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Articles from AnswerStat

Provide Multi-Channel Access

Be Sure You Deliver the Options Today’s Consumers Expect

Author Peter Lyle DeHaan

By Peter Lyle DeHaan, Ph.D.

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

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

Here are some multi-channel access points to consider.

Telephone

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

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

And most consumers expect you to answer their telephone calls.

Email

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

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

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

Text Chat

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

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

Social Media

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

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

Other Channels

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

Multi-Channel Access Conclusion

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

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

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

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

TriageLogic

By Ravi K. Raheja, MD

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

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

1. Abuse and Neglect

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

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

2. Unauthorized Callers            

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

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

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

3. Chronic Ailments and Repeat Callers

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

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

4. Medical and Psychosocial Concerns

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

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

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

5. Excessively Anxious or Angry Callers

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

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

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

6. Propose an Action Plan

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

Some examples include:

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

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

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

7. Callers Who Are Difficult to Understand

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

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

In Summary

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

TriageLogic

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.

Avoid Liability with Proper Documentation for Telehealth Nurse Triage

TriageLogic

By the very nature of their profession, telephone triage nurses can’t physically see their patient callers. This begs the question, what kind of liability do they face when they provide dispositions for care? That’s why we were excited to sit down with D.D. Fritch, MSN, MHA, RN, a tenured clinical leader in this area of healthcare, who was happy to shed some light on the legal perspective and why it’s crucial for nurses to have the proper documentation.

Question: Tell us a little about your background. What’s your experience with nurse liability as it pertains to telephone/telehealth triage? How did you get involved in nurse triage?

Answer: I am a pediatric nurse of 33 years, working as a nurse and nurse leader at Children’s Healthcare of Atlanta for 31 years. During my tenure at Children’s, I was the director of the contact center for nine years, which was responsible for their Nurse Advice Line. Since 2018, I have been working as a healthcare consultant, assisting clients with clinical call management, call center operations, and practice administration.

As far as my experience with nurse liability, whether a nurse is practicing in person or virtually, the liability is the same. With that being said, nurse triage has many components of liability that need to be considered.

Q: What information should triage nurses make sure is documented in every clinical note?

A: Documentation is vital. Document the patient’s history, findings, dispositions, what the caller describes verbatim, and the nursing education that is provided. Documentation as a nurse working on the phone is not very different than in person, but there is a skillset to communicating with the patient or caregiver to ensure that documentation is complete and accurate.

Q: What factors are important for the credibility of a clinical note?

A: Credibility comes from documenting the facts, and when you are a triage nurse it is vital for you to record the initial concern as the caller describes. “Reading into” what the caller is saying is very different than completing an assessment and documenting the findings of that assessment.

Q: What happens if a patient has a bad outcome following a triage call that relates to the symptoms they were calling about?

A: This is a broad question. Organizationally, the chart should be reviewed to see if there were any opportunities where the nurse should have acted differently or made a different decision. If the triage company is acting on behalf of a provider, the provider should be notified and the situation should be discussed. If there is an untoward event due to negligence of the triage nurse, then the nurse and the organization that they work for or represent could be liable.

Q: What would need to be proven for a lawsuit to move forward against a triage nurse or their organization or practice?

A: Each state has licensing requirements, and the nurse always needs to practice within scope and according to their license. Practicing out of scope would be a significant concern in a lawsuit.

Q: Do juries tend to look upon nurses in a particular light? For example, do they tend to trust their judgment?

A: The nurse has a license to uphold and an ethical duty to serve, just as any other credentialed witness would.

Q: When is the duty to a patient caller established?

A: Upon initial connection with the nurse.

Q: If a specific nurse triage line is set up solely for patients of a particular healthcare provider, and someone calls in who is not currently a patient, what is the legal responsibility of the nurse who answers that call? How should they respond?

A: This depends on how the call is handled on the front end. Many times the nurse is not the first one to speak to the caller. This information would need to be a part of the initial information gathering prior to any clinical information being captured.

Q: When using Schmitt-Thompson protocols to evaluate a patient caller’s symptoms, do triage nurses need to document all negative responses leading up to the first positive response?

A: How the nurse documents is up to the provider or organization. There is an option to document all negatives or only the positives. Either way, there needs to be an organizational policy and then training for staff to ensure that there is consistency.

Q: How should a triage nurse handle documentation they may have missed adding to a patient’s chart during a call? Are there things they shouldn’t do if they need to update a chart?

A: Document any late entries as an addendum, ensuring that the time and date of the entry as well as the interaction are captured.

Q: Is there any additional information you’d like to add regarding the legal responsibilities and requirements for telephone or telehealth nurse triage?

A: Legal considerations as a triage nurse are something that should be a topic of education and continued competency on an ongoing basis. Quality audits should also be a part of the operating procedures of the nursing leadership team.

