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The August/September 2019 Issue of AnswerStat

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



Feature Content:

AS TOC-August 2019

Mitigating Medical Call Center Risk, by Traci Haynes
Hospitals throughout the country are aggressively tackling performance improvement within their own organizations, and evidence shows their efforts are working, helping to reduce risk…. read more >>

Vital Signs: Retain Staff by Establishing Their Growth Potential, by Peter Lyle DeHaan, PhD
When talented staff sees the employee growth potential for their career within your organization, they are more likely to stick around so they can realize the possibilities.… read more >>

Cyber Security and HIPAA in a Medical Contact Center, by Bobby Bennett
With SMS, text messages could remain on a device. If it’s recycled, lost, or accessible to unauthorized persons, HIPAA violations may occur. You must provide safeguards to reduce your exposure to these risks…. read more >>

Disaster Coverage: The Critical Role Hospital Call Centers Play During and After a Catastrophe, by Nicole Limpert
Organized communication and the efficient use of community resources during a crisis helps save lives and speed recovery efforts…. read more >>

Should We Worry about Physician Burnout? by Shannon Bays-Crockett
By using accredited health call centers for after-hours telephone triage, healthcare providers can enjoy their professional as well as their private lives…. read more >>

State University of New York (SUNY) Upstate Medical University
Check out this case study of SUNY Upstate Medical University’s call center, Epic Systems, and 1Call…. read more >>

Ten years ago: The Advantages of Automated Appointment Reminders
Healthcare organizations use automated reminder systems to streamline operations, lower costs, enhance patient relations, and gain a competitive edge.… read more >>

Industry News

        

Call4Health      TriageLogic

1Call      Startel

TeamHealth Medical Call Center      Ambs Call Center

AAACN       Citra Health Solutions

Call Center Sales Pro, providing proven healthcare call center solutions      Pulsar360


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.

Mitigating Medical Call Center Risk


LVM Systems

By Traci Haynes

Does the word risk evoke an emotional connotation? Regardless of the inference and based on life experience, the word can carry an emotive element. There are uncertainties in risk, which may be associated with hobbies, tasks, or employment. 

Calculated risk is one in which a chance is taken after careful consideration and estimation of the probable outcome. Healthcare organizations employ risk managers to identify and evaluate risks to reduce injury to patients, staff, and visitors within the organization. 

The five basic steps of risk management include: 

  1. establish the context
  2. identify risks
  3. analyze risk
  4. evaluate risks
  5. treat/manage risks
Minimizing risk is essential in the medical call center environment. Consider your potential for risk; then analyze, evaluate, and manage it. Click To Tweet

Risks do exist in a medical call center. There are employee risks and patient risks. These can include risks from the physical environment, clinical management, and technology. What can organizations do to help mitigate these risks? Be calculative, carefully considering and estimating probable outcomes. Even doing so will not eliminate total risk.

An excellent resource that covers information on risk is The Art and Science of Telephone Triage: How to Practice Nursing over the Phone. It is a book written by two industry leaders in the field of telehealth nursing practice, Carol Rutenberg, RN-BC, C-TNP, MNSc, and M. Elizabeth Greenberg, RN-BC, C-TNP, PhD. The book also documents the history of telephone triage and its subsequent evolution, real case scenarios, a chapter of FAQs, best practices, and other topics. 

Minimizing risk is essential in the medical call center environment. Consider your potential for risk; then analyze, evaluate, and manage it. Also essential is focusing on ways in which the medical call center can support the organization’s risk avoidance. Of utmost importance to every organization is supporting the Institute for Healthcare Improvement’s Triple Aim initiative and optimizing health system performance of better outcomes, lower costs, and improved patient experience. 

Hospitals throughout the country are aggressively tackling performance improvement within their own organizations, and evidence shows their efforts are working, helping to reduce risk. The recent addition of a fourth aim emphasizes the importance of improving the experiences of those in the workforce who provide healthcare. The Quadruple Aim focuses not only on better outcomes, lower costs, and improved patient experience, but also on improved clinician experience. 

A medical call center’s number one asset is its staff. Employees need to feel recognized for the work they do. Their working environment should encourage respect and foster a sense of belonging and purpose. They should have the ability to influence their work, as well as given opportunities for professional growth.

