How Contact Centers Impact Patient Experience



By Donna Martin

Hospitals and healthcare organizations are competing more fiercely to gain and retain patients’ business. And first impressions are critical. That’s why a modernized patient contact center is critical both for differentiating your organization from the competition and for preventing revenue leakage.

How is your organization leveraging this critical contact point? What success are you having getting patients through your front door and retaining them as loyal consumers?

Assessing Your Patients’ Needs: Just like you, your health system’s patients are consumers who shop at Amazon, purchase airline tickets, and stay at hotels. They’ve grown accustomed to a concierge-level of customer service, and this has altered their perceptions of what a high-quality healthcare experience should look like.

The retail world has decades of experience providing this level of service and has leveraged modern technology to make constant improvements to help differentiate their brand, as well as retain and grow their customer base. The healthcare industry is just starting to catch on—not just because it makes good business sense, but also because they are now being incentivized to implement value-based care throughout the patient experience and and penalized if they fall short.

Let’s explore how to measurably improve patient experiences and engagement in ways that are realistic and based on the unique requirements of healthcare delivery.The goal of contact centers should be to make the patient experience as easy as possible. Click To Tweet

Phase 1: Establish the Foundation: From your patients’ perspective, even small hospitals can be difficult to navigate via telephone. Partial or full automation of inbound phone calls from patients allow providers to create a “single front door” for patients. This creates a unified patient experience and reduces needless call transfers. Adding automated patient identification and authentication not only personalizes the interaction and ascertains the primary reason for the patient’s call, but it also leads to complete resolution for a host of common inquiries such as appointment confirmations, directions, hours, and payments without ever needing to engage an agent.

With this streamlined foundation in place, providers can begin to continuously and consistently track patient interactions to build intelligence for future interactions as well as gather communication preferences where possible. Every new element of data collected builds on previous elements, fostering a holistic portrait of patients. This creates the foundation for predictive intent and provides a better patient experience. In addition, as you develop a performance baseline, you can leverage patient experience surveys to use actionable data to make targeted improvements.

Phase 2: Build on Your Success: One goal of value-based care is keeping patients in your health system but out of the hospital. Why not pursue a similar goal with patient engagement? By applying dynamic decision-making to the data collection efforts established in phase 1, you can begin to develop proactive patient engagement strategies to reduce the need for patients to call you.

For example, with the right automated inbound solution, you identify patients calling from a mobile device and then take that opportunity to drive them to alternative, lower cost channels, such as text communications and patient portals. These elements will further the productivity of your access center, drive cost from your business, and maximize the patient experience. This will also provide you with a steady stream of valuable patient data to continue to enhance and optimize your solution.

Phase 3: Patient Preferences: This segment includes all components of phases 1 and 2, layering in patient communication preferences and cross-channel patient interaction data. In this scenario, you could see that a patient accessed the patient portal to find a specialist and is now calling into the access center for help. An intelligent self-service solution recognizes the patient, confirms they are looking for a specialist, and sends the patient directly to the appropriate scheduling agent. This happens without the patient having to make a single menu selection. Again, this provides an effortless and loyalty-building patient experience.

Finally, with all three phases offered in a cloud-based, self-service environment, you will achieve maximum scalability, reliability, and flexibility for agents who work in either a brick-and-mortar setting or through a business process outsourcing partner. This ensures your access center will always be available to support patients and providers.

The goal of contact centers should be to make the patient experience as easy as possible through both personalization and self-service. The intent is to strive for that perfect balance between automation and live, human-touch interaction.

Your health system has invested considerable time, energy, and money to provide value across the continuum of care. Why squander it over a bad first impression? By taking practical steps toward patient-centric engagement, providers can create a high-quality, intuitive, and effortless consumer experience that has elements of a world-class retail service, while meeting the unique needs of the healthcare setting.

Donna Martin is senior vice president, Global Health Services, at Hinduja Global Solutions (HGS).

Video-Based Doctor Visits


LVM Systems


By Mark Dwyer

Video-based doctor visits (e-visits) have received renewed interest to address the shortages of primary care physicians nationwide, especially in rural areas. The healthcare industry is ripe for a strategy to address what many believe to be one of the greatest challenges of the Affordable Care Act (ACA)—providing government subsidized insurance coverage to thirty million Americans while struggling with a major shortage of primary care physicians throughout much of the country.

Providing insurance to uninsured individuals was seen by many as a vital component of a successful ACA. Unfortunately, most individuals initially receiving government subsidized healthcare were without a primary care provider. These early enrollees were also those with serious health issues related to the costliest health conditions. Consequently, the already over-crowded emergency departments across the country became even more congested only now with newly insured individuals who had nowhere else to go to receive the healthcare they needed.

The demand for healthcare has further increased due to our aging population, along with a declining supply of primary care physicians. According to the Association of American Medical Colleges, by 2030, the United States will have a shortage of as many as 43,100 primary care physicians.

What does this have to do with call centers?

Since their inception, healthcare call centers’ mantra has been to get patients “the right care—at the right time—at the right place.” Video-based doctor visits are a logical source for patients to be served as an extension of the call center. The most successful organizations that offer healthcare triage call center services may be those who devise a strategy to integrate video-based physician visits as a triage end-point for immediate, real-time appointments. Video-based doctor visits are a prime example of how patients can connect with providers. Click To Tweet

According to the American Telemedicine Association, “as the US healthcare environment continues to evolve due to changes in reimbursement, legal issues, and shrinking healthcare resources, the expanding role of telehealth nurses will continue to evolve.” In distant, rural, small, and sparsely populated areas, telephone triage nursing can remove time and distance barriers between providers and patients. Video-based doctor visits are a prime example of how patients can connect with providers to make better use of shrinking healthcare resources.

It is clear there are not enough primary care physicians to handle patients physically able to be seen in the office setting. But that is not the only concern resulting from the shortage. There are an estimated two to four million people who need doctors, nurses, and healthcare providers to make house calls. Unfortunately, the number of physicians and health practitioners who make house calls has also greatly decreased over the years.

In an August 8, 2017 article by Elizabeth Whitman titled “When patients need house calls, there may be no doctors nearby,” the author referenced a study by Aaron Yao, an assistant professor at the University of Virginia School of Medicine. Yao’s study cited findings that showed more than half of Americans live over thirty miles away from full-time providers of home-based medical care. These centers limit how far they send doctors, nurses, physician assistants, or other primary care providers. Consequently, the healthcare system needs to expand ways to get care to these homebound patients, many of whom suffer from chronic diseases.

“These are the high-cost, high-need people,” Yao said. “We live longer, but we also suffer for longer years,” he added, noting that if doctors can get to patients’ homes and manage their symptoms, they could help prevent emergency room visits and hospitalizations.

