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Articles from AnswerStat

Using Device Data and Nurse Triage to Improve VA Healthcare


TriageLogic

By Ravi Raheja

New technologies are transforming how clinicians deliver healthcare. At the same time, digital solutions alone are not enough to help patients. Incorporating some human component increases patient compliance and education, further reducing healthcare costs. Medical call centers should be adopting software and increasing the role of triage nurses to complement traditional care settings. 

For example, digital diabetes prevention and treatment platforms connect users with support communities and health coaches who can remotely monitor chronic conditions such as weight, blood sugar, diet, and medicine intake. Thresholds and alerts can be set up to alert healthcare providers about abnormal and potentially abnormal or dangerous values. While the devices can collect and transmit data and even have a certain threshold, a medical professional still needs to interpret the data and then direct patients about the next steps based on the data and in the context of their symptoms and current health status.

Telephone triage nurses play a vital role in interpreting the data and providing appropriate follow up for patients who use these technologies. They act as the first line of screening when an alert or abnormal value is reported. They have the training to talk to patients, assess their symptoms, and determine the next best steps based on combining the data with the full patient assessment over the phone.

To assess patients and direct them appropriately, the nurses need triage protocols. Most medical call centers use the gold standard protocols from Schmitt-Thompson to assess symptoms. Call centers should also incorporate robust protocol builders, a technology that enables an organization to modify existing protocols to meet their needs and create new protocols when required.

By using custom-developed protocols, triage nurses can assess a patient using the data received from devices with appropriate next steps for medical care. As a result, triage nurses play a significant role in this new digital era, driven by value-based care. By combining the data from devices and other sources with innovative triage technology, triage nurses can act as the bridge between patients and providers. This creates a viable monitoring solution that provides cost-effective care.

In conjunction with the custom protocols, organizations should use platforms to put in custom workflows. As an example, once a nurse has determined the appropriate level of care, they can now further direct the patient to specific care locations, referral numbers, or provide handouts via text or email. This allows the triage nurse to serve as an effective first point of contact and get the patients to the appropriate next steps on the first call.

Finally, look for companies that can provide an optional mobile app to enable patients to take advantage of increased self-service, access to customized resources, and insight into their own information. Technology is changing the access, monitoring and delivery of healthcare. Value-based solutions are now possible to optimize patient care and decrease healthcare expenses.

TriageLogic

Ravi K. Raheja, MD is the COO and medical director of the TriageLogic Group. Founded in 2005, TriageLogic is a URAC accredited, physician-led provider of high-quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. The TriageLogic group serves over 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com and www.continuwell.com.

Mitigating Medical Call Center Risk


LVM Systems

By Traci Haynes

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

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

The five basic steps of risk management include: 

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

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

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

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

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

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

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

Clinical Management

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

Technology 

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

Physical Environment

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

Patients and Families

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

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

Cyber Security and HIPAA in a Medical Contact Center



By Bobby Bennett

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

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

Ways to Prevent Cyber Attacks

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

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

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

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

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

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

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

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

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

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

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

Retain Staff by Establishing Their Growth Potential



Increase Employee Tenure by Showing Them Their Future with Your Organization

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan-employee growth potential

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

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

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

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

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

Add Responsibilities 

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

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

Expand Position Scope

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

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

Promote to a New Position

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

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

Adjust Compensation

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

Develop a Career Path

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

Employee Growth Potential Summary

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

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

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

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


1Call-call center

By Nicole Limpert

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

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

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

Disaster Planning

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

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

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

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

Disaster Communications

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

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

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

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

Cloud Technology and Virtual Servers

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

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

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

Disaster Recovery and Relief

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

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

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

Summary

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

1Call, a division of Amtelco

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

State University of New York (SUNY) Upstate Medical University


1Call-call center

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

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

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

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

Identifying Areas for Improvement

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

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

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

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

Healthcare Communication Partners

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

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

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

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

Testing the Integration 

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

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

Evaluating Results

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

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

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

Future Integration Plans for Efficient Workflows

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

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

1Call, a division of Amtelco

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

Should We Worry about Physician Burnout?