Let’s drill down a little further on potential risks in a medical call center. Please note this is not an all-inclusive list and not in order of importance. However, it is information to consider. 

Clinical Management

  • Clinical oversight (such as the medical director): approval of clinical content, decision support tools, educational material, medications, orders, etc.
  • Job descriptions: title, clear description of work duties, purpose, special skills, and qualifications for the position
  • Scope of service: what type and for whom 
  • State Board of Nursing Nurse Practice Act: Follow standards of practice
  • Licensure: state license, Nurse Licensure Compact 
  • Orientation/Training/Preceptor: defined program with monitoring, feedback, and evaluation
  • Policies and procedures: associated with call handling and call scenarios
  • Performance monitoring/evaluations: formal approach using call records and/or call recording
  • Continuous quality improvement: process to identify issues, implement/monitor corrective action, and evaluate the effectiveness

Technology 

  • Electronic Health Record (EHR): access and by whom
  • Computers: hardware/software, latest recommendations, updates, backup, and archiving
  • Database: decision support tools and functionality for a standard method of documentation of the encounter, optimizing the intake of information, and supporting a consistent approach to provision of information and directions for care; reporting of outcomes
  • Telephone system: supports call handling that may include auto-attendant, call routing, tracking average speed of answer, time in queue, abandonment; real-time monitoring, reports, and recording of calls
  • Chat/email/texts/photos: accept and save as part of EHR
  • HIPAA compliant: protecting health information

Physical Environment

  • Outdoor surveillance monitoring
  • Lighting: internal measurement, general, task, emergency, external
  • Security locks: after-hours or 24/7
  • Parking: onsite, offsite, monitored, lighting
  • Security personnel: onsite, offsite
  • Sound: acoustics, masking, privacy 
  • Workstation ergonomics: standing/sitting, monitor height/distance, keyboard/mouse position, adjustable chair with height/arm height/back support, headset, and so forth. 
  • Repetitive stress injuries: most commonly affects injuries to the upper extremities (wrists, elbows, and hands) due to repetitive keyboard activities

Patients and Families

  • Medical call center access: 24/7, after-hours, business hours, community service, or provider/payer service
  • Reason of call: emergent, urgent, semi-urgent, and non-urgent
  • Language and culture: linguistically and culturally appropriate and using an individual’s primary language
  • Age-specific or all age groups
  • Social determinants of health: influences an individual’s quality of health
  • Past medical history: health status prior to encounter and effect on the reason of call/disposition
  • Chronic conditions: type, number, affect the reason for call/disposition
  • Medications: routine, prn, affect the reason for call/disposition
  • Preventive health: affect overall health
  • Disabilities: type, affect the reason for call/disposition
  • Disposition: collaborative decision, access for care as needed
LVM Systems

Traci Haynes, MSN, RN, BA, CEN, CCCTM, is the director of clinical services at LVM Systems, Inc.

Cyber Security and HIPAA in a Medical Contact Center



By Bobby Bennett

With cyberattacks on the rise, what steps should a contact center take to prevent falling victim? First is to recognize it could happen to anyone. Do not equate small with safe. According to a 2017 Trend Micro online survey, 45 percent of small business owners believe they will never be targeted. The cyber security firm 4iQ states in its 2019 Identity Breach Report that cybercriminals targeted small businesses with cyber-attacks at an inordinate rate in 2018—up 425 percent over the previous year. 

With cyberattacks on the rise, what steps should a contact center take to protect its patients health information? Click To Tweet

Ways to Prevent Cyber Attacks

  • Install, use, and regularly update antivirus and antispyware software on every computer used in your business.
  • Use a firewall for your Internet connection.
  • Download and install software updates for your operating systems and applications as they become available.
  • Make backup copies of important business data and information.
  • Control physical access to your computers and network components.
  • Secure your Wi-Fi network and make sure it is hidden.
  • Require individual user accounts for each employee.
  • Limit employee access to data and information. Also, limit authority to install the software.
  • Regularly change passwords.
  • Consider two-factor authentication such as password and PIN.

The Federal Communications Commission provides a Small Biz Cyber Security Planner on their website. 