Despite the study’s limitations, Yao said his findings drove home crucial points about the need for more, and more widely available, home-based medical care providers in the US. That said, Yao admits, “It’s not a high-paying job,” and comes with related challenges making it less appealing to many healthcare providers. This challenge also lends itself to the use of video-based doctor visits.

So how do e-visits work in conjunction with triage call centers? First, it is important to understand that not all e-visit programs are the same. Like any system that uses patient data, e-visit programs need to be HIPAA compliant. Strong e-visit programs are designed around optimal provider workflows with simple to navigate virtual waiting rooms. E-visit technology allows a physician to connect with a patient via secure, high-resolution video. These connections can be used for a remote visit, to share medical images, to send text messages or online chats in real-time, and to submit prescriptions to the patient’s pharmacy. E-visits help keep patient flow moving with flexible, on-demand virtual visits. When the triage disposition calls for an urgent care referral or to see one’s doctor immediately, patients can get quick “walk-in” care without leaving their house, eliminating long wait times at the urgent care facility.

In addition, a strong e-visit program can increase patient satisfaction by quickly addressing patients’ needs. With e-visits, you can quickly offer patients 24/7 care without the commute or long wait at the clinic. Access to high-quality, convenient care keeps patients happy. According to survey data, 37 percent of parents would choose a virtual care option for their child in the event of a minor illness. That percentage more than doubles for parents in rural areas with minimal access to pediatric specialty care.

How does one monetize the e-visit? Many insurance companies now allow reimbursement for telemedicine services, especially remote visits done via two-way video. As of January 2017 Cigna, Aetna, United Healthcare, and thirty other payors put telemedicine in plans nationwide. In order to be reimbursed, each telemedicine visit needs to be well-documented. Whether stored in the call center software’s triage transaction notes or in the patient’s EHR, everything must be saved in one place and be up-to-date. Some e-visit programs may also integrate with an EHR system for seamless record-keeping. The top telemedicine software solutions allow healthcare providers to easily document the patient encounter and then submit the record for reimbursement.

In addition, through use of e-visit programs, unbilled work also gets reimbursed. From refilling a prescription to treating an illness, some e-visit programs can collect payment from patients and provide a detailed medical chart to submit for reimbursement. E-visits also help to reduce costly no-shows. Missed appointments can cost a provider’s practice thousands in lost revenue. When the visit is real-time via an e-visit program, the service is paid for at the time of care. This creates a more profitable practice further aligning the provider to the facility hosting the call center to which the e-visit program is associated.

Telemedicine solutions come in various configurations. The sophistication of the technology, equipment, training, set-up, and number of users required will all affect the cost of a telemedicine service. Healthcare providers should evaluate their budget for an e-visit program and make sure they consider how much training and staff resources they will need to implement the telemedicine software. Since telemedicine providers offer solutions for single-provider practices all the way to huge health systems, it is imperative to do your homework.

E-visit solutions have the power to change the way we provide and receive healthcare for the better.

LVM SystemsMark Dwyer is a thirty-year veteran of the healthcare call center industry and the COO at LVM Systems, which provides healthcare call center software.

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Translation And Health Literacy In Telemedicine

Are we speaking the same language? How telehealth can help

By David Thompson, MD

“Fever” may sound different in other languages, but it means the same thing. Whether a patient says fever, fiebre, or fièvre, it’s the telehealth provider’s job to deliver the correct diagnosis and treatment. Language differences can add complexity to an already confusing situation for patients. Fortunately, healthcare professionals can help bridge this gap using digital health tools to capture symptoms in the patients’ own language.

Language Translation: So, how can healthcare systems reach the broadest patient base possible and ensure telehealth options benefit everyone? One answer is offering an e-visit intake process (rapid medical history) to patients in multiple languages.

Language-specific documentation checklists support healthcare providers by capturing a detailed history of the patient’s symptoms at the beginning of the medical encounter. Language localization also makes it easier for non-English speaking consumers to use e-health tools and applications to ensure greater accuracy when they use virtual care. Language differences can add complexity to an already confusing situation for patients. Click To Tweet

The most recent National Assessment of Adult Literacy (NAAL 2003) found that 89 million Americans have limited health literacy. It’s fair to say a significant percentage of those have English as a second language or speak no English at all. This highlights the need for global health literacy guidelines and healthcare options for all languages. Consider the following reasons to offer multilingual telehealth options.

Improve patient engagement: By using a multilingual telehealth platform, clinicians can help patients of all language backgrounds—even if they, themselves, don’t speak the same language. In addition, more tech-savvy patients can choose their language preference when using e-health applications. The simple ability to communicate health information in their preferred language can improve patient engagement and satisfaction by:

  • Providing easy-to-understand information;
  • Making patients feel they’ve received customized, personal attention;
  • Offering flexibility for individual situations; and
  • Giving patients control over their healthcare, regardless of language.

The bonus is that health systems using flexible telehealth platforms can also see improved retention due to patient engagement and satisfaction.

Support communication along the care continuum: Not only can telehealth technology offer engagement solutions, but it also has the benefit of connecting providers and patients along the care continuum. Patients can see health information in their preferred language, while the telehealth platform provides data coding and translates it into medical terminology. This data can then be shared among medical call center nurses, telemedicine providers, hospitals, and primary care providers. There’s never a need for patients to feel they have less access to quality care because of language barriers.

With advancements in translation technology and digital health platforms, the future of healthcare will be measured by how well organizations and providers appeal to a broad patient audience; capture health information; share data with other providers; and leverage that data to improve medical care, speed up care delivery, and reduce costs.

Consider the case of John Gomez, a twenty-two-year-old, whose primary language is Spanish. John has had knee pain for two days and contacts a telemedicine provider.

Step 1: The initial call: John calls a service representative who works with his doctor. This service representative does not speak Spanish. Using a symptom-checking engine that offers symptom options for “knee pain” in Spanish, she collects information about the patient’s condition. The representative then obtains John’s demographic information, transcribes his chief complaint and helps him complete an online “rapid medical history” for knee pain. The telehealth platform lists recommended care options based on John’s symptoms, his availability, and doctor preferences. The service representative then arranges a telemedicine encounter.

Step 2: The telemedicine encounter: John can speak with a Spanish-speaking doctor or an English-speaking doctor because his information has been transcribed and coded as data in medical terminology. The doctor reviews the medical history, validates the information during the telemedicine encounter and provides treatment recommendations.

Step 3: Follow-up: A nurse in a centralized call center contacts John in two days to make sure he is following treatment recommendations, getting better, and has no further questions.

Serving a broad population: Healthcare is confusing, but fortunately, patients are increasingly becoming more involved in their care. As healthcare and technology continue to evolve, healthcare systems and providers must adapt to serve a broad patient base with consumer-friendly tools and information.

