All posts by Peter Lyle DeHaan

Peter DeHaan is the president of Peter DeHaan Publishing, Inc., ( the publisher and editor of Connections Magazine, AnswerStat, TAS Trader, and Medical Call Center News. Peter DeHaan ( is a published author and blogger.

Improving Response to Critical Laboratory Results with Secure Messaging

By Nicole Limpert

George Bernard Shaw once said, “The single biggest problem in communication is the illusion that it has taken place.” This is especially true in the healthcare sector. Unfortunately, ineffective diagnostic communication can have dire consequences for patients. It is estimated that there are 40,000–80,000 deaths in the United States each year due to diagnostic error. Poor communication of laboratory test results is a contributing factor in these errors.

Critical laboratory results, also known as panic results or values, are defined as test results that exceed established high or low limits. Abnormal results are different from critical values. “Abnormal” and “critical” are not used interchangeably.

Critical results are considered life threatening and require corrective action to be taken promptly. After the critical laboratory results has been verified and entered into the lab’s computer system, notifications are sent to the patient’s physician and/or physician’s representative, the ordering entity, and any other clinical personnel responsible for the patient’s care.

Critical Results Reporting Standards

According to the “National Patient Safety Goals” set by The Joint Commission, timely reporting of critical results need to be made to the responsible licensed caregiver(s) within an established time frame so that the patient can be promptly treated.

They outline three elements of performance to achieve this goal:

  1. Collaborate with organization leaders to develop written procedures for managing the critical results of tests and diagnostic procedures that address the following:
  • The definition of critical results of tests and diagnostic procedures.
  • By whom and to whom critical results of tests and diagnostic procedures are reported.
  • The acceptable length of time between the availability and reporting of critical results of tests and diagnostic procedures.

2. Implement the procedures for managing the critical results of tests and diagnostic procedures.

3. Evaluate the timeliness of reporting the critical results of tests and diagnostic procedures.

Critical Lab Communication

When a critical lab value is verified, often a phone call is made to report the result and it is documented in the laboratory information system. To comply with patient safety goals, the person taking the call must read back the patient’s name, the hospital number, and all laboratory results. Read back is required to ensure accurate transmission of information.

Historically, verbal communication has been considered the preferred procedure for notifying critical values. However, the need to communicate lab diagnostics quickly and accurately is paramount for lowering the risk of a patient experiencing an adverse medical event.

An article in the National Library of Medicine titled “Critical Laboratory Values Communication: Summary Recommendations from Available Guidelines” finds that “The results of surveys conducted in the UK, Italy, US, China, and Croatia have notably emphasized that there is poor consensus regarding many aspects of critical values management. This is a concerning issue, for not less than three good reasons.

“First, the lack or delayed communication of critical values has been clearly recognized as a source of significant harm to the patients, since these test results may lead to treatment modification in as many as 98 percent of patients admitted to surgical wards and up to 91 percent of those admitted to medical departments.

“Then, critical values communication is an integral part of many accreditation procedures for medical laboratories, including the universally agreed International Organization for Standardization (ISO).

“Finally, timely notification of critical values has been endorsed as one of the leading quality indicators of the post-analytical phase [of laboratory medicine] by the Working Group ‘Laboratory Errors and Patient Safety’ (WG-LEPS) of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).”

Information technology tools are becoming an essential component of medical lab communication because they provide:

  • Fast and accurate communications
  • Automated systems
  • Reporting
  • Simplified communications
  • HIPAA compliance to protect patient health information

The Traditional Process of Reporting Critical Values

The College of American Pathologists (CAP) offers a laboratory accreditation program. To attain accreditation through the CAP, they require that at least 90 percent of critical values be reported within 30 minutes after obtaining a verified result. A similar requirement is in place through The Joint Commission.

Sometimes it is difficult for organizations to attain or retain accreditation because the traditional process to verify and document notifications (read back) can be time consuming. Typically, institutions will designate categories of personnel who are authorized to receive critical values, usually physicians and nurses.

If the critical laboratory results are communicated to a suitable medical staff member, the name of that person, time of contact, and documentation of read back is recorded. If the result is provided to non-medical personnel, that person is required to notify the correct physician, record the notification, and read back in the patient’s medical record.

If the non-medical personnel are unsuccessful in contacting an appropriate person for transmission, the next step is often to page the provider. Significant delays can result if there are issues with contacting the provider or using precious time to find out who is on-call.

