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Articles from AnswerStat

Do Your Call Center Employees Believe They Receive Adequate Recognition?

By Mike Hill

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

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

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

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

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

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

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

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

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

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

LVM Guest Column

Using Technology to Support A Strong Patient Access and Retention Strategy

By Mark Dwyer

Today, interoperability and integration are standard must-haves for successful healthcare contact center software. Healthcare systems must provide a contact center solution that utilizes multiple channels to deliver accurate answers and quick responsiveness. Customers now expect this level of service and seek out organizations that provide it.

Let’s first look at the benefits interoperability offers. Many older customers remain most comfortable with traditional face-to-face, email, or phone interactions with their healthcare providers. Consequently, these communications methodologies remain critical.

However, hospitals must embrace new, interactive technologies to capture today’s Millennials and Gen Z healthcare consumers. These customers prefer to chat, group text, receive secure messages, and interact with a dynamic self-service web app. The interactive technologies you use may determine the future success of your patient access and retention strategy.

We begin by looking at one of the tactically strategic components, the user-friendly, self-service web app. This outreach tool should include quickly accessing subject-relevant topics and current health information. It must also provide the ability to self-refer to an appropriate physician.

Data about the physician should include demographics, insurance eligibility, and procedural payment estimates. When using the self-service web app, consumers also need the ability to register for classes, screenings, and any available population health programs. In addition, a quality, healthcare self-service web app should support hospital/patient transfer and marketing outreach programs. Finally, it must also support real-time, bi-directional chat capabilities.

Other interoperable technologies such as secure messaging, group texting, and an integrated answering service function also are critical in a healthcare contact center.

For example, sending personal health information to a patient about upcoming hospital procedures or needed follow-up requires using an encrypted, secure messaging portal. In addition, often, when serving elderly patients, the ability to group text to the patient, their caregiver, and out-of-state family members reinforces your patient/hospital bond.

This technology will reduce the elderly patient’s need to be the historian of their information. In addition, offering an integrated answering service option to your on-staff providers improves their relationship with your patients and your organization.

Having discussed how an interoperable solution can improve your patient access and retention strategy, let’s discuss how system integration through data sharing across multiple entities further enhances your efforts.

Sharing data between the hospital’s contact center and other shareholders depends on the ability of the contact center software to ingest data from multiple data sources. Today, customers expect that all participants in their healthcare journey have access to their cumulative health history.

Successful contact center solutions address this expectation from the very beginning. Examples include:

  • Use phone integrations to receive a notification when a call comes in and automatically populate the caller information based on the phone number while simultaneously starting a transaction.
  • Integrate your hospital Electronic Medical Record (EMR) with the contact center to provide the nurse access to additional health information.
  • Send messages from your EMR to the contact center application to initiate smart actions with your clients, customers, or patients. For example, upon discharge, the software can assign follow-up calls to conduct satisfaction surveys and verify that the patient saw the referred to physician, filled any prescribed medications, and took them as directed.
  • Create post-op messages to trigger the software to notify caregivers of any next steps. 
  • Use HL7 triggers to create limitless possibilities for interactions and data exchanges.

Another vital component of a patient access and retention strategy is to use customer relationship management (CRM) campaigns to mine your contact center’s transactional and demographic databases to target appropriate customers for applicable programs and services.

Look for a contact center system with CRM capabilities built into the software, preferably with cross-marketing codes visible during the call. These codes enable contact center representatives to find other relevant programs for the caller, increasing the available service offerings.

Last, but certainly not least, is the need for a healthcare contact center solution that can measure your patient access and retention system’s value to your organization’s bottom line. Access to the wealth of data described above should enable you to generate extensive ROI (return on investment) reporting through the contact center’s real-time data analytics. Use this information to fine-tune your strategies to better align with organizational goals.

So where does your healthcare contact center stand? Are you out front leading the industry, at the back of the pack, or somewhere in the middle?

Wherever your contact center ranks, you can strengthen your patient access and retention strategy by implementing these components in your healthcare contact center.

Mark Dwyer is the COO at LVM Systems.

Scripting Helps Hospital Call Center Manage 850,000 Calls per Year

By Nicole Limpert

One of the United States’ oldest pediatric hospitals, recently recognized by the News and World Report, and named one of Healthcare’s “Most Wired” for several years for their dedication to leading the way in children’s health through technology and innovative research, receives thousands of calls every day.

Calls from worried parents concerned about their child’s health to specialists looking to connect with other experts through the Physicians Priority Link. Managing all of these calls every hour of the day, 365 days a year, is the Customer Connections call center in the hospital’s Access Services Department.

Customer Connections handles 850,000 calls per year from people nationwide—with as many as 4,500 calls in one day. With only six or seven operators on the phones simultaneously, the Customer Connections call center must be highly efficient, organized, and accurate to route the calls to the right person immediately.

Call Center Software Is Key

This small but dedicated team handles several types of calls: general incoming calls to the hospital, direct-to-department calls, after-hours answering service, and physician-to-physician consults. They also manage contacting the Medical Response team.

