their smartphones to communicate. Most of that communication is via text, email, or social media instead of the traditional phone call. To keep up with consumer expectations, patients need to be able to access a triage nurse from their smartphones or tablets without having to make an initial phone call.
This can be accomplished by having a smartphone app that connects to the call center’s triage platform. Patients can download the app and request a callback from a nurse at a touch of a button. The clinical triage call still needs to be done over the telephone so the nurse can assess the patient properly. However, the initial request no longer needs to be a phone call. A similar request to a nurse can be generated from any Web-based computer or smart device. Providing alternate ways to contact a nurse increases access and improves customer service.
Call centers will be able to incorporate triage protocols into their own electronic medical records (EMRs): Triage platforms have traditionally been freestanding EMR-like systems that must be installed, configured, and maintained by the call center. As call centers have evolved, they now have their own in-house EMR or electronic platform. Adding on triage capability should not require adding and integrating an entirely new system.
A call center should have the option to “plug and play” triage protocols into its own system, which can be accomplished through prebuilt APIs (Application Programming Interfaces) and Web services. This technology allows for any Web-based system to embed the triage protocols and integrate triage data into the call center’s existing system with very few IT resources. It also decreases costs by eliminating the need to maintain another entire platform.
Answering services will securely enter calls directly into the clinical call center triage queue without sending a fax: As long as the call center’s triage platform is Web-based and the answering service has Web-capable software, the technology is available for any answering service to securely enter calls into the triage queue for the nurses. This is accomplished via APIs as well.
The answering service takes the message in its own system and then securely submits it via the API to the system software of the triage call center. This process allows practices and hospitals with their own non-clinical front-end staff to work seamlessly with their clinical call partners, whether in-house or outsourced.
Triage notes from the call center can be sent directly back to the client’s EMR system: Continuity of care is important. That is why triage plays such an important role. The nurse documents the after-hours calls and creates a record of the encounters. Whenever possible, the providers want all the information to go back into their own EMR systems. One of the most common ways of communicating data is through HL7 transactions.
HL7 is a special language developed to facilitate communication between different medical systems. It requires a special integration engine to take the various data formats and translate them into a common language that other systems can process. As EMR systems develop more sophisticated Web capabilities, integration will become simplified through Web services.
A call center will be able to send the triage encounter securely to a Web service (a Web-based data receiver). The practice can then program the data to be placed in its EMR database so the triage information can appear directly in its EMR. This option makes it possible to integrate triage data with EMR systems and other non-clinical platforms (such as salesforce.com).
The rapid evolution of technology is helping nurse triage call centers provide improved service to both providers and patients. Patients will more easily access nurse triage at the touch of a button on their smartphones, and they will be able to communicate securely with their provider via SMS. Nurses and physicians will count on having all of their patients’ information readily accessible thanks to integrated EMRs and improved communication between distinct medical information systems. All of these enhancements are either happening now or will be implemented soon, and they will contribute to the ability of nurse triage systems to ensure that every patient is directed to the right level of care at the right time.
Ravi K. Raheja, MD, is the COO and medical director of TriageLogic (www.triagelogic.com), a URAC-accredited provider of triage solutions serving 3,000 physicians and covering 6.5 million lives. Contact him at ravi.raheja@triagelogic.com.
[From the Feb/Mar 2015 issue of AnswerStat magazine]