Telephone triage nurses play a
critical role in suicide prevention and serve as the first point of contact for
callers in need of immediate assistance. According to the CDC, 123 Americans
die by suicide every day, and for every person who dies from suicide every
year, another 278 people think seriously about it but don’t kill themselves.
As the demand for mental health
services grows, practices are turning to outsourced telephone triage call
centers to support their practices. Call center triage nurses trained in
treating patients with mental illnesses are better prepared to intervene and
often alleviate lengthy interruptions to the normal call flow of a practice.
In moments of crisis, connecting
with a trained triage nurse can deescalate the suicidal crisis and provide
immediate help. It is never easy to talk about suicide, but it is crucial for
triage nurses to be comfortable talking about suicide in the same way they talk
about chest pain. How they handle each call can be life-changing for the
Triage nurses need to find a connection with the patient,
find the patients local emergency assistance numbers, and be ready to involve
all resources available to help prevent this patient from harming him/herself.
It is essential for the triage nurse to be sympathetic,
non-judgmental, and accepting. The caller has done the right thing by getting
in touch with another person. No matter how negative the call seems, the fact
that it exists is a positive sign, a cry for help.
Triage nurses always have the caller’s safety in mind. They
combine both clinical judgment and emotional connections to assess the
patient’s situation to identify possible mental health issues.
Even though remote triage nurses typically can’t see their
patient, they must develop that all-important trust quickly and by means other
than visualization for the caller to open up and be honest with the nurse. Not
all patients can accurately describe their condition, history, medical
conditions, or other pertinent information. The telephone triage nurse must decipher
Sometimes the patient needs emergency treatment, while other
times they are reaching out for someone to talk with and work thru difficult
situations like substance abuse, economic worries, relationships, sexual
identity, getting over abuse, depression, mental and physical illness, and
Just talking about their problems for a length of time gives
some suicidal caller’s relief from loneliness and pent up feelings, an
awareness that another person cares, and a sense of someone understanding them.
Also, as they talk, they get tired and their body chemistry changes. These
things take the edge off their agitated state and help them get through a bad
night. Suicide calls can be difficult, but with proper training, protocols, and
disposition, telephone triage nurses save lives, one call at a time.
Ravi K. Raheja, MD is the CTO and medical director fo the TriageLogic Group. Founded in 2005, the TriageLogic Group is a URAC accredited, physician-lead provider of high quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. The TriageLogic group assists their clients with value based care and serves over 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com. and www.continuwell.com.
As practices and organizations move to value-based care, medical call centers can play a crucial role in improving the patient experience and the quality of care while containing costs. An effective way to find a solution is to evaluate data from nurse triage call centers on patient concerns, caller demographics, nurse triage disposition and effectiveness, and other measures to improve the call center and the patient experience.
Value-based programs focus on the quality of the care given, rather than fee-for-service. Ensuring patients receive the right level of care for their symptoms is an important action to decrease healthcare waste. Providing a quality medical call center that patients can access 24/7 is a great first step in transitioning to value-based care. Providers and hospitals can then gather information from the patient callers to further improve their service while containing costs.
For new call centers and those selecting a new platform, start by evaluating data you’ve already collected and what you need to know to help the patients and the practice. For example, TriageLogic’s data portal collects information on the number of calls per protocol, calls per nurse, dispositions, and disposition override. Call centers also get data on nurse performance, such as the number of calls per hour and percentage of patients told to seek emergency care. Information on nurse performance provides a valuable tool to evaluate nurses and determine the focus of further training.
While gathering the data is a crucial first step, the platform also needs to have a simple dashboard for the manager to monitor the key metrics of patient calls and nurse performance. For example, the TriageLogic data dashboard allows the user to break down the data by date, location, nurse, and so forth. Reviewing the various data sets can help caregivers gather insight on the performance and find ways to improve care.
For example, with the data dashboard, users can see the percentage of the dispositions given to the patient callers. Users can also see the actual data as the number of calls and the percentage of the total, as well as graphs that illustrate any trends of the different disposition percentages.
Report on Data
After analyzing the data from medical call centers, physicians or organizations can better understand their patient population. Look for a quality call center platform that allows call center managers to easily export the information in various formats and then share it with their practices. This is an important feature to improve coordinated care between the office and the call center.
Physicians can see what concerns their patients have after-hours and make positive changes that can address those concerns ahead of time. For example, an increase in stomach pain related issues may mean that a virus is hitting their population.
Another important use of data is to compare the number of patients you prevented from going to the ER. The number of those patients shows how much value the call center is creating for the practices (ROI), and it may motivate hospitals and providers to continue encouraging patients to call a nurse line before going to the ER.