Registered nurses are licensed in the state in which they practice (where the patient is located). The nurse should be familiar with clinical protocols and nurse triage details related to their Nurse Practice Act in each state in which they practice. Most states require that nurse triage be performed by a registered nurse. Educate yourself on what your state requires.

In addition, the book The Art and Science of Telephone Triage: How to Practice Nursing Over the Phone, written by Carol Rutenberg and M. Elizabeth Greenberg, is a good resource. There is a chapter on risk management and common pitfalls.

D.D. Fritch is passionate about enhancing care for children and patients through technology. As a nursing leader, D.D. spent most of her 32-year career at Children’s Healthcare of Atlanta, improving its contact center, supporting its telemedicine program, and optimizing its Pediatric Nurse Advice Line. Connect with her at dd@connected2consulting.org.

TriageLogic

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

Sticky Customer Service

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

Author Peter Lyle DeHaan

By Peter Lyle DeHaan, Ph.D.

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

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

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

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

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

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

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

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

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

Effective Call Center Software Improves Patient Transfer Center Workflows

1Call, a division of Amtelco

By Nicole Limpert

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

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

Patient Transfer Call Center

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

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

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

Patient Transfer Centers and Call Center Software

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

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

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

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

Connecting with On-Call Medical Staff

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

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

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

The Importance of Recording and Reporting

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

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

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

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

1Call, a division of Amtelco

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

How to Safely Redirect Patients Away from the Emergency Department

LVM Systems

By Mark Dwyer

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

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

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

Front-Ending Clinical Calls

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

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

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

Follow-Up Options

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

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

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

Summary

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

LVM Systems logo

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

Nurse Triage Protocol Software

TriageLogic

By Ravi K. Raheja, MD

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

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

Developed by Doctors

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

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

Updated in Real-Time

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

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

Daytime and Nighttime Protocols

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

Integration

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

TriageLogic

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

Remember to be Thankful

In The Middle of Struggles, Turmoil, and Difficulties, Pause to Celebrate the Positive

Author Peter Lyle DeHaan

By Peter Lyle DeHaan, Ph.D.

The United States and a few other countries will celebrate Thanksgiving in November. Canada and some other nations do so in October.

Regardless of when you celebrate Thanksgiving—or even if it’s not a holiday where you live—take a moment to remember and give thanks for the positive elements in your life.

With all that’s happened in the past couple years it’s easy to focus on the negative, which can pull us down with discouragement and overwhelm us with despair. Yet there are positive things happening as well. We just need to acknowledge them and embrace them.

Here are some things to be thankful for.

Be Thankful for Health

I take my health for granted—until I get sick. Then I’m reminded to appreciate the rest of the time when I am healthy, which is most every day.

Even though few people have zero health concerns, with our health status existing on a continuum, let’s be thankful for the positive aspects and not wallow in the negative.

Be Thankful for Work

I doubt any job is 100 percent perfect, but having a job in the first place—when many don’t—is a huge reason to be thankful. Our jobs allow us to earn a living to support ourselves and our family.

Without them we would have to rely on the generosity of others or the support of government. The next time when your work hasn’t gone so well—and it will happen—wrap up the day by giving thanks that you have a job.

Be Thankful for Family

In the past two years, I‘ve spent more time with family then in the past and have appreciated them more fully. Though we can choose our friends, we can’t choose our family. They’re ours for life.

May we celebrate each familial relationship for the good parts of it and be able to overlook the rest.

Be Thankful for Friends

True friendships don’t occur easily for most people. We have acquaintances, coworkers, and neighbors, but that doesn’t necessarily make them friends. But celebrate the friendships we do have for how they enhance our life. We should never take them for granted.

And if you’re a bit short in the friend department, remember that to find a friend, you need to first be a friend.

Be Thankful for Opportunity 

If you find it difficult to be thankful in one of the above areas—health, work, family, or friends—because you don’t see it as part of your life or are experiencing a shortfall, be encouraged. This is because the future provides an opportunity to change your present situation. 

Starting today you can work to improve your health, make your job more meaningful or find a different one, embrace your family, and grow your friendships. But to make the most of this opportunity, you must first seize it. And that opportunity is another thing to be thankful for.

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

Physical Safeguards Your Cybersecurity Needs to Protect Patient Data in Telehealth

TriageLogic

By Ravi K. Raheja, MD

The past year and a half has redefined the healthcare industry. Not only have hospitals and practices quickly adapted to an emergency pandemic and a heavy demand for telehealth, but they’ve also seen an increase in cyberattacks. These have placed medical organizations on high alert to review their network security, as well as their patient data and the vendors who collect it. 

According to a recent article in Forbes, “The number of hacking incidents reported in healthcare climbed for the fifth straight year in 2020 … [comprising] more than half of all last year’s patient data breaches—62%—up from 2019.”

