Category Archives: Articles

Articles from AnswerStat

Unify and Simplify Communications in Your Organization

By Nicole Limpert

Did you know that the average hospital has relationships with more than 1,300 different vendors? Tools and technologies from various vendors are often disconnected and difficult to manage—even communication solutions meant to streamline workflows. Healthcare leadership may not realize that the software and apps used by their call center can help unify and simplify communications throughout the entire organization.

Call center operators are the information hub for patients, medical personnel, and other stakeholders. Agents access data from multiple sources via highly interoperable omnichannel hospital contact center software and apps that work together as a single solution.

This article examines three scenarios where a hospital’s contact center platform helps to unify and simplify communications related to on-call schedule management, secure messaging, and automation.

Unify On-Call Schedules and Communication

Hospital on-call schedules are complex. Miscommunications and delays can be disastrous for patients and health systems. An article from StatPearls entitled Medical Malpractice notes, “Weekends, holidays, and nights are a particularly treacherous time for physicians because of a lack of communication: Many lawsuits are filed because the physician covering the weekends, holidays, or overnight failed to communicate.”

When supervisors at Providence Swedish in Washington State noticed an uptick in errors related to nighttime on-call communication inefficiencies, they discovered the issues stemmed from an outdated, disconnected system. “We had our on-call schedules in several different scheduling platforms from three vendors,” says Brenda Frieboes, on-call manager for Providence Swedish. “There wasn’t a way for a general announcement to go out when a provider had a schedule change.”

After updating to a comprehensive contact center platform with an integrated on-call scheduling solution, staff at Providence Swedish can now instantly contact the correct on-call personnel via their desired contact methods. Updates are sent in real time via automated notifications, and a complete audit trail is kept of all schedule updates for custom reporting.

Medical professionals are dedicated to patients, but being on-call can be exhausting—and dangerous to staff and patients if not managed correctly. Organizations today are focusing more on their staff’s mental health and well-being. Schedule flexibility plays a significant role in combating burnout, recruitment, and retention.

Robust on-call scheduling software helps to ensure on-call assignments are mindfully assigned and provides useful management features such as:

  • Advanced notification of unfilled schedules
  • Accessibility for staff to enter and update their own schedules
  • Adding on-call schedules to personal and mobile calendars
  • Automated, real-time updates
  • Integration of on-call schedule information with a secure messaging app

Simplify Critical Communications with Secure Messaging

Mountains of crucial healthcare data need to be communicated on a daily basis. Healthcare personnel can become overwhelmed with the number of notifications they receive for these critical communications. Studies have revealed that clinicians can receive more than one hundred alerts per day.  Unfortunately, well-intentioned tech can add chaos, increase bureaucratic tasks, and complicate communication. Integrated secure messaging apps can help organizations consolidate alerts and harness data to improve the flow of communication, better care for patients, and reduce alarm fatigue.

When using an integrated secure messaging app, data from EMR HL7 messages, ADT messages, smart beds, nurse calls, appointment desks, diagnostic communications, and housekeeping can be instantly sent to appropriate staff via technology already used by the organization—such as Vocera badges or IP phones from Cisco—or personal devices. The number of devices staff carry can also be reduced when direct notifications from different platforms are routed to a single smart device.

HIPAA-compliant secure messaging apps offer a lot of flexibility by enabling staff to easily share texts, photos, videos, or voice recordings via mobile phones, smartwatches, tablets, laptops, and desktop computers. Timestamps indicate when messages were delivered, read, and completed.  Administrators have access to full reporting for every message sent to ensure follow-through and accountability for all messages.

Automate Notifications and Organizational Processes

Errors are not about the people who make them; they are about the process. Automated processes help reduce mistakes and time-consuming administrative tasks. Automatic notifications are instantly sent to staff for everything from emergencies to hospital bed turnover, and even everyday reminders.

Integration engines that are built into the contact center software facilitate the exchange and sharing of information. More efficient workflows can be established when seamless communication improves processes. “We automate our nuclear medicine program and procedures using our call center software,” states Alicia Wise, former IS project coordinator for AnMed Health in Anderson, South Carolina. “When a patient is scheduled for a test, the information needed by our isotopes vendor is sent automatically. This automation speeds up the process for the patient, generates revenue for our organization, and saves any costs that would have been incurred if the process was put on hold or standby because of communication delays.”