When collecting patient data, it is vital that all data from the call center software be fully secure and that products are evaluated and updated as technology and standards change. When evaluating call center software, make sure you understand how it stores and secures patient data. Also, ensure you can share the information with providers securely or without any PHI.
The goals of value-based care are to provide better care for patients, create a healthier population, and reduce healthcare costs. A nurse call center system armed with good data analytics allows you to identify the quality of the clinical call center and improve the efficiency of the nursing staff while helping patients at the same time. Having access to this data, analyzing it, and sharing the information with providers improves patient care, while at the same time showing the value of your call center service and saving valuable healthcare dollars.
Founded in 2006, TriageLogic is a URAC accredited, physician-led provider of high-quality services and software for telehealth. TriageLogic is a leading provider of top-quality triage technology, mobile applications, and call center solutions. The TriageLogic group serves over 9,000 physicians and covers over 18 million lives nationwide.
person medically underserved, is someone who does not have health insurance. Estimates
from the Centers for Disease Control and the National Health Interview Survey cite
that in 2017, 29.3 million, or 9.1 percent of the population were uninsured.
studies have found that vulnerable populations in the United States, including
the elderly, low-income, ethnic minorities, migrants, and people who received
limited education, are also medically underserved.
with various life experiences may interpret symptoms differently, such as thinking
a seizure is a spiritual issue rather than a medical complaint, or expressing
concerns about depression as anger rather than sadness.
Poor Access to
in a rural location and having inadequate transportation present challenges
when trying to access healthcare. Rural areas are sparsely populated, resulting
in a lack of available services. Rural communities comprise roughly 20 percent
of the United States, yet less than 10 percent of doctors practice in these
in rural areas rely on their own transportation to and from health services. A
report released in December 2018 from Pew Research Center, found the average
travel time by car, to the nearest hospital for rural Americans, is about 17
minutes compared to 10 minutes in urban areas.
even people in urban areas have difficulty visiting their doctor’s office.
Transportation can be a challenge for people with disabilities, those with
chronic illnesses, the elderly, and people who are low-income. Approximately
3.6 million Americans, from both rural and urban areas, experience missed or
delayed medical appointments due to transportation issues.
enables medical call centers to effectively become an extension of a hospital
or clinic’s operations. The communication software used by medical call centers
can securely access a patient’s electronic medical record (EMR), update EMRs
with notes, and record calls needed for insurance claims and workmen’s
compensation. Because everything is documented, detailed reports can be
generated for reporting purposes.
call centers can provide or facilitate healthcare-related services 24 hours a
day, 7 days a week. They play a critical role in helping to serve the medically
underserved, by addressing two of the biggest barriers to healthcare: language
Language: Healthcare staff
work with an enormously diverse patient population. Understanding a person’s
language leads to better healthcare. Multi-lingual call centers hire operators
to assist non-English speaking patients or use confidential over-the-phone
interpreting (OPI) services for access to hundreds of different languages.
Transportation: Patients with
mobility challenges or who live in rural areas don’t have to leave home for
some services. Operators can coordinate care, make follow-up calls, schedule
visits, contact on-call medical staff, and manage referrals.
call centers staff nurses or multidisciplinary teams (such as a resident,
pharmacist, and social worker) who are qualified to make health assessments,
give medical advice, and escalate critical concerns. These call centers can
offer nurse call helplines, emergency mental health counseling, and other
Helping Hospitals that Help the
recent study done by Harvard suggests that hospitals located in low-income
areas are more likely to receive penalties due to Medicare and Medicaid’s survey-based
reimbursement programs. Patients are asked to provide information about their healthcare
experience via the Hospital Consumer Assessment of Healthcare Providers and
Systems (HCAHPS) survey. Unacceptable survey outcomes can result in hospitals
losing some reimbursements.
American Medical Association Journal of Ethics reports that the Centers for
Medicare and Medicaid Services (CMS) can currently withhold one percent of
Medicare payments—30 percent of which are tied to HCAHPS scores. When Medicare
and Medicaid account for more than 60 percent of all care provided by
hospitals, the possible amount of dollars lost due to poor patient experience
is a significant number. In 2017 alone, approximately 1.7 billion dollars in
reimbursements were withheld from hospitals.
call centers play a critical role in patient satisfaction surveys, because they
function as a virtual lobby for a hospital and are often the first point of
contact with a patient. The patient’s experience with coordinating their care
via call center agents can positively affect their feedback on the survey.
CMS reports that nearly one in five Medicare patients are readmitted to a
hospital within 30-days of discharge, yet a recent study from the University of
California San Francisco (UCSF) and published in JAMA Internal Medicine found
that twenty-seven percent of all 30-days hospital readmissions are preventable.
