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Articles from AnswerStat

Nurse Triage for Morbidity and Mortality


Save Lives and Lower Healthcare Costs

By Ravi K. Raheja, MD

We recently discussed why a nurse triage service is important for helping patients avoid unnecessary ER visits. The same holds true for those patients who have serious conditions but hesitate to seek emergency care. Read on to learn why implementing nurse triage can reduce patient morbidity and mortality and lower the associated healthcare costs at the same time.

Why Patients Delay Care

Many patients can feel self-conscious about their health, and don’t like to go to the ER unless they think it’s absolutely necessary. They may also be worried about insurance costs and would prefer waiting to see if their symptoms improve. But this hesitancy can put their overall health at risk if they’re exhibiting symptoms associated with underlying conditions: for instance, neck and shoulder pain that may be precursors to a heart attack.

Even if these symptoms don’t seem problematic immediately, it can take a very short period of time—sometimes less than 24 hours—before they may worsen. Having a qualified triage nurse who can talk with that patient and evaluate all of their symptoms using Schmitt-Thompson protocols will give them a definitive answer about whether or not they need the emergency department.

Not only does this lower the mortality rate at a given practice, it also helps patients avoid high medical bills. Those who may experience symptoms but continue to delay care may find themselves ultimately needing the ER anyway—and potentially an ambulance to get them there—and will have to pay more out of pocket compared to those treated early by a PCP. 

Conversely, patients who take active roles in their own healthcare are better able to avoid these situations. But they still need to know when their symptoms warrant going to the ER. Nurse triage is the best means of determining that.

Benefits of Nurse Triage

Nurse triage is a service where registered nurses talk with patients—either over the phone or through telehealth videoconferencing—to evaluate their symptoms and determine the best dispositions for care.

Those dispositions can be applied to both pediatric and adult cases. For a more in-depth discussion of how these age groups differ, and why there is a high referral rate for ER visits for adults, check out the e-book, Patient Symptoms & Outcomes.

Nurse triage should include:

  • Understanding the 10-step process for handling each call,
  • Access to the most up-to-date versions of daytime and after-hours triage protocols,
  • Use of intuitive nurse triage software to document all patient interactions, and 
  • Proper training on how to interact with all types of patients.

This service has demonstrated its ability to enhance patient health outcomes and provider revenue by assisting patients in comprehending the gravity of their symptoms, whether related to physical or mental health. It covers a spectrum from moderate to severe or even chronic conditions, and effectively identifies suitable healthcare professionals capable of providing treatment. This can even extend to ER referrals when necessary.

Morbidity and Mortality Examples

In a recent study we identified 60,753 patient callers who did not originally intend to go to the ER. Once evaluated by our triage nurses, we found that: 

  • 40,596 were correct and did not need to go,
  • 20,157 did need to go (33.2 percent), and 
  • 343 were actually instructed to call 911.
Morbidity Article Graph

Here are some examples of when our triage nurses have advised patients to seek treatment at an emergency department.

Case 1: 3-Day-Old Newborn with Loss of Appetite

Problem: A father called our nurses, worried that his newborn was not feeding or latching after just coming home from the hospital. The baby had been feeding and latching well earlier that day.

Outcome: After assessing that the newborn had demonstrated abnormal behavior, our nurses recommended emergency response.

Case 2: 22-Year-Old Adult with Chest Congestion

Problem: A patient called our nurses to ask for a refill on his inhaler, which expired earlier that year. He complained of chest congestion, a runny nose, and a sore throat that had started two days prior.

Outcome: After asking further questions about the patient’s symptoms, nurses learned he had difficulty breathing, shortness of breath, and a pulse of over 100 BPM. They then determined the patient’s case was more severe than he realized and directed him to the ER.

Case 3: 47-Year-Old Adult with Chest Pain and Vertigo

Problem: A patient called our nurses and said that he was feeling chest pain, vertigo, dizziness, and headaches after taking his first dose of an SSRI earlier that day.

Outcome: After learning that the patient’s chest pain was intermittent, but increasing in severity, our nurses directed him to the ER.

Reduce Morbidity and Mortality Rates

Nurse triage plays a crucial role in assisting a wide range of cases, from new patients experiencing moderate symptoms like dehydration, to established patients with chronic conditions like heart disease. Whether you manage this service in-house or choose to outsource it, you’ll immediately see how these nurses can reduce incident rates and the number of deaths.

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 25 million lives nationwide.

Contact them to talk about a program to reduce morbidity and mortality.

Call Center Stakeholder Integration

Connect with Critical Groups Who Often Go Overlooked

By Peter Lyle DeHaan, Ph.D.

