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Provide Multi-Channel Access

Be Sure You Deliver the Options Today’s Consumers Expect

Author Peter Lyle DeHaan

By Peter Lyle DeHaan, Ph.D.

For years we’ve talked about the need for healthcare call centers to become contact centers. This name realignment shifts our attention from telephone calls to embrace other forms of contact as well. This is a multi-channel mindset, and we provide multi-channel access to deliver the contact options that today’s consumers expect, which we must do if we’re to remain viable. 

Some people call this omnichannel, which implies all channels, while multi-channel more realistically looks at many channels. We’ll not debate which name is more appropriate. Instead, we’ll focus on the concept of moving beyond the telephone. 

Here are some multi-channel access points to consider.


The telephone remains key for most people in most industries. In our push for multichannel access, let’s not forget the telephone as it will continue to be the foundation for what we do. The telephone has been around for a long time, longer than any of us. 

The first healthcare call centers started nearly a century ago in the form of medical answering services, often called doctors exchanges. The telephone is proven, ubiquitous, and dependable. It’s not new or exciting, but it is stable. 

And most consumers expect you to answer their telephone calls.


Email has been around for several decades. It’s no longer novel, with naysayers long claiming that email is dead. It’s not. It’s very much alive. When you consider growing your call center beyond the telephone, the first multi-channel access option to consider should be email.

Email integrates smartly into call center activity. Unlike the telephone, where callers expect a timely answer with minimal delay, their expectation with email is less demanding. This doesn’t mean you can sit on a pending email message for days and should aim for a same-day response, but most people accept a reasonable delay as normal. This provides the opportunity to set email aside when call traffic is high and to process email messages during slow times.

Email agents should be able to read and absorb typed information quickly. They should also be able to type fast and accurately, without the need for editing.

Text Chat

A third multi-channel access option to consider is text chat. This common, and increasingly popular, communication option is how many people communicate with their family and friends. It’s no wonder that they expect businesses—including the healthcare industry—to embrace it too. 

Text chat agents, like email agents, must be able to quickly process typed messages and respond with accuracy. Unlike email, however, texting carries with it the expectation of minimal delay. In comparing chat with telephone calls, where multitasking doesn’t work, experienced chat agents can effectively handle multiple simultaneous chat sessions.

Social Media

Next consider social media. If patients try to contact you on social media, be prepared to respond. If you ignore them or take too long, they’ll be sure to vent their frustration to everyone on their platform of choice.

Social media agents need many of the same skills as email and chat agents. In addition, they must understand and be comfortable using each of the social media platforms that people could use to contact you.

Other Channels

This list is a great start, but it’s not conclusive. If people want to contact you by mail or fax, be ready to handle those interactions. Also watch for emerging communication technologies so you can prepare for them before your patients ask.

Multi-Channel Access Conclusion

If your call center is already providing multi-channel access, that’s great. Look for ways to make your channel offerings more effective. 

And if your call center focuses exclusively on the phone, explore how you can move decisively and methodically forward to offer multi-channel access to your patients and customers.

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.

1Call Announces Intelligent Series 5.5 Release

1Call, a division of Amtelco

1Call, a division of Amtelco and a leader in developing software solutions and applications for the healthcare communications and call center marketplace, announced the release of version 5.5 for their Intelligent Series (IS) suite of call center applications.

New features include:

  • Single Sign-On: The single sign-on saves time by providing single sign-on authentication with security assertion markup language or active directory federation services. This feature keeps track of passwords and performs authentication.
  • Conference Bridge: Conveniently provides concurrent multi-party conferences. Moderators have improved control over conferences and can leverage the ANI (automatic number identification) display, manage the total number of participants for each bridge, mute an individual attendee or the entire conference, disconnect individual participants from a conference, and add customizable notes about participants or the conference.
  • Script Event Tracker: The script event tracker gives supervisors detailed information about each step that a script performs, including what happened with and without agent involvement. This provides valuable information about call handling, making it an extremely useful tool for evaluating the efficiency of hospital call center scripts and investigating what happened on a particular call.
  • Artificial Intelligence: Enhances the patient caller’s experience by utilizing machine learning to determine the optimal way to route calls based on prior call history. It uses data about which agents have previously worked with the caller and any dispatches that an agent has started to help determine the best agent for the call. This use of artificial intelligence saves time for both callers and operators to provide a better patient experience.
  • Speech Analytics: Provides a deeper analysis of call logs, including a transcript of the call and describing the overall tone of the caller. This is an important feature for all hospital departments.