Another factor to be mindful of as a call center that takes calls for healthcare providers and clinics is that you are a business associate of the covered entity. A HIPAA business associate is a contractor or vendor to a HIPAA-covered entity that creates, maintains, or transmits protected health information in performing a function or service to the covered entity:

If a covered entity engages a business associate to help it carry out its health care activities and functions, the covered entity must have a written business associate contract or other arrangement with the business associate that establishes specifically what the business associate has been engaged to do and requires the business associate to comply with the Rules’ requirements to protect the privacy and security of protected health information. In addition to these contractual obligations, business associates are directly liable for compliance with certain provisions of the HIPAA Rules. (HHS.Gov)

A business associate contract serves to clarify and limit, as appropriate, the permissible uses and disclosures of protected health information (PHI) by the business associate. They may use or disclose PHI only as permitted or required by its business associate contract or as required by law. 

A business associate is also directly liable and subject to civil and criminal penalties for making uses and disclosures of PHI not authorized by its contract or required by law. It is important that employees are trained and understand the HIPAA rules required of a business associate. You can find sample Business Associate Agreement Provisions and training resources on the HHS.gov website.

Text messaging or SMS has become the preferred method of message delivery for both the contact center and healthcare providers today. With this growing trend comes risk associated with the transmission of PHI. 

Standard forms of SMS could mean that text messages may remain on a device for an extended time. If the device is recycled, lost, or left accessible to unauthorized persons, HIPAA violations may occur. You must provide safeguards to reduce your exposure to these risks. 

Secure Messaging is a secure, HIPAA-compliant way to safely exchange sensitive information via text. Most contact center system vendors have developed secure messaging applications for use with their systems. However, quite often it is difficult for a contact center to convince a large medical group to make changes and convert from their current secure messaging provider to one offered by the contact center. 

If you are not using a HIPAA-compliant application for text messaging, do yourself a favor and contact your vendor to see what they have available.

Bobby Bennett is the western regional sales manager for Startel, Professional Teledata, and Alston Tascom, leading providers of best-in-class contact center solutions for healthcare and medical telephone answering service call centers. Startel’s Alston Tascom Division has created a stand-alone, vendor-agnostic secure messaging gateway which has integrations with some of the most popular secure messaging providers. Contact Bobby at bobby.bennett@startel.com or 800-782-7835.

Retain Staff by Establishing Their Growth Potential



Increase Employee Tenure by Showing Them Their Future with Your Organization

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan-employee growth potential

In considering the five tips to better retain call center staff, we’ve looked at agent compensation, agent benefits, and learning situations. Now we’ll address providing staff with employee growth potential opportunities. 

With your employees learning enhanced work skills, don’t leave them frustrated by not providing the opportunity for them to apply what they learned. Though this could relate to personal growth, it’s best to focus on job-related growth potential within your organization—and not force them to seek their own growth solutions someplace else.

As you do this, you’ll show them their potential for job enhancement. This applies for both their existing position, as well as advancement opportunities. By sharing with them that they have a future at your organization and how they can get there, they’re more likely to stick around. Not only will you have retained a valued employee, but you will have prepared them to become a more essential member of your team.

Don’t be the manager that causes your best employees to leave. This will hurt your operation and could end up benefiting your competitor. Click To Tweet

Here are some ways you can provide employee growth potential for your staff. 

Add Responsibilities 

Each time your staff learns a new skill or acquires enhance capabilities, look for ways to incorporate these into their current position. Often you can accomplish this by adding responsibilities to their existing job description. As they’re afforded opportunities that their peers don’t have, they’ll see themselves as more important and more integral to your call center.

This will increase their self-esteem, improve their work attitude, and enhance their job satisfaction. All these will combine to increase their tenure with your company.

Expand Position Scope

As they prove themselves capable by handling more responsibilities, they may be ready to take on an increased scope to their job. Look for ways they can be a call center agent and something else. This may be agent and shift leader, agent and backup supervisor, or agent and trainer. 

Another option is for them to serve on an ad hoc committee or workgroup to consider new software, implement a new procedure, or overhaul the training manual. Though these are short-term assignments, success in these areas prepares the employee to take on more.

Promote to a New Position

Those who have proven themselves by taking on more responsibilities and increased the scope of their job, stand to receive prime consideration for advancement opportunities in your organization. Note that this could be within the call center or to another position within the company.

Don’t be selfish and try to keep your most talented employees in your call center. Each time they advanced to other company departments, you’ll realize the benefit of having a call center ally who understands what you do and can advocate for you.