As we wrap up our five-part series, Integrate Your Call Center, our fourth consideration is stakeholder integration. (If you want to review, the other three are Integrate Your Call Center Staff, Integrate Your Call Center Tools, and Integrate with Your Organization.)

When we integrate our call center with our stakeholders, this means a better information flow between you and other groups that are ancillary to the call center but also integral to success. Here are some items to consider when it comes to integrating with your stakeholders.


First up for stakeholder integration is your vendors and suppliers. They are critical to your call center success, so it’s critical to have a good relationship with them. I’ve been on both sides of adversarial vendor-call center relationships, and the results are never good. For this reason, I always strive for mutually supportive, win-win interactions.

When you lift your vendors up, they’ll lift you up. And if you tear your vendors down, your operation is apt to suffer as a result. Seek interactions and solutions that are in your mutual self-interest. Your positivity will be rewarded.

And when difficulties arise—which they invariably will—seek to work with your vendors to find a solution rather than harass or threaten them. Remember, patience goes both ways.


Whether you’re part of a for-profit or nonprofit organization, someone has invested money in your operation, and they expect a return on that investment (ROI). If the call center fails to provide the return they expect, they’ll close it down and outsource the work. In a worst-case scenario, the organization will go out of business and close their doors. Either way, all those calls center jobs will be lost.

Yes, it’s the owners of your operation that control the purse strings. They are the ones who can say no to your funding requests. But they are not your enemy, so it’s important to have a good working relationship with them.

Call center investors and owners are the second source of stakeholder integration.


We’ve already talked about the importance of cross training when it comes to integrating your staff, yet call center employees are also stakeholders. They can be appreciative of their employers or hostile towards them. While this is a choice they decide, management plays a critical role in how well they’re integrated into the mission of the organization.

Key elements include their compensation package, managerial support, and how appreciated they feel for the work they do. Other areas are scheduling, workload, and a sense of a shared vision.

If they’re unhappy they’ll vent their frustrations with their coworkers, their family and friends, and potentially everyone who calls. Since they talk to a lot of people every day, a disgruntled telephone agent can harm your brand and hamper your objectives in quick order.

Thankfully, the opposite is also true. When they’re treated right, they’re much more apt to be happy and satisfied with their work. Then they’ll likewise let other people know, and their work will show it.


When it comes to making your call center the best it can be, be sure to include your stakeholders and integrate them into your operation. Though these groups often go overlooked, they are critical to your success. Don’t overlook stakeholder integration.

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 or his book, Healthcare Call Center Essentials.

Case Study: Improving Medical Message Intake with Augmented Intelligence for Your Operators


By Ravi K. Raheja, MD

How accurate are the medical messages that your nonclinical operators send to your providers? According to Gilman and Bedigian, LLS, a law firm that specializes in medical malpractice, one of the biggest factors that leads to a lawsuit is when operators don’t send critical messages to doctors immediately. In fact, we have found that out of all emergency messages, about 30 percent do not accurately relay the situation for the provider to react. (Also see this white paper on the accuracy of medical messages.)

So how do you ensure that nurses and providers are receiving appropriate information? Below we discuss an easy-to-use tool that helps train operators so that all medical message intake verifies potential emergencies related to each patient complaint. Best of all, this solution only increases call time by an average of 30 seconds. 

Consider this example of a patient message: a patient calls and reports they are feeling dizzy, experiencing both a headache and what they think is a sinus infection. At first glance, this may not be serious. To an uncertified operator, this wouldn’t sound like an emergency. However, after using our augmented intelligence tool, MedMessage Assist, the message adds that the patient is feeling weakness in their arm, leg, or face. 

This information, coupled with the reported headache, automatically reprioritizes the patient’s request. The triage nurse calls the patient back within a minute and ends up advising them through triage protocols to go to the emergency department immediately.

The bottom line: the difference between a nonurgent and emergent call can be a single overlooked symptom.

When we refer to accuracy, we aren’t just talking about how well an operator records what a patient tells them, we’re talking about whether the operator knows to ask additional questions based on those symptoms. This is because patients and operators aren’t medically certified, so it’s easy for both of them to overlook potentially harmful health conditions that their initial symptoms represent. 

This also means that if a message doesn’t accurately reflect the urgency of the patient’s symptom, the patient might end up waiting too long to receive a callback. Unnecessarily long wait times for patient care then leads to poor health outcomes.

So how can augmented intelligence improve medical message intake?

Analyze Data Recorded by Your Operators

When you implement MedMessage Assist (MMA), its software will analyze the text that your operators are typing into their online forms while they’re listening to patient callers. Then, when it detects symptoms that might indicate more severe medical conditions, it prompts operators to ask qualifying follow-up questions. Those answers will improve the specificity of each message and allow providers to establish a proper sense of urgency for processing patients’ requests.