Telephone outages, power outages, and natural disasters can happen suddenly and unexpectedly. Organizations that involve their contact center in their disaster response and business continuity plan know communication failure is not an option. Automated contingency communication plans ensure seamless operations during a disruption with:

Web-based notifications: Browser-based mass notifications enable operators to create, edit, and trigger alerts from virtually anywhere to contact the appropriate personnel in crisis situations.

Hosted emergency access: Hosted emergency access service provides a fast and easy failover system at a secure, geographically separated location. Automatically maintain essential call-handling functions during a telephone outage, power outage, or natural disaster.

Network and systems backup: Network backup provides the ability to have a live standby server in place with a current database. The automated Windows system backup tool schedules routine data backups.

“In the event any of our clinics has a power outage, their calls automatically roll to us at the contact center. So, we provide our organization with an invaluable strategic service. We have a lot of plans in place, and we’re always prepared,” states Rossi Fraenkel, business team lead for Allina Health in Minneapolis, Minnesota.

A healthcare system’s core business is patient care. When communications are unified, simplified, and automated, it helps medical personnel focus more on their patients.

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

This Healthcare Tool Can Empower Staff with Medical Message Intake

By Ravi K. Raheja, MD

The healthcare industry continues to suffer a labor shortage that could have considerable long-term effects, with some estimates showing the United States could have a deficit of 124,000 physicians in the next decade. But finding enough doctors and nurses isn’t the only concern. Practices are also experiencing difficulty maintaining nonclinical staff for their medical message intake. These positions—either at the front desks of practices or in medical call centers—are going unfulfilled due to the demanding nature of their roles. The good news is that technology offers a solution that can entice more people to apply for these positions and train them quickly.

Changes in Healthcare Since COVID-19

It’s no secret that the pandemic took a heavy toll on the healthcare industry. It expedited the transition to telehealth services for many providers, led to widespread physician and nurse burnout, and caused many patients to question their health symptoms and whether or not they should seek in-person care. Furthermore, nurses shifting to higher-paying travel positions also added another layer of complexity to practice staffing issues.

Now, even with COVID-19 considered endemic and many workers getting reaccustomed to in-person care, the healthcare community is still trying to find the resources and staff members needed to maintain or scale their services.

These staffing concerns have trickled down to nonclinical front desk workers who are having to pick up some of the slack involved with patient documentation and medical message intake. They have to be able to help patient callers by relaying messages about their symptoms, as well as assist patients who are physically present for evaluations. However, because they aren’t medically trained, these front desk workers can easily miss symptoms that indicate when these patients’ cases are more severe than they’re letting on. That’s where technology solutions like MedMessage Assist can serve them best.

A Technology Solution for Medical Answering Services

To ensure they don’t miss any details, nonclinical operators such as front desk workers can use MedMessage Assist (MMA) as a real-time symptom-analysis tool when completing their medical message intake. Developed by TriageLogic, this program utilizes augmented intelligence to review the text that workers type while they’re listening to patient callers. When it identifies a symptom that could indicate a more severe condition, it generates follow-up questions to ask the patient. With an accuracy rating of over 99 percent, MMA ensures that when the message is relayed to a triage nurse, it has all the information needed to correctly identify patient concerns as nonurgent, urgent, or emergent.

MMA also establishes a means of streamlining patient calls so that front desk staff members can effectively manage patients, both over the phone and in-person. In turn, this decreases medical malpractice liability, as it avoids the potential for lawsuits like this one, involving a Wisconsin doctor who faced a malpractice lawsuit for not returning the phone call of a patient who later died. Implementing MMA can significantly enhance the overall patient experience and reduce legal risks for healthcare providers.

Finally, MMA empowers nonclinical operators with confidence for handling patient calls, recording accurate messages, and balancing their time with other priorities. This improves employee retention and can also be a hiring perk for future nonclinical applicants. Furthermore, this solution includes self-guided training, which reduces the onboarding period for new operators by up to two weeks.

See How MedMessage Assist Can Work for Your Organization

MedMessage Assist operates as a stand-alone module or can be integrated with existing software in order to improve the accuracy of your practice’s medical message intake. It also comes with high-level cybersecurity and meets all standards of HIPAA-compliance.

If you’d like to see how it can benefit your practice, contact us today to schedule a demonstration.

Ravi K. Raheja, MD, is the CTO and Medical Director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC-accredited, physician-led provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. Their comprehensive solutions include integrated mobile access and two-way video capability. The TriageLogic group serves more than nine thousand physicians and covers more than 25 million lives nationwide.