Adjust Compensation

Sometimes asking an employee to take on added responsibilities or an expanded scope falls within their current pay rate. However, don’t be stingy. Carefully assess when it’s warranted to offer a pay raise, added perk, or compensation incentive. Failing to do so will result in them being overqualified and underpaid. Then they become a prime candidate to leave your organization and go somewhere else. Don’t make that mistake.

Develop a Career Path

We’ve already addressed the idea of developing an employee career path when we talked about learning opportunities, but career path is also appropriate when discussing employee growth potential. When doing so, it’s critical to provide a realistic timeframe for a prospective career path. This is because you don’t know when an existing position will become open or a new one will emerge. If you don’t include timing variability when developing a career path, your most qualified employees will grow impatient and leave if they don’t see things happening as quickly as they think they should.

Employee Growth Potential Summary

When talented staff sees the employee growth potential for their career within your organization, they are more likely to stick around so they can realize the possibilities. Most people don’t want to go through the hassle and invest the time to find a new job—unless you force them into it. 

Don’t be the manager that causes your best employees to leave. This will hurt your operation and could end up benefiting your competitor.

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.

Disaster Coverage: The Critical Role Hospital Call Centers Play During and After a Catastrophe


1Call-call center

By Nicole Limpert

The ever-increasing threats from natural and human-made disasters have made the use of disaster response systems a necessity. Nearly two-thirds of U.S. residents live in areas rated as having a moderate to very high risk of experiencing a natural disaster: hurricanes, tornadoes, floods, hail, wildfires, and earthquakes.

In the Federal Bureau of Investigation’s (FBI) report titled, “Active Shooter Incidents in the United States in 2018,” identified twenty-seven shootings as active shooter incidents, which resulted in eighty-five deaths and 128 people wounded (excluding the shooters).

When disaster strikes, both local and national call centers provide critical communication services to help coordinate first responders and rescue teams, organize relief efforts, enable communication between loved ones, and support communities during recovery.

Disaster Planning

Disasters often occur without warning. Weather events, mass violence, and other incidents can cause an outage or strain communication systems. However, organizations can formulate a disaster preparedness and business continuity plan in anticipation of a catastrophic event. Hospital call centers are an important component to any disaster preparedness plan because they often become a communications hub during an emergency.

Hospital call centers in a coordinated call center system, is crucial when developing a disaster preparedness and recovery plan. Click To Tweet

National, state, and local agencies often work with hospitals to develop a plan for coordinating call centers. They identify partnerships with organizations such as 9-1-1 and Emergency Medical Services (EMS), to determine how to integrate each call center into a larger communication network, for efficient allocation of services and dissemination of public health information.

The use of technology enables call centers to execute their disaster preparedness and business continuity plans quickly and efficiently. Automatic call distribution (ACD), interactive voice response (IVR), uniform call distribution (UCD), and other communication software can automate call routing systems. Leveraging automatic notifications and critical alerts helps to speed communications and shorten reaction times.

Disaster Communications

Methodist Medical Center of Illinois, part of Unity Point Health Methodist, located in the heart of Peoria, Illinois, includes a 330-bed hospital with almost 600 board-certified physicians. 

To ensure the safety of patients and staff, the technology used by the call center at Methodist helps to prepare them for any type of situation. By using a customizable critical alert system, operators can quickly contact multiple people when various disaster and code calls come through their center.

When an emergency notification is needed, an operator triggers the alert by simply selecting a group to notify and typing in the alert message. This broadcasts the message to the appropriate personnel via each recipient’s preferred contact method. This helps ensure that hospital personnel can respond to each situation as quickly as possible.

The flexible system allows the call center manager to determine whether each type of notification requires a response from the person who receives an alert. While a reply and estimated time of arrival is required from someone responding to a disaster, a reply may not be needed from a staff member on the leadership team who is using their real-time monitor to oversee the situation. Managers can view the estimated time of arrival for each person and determine if additional personnel need notification. Access to their web-based, real-time monitor can even occur from home should an alert occur in the middle of the night.

Cloud Technology and Virtual Servers

Communications failure is not an option during a disaster. Having the ability to route calls to another center in the event of an emergency is crucial. For example, if a call center is physically located in an area that has become inaccessible or damaged due to a catastrophe, calls can route to operators off-site, using cloud technology on a virtual server. A single virtual server, located anywhere in the country, can bring call centers together to operate seamlessly, even if they all use different PBX telephone systems.