David Thompson, MD, FACEP is CEO and chief medical officer at Health Navigator. A part-time faculty attending in the Northwestern Memorial Hospital Emergency Department, Dr. Thompson also works as an author and partner with Self Care Decisions, LLC and Schmitt-Thompson Clinical Content, LLC. He is board-certified in both internal medicine and emergency medicine, having completed a dual residency at Northwestern Memorial Hospital at Northwestern University. Dr. Thompson is a Fellow in the American College of Emergency Physicians. He can be reached at david.thompson@healthnavigator.com.

Why is Your Contact Center Essential to Your Organization?

Echo Access provider directoryBy Richard Stier

You are your health network’s senior leader for access with direct responsibility for the contact center. This morning your CEO asked you a question that has dominated your thoughts. “We’re taking a hard look at the budget,” she said. “The contact center represents a significant line item. Can you help me understand if, or why, the call center is vital to us? Why should it remain in our budget?”

How would you respond? Three key criteria provide the foundation for your effective reply.

Criteria 1: Structure the Framework: Align your contact center’s priorities with C-suite imperatives.

You have an ongoing conversation with your vice president about the organization’s driving priorities, and you’ve focused your contact center to support three of them:

  1. Reduce avoidable readmissions to eliminate a recent fine from CMS,
  2. Improve CAHPS scores for patient satisfaction to improve reimbursement, and
  3. Fill practices of newly employed physicians to accelerate the revenue cycle.

Because reducing preventable readmissions is an organization-wide priority, you’ve made it a contact center priority. At discharge, a contact center ambassador asks patients for permission to contact them and their caregivers when coordinating follow-up appointments. Your contact center receives discharge reports every morning from each member hospital. The ambassador calls, emails, or texts the discharged patient and the authorized caregivers to coordinate a day and time for the follow-up physician appointment.

After the scheduled day and time, a contact center ambassador calls the physician office to see if the patient kept the appointment. If the appointment was not kept, they reconnect with the patient or the patient’s approved caregiver to reschedule.

The results have been substantial. The readmission rate declined from 25 percent to 15 percent, and a fine from CMS was reduced by two million dollars over the past two years. Kept appointment rates for post-discharge physician visits have climbed to over 85 percent.

You’ve used tools in your contact center software to document and improve first experience satisfaction scores, and your overall CAHPS scores have been steadily rising. And, you have documented the stream of patients for whom the contact center has made appointments with newly employed physicians at eight practices.Your healthcare contact center is the virtual front door for personalized support and referrals. Click To Tweet

Criteria 2: Place the Rebar: Hardwire your contact center to strengthen your organization’s patient experience (PX) advantage.

You’ve shared with internal colleagues that healthcare currently has a 29 percent patient experience failure rate (per research by Hospital Compare). Only 71 percent of inpatient patients report they received the “best possible care.”

You’ve challenged your peers to ask, “In what universe is a 29 percent failure rate acceptable? Could we miss our revenue projections by 29 percent? Be over budget by 29 percent? Could we even conceive of missing our quality metrics by 29 percent—we only drop 29 percent of newborns, so we meet the standard?” Seriously.

You’ve communicated your belief that “best possible care” experiences begin before a patient receives care and continues after the patient returns home. You explained that your contact center is uniquely positioned to serve as the virtual front door for personalized support and referrals—whether on the website or on the phone—before using a clinical service and for individualized follow-up and coaching after discharge.

You’ve taken several actions to strengthen patient experience advantage:

  • You now include patient ratings and comments in your online provider directory. This key information for prospective patients increases the probability of a good match with one of your providers. Better alignment between patients and providers results in higher patient satisfaction.
  • Your contact center conducts pre-CAHPS patient satisfaction surveys to identify areas for improvement before the CAHPS surveys are conducted. The contact center leverages relationships with callers as a conduit of opportunity to improve CAHPS scores across the enterprise.
  • You place contact center ambassadors in your emergency department to capture patients without a primary care physician. This has resulted in less congestion in the ER, patients being re-directed to more appropriate sites or levels of care, and incremental patients being referred to in-network providers.
  • You have a pre-admission patient hotline where contact center ambassadors work with patients to keep them in-network, secure financial clearance, and arrange for a deposit prior to their visit. Ambassadors add value by providing patients with information about directions, location, and parking.
  • You shift your team culture to celebrate “phone hugs,” redirecting the focus from processing transactions to building relationships with patients through empathic conversations.
  • You launch digital patient experience journey mapping to document experiences from patients’ perspectives starting with the first online or phone contact to handoff of care to post-discharge connections.
  • You recognize the maturation of contact centers to require super agents whom you call “senior ambassadors.” They serve as indispensable personal coaches. They have a proven ability to calm difficult callers and help them with their most challenging situations. For example, they may coordinate pre-visit scheduling for multiple tests that need to be completed before the patient has their physician appointment.
  • You’ve integrated your contact center’s provider data into a single master provider database as a source of truth. The benefits include a comprehensive and more accurate database, reduced data errors, greater data security, increased provider satisfaction, and an improved caller experience.
  • You took two important steps to strengthen your organization’s patient experience advantage:
  1. You recognize your contact center’s role to deliver differentiating, memorable first experiences. In collaboration with your chief patient experience officer, you pulled together a team of first touchpoint and access leaders to multiply your impact.
  2. Your first touchpoint team understands the first three seconds of that initial interaction influences hospital selection and preference (SHSMD 2012). The team identified a shared metric for targeted improvement: first experience satisfaction score. You regularly monitor this and have ongoing first touchpoint team challenges across several departments to improve it. Your first experience satisfaction score has moved from 58 percent two years ago, when you implemented this initiative, to 84 percent last quarter. Future metrics considered by your first touchpoint team are: improved CAHPS scores and improved patient satisfaction with specific handoffs of care targeted for improvement.

Criteria 3: Pour the Concrete: Confirm your contact center as an investment, not an expense.

Expenses are cut. Investments are funded. You understand that if your contact center is perceived as an expense, you must be prepared for tough questions.

You’ve collaborated with your CFO to develop and publish a quarterly one-page contact center executive dashboard report for your leadership team. The metrics in this report are reviewed with your CFO annually and revised as needed.

Your contact center executive dashboard report includes three columns:

1. Executive Briefing on Strategic Priorities: The left column includes a bulleted list of metrics aligned to support Criteria 1 priorities.

In this case, you’ve provided a list of indicators under heading “Reduce avoidable readmissions.” Those indicators include: baseline, target, and current readmission rate; baseline, target, and current kept appointment rate; and baseline, target, and current percentage of PCPs with patient follow-up appointments within seven days of discharge.