“The new features that our 5.5 update provides are not only important to an organization’s many unique call centers, but they also impact more immediate care team communications and patient satisfaction enterprise wide,” said Tom Curtin, CEO of Amtelco and 1Call. “These updates have been designed to be a time-saver for staff and help provide better service to patients.”

Seven Difficult Telehealth Triage Calls a Nurse Should Be Prepared to Take


By Ravi K. Raheja, MD

During trying times it isn’t surprising for telehealth triage nurses to see an increase in difficult calls. When we say difficult, we refer to those that are either: about cases of abuse or neglect; from unauthorized callers; about chronic ailments or repeat callers; about complicated medical or psychosocial issues; from callers who are excessively worried, anxious, or angry; and from callers who are hard to understand or communicate with. 

Like all areas of effective nurse triage, there are ways to handle each of these calls effectively so that patients receive the proper dispositions for care. Here’s a breakdown of each type, and the best ways for triage nurses to handle them. 

1. Abuse and Neglect

When telehealth triage nurses receive calls about these concerns, they must gather as much information as possible, often using open-ended questions, especially when these calls are about children. In the US alone, approximately five children die a day because of abuse and neglect. 

Nurses must remain professional and empathetic, as this will improve their chances of obtaining that information and determining if anyone is in immediate danger. If the call is about a child, nurses will also determine whether the patient’s physician should be informed to provide additional instructions, both for the child’s immediate care and for the next steps regarding their situation.

2. Unauthorized Callers            

Some individuals call a triage line to ask about a patient whom they are neither directly related to nor have received permission by that patient to receive information about their health. How a triage nurse responds will depend on the specifics of the call.

For instance, friends and relatives who are taking care of a pediatric patient may be treated the same as though they are the patient’s guardians. But if someone calls to ask only for information about that child’s health, that caller must be referred to the patient’s actual parents.

In some cases, it may be a child who phones the triage line directly. If this is the case, the best way to handle this call is to encourage the child to hand the phone over to an adult for further discussion.

3. Chronic Ailments and Repeat Callers

There will be times when callers need extra reassurance about their medical concerns. Others may have medical conditions that are not easy to identify. Each deserves the appropriate level of empathy and attention.

For example, patients who call back about the same concern within twenty-four hours are often known as acute callers. In such cases, it is imperative that nurses make sure to use reflexive listening to talk about those health concerns and encourage the patient to seek the most appropriate level of care—whether that care is at home, from their physician, or at the ER. If no serious issue presents itself based on reported symptoms, the nurse should console the patient and encourage them to make an appointment with their doctor.

4. Medical and Psychosocial Concerns

Calls that fall into this area of healthcare often rely on three solutions.

If they’re found to be minor or acute medical concerns, triage nurses rely on the appropriate protocols. If the caller’s concerns are chronic, nurses must follow specific guidelines from the physician’s practice or the applicable protocols.

In situations where guidelines or protocols are either not available or do not cover the issue at hand, the nurse must contact the physician directly to get further instruction. If that physician is not available, the nurse may determine that the best course of action is to encourage the caller to seek advice and care from the closest ER.

5. Excessively Anxious or Angry Callers

People are at their worst when they’re scared, sick, tired, or hungry, so it’s no surprise when their health influences one or all these factors. That’s why triage nurses must always use compassion to diffuse any heightened tension from an angry caller, gain the caller’s trust and understanding, and encourage the caller to follow their instructions. Effective telehealth triage nurses should:

Listen: They focus on what the caller is saying, don’t talk over the caller, and ask them to clarify when necessary.