Using web-based call center communication software, any computer may become a secure, professional telephone agent station accessible from the internet. Operators located in a different center or home-based agents handle the calls, and all the tools used by in-house operators are accessible to these virtual agents.

Hospitals and clinics that are part of a larger healthcare enterprise use this technology to provide backup call handling within their own system. Rossi Fraenkel, business analytics team lead for Allina Health in Minneapolis, Minnesota comments, “In the event that any of our other clinics were to have a power outage or go down, those calls roll to us at the contact center. We provide our organization with a really good, strategic value. It’s absolutely critical that we take calls no matter what.”

Disaster Recovery and Relief

Hotlines managed by agencies such as the Federal Emergency Management Agency (FEMA), provide callers with assistance related to government disaster aid, insurance claims, and home repairs.

Hospital call centers experience an influx of calls from people inquiring about hospitalizations of loved ones, safety advice, and help for themselves. Individuals who witness or experience a catastrophic event often face negative effects from it. Coping with the shock of a disaster can make someone fearful, confused, and suffer from anxiety.

Call center agents can connect callers with disaster crisis counseling to help people affected by traumatic events. Callers who are patients of a healthcare organization who participates in telehealth, may be able to take advantage of instant, secure video access to mental health professionals.

Summary

Including hospital call centers in a coordinated call center system, is crucial when developing a disaster preparedness and recovery plan. Establishing a comprehensive policy may require a significant time commitment and thoughtful input from a variety of agencies and organizations. However, the effects of organized communication and efficient use of community resources during a crisis, helps save lives and speed recovery efforts.

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.

State University of New York (SUNY) Upstate Medical University


1Call-call center

Integrating Epic’s EMR System with SUNY Upstate Medical University’s Call Centers Saves Time and Enhances Patient Caller Experience

State University of New York (SUNY) Upstate Medical University, located in Syracuse, New York, has a campus comprised of hospital, clinical, academic, research, residential, and campus facilities. The Upstate University Health System includes Upstate University Hospital, Upstate University Hospital at Community Campus, Upstate Golisano Children’s Hospital, and multiple offices to serve 1.8 million people. The care they provide extends from Canada to Pennsylvania and includes a robust telemedicine program to assist rural communities.

The origins of SUNY Upstate Medical University stretch back to 1834 and today is the only academic medical center in Central New York. The University includes four colleges: College of Nursing, College of Medicine, College of Health Professions, and College of Graduate Studies, with a total enrollment of over 1,500 students.

SUNY Upstate Medical University is the region’s largest employer with 9,460 employees. With a 600-million-dollar payroll and numerous facilities, Upstate is a powerhouse for the economy of Central New York, generating 2.3 billion dollars for the region.

Identifying Areas for Improvement

SUNY Upstate Medical University wanted to improve their healthcare call center performance and reduce caller wait times, shorten the time spent on each call, lower the call center’s abandonment rates, and provide a better caller and patient experience. 

When looking at the call answering process, they discovered the time it took for operators to obtain information from callers could be improved. “We realized operators had to ask a series of questions to figure out which patient they were talking to,” says Jody Williams, call center systems administrator for Upstate. “Right now, they answer the calls with, ‘Thank you for calling, this is Jody, may I have the patient’s date of birth?’ and they search for everyone by birth date.”

The call center operators needed more information about each caller sooner, to reduce the overall time of the call, and to handle calls more efficiently. Staff from Upstate’s IT and call center departments realized that integrating with the Epic electronic medical record (EMR) software used by the hospitals and clinics would save valuable time.

SUNY Upstate Medical University wanted to improve their healthcare call center performance and provide a better caller and patient experience. Click To Tweet

Healthcare Communication Partners

Healthcare organizations and their patients rely on good IT partners to help with fast and accurate communications. However, most healthcare facilities use a mix of disconnected technology, and sharing information among healthcare IT systems has traditionally been a challenge.

Upstate has used 1Call’s healthcare communication software since 2006 and works closely with 1Call staff to meet their enterprise-wide communication needs. Jody comments, “We use several products from 1Call. Perfect Answer enables us to record custom greetings and automatically plays those greetings before operators answer calls. We use appointment reminders and just started using MergeComm to send SMS reminders, which people seem to really appreciate.”