The Benefits of Using a Secure Messaging App

Secure messaging apps can outperform traditional phone calls by improving timeliness when reporting critical laboratory results. When healthcare organizations change their process of reporting critical values by telephone to using a secure messaging app instead, they can meet or exceed the standards put forth by accrediting agencies, experience increased efficiency by immediately getting the results to the right person, see a reduction in the time it takes to report results, and have a reliable record of the communication because messages are automatically time-stamped when sent, received, and read. Built-in reporting features provide accurate information about the communication process.

A secure mobile messaging app also provides:

  • End-to-end message encryption to protect electronic patient health information and ensure all communications are secure and protected
  • Freedom from outdated pagers. Devices can be consolidated through secure messaging apps so that all correspondence can be done from a smartphone, tablet, laptop, smartwatch, or desktop computer
  • Ease of use
  • Customization
  • The ability to send massive amounts of data quickly and accurately while keeping users connected through WiFi and cellular networks
  • Voice-to-text modes so users can speak a message into their device, and it automatically converts into text
  • Persistent alert settings ensure important messages won’t be missed
  • A message log to keep track of messaging histories
  • Interoperability by having the ability to seamlessly integrate with on-call scheduling
  • Safety features such as bio-metric access and remote disabling if a device is lost or stolen

Notification of critical laboratory results is a crucial function of the clinical laboratory. Using technology such as secure messaging, ensures information is received by the correct personnel, quickly and accurately, to help improve patient care.

Nicole Limpert is the marketing content writer for 1Call. The 1Call Division of Amtelco is a leader in developing software solutions and applications designed for the specific needs of the healthcare call center marketplace. 1Call features a complete line of modular solutions specifically designed to streamline enterprise-wide communications, save an organization’s limited resources, and make them tremendously efficient, helping them bring wellness to their members and their bottom line.

Multi-Channel Integration

Serve Patients Better and Produce Superior Outcomes

By Peter Lyle DeHaan, Ph.D.

Some healthcare call centers only handle telephone calls by design and others do it because that’s what they’ve always done. But most have embraced a contact center mindset, where they’re handling more than telephone calls. This can include email, text messaging, and web chat. They may also incorporate social media monitoring and response.

There is also an opportunity with video. Integrating video communications into the call center has received much theoretical attention for a couple of decades, with proponents predicting it would be only a year or two out. We are, at last, moving from potential to possible.

Over the past two years many people have become more comfortable talking to a camera to communicate with someone far away. Though not everyone embraced this as an acceptable alternative to in-person meetings, they did, however, become more comfortable using it and less resistant to the technology.

This prepares people for the option of video chatting with their healthcare provider, nurse triage operation, or medical call center. These are exciting times for patients and their healthcare call centers.

All these options, however, will inevitably lead to patients using multiple communication channels to accomplish their task, depending on what’s available at the time or what will achieve their goal the fastest.

What could start as a telephone call could switch to video for face-to-face interaction. In the same way, a text message chain could migrate to the telephone or a social media post to email. The only limit to the sequences is our creativity.

Yet regardless of the scenario, one key issue remains paramount. Each channel must integrate with all the others, allowing information to effortlessly pass from one option to another. We must eliminate isolated silos of information that don’t communicate with each other. We need full multi-channel integration.

This usually falls to the platform vendor. If you use a singular system to handle all communication channels, you’re one step closer to making multi-channel integration a reality. Though harder, integration between disparate systems can also occur. It just requires more effort on the part of the respective vendors to pull off.

Here’s what you can do to move things forward to enjoy multi-channel integration.

Educate Staff

Make sure your front-line employees know what they must do to allow for the smoothest information handoff as patients move from one channel to another. If your staff doesn’t do their part correctly, the decree of integration won’t matter.

Test Your System

Make a contact on one channel as a patient would. Then switch channels and see what happens. Is your text messaging exchange accessible by the telephone rep when you switch to voice? Or do you need to start over and re-state the same information?

Test this in each combination of channels possible, regardless of how unlikely it seems to you that anyone would ever make that switch. Know that someone will.

Identify Weaknesses

As you conduct your field test of switching channels, look for three things. Identify what works well, what somewhat works, and what doesn’t work at all. Celebrate the areas of success, seek ways to shore up the areas that have limitations, and note what doesn’t work at all.