Relate. They show empathy to the caller’s situation. A caller wants to feel heard and understood, so nurses can offer condolences about the confusion the caller may be experiencing, the situation the caller is in, or the caller’s feelings about it.

6. Propose an Action Plan

The triage nurse should lay out instructions on what type of care the caller should seek, whether customized instructions from a physician’s practice or based on triage protocols. Nurses should use comforting terminology to remind the caller that they are there to help. 

Some examples include:

  • “Based on what you describe, I’m going to assist you by following the protocols set by your doctor.”
  • “I’m concerned about your symptoms, so please hang up and call 911. I’ll call back in five minutes to make sure you’re okay.”
  • “I’ve noted your concerns and symptoms and will have your physician contact you to review them. I’ll ask them to call you at their earliest convenience.”

There will also be times when the patient is either not responsive to the nurse’s guidance or is verbally abusive. Don’t expect triage nurses to tolerate inappropriate behavior directed at them from a patient caller. 

In these instances, they should inform the caller that they want to help them, but that if they do not cease the abuse and calm down, the nurse will not be able to assist them any further. If the caller persists after a second warning, the triage nurse should inform them that they are hanging up and that the caller’s physician will contact them.

7. Callers Who Are Difficult to Understand

The holidays also tend to see increases in alcohol and drug use, which can influence how well telehealth nurses may or may not be able to understand patient callers who are under the influence. If those nurses can’t establish a dialogue, their best course of action—like the example above—is to ask their supervisor first, then contact the caller’s physician. If their physician is not available, the nurse should instruct the caller to go to the ER.

This may also be the case if nurses do not understand the patient’s language or if the patient has a speech or hearing impairment.

In Summary

Telehealth triage nurses will meet a wide range of patient callers, personalities, and symptoms that can influence how well they’re able to arrive at the best dispositions for care. With the right training, triage software, and triage protocols, their services will be even more effective at improving health outcomes. 


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 twenty-five million lives nationwide.

The January 2022 Issue of Medical Call Center News

Read the January 2022 issue of Medical Call Center News.

Medical Call Center News is an e-newsletter published by Peter DeHaan Publishing Inc, in conjunction with AnswerStat magazine.

Please tell your coworkers about Medical Call Center News.

Thank you!

[Medical Call Center News is published by Peter DeHaan Publishing IncPeter Lyle DeHaan, editor.]

December 2021 Issue of AnswerStat

Read the December issue of AnswerStat, the information hub for healthcare contact centers.

Feature Content:

December Issue

How to Safely Redirect Patients Away from the Emergency Department, by Mark Dwyer
To provide an effective integrated ED solution, the call center must work across the healthcare delivery system to provide a holistic solution. . . . read more >>

Vital Signs: Sticky Customer Service, by Peter Lyle DeHaan, PhD
The book Sticky Customer Service explores service successes and failures to inform our contact centers and prepare us to better meet patient expectations. . . . read more >>

Effective Call Center Software Improves Patient Transfer Center Workflows, by Nicole Limpert
Every patient transfer center is different and has diverse needs, but they all require careful coordination. . . . read more >>

Nurse Triage Protocol Software, by Ravi K. Raheja, MD
Nurse triage protocol software is meant to be used in combination with a nurse’s own expertise. When integrated with EHR, the result is better outcomes. . . . read more >>

Ten Years Ago: It’s a Wireless World, by Kevin Beale
Explore this outlook of wireless technology from ten years ago to see how far we have come and envision what the future holds. . . . read more >>

Send us your healthcare call center news for consideration in the next issue of AnswerStat.

Marketplace Directory: AnswerStat Directory of leading Healthcare Contact Center vendors:

Ameridial healthcare solutions
Call 4 Health
Keona Health

About AnswerStat
AnswerStat is the information hub for healthcare contact center news and resources, published specifically for hospital and medical contact centers and distributed free to qualified readers, decision -makers, and influencers at hospitals and healthcare contact centers worldwide.