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

Six Keys to Produce a Happy and Effective Workforce

Address These Critical Items to Better Retain Staff and Serve Callers

By Peter Lyle DeHaan, PhD

Operating a successful call center in the healthcare industry is hard. There is a never-ending tension to balance the expectations of patients and callers with the needs of operational staff, all the while remaining fiscally viable.

Here are six tips to help you produce a happy and effective workforce to keep your operation running smoothly and efficiently.

1. Compensation Package

I’ve never talked with anyone who thinks they’re overpaid. And only a few people ever think they receive appropriate pay. Most think they deserve more.

Ask any call center employee what’s most important to them in their work, and they’ll likely say their compensation. They work to earn money so they can cover their needs and wants. Though their actual paycheck is a big part of their compensation package, they’re also looking for other benefits such as healthcare coverage and provisions for time off, including vacation, sick days, and personal time.

Though you could bust your budget trying to provide the compensation package your employees think they deserve and expect you to provide, you don’t need to do so if you address other, less tangible workplace-related items.

Providing a competitive compensation package, along with covering the next five items, will help you produce a happy and effective workforce.

2. Managerial Support

Employees want to feel the support of their supervisors and managers. This starts with listening to what they say and showing them you care.

Let them know you understand what it’s like to answer phone calls all day long. You do know this, right? When they see you periodically sit down and take calls like the rest of them, it will do much to garner their attention and gain their respect.

3. Appreciation

Most managers say they appreciate their staff. But how often do they take the time to actually tell their employees? How often do they do things to show it?

This doesn’t need to be anything expensive or spectacular. I once had a boss who each payday would look me in the eye, hand me my paycheck, and say, “Thank you.” He did this for every employee. I was often frustrated with him in other areas, but I had no doubt he appreciated me and my work. Though this might be hard to implement if your call center operates 24/7, look for creative ways to produce the same results. And if your staff receives their pay and documentation electronically, look for other opportunities to make eye contact and sincerely say, “Thank you.”

4. Scheduling

Appropriately staffing a call center is a tricky issue. You need to have the right number of people working to efficiently handle the calls and other communications that come in. If you don’t have enough people present, those who are there will end their shift exhausted, frazzled, and frustrated. Yet if you have too many people working, your labor costs will escalate, and you’ll be over budget. Seek to find a scheduling balance that doesn’t overwork your staff or tax your budget.

When developing a schedule, be considerate of the needs of your employees. If they rely on public transportation to get to work, don’t schedule them on days or times when they’ll have trouble getting to work or making it home. If they go to school, be sure to work around their schedule.

5. Workload

Call center employees who move continuously from one call to the next throughout their entire shift are less likely—and less able—to give their best to every caller every time. They’ll soon grow immune to the number of calls in queue and plod through their day from one call to the next. However, if they have too much idle time between calls, they’ll become bored, and their focus will wane. This doesn’t provide for good customer service either.

Instead, strive to develop a schedule that will give your call center staff a balanced workload that is just right—neither too busy nor too slow. It will make their shift go by quicker and produce better results.

6. Shared Vision

This final item is by no means the least important. In fact, when you and your call center staff share a compelling vision about what you’re doing and what you want to accomplish, the first five points on this list become less important. This doesn’t mean you can ignore those items, but when you have a shared vision with your staff, they may be a bit more open to overlooking shortcomings in other areas.


Though it takes work to produce a happy and effective workforce for your call center, it can happen. Follow these six tips to move you closer to achieving that goal.

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.

Case Study | Providence Swedish

Improving On-Call Communication Delays and Code Call Workflows with Web-Based Platforms

By Nicole Limpert

Swedish Health Services was founded as Swedish Hospital in 1910 by an immigrant from Sweden named Dr. Nils August Johanson. Over the years, the campus expanded and merged with other health systems to become Swedish Health Services. It is the largest nonprofit health provider in the Seattle metropolitan area, with five hospital campuses, two ambulatory care centers, and a network of more than one hundred primary-care and specialty clinics.

Swedish Health Services merged with Providence Health & Service, one of the largest health systems in the country, in 2022 after working together for ten years to provide comprehensive care across Western Washington state. The Sisters of Providence founded Providence Health & Services in 1859 as a nonprofit Catholic healthcare system. The health system expanded to include more than fifty hospitals, eight hundred-plus non-acute care facilities, and many assisted living facilities.