The next indicator in the “Executive Briefing on Strategic Priorities” column is improve CAHPS scores. Your indicators are baseline, target, and current score for first contact satisfaction, and the number of pre-CAHPS patient satisfaction surveys completed by the contact center.

The third indicator is “Fill practices of newly employed physicians.” Indicators are baseline, target, and current number of referrals and appointments made to employed physician practices and the baseline, target, and current number of referrals and appointments made to all participating physicians for this quarter.

2. Strengthen PX Advantage: The center column includes metrics aligned with Criteria 2 priorities. Your indicators include: number of click throughs on patient ratings and comments in the online provider directory; number of unattached ER patients referred to in-network PCPs; number of patients served this quarter with the pre-admission patient hotline; and baseline, target and current patient satisfaction with handoffs of care from the contact center to employed practices.

3. Contact Center Investment Summary: The right column metrics support the priorities in Criteria 3. Indicators include a bulleted list of metrics after contact center interactions and clinical triage such as inpatient admissions, outpatient visits, ER visits redirected, total physician referrals, total physician appointments, incremental gross revenue, estimated net contribution (supported with attached detail), and estimated ROI.

When you meet with the executive team, you have three additional categories of metrics available to discuss, in anticipation of questions.

  1. The first is priority service line measures with indicators for each clinical center of excellence such as referrals resulting in inpatient admissions and referrals resulting in outpatient visits.
  2. You have also identified metrics for integrated access centers such as number of switchboard calls, call length, total handle time, abandonment rate, caller satisfaction, appointments scheduled by clinical service and practice, number of transfer center transactions, number of physician-to-physician consults, and gross revenue from physician-to-physician consults.
  3. Finally, you are prepared to update the group on contact center operation indicators such as total website conversions, total appointments scheduled, kept appointment rate, average seconds to service, and call abandonment rate.

Your reply: As you mind concludes this mental review, you take a breath and hear yourself respond to your CEO’s question with confidence.

“I believe our contact center is essential to our ability to achieve our strategic imperatives. We intentionally support our priorities to reduce avoidable readmissions, improve our CAHPS scores, and fill the practices of employed physicians. Our contact center strengthens patient experiences as our competitive advantage, beginning at the important first point of contact—whether online or on the phone.

“Importantly, our contact center delivers a tangible return. Our Executive Dashboard Report documents an ROI of three to one. That is, we get three dollars returned for each dollar invested. In summary, our contact center delivers a solid ROI while improving patient satisfaction.”

As your organization’s leader for access, you made the shift from managing transactions to delivering transformative experiences. The contact center team you lead builds competitive advantage by ensuring extraordinary patient experiences at the critical first touchpoint and beyond. Your contact center is vital to your organization’s mission-critical priorities.

Echo, a Healthstream CompanyRichard D. Stier is vice president marketing at Echo, A HealthStream Company. He is a results-proven proponent of delivering transformative patient experiences. Echo, a HealthStream® Company, delivers enterprise-class, innovative solutions to optimize patient experience contact centers. Echo’s solution for hospital-based contact centers, EchoAccess, enables your organization to deliver intentionally memorable experiences that mitigate risk, solidify loyalty, and reduce unnecessary readmissions.

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Improve the Way You Manage Patient Calls


TriageLogic


By Charu Raheja, Ph.D.

As a practice manager or doctor, managing patient calls effectively is critical in ensuring high-quality, well-coordinated care for every patient. The first step is to make sure the people answering your phones triage patients efficiently and effectively. Establishing a consistent nurse triage system will improve the way you manage patient calls, improve patient satisfaction, and decrease unnecessary medical expenses. Triage nurses can direct patients to the appropriate care for their symptoms and give patients the peace of mind that their questions and concerns are being answered.

The benefits of nurse triage include better patient access, coordinated care, and cost savings. In addition, it gives patients better access to providers even if they are not seeking emergency care. This can improve patient satisfaction, prevent future complications, and allow providers to educate patients.

With the evolution of new technology there are several cost-effective options available for nurse triage services. We will detail three options available for setting up a nurse advice line:Hospital call centers play a significant role in any hospital’s clinical communications. Click To Tweet

1. Do it Yourself In-house: Start Your Own Call Center: Starting your own call center involves setting up the call center infrastructure. The requirements depend on the scale and number of calls received. For daytime calls, many practices choose to have their own staff nurses take calls using daytime triage protocols.

These protocols are available in book form or in electronic format. For night calls, the requirements include hiring an experienced call center manager, purchasing triage software for night-time protocols, and hiring clinical and non-clinical staff to answer the phones and handle patient calls.

Pro: Having your own system gives your staff the flexibility to perform multiple tasks in addition to triage, such as physician referrals, scheduling, disease management, class registration, and surveys.

Con: Setting up a call center requires a high initial investment. It is labor intensive for the nursing department, and it requires human resources and IT involvement. Moreover, there are significant differences in terms of hardware requirements and capabilities with various software programs, so it is important to do your research and speak with a variety of vendors. This is a long-term project with a slow return on investment.

The organizations most likely to succeed with this approach are larger organizations with high call volumes, who expect to handle over 50,000 triage calls a year. These companies are the right fit because they already have some call center infrastructure and they just need to add to it. The high call volume also allows the center to use nurses’ time efficiently.

2. Outsource to a Nurse Triage Center: If the thought of setting up your own call center seems too daunting, you could use an outside vendor for your patient calls. The vendor provides access to a call center infrastructure that patients can call to access a nurse when they have clinical questions or concerns.

Pro: This option has a relatively low start-up cost. Your practice would not need to train nursing staff, and there is no need for human resources and IT staff. Since the outside vendor is already taking calls, startup is quick, and there is an immediate return on investment (ROI). In addition, vendors may have more experience and expertise in the niche area of triage, resulting in better care for your patients.

Con: When outsourcing your patient calls, you will have less direct control over the nurses and some nurse triage vendors cannot integrate with electronic medical records (EMR).

For the best outcome, be careful about interviewing vendors and make sure you are comfortable with them. In addition, costs may vary significantly depending on the vendor and while you “get what you pay for” you get less from some than others. Still, assuming you have done your homework in interviewing and discussing costs, outsourcing can be a good option for small to medium size practices.

3. Use a Combination of In-house and Outsourced Services: In this model an organization uses its own nurse triage software and nurses during high call volumes and outsources the triage to a service during low call volumes. This combination can be accomplished seamlessly with the call center technology, integration engines, and communication platforms available today.

Pro: A combined model can prove to be a way to improve services and decrease costs. Most triage centers lose money when the call volume is low because nurses are sitting idle waiting for phone calls. By outsourcing during those low volume times, the call center can continue to provide service at a reduced cost.