Contact us for more information.

Sticky Customer Service

With Increased Competition and More Patient Options, Providing Excellent Customer Service Is More Important Than Ever

Author Peter Lyle DeHaan

By Peter Lyle DeHaan, Ph.D.

I’ve covered various aspects of the call center industry, focusing here on healthcare contact centers, for the past 20 years. A persistent and reoccurring theme throughout this time has been customer service. This, I’m confident, will continue to be an essential focus for our industry going forward. 

Every telephone interaction we handle is a form of customer service in one way or another. Though I delight in sharing those customer service interactions that went extremely well, too often I find myself detailing customer service failures. During the past two decades, I’ve written hundreds of articles that address this critical topic of customer service.

Now, I’ve compiled the best of these articles, along with fresh content, in my book Sticky Customer Service. Just as with my articles, Sticky Customer Service celebrates customer service successes and explores customer service disappointments. We can learn from both. While the customer service wins give us something to cheer about, it’s the customer service failures that provide us with ample learning opportunities. May we learn much from these episodes that we can apply to make our content centers even better.

Though many of our customer service opportunities occur over the telephone, other interactions take place in person, while a growing number happen online. Each of these three areas are most relevant for the healthcare industry. And each of these connection points interconnect, with one channel often migrating to another. 

In Sticky Customer Service, uncover helpful customer service tips through this compelling read, encouraging your operation to do better and celebrating what you do best. Learn how to meet your patients’ (that is, your customers’) expectations every chance you get.

Sticky Customer Service is available in e-book, paperback, and hardcover.

Sticky Customer Service is the first book in the Sticky series. Upcoming titles include Sticky Leadership, Sticky Sales and Marketing, and Sticky Living.

Get Sticky Customer Service and turn customer service and patient retention into a core strength for your healthcare organization.

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.   Read more of his articles at

Effective Call Center Software Improves Patient Transfer Center Workflows

1Call, a division of Amtelco

By Nicole Limpert

There is a lot of coordination involved when getting a patient from point A to point B. That is why hospital systems will have a dedicated patient transfer center to coordinate inpatient-to-inpatient, emergency department-to-emergency department, and hospital-to-hospital transfers for adult and pediatric patients. Communication occurs between medical staff and the call center agent.

Patients may be admitted to a hospital from their home, workplace, other hospitals, or clinics. They can arrive a variety of ways including via ambulance or helicopter, or they may already be within a hospital but need to be moved throughout the facility for tests, treatment, surgery, recovery, and visits with other medical personnel located on a hospital campus.

Patient Transfer Call Center

Patient transfer centers are dedicated call centers that provide a way for medical personnel to reach an appropriate hospital or specialist for their patient’s needs when they must transfer a patient from an outside hospital or residence, or within their healthcare organization. Typically, a referring physician calls one number that directs them immediately to the patient transfer center.

The operators at these centers are experienced professionals and are often registered nurses or EMTs with critical care experience. They are available 24/7 and have access to vast hospital and clinical networks. They conveniently and efficiently coordinate:

  • Emergency transfers or direct admissions.
  • Securing an accepting physician.
  • Bed assignments.
  • Paramedic and ambulance arrangements.
  • Transfers for critical care such as burns, cardiac, or stroke.
  • On-going communication with referring physicians.

Patient Transfer Centers and Call Center Software

Calls come into a patient transfer center in a variety of ways including via two-way radio, web, phones, and various apps. The workstation of one of these operators often has the same layout as a 911 dispatcher with at least three computer monitors, multiple keyboards, mice, and sometimes foot pedals while also using a radio.

This mixture of components from different vendors all have their own software. It is paramount that the call center software they use can seamlessly integrate with the different technologies to streamline communication and workflows.

When a call comes in the agent will immediately ask for the accepting and referring physician’s name, the patient’s name, the current location of the patient, the patient’s diagnosis, and specific medical needs. This information helps operators assess the patient’s needs and arrange for the transfer.