Hospital Readmissions Reduction Program (HRRP) lowers payments to Inpatient
Prospective Payment System (IPPS) hospitals who report too many readmissions. According
to the CMS, 2,573 hospitals received penalties in 2018 and had around 564
million dollars in payments withheld.
indicate that a post-discharge call program can help hospitals reduce their
readmission rate. IPC Healthcare (IPC) tested the effect of post-discharge
calls on readmission rates from October 2010 through September 2011. The IPC
call center contacted 350,000 discharged patients to check symptoms, review
medications and treatment plans, and remind patients of follow-up appointments.
Successful contacts occurred with thirty percent of patients, with an estimated
1,782 avoidable readmissions prevented over that year.
Nicole Limpert is the marketing content writer for Amtelco and their 1Call Healthcare Division.
Amtelco is a leading provider of innovative communication applications. 1Call
develops software solutions and applications designed for the specific needs of
story hits close to home, because it involves my family members. I share it to
illuminate where the call center is failing its customers. Today’s call center
can offer supportive resources and referrals to patients and their caregivers
and ensure that interventions are applied as needed. That is what coordinating
care and managing transitions is all about. It is not necessarily about a
specific disease, but it’s more about the patient’s and family’s needs.
you ever had to move a loved one into a long-term care facility, you know how
incredibly hard it can be. Especially when all your loved one really wants is
to simply stay or go home. I’ve had to deal with this situation now three times
in my life. First with my mom as she suffered with Lewy Body Disease, then dad
with Alzheimer’s, and last week with my dear little brother as he is in the
final stages of Early Onset, Frontal Lobe Dementia.
is the cruelest of all. Not only was he afflicted with this terrible disease at
such a young age, he’s now just fifty-eight years old, but it is a horrifying
disease for all whose lives are touched by it. At this point, his disease
causes him to rarely sit still. He paces the halls, head bent downward. His
navigational skills are amazing. But what is he seeing, what is he processing?
His vocalizations fluctuate between quiet utterances to loud vulgarities and
heinous, hateful words spewed upon his loving wife. She does her very best to
comfort him despite occasional punches, attempts to choke her, and comments
more vile than one would say to their worst enemy.
makes this even worse is that my brother was never an angry, nasty man. Quite the
opposite. He was the life of the party, always the kidder, the storyteller, the
embellisher. He never met someone he did not greet with a smile.
that was then, and this is now. This past week, I saw everything from enormous
amounts of love and compassion, to raw agony on the face of my sister-in-law. I
saw complete confusion and despair on the face of my brother. If I had a
mirror, I most certainly would have seen overwhelming sorrow on my own.
Where Was the Call Center?
could not help but wonder as I was loading my brother into my sister-in-law’s
SUV moving him from the psych ward to a supposedly “qualified” dementia nursing
care facility 2.5 hours away, where was the call center?
had my sister-in-law never spoke with someone in the call center about how best
to transfer him? How to get him into the car without a struggle or to distract
him along the way? How to help him with the transition into new surroundings?
Before we set off on our road trip, why hadn’t someone from the call center
reached out to the new care facility and asked the hard questions to determine
if they were qualified to accept and care for my brother? Why?
have not spent over half my life in this industry to have it fail me now. Why
had the hospital not taken the initiative to begin using the call center to
support transitional care? Who better than skilled nurses trained to ask
probative questions and educated to listen between the answers? Why hadn’t
experienced call center staff been brought into the fold to offer this much
needed service to the community? Surely, my sister-in-law or I would have paid
for such a service. We cannot be the only ones who would.
there was no call center support. My sister-in-law and I loaded my brother into
the car and began our 2.5-hour transition to the dementia nursing care facility
without educational or emotional support.
after years of caring for my brother, his wife smartly knew to bring a few
items to distract him along the way. For the most part, he was content to play
with a stuffed animal that reminded him of his cat. The trip progressed
we arrived at the facility, there was no one to greet us. Instead, a kind young
lady led us to an area where patients were eating lunch. Not the best way for
my brother to start his new life. Too much confusion, too many people all
looking at him. Too many strangers.
they showed us his room. My sister-in-law had brought many of his toys,
pictures, wall hangings, blankets, etc. As she made up his room, I joined my
brother in his thousand-step trek around the facility. Not only does he like to
walk, he likes to walk fast, a challenge for an older brother with a bad hip.