Your organization can continue to provide the same level or increased levels of service and at the same time decrease your operating costs to work within a given budget. It also allows organizations to keep their current infrastructure and resources. Under this option, your practice may also be able to expand into other areas of call center work to increase revenues.

Con: Just as in the previous option, it is important to take time to find the right partner with the technology and service-level knowledge to implement a combined model. There can be an interruption in patient care if their system does not align with yours.

This model is best for organizations that have some existing nurse triage infrastructure and face budget cuts. Physicians also have their own practice-specific needs, and those requests must be followed by both parties consistently. Therefore, it is crucial to select your partner carefully. Make sure you interview and discuss your software and services with your partner before making a commitment.

Each patient encounter starts with a phone call. Make sure your nurse triage service, whether in-house, outsourced, or a combination, is a seamless experience for your patient.

It is important to examine options for managing patient calls and find the solution and product that aligns with your needs.

TriageLogicCharu Raheja, Ph.D., is the CEO of TriageLogic a leading provider of quality, affordable triage solutions, including comprehensive after-hours medical call center software, day time triage protocol software, and nurse triage on call. Customers include both institutional and private practices. If your hospital or practice is looking for information on setting up a nurse triage service, contact TriageLogic to get a quote or set up a demo. If your organization is also looking for a tool to decrease employee absenteeism and save on staff healthcare expenses, contact us to find out more about TriageLogic’s latest product Continuwell.

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Hospital Call Centers



The Vital Ingredient in Clinical Communication

By Kevin Mahoney

 A robust and effective communication system is essential in any hospital, as it forms the backbone of the provision of exceptional patient care. The adaptation and growth of evidence-based medicine have led to growth in multidisciplinary approaches in patient care and increase in research among healthcare professionals.

Multidisciplinary approaches and evidence-based practice, therefore, have necessitated constant and efficient communication among health professionals, especially at the hospital level. The sensitivity of patient care and the fast growth of technology, both clinical and non-clinical, further necessitate a need for balance and maximizing of the right forms of technology for effective clinical communication.

The hospital call center serves as a vital platform in the cog of hospital communications. Often it serves as the patient’s first contact with the hospital. In general, the call center is tasked with providing patients and staff with information pertaining to emergencies, appointments, health monitoring, and the provision of specialist information. It is also a source of patient data and interdepartmental communication. This hospital call center platform, therefore, is multifaceted in its communication functionality. The facets of communications that are related to the hospital call center are patient-to-hospital communications, internal communications, and hospital-to-patient communications.

Patient to Hospital Communications: Call centers at healthcare facilities allow the communication of the patient with the hospital and provide treatment access and patient support. The hospital call center has evolved to be a key primary contact area in the healthcare system.

Treatment access begins with proper scheduling services that taps clinical assessment and triage. This is done to allow the patient to access the right specialized care specific to the individual. For instance, it considers previous admissions, patients’ insurance information, and urgent and emergent situations and classifies patient procedures as either inpatient or outpatient. Hospital call centers play a significant role in any hospital’s clinical communications. Click To Tweet

Patient support goes far beyond initial contact and the initial care received at the hospital. The medical call center has evolved to incorporate preventive and rehabilitative features into the platform. Moreover, call centers now use disease management programs to increase awareness of certain preventable diseases. Furthermore, they help the patient schedule appointments and remind them of screening programs.

The medical call center also helps patients access hotlines suited to their ailments, such as giving patients information about suicide prevention resources. Consequently, these platforms have improved communication features by integrating holistic curative, preventive, and rehabilitative features. This patient communication is an essential part of providing health services by a hospital.

Internal Communications: Additionally, the hospital call center supports clinical communication within the hospital staff. This is evident in environments where there is a centralized web directory. In such instances, the call center acts as the medium for vital information within the hospital. This essential information includes work schedules, contact information, and information about the employees on call. It is a critical component of providing well-coordinated care within the hospital system.

Furthermore, such call centers are tailored to communicate emergency codes and deliver critical messages to clinicians. These critical messages are essential, as they allow patient access to clinicians and contact among clinicians themselves.

A hospital call system, therefore, must be well-coordinated, time sensitive, reliable, and suited to the hospital devices available to the healthcare professionals. Hospital call centers and systems are further being improved upon to allow the tracking and escalation of messages provided to clinicians. This is essential in urgent and emergent service delivery in hospital environments.

Medicine is adopting a multidisciplinary approach to allow more holistic care and treatment to the patient. This requires constant and effective communication among medical professionals. Therefore, the hospital call center is essential, as it acts as a referral point among specialists and a resource for specialists to get access to a client base from the hospital.

Hospital to Patient Communications: Last, call centers allow the communication of the hospital and the patient who is the primary customer of the healthcare facility. The hospital marketing department benefits from the communications between the patient and the call center. The hospital call center is a point of increased patient satisfaction and improved marketing information. Patient satisfaction must be the most important goal and a practice ingrained within the organizational culture.

The hospital, therefore, should aim at optimizing the call experience for the patient. This can be done by cutting down the call waiting time, coordinating points of services, and improving patient registration and billing.

The internet has made it easy to widely disseminate information. A patient can communicate his experiences to a potential customer base. Patient experience, therefore, in the internet age, is an essential form of hospital advertisement. Improving patient experience builds upon the hospital brand and helps set it aside from the competition.

Optimizing patient experience goes beyond a single interaction to anticipate the needs of a patient and tailor services to meet those needs. The increasing need for data within the information age, therefore, cannot be understated. Data from call centers helps the marketing department find effective ways of communicating with the patient.

Each hospital call center must have a means of feedback. This helps identify and document potential issues the client had with the system. There is currently an adaptation of use of proprietary tools such as live metric dashboards and quality assurance and tracking tools. Therefore, most hospitals are collecting data to learn the needs of the patient and tailor their customer care services accordingly. For instance, most call centers now use customized call scripts; this ensures the provider maximizes care support and efficiency.

Optimizing the customer experience has led to call centers evolving as new and exciting forms of hospital income generation. The consequences of effective customer service are based on optimizing the patient experience, which leads to an increase in hospital revenue.

Final Thoughts: Clinical communication is a hugely faceted subject with far reaching consequences that go beyond hospital walls. Hospital call centers play a significant role in any hospital’s clinical communications. This role is expected to continue growing in the coming years as modern technology makes it easier and faster to communicate.

By optimizing communications, a hospital call center can improve patient health outcomes, fill an essential healthcare gap, and serve to improve overall patient care. It is, therefore, imperative that hospitals find effective ways of maximizing call centers, not just as a channel of communication, but also as a huge income-generating department.

1Call, a division of AmtelcoKevin Mahoney is a hospital and healthcare-related account advocate and sales engineer at Amtelco, a manufacturer and supplier of call center solutions. Contact him at kmahoney@amtelco.com.