How Telephone Triage Call Centers Can Help

By Shannon Bays-Crockett

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

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

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

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

Physician burnout symptoms might include:

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

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

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

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

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

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

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

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

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

The rates of burnout among medical specialties are:

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

Addressing Physician Burnout 

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

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

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

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

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

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

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

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

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

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

Healthcare Call Centers

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

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

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

Use Telehealth to Extend Healthcare and Save Money



By Nicole Limpert

Sometimes a simple visit to your doctor’s office can be more complicated than expected. Typical doctor office hours are 8:00 a.m. to 5 p.m., Monday through Friday. However, symptoms and complications from being sick don’t adhere to business hours.

It can be a challenge for people who live in rural areas just to have access to a local medical facility. Often going to a doctor appointment means time off work for travel to and from the medical office. Those with limited mobility experience similar obstacles, no matter where they live, because traveling is a time-consuming endeavor.

With the help of technology, telehealth makes healthcare more accessible by bringing medical services to the patient.

What is Telehealth?

The Health Resources Services Administration (HRSA) defines telehealth as, “The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.”

One of the most common forms of telehealth is a Nurse Hotline. Most U.S. health insurance companies offer a toll-free nurse advice hotline to their customers. Other types of telehealth services include:

  • Virtual Appointments: Patients can visit a doctor or nurse via online videoconferencing or using a web-based question and answer portal.
  • Medical Staff Consults: Telehealth isn’t only for patient/doctor communication. Doctors, nurses, and specialists use virtual consultations to coordinate care for their patients.
  • Remote Health Monitoring: Communication between patient medical devices and doctors. Patients can use home monitoring equipment, wearable devices, or apps to wirelessly communicate various health readings to their doctor or medical care team.
  • Non-Clinical Services: Telehealth also refers to remote, non-clinical uses such as, administrative meetings and provider training and education.
With the help of technology, telehealth makes healthcare more accessible by bringing medical services to the patient. Click To Tweet

Removing Barriers to Healthcare

Telehealth not only makes access to healthcare easier for the public, it has also proven to be a necessity for both large organizations and niche markets.

Members of the United States military, and their families, are stationed all over the world. The Department of Defense’s (DOD) Military Health System (MHS) provides healthcare to more than 9.4 million people through a network of fifty-six hospitals, 365 clinics, and other facilities worldwide. Telehealth programs connect military patients to providers across the world to deliver direct access to quality healthcare, tele-radiology, and tele-pharmacy services.

The United States Department of Agriculture (USDA) is heavily involved with providing telehealth services to rural communities and administers telecommunications telehealth grants through two major programs: the DLT Program and the Community Connect Program. Similarly, the United States’ Indian Health Service uses telehealth to assist with accessing health services for American Indian and Alaska Natives populations who live in outlying communities.

Other isolated, niche markets use technology to improve healthcare. Alaska’s Maritime Industry uses a telehealth platform to enhance access to care for those who work in the dangerous waters off Alaska. Internet connections are unreliable, so they primarily use a phone-based system to instantly connect with doctors. The Federal Bureau of Prisons (FBOP) uses telehealth to expand their internal healthcare program by consulting with external healthcare providers via collaborative practice agreements.

Telehealth and Medical Call Centers

Regardless of where people are located, telehealth is a critical tool that brings the best possible care to patients. Medical call centers play a significant role by providing the technology and medical expertise needed to bring remote healthcare to patients.

Technology enables medical call centers to effectively become an extension of a hospital or medical center’s operation. The communication software used by medical call centers can securely access a patient’s electronic medical record (EMR), update EMRs with notes, and record calls needed for insurance claims and workmen’s compensation. Because everything is documented, detailed reports can be generated for reporting purposes.

Medical call center operators can coordinate care, make follow-up calls, schedule visits, contact on-call medical staff, and manage referrals. Some healthcare call centers staff licensed medical professionals who are qualified to make health assessments, give medical advice, and escalate critical concerns.