We walked, and we walked, and we walked, occasionally setting off door alarms if
I failed to redirect him in time. Meanwhile, my sister-in-law completed all the
needed paperwork. Again, why didn’t the call center complete this prior to our
an inordinate amount of walking, all the paperwork was completed (again
paperwork that should have been coordinated and completed in advance of our
arrival) and we were able to get my brother to settle down in his room.
so we thought.
had been with him for most of the day, so we decided to head home before dark
set in. We made one last stop at the nurses’ station to confirm they felt
comfortable caring for my brother. That they felt they had adequate staff and resources
to provide him with the care we expected.
Leaving Too Soon
their assurances, we headed home. As we began our 2.5-hour return trip, my
sister-in-law and I discussed how we felt my brother would do. As we began to
convince ourselves that he’d be fine, the phone rang. It was the dementia care
facility. We had travelled for less than thirty minutes and already the nurse
was calling us to come back and get my brother. He was scared and agitated in
his new surroundings, and when they tried to calm him, he swung at one of the
staff. That’s all it took.
turned around, reloaded his things, and headed back to the psych ward from
whence he had come, feeling totally defeated. There had clearly been inadequate
transitional care support. Not enough questions had been asked. My brother’s
specific needs and issues were either not communicated or were not fully understood
by the care facility agreeing to take him.
add to our frustration, when we arrived back at the hospital, the less than friendly
security guard informed us that the hospital could not, and would not, admit my
brother unless he was willing to choose to admit himself. Mind you, we are
talking about a man who has only fleeting moments of cognitive lucidity, and
this guard wanted him to state he desired to be checked back in. Again, a
perfect place for someone in the call center to have assisted in his transition
back to the psych ward.
sister-in-law lost it. She returned to the car, violently sobbing, determined
to simply take her husband home and care for him herself. As she pulled away
from the hospital, I reasoned with her explaining that there was no way we
could take care of my brother at home by ourselves, and that with me leaving
town the next day, there certainly was no way she could do it herself.
it finally dawned on her that she had no medicines for my brother, she realized
we had to return to the hospital. Fortunately, at her request, this time nurses
from the psych department came down to the ED bay and facilitated getting him
checked in and back to the same room he had left merely ten hours earlier.
hours I will never forget.
Mark Dwyer is a thirty-three-year veteran of the healthcare call center industry. He currently serves as COO of LVM Systems.
care is defined as a set of actions designed to ensure the coordination and continuity
of health care as patients transfer between different locations or different
levels of care within the same location. Representative locations include (but
are not limited to) hospitals, sub-acute and post-acute nursing facilities, the
patient’s home, primary and specialty care offices, and long-term care
facilities” (Coleman & Boult, 2003, p.
a. Transitional care is based on a comprehensive
plan of care and the availability of health care practitioners who are
well-trained in chronic care and have current information about the
individual’s goals, preferences, and clinical status.
b. It includes logistical arrangements, education
of the individual and family, and coordination among the health professionals
involved in the transition.
c. Transitional care, which encompasses both the
sending and the receiving aspects of the transfer, is essential for persons
with complex care needs (Coleman & Boult,
in America occurs in every state and has many causes. According to the January
2017 Point-in-Time (PIT) count by the National Alliance to End Homelessness,
the most recent national estimate of homelessness in the United States
identified 553,742 people experiencing homelessness. The PIT count is acount of sheltered and unsheltered homeless persons on a
single night in January. Like all surveys, the PIT count has limitations.
Results are influenced by the weather, availability of overflow shelter beds,
the nature of the volunteers, and the level of engagement of the people being
of this population lives in some form of shelter or transitional housing. However,
approximately 35 percent live in places not meant for human habitation. The
nature of homelessness makes it difficult to quantify the true size of the
homeless population, not to mention the Point-in-Time methodology (although
generally acknowledged to be the most accurate way to establish valid trend
data). It is challenging to calculate the exact number of individuals who are
homeless, because many live in hidden areas in parks, vehicles, or abandoned
houses, and because numbers fluctuate, based on weather.
individuals are at a relatively high risk for a range of acute and chronic
physical and mental illnesses. Some health problems precede and may contribute
to homelessness, while others are often a consequence of being homeless. And
homelessness complicates treatment of many illnesses.
example of a health problem that can cause homelessness is a major mental
illness, such as schizophrenia. Without therapeutic interventions and supportive
housing arrangements, such an individual may become homeless.
example is an accidental injury, including job-related injuries. Even with
benefits under employer programs, these individuals may experience major
economic costs leading to loss of housing.
of the extremities, skin disorders, malnutrition, degenerative joint diseases,
dental and periodontal disease, communicable diseases, and the possibility of
trauma are other health problems that may result from, or frequently occur in,
the homeless population. Medical care and treatment for acute or chronic
illness can be extremely difficult.
rest may be non-existent for a homeless individual who has no bed or only has a
bed in a shelter at night. Special diets and medication adherence are impossible
to maintain for a person who is homeless.
centers have long been known for assisting their organizations in offering
triage, coaching, remote patient monitoring, and care management for an
identified population. Some contact centers have also assisted other community
agencies or services in filling a need or gap.