How big of a difference that could really mean?

By the Numbers

When reviewing 2,661 report tickets for patient complaints submitted to triage nurses, MedMessage Assist generated additional information for 726 of them, or roughly 27 percent.

We also learned that about a third of all emergency messages submitted were initially insufficient. MMA helped clarify the messages that were emergencies, and in about 2 percent of the cases, the symptoms were serious enough to require 911 intervention.

Using MMA adds little time to any patient call: roughly 24 seconds when the original complaint isn’t changed, and 40 seconds when it is. That means each call requires less than a minute to ensure the accuracy of patient symptoms so that they receive the appropriate care advice.

As operators gain more experience with MMA, we also expect to see them anticipate which questions to ask and use MMA to compare their work. Implementing MMA has led to accuracy scores of over 99 percent, in some cases vastly improving the message intake that some providers previously reported.

Additional Benefits

Message accuracy has a positive domino effect on several additional aspects of the patient experience.

Improving the patient intake process leads to faster dispositions and greater safety for those who may need assistance sooner than scheduled appointments. In turn, operators become more efficient, which shields providers from malpractice liability.

Beyond these benefits, MMA can work with existing software, so you don’t have to worry about implementing an entirely new system or synchronizing your data with it. There’s also a minimal learning curve for MMA, as the system is designed to be self-teaching. Finally, it meets all requirements necessary to be HIPAA compliant.

Improve Medical Message Intake with a Free Trial of MMA

We’re confident that MedMessage Assist and its augmented intelligence will transform the way that offices manage its patients’ calls. 


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.

Are you ready to improve medical message intake and your patient health outcomes? Email us at to schedule a 15-minute demo. You may also qualify for a free trial of MedMessage Assist.

Gamification in the Contact Center


By Nicole Limpert

When was the last time you played a game? Did being competitive give you a boost of energy and make you feel engaged in what you were doing? According to WebMD, when a person wins a competition, their brain releases dopamine—a chemical that makes people feel good. The experience is also a learning opportunity and offers people a chance to improve their performance.

Human resource managers use game elements in the workplace to engage and motivate employees. Gamification in a traditionally non-game environment, such as when used within a company, leads to happier, more productive employees.

According to a Gamification at Work Survey from TalentLMS, gamification in the workplace made employees:

  • Feel more productive (89 percent) and happier (88 percent).
  • Believe they’d be more productive if their work was more gamified (89 percent).
  • Feel motivated during training (83 percent). For comparison, 61 percent of those who received non-gamified training felt bored and unproductive.

The Benefits of Using Gamification in Your Call Center

According to the 2022 NICE WEM Global Survey, the call center employee attrition rate in 2021 was 42 percent—one of the highest percentages of all industries. The same report found that 31 percent of customer service agents and managers were job hunting, and 40 percent of that group were so unenthused with the industry that they were searching for jobs in entirely different fields. One of the conclusions drawn by the report was, “It’s essential that organizations find ways to engage their existing agents to enhance loyalty and retention.”

Contact center gamification is an enjoyable and engaging approach to improve agent performance. Using gamification in conjunction with key performance indicator (KPI) management, present and share data in a fun way that taps into natural human behavior to increase productivity levels and support teamwork—even if your workforce is remote.

Gamifying call center analytics not only makes it more pleasant for managers to monitor operator performance, but it can also result in agents getting a boost of morale from the camaraderie fostered through friendly competition and receiving performance feedback in a fun way.

Call center metrics that can be gamified include:

  • Number of successful inbound calls and missed calls.
  • Call transfer rates.
  • Average call handling time and call length.
  • Hold times and call queue wait times.
  • Customer satisfaction scores and first call resolution rates.

Give prizes, such as gift certificates, to agents as a reward. If individual awards aren’t an option, consider donating to a charity to honor your employee or team. Doing something good for the community raises morale too.

Gamifying Contact Center Metrics

Some vendors include gamification tools in their workforce management software, while others support third-party integrations. If your contact center software has superior call metric capabilities, then you already have the data you need to take advantage of gamification in your call center.

Leverage call analytic reports to provide scores to determine how well agents handle calls. Call scoring tracks operator performance regarding:

  • Answer time (critical for code calls).
  • Accuracy of answer phrase.
  • Required questions asked
  • Proper grammar (such as saying yes instead of yeah or yep)
  • Manners (saying please and thank you)
  • Pacifying words (such as um, or ah).
  • Accuracy of call close

For specialized calls, such as code calls, customized scripts can verify that the agent correctly obtained the type of code, patient location, patient status, and if the agent announced the code overhead (if required), along with the timing from the answer to initiation and completion of paging.