Customer Connections has been using its communication software to handle these calls since 2006. “Our call center software does everything we need,” says the access services manager. “We haven’t found another platform that does everything. It’ll route your calls—plus you can do scripting. The flexibility of the system is the beauty of it. Whenever a department requests that we support them, we build a script. To me, the script is the best thing. It 100 percent keeps us from making errors.”

An individual operator averages 450 calls daily, with no two calls being the same. The organization uses its scripting software to automatically detect call flow and determine the scripting options based on the hospital’s protocols, ensuring that the correct information is gathered and communicated.

The Customer Connections team at this Midwest hospital regularly creates custom scripts for the many departments whose calls they handle. Scripts significantly reduce the time needed to train operators to answer and route calls for new departments. They also help operators manage tense situations, such as emergency calls, which helps the callers and operators feel more at ease and ensures that medical response teams receive sufficient information.

“We’ve got multiple departments that have departments within departments, and so the scripting can get quite involved, but it’s what saves us,” explains the manager. “We support so many departments and take so many different phone calls that there’s no way we could do this job accurately without the scripting.”

Agent Scripts Save Time and Reduce Errors

Accurate and easy-to-follow scripts are essential, with phone calls averaging 8-10 seconds. A staff member was hired and trained to build, write, and maintain the scripts. The team’s scriptwriter makes customized scripts for any type of call (even emergencies) in as little as 20 minutes by using the drag-and-drop scripting tool and easily edits phone numbers, doctors’ names, and any other custom information as requested by the departments.

Keeping these scripts up to date helps reduce operator errors, improves efficiency, ensures professional call handling, and provides accurate information.

The access services manager further states, “The script building is a lifesaver, and we do it all ourselves. Our script writer is the ‘who’s on-call’ guru for the hospital. He is what makes this department go.”

Remote Access

The Customer Connections team maintained its high call volume when the operators moved to work remotely from home. All the operators needed were phones, headset adapters, and computers loaded with the call center software.

They can sign in from anywhere and work remotely because the software enables any computer to act as a fully functioning, professional operator workstation, just as if they were working from the call center. They still reached all their goals for call-answering time, hold time, and other audit scores.

Physician Referral Capability

The ease with which the Customer Connections department handles the wide variety of calls—especially the Physicians Priority Link (PPL)—has captured the attention of other hospitals that want to implement a similar physician-to-physician referral line.

“I get a lot of calls from different hospitals asking about PPL, how we take the information, and what we do with it,” says the Access Services manager. “I’m always surprised when I realize their software doesn’t allow them to do the scripting and take messages.”

Customizable Scripts

Agent prompts, lookups, and navigation can be customized and built into database-driven call scripts that automatically guide operators through:

  • Main number calls
  • Patient and medical staff appointments
  • Physician referrals
  • Nurse triage
  • Patient transport
  • Code calls
  • Paging
  • Physician answering services
  • Prescription renewals
  • Scheduling
  • Consultations
  • Admissions
  • Complex care calls
  • Crises and emergencies
  • Facility directions
  • Messages for physicians, staff, and departments
  • Patient satisfaction surveys

The look and function of the attendant console are also customizable, and various locations or departments can use assorted colors or layouts to reduce communication errors. Color-coding helps agents instantly identify call types, and time-of-day and day-of-week messaging and dispatching ensures the correct navigation script and dispatch options are displayed.


When a phone call is one of the first personal connections a patient makes with a hospital, the operator’s ability to handle the call professionally and accurately plays a prominent role in the patient experience. In support of this hospital’s vision to lead the nation in innovative technology and continued improvements in patient care, the Customer Connections department excels at answering and routing all calls correctly and efficiently. 

Nicole Limpert is the marketing content writer for 1Call, specializing in offering enterprise-wide communication solutions for healthcare organizations.

Integrate Call Center Staff

Pursue Agent Cross Training to Produce Better Outcomes and Improve Efficacy

By Peter Lyle DeHaan, Ph.D.

In my article “Integrate Your Call Center” I discussed various integration strategies to pursue. Now I’ll dive into each one of them with more intentionality. First up is to integrate call center staff.

The key requirement to staffing integration is cross training. Cross training will improve efficiency, increase employee skills, and better serve callers. Cross training also moves your operation closer to FCR (first call resolution), which produces both caller-centric benefits and improved operational outcomes.

Here are some ways cross training can take place:

Channel Cross Training

Many people use the phrase call center, and we all understand what it means. A better label, however, is contact center. This reflects that we no longer process just calls, but contacts. These various forms of contact come to us on different communication channels.

The most common communication channel is voice, as in the telephone. It is ubiquitous and will continue to serve a vital role in our contact center.

Text chat emerges as another critical channel with increasing acceptance and use. Many customers persist in texting even when reverting to a phone call would more effectively meet their objective, both in terms of accuracy and timeliness.

Email communication is another channel. Some rely on it completely and expect contact centers to provide that option.

Social media is a fourth channel that is the default for some, even though it’s not always ideal for healthcare scenarios. And there are other possible channels.