Patient transfer centers must ensure that their call center software can provide conference bridges and conference joins for physician consults, offer customizable scripting options to help walk operators through a dizzying array of calls, and is supported by a reliable, single source of truth directory to ensure that all updates propagate to the entire system without duplication.

Connecting with On-Call Medical Staff

Patient transfer centers give their agents the authority to access and view on-call schedules in real-time. To connect with on-call medical staff, many centers use a HIPAA-compliant secure mobile messaging app to ensure security when communicating about a person’s health. 

These apps provide end-to-end encryption and can integrate with the center’s software to send secure texts, photos, videos, and audio files. Operators can use the app from their desktop or any smart device.

Once a message is sent, agents can see if it was delivered and read. If they don’t receive a response from the person on-call, they can escalate it to another physician. These apps usually provide a way to track message activity, including a message log, message histories, indicate to whom messages were sent, when messages were read, who replied to a message, and so forth. The apps can present the data as reports for hospital and call center managers. 

The Importance of Recording and Reporting

The patient transfer center must keep reports for hospital leadership. Reports such as physician transfer choices, number of transfers, and call logs provide data to help protect callers, operators, and hospital systems in litigious situations. Calls, screen capture videos and images, messages, and more can be recorded, tracked, time-stamped, and stored.

Call analytics also help the patient transfer center improve workflows and increase caller satisfaction. It is important that reports can be customized, however, there are common reports that provide helpful information such as:

  • Agent Activity: Analytics about an agent’s activity including number of calls, holds, conference time, dispatch activity, and events such as login/out and ready/not ready.
  • Billing: Centers that need to charge departments or facilities for services can use billing codes to track accounts and their call activity for invoicing.
  • Call Details: Detailed call information including dispatch jobs, dial-out activity, messages, message history, events by agent, speech recognition events, and live call information.
  • Call Traffic: An interval-based assessment of live call traffic to help gauge call volume and agent staffing.

Every patient transfer center is different and has different needs. However, they all require an enormous amount of coordination. Transporting patients can be a life-saving effort and is an integral part of patient flow, patient care, and the patient experience. It is critical that patient transfer centers use a robust call center software program that readily integrates with other products to increase efficiency.

1Call, a division of Amtelco

Nicole Limpert is the marketing content writer for Amtelco and their 1Call Healthcare Division. Amtelco is a leading provider of innovative communication applications. 1Call develops software solutions and applications designed for the specific needs of healthcare organizations.

How to Safely Redirect Patients Away from the Emergency Department

LVM Systems

By Mark Dwyer

One of the most significant challenges hospitals faced over the past two years was handling the heightened number of ED calls and visits due to the COVID-19 pandemic. In many areas of the country, staff had to perform at heroic levels. And due to the ongoing variants, some are still facing tremendous challenges.

Having spent my career in the healthcare call center industry, I was pleased to see call centers across the country step up and field calls from millions of concerned individuals. However, much more is possible. 

Today’s call centers efficiently handle both clinical and non-clinical inbound and outbound calls. In addition, many accept text messages and bi-directional chats to facilitate patient access to care. These expanded communication options provided much-needed additional contact points during the pandemic. So, what other opportunities exist for the call center to play an even greater role? 

Front-Ending Clinical Calls

One such option is to position non-clinical agents to front-end clinical calls asking a brief set of questions to determine severity. Then, if the call meets any of four to five critical conditions pre-defined by the hospital, the front-ender passes the call off to a live Triage Nurse. If the call is determined to be less critical, it is placed into the nurses’ call-back queue for the next available nurse to process.

For decades, Triage Call Center nurses have used clinically proven protocols to guide callers, based on the severity of their symptoms, to the appropriate sources of care. In addition, the same clinical authors who wrote the Gold-Standard of triage protocols have added and revised multiple COVID-19 protocols and Care Advice over the past two years, enabling call center nurses also to triage COVID-19 patients. 