Triage Call Centers Can Help
Address Health Concerns of the Homeless
we all know homelessness exists, and it is a tremendous problem, but what does
that have to do with triage call centers?
community triage contact center at EvergreenHealth in Kirkland, Washington
implemented a program around 2000, in which they began to offer low-level
acuity triage for their regional 911 dispatch centers. The dispatchers would go
through their algorithms with the caller, and once they ruled out any emergent
or urgent issue, the caller was offered the option of speaking with a nurse. If
the caller preferred, she or he could be connected with an appropriate unit or
the individual could be transported to the Emergency Department (ED). This
program proved a huge success in both caller/patient satisfaction and dollars
study was published in 2015 for a comparable 911 program in two cities with similar
outcomes. Fort Worth, Texas (MedStar) provided nine
months of 911 call data, and Louisville, Kentucky (LMEMS) provided thirty-four
months of 911 data. The study reported that the 911 program had a
significant reduction in callers routed to the Emergency Department (ED) at a
cost savings of 1.2 million dollars in payments, as well as a decrease in
emergency ambulance transports resulting in a cost savings of 450,000 dollars,
and a resultant increase in access to alternative care. Overall, patient
satisfaction was 91.2 percent.
As a result of the involvement with the
regional 911 dispatch centers, the contact center was asked to become involved
with yet another identified need: The growing population of homeless
individuals. County shelters and housing facilities for the homeless population
needed a resource for individuals with low to moderate acuity symptoms, when
medical/nursing personnel were not on site. The fire department was handling
90,000 incidents per year, which resulted in overuse or misuse of the emergency
medical response (EMR) system. And while the county shelters were not the
majority of the calls, they were a contributor.
Addressing the Concerns
of the Homeless
A very important concern to the homeless
individual is whether they will lose their shelter bed for the night, if they
are transported. The fire department is not authorized to make a medical
diagnosis on the scene, to provide advice or guidance about disease management,
to make a referral to other medical resources, such as a primary care doctor,
or to provide transportation anywhere except an ED.
The contact center had the system and
tools in place to assist the RN with the individual at the county shelter’s
assessment and make recommendations of care. “Right care, right place, right
time,” which is the fundamental premise of contact center RN triage. Their
service provided a much-needed solution to an ongoing gap in care. They
currently support five dispatch centers in providing contact center RN triage
for thirteen shelters.
The contact center educated the staff at
the shelters and facilities. They provided training on when to call 911 (a red
flag list), and when to call the contact center’s health line. Each homeless
individual received HIPAA information that included “understanding and
agreement that a copy of the information discussed during the call interaction
would be shared with the residence so that they may further assist the
individual with their care.”
The workflow included one number for all
facilities to dial into the Healthline contact center. The case manager and the
resident had to be available at the time of the call. The RN in the contact
center triaged the individual, and then the case manager determined the best
non-EMR transportation based on the disposition. The triage note was then faxed
to that facility.
Challenges included the individual
wishing to remain anonymous, the individual being a vague or poor historian,
individuals declining triage or the recommendation, availability of OTC meds,
and their psych/social needs.
months after the start of the program, the facility staff was queried, and all
were either very or somewhat comfortable in knowing what situations required
911. Over 85 percent of the staff felt the service was very important to the
far, the majority felt the nurses at Healthline were very knowledgeable (83.33
percent). Beyond 85 percent also felt the nurse line process was easy-to-use,
and felt the residents were satisfied with the service. Most of the staff felt
very satisfied once the resident had talked with the nurse, and 100 percent
indicated the importance of having the service available 24/7, adding that it
was practical and helpful to the residents in the facility.
Traci Haynes MSN, RN, BA, CEN, CCCTM is the director, clinical services at LVM Systems, Inc. and has been involved in the contact center industry for over twenty-five years. (Traci thanks Cheryl Patterson, BSN, RNC—TNP, clinical manager—quality and education, Healthline, for her contributions to this article.)
Spend More on Retaining Staff and Less on
Hiring and Training Their Replacements
By Peter Lyle DeHaan, Ph.D.
We’ve looked at five
tips to better retain call center staff. Agent compensation is first on
most people’s list. However, it might not be the most important item, merely
the one most cited. Pay rate alone isn’t enough to keep most call center agents
happy and employed. Other items factor into this equation. A related issue is
benefits. Today’s workers expect more than decent pay. They expect benefits too.