Upstate contacted 1Call for help, and 1Call confirmed it was possible for their guided scripting to bridge the communication gap, while making sure calls would look the same to operators.

For incoming calls, the automatic number identification (ANI) would be sent to Epic’s EMR database. Jody explains, “When the call comes in, the caller ID is pushed out to Epic, and then Epic returns the patient’s record on the operator’s screen. Operators can verify who they are speaking with using shorter lists of questions that are related to everyone who’s associated with that caller ID.”

Testing the Integration 

Integration testing began between Upstate, 1Call, and Epic. 1Call worked on the scripting piece, and Upstate’s in-house Epic staff worked with experts located at Epic’s Verona, Wisconsin campus.

“For this project, we collaborated with 1Call staff, several members of our IT group, and one of our Epic experts on site who worked with an expert from Epic’s home office,” says Jody. “Before the integration was a success, we had several calls between all parties to identify system requirements and build the scripts using suggestions from Epic. 1Call staff did virtually all of the scripting, and they’ve been outstanding to work with.”

Evaluating Results

Over time, Upstate will use 1Call’s detailed reporting function to assess the results of the integration and determine how much time this project has saved. 1Call keeps track of the time spent on calls and they are looking forward to seeing improved statistics.

“The integration will first be used with our ambulatory call center because they handle virtually all of the incoming calls for about fourteen of our ambulatory departments, which includes general medicine, dermatology, pulmonary, etc.,” Jody explains. “They do some appointment scheduling, a lot of message taking, and transferring calls to a nurse, and various requests that come from the patients. Any time a patient dials the main number for each of those departments, it goes to this call center and the wait time had been extremely high. 

“We implemented the Epic integration nine months ago, and as of now, it looks like we are saving an average of about fifteen seconds on each call. We’re hoping we can cut 10-20 percent off the duration of each call. That will make a huge difference over the course of the whole day.”

Future Integration Plans for Efficient Workflows

There are plans to use this technology throughout more of Upstate’s call center departments. Some of the call center groups rely heavily on scripts which are used for appointments, physician referrals, prescription renewal, scheduling, crises, and emergencies. These areas hope to also save time on calls and serve patients more efficiently by taking advantage of the Epic integration.

Scripts can be shortened because much of the information the operators need will already appear on their screen as they answer the phone call. According to Jody, “Our medical messaging group currently follows and completes a script with a caller’s name, patient name if different, provider information, and then they look up the doctor on call and add that to the script. After the integration, we will be able to pull most of that info from Epic.”

1Call, a division of Amtelco

Epic Systems Corporation, or Epic, is a privately held healthcare software company founded in 1979 by Judith R. Faulkner and located in Verona, Wisconsin.Since 1976, Amtelco has been providing innovative communication solutions to call centers around the world. In 1997, the 1Call Division was formed to offer enterprise-wide clinical communication solutions designed specifically for healthcare organizations. 1Call is dedicated to serving the unique call center and communication needs of healthcare organizations, helping improve communications between patients, physicians, and staff by connecting people and information.

Should We Worry about Physician Burnout?



How Telephone Triage Call Centers Can Help

By Shannon Bays-Crockett

When studying worrisome symptoms among physicians and mental health workers in the 1970s, Herbert Freudenberger, a German-American psychology, coined the term burnout. HHS described professional burnout in 2017 as an occupational hazard that could lead to high-quality healthcare professions leaving the practice of medicine. By 2017 physicians reporting frequent or constant feelings of burnout totaled 51 percent—up from 40 percent in 2013.

The Center for treatment of Anxiety and Mood Disorders reports that physician burnout is growing in the United States. One in three physicians experiences physician burnout at any point in time. Compared to other professions, physicians are fifteen times more likely to experience burnout. About 45 percent of physicians report that they would quit the profession if it weren’t for the money. Approximately 400 physicians commit suicide each year. Those numbers emphasize the need to quickly address the burnout issue.

Physician burnout symptoms seem to mirror indications of other stress disorders, but there are also distinct differences. Dr. Dike Drummond, author of the blog “The Happy MD,” talks about physician burnout in his article “Physician Burnout and the Four Phases of Compassion Fatigue” (blog post #297) when he says, “Losing the ability to feel empathy, sympathy, and compassion for your patients is a constant risk for all of us.” 