The goal of channel-cross training is to have all operators adept at all channels. Though some may specialize, they need to know how all channels work and be able to function efficiently on each one. This allows you to integrate call center staff and have them move between channels as needed, either according to schedule or on demand.

Call Type Cross Training

The second type of cross training relates to call types. For example, an agent who focuses on taking messages, should also be able to schedule an appointment or take a class registration. Or an agent who functions as a receptionist and spends all day transferring calls, also needs training on other features to better meet caller needs.

Without cross training, patients and callers can easily bounce around from one agent to another based on employee specialty and training particularity. With cross training, however, one agent can address whatever need the caller may have. They could take a message for the doctor’s office, register a patient for a class, and cancel an appointment, all before transferring them to a different department—assuming that’s needed.

Call type cross training allows you to integrate call center staff more fully.

Cross Training Pitfalls

Yet not all cross training is wise. So use common sense when you integrate call center staff. Though you don’t want a highly paid nurse taking a message for billing, there’s no harm in them doing so. Yet you don’t want non-medically trained personnel addressing a patient’s questions about a healthcare concern. This is a disservice to the patient, will likely provide misinformation, and could result in a lawsuit.

Therefore, encourage agents to have a patient-first perspective and seek to help callers in every way possible, while at the same time communicating clearly their limitations.


Embarking on an intentional and robust cross training initiative will help you to fully integrate call center staff. The goal is that, within reason, any employee can help any caller on any request through any channel.

When you do this your patients and callers win, your contact center becomes more efficient, and your agents increase their value to your organization.

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

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

Spotlight on LVM Systems

LVM Systems Releases LVM One v1.5 

LVM Systems announces the release of version 1.5 of its flagship LVM One healthcare contact center solution. For the past thirty-four years, LVM has served the healthcare contact center industry, establishing a reputation for quality software, robust functionality, unwavering customer support, and industry-leading product customization.

LVM offers healthcare organizations an installable desktop solution, a web-deployable Web application, and an option to either host the software on LVM’s Virtual Call Center (VCC) running on Azure or directly on a locally hosted Azure network.

The desktop version offers many options for system administrators to customize the software. In addition, development customizations are available to meet unique client requests to address organization-specific business opportunities. Using the web version provides a lightweight, secure, and convenient way to handle many day-to-day contact center activities using customizable, unique workflows.

The desktop and web versions enable staff to monitor their active calls and follow-up queues, pull system reports, and report on valuable contact center information. LVM’s solutions support both clinical and marketing functions.

Clinical functions supported include nurse triage, patient transfer, behavioral health intake & assessment, population health, disease management, care coordination, and post discharge follow-up. Below are descriptions of two solutions LVM offers as part of the integrated solution or as stand-alone products.

Patient Transfer

LVM’s Patient Transfer solution allows organizations to manage the activities and communications critical to this patient acquisition function. The LVM Patient Transfer function supports improved call flow while tracking numerous customizable data points. It also enables staff to streamline and track the sequence of communications needed to find available physicians, locations (hospitals, rooms, beds), and transportation services.

The Patient Transfer solution enables staff to send direct messages to each other using an optional component. It also provides real-time, multi-user updates (timestamped with any updates or changes), management oversite and approval, and detailed transfer reporting. In addition, the LVM Patient Transfer solution enables transfer centers to track the transfer workflow from start to finish. LVM’s Communication Portal facilitates real-time conversations between the sending facility, transport company, and receiving facility. Organizations can run it as part of LVM’s multi-function, integrated solution or as a stand-alone solution.

Behavioral Health Intake & Assessment

LVM also offers a Behavioral Health Intake & Assessment solution. This solution tracks all aspects of the intake process, from services requested, to providers involved, to assessments needed. It provides a comprehensive blueprint of data points used during an intake call. In addition, LVM’s solution allows organizations to customize and fine-tune the workflow to meet their specific needs.

All data recorded, including insurance and all contacts associated with an intake and admit/discharge, is stored in reportable fields. Capturing the data ensures the complete intake process is documented and reportable in any way needed. Organizations can also interface the transaction’s history with their EMR. Like the Patient Transfer Communication Portal, LVM’s Behavioral Health Intake & Assessment can run as part of the overall LVM solution or as a stand-alone product.

Other Solutions

In addition, LVM supports marketing functions such as Data-Driven Relationship Management, Physician Referral and Appointment, Marketing Outreach, Feedback Management, Answering Service, Class Registration, Service Lines, Web Self Service, Smart Surveys, Interactive Chat, Data Integrations via Smart HL7, Ad-Hoc Analytics, and many other interactional functions.


The integration capabilities of LVM’s solutions allow them to ingest multiple sources of data to utilize when interacting with customers. For example, through bidirectional integration, LVM can push/pull data to/from other systems using HL7. Doing this enables the systems to share information across the organization. For example, sharing data among all systems in a hospital informs each department of the complete patient experience as they communicate with the patient.