This includes part-timers. Yes, your part-timers deserve benefits. If you want
to keep them, you better provide what they want.
Your agents work hard for you and
your callers. They deserve a vacation. This gives them a break from the routine
of work, provides something for them to look forward to, and helps them
recharge. A paid vacation is the top benefit employees seek. Be sure to provide
it to them, both full and part-timers.
(As with all benefits for part-time
agents, make it proportional to the average amount of time they work. For
example, if they work twenty-hours a week, their vacation pay should be based
on a twenty-hour workweek.)
Paid Time Off
Next up is paid time off. This
includes sick days and personal days. Ideally, we want healthy employees who
don’t get sick and who schedule their appointments on their days off. But this isn’t
always feasible. Failing to provide paid time off could result in an agent
coming into work sick or not attending to some important personal issue, which could
have negative consequences later.
Though not every employee thinks
about retirement, some do. And for those who do, it’s of critical importance.
They want to take control of what their retirement looks like, and that means
planning for it now, regardless of how far away it is. Be sure to offer them
the option to set money aside now for their retirement.
Next up is the ability to pursue
ongoing education. As with retirement, this isn’t a benefit that most people
seek or will use, but for those who want it, it could make the difference
between them quitting or staying. Tailor your program so that it provides value
to participants and to your organization too. Also include a reasonable
precaution to avoid abuse, but be fair. An employee with the opportunity to
learn more, will provide more value to your organization and be more loyal.
The last significant benefit is
healthcare coverage. Healthcare coverage is a growing concern for people in the
United States. The cost rises and the coverage shrinks. Yet being in the
healthcare industry, we’re in the unique position to help our agents with
decent healthcare coverage, or at least we should be.
When it comes to retaining call
center staff, don’t skimp on benefits. Offer them paid vacation and time off,
retirement and continuing education options, and healthcare coverage. This will
increase their loyalty to your organization and decrease the likelihood of them
leaving your call center for another company that does provide these benefits.
Just as with compensation, the cost of providing
benefits concerns most managers. The key is to offer what you can without
jeopardizing your organization. But if you think you can’t afford to offer
benefits, the reality is that you can’t afford not to.
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.
Wellness programs allow an employer or healthcare plan to provide participation incentives to members. These incentives may include cash awards, gym memberships, and premium discounts. Some popular options provided by wellness programs include smoking cessation, stress management, weight loss, and diabetes management.
Wellness programs have the direct goal of helping participants move into a healthier lifestyle, with reduced healthcare concerns. The indirect goal is lower healthcare costs. These benefit everyone: the employee, the company, and the healthcare provider.
Wellness programs can tap call center services to better achieve these two goals and add value to their program. Here are some things that a call center can provide to enhance a wellness program.
Though most signups for wellness programs happen online, this isn’t a solution for everyone. Some people feel more comfortable talking with a real person over the phone and others have questions. And what happens to those people who can’t access the web form or encounter problems once they get there? Provide a ready solution for these people by offering the option to enroll over the phone.
Class and Event Registration
Most wellness programs offer various classes and events to their participants. These might include stress reduction classes or a 5k race. Just as with enrollment, signing up for classes and events mostly happens online. But this solution won’t work for everyone. That’s why providing alternative phone backup is the way to go to help maximize participation.
Another service call centers can provide to wellness programs is offering web chat capabilities. When a website visitor doesn’t see the option they want or can’t find the answer to their question, help is a click away with web chat. From a technical standpoint, adding a web chat option to a website is easy. Staffing it around-the-clock is hard. That’s where a call center comes in. They’re available 24/7 to help participants anytime of the day or night.
Class and Appointment Reminders
Just because someone signed up for a class or made an appointment doesn’t mean they’ll show up. No-shows result in inefficiency and cause a financial loss for the provider, as well as accomplishing nothing for the participant. Making strategic reminders to participants by phone, email, or text will help increase their commitment and ensure their participation. It’s an easy solution for your call center to provide and pays off huge.
People increasingly expect 24/7 customer service and support. This is challenging for any organization to offer and cost prohibitive to provide in house. Yet a call center already has staff in place, so extending around-the-clock availability to program participants is a cost-effective solution.
We’ve talked about self-service over the internet and personal service over the phone. Yet there are other communication channels available for people to use. Why not let them use their channel of choice? This might include email, text messaging, or social media. A full-service call center is already set up to use these communication channels, so why not extend these options to your program participants?