Encourage Your Vendor

Armed with this information, approach your vendor, not in a confrontational manner, but with a positive, let’s-work-together attitude to move toward full multi-channel integration.


Multi-channel integration is what your patients expect. It’s what they deserve. Start now to move toward this outcome.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat. He’s a passionate wordsmith whose goal is to change the world one word at a time.

How Effective Communication Helps Organizations Achieve the Quintuple Aim

By Nicole Limpert

What is the goal of healthcare? An answer such as “good health” may seem like an obvious response, however, sometimes a simple question has a complex answer. For many years, one of the most influential answers to this question was put forth in 2001 by the Institute of Medicine (IOM) in a report called “Crossing the Quality Chasm.” Their framework included these six goals for any healthcare system:

  • Safe: Avoiding harm to patients from the care that is intended to help them.
  • Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding under-use and misuse).
  • Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.
  • Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.
  • Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.
  • Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

In 2006, two faculty members of the Institute for Healthcare Improvement, John Whittington, MD and Tom Nolan, MD, developed the idea of the “triple aim” to define the aims of healthcare. They concluded the social needs outlined by the IOM were only for individuals who needed care. The health of the population was a second component that wasn’t included in the IOM framework.

The Triple Aim consists of three points:

  • Experience of Care: The original IOM list (above).
  • Population Health: Addresses the “why” related to healthcare needs. “Why does a person have a heart attack, break their arm, or experience depression?” This point looks at the causes of why a person experiences an adverse health event, and how to keep everyone in good health.
  • Per Capita Cost: Keep costs down because most individuals, companies, and governments have limited resources and need to spend funds on things other than healthcare.

Additional aspects to the triple aim have been adopted by healthcare organizations to include “improved clinical experience” (the quadruple aim) to combat staff burnout and lower patient satisfaction and health equity (the quintuple aim) as it pertains to policy including systematic incorporation, measurable and transparent reporting, consideration of systemic contributing factors, and reimbursement.

Contact Center Software
and the Quintuple Aim

Most of the previously mentioned goals include a communication component. Effective communication software that works with an organization’s existing technology is a crucial tool to help healthcare systems achieve the quintuple aim.

Removing Barriers to Health Equity

The Health Resources and Services Administration (HRSA) is a federal agency of the U.S. Department of Health and Human Services focuses on improving the healthcare of people who are geographically isolated, and economically or medically vulnerable. Medically under-served populations and areas are designated by HRSA as having too few primary care providers, high infant mortality, high poverty, or a high elderly population.

These populations include uninsured individuals, vulnerable populations including the elderly, low-income, ethnic minorities, migrants, and people who received a limited education, and those with poor access to healthcare because of inadequate transportation or a lack of available services.

Technology enables medical contact centers to effectively become an extension of a hospital or clinic’s operations 24 hours a day, 7 days a week. Robust communication software used by hospital centers can securely access a patient’s electronic medical record (EMR), update EMRs with notes, and record calls that need to be used for insurance claims and workman’s compensation. Because everything is documented, detailed reports can be generated for reporting purposes.

Hospital contact centers help to address two of the biggest barriers to healthcare: language and transportation. Medical staff work with an enormously diverse patient population. Understanding a person’s language leads to better healthcare. Multi-lingual contact center operators or confidential over-the-phone interpreting services can be used for access to hundreds of different languages.

Patients with mobility challenges or who live in rural areas can receive some health services via telehealth. Operators can coordinate care, make follow-up calls, schedule visits, contact on-call medical staff, and manage referrals. Contact centers that are staffed by qualified nurses or multidisciplinary teams (such as a resident, pharmacist, and social worker) can make health assessments, give medical advice, mental health counseling, and escalate critical concerns.

Timely, Efficient, Patient-Centered Care for an Improved Clinical Experience

Getting the right message, to the right person, at the right time can improve patient care. The need for efficient, reliable communication is present throughout a patient’s journey. A hospital’s contact center is the hub of communication for an organization’s calls and chats and the same software that is used at the center can also be leveraged within the hospital or clinic to improve clinical communication and workflows.

When a patient is admitted into a hospital, they may be moved from one room to another while waiting for tests and procedures, and during recovery. It can become difficult to locate and communicate with a patient once they are receiving care within the system.

A robust contact center platform can assign a fixed phone number to each patient to follow the patient for the duration of their stay. Associating each patient with one phone number helps ease the stress of family and friends who are trying to contact them, streamline the communication process for anyone on the patient’s care team, and reduce the number of calls to the hospital’s contact center.