Health systems must provide a contact center solution that utilizes multiple channels to deliver accurate answers and quick responsiveness. LVM uses multiple tools to improve interoperability, reducing customer and contact center efforts to access knowledgeable responses for all inbound inquiries, outgoing communication, and coordination assistance.


Surveys are a critical tool in healthcare today. LVM solutions include customizable surveys for use in feedback management, behavioral health intake, patient transfer, population health, disease management, and care coordination.

Contact center staff can also use surveys post-discharge to validate patient follow-up, as follow-up on physician referrals, or to assess class satisfaction. The information gained allows for rapid course correction and problem mitigation.

Staff Supports

LVM’s solutions include customized workflows with guided scripts. New staff quickly become more efficient when using workflows, thus reducing their stress, errors, and call times. Using workflows also increases completed call counts while enhancing the caller’s experience.

The point-and-click documentation saves staff time, reduces errors, and lessens staff fatigue, freeing staff up for more critical interactions. Other efficiency tools include type-ahead tables and rapid notes.

In addition, LVM leverages critical efficiencies throughthe following capabilities.

Single Sign-on: With single sign-on, users more quickly access the LVM solutions while adding a layer of security. Single sign-on allows users to maintain their single secure user and password without creating and remembering a new user and password, seamlessly authenticating to the LVM software.

Speech-to-Text: Using LVM, nurses can populate their call notes into the patient’s call record by voicing them. No more need to manually enter them. Doing this reduces call time and errors.

Call Templates: When a disaster or a pandemic hits, healthcare organizations need an easy way to create workflows that include specific physicians, facilities, surveys, classes, and other specific resources. LVM’s Call Templates enable contact centers to pre-define these resources. Contact center staff can also use Call Templates in support of marketing campaigns to organize similar calls into different categories or in support of specific service lines.

Dashboards: LVM’s solution includes Real-time Command Center Dashboards to support contact center efficiency. Dashboard reports provide the ability to compile aggregate data from multiple systems into a single report.

Data sources can include data from various contact center solution modules, internal and external databases, and data from the phone system, to name a few. They represent an overview of multiple individual reports when presented as dashboard reports. The design aesthetics can suit each organization’s needs. Organizations can design graphs, legends, and layouts to address specific organizational needs.

Custom Reporting: In addition to the existing reports on current and historical data, LVM provides tools to create custom reports for export to Excel or other applications. All fields are reportable without exception. Clients can also run reports on trending, such as average call times, most commonly used protocols, performance evaluation reports, QI audit reports, frequent callers, and the number of calls by guideline. Additional reports include redirection of care, calls by insurance, ROI reporting, dashboard reporting, and many more.

Discovery Reporting: LVM Report Discoveries (Ad-Hoc Reports) allow contact centers to identify and select fields to pull into custom reports. Discoveries allow reporting data for a given period and comparing period over period.

This tool enables contact center managers to create reports within an intuitive interface that does not require SQL or other programming-type knowledge. After completing a report, save it, add it to favorites, create it as a PDF, export data to Excel, or send it via email. Year-over-year reporting is also available with any criteria and report automation.

Usage Stats: Usage Statistics allows clients to send anonymous data to LVM. This data is then available to participating clients to see trends across all participating clients in various geographic areas with different workflows and staffing models. LVM encourages all clients to turn this feature on and take advantage of the aggregate reporting that Usage Statistics offers. Participating clients can run these reports with different date ranges to see trends, selecting the specific data to compare.

Security Initiatives: Today, contact centers face the ever-increasing dangers of hackers attempting to access patient data. As a result, LVM has taken measures to strengthen its security posture, including investing in a third-party security audit. In addition, LVM completed a 2022 (SOC) 2 Type 2 with HITRUST Mappings Examination to help ensure contact center data remains safe.

Microsoft Gold Partner

For the past sixteen years, LVM has been a Microsoft Gold Partner. Microsoft confirmed the value of LVM through client satisfaction surveys on which LVM scored above average. In addition, working with LVM provides clients the security of knowing both the software and the developers who create it meet the high standards they expect.


Collaborating with a healthcare contact center company that understands the importance of security and can customize its system to address the needs of the organization’s different audiences is critical in today’s consumer-focused world. Whether it is additional data elements to capture and report on or unique workflows to fit the callers’ needs, today, more than ever, healthcare organizations need a customizable system to drive patient encounters.

With over three decades of serving this industry, LVM Systems has the tools, knowledge, and experience to assist healthcare organizations in meeting these needs.

State University of New York Upstate Medical University Case Study

Integrating with Epic’s Electronic Medical Records to Save Time and Enhance Patient Caller Experience

By Nicole Limpert

State University of New York (SUNY) Upstate Medical University, located in Syracuse, New York, has a campus that is 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 payroll and numerous facilities, Upstate is a powerhouse for the economy of Central New York, generating $2.3 billion 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.

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 their current vendor’s healthcare communication software since 2006 and works closely with them to meet their enterprise-wide communication needs. Jody comments, “We use several products from our vendor. One solution enables us to record custom greetings and automatically plays those greetings before operators answer calls. We use another for appointment reminders and just started using their integration engine to send SMS reminders, which people seem to really appreciate.”