Present the analytics gathered by your call center software using gamification principles. Report call assessments alongside informative graphs and scores to create individual and team rankings and leaderboards.

Creating a Call Center Gamification Strategy

Creating a strategy for your contact center’s use of gamification will guide decision-making and ensure you retain the original focus(es) over time.

Define what you hope to achieve by incorporating gamification into your contact center: Set goals such as higher employee satisfaction, lower turnover rates, improved productivity, better caller satisfaction scores, or shorter call times.

Measure success by setting clear, attainable, and objective benchmarks: Define how your scoring system will work. Explain what data will be measured, how they will be weighted, and any rules that fit your organization’s needs. Standard scoring tools include point systems, graphs, rankings, or levels.

Recognize good work and provide feedback on areas for improvement: Performance evaluation gives managers an opportunity to identify operators who would benefit from additional training and reward those who attain or exceed goals. These numbers from Gitnux highlight why it is essential for a company to have a recognition program:

  • Eighty percent of employees would work harder if they felt better appreciated.
  • Strong employee recognition programs reduce turnover rates by 31 percent.
  • Employees recognized for their work are almost six times more likely to stay at their jobs than those who aren’t.
  • Ninety-two percent of employees are likely to repeat a specific action if given recognition for it.

The evidence is clear. Gamification of call analytics is a win for everyone.

1Call, a division of Amtelco

Nicole Limpert is the marketing content writer for 1Call, a division of Amtelco.

Embracing Digital Transformation

Enhance Member Support in the Changing Landscape of Healthcare

By Mark Montgomery

In the wake of the digital revolution, the healthcare industry is beginning to embrace technology and transforming the way patient care and support is delivered. The shift to digital platforms has undoubtedly improved accessibility and convenience for patients. However, as healthcare providers race to keep up with the digital wave, concerns have emerged regarding the potential erosion of patient-centric care.

From Crisis Response to Patient-Focused Approach

During the peak of the pandemic, healthcare providers quickly pivoted to telehealth services to address immediate digital needs. This shift not only demonstrated the effectiveness of virtual care but also paved the way for broader acceptance of digital healthcare management. Deloitte’s recent digital health integration research shows that 75 percent of health system leaders surveyed said their organizations are rethinking business models by shifting away from a treatment-based approach to focus on maintaining patients’ health and well-being through digital technologies and patient support systems.

In the evolving landscape of healthcare, providers must not overlook the crucial role that customer support tools and investments play in ensuring a seamless and patient-centric experience. By leveraging these resources effectively, providers can enhance patient support, improve communication, and elevate the holistic experience they deliver.

Facing An Array of Challenges

With the rapid shift to digital healthcare as a main platform, patients still face challenges in accessing care, scheduling appointments, and communicating with healthcare providers. Communication issues, such as the use of complex medical jargon and rushed consultations, leave patients feeling confused and unheard. Additionally, inadequate patient engagement, billing and insurance complexities, and a lack of emphasis on the overall customer experience contribute to dissatisfaction.

The existing challenges are exacerbated by fragmented care coordination. To enhance customer service, healthcare providers should prioritize accessibility, effective communication, patient engagement, transparent billing processes, and comprehensive care coordination.

Several significant factors contribute to these challenges:

  • Decreased Human Connection: The rise of digital interactions has inadvertently diminished the human connection between healthcare providers and patients. Studies show that patients value empathy, compassion, and personal attention, which can be compromised when most interactions occur through digital channels.
  • Communication Gaps: Digital platforms often fall short in replicating the nuanced communication offered by face-to-face interactions. This can result in misunderstandings, reduced patient satisfaction, and compromised healthcare outcomes. Patient concerns may be misinterpreted, explanations may be inadequate, and limited opportunities for patients to ask questions can arise.
  • Fragmented Healthcare Experiences: Over-reliance on digital technologies leads to fragmented healthcare experiences. Throughout their care journey, patients encounter various digital touchpoints such as online scheduling, telemedicine visits, and remote monitoring apps. While these innovations offer convenience individually, the lack of integration among these platforms can result in disjointed experiences, leading to confusion and frustration.
  • Information Overload: Digital platforms generate an overwhelming amount of health information readily available to patients. While patient education is crucial, excessive information can confuse patients and hinder their decision-making process. Moreover, patients may come across inaccurate or unreliable information, potentially exacerbating their concerns or leading to self-diagnosis.