Nurse triage call centers help physicians achieve work/life balance by reducing or eliminating after-hours and on-call requirements. Click To Tweet

Physician burnout symptoms might include:

  • Physical and emotional exhaustion that leaves physicians worn out and unable to recover during downtime
  • The development of a cynical and negative attitude regarding work and patients
  • A reduced sense of purpose along with a feeling that what they’re doing has little to no meaning or value

Ashley Altus, a writer for The DO for the American Osteopathic Association (AOA), reported on Dr. Octavia Cannon’s talk to the January 25, 2018, AOA LEAD (Leadership, Education, Advocacy & Development) Conference in Austin, Texas. Dr. Cannon challenged physicians to teach students and residents about the importance of life outside of medicine. “Encourage them to take time for themselves,” Dr. Cannon said. 

Dr. Cannon continued to discuss how stress for young physicians is at its peak during training in medical school and residency, citing Medscape’s 2018 National Physician Burnout and Depression Report in which data suggested that 42 percent of physicians reported symptoms of burnout. Ms. Altus reported on five key takeaways.

1. The highest rates of burnout occurred in critical care medicine, neurology, family medicine, OB-GYN, and internal medicine. The lowest burnout rates appeared in the specialties of plastic surgery, dermatology, pathology, ophthalmology, and orthopedics.

2. More than 50 percent of physicians feeling burned out noted that a contributing factor was that they had too many bureaucratic tasks, such as charting and paperwork.

3. Patient care declines when physicians suffer from depression. Approximately one-third of physicians reported that they are easily exasperated, and 32 percent reported that they were less engaged with patients because of depression.

4. About 50 percent of physicians reported that they cope with burnout through exercise, while about 46 percent talked with family members and close friends, and about 42 percent coped by getting more sleep.

5. Physicians are split on possible solutions to burnout. About 35 percent favored reduced financial stress through increased compensation. About 31 percent favored a more manageable work schedule and on-call hours. And about 27 percent felt that decreased government regulation would be the most popular suggestion.

Senior news writer for the American Medical Association Sara Berg suggests that medical students might consider the inherent or potential stressors of a specialty as part of their decisions about the specialty they want to practice. In a recent survey about burnout and depression, more than 15,000 physicians from twenty-nine specialties provided responses that indicated 42 percent of respondents were burned out, which was down from 51 percent the prior year. 

The rates of burnout among medical specialties are:

  • Critical care: 48 percent
  • Neurology: 48 percent
  • Family medicine: 47 percent
  • Obstetrics and gynecology: 46 percent
  • Internal medicine: 46 percent
  • Emergency medicine: 45 percent

Addressing Physician Burnout 

Private practice physicians have similar issues. Imagine the pediatrician at a daughter’s dance recital or a son’s football game, and the phone rings. The caller is the worried parent of a child who is spiking a fever. The physician is torn away from the family activity to advise the child’s parent. The doctor becomes frustrated by missing his own child’s big moment in the spotlight and can’t get that back. Somebody loses out, and the choice between duty, frustration, and guilt is not an easy decision. 

Physicians list the top stressors to be bureaucratic tasks, heavy workloads, computerization, and working around the clock.

In their article, Adams and Loftus discuss steps that Emory University’s GME program, the seventh-largest GME program in the country, has taken to prepare future physicians. Highlights of the Emory program are.

Pay Attention: Stress often takes a silent toll. Physician wellness improvement programs can be implemented at worksites.

Fill the Tank: Stress is cumulative and must be managed early and continually. Ensure that staff takes time for meal breaks, makes priorities of time with family and vacations, exercise, eats properly, and sleeps enough hours to restore the body and mind. 

Boost Empathy: Ensure that psychological and/or spiritual support is available for physician and nursing staff when disasters, both big and small, happen. Adams and Loftus offered this from George Grant, a psychologist and theologian: “A major cause of physician stress and burnout is ‘empathic’ imbalance. Most clinicians, to devote the fullest attention to patient and program, are taught to suppress their own concerns and feelings.”

Champion Wellness: Just as physicians tell patients to eat better, exercise, quit smoking, and find healthy ways to relax, the message needs to be passed along to other physicians and medical colleagues.