Contact center software can work together with a hospital’s event notification software system to expedite enterprise-wide critical alerts in healthcare environments by capturing requests from ADT (admission, discharge, and transfer) messages, nurse call messages, smart beds, pain management, alerts, alarms, orders, or appointments. Then, emergency notification software instantly sends those messages to designated medical staff recipients using a wide variety of methods, including Vocera badges, IP phones from Cisco and Spectralink, SMS, email, secure messaging apps, and more.

All statistics can also be accumulated for each notification to provide an easy-to-follow audit trail for reporting purposes and to help healthcare organizations refine their communication processes.

Enhancing Patient and Staff Safety with Web-based Communication

The ability to access health information at any time from any place is a fundamental and critical part of any healthcare organization’s communication protocol. Hospital personnel can use some of the same web-based communication software that is used in their call center to deliver fast, secure communications.

  • Secure Messaging: Secure organizational communication is crucial for protecting patients, medical staff, and hospital organizations. HIPAA-compliant messaging apps send secure text, photo, audio, and video content while protecting patient privacy. These apps can be used via smartphones, tablets, and desktop computers. Secure messaging apps can be leveraged to simplify collaborative care to provide a better patient experience, and speed the process of patient admissions, lab results, and patient transport.

    An additional benefit of secure messaging is the ability to triage low-priority alerts and route alarms directly to clinician devices to reduce sensory overload for both patients and care providers. Patient care is improved when important alarms get a response as quickly as possible, but a restful, quiet healing environment is also important for patient recovery.
  • Care Team Collaboration: Nurses, physicians, and other staff use mobile-friendly care team collaboration applications to remotely access on-call schedules, directories, messages, and reports.
  • Workforce Management: Staff can view, edit, copy, override, assign, and unassign schedules in real-time. They can use directories to quickly find and contact staff and use the reporting function to track, view, and print communications.

Correcting inefficient communication can help an organization towards their triple, quadruple, or even quintuple aim. Using the tools and software that may already be available in a hospital’s contact center provides a path to successfully attain the goals of the entire enterprise.

Nicole Limpert is the marketing content writer for 1Call. The 1Call Division of Amtelco is a leader in developing software solutions and applications designed for the specific needs of the healthcare call center marketplace. 1Call features a complete line of modular solutions specifically designed to streamline enterprise-wide communications, save an organization’s limited resources, and make them tremendously efficient, helping them bring wellness to their members and their bottom line.

Wisconsin State Journal Names Amtelco Top Workplace in 2022

1Call, a division of Amtelco, announced that Amtelco has been awarded a Top Workplaces 2022 honor by The Wisconsin State Journal Top Workplaces. The list is based solely on employee feedback gathered through a third-party survey administered by employee engagement technology partner Energage, LLC.

The anonymous survey uniquely measures fifteen culture drivers that are critical to the success of any organization: including alignment, execution, and connection, just to name a few.

“Companies need to authentically represent their brand to job-seekers,” said Eric Rubino, Energage CEO. “The employee experience needs to be on the mission-critical list. Leaders who embrace a people-first culture will benefit greatly. By giving employees a voice and showcasing your authentic culture through employer branding, organizations can attract those job seekers who complement their culture. Culture drives performance.”

Amtelco, a family-owned business located in McFarland, Wisconsin, has been a trusted name in call center systems, software applications, and secure texting technologies for over forty-five years. Beginning in 1997, the 1Call healthcare division of Amtelco was formed to provide the same innovative contact center technology to healthcare facilities.

Founder Bill Curtin, II, and Amtelco have received more than thirty U.S. Patents for telephony software, data handling methodologies, and telephone switching devices. Millions of calls are processed every day by Amtelco systems around the world.

Mr. Curtin’s ingenuity and generous spirit are reflected throughout the company. Amtelco has earned industry praise with its award-winning products and proudly supports local and international charities.

Both employees and customers are treated with respect. Kathy Mealer, Manager Information Systems at West Tennessee Healthcare, and a customer of Amtelco’s 1Call healthcare division states, “1Call has been fantastic. I think they have been more of a business partner than any vendor I’ve dealt with in my thirty plus years of working in IT.”