Evaluating your vendors and security systems are paramount to data protection from these increased ransomware and malware attacks. But an often-overlooked part of that process is the training your staff needs on the physical safeguards they should use. If you aren’t sure what those are, here’s a good place to start.

Portable Data

Do you rely on flash drives or mobile devices to share and review data? Make sure to lock those up when they aren’t in use, both while you’re at work and when you leave for the day. Taking them outside of the office not only risks a breach in compliance, it also increases the chances for that equipment to be stolen, as was the case for this unencrypted laptop.

Passwords

Remind staff not to use the same password for all of their devices, and don’t be like more than half of surveyed workers who write them down on sticky notes. Even if your team trusts each other, there’s always the chance that someone will take advantage of another’s access and leave them footing the bill in damages. 

If they juggle a lot of passwords between different programs, have them use a password manager that stores and encrypts them online for convenient access. Some to consider include LastPass, Dashlane, Bitwarden, or 1Password, among others.

Keycards

Institute keycard access for sensitive areas and avoid holding the door for tailgaters, as this defeats the purpose of this physical safeguard.

Paperwork

Have a lot of hard-copy paperwork? Consider housing it in a secure, offsite location. This allows you to maintain HIPAA compliance for file retention while protecting those documents from damage that an on-site fire or natural disaster could cause.

When it’s time to dispose of those hard copies, make sure to shred them first. Shredded papers won’t give thieves much to leverage, especially when they’re all mixed together.

Contracting with a document disposal service can certainly help, but keep in mind that locked trash bins still have the potential to be accessed between the time you drop a file in them and the time the disposal service arrives. 

Disposal of Hardware

Getting rid of computers, mobile devices, or digital copiers? Make sure to use software that wipes all patient data from them first. Simply sending a file or folder to the trash bin doesn’t automatically delete it. And you may also find it necessary through HIPAA to destroy those media tools once they’ve been wiped. 

Multi-Factor Authentication

Use multi-factor authentication to log into your user accounts and file sharing services. This reduces the chances that an outside intruder will be able to hack your credentials and gain access to more—or all—of your network.

Staff Training

Train everyone on your staff about these physical safeguards. Even employees who can’t review sensitive patient or company information should still be aware of corporate policies on data management and how to respond to a potential breach in security. For more on what that includes, review the FTC’s guidelines.

TriageLogic

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. Contact them if you need help with telehealth nurse triage, telehealth appointment-setting, or nurses to manage data for remote patient monitoring.

How Call Center Technology Helps Hospitals, Staff, and Patients

1Call, a division of Amtelco

By Nicole Limpert

Hospital call centers provide a critical service to both patients and healthcare organizations. In previous articles we’ve explored how call centers are supporting emergency departments during the pandemic, help patients connect remotely with their care teams via patient monitoring devices and telehealth, and how medical answering services have grown to include telephone triage as part of their support.

Healthcare communication is complex and notoriously disconnected. Different departments rely on different systems to perform their job and these technologies typically don’t talk with each other. It may surprise some, but some call center software is highly interoperable, which hospitals and clinics leverage to bridge communication gaps between disparate technology to streamline communication. This improves hospital workflows and both patient and staff satisfaction.

Integration engines, also called middleware, used in hospital call centers can streamline inbound and outbound communications, trigger scripting, and automate dispatching. Integration engines are the interoperable piece that connects different technologies, so they communicate with each other. A robust middleware is completely scalable and works with software from other vendors. 

Using Integration Engines to Enhance Patient Care

Here are some common applications:

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

An integration engine with an HL7 interface can assign a fixed phone number to each patient, which will follow them for the duration of their stay. Associating each patient with one phone number helps:

  • Ease the stress of family and friends who are trying to find their loved one when they are transferred to a different room.
  • Streamline the communication process for anyone on the patient’s care team.
  • Reduce the number of calls to the hospital’s call center.

Critical Alerts: Integration engines work together with a hospital’s event notification software system to expedite enterprise-wide critical alerts in healthcare environments. The integration engine captures requests from hospital systems such as ADT (admission, discharge, and transfer) messages, nurse call messages, smart beds, pain management, alerts, alarms, orders, or appointments. Then, emergency notification software instantly sends those messages to designated recipients using a wide variety of methods, including Vocera badges, IP phones from Cisco and Spectralink, SMS, email, and secure messaging apps.

Using an integration engine means automated notifications, customized to fit a hospital’s needs, based on configurable rules. Notifications can be sent via preferred contact methods to an individual, an entire group, or the current on-call personnel, which enables recipients to respond quickly to provide better patient care. 

Accumulated statistics for each notification provide an easy-to-follow audit trail for reporting purposes and help healthcare organizations refine their communication processes.