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Vendor Spotlight on Echo, a HealthStream Company


Echo Access provider directory


Redeploy Your Legacy Call Center to Transform Patient Experiences

With CMS’s (Centers for Medicare and Medicaid Services) launch of the Consumer Assessment of Healthcare Provider and Systems (CAHPS) program in 2006, hospitals have dedicated significant resources to improving survey results. Centralizing access and strengthening trust through a patient experience contact center begins at the first point of contact. For example, perhaps the caller is new to the community and is looking for a physician referral.

That first touchpoint is critical. According to Society for Healthcare Strategy and Market Development (SHSMD) 2012, the first three seconds of the initial interaction influences both hospital selection and subsequent preference.

A patient experience contact center serves as a health network’s virtual front door. It delivers personalized, trust-building support, and referrals before a patient receives care and individualized follow-up and coaching after the patient returns home.

EchoAccessUnlike a legacy call center, the EchoAccess PX Hub™ provides the specific resources you need to deliver engaging experiences.

Tools that Transform Caller and Patient Experiences:

  • Automate satisfaction surveys and patient experience scores.
  • Track population health goals and document messages to callers and patients.
  • Monitor and improve kept appointment rates.
  • Deploy post-discharge surveys.

Provider Directory with Visual Ratings:

  • Strengthen trust with graphically illustrated CHAPS scores and comments from previous patients.
  • Enjoy the flexibility of four deployment options which are cloud-based and API (application program interface) enabled.
  • Discover the relationship between patient experience ratings and provider directories.

Physician Referral and Physician-to-Physician Referral:

  • Sort provider lists by rotation priority, proximity, or next available appointment.
  • Connect referring providers and their patients with a panel of expert providers.
  • Select from dozens of criteria to ensure the optimal provider match.

Class Enrollment:

  • Add value to patients with user-friendly class and event registration on the phone or online with secure payment.
  • Enable online users to manage their registration with MyEnrollment.

Gold Standard Clinical Triage:

Avoidable Readmissions Reduction:

  • Document and track calls and texts to both patients and caregivers to increase rates of kept follow-up appointments.
  • “It’s a new day in healthcare,” said Mary Alice Worrell; director, contact center services of St. John providence Health System. “Our contact center’s readmission reduction program, powered by EchoAccess, is a vital part of our standard of care.”
  • Learn how St. John Providence Health System reduced preventable readmissions.

Computer/Telephony Integration:

  • EchoAccess offers computer telephony integration (CTI) with CTI-ready telephone software. This technology reduces call times and results in more accurate data entry.
  • Seamlessly transfer calls to specific agents with the caller’s phone number and appropriate call classification.
  • EchoAccess will
    1. start the call,
    2. apply the call type (physician referral, class enrollment, health information, and so forth), and
    3. identify previous population records that match the calling phone number. This saves time for call center agents, shortens call length, and improves data accuracy.

Best Practice Content: Utilize a library of referral letters and reports, including caller letters, class configuration emails, and monthly operations reports.

HealthStream Benefits:

  • Includes HCAHPS score integration provided by HealthStream, a CMS-certified HCAHPS survey provider and Echo’s parent company. Patient satisfaction scores by provider is vital information for callers and patients when selecting a physician.
  • Provides the option of installed software, cloud deployment, or outsourced services for evenings, weekends, and peak call times.
  • Combines EchoAccess product expertise with patient experience consulting through the HealthStream Engagement Institute. The HealthStream Engagement Institute has coached over 350 healthcare organizations to create patient-centered cultures with measured increases in patient satisfaction, employee engagement, care quality, and profitability.
  • Clients can harness talent for patient experience journey mapping, enterprise contact center consolidation for integrated access, contact center operations, emerging technologies, and customer service certification.
  • Customer service certification assures your team has the skills and toolset they need to consistently deliver extraordinary patient experiences beginning at the first point of contact.
  • Echo, a HealthStream company, delivers healthcare’s only patient experience contact center software solution from a CMS-certified provider of HCAHPS surveys. HealthStream’s deep, nationwide experience provides unique insight into raising HCAHPS scores. Raising HCAHPS scores improves reimbursement.

Explore the timely benefits of redeploying your legacy call center to transform patient experiences. Exit the call center: Yesterday’s call centers managed transactions. Enter the patient experience contact center: Today’s patient experience contact center serves as the organization’s virtual front door. It delivers intentionally memorable experiences that mitigate risk, solidify loyalty, and reduce unnecessary readmissions. Compared to EchoAccess PX Hub, everything else is just a call center.

HealthStream Provider Solutions—comprised of Echo, a HealthStream® Company, and Morrisey®, a HealthStream Company—is dedicated to deploying process improvements, automation, and validated provider data to improve credentialing, privileging, enrollment, and patient experience contact centers for more than 3,000 hospitals and medical groups. Echo’s solution for hospital-based contact centers, EchoAccess, enables organizations to deliver intentionally memorable experiences that mitigate risk, solidify loyalty, and reduce unnecessary readmissions.

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Do You Provide Contact Options For Your Patients?



A successful omnichannel strategy requires intentional implementation

By Peter L. DeHaan, PhD

Peter DeHaan, Publisher and Editor of AnswerStatHave you ever had a company ask how you wanted them to contact you? Options might include phone, email, text, fax, mail, or social media private messaging.

How well did they do at complying with your request?

With one company I asked for email communications, but they called me. When I reminded them I preferred email, they switched to that channel. But after too many emails failed to make progress, I switched to the telephone, which confused them. In the end, I accomplished my objective and gained something to write about in the process.

Another organization asked the same question. Text messaging seemed the way to go, since I envisioned short, succinct communications with them. Though I opted for text, they emailed me instead. In fact, they always email. Once when I called and left a message, they emailed me back. Another time I specifically asked for a text to confirm an appointment, but they emailed me. Email is their preferred contact method, even if it isn’t mine.

I applaud these organizations for asking my preference and criticize them even more for not following through. If you can’t comply, you shouldn’t ask. That way you don’t establish false expectations or cause frustration with your patient or customer.Providing excellent customer service relies on excellent communication. Click To Tweet

In considering these two experiences, a few thoughts come to mind, which apply to any contact center that truly has a customer-focused perspective.

Offering Channel Options Is Good: Letting patients and their caregivers select their preferred contact method is a customer-friendly move. It’s also a great idea, given that patients often have options for healthcare providers and are quick to exercise those options if you disappoint or disrespect them.

Not Honoring Channel Requests Is Bad: Not using the channel a patient requests is worse than not offering the option in the first place. If you can’t (or won’t) contact patients and prospective patients by the method they request, then don’t bother to ask.

Not Responding On Any Channel Is Even Worse: Making no effort to contact patients or customers when they request it is the worst possible error to make. And this mistake happens too often.