Upstate contacted their contact center software vendor for guidance, and they confirmed it was possible to use the guided scripting solution 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 a shorter list of questions that are related to everyone who’s associated with that caller ID.”

Testing the Integration

Integration testing began between Upstate, their vendor, and Epic. The vendor 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 vendor 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. The staff from our vendor did virtually all the scripting, and they’ve been outstanding to work with.”

Evaluating Results Using Detailed Reporting

Upstate is using their call center software to keep track of the time spent on calls. Over time, the detailed reporting function will assess the results of the integration and determine how much time this project has saved. They look forward to seeing improved statistics.

“We implemented the Epic integration nine months ago, and as of now, it looks like we are saving an average of about 15 seconds on each call. We’re hoping we can cut 10-20% off the duration of each call. That will make a huge difference over the course of the whole day,” Jody explains. “The integration was first 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. They do some appointment scheduling, a lot of message taking, 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.”

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.”

Nicole Limpert is the marketing content writer for 1Call, specializing in offering enterprise-wide communication solutions for healthcare organizations.

Cold vs. Flu, or RSV?

How Telehealth Nurses Can Use Triage Protocols to Address All Three

By Ravi K. Raheja, MD

Since COVID-19 restrictions have been eased, this fall is already experiencing a surprising surge of respiratory syncytial virus (RSV) in conjunction with flu and the common cold. Telehealth nurses have experienced a roughly 20 percent increase in patient call volumes and winter hasn’t even started.

While RSV symptoms are typically cold-like in appearance, the virus can be detrimental to infants, older adults, and those with medical conditions that put them at higher risk for serious, life-threatening complications. Symptoms for all three of these ailments can be similar, and because health systems are already being taxed with cases of RSV, it’s important that call centers and telephone triage nurses have the tools to accurately evaluate them.

Up-to-date nurse triage protocols developed by Drs. Barton Schmitt and David Thompson can help determine which ailments patients may have and direct them to the appropriate care. These protocols aren’t a substitute for the medical knowledge of a nursing staff; rather, they serve as a guide for their patient interactions to standardize care and avoid potential diagnoses.

First, let’s review the common symptoms and complications for colds, flu, and RSV, and then explore how protocols can address all three.


Although common, colds are typically mild. They usually begin slowly, starting with a sore throat before leading to nasal congestion and drainage. Common symptoms a few days after infection include coughing, sneezing, as well as a slight fever that usually doesn’t exceed 101 degrees.

As symptoms progress, nasal drainage can change from clear to dark, and become thicker. Many patients who come down with colds find it difficult to perform activities of daily living (ADL) compared to their normal energy levels. It’s also possible that colds will lead to other complications, like sinus congestion and ear infections.


A case of the flu is more severe than a cold and has faster onset symptoms. Because sore throats and fevers are common with both ailments, they can sometimes be confused. That said, coughing and congestion are more likely to be worse with the flu, and are usually accompanied by headaches, muscle aches, general soreness, and even severe exhaustion.

In layman’s terms, a bout of the flu usually makes patients “feel rundown” for a week or longer. Complications can also be harder on the body, including sinusitis, bronchitis, ear infections, and pneumonia.


The Centers for Disease Control and Prevention (CDC) notes that, as a respiratory illness, “RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than one year of age in the United States,” and that the vast majority of all children have experienced it by the time they turn two.

Initial symptoms are usually in the form of runny noses, decreased appetites, and coughs that may evolve into wheezing and trouble breathing. Infants may also be irritable and experience apnea. Older adults with heart or lung disease, or those who have weakened immune systems, are also at risk.

Similar to colds, there is no vaccine that can prevent an RSV infection, although palivizumab is a commonly prescribed medicine for young children who are more susceptible to extreme illness, including bronchiolitis or pneumonia.

There were already expectations that flu and COVID would both see higher case counts as we continued into the fall and winter months. But many health systems are now seeing a surge in RSV cases, and MassLive notes how this has pushed some of them to delay elective procedures for children to conserve available beds.

One doctor said that you typically have “hand-foot-mouth in the summer, RSV in the winter, [and] flu in the winter,” but that de-masking has now allowed all of them to spread sooner, and “with a vengeance.”

With RSV season here early, it can be difficult for parents (especially new ones) to evaluate potential cases in their children—not simply because the symptoms are similar to other respiratory viruses, but because their children aren’t able to verbalize what hurts.

Telephone and telehealth triage nurses—who are trained on how to obtain information about physical symptoms that they can’t see—rely on Schmitt-Thompson protocols to evaluate these symptoms and select the best dispositions for care.


These protocols are considered the gold standard for telephone triage because they cover symptoms for infants, children, and adults, including concerns about colds, the flu, and RSV. They do this by offering a decision-tree to nurses to identify and evaluate patient symptoms, which then determines where those patients should receive care—either from themselves at home, from a primary care physician, or a medical professional at an urgent care or emergency room.