Now, the call center nurse can triage COVID-19 patients directing them to “call 911,” “go to the ED,” “Go to Urgent Care,” “See their PCP,” or provide home care instructions (among other endpoints). Doing so can redirect numerous patients to less urgent care options before they arrive at the ED unnecessarily. 

Follow-Up Options

After completing the triage portion of the call, if appropriate, the nurse can pass the call to a non-clinical call center agent to share directions to the referred facility, hours of operation, information on where to park, rules regarding caregivers accompanying the patient, and so forth.

If the patient requires admission to the ED, through integration to the hospital’s EMR system, the call center agent can keep the caregiver advised of the patient’s progress. This way, the agent can text the caregivers to update the patient’s status and discharge plans. In addition, when appropriate, the agent could either fax, text, or send by secure message any follow-up instructions for the patient.

The next day, the nurse or agent should call the patient or caregiver to make sure the patient filled any prescriptions they received, scheduled a follow-up appointment with their PCP, and followed other discharge instructions. Not only does this engender tremendous goodwill, but it often can be all that is needed to keep the patient from returning to the ED. 


To provide an effective integrated solution, the call center must work across the healthcare delivery system. It needs to team not only with its ED but also with area hospitals, emergent and urgent care centers, wellness and preventive care facilities, PCPs, and other services often needed by patients seeking care post-ED. If so, by creating a network of healthcare providers willing to accept and treat patients within reasonable timeframes, call centers can build trust in patients, so they are confident in the information and resources provided.

LVM Systems logo

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

Nurse Triage Protocol Software


By Ravi K. Raheja, MD

Healthcare organizations benefit greatly when their nurse triage and telehealth services use triage protocol software. This has been shown to decrease unnecessary provider spend and substantially improve patient health outcomes. 

Many prefer the Schmitt-Thompson protocols as the best method for dispositions on patient symptoms. Here’s why:

Developed by Doctors

As a pediatrician, Barton Schmitt, MD contributes to office-hours and after-hours protocols focused on child symptoms and severity. He wrote the first book on pediatric telephone triage in 1980, and currently serves as Professor of Pediatrics at the University of Colorado School of Medicine. He was also the previous medical director for the after-hours call center at Children’s Hospital Colorado.

Specializing in internal and emergency medicine, David Thompson, MD contributes to those same protocols by addressing adult symptoms. He’s published several medical articles that focus on patient satisfaction and chief complaint coding. He currently serves part-time with the faculty at Northwestern Memorial Hospital’s emergency department.

Updated in Real-Time

Schmitt-Thompson protocols receive regular updates for accuracy and relevance. Typically done by a board of medical professionals on a yearly basis, doctors can submit periodic recommendations for changes as they use them.

Protocols may also undergo updates or additions when an immediate need arises. For instance, some were developed at the start of the COVID-19 pandemic and are now on their seventh revision. When these changes go into effect, nurse call centers have access to them and can utilize them in conjunction with their triage software.

Daytime and Nighttime Protocols

Schmitt-Thompson protocols have two versions: one to employ during office hours and one for after when there is not an option to send the patient to see their doctor. 


Protocols are meant to be used in combination with a nurse’s own expertise. The software with the protocols can be integrated easily with electronic health records (EHR) or other health cloud systems such as Salesforce. This allows telehealth or triage nurses to fully document all patient interactions and synchronize that information directly to a provider’s in-house EHR. The result is a digital paper trail and stronger continuity of care.


Ravi K. Raheja, MD is the CTO and medical director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC accredited, physician-led 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 twenty-five million lives nationwide.

The November 2021 Issue of Medical Call Center News

Read the November 2021 issue of Medical Call Center News.

Medical Call Center News is an e-newsletter published by Peter DeHaan Publishing Inc, in conjunction with AnswerStat magazine.

Please tell your coworkers about Medical Call Center News.

Thank you!

[Medical Call Center News is published by Peter DeHaan Publishing IncPeter Lyle DeHaan, editor.]