Advances in technology is helping the contact center industry to grow and continue to be the hub of information. Amtelco CEO Tom Curtin is proud of the entire Amtelco employee team. He stated, “Thanks to our dedicated employees, 2021 ended as the best year we have ever had in our forty-five plus years. Last year we added many new positions to our growing staff and are currently hiring for more positions this year to support our expanding customer base.”

1Call Announces Certification with Cisco CUCM Release 14

1Call, a division of Amtelco and a leader in developing software solutions and applications designed for the healthcare communications and call center marketplace, announced their call center software and 1Call Web Agent web browser-based telephone agent interface are certified for use with Cisco’s Unified Communications Manager (CUCM) Version 14.

1Call’s all-inclusive healthcare call center software suite features multi-channel integration with enhanced call processing to help prioritize critical calls and can use built-in speech recognition, text to speech, and voice services to improve call routing and management.

1Call Web Agent is a web browser-based telephone agent interface that offers simplified installation and maintenance, which is especially helpful for remote operators. 1Call Web Agent is compatible with most modern web browsers and enables agents to process multi-channel calls via desktop computers, laptops, tablets, and smartphones.

“1Call Web Agent connects to Cisco Unified Communications Manager (CUCM) via session initiation protocol (SIP) trunks via the Amtelco/1Call soft switch,” said Tom Curtin, CEO of 1Call. “1Call Web Agent provides intelligent attendant console services, integrated call and screen recording, personnel directories populated from an organization’s HR data sources, patient directories populated from Health Level 7 (HL7), admit discharge transfer (ADT) updates, operator scripting, on-call scheduling, and advanced automated messaging and dispatching with our MergeComm integration engine.”

Amtelco/1Call is a Preferred Solution Partner with Cisco. The partnership enables 1Call to deliver solutions that interoperate with Cisco’s technology. As a Preferred Solution Partner, 1Call can submit products to Cisco for compliance testing and a team of Cisco engineers develop a comprehensive test plan for each application to verify its compatibility with Cisco. This enables mutual customers to confidently add best-in-class capabilities to their network without having to replace their existing infrastructure.

The 1Call Division of Amtelco is a leader in developing software solutions and applications created for the specific needs of the healthcare call center marketplace. 1Call features a complete line of modular solutions specifically designed to streamline enterprise-wide communications, save an organization’s limited resources, improve efficiency, and help bring wellness to their patients.

Recent additions include the MergeComm automated notification integration engine, which incorporates an HL7 integration, along with miSecureMessages secure smartphone paging and two-way messaging.

Tools to Improve Call Center Efficiency

By Mark Dwyer

The Merriam-Webster Dictionary defines efficiency as the effective operation measured by comparing production with cost (energy, time, and money). Never has call center efficiency been as critical as today with the limited number of available telehealth nurses and trained call center agents, the high costs of hiring and retaining qualified staff, increased call volumes, and the growing costs of technology, hardware, and space for running a call center.

So, how can you increase your call center’s productivity, whether you use it for nurse telehealth triage, marketing, referral, or any number of functions? Let us review several opportunities.

Start with Information

Data is king when evaluating how efficiently your call center staff handles calls and how successful it is in satisfying customers/patients. There are numerous standard reports in most call center solutions that provide the data needed to calculate your call center’s efficiency. If valid, you can use this data to project basic staffing needs.

There are several free and fee-based staffing tools available. Two such tools include the Erlang Calculator for Call Center Staffing and a staffing tool developed by Bright Pattern. Remember to consider values such as attrition rate, shrinkage, abandoned calls, and multi-skilled agents in your calculations. You can use these formulas to determine both non-clinical and clinical call center staffing needs, provided you use values that accurately represent your call center.

Regardless of the tool you use, be sure to generate graphical trend reports as they more clearly present times when your staff either under or over-performs against your target metrics. If you’re new to call center staffing, I recommend the YouTube video by Call Center Management titled “Calculate the # of agents you need.

Integration Increases Efficiency

Efficiency strategies include many things. For example, some systems can preload the caller’s name and several other demographics by using caller ID before the nurse or agent receives the call.

At institutions with centers of excellence that maintain their own focused call centers, use your phone system to direct calls using skills-based routing. For example, the system can direct cardiac calls to the heart center, oncology calls to the cancer center, etc.

When integration with your phone system is unavailable, many sites use front-enders to gather initial demographics before handing the call off to a nurse. Some organizations go even further using the front-enders to identify callers needing urgent attention to hand off immediately to a nurse versus those they can safely add to the nurse follow-up call queue.