Their newly branded organization, Providence Swedish, provides an array of care throughout the Puget Sound region. Their system of eight hospitals and 244 clinics employs more than 2,200 providers and 22,000 caregivers. Providence Swedish delivers the most comprehensive healthcare service in Western Washington, providing care for 1.2 million unique patients annually.

Identifying Healthcare Communication Inefficiencies

Providence Swedish is committed to protecting its patients and has a rigorous quality and patient safety program. Staff submits a “Quality Variance” to their supervisors if an unexpected incident or event occurs that is inconsistent with the organization’s standards. This process results in service reports internally known as eQVR.

This dedication resulted in the First Hill and Cherry Hill campuses earning the highest hospital safety grade of A in 2022 from the Leapfrog Group in their biannual Leapfrog Patient Safety Survey. These campuses were recognized for success in protecting patients from harm and error.

Research indicates that poor communication among healthcare professionals is a leading cause of patient harm. In one study that examined healthcare communication flows, Improving Patient Safety Through Provider Communication Strategy Enhancements, researchers cited that time spent searching for and contacting appropriate providers (a.k.a. “problematic time”) was a crucial communication issue. “As data collection progressed, it became apparent that ‘communication events’ were complex and included time spent ‘hunting and gathering’ for the correct information related to whom to call, how to best contact them, and what to do when the primary person was not available. On average, ‘problematic time’ consisted of 10 to 40 percent of total communication time . . .”

The study’s results found that taking action to enhance teamwork and communication is crucial in preventing unfavorable patient outcomes. Taking action is exactly how leaders from Providence Swedish responded when they identified a communication weakness in their on-call system.

Supervisors at Providence Swedish noticed an uptick in eQVRs related to nighttime on-call providers failing to return calls or pages about patients. The eQVRs were escalated up the chain of command. It was discovered that communication breakdowns and delays were happening due to how updated on-call schedules were handled by the on-call system.

“We had situations where a provider may have a last-minute schedule change, an after-hours availability update, or needed to change their preferred method of being contacted,” said Brenda Frieboes, on-call manager for Providence Swedish. “The previous process for communicating those changes was for the providers to contact the call center and inform an operator. However, the only thing a hospital operator could do at the time was to take a message and put it in their ‘notes of the day’ system. There wasn’t a way for a general announcement to go out. That meant a nurse on the floor wouldn’t know about a schedule change unless they happen to contact the call center looking for help because they couldn’t reach a provider.”

Improving On-Call Communication and Response

Elizabeth Wako, MD, chief executive for Swedish Seattle, initiated the process of searching for a new on-call scheduling platform. She tapped the call center manager at Providence Swedish to find an advanced on-call scheduling system that could handle the roughly two hundred schedules that needed to be managed.

Brenda explained, “We had our on-call schedules in several different scheduling platforms from three vendors. The web program we used hosted every link for every schedule, both for the landing page and for the schedules themselves.”

The team needed an accurate on-call scheduling solution that made it easy to create, view, and update schedule coverage with the ability to easily dispatch messages to on-call contacts using their preferred method of communication. Brenda said, “We literally called around to different hospitals to see what system they used, and we became aware of the vendor we chose.”

The new on-call scheduling solution offered many benefits, including several that addressed the needs of the team, such as:

  • Advanced notifications about unfilled schedules
  • The ability for departments and clinics to enter and update their own schedules and add them to personal and mobile calendars
  • Automated real-time updates

Staff who needed remote access to their schedule could do so via the internet using the vendor’s mobile-friendly care team collaboration application to:

  • Access and view their on-call assignments and assign or request their own on-call assignments
  • Swap shifts with one another
  • Display information about on-call assignments for selected roles

Enhancing Patient Safety with a Frictionless Code Call System

When the call center team at Providence Swedish began the process of finding a new on-call scheduling system, they also decided to update their hospital phone operator console with a more robust platform that could better handle the roughly 2,500 calls they receive each day and to improve the code call process.

Brenda explained, “Providence Swedish has many different locations, and our hospital operators had to manually process code calls from each location using code sheets. For example, if someone from our Cherry Hill campus called a code stroke, operators had to write down the information, pull a Cherry Hill stroke form specific to their campus versus one from another site, and then call the code. There were about one hundred different code sheets for all our campuses. Depending on the code, this manual process could take up to two minutes each. We needed a system that could dispatch codes automatically.