The services provided by medical call centers are available 24 hours a day, 7 days a week. Medical operators can work different hours and be located anywhere in the world, in any time zone. For example, if a medical center on the east coast of the United States is closed, operators on the west coast are still available.

Telehealth Benefits Hospitals

In the 2017 American College of Healthcare Executives’ (ACHE) annual survey, hospital CEOs ranked their ten biggest challenges for the year. Telehealth services can address six of these ten concerns. Specifically, financial challenges (first), personnel shortages (third), quality of care (fourth), patient satisfaction (fifth), access to care (seventh), and population health management (ninth).

Multiple small and large-scale studies cite the use of telehealth as a cost-effective method to deliver quality care, improve outcomes, enhance the patient experience, and expand access to healthcare. The patient’s experience with their healthcare team plays a critical role in their satisfaction. Patients are asked to provide information about their care experience via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Unacceptable survey results can result in hospitals losing some reimbursements. In 2017 alone, approximately 1.7 billion dollars in reimbursements were withheld from hospitals.

The cost savings are also passed along to patients. Call center data from Health Navigator cites the top five reasons for calling a nurse hotline are fever, vomiting, stomach pain, cough, and head pain. Less than 10 percent of the cases were high risk. On average, telehealth appointments for nonemergency reasons cost approximately 45 dollars, as opposed to 100 dollars for an in-person visit at a doctor’s office or 160 dollars at an urgent care clinic.

The Future of Telehealth

The population growth for the United States, from 2008-2030, is estimated at 20 percent, totaling 363 million people. This spike in population will exacerbate an already strained shortage of healthcare professionals. Telehealth services may become more of a healthcare necessity rather than a convenience.

As technology advances, telehealth can become more complex by not only connecting patients with expertise in real-time, but also enabling computer assisted medical procedures in remote locations by specialists thousands of miles away, creating global care teams for patients.

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.

Vendor Spotlight: 1Call, a Division of Amtelco


Our mission: Working together to provide the very best communication product solutions, backed by the best support available.

Since 1976, Amtelco has provided innovative communication solutions to call centers around the world. In 1997, the 1Call Division was formed to offer enterprise-wide clinical communication solutions designed specifically for healthcare organizations. 1Call is dedicated to serving the unique call center and communication needs of healthcare organizations, helping improve communications between patients, physicians, and staff by connecting people and information. Amtelco has received twenty-eight patents, covering a wide range of communications processes.

Hospitals and healthcare organizations around the world turn to 1Call to solve their medical call center, answering service, on-call scheduling, call handling, secure messaging, voice processing, conference calling, and automated integration engine notification needs. In an independent survey, 100 percent of the respondents said they would highly recommend Amtelco and 1Call to another healthcare organization.

Five-Star Service and Support

AvvCustomer advocates, solutions architects, and product managers are available to help customers and answer questions before, during, and after the sale.

1Call has a reputation for complete, professional system support, offering training, installation, and technical support staff on call on a 24-hour basis. When customers need assistance for their call center solutions, 1Call’s customer support staff provides fast and reliable service.

1Call understands that every healthcare organization has unique needs. Click To Tweet

1Call’s customer support staff includes implementation specialists, installers, project managers, and technical support staff. The customer support staff has an average tenure of over fifteen years, which is virtually unheard of in technology and IT businesses. All support staff members are in the United States. While many of the staff members are in the Midwest home office, there are several regional offices around the United States.

Help When Needed

When help is needed, it’s just a phone call away. 1Call customers can also email the support team or access the exclusive online TechHelper tool, where documentation, manuals, videos, and many more training tools are available. TechHelper is available 24-hours a day, with unlimited access. Emergency assistance for 1Call systems is available 24-hours a day, 365-days a year.

Software upgrades are included with support agreements, helping ensure that 1Call customers always have access to the newest features.

In an independent customer satisfaction survey, 97 percent of the respondents said the Amtelco and 1Call service and support was excellent (Amtelco Satisfaction Research Study conducted by TMA+Peritus, February 2015). 1Call looks forward to partnering with more healthcare organizations to provide this same level of service.