Put Patients First

In the era of digital healthcare, customer service plays a crucial role in ensuring patient satisfaction. Patients have high expectations for timely and personalized support throughout their healthcare journey. Using technology, healthcare providers can offer efficient and responsive customer service. This includes addressing inquiries and concerns through various channels like phone, chat, and email. There are several important opportunities for healthcare providers to enhance patient support, such as:

  • Creating Seamless Omnichannel Experiences: Providers should prioritize the development of integrated digital platforms that streamline the patient journey, with patient support and service at the forefront. By harmonizing different touchpoints such as telemedicine, online scheduling, and patient portals, healthcare organizations can ensure smooth transitions between channels to improve the overall patient experience. By engaging a BPO partner, providers have an opportunity to gain a comprehensive view of patient data and needs more seamlessly. This facilitates better care coordination and enabling providers to deliver personalized, patient-centric services and support networks.
  • Placing Importance on Human Interaction in Digital Experiences: While technology is instrumental in enhancing efficiency, healthcare organizations must find ways to incorporate a human touch into digital interactions. The implementation of empathetic chatbots (yes, that is a thing), video consultations with healthcare professionals, and personalized follow-up communications can bridge the gap between automation and authentic patient experiences. These initiatives emphasize the significance of patient-centricity and help build trust in the digital realm. Having a partner in customer support that can rapidly ramp up support during spikes or critical times, all while understanding the business needs and patient demands is crucial to the long-term success of patient support programs.
  • Leveraging Data for Personalization and Proactive Care: By harnessing the power of data analytics, healthcare providers can customize services to meet individual patients’ needs, providing personalized care on a larger scale. According to the Harvard Business Review, the healthcare sector has more customer information than any other industry. By utilizing patient data such as medical history, preferences, and social determinants of health, providers can anticipate patient needs, identify potential health risks, and offer proactive interventions. This data-driven approach empowers patients and ensures their care remains at the forefront of healthcare delivery.

Patient customer service should proactively engage patients by providing educational resources, preventive care reminders, and personalized wellness programs. What’s more, by utilizing data analytics, healthcare providers can gain valuable insights into individual members’ needs and preferences, enabling proactive and personalized user engagement. This approach not only strengthens the patient relationship but also contributes to better health outcomes.

In an increasingly competitive healthcare landscape, health systems must prioritize customer service elements to position themselves for growth. Being data-driven is crucial, but it is equally important for health systems to align themselves with measures that cater specifically to healthcare users. By focusing on patient-centric information, health systems can effectively compete for patients’ share of care in an environment where the supply of services exceeds the current demand.

Mark Montgomery is the head of global operations delivery at Ubiquity. He is responsible for contact center operations and client delivery across Ubiquity’s global footprint. He has more than twenty-five years of management and operational excellence experience in the BPO space.

3 Reasons Why Triage Nurses Need to Train with Simulated Patients


By Ravi K. Raheja, MD

Simulated patients can take many forms, yet they all serve the same purpose: to provide a safe and controlled environment for nurses to practice their skills. Nurses can make mistakes and learn from them without putting real patients at risk. Some simulated patients have been standardized patients (SPs) who have been coached so well that clinicians may not know the difference.

Now, the development of artificial intelligence (AI) has allowed this area of health care to become even more effective thanks to the realistic nature of the calls they provide, and the ability to customize them. Here are three reasons why your triage nurses would do well to train with it.

1. Simulated Training Improves Nurse Confidence and Patient Outcomes

Studies have found that nurses who train with simulated patients are more confident and competent in their skills. They’re also able to provide high-quality care to their patients, which leads to better patient outcomes.

The same is true for triage nurses who answer patient phone calls and evaluate their symptoms. By practicing how to ask the right questions, document all symptoms, and anticipate worst-case scenarios, these nurses can provide the best dispositions on the types of care that patients should seek.

By extension, this helps patients learn when it is or isn’t appropriate for them to seek out emergency care, translating to better health outcomes for them and larger revenue savings for their providers (especially when their clinics aren’t overwhelmed).

2. Simulated Training Improves Muscle Memory

The more you practice a behavior, the more it becomes second nature. Nurse triage training is a unique environment unto itself, requiring not only specific skills from nurses, but also the right mindset on how they should interact with patients prior to any physical examination. This comes down to how well nurses:

Triage nurses rely solely on their communication skills to gather information and provide appropriate care. By practicing with simulated patients, they can learn how to ask the right questions, elicit essential information, and provide appropriate care based on each patient’s specific needs.

3. Simulated Training Offers a Wide Range of Scenarios

Simulated patients can be used to train nurses on a wide variety of patient encounters they are likely to have in their careers. For example, a simulated patient may be experiencing chest pain, or they may be angry and upset.