“Providence Swedish wanted an operator console that could work enterprise-wide to guide agents through code calls and quickly dispatch to the correct location with a system that also tied into the on-call software. Our team also chose the vendor’s operator console,” said Brenda. “The vendor’s contact center software and widget-based care team collaboration app we use to manage on-call schedules can speak to each other. The codes are now dispatched through the system, which met all our needs.”

The scripting component of the operator console is fully customizable to efficiently guide operators through any type of call, including complex code calls. Scripts are preprogrammed into the call center software to ensure agents ask pertinent questions, provide the right answers, and direct calls to the appropriate person, department, or campus. Once the scripts have been programmed into the system, the call center agents simply read the prompts and follow the script.

Code calls can be incredibly stressful, and accuracy and speed are critical. Using the console system along with the app helps to:

  • Reduce operator errors
  • Improve efficiency for a better patient experience and outcome
  • Contact the correct on-call personnel
  • Provide detailed reporting analytics

“Now, when a code call comes in, it rings to an available operator, they select which campus, the code, and input any additional info needed into the fields to make the overhead announcement. It’s ‘click, click, click’ and they’re done,” Brenda said. “We dispatch between one thousand to twelve hundred codes a month from all eight of our hospitals, and most of our codes are dispatched in under a minute now. Dispatching our codes through this new system versus pulling the code sheet has significantly decreased the number of serious safety events.”

There are plans to introduce more automation and take advantage of the care team collaboration app’s interoperable capabilities. Currently, if a code STEMI comes through, the operator must navigate to the on-call schedule page to find and contact the on-call doctor. Soon, when the cardiology schedules are fully rolled over to the app and the operators dispatch a code STEMI, the system will automatically pull the STEMI doctor’s name, contact information, and notify that provider.

“We’re also working with the neuro-hospitalist team to complete an integration with the app and a notification application used in the ED,” said Brenda. “When a code stroke or code STEMI occurs, AMR (American Medical Response) calls from the field to notify the emergency department that they are bringing in a patient who is having a stroke. That sends a notification to the call center about a code stroke coming in. Currently, if our call center doesn’t hear from the ED within five minutes to initiate a code, an operator calls the ER to ask if a code stroke should be initiated. In this situation, time is obviously of the essence. We want to improve that process by using the information from the ED application to automatically notify the appropriate teams if there’s a code stroke that requires intervention.”

Implementing and Using the New Systems

Coordinating and implementing new software can be challenging for a system as large as Providence Swedish. While the hospitals will update their on-call scheduling platform to the care team collaboration app, hospitalist groups and other departments can decide to keep their current system. The entire organization is closely watching the project to see how it’s done and how successful it proves to be.

Brenda and her team began with a pilot group to train and roll over their schedules to the system. The providers, caregivers, nurses, and technicians who were involved all got twenty-four-hour access to their schedules via a QR code they scanned. When other departments saw the results and how easy it was to use, they were also interested in the care team collaboration application.

“Nuclear medicine and others wanted their schedule online too, so I’ve built quite a few new schedules for groups and departments who didn’t have online schedules before,” said Brenda.

Providence Swedish also has groups from a polyclinic with Kaiser Permanente Washington that admit patients to Providence Swedish hospitals. In the past, Providence Swedish providers would call Kaiser Permanente and speak with a polyclinic operator. The agent would connect the doctor from Providence Swedish and the doctor from Kaiser Permanente for a patient consult. These extra steps occurred because Providence Swedish operators could not access the polyclinic’s on-call schedules. Now the Kaiser polyclinic staff have their schedules online, making it much easier to find the information they need via the app.

Brenda continued, “More schedules than ever before are coming online and are easier to access. Plus, it’s direct access to the providers instead of going through an answering service or another switchboard. This is one of the huge benefits of the on-call schedules. I can build as many as I need with as many shifts listed per day as needed. The hospital schedules forty shifts a day. There’s really no end to what we can do or who we can accommodate as far as an on-call schedule. We’re already seeing the benefits of this program.”

Change can be intimidating to staff who are used to doing things in a certain way. However, once new users try it, they report it’s surprisingly easy to use. “The care team collaboration application is user-friendly,” said Brenda. “To be able to sit down and look at it, and then figure out how to do something with a program you’re not familiar with within a few minutes—if that isn’t user-friendly, I don’t know what is. When we were rolling out in the early stages, I had some difficulty getting the groups to enter their schedules for the next month into the app. I’d send a reminder and promise it would only take them a few minutes to complete. Then, I’d suddenly receive a message back a half hour later saying it was so easy that they got the next three months done!”