Once in the call queue, ongoing attention to the queue is paramount to make sure calls with the greatest need for care receive priority. Many busy sites dedicate a nurse or nurse manager to perform this task during peak call times.

Consider Chat and Automation

Chat is also becoming a vital tool in off-loading both inbound and outbound calls from the queue. Today’s healthcare users often prefer to chat rather than talk on a phone.

By using chat and AI-generated chatbots, sophisticated systems can ask preliminary questions before transferring the caller to a live nurse or agent for a further chat or live phone interaction. Chat reduces staffing and provides the techno-savvy generation with their preferred communication methodology. Automation can further increase efficiency by redirecting general requests for information to the hospital website’s Q&A section.

Optimize Call Flow

Remember, as I stated, data is king. From the data gathered by the software as staff process calls, managers can simplify call flow to streamline the process. In addition, as your users learn the system, you can remove specific prompts, call guides, and fields, eliminating unneeded keystrokes.

Some software also provides hot-keys (such as Alt-S) to access additional software functions supporting full-on keyboarding. Others offer systems that are more mouse-click friendly. The best offers both options to enable your different types of users to process calls most efficiently.

When talking about call flow, I would be remiss not to mention the strategic value provided by software that is customizable to meet your needs. A solution that claims to fit all clients does not fit any. To be truly efficient, you need to work with vendors that partner with you to design a system that serves your unique needs.

The ideal solution should also include reports to track the fields used and not used, enabling you to hide the unused fields. Can your team hide the fields, or does it require vendor support? Remember, vendor support means additional costs.

Tap Video

Another commonly used efficiency tool is the video visit. Video visit is especially valuable if your call center also provides care management or disease management services. In addition, videos are of value when triaging certain situations. A good example is when a mom calls about a lethargic child. Seeing a video of the child facilitates more accurate, quicker triage.

For sites not equipped for video, even the ability to accept static photos increases efficiency by allowing the nurse to see the severity of a rash, laceration, or other condition.

Other Tools

Another feature that goes a long way to improving call center efficiency is a solution that provides a command center dashboard. This real-time data enables the call center to switch directions as needed, reallocating staff and staffing based on real-time data.

Quality review auditing tools also enhance productivity by identifying improper call handling or triaging early in a call center agent’s or nurse’s career, enabling fast remediation before bad, efficiency-zapping habits become habitual. Managers must conduct ongoing reviews of call center staff to identify potential areas for improvement. Of great value here are resources provided by your software vendor, including new hire training, refresher courses, training documentation, and no-cost webinars to keep your staff using the software at its peak efficiency.

Benchmark Your Performance

Finally, be cautious not to become overly impressed with your call center’s performance until you compare it to the industry’s standards and, more importantly, to other call centers using the same software solution. For example, your site’s call times may beat national averages. However, do they stand up against the call times of other hospitals using your same software?

Be sure to look for a vendor that can anonymously collect non-PHI call data from its clients to generate individual call center-specific numbers and multi-site aggregate results. This will enable you to evaluate your data against that of the aggregate. By comparing apples to apples, you can more accurately identify if you’re being as efficient as possible.


Time is money, and saving time saves money. The best way to accomplish this is by using your call center solution as effectively as possible.

Mark Dwyer is LVM Systems’ chief operations officer. He has more than a quarter century of experience in the healthcare call center industry.

Self-Care Tips for Physicians, Telehealth Triage Nurses, and Office Managers

By Ravi K. Raheja, MD

Due to the many hours they work and the number of patients they see, it can be easy for physicians, nurses, and office managers to neglect their own wellness. That’s even before tacking on the increased volume in COVID-related calls that many health systems are experiencing, and the mental health concerns often seen during the winter months.

All these factors reinforce how necessary it is for workers to have a means of alleviating the physical and mental stresses they experience on any given day. With that in mind, here are some of our top recommendations for healthcare staff on how they can manage theirs.

Start With the Heart

The American Heart Association phrases it best: move more. This is especially relevant to triage nurses as their jobs put them in front of computer screens for extended periods of time answering patient phone calls and offering the best dispositions for care. While they might not be able to leave their workstations frequently, there are several desk exercises that are available to them for maintaining their energy levels and staying motivated. Here are two examples:

Neck Stretch: This simple stretch helps loosen the upper back and neck muscle called the trapezius, which can ease tension, reduce stiffness, and prevent headaches.