Ideally, these training scenarios will begin with simple exercises so that nurses can become familiar with the 10-step process they should follow, and the types of questions they need to ask. Then, more complicated scenarios can be used to test their knowledge and ability to handle upset patients, those who are difficult to understand, and how to overcome other aspects like background noise that may interfere with their calls.

AI Training with Simulated Patients

Nurse triage training can likewise use artificial intelligence to simulate real-life scenarios. Here are the benefits of using AI training with simulated patients:

  • Most simulated patients in traditional triage training are seasoned triage nurses. This means that a live manager needs to spend the time and resources training another nurse. Using computer simulated training relieves managers of this responsibility and lets them focus on taking live calls.
  • Training evaluators can spend more time coaching new nurses based on their individual performance, rather than administering these exercises directly.
  • Providers can access trackable results for all nurse training performances.
  • All training is consistent and standard across nurses. 

How does a nurse training module accomplish these outcomes?

  • Trainees are given reference materials for review, including key concepts and the 10-step process for every nurse triage call.
  • Nurses start training with basic situations that prompt them with the steps they need to take and the questions they should ask. 
  • Training simulations become progressively more difficult, omitting steps and questions so that nurses must use what they’ve learned to address each simulated patient’s symptoms thoroughly and accurately.

Each situation can be taken multiple times for improved scores. Each can also be customized so that the caller’s voice and tone, attitude, gender, and surrounding environment influence their reactions and the progression of a given scenario.

After completion of an exercise, a transcript is generated that provides performance feedback. This solution is self-guiding, meaning that normal trainers and triage nurses don’t have to spend time administering it; they can simply review its results and give pointers as needed.

Nurse Triage Training

Training with simulated patients is a critical step in ensuring that nurses are well-prepared to provide high-quality care in real-world situations. By creating a safe and controlled environment for nurses to practice their clinical skills, simulated patients allow nurses to make mistakes and learn from them without putting actual patients at risk. 

Ravi K. Raheja, MD is the CTO and medical director of the TriageLogic Group. If you’d like to discuss how our program can benefit your team of healthcare professionals, let’s schedule a call.

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.

Integrate with Your Organization

Don’t Stay in Your Silo or Function in Isolation

By Peter Lyle DeHaan, Ph.D.

I once needed to call a company in the healthcare sector. With their call center I encountered long wait times, surly representatives, and little help in resolving my dilemma. I made many unsuccessful phone calls. At last, one rep transferred me to a different department. My experience with that call center was the opposite of the first one.

The employee answered quickly, was cheerful, and offered help. In one phone call, lasting but a couple of minutes, she resolved my concern. I thanked her for her helpful resolution and remarked how difficult it was to get to her department. Her response took me aback.

“No one knows we exist,” she laughed. “We’re our company’s best kept secret.”

It seems she worked in a silo within her organization. Her silo functioned wonderfully, in contrast to the organization’s primary call center. What made the difference? I assume it was management, but that’s a topic for another time.

Today’s discussion is about integrating your call center with the rest of your organization.

It’s Us Instead of Them

When you integrate with your organization you move away from the mindset of us referring to the call center and them referring to the rest of the organization.

Instead, everyone in the company becomes us.

Making this mental switch is key. Without it, any plans to integrate with your organization will not succeed. Embracing a holistic us mentality is the first step to successfully integrate with your organization.

It’s Focusing on Others Instead of Self

As you make this mindset shift, you also shift your focus. By redefining us to include the entire organization, you encompass a greater set of employees who can band together to serve patients and callers. Isn’t that why your organization exists? To help patients and callers? To best accomplish this the focus must be on callers and what you can do—with your whole company behind you—to best address their concerns or needs.

It’s a Team Approach

This reformed focus embraces a team approach to problem solving. The goal isn’t to make yourself look good or even your whole department. The goal is to work as a team to make your organization look good. When you do this you and your company win, and—more importantly —so do your patients and callers.


This grand vision to integrate with your organization is easier to visualize than to realize.

Though you can start it from within your call center, it will take time to permeate through your entire organization. It’s easier when the initiative comes from the C-suite. And, of course, some managers will resist this change. But this reveals their selfishness. They’re more concerned about maintaining the status quo than about what’s best for the organization and your 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.

Read more of his articles or his book, Healthcare Call Center Essentials.

How Technology Can Help During Nurse Shortages


By Nicole Limpert

We have all seen reports and heard stories about how nurses have left the medical field amid the pandemic. In truth, the United States healthcare system has been experiencing a series of nursing shortages for decades—studies dating back to the 1920s point to low wages and undesirable working conditions.