Brenda continued, “It’s better compliance to have schedules completed promptly. Before using this process, I would have to look at every schedule the week before they were due, and I’d have to email staff about it and offer to post it for them. That scenario has dropped considerably and made my job a lot easier. Now, staff gets their schedules completed on time.”

Customizable, Flexible Communication Software for an Evolving Industry

The United States doesn’t have a uniform health system. This means each organization or even department within the same organization operates in its own unique way and has particular needs regarding technology.

Operating systems used by healthcare have to be customizable and flexible to meet the needs of an industry that is embracing new tools to modernize internal systems. “We’ve had a lot of asks of our vendor, such as needing a customized single sign on process that our IT security wanted, the appearance of the on-call schedules, and tweaks to the software to make it work better for us,” said Brenda. “Their staff has always been very good at accommodating our requests or taking time to code something we need to work a certain way. I know that I can take any question, any ask to them, and it will be looked at and taken seriously.”

While health systems are trying to cut costs, they still must solve efficiency problems to address staff needs and better serve patients. Newly purchased technology should be an investment that can serve an organization with its present and future needs. “I personally wanted this vendor’s operator console and care team collaboration app. I was glad it met the hospital operator’s needs and was chosen,” said Brenda. “I fill in for the agents sometimes, and I liked it because it was a program that would grow with us. In five to ten years, we won’t be doing this process again. We’re not going to be looking for a new on-call scheduling platform or a new operator console system because our vendor will be able to meet our needs, as I see it, for the foreseeable future.”

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

Nurse Triage for Morbidity and Mortality

Save Lives and Lower Healthcare Costs

By Ravi K. Raheja, MD

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

Why Patients Delay Care

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

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

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

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

Benefits of Nurse Triage

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

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

Nurse triage should include:

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

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

Morbidity and Mortality Examples

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

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

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

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

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

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

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

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

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

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

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

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

Reduce Morbidity and Mortality Rates

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

Ravi K. Raheja, MD is the CTO and Medical Director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC accredited, physician-led provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. Their comprehensive solutions include integrated mobile access and two-way video capability. The TriageLogic group serves over 9,000 physicians and covers over 25 million lives nationwide.

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

Call Center Stakeholder Integration

Connect with Critical Groups Who Often Go Overlooked

By Peter Lyle DeHaan, Ph.D.

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

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


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

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

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


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

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

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


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

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

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

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


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

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

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

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

By Ravi K. Raheja, MD

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

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

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

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

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

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

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

So how can augmented intelligence improve medical message intake?

Analyze Data Recorded by Your Operators

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

How big of a difference that could really mean?

By the Numbers

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

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

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

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

Additional Benefits

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

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

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

Improve Medical Message Intake with a Free Trial of MMA

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

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

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

Gamification in the Contact Center

By Nicole Limpert

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

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

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

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

The Benefits of Using Gamification in Your Call Center

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

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

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

Call center metrics that can be gamified include:

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

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

Gamifying Contact Center Metrics

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

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

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

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

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

Creating a Call Center Gamification Strategy

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

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

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

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

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

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

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

Embracing Digital Transformation

Enhance Member Support in the Changing Landscape of Healthcare

By Mark Montgomery

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

From Crisis Response to Patient-Focused Approach

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

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

Facing An Array of Challenges

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

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

Several significant factors contribute to these challenges:

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

Put Patients First

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

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

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

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

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

3 Reasons Why Triage Nurses Need to Train with Simulated Patients

By Ravi K. Raheja, MD

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

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

1. Simulated Training Improves Nurse Confidence and Patient Outcomes

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

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

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

2. Simulated Training Improves Muscle Memory

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

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

3. Simulated Training Offers a Wide Range of Scenarios

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

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

AI Training with Simulated Patients

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

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

How does a nurse training module accomplish these outcomes?

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

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

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

Nurse Triage Training

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

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

Founded in 2007, TriageLogic is a URAC accredited, physician-lead provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. Their comprehensive solutions include integrated mobile access and two-way video capability. The TriageLogic group serves over 9,000 physicians and covers over 25 million lives nationwide.