  • Sit up straight in your chair.
  • Try to touch your ear to your shoulder without lifting your shoulder.
  • Use your hand to push lightly until you feel the stretch in your neck.
  • Hold for ten to fifteen seconds.
  • Repeat on the other side.

Shoulder Roll: Although not a stretch, this technique relieves stress because people unconsciously hold tension in their shoulders.

  • Sit up straight in your chair.
  • Roll your shoulders forward ten times at a slow, consistent pace.
  • Switch and roll your shoulders backwards ten times.

Get Some Sun

Chances are, you already know plenty about the importance of sunlight. It ramps up your body’s production of Vitamin D, which protects you from inflammation, lowers your blood pressure, strengthens your muscles, and improves your brain function. And all you need is five to fifteen minutes of it a day to experience these positive effects. It only makes sense, then, that physicians, nurses, and office managers take time to soak up some rays—even if it’s before and after their shift —by taking brief walks outside. This also gives them the perfect opportunities to…

Practice Breathing Exercises

The healthcare field can make you tense. It’s especially challenging triaging patient symptoms over the phone when callers are emotional or have difficulty explaining their concerns.

While nurses receive training on the best ways to manage difficult calls, they also need to take time in between those calls to breathe and reduce tension. As mentioned above, this is easy to combine with walks outdoors, but it’s also possible to do from workstations. Either location requires the same basic steps:

  • Sit up straight in your chair if indoors or stand up straight if outside.
  • Inhale for five seconds at a pace that allows you to fully expand your chest on count five. Try to use your diaphragm.
  • Hold your breath for three full seconds.
  • Exhale for seven seconds at a pace that empties your lungs by count seven.
  • Repeat this process ten times, or as necessary.

It might not seem like much at first, but these exercises can have substantial effects on your heart rate and cognitive abilities.

Share the Workload

There’s a lot of turnover in the healthcare industry. Some of that can be alleviated by giving physicians, nurses, and office managers more flexibility in how they use their time. Outsourcing calls can go a long way toward freeing up in-house resources for handling immediate, in-person patient needs.

Ravi K. Raheja, MD is the CTO and Medical Director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC accredited, physician-lead provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. Their comprehensive solutions include integrated mobile access and two-way video capability. The TriageLogic group serves over 9,000 physicians and covers over 25 million lives nationwide.

1Call to Exhibit at 2022 HIMSS Conference

1Call, a division of Amtelco that specializes in offering enterprise-wide communication solutions for healthcare organizations, will be an exhibitor again at the 2022 HIMSS conference, taking place at the Orange County Convention Center in Orlando, FL on March 14-18, 2022.

1Call can be found at booth 3541 where visitors will be shown demonstrations of their products including the HIPAA-compliant miSecureMessages secure messaging app and care team collaboration miTeamWeb app.

This year, 1Call is celebrating its twenty-fifth anniversary and invites attendees to join them in their booth on Wednesday, March 16 from 4:00–5:30 pm for food and drinks during a 1Call Happy Hour in honor of their twenty-five years.

HIMSS (Healthcare Information and Management Systems Society) is a global advisor, thought leader, and member-based society committed to reforming the global health ecosystem through the power of information and technology. Their annual conference brings together health IT professionals, clinicians, executives, and vendors from around the world. HIMSS membership includes more than 110,000 individuals, 480 provider organizations, 470 non-profit partners, and 650 health services organizations.

Follow 1Call during HIMSS22 using the hashtags #How1CallHelps and #Why1CallHelps. For more information on 1Call Seminars, contact 1Call at 800-225-6035 or

The 1Call Division of Amtelco is a leader in developing software solutions and applications designed for the specific needs of the healthcare call center marketplace. 1Call features a complete line of modular solutions specifically designed to streamline enterprise-wide communications, save an organization’s limited resources, and make them tremendously efficient, helping them bring wellness to their members and their bottom line.

How Telehealth Triage Nurses Can Address Mental Health Calls During Winter

By Ravi K. Raheja, MD

Much like the holidays that precede them, the winter months usually see an uptick in reported mental illness. These include seasonal affective disorder (SAD), depression, and suicide, reflected in the types of patient calls received through nurse triage. Because these mental health cases demonstrate similar symptoms, it’s important that telehealth triage nurses have the tools to properly address each.