These protocols are ideal for several reasons:

  • All calls are standardized and treated with the same procedures.
  • Patient needs are evaluated in the appropriate windows of time.
  • Patients are guided to the correct care providers, which means less chance for delayed care, potential health complications, or overcrowded ERs.

When selecting the appropriate protocol for cold, flu, or RSV, the best triage nurses know that you always give the highest acuity—or the safest outcome—for the patient.

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. They have both daytime and after-hours versions available and offer intuitive telehealth and telephone nurse triage software that uses these protocols to document all patient interactions and share that information securely with providers.

Integrate Your Call Center

Facilitate Better Communication and Connectivity Within and Outside Your Operation

By Peter Lyle DeHaan, Ph.D.

With the staffing challenges that most every healthcare call center faces, it’s more critical now than ever to optimize your operation for greater effectiveness and increased efficiency. One way to do this is to integrate your call center.

Let’s consider some ways for enhanced contact center integration.

Integrate Your Staffing

To integrate your call center staffing is essentially a move from specialists to generalists. This means cross training. It includes both cross training on types of contacts (such as give information, transfer calls, take messages, schedule appointments, and so forth) and channels (such as phone, text, email, and social).

Granted, you may have some areas where cross training doesn’t make sense, but these should be rare exceptions and not the norm.

Cross training improves operational efficiency, increases employee skill level, and better serves patients and callers. Cross training also moves your operation closer to FCR (first call resolution), which produces both caller-centric and center-centric results.

Integrate Your Tools

How often do your employees need to rekey information? Ideally the answer is never. Yet reality falls short of this ideal. Not only is re-entering data time consuming, but it’s also error prone. And although a cut-and-paste transfer helps in both areas, it’s not a solution but more of a shortcut.

Related to this in integrating your auto-attendant with your agent screens. Making an agent ask in person for information the caller has already shared electronically wastes agent time and infuriates callers.

The simple solution is to integrate your call center technology and smartly avoid this needless duplication.

Integrate with Your Organization

Next is to integrate your call center operation with other departments or divisions within your organization. Move from an us-versus-them mentality to a holistic we-and-us team approach. Seek proverbial win-win outcomes as opposed to clinging to a win-lose mindset.

This may be the most challenging integration initiative as it requires a shared perspective to reach a mutually beneficial result. Without having a common goal, the altruistic call center manager can fall victim to the me-first mentality of a predatory counterpart.

Integrate with Your Stakeholders

The final consideration is to integrate your call center with your stakeholders. For the inhouse call center, this means a better information flow between you and other departments, such as marketing. For the outsourcing operation, this means a better data exchange between you and your clients.

Also don’t overlook your staff. Seek to better integrate with them and their needs. Look at schedule development and posting, performance reviews, and handling the compensation aspects of their work. This integration is even more critical now in face of a worker shortage. Although your primary stakeholders are those you serve, without your staff, you’d have no chance to serve them.


Pursue integration initiatives to make your call center operation be more effective and a nicer, saner place to work.

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.

Who Owns Me?

The Enterprise Nature of the Call Center in Healthcare

By Robert Kobek

Given two very long and I believe distinguished careers in the contact center industry and the hospitality industry, I’m not surprised about how little patient feedback information is shared between stakeholders in a company.

Being new to the healthcare industry, I’m keenly aware of the requirement to survey for Medicare reimbursement. What about the rest of the journey?

Very few of us executives have the luxury of focus. We look at the entire landscape, ecosystem, culture, call it what you will. There are times when focus can be misunderstood. One specific example is the way an organization views its contact center.

It’s imperative to use horizontal/peripheral vision. This phenom is what will create an enterprise view of how your contact center remains a profit center. From appointment to billing, the contact center is the point of the spear in managing the relationships between you and your patients.

Later I will use three examples to show the impact of a contact center report on at least seven departments or silos in an organization.

And in the case of gathering patient experience for the contact center where there are at least two outcomes, enhancing the patient experience through process improvement.

There is also a big difference between research and online feedback management where measurement of every key performance indicator is reported to more business silos.

Invariably, there is someone in the company who will treat a contact center like they are an orphan. Here is some guidance: Do what you can to help them understand what goes on in that critical, tip-of-the-spear part of the business. Contact centers are profit centers. Treating it any differently is a mistake.

Measuring the patient experience (PX) at the point of the omnichannel contact center/phone call has significant benefits when measuring the appropriate KPIs.

Applying them to training, retention efforts, net promoter scores, customer effort scores, and a host of other important process improvement efforts, requires dedicated energy. With measurement, effort becomes a project, a project becomes executable.

The beginning of the complete process to measure to enhance the patient journey has begun. The complete journey with qualitative and quantitative data, both structured and unstructured data (reporting).

What is particularly interesting (if you are anywhere near the data geek I am) about measuring the voice of the patient is how it compares with the way your dialing machine tracks a distinct set of KPIs.

And, depending on your contact center stretch goals, there are comparisons between average speed to answer and a customer effort score (CES) question to the patient. Comparing those measurements with the disposition given by the agent and you have quantifiable evidence of a disconnect.