Solutions That Work

1Call features a complete line of modular solutions specifically designed to streamline enterprise-wide communications, eliminate errors, and reduce training time for new hospital call center operators. All the specialized 1Call solutions save an organization’s limited resources, making each organization tremendously efficient, enhancing the patient experience, and improving their bottom line.

Each 1Call solution comes with the benefit of Amtelco’s forty plus years of experience in the field of call handling and messaging. Thousands of 1Call and Amtelco systems are in operation around the world, 24-hours each day.

Easily Customizable

1Call understands that every healthcare organization has unique needs and that they sometimes receive unusual requests from physicians and departments. That’s why 1Call offers powerful solutions that are easy to customize by the customer. Customers have access to a wide variety of administrative functions, including the ability to customize scripts for any department, with individual scripts for every physician, if needed. 1Call also has a scripting team that is available to assist customers with any specific requests.

Why Choose 1Call?

Hospitals continually recommend 1Call solutions to other healthcare organizations. So, more healthcare organizations continue to switch to 1Call. And it’s no wonder. With all the customizable hospital call center solutions available, the high levels of customer satisfaction and quality support services, 1Call is in a class by themselves.

What do customers say about moving to 1Call? Here’s one example: “It was a great decision switching to 1Call. The 1Call technology is innovative. It’s easy to learn, and it really seems to mold around what the particular needs of our hospital are. Everything runs so much more smoothly now. I think it’s also worth noting, the customer service: great. We couldn’t be happier.” Read more at www.1call.com/support/customer-service.

Strong Partner Relationships

Hospital CIOs and CTOs are under tremendous pressure to do more with smaller budgets and staff. It’s paramount that they have a reliable health communications IT partner. 1Call forms solid partnerships with their customers. Each organization is encouraged to work closely with the 1Call team of consultants and engineers through each phase of system planning, configuration, and implementation. This helps ensure that the 1Call systems are at their optimum performance levels to meet all the communication needs of their organizations.

1Call also works closely with key technology partners to provide organizations with the solutions that best fit their communication and technology requirements. 1Call’s partners integrate at a high level with the call center, on-call scheduling, HIPAA secure messaging, alarms management, and emergency notification solutions to produce a comprehensive solution that satisfies the needs of each organization.

The 1Call technology partnerships include:

  • American Messaging
  • Apple iOS Developer Program
  • Avaya DevConnect Community
  • Black Box
  • Bluestream
  • Cisco Solution Partner Program
  • Cisco Developers Network
  • Copia OEM Partner
  • GENBAND Partner Program
  • Google Play Developer

  • Health Level 7 International (HL7)
  • HISCALL
  • Interactive Intelligence Global Alliance
  • Interbit Data
  • Microsoft Developers Network
  • Mitel Solutions Alliance
  • NEC UNIVERGE Solutions Partner Program
  • ProScheduler
  • QGenda
  • SAP OEM Partnership Program
  • ShoreTel Innovation Network Alliance Partner
  • Spectralink Application Integration and Management Solvers Program
  • Unify (formerly Siemens) Technology Partners – Advanced Level Status
  • Vocera Solution Partner Program
  • Windows Development Center Member

One Company, One Solution

The development and customer support teams are in the “Innovation Way” hallway at the Amtelco and 1Call home office. These teams work together closely, and when a question arises, it’s a quick walk down the hallway to find the solution. One company, one solution, proudly located in the USA.

Recent Innovations

As customers have come to expect, Amtelco and 1Call continue creating innovative solutions. In addition to frequent enhancements to Intelligent Series, soft agent, and miSecureMessages, the newest innovations are MergeComm, Genesis, and miTeamWeb.