Federal regulation 42CFR 482.23(b) requires hospitals certified to participate in Medicare to “have adequate numbers of licensed registered nurses, licensed practical nurses, and other personnel to provide nursing care to all patients as needed. There must be supervisory and staff personnel for each department or nursing unit to ensure, when needed, the immediate availability of a registered nurse for bedside care of any patient.”

However, the regulation does not provide a clear nurse-to-patient staffing ratio. It is the responsibility of each state to determine appropriate staffing needs. What is clear is that fewer nurses are helping more patients, and their excessive workloads are linked to higher patient adverse outcomes, including patient mortality.

Useful Technology to Streamline Workflows

Any technology that automates and simplifies nursing duties will free nurses to spend more time with their patients which leads to better patient outcomes. According to an article by Katherine Virkstis, ND and Karen Drenkard, PhD, RN, NEA-BC, FAAN entitled, “It Is Time to Focus Digital Strategy on Supporting Nurse Workflow,” there are many technologies healthcare organizations can leverage to improve nurse workflows. Some of the solutions they list include:

  • Technology-driven pumps and monitors that automate the collection of information needed for care.
  • Smart devices, including automated beds and vital sign monitoring.
  • Wearables that provide clinical data to the provider.
  • Electronic white boards integrated with the electronic health record to keep patients and families up to date.
  • Centralized data command centers that integrate multiple systems into a single monitoring center, including coordination of care, requests for services, and discharge tracking.
  • Tele-technology that enables virtual inpatient care models, including virtual sitter and virtual expert RN models.
  • Mobile apps that enable bidirectional communication between patients and clinicians across all levels of care.

Tapping into Remote and Part-time Workforces

Currently, the average age of a nurse is around 52, and there are concerns that 4 million nurses will retire by 2030. This will only exacerbate future nursing shortages. However, technology can provide a way for retired nurses, or those who are on their way to retirement and want to work less hours, to provide non-traditional care and support to patients.

Virtual nursing is a newer model of care that provides nurses with a flexible, less demanding schedule. Virtual nursing can include anything from nursing triage or nurse on-call via telehealth, to overseeing alarms and alerts in a command center.

Nurses can use telehealth to prescreen patients for virtual appointments. Depending on the patient’s needs and if the nurse is advanced enough, virtual nurses can even meet with patients for their telehealth visit and avoid handing off the appointment to a physician.

Instead of the traditional bedside nurse capturing patient health data while also trying to care for patients, health systems can dedicate virtual nurses to conduct pain assessments and data collection remotely. They can look at lab values, alarm notifications, and other monitor alerts and escalate when appropriate.

Where Are the Next Generation of Nurses?

Another contributing factor to the nursing shortage is the scarcity of nursing school instructors. It has been common for nursing programs to use a lottery system for selection into their programs for years. The 2020-2021 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing report (also here) from the American Association of Colleges of Nursing (AACN) states, “U.S. nursing schools turned away 80,521 qualified applications from baccalaureate and graduate nursing programs in 2020 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints.” The report further says most universities cited a lack of qualified teaching faculty as a key reason for having to reject the qualified nursing applicants.

When instruction doesn’t require teachers and students to be physically present in a classroom, technology can play a role in addressing the educational needs of students by using online education. Virtual learning won’t completely replace traditional instruction, however Virtual Reality (VR) simulation and high-fidelity simulation that uses realistic, life-like manikins (a full-body patient simulator) to mimic human anatomy and physiology can teach clinical skills and help alleviate the instructor shortage.

Overcoming Negative Aspects of Technology

Sometimes, you can have too much of a good thing. One of the major challenges of using multiple technologies is when they are not interoperable or don’t function smoothly in a clinical setting. Health systems must avoid having a scenario where the nurse becomes a human interface between disparate and clunky technologies. If nurses are recording data from one system into another or logging in and out of multiple technologies, inefficiencies take up their time and keep them away from patients.

Ideally, design thinking principles are part of the process when creating tech solutions. Input from the people who are going to use the technology from the beginning, during usability testing, and throughout implementation will ensure the technology works smoothly in real-world application.

It’s essential for technology companies to have this usability component to make sure their designs won’t negatively impact nurses and other clinicians.

How Contact Center Software Fits In

Hospital contact centers are the communication hubs for the hospital enterprise. They not only handle a multitude of different calls, the same communications integration engine software used by a hospital call center can also integrate with technologies being used to address the nursing shortage. With the right integration engine acting as a bridge between software solutions, contact centers, and other devices, hospitals can be sure the solutions they are using to streamline nursing workflows speak to each other to communicate quickly and seamlessly.

These systems, leveraging standardized communication protocols like HL7, eliminate the chaos of moving information between systems and between people. Integration engines act as the glue that holds these many IT systems together and translates a variety of different inputs in such a way that other solutions can interpret the data and react accordingly.