 A positive experience on the initial patient call sets the tone for the rest of the journey. Like the golf tournament precedes a trade show. With the enhancement of the patient journey at the contact center, the enterprise journey walks in step with the patient.

An example will help. The following comes directly from an NPS report.

In this case, there are several stakeholders inside your organization that can benefit from a customer comment. At a minimum:

  • center management
  • training
  • scheduling
  • patient experience professionals

This verbatim comment is the result of a patient responding negatively to one question “would you recommend us?”

Another example, and perhaps more important—the CES question. “Did xxx made it easy for me to do business?”

On a 7-point scale, one being they made it hard, seven it was easy, wouldn’t it be good to know why the scores from one to five were so low? Who should care?

  • accounting
  • marketing
  • training
  • center management

Then yet a third, the email delivery report. This one drills down on your ability to communicate effectively with the patient, at all levels. A clean list is a happy list.

Who benefits:

  • the patient
  • center management
  • IT—data managers
  • digital marketing
  • patient EX management

Who owns the feedback? Every stakeholder in the enterprise owns the obligation to enhance the patient experience.     

The lesson here: work with the patient throughout their journey by asking them about their experiences. Every stakeholder in your organization should play a part in deciding what the voice of the patient should be. Then use that information to enhance that experience.

There will be certain outcomes for sure. Your patient will remain loyal to you and in the event you are billing Medicare your star ratings will come in much faster and higher.

It will be an honor to work with you at your convenience.

Robert Kobek is the president of Mobius VP, LLC, and Patients-Count®.

Case Study: MD Anderson Cancer Center

The Technical Side of Operators Working from Home

By Nicole Limpert

The University of Texas MD Anderson Cancer Center is named after Monroe Dunaway Anderson, a banker, and businessman born on June 29, 1873, in Jackson, Tennessee. His family began buying and selling cotton in 1904 and in 1907 MD Anderson moved to Houston, Texas to grow the family business. Monroe established the MD Anderson Foundation in 1936 before his death in 1939. When the Texas Legislature authorized The University of Texas to establish a hospital for cancer research and treatment, the MD Anderson Foundation matched the $500,000 that was appropriated for the hospital which was then named for its benefactor.

MD Anderson is the largest cancer treatment center in the United States and ranks number one in cancer care by U.S. News & World Report. MD Anderson is also a degree-granting academic institution and research center. MD Anderson employs more than 22,000 people, including 1,788 faculty members, has more than 680 inpatient beds, several research buildings and outpatient clinic buildings, two faculty office buildings, a patient- family hotel, and other off-site facilities for clinical and research use, making it one of the largest cancer centers in the world.

The Road to Remote Operators

The askMDAnderson service, formerly known as the Welcome Center, was established to provide answers, resources, and expertise to people with a cancer diagnosis. According to MDAnderson’s website, askMDAnderson (askMDA) can help people:

  • Make an appointment
  • Understand treatment options
  • Learn about research studies
  • Navigate the MDAnderson website
  • Find out about patient amenities (such as travel and support resources)
  • Access prevention and screening services
  • Find accurate cancer information
  • Locate community cancer resources

When a pandemic was declared in March 2020, MD Anderson required non-direct patient care personnel to work remotely. This included the operators for the askMDA line. “Before April 2020, our operators had never worked remotely,” says Ninette Thomas, askMDA Operator Manager. “We began to look at the resources we already had to develop a hybrid remote call center and realized we were not harnessing the full capability of the technology available to us. That lead to a collaboration with a lot of other departments at our organization to establish our hybrid remote call center.”

IT Mobilization

“The very first step was to determine the feasibility of allowing our operators to work from home. Luckily, we were already investigating the prospect of working from home, but the pandemic fast-tracked all our ideas and testing for how operators could work from home. We knew it was a possibility and we needed to figure out a way to make it happen,” says Jeffrey Cain, Applications System Analyst.

Once the IT team determined it was technically feasible for the operators to work from home, they began preliminary testing. That was followed by a new hardware roll out, new software installation, technical testing, and regression testing. Jeffrey says, “We had a mixture of technical and regression testing. We simulated a remote workflow in our testing environment and included our regression testings and scripts to determine if we needed to change anything in our ANI (automatic number identification) screening table.”

Custom call center agent scripting guides operators through each call no matter where they are located. Remote operators are provided with the exact information they need to provide the best patient experience and reduce call center error rates.

Michael Wolf, Principal Applications System Analyst and Technical and Support Lead for the IT team that supports the operators adds, “As IT support we had been working remotely one or two days a week for years. So, for our ongoing support, we were already working remotely using our call center software for regression testing, developing new call scripts, and modifying call scripts. We were able to go through the entire workflow for a couple of years which helped us transition after COVID-19 hit.”