Knowing When to Switch Channels is Key: Sometimes a preferred channel bogs down communication. When emails or texts go back and forth without resolution, it’s time to pick up the phone, but before doing so, make that suggestion through the patient’s channel of choice. And if the patient opts to switch channels, make sure their contact history follows them to the new channel.

Asking people how they want you to contact them is great, providing you follow through. But if you don’t do as they request, you’re better off not offering it as an option. Conversely know when it’s appropriate to switch channels. And most importantly, always, always follow through.

Providing excellent customer service relies on excellent communication, whether it’s within the requested channel or if there’s a need to move outside of it. Just don’t arbitrarily jump channels. The only thing that will accomplish is patient frustration.

If your contact center has an omnichannel strategy be smart about the implementation.

Peter L. DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat and a passionate wordsmith. Connect with him on his blog, social media, and newsletter, all at www.authorpeterdehaan.com.

AAACN Conference Hits Attendance Record



More than 1,200 nurses attended the American Academy of Ambulatory Care Nursing (AAACN) 42nd Annual Conference held recently in New Orleans, a number that broke all previous records for this thriving specialty nursing association.

With heightened interest in such areas as Care Coordination and Transition Management (CCTM), telehealth, and other ambulatory care nursing roles, nurses rely on the AAACN conference for high-level quality education. As a result, AAACN is enjoying a groundswell of growth and success as it expands, offering broad education and services that help nurses excel in their professional practice. AAACN Conference Hits Attendance Record Click To Tweet

“One of the best aspects of this conference is how warm and welcoming the AAACN community is,” said 2017-18 AAACN president M. Elizabeth Greenberg, PhD, RN-BC, C-TNP. “I’ve been so impressed by nurses’ willingness to share their expertise and help their colleagues reach their potential. During the conference I witnessed time and again the nurses working together to advance our practice and help our voices to be heard.”

Conference Highlights: Outgoing AAACN president Debra Cox, MS, RN, CENP, opened the conference on May 10, with the official “Welcome and President’s Address.” Cox encouraged attendees to make new connections at the event as well as share what they learned with colleagues at home.

Immediately after the welcome session, author and nursing leader Connie Merritt, BSN, RN, PHN, delivered the conference keynote address, “Pressing Forward in Challenging Times.” Merritt offered attendees ways to meet the demands of today’s complex healthcare environment by confidently leading and inspiring others.

Concurrent and general sessions on a broad variety of ambulatory care nursing topics continued through Friday, May 12. Additional continuing education was offered with 120 poster presentations that showcased the nurses’ best practices and innovations.

Attendees enjoyed special events, networking, and conversations with vendors in the exhibit hall. At the always popular opening reception, the silent auction, which benefits AAACN’s scholarships, grants, and awards program, raised $6,000.

The conference closed on May 13, with the Ambulatory Care Nursing Certification Review Course post-conference workshop. (View conference photos.)

Highlights include:

New Officers Inducted: Greenberg, who is Associate Clinical Professor, Northern Arizona University, Tucson, AZ, was inducted as AAACN 2017-2018 president for a one-year term. In this role, she will lead the AAACN board of directors (BOD) in fulfilling the association’s strategic plan and steering the direction and vision of AAACN in the coming year.

CEO Recognition: The BOD honored Cyndee Nowicki Hnatiuk, EdD, RN, CAE, and FAAN, who is retiring from her role as AAACN CEO. Hnatiuk served AAACN for twenty-two years and helped the association steadily grow and succeed. She received a lifetime AAACN membership and the highest praise from AAACN leaders.

“Cyndee is the quintessential nurse leader and professional,” Greenberg said. “More than any other individual, Cyndee has been responsible for guiding and nurturing AAACN into the exceptional organization it is today.”

Awards and Scholarships: The following awards were presented:

  • President’s Above and Beyond Award (highest award to AAACN members who exceed the expectations of their volunteer roles). Two recipients:
    • Joan Pate, MS, BSN, RN-BC, was recognized for her longtime commitment and exemplary service to ambulatory care nursing and AAACN, including ongoing and active contributions to AAACN Viewpoint and other publications, as well as serving on the Editorial Board and Leadership SIG Advisory Board.
    • Beth Ann Swan, PhD, CRNP, FAAN, was honored for continually seeking opportunities to elevate the role of the ambulatory care nurse and for her many contributions to AAACN, including serving as past president disseminating and implementing the Care Coordination and Transition model.
  • Research/Evidence Based Practice Project Award: $1,000, Julie Alban, MSN, MPH, RN-BC, CCCTM, Belleview, FL, for her study, “Ambulatory Care Nurses’ Role in Advance Care Planning.”
  • Conference Scholarship (members in nursing 2+ years): Sarah Espin, MSN, RN-BC, VHA-CM, Inverness, FL.
  • Conference Scholarship (members/New RNs in nursing two years or less): Linda Schnolis, BSN, RN, Philadelphia, PA.
  • Conference Scholarship (nursing students): Angela Williams, Boise, ID.
  • Education Scholarship: Gina Hernandez, BSN, RN, PHN, Valley Center, CA.
  • Clinical Excellence Award (sponsored by the Anthony J. Jannetti, Inc. Nursing Economic$ Foundation, given to a AAACN member who personifies clinical excellence in ambulatory care): $500, Jane “CJ” Mazzeo, BSN, RN-BC, CCCTM, VHA-CM, Leesburg, FL.
  • Administrative Excellence Award: Julie Tuttle, MSN, RN-BC, Nashua, NH.
  • 2017 Viewpoint Writer’s Award (given for an outstanding article published in the association’s official newsletter, Viewpoint): Dawn M. Rito, BSN, RN, Clinical Nurse, and The Metro Health System Cleveland, OH, for the article: Changing the Physical Environment in the Urodynamic/Gynecological Procedure Room, May/June 2016.

AAACN also awarded the Candia Baker Laughlin Certification Scholarship and Certified in Care Coordination and Transition Management (CCCTM) Certification Grant to two recipients. Those recipients will be announced after they have passed the ambulatory care nursing certification exam and the CCCTM exam.

The poster presentation winners are:

First Place: Group B, Poster 3: Enhanced Nurse Visits for Medication and Lifestyle Management for Patients with Uncontrolled Hypertension. Presented by a nursing team from the Mayo Clinic, Rochester, MN.

Second Place: Group A, Poster 4: RN Care Coordination for Patients with Metabolic Syndrome in Ambulatory Care. Presented by a nursing team from the Edward J. Hines, Jr. VA Hospital, Hines, IL

Third Place: Group A, Poster 22: A Toolkit for New Ambulatory Care Nurses: Applying Available Resources for the Job at Hand. Presented by nurses from the Veterans Health System/Southern Tier Outpatient Clinics North Florida South Georgia VHS, Inverness, FL; and the Department of Veterans Affairs, Jacksonville, FL.