Wellness programs empower employees to improve their health and help companies hold down healthcare costs. To maximize the utility and results of a wellness program, tap a full-service call center to add value. A call center can handle telephone enrollment, offer class and event registration, and provide web chat. They can also remind participants of classes and appointments. In addition, they offer 24/7 availability and multi-channel access, which will delight participants and increase their involvement. This improves health outcomes and saves money.
Emergency Room (ER) overcrowding
is widespread in hospitals, creating delays and diversion from those who need care
the most. According to a recent article, “Compounding the problem is the alarming
trend of a decreasing number of ERs and an increasing number of ER visits.”
All too often, injury or illness appears without warning for patients. For hospitals trying to control overcrowding, the obvious solution is to redirect patients who don’t need to be in the ER to more appropriate paths for care. Who then determines if it’s necessary for a patient to go the ER? Most people aren’t trained medical professionals, and as a result, they worry and end up in the ER for non-urgent symptoms.
Patients faced with uncertainty
about where to go, all too often, end up calling the ER department and receive a
standard response: “We are not allowed to give advice over the phone. If you think
you have an emergency, please hang up and call 911. If you think you need to see
someone, you can come to the emergency room or call your doctor.”
So, who do you call?
One hospital in Oklahoma, with a similar issue, wanted to change this process. What if they provided a nurse triage line that would be available to receive calls from the patients calling the ER? Having the reassurance of a triage nurse could help decrease the number of people in the ER for non-emergency reasons.
This would provide patients with
quick and easy access to a trained medical professional to assist in determining
the appropriate next steps based on their symptoms and medical history. Also, since
the nurses work independently from the hospital system, the nurses would provide an objective opinion increasing
The results were inspiring. The nurses significantly decreased unnecessary emergency room visits. A random survey of about 520 patients uncovered their plans before talking to a nurse. This helped determine the effectiveness of the system.
Out of 240 patients who were planning to go to the ER, 42 percent of them were diverted to a lower level of care, including 17 percent that received home care needing no additional follow up actions. This translated into a savings of at least 215,000 dollars in unnecessary ER visits, not to mention providing peace of mind for patients being able to stay home and rest.
Better Health Outcomes
The benefits didn’t just stop at ER costs savings. Consider the patients who called into the nurse triage line and were not intending to go to the ER. Some medical conditions are considered emergencies because they require rapid or advanced treatments.
Surprisingly, close to 20 percent of the patients who called into the nurse triage line had symptoms that were serious enough to warrant a visit to the ER. Without the nurse line, the outcomes for these patients could have been life threatening or fatal.
While nurse triage has shown significant
effectiveness in an outpatient setting, this preliminary data shows even greater
promise to expand this model to emergency rooms around the country.
Providing local communities with a nurse triage program not only prevents unnecessary ER visits and saves on healthcare costs, but it also ensures patients get appropriate care when a serious symptom arises. For the hospital, this increases goodwill in the community while addressing the overcrowding of the ER: a win-win all around.
Dr. Charu Raheja is the co-founder and CEO of the Triage Logic Group. Charu’s personal struggles and triumphs with her health define both her personal and her professional mission. Most recently, her experience in overcoming a life-threatening health event led her to launch the Continuwell brand. The TriageLogic Group provides telehealth software, mobile communication solutions, and services to large medical centers and businesses around the country. It is part of the Women’s Business Enterprise National Council (WBENC), and it covers over 25 million lives nationwide. Visit www.TriageLogic.com or contact Amy Smith at 888-TEAMTLC for more information.
The average cost of a data breach in the United States has hit an all-time high of 7.35 million dollars. Just this year, there have been more than one hundred hacker attacks on healthcare organizations, according to the U.S. Department of Health and Human Services. Despite better awareness among healthcare organizations, data breach costs average 408 dollars per record. Cybercriminals use weaponized ransomware, misconfigured cloud storage buckets, and phishing emails to attack.
Hidden costs in data breaches are difficult and expensive to manage, resulting in customer turnover, reputation damage, and increased operational costs. Knowing where the costs lie, and how to reduce them, can help companies invest their resources more strategically and lower the huge financial risks at stake.
Here are a few critical questions you should consider when selecting your partners in healthcare:
Do you have a chief information officer (CIO) who oversees the security program?
Do you have a formal security compliance program in place with yearly audits?
Is the vendor URAC accredited so there is a third party auditing the triage call center policies and procedures to ensure they are followed?
Does the vendor sub-contract services? If they do, are the proper BAAs (business associate agreements) and contracts in place?
What is their data breach insurance policy limits?
Is the data center infrastructure set up to maximize data protection along with regular scanning of the software and servers?
Does the vendor have an intrusion detection system to alert potential threats?