The MergeComm Integration Engine

MergeComm automates communications throughout an organization, speeding response times to help organizations provide better patient care. MergeComm takes an incoming message and uses a script to determine who needs to receive that information. MergeComm can receive a message from a wide variety of sources, including alarms, alerts, HL7 messages, nurse call, severe weather alerts, TCP, WCTP, and web services. Notifications can go to an individual, to an entire group, or to the current on-call personnel. Notification methods include email, miSecureMessages, IP phones, pagers, phones, smart devices, SMS, and Vocera badges.

The Genesis Software Switching Solution

Provides the Intelligent Series applications with advanced software-based telephony. Genesis provides an all-inclusive call center solution with ACD, call management, reporting, and call center applications based on the Intelligent Series. A few of the many benefits of Genesis include reducing the need for hardware, virtualization of the switching platform, integrating with SIP-enabled PBXs, connecting remote agents, and automating overhead paging.

MiTeamWeb is a Web Interface

Hospital staff uses miTeamWeb for fast online and mobile access to on-call schedules, messages, directories, and status. MiTeamWeb is available using secure browser access from a PC, smartphone, or tablet.

The Future

1Call, a division of Amtelco

As technology continues to evolve (and everyone knows it will) and as customers have new communication challenges, rest assured that 1Call and Amtelco will continue to develop new innovative solutions, as they have for over forty years.

Offer Learning Opportunities to Better Retain Staff



Everyone Wins When You Provide Strategic Training for Your Staff

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan

We’ve looked at five tips to better retain call center staff. The first two addressed agent compensation and agent benefits. Now we’re going to look at learning opportunities.

Today’s entry-level workforce values jobs that allow them to grow mentally. Educational opportunities provided at work, or through work, help to better connect employees with the job they do, increase their job satisfaction, and lengthen their tenure.

Not only are learning opportunities a wise retention tactic, it’s also a smart recruitment tool. Many workers so value learning opportunities that they’ll take a lesser-paying job if it provides the chance to grow, versus a higher paying position that doesn’t.

Here are some learning opportunities that you can offer to your staff.

In-House Training

Delivering internally produced training to your staff is a cost-effective way to provide the learning opportunities they crave. This can be unstructured teaching offered as needed or more organized educational offerings. The best thing about developing in-house instruction is that you can tailor it to the specific needs of your call center.

Possibilities include one-on-one training, classroom scenarios, and management coaching. You don’t need to provide all these options or offer them to all employees, but the smart move is to offer some in-house training to those employees you want to keep or groom for promotion.

Local Seminars

More general business training is available in the form of local seminars. These are usually half-day or full-day events. And since they’re local, there’s little expense beyond the registration cost. Not only do these provide important skills your staff can apply to their work, it’s also a way to increase their job satisfaction and enhance their self-esteem.

Industry Events

Don’t forget industry conferences and conventions. These include both those that are healthcare related and those that are call center related. If they cover both, that’s a bonus. These opportunities, of course, are more expensive. Registration for conferences and conventions carry a higher fee then local seminars, plus there’s also travel costs involved, which can add up. Therefore, reserve attendance at industry events for employees in management or on a management track.

Formal Education

Next on our list is post-highschool education, usually through college courses. Though this can be towards degree fulfillment, a better solution is to pick specific classes that will directly benefit your call center. Be sure to look for opportunities to audit the class. Although this won’t result in any credentials for employees, it could reduce or eliminate the cost for the class.

For these last three options, formal seminars, industry events, and formal education, you may want to ask participants to report what they learned to their colleagues. This has three benefits. One is that it reinforces what they learned. The second is that it allows others in your organization to also benefit from it. Third it enhances the employees’ self-esteem.

Develop a Career Path

To further enhance the value of these learning opportunities, integrate them with a career path for employees who you feel have the potential to advance in the organization. This includes both those who you see in various future supervisory roles, as well as managerial positions and support staff functions. When employees see the potential that awaits them from these learning opportunities, they will stay with your organization longer and provide increased value while they’re there.

The Benefits of Providing Learning Opportunities for your Staff

Not only will these learning opportunities extend staff retention, they’ll also increase job satisfaction and improve performance. However, most importantly, as you train employees to do more, they become a more valued resource for your healthcare call center.

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.