Online Library: Nurses who attended the full conference have access to an extensive source of CNE contact hours in the AAACN Online Library, which can be used for certification and licensure requirements. For more information about accessing conference content, visit library.aaacn.org/aaacn/

2018 Conference: The AAACN 43rd Annual Conference will be held May 9-12, 2018, in Lake Buena Vista, FL. Poster abstracts are being accepted through December 15, 2017.

For more information about AAACN, visit aaacn.org; call 800-262-6877, or email aaacn@aaacn.org.

Medical Call Centers Are Here to Stay


TeamHealth Medical Call Center


By Gina Tabone

Changes to the United States of America political scene are upon us and most certainly will have an impact on the provision of healthcare. Regardless of party affiliation, several healthcare reform objectives need to remain in the forefront by future government leaders. Examples include enhancing quality of care, improving interdisciplinary coordination and collaboration, and better utilization of available resources.

Focusing on these concepts will contribute to the goal of improved outcomes for both individuals and the patient populations we serve. The benefits achieved from the implementation of the triple aim must continue, regardless of who is leading the country. Nurse triage, as a component of an integrated medical call center (MCC), is a pivotal—and no longer optional—intervention.

The world of medical call centers has finally gained the recognition and credibility in the healthcare marketplace that many of us have been trying to expound for two decades. Centralized medical call centers are rapidly emerging as the backbone of health systems because they are integral in achieving better patient outcomes.

The new administration has wisely sought healthcare advice from the most innovative physician leaders in the United States. For example, Toby Cosgrove, of Cleveland Clinic, and John Noteworthy, of the Mayo Clinic, were invited to meet with President Trump to share their thoughts on the Affordable Care Act (ACA) and offer ideas to plot out the best plans for the future. Improving patient experience of care requires open access channels. Click To Tweet

Concerns were expressed that the current model needs to focus more on patient health and wellness and less on the avalanche of paperwork. This has negatively impacted the day-to-day responsibilities of clinicians who are held accountable for reporting on hundreds of quality indicators. These points of contention are agreed upon by most caregivers. Cleveland Clinic and Mayo Clinic have improved patient access, outcomes, and satisfaction by integrating state-of-the-art integrated call centers with clinical access across their multi-state enterprises.

Hopefully, their example will resonate and continue to motivate other organizations to rapidly integrate outsourced or optimized in-house MCCs as a proven solution for reaching the three goals of the triple aim: improving the patient experience of care, improving population health, and reducing the per capita cost of healthcare.

Improving patient experience of care requires open access channels. Access means that patients can receive the most appropriate level of care needed, in a timeframe best determined by specially trained nurses guided by evidence-based tools. The patient learns to expect reliable advice that takes their current health state into account and is consistently available day or night. Gaps in care are eliminated, and delays are avoided, leading to favorable patient outcomes and higher reimbursements in a fee-for-value model. When patients’ wellbeing is enhanced, everyone gains—especially patients. MCCs can stake a claim for making this happen.

The year 2017 will have many organizations taking a close look at their operations and making tough choices about what functions are best accomplished internally and which ones can be entrusted to an outside partner. IT departments are now being outsourced by some of the largest hospital systems in the country. IBM is, by far, the vendor of choice. Patient Financial Services is another service with options for outsourcing where the benefits to an organization outweighs the cost incurred. Incentives for meeting targets are common. Last, there is a surge by strategic decision makers to explore nurse triage services being performed by an outside call center partner.

The common denominator in all three areas where outsourcing is increasing is the fact that there is a reliance on human capital and all the contingency costs that goes along with being an employer. High labor costs often consume up to 70 percent of many call centers’ operating budgets. Outside partners can assume the responsibilities with greater efficiency, better outcomes, and lower costs.

There is also the possibility that many vendors are willing to assume some of the risks associated with the successful attainment of goals. The choice to retain, outsource, or develop a hybrid of both is a multi-faceted decision that is reserved for leaders at a higher level than the call center. Organizations must evaluate which option best aligns with their mission, vision for the future, and strategic plans.

Medical call centers are branching out and taking on a variety of responsibilities that are well suited to be conducted remotely and reliant on state-of-the-art technology and a dedicated workforce. Once the technological infrastructure is created, the MCC can be enhanced to take on additional functions.

The task of appointment scheduling is the most common function of many MCCs and often happens in tandem with the strategy of centralization. Electronic Medical Records (EMR) products have customized templates embedded with providers’ schedules that are used for office visits, imaging, or procedural appointments. Outbound calling campaigns are often conducted in conjunction with scheduling for appointment reminders.

Centralizing all medication refill requests is emerging as a successful addition to many MCCs. Call center technology such as CRM allows for requests to be tracked, acted upon, and measured, ensuring that established targets are being met in a timely manner. Without measurement, there is little possibility for improvement.

Patients can expect a standard process for medication needs and defined timeframes for responses or resolution. Medication management and compliance is critical for optimal outcomes, so implementing a process that fosters it is a good idea. Patients stratified as high-risk garner the most advantages, which contribute to maximum reimbursements for medical treatments.

MCCs have taken on the significant task of not only caring for the acute needs of primary care patients, but also the chronic needs of vulnerable high-risk patients. The successful coordination and transition of care is central to every health system’s strategy for sustainability today and growth tomorrow.

Nurses are the clinicians assigned to figure out how to morph from case management to transitional care coordinators. Regular communication between patient and caregiver is vital and is often done via telephone, text, or email. Training the newly created transitional care nurses in the fundamentals of remote patient care is imperative and is based on the standards of care for telephone triage nurses. The practice of triaging acute symptoms has branched out and will serve as the starting point for nurses involved in coordinating care.

It is up to those of us established in the medical call center world to continue to proclaim the unlimited value of a MCC to the healthcare industry. In many healthcare organizations, more than 10 percent of employees spend most of their day doing their job on the telephone. The benefits of centralizing and consolidating the work they do are undeniable.

C-suite leaders must accept the fact that medical call centers are no longer considered an expense but an investment with impactful ROI.

Initially there were call centers; then access centers came along, followed by contact centers. In 2017, we are now called engagement centers. The task at hand is to capture the limited attention of decision makers and educate them on the role MCCs play in a fee-for-value system and the distinct results that are possible. The future may be uncertain, but there remains a need for products, services, and expertise that bring the call center to the forefront of patient care.

TeamHealth Medical Call CenterGina Tabone, MSN, RNC-TNP, is the vice president of strategic clinical solutions at TeamHealth Medical Call Center. Prior to joining TeamHealth, she served as the administrator of Cleveland Clinic’s Nurse on Call 24/7 nurse triage program.

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