Strengthen Compassion: Research has proven that compassion is not an inborn trait. It can be taught and strengthened through instruction.

Restore Joy: The Blue Ridge Academic Health Group report, an annual publication, stated in one of its recent issues: “We pay a staggering cost in lost productivity, risks to mental and physical health, eroding quality and safety, diminished patient satisfaction, staff turnover, and lost dollars. 

“At the extreme [is the] personal toll of depression and suicide…. When joy is lacking and burnout is present, the stakes are high.”

Healthcare Call Centers

One popular solution—after-hours telephone triage—works well to achieve all the above goals as well as serve the needs of anxious patients. Nurse triage call centers help physicians achieve work/life balance by reducing or eliminating after-hours and on-call requirements by offering patients telephone access to advice that is based on guidelines established according to preferences of each provider’s practice. All patient calls are triaged using evidence-based guidelines and are directed to the appropriate level of care. All call records are forwarded directly to the patient’s care provider so they are available the next business day.

By partnering with accredited health call centers for after-hours telephone triage, providers can enjoy their professional as well as their private lives. Other benefits of afterhours nurse triage are reflected in improved physician recruitment and retention, as well as a more satisfying patient/physician encounter when the physician is rested and refreshed. 

Shannon Bays-Crockett is a strategic communications specialist with AccessNurse.

Call 4 Health Wins 2019 Award of Excellence and Call Center Award of Distinction!

On Thursday June 13th, Call 4 Health received the 2019 Award of Excellence (for 5 consecutive years in a row!) and the Call Center Award of Distinction from ATSI—The Association of Teleservices International, Inc.

The Award of Excellence involves an independent firm that “mystery shops” messaging services and grades the service they observe.

The Call Center Award of Distinction is a sister program to the Award of Excellence that focuses on longer, more involved call handling designed to measure the skills of professional call center agents throughout North America.

These awards go only to companies that achieve the highest scores on a broad set of criteria like ring time, accuracy of answer phrase, operator guidance of call, manners, etc.

Call 4 Health

Congratulations to our team for all of your hard work! We couldn’t have done it without you!

Interbit Data and 1Call Deliver Lab Results to Clinicians via Secure Text

1Call, a Division of Amtelco, announced a partnership with Interbit Data, a leader in ensuring hospital staff has ubiquitous access to critical healthcare information. Using Interbit Data’s NetDelivery intelligent report distribution software, patient lab results can be delivered to clinicians via 1Call’s miSecureMessages application. The integration enables a hospital to distribute the critical lab results requiring action to the appropriate clinician’s tablet or smartphone.

NetDelivery intelligent report distribution enables hospitals to send patient information simply and securely, such as lab results, from the healthcare information system. NetDelivery allows a hospital to collate and direct reports to the proper recipients based on user defined rules. It also enables decision-based delivery, speeding and simplifying actionable information to the right clinicians, at the right time and in the right place.

1Call, a division of Amtelco

1Call’s miSecureMessages is an encrypted two-way HIPAA and HITECH compliant messaging app that simplifies hospital communications with fast, reliable, secure messaging to help care teams provide better patient care. MiSecureMessages apps are available for Android™ and Apple® iOS devices, as well as a secure web application for desktop use.

1Call Partners with Trusted Service Provider, American Messaging

1Call, a division of Amtelco, announced their partnership with American Messaging Services, LLC (“American Messaging”), one of the largest private critical messaging companies in the United States.

Combining 1Call’s Operator Console with American Messaging’s critical messaging service, will greatly improve critical communications in healthcare areas that are designed to keep other wireless technologies out. American Messaging’s superior in-building coverage penetrates areas inaccessible to current cellular technology such as radiology labs and deep basements.

Mike Friedel, 1Call’s vice president of sales stated, “Our operator consoles are loaded with features and advanced technologies, but we were missing a traditional messaging component. This exciting partnership with American Messaging elevates the capabilities of our operator consoles to better serve customers who utilize paging services.”

1Call, a division of Amtelco

Dave Andersen, American Messaging chief operating officer noted, “We are thrilled to further integrate our commercial and private messaging networks with the 1Call platform. Paging remains the most reliable technology for critical healthcare communications and our partnership with Amtelco helps to optimize current workflows for our customers.”