IT Challenges and Departmental Collaboration

One of the biggest challenges the team faced was that all their operators worked on-site and used desktops. The IT team replaced all the desktops with laptops for each operator for a total of twenty-two new laptops. Each laptop required:

  • A docking station
  • The hardware operators needed to use the laptops in their homes
  • Installation of all the relevant call center software used by operators and managers
  • USB headset, wireless keyboard and mouse, and a mouse pad

New hardware and applications had to be used and integrated to ensure the system ran smoothly, “The introduction of the other applications meant we had to familiarize ourselves with these applications that interface with our call center platform because they had become an integral part of the operator’s workflow,” says Jeffrey.

Testing, planning, and coordinating how to work from home wasn’t just for the askMDA operators. All of IT had to go remote in April 2020. This meant deploying thousands of laptops to people across MD Anderson’s institution to give them the ability to work remotely.

Michael says, “It was a huge undertaking with a lot of coordination between IT groups. A command center was set up in our main administrative building for people to come in and get any equipment they would need to work remotely. This took some work and collaboration between our colleges on the Voice Engineering Team and us on the Applications Support Team. We had to work out all the kinks, but it did work thanks to a lot of cooperation and collaboration.”

Remote Operator Setup, Training, and Support

Working remotely meant new workflows and procedures would be introduced. Operators had to be trained on using VPN access, two-factor authentication or Velo-Cloud, and establishing audio just to log in. Ninette comments, “We wanted to make sure our operators had the exact same setup they had at home as they did on-site. They also got a pager so when we have a situation like a code blue, they know it went through successfully even though they are at home.”

“The operators were using physical desk phones and their extensions are tied to the ANI screening table and the call center software. We needed to be sure that they could now transition seamlessly back and forth from their desk phone when they’re on-site to working from home,” says Jeffery.

Additional procedures were also established such as:

  • Following a specific login order to ensure nothing disrupted the system and it remained operable
  • Steps to be done when returning to campus
  • Using RDP (Remote Desktop Protocol) so IT can access the remote machines and make administrative changes

“Our training is 100 precent on-site because we want operators to be comfortable using all the applications before they go home. They are required to work 100 precent on-site for the first thirty days so they can ask questions,” says Ninette.

Remote Challenges

Web-based communication is fast, secure, improves communication times, adds efficiencies through remote access, and reduces the number of potential errors caused by miscommunication and absences. Yet, challenges still exist but they can be overcome with solid procedures and backup solutions.

Outages: Houston, Texas experienced a winter storm in February 2021 that essentially shut down the entire city. This demonstrated how important it was for MD Anderson to have remote procedures in place because some employees were unable to leave their homes. During and after the storm, many team members were without power which can be a downfall of working remotely. However, this organization has backup systems and procedures so communications could continue.

“We have backup procedures in case of a server or phone outage. There is a phone line that isn’t connected to our server so we can use that line for Code Blue and other emergency communications. If the phone system is down, we have landline phones that are hardwired into the building that are designed to work for codes,” says Ninette.

Staff management: Ninette comments, “We’ve been utilizing the reporting functionality of our call center software a lot more now that operators are remote. When we’re in the office and working together, I can hear my staff and know that they are working on calls. Now I’m using the reports a lot more than in the past to monitor productivity and availability. What was surprising to me was that I anticipated having a problem with performance when they went home, but what I found was that our productivity actually went up.”

Remote Benefits

MD Anderson had a separate “ride out” location in another building that was specifically designated as the location all the operators should go to in case of a disaster. The operators would relocate to this command center, which was outfitted with two desktop workstations and multiple open phone ports, where they could resume their normal workflows.

“We are now more prepared for hurricane season. We have less staff required for ride out because we have more people who are available to work remotely—provided they have power and internet. All we need is a power source to continue to work. We can literally work from anywhere,” states Ninette.

Michael adds, “Now that the operators have the ability to work remotely, the IT department has experienced benefits such as decreased overhead to maintain the equipment or perform quarterly tests and reduces our support time.”

Another benefit that came about with the operator’s ability to work remotely was schedule flexibility. After the thirty-day on-campus training, operators were able to go to a four-days-a-week/ten-hours-a-day schedule. The department originally offered only three shifts to cover their 24-hours-a-day, 7-days-a-week operation, but that has increased to seven shifts for more flexibility.

The team rotates the schedule so each operator is located on-site for only two days per week. This results in more flexibility for the operators, easier commutes, and they can limit the number of people on staff in compliance with their institution’s response to keep their employees safer during the pandemic.

Patient and employee safety are paramount. Even though between 82 to 91 percent of the operator staff work remotely per shift, there are still at least two operators in the building at all times in case there is a communication outage. Having a redundancy of operators on-site ensures normal operations without any interruptions.

“As a team, we have the difficult task of balancing patient safety, employee safety, and employee satisfaction. We have made every effort to make sure we are not putting anyone in harm’s way by taking unnecessary risks. Implementing a hybrid remote call center in the middle of a pandemic was challenging. However, the collaboration between the different IT groups and the askMDA operator team have made this a successful transition,” says Ninette.

Nicole Limpert is the marketing content writer for 1Call, specializing in offering enterprise-wide communication solutions for healthcare organizations.