Does the vendor have adequate IT resources to monitor all systems and to respond quickly to any potential threats?
Do the products meet HIPAA, HITECH, and other security requirements?
Do the security reports meet all auditing and HIPAA reporting needs?
Do you have a formal HIPAA training program for all staff members?
Does the data center where the data is stored have proper security certifications?
Is the patient data secured at all times and in all modules of the product? (This must include strong password protection or other user authentication, data encrypted at rest, and data encrypted in motion.)
Is the patient’s data secured when accessed via handheld devices, such as through secured through SSL web sites, iPhone apps, and so forth?
If the answer is no to any of the above questions, then it may be an indication that you should look deeper and compare vendors before selecting one that will protect your patient data properly. Don’t be afraid to dig deeper and ask vendors questions if you have any concerns. Remember, it is a lot harder to change vendors once you implement a program than to ask questions and make sure that you have the best system in place for your needs.
Ravi K. Raheja, MD is the COO and medical director of the TriageLogic Group. Founded in 2005, TriageLogic is a URAC accredited, physician-lead provider of high-quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. The TriageLogic group serves over 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.comandwww.continuwell.com.
In 1988, Les Mortensen had the foresight to create a product to help hospitals help the patients they serve. Since then, hundreds of hospitals, thousands of users and millions of patients have benefitted.
LVM is now one of the industry’s largest providers of hospital-based healthcare call center solutions. It celebrated another successful year in 2018, marking its thirtieth year serving the healthcare industry.
When reflecting upon how LVM has continued to grow throughout its 30-year history, three critical components come to mind: providing comprehensive, efficient software; using recognized, quality clinical content; and building positive relationships with clients across all company departments.
At LVM, past accomplishments drive ongoing improvements and the development of additional functionality to increase the success of its clients. What keeps LVM the logical choice when selecting a healthcare call center partner is its practice of constantly adding increased functionality, greater usability, and enhanced call handling efficiency to its products. Client input assists the LVM development team to assure the products and services LVM delivers address the industry’s greatest needs.
Some recent enhancements include:
The chat product is a web-based function that is setup on the client’s website to allow a patient to engage and start a chat with the contact center.
An alternate, streamlined hospital transfer module provides clients a more efficient method to process the initial call’s data capture and needed sending information, track a working diagnosis, and record the data necessary to complete acceptance tracking. This simplifies the process while still collecting all the pertinent information.
Quick Entry Screen
A reformatted quick entry screen optimizes data entry and ease-of-use.
Auto Merge Data on Save
A new view records option appears on the data conflicts screen. Selecting this option allows the user to evaluate the record in conflict for changes when saving.
The following fields are marked “protect this field” by default: myLVM password, SMTP password, credit card user password, and PDF owner password. Data stored in these fields is not viewable during a call.
Read Only Fields
Fields can be set as read only giving the user the ability to see the information displayed in the field, but they will be unable to make changes. The field will be grayed out on the screen.
The updated sign on screen alerts the user that their password is going to expire by the changing background color. The color changes when the password is going to expire in less than ten days.
The optimized and updated security settings provide for more finite control and consistent security measures. The following are some recent changes regarding password security set-up and use rules designed to make using the product more secure:
Heightened Login Security: When a user exceeds the number of failed login attempts, their record is locked. It requires a user with manager authorization to unlock the record.
Inactive Accounts Expire in x days: Sets the number of days until the password automatically disables inactive user accounts. Inactive user accounts are marked “Don’t Use” when disabled.
Login Attempts Before Account Lock: Designates the number of consecutive failed login attempts required before locking a user’s account. Once locked, a manager can unlock the account, or the user must wait the designated time before it will unlock.Account Lock Will Expire in x minutes: Designates the number of minutes before a user’s account will unlock and they can try to login again. This field works in conjunction with “login attempts before account lock.”
Password History Entries: Choose how many previous passwords are kept to prevent re-use. The user will be prevented from using these passwords when creating a new one.
Password Minimum Special: Choose the minimum number of special characters required to be in the password.
LVM’s team of industry experts constantly study changes in healthcare to stay abreast of significant changes affecting healthcare call centers. These efforts distinguish LVM from other companies whose sole focus is software development.
At LVM, healthcare organizations have a partner to provide ongoing updates to its pediatric and adult nurse triage functionality, CRM database segmentation and marketing capabilities, physician referral, class/membership management, service referral, patient transfer, behavioral health input, and many other functions. LVM also offers a comprehensive co-morbidity care management program (CCMP) for individuals with chronic disease(s). CCMP focuses on educating and engaging individuals, earlier interventions, coordinating care, and