Although cases of seasonal affective disorder are known to happen in warmer months, most tend to manifest and peak during winter. Symptoms can range from mild—increased appetite, weight gain, low energy, and oversleeping—to more severe, like feelings of hopelessness and worthlessness, problems sleeping, and thoughts of suicide, reportsNIH.

Recommendations: In milder cases, being active and getting more sunlight (at least ten minutes in the morning and ten minutes in the afternoon) may be all that’s needed to improve a person’s mood, but severe symptoms warrant guidance by the appropriate mental health professional. Nurse triage protocols provide nurses with the right questions to glean information from patient callers and guide them to the appropriate care.


According to NIH, roughly 7.8 percent of US adults ages 18 and above experienced at least one major depressive episode in 2019. Unsurprisingly, depression rates were exacerbated at the start of the COVID-19 pandemic—nearly three-fold, notes Vox—leading up to our current days of “pandemic fatigue.”

Recommendations: Triage nurses recognize that there will be times that require them to act as emotional counselors before they’re able to ask patients about their symptoms. Start by training nurses on the 10 Critical Steps to Taking a Triage Call that include methods for coaxing callers into the proper states of mind to obtain the information they need.


Perhaps surprisingly, overall suicide rates reportedly dropped over the last couple of years. It’s worth noting that these statistics do not take into consideration unintentional drug overdoses, or the disproportionate suicide rates based on race and ethnicity. Furthermore, this shouldn’t diminish the fact that suicide remains one of the leading causes of death in younger adults, both in the 15-24 and 24-35 age brackets.

Recommendations: Telehealth triage nurses can assist callers who are contemplating suicide by establishing connections with them, as this serves as the best means of de-escalation. Pulling again from the 10 Critical Steps, nurses offer sympathetic, non-judgmental assistance, acting as a positive force for these callers in order to understand what they’re experiencing.

It’s important to note that any caller who says they’re contemplating suicide is still actively seeking help.


A telehealth triage nurse received a call from a retired firefighter who stated that they were planning to end their life. By acknowledging and listening to the patient, the nurse learned they were a cancer survivor, had recently been diagnosed with metastasis, and were given three months to live.

The nurse’s solution was to keep the patient calm and talking while simultaneously alerting their manager on duty, who contacted local police to perform a safety check on the patient. Thankfully, that patient was found in their car and transported to a hospital for care.

Additional Recommendations

While professional healthcare providers are necessary when it comes to severe mental illness, telehealth triage nurses still can offer simple solutions to patients with milder symptoms to help them improve their mood, boost their energy levels, and sharpen their mental focus. These can include exercising, improved diet, and reduction or elimination of alcohol.

Ravi K. Raheja, MD is the CTO and Medical Director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC accredited, physician-lead provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. Their comprehensive solutions include integrated mobile access and two-way video capability. The TriageLogic group serves over 9,000 physicians and covers over 25 million lives nationwide. Contact them today to find out more.

1Call Celebrates 25 Years of Healthcare Communications

1Call, a division of Amtelco, announced they are celebrating their 25-year anniversary and continued growth of the software solutions and applications they create for the healthcare contact center marketplace.

Amtelco, 1Call’s parent company, has been a leading provider of communication applications since 1976. Amtelco was supplying innovative communication solutions for more than twenty years to all types of industries, including healthcare, when leaders recognized an opportunity to focus on the unique communication needs in healthcare facilities. The 1Call Division was created in 1997 to help streamline communications.

1Call’s complete line of modular solutions are specifically designed for hospitals and clinics to help unify enterprise-wide communications, save an organization’s limited resources, and improve efficiencies, all with the goal of bringing wellness patients.

“Reliable healthcare communication is crucial,” said Tom Curtin, CEO of 1Call. “We are honored that our hospital customers have trusted us for twenty-five years with their call center software needs. We have a responsibility to help our customers support the communities they serve, especially during the pandemic.

“Scripted workflows have been incredibly useful right now because information surrounding COVID-19 is always changing. Our intelligent messaging scripts are easy to edit to guide agents through each call with up-to-date information. Web-based communication options continue to be a popular option for remote operators. Our web agent enables customers with running their call centers in a virtual server environment or in the cloud.”

Over the past twenty-five years, 1Call has been successful at leveraging technology to meet and exceed the needs of their customers and outperform other industry business platforms to position itself in the most competitive way possible.