Patient Transfer: The Joint Commission found 80 percent of serious medical errors were the result of miscommunication between caregivers during patient handovers. Multiple studies have highlighted the need for better communication during patient transfers. 

One study states, “Some challenges transferring physicians face with communication include physician shift changes, ancillary staff changes, delays between ordering tests and receiving results, and competing attention of other active patients. Accepting physicians also face their own challenges related to patient transfers. . . . Calls back to the transferring facility are far from efficient and are often routed through emergency departments, medical records departments, and radiology reading rooms making information gathering cumbersome.”

More hospitals are establishing patient transfer centers, and integration engines are facilitating communication between clinicians and transport assets. Each staff member involved in a patient transfer needs to have the same information. Integration engines enable staff to have access to key directory databases such as on-call, hospital personnel, and patient directories (which include ADT and EMR [Electronic Medical Record] data) to ensure information is communicated accurately and efficiently to enhance collaborative care. 

Using Integration Engines for Automated, Emergency, and Mass Notifications

Automated notification and reminder communications can help healthcare organizations ensure utilization of every resource to its full potential and reach more staff personal in less time. Notifications for emergencies, events, changes in weather, and everyday reminders can instantly be sent to designated recipients using secure messaging apps, Vocera badges, IP phones from Cisco and Spectralink, SMS, and email.

The primary role of an integration engine is to facilitate automated communications. An operator in a call center can initiate dispatch scenarios. But they can also run automatically based on inbound triggers such as HL7 and email messages, scheduled to run on a recurring basis, initiated by a web user running a web script, or triggered by a third-party application.

Mass notifications make it possible for an organization to be better prepared for planned and unplanned events, such as natural disasters, emergencies, service outages, meetings, and other instances when large groups, small groups, and individuals need quick and accurate notification.

Third-Party Integration with APIs

Third-party integration happens when a vendor connects to another vendor’s application. API’s (application program interfaces) can achieve this connection. Using an API means that developers can build a new solution using existing components instead of creating code from scratch. Integrating an API into another vendor’s solution saves an incredible amount of time, is less costly, and results in a solution that best fits a hospital’s communication and technology requirements.

The same APIs used in hospital call centers to streamline communication can also enable healthcare facilities to interface with:

  • alarms
  • dashboard workforce management
  • electronic health record (EHR)
  • faxing
  • landline to text
  • nurse call and triage
  • on-call
  • short message service (SMS)
  • secure messaging
  • telehealth video conferencing 
  • wireless communications transfer protocol
  • wireless devices

Web-based Communication

Both hospital call center staff and clinicians must be able to access the information they need at any time from any place; it’s a fundamental and critical part of any healthcare organization’s communication protocol. Hospital personnel can use some of the same web-based communication software used in their call center because it delivers fast, secure communications and adds efficiencies through remote access to reduce the number of potential errors caused by miscommunication and absences.

Web-based communication applications specifically developed for the healthcare industry include encrypted secure messaging, care team collaboration, and workforce management tools. Enterprise access to these healthcare communication tools improves workflows because clinical staff can find the information they need on their own, without interrupting co-workers or employees in other departments. 

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

Care Team Collaboration: Nurses, physicians, and other staff use mobile-friendly care team collaboration applications to remotely access on-call schedules, directories, messages, reports, telephone scripts, and even historical call management data quickly and efficiently either through the Internet or through a healthcare organization’s internal networks.

Workforce Management: Staff can view, edit, copy, override, assign, and unassign schedules in real-time; use directories to quickly find and contact staff (titles, departments, office hours, and preferred contact method displayed); and use the reporting function to track, view, and print communications (with complete and accurate statistics). 

Any authorized staff member, from any location, can schedule and manage appointment calendars, class registrations, event calendars, and workforce schedules.

Paging Extensions

Hospital call centers are the hub of communication for an organization. This includes being part of an organization’s paging system to reach on-call personnel. However, some hospitals use the same status-based messaging system without involving an operator.

Physicians and staff members can call a special paging extension and enter an identification number for the person they want to reach. This paging technique locates the requested person in the personnel directory with information about that individual’s status such as in office, making rounds, out of office, or on-call.

The system announces the individual’s name and status to the person who has called the paging extension and prompts them to enter a callback number or message. Then the message or callback number is sent via the person’s preferred contact method.

This method also provides paging reports and analytics so departments can leverage the data to improve service metrics, workflows, and to help protect both patients and hospitals in litigious situations. The reports provide useful information such as the number of pages, detailed logs that indicate if each page attempt was successful or not, and counts for email messages, SMS messages, secure messaging app messages, and other types of paging.

Conclusion

Improving communication in hospitals is paramount. Healthcare organizations can reduce many root causes of inefficient communication by using the software and technologies that may already be in use in their call centers.

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.