1Call, a division of Amtelco

Nicole Limpert is the marketing content writer for 1Call, a division of Amtelco.

Integrate Your Call Center Tools

Make Sure Each Piece of Contact Center Technology Works as a Seamless System

By Peter Lyle DeHaan, Ph.D.

In continuing our series on call center integration, we move to the topic of technology, specifically the need to integrate your call center tools. Today’s vendors offer a wide array of technology options to enhance the contact center operation. Yet if these tools don’t integrate with each other, we lose—or even negate—their promised productivity pronouncements.

Technology tools that won’t talk with one another is almost as detrimental as not having the tools in the first place. Therefore, it’s essential that we integrate our contact centers’ tools and technology. That’s why you need to integrate your call center tools.


We’ve all called places and given basic information in step one of the contact, only to have to repeat it in step two. This happens too often, and it infuriates callers, setting the stage for ineffective communications from the onset of a contact. I’ve also had cases where I had to repeat the same information a second time. Another company made me reconfirm my identity each time they transferred my call.

Today’s consumers—your healthcare systems’ patients and customers—deserve better. And they expect more. Complete integration passes on all collected information through each step of the call. This includes transfers, switching channels, and moving between systems.


Today’s healthcare providers amass a plethora of information. This data ends up in a database. But not just one. Multiple databases. Too often inter-database integration is nonexistent. Even a basic interface is missing.

This requires contact center agents and healthcare professionals to re-enter information, transferring it from one database to another. Sometimes this requires rekeying, which is time consuming and error prone. Even copy-and-paste functionality fails to provide the desired ease of information transfer.

Then with the same information existing in two places, a nonintegrated environment means that updates must also occur in two—or more—places. This seldom happens and points to the need to better integrate your call center tools.

I know. In the past week I’ve had two organizations try to call me on a number I haven’t had in eight years. Though I let them know of the change when I moved, not everyone’s records received the update. Hence needless frustration on their part and mine.


Similar to databases are apps and software. Though on a basic level this is addressed with interoperability initiatives and database integration, more work still needs to be done.

Many times I’ve had reps tell me they were writing down the information I gave them so they wouldn’t have to have me repeat it as they moved from one program to another. I’ve also had instances where they didn’t write down what I gave them, but they tried to remember it. And they remembered it wrong. This meant I had to give them the same information again.

Does your message taking app integrate with your appointment setting app? Does your answering service software integrate with your telephone triage software? Does your class scheduling program interface with your literature request program?


To provide a holistic and satisfying solution to your patients and customers, you need to fully integrate your call center tools to optimize your operation. When you do so you will enhance outcomes, increase agent workflows, and improve customer satisfaction.

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 or his book, Healthcare Call Center Essentials.

Do Your Call Center Employees Believe They Receive Adequate Recognition?

Patients-Count: Enterprise patient feedback solution

By Mike Hill

If you are like most companies, you have a mix of employees working full-time from the office and others working full-time from a remote office, or a third group that work sometimes from the office and some from a remote location. Whichever case you have, you need to make sure all your employees receive adequate recognition.

Without recognizing your employees’ contributions, they can feel disconnected from your organization, and disconnected employees are the ones that are the least productive. In this article, we will concentrate on employees working from a call center. Without having face-to-face contact, recognition can be challenging, but it can be done.

Recognition has been described as a “core” human need. So, what can recognition do for your organization?

  • It can boost the employee experience helping them to feel more competent and boost their self-esteem.
  • It can help lower turnover. When employees’ achievements and efforts are recognized, they feel connected and valued. This acts as a motivator to repeat excellent performance.
  • When you become known as a company that recognizes your employees, as compared to a company that does not, you will attract that level of employee that will make your company successful.

So, how do you take advantage of an employee recognition program for call centers?

You use some of the same techniques you use to recognize any other employee:

  • Make sure the employee is aware of what results will be recognized. Think measurable criteria.
  • Decide on what the rewards will be. Ask for employee input.
  • Make it personal. Call the employee; visit them in person.
  • Announce to the rest of the call center who you’re recognizing and why.

Finally, and this is particularly important to call center employees: a recognition program helps your agents to find the why with regard to their job. Author Simon Sinek states that when an employee knows their why behind their job, they become more engaged, more motivated to perform at a higher level, and more inspired.

How do you know when you are meeting or even exceeding your employees desire to be recognized? You need to ask them. Do not assume you know what they are thinking or feeling.

Mike Hill is the employee experience expert at Mobius Vendor Partners and author of Measuring to Manage. At Mobius Vendor Partners, their employee experience team has the expertise and software to make sure employees are equipped with the material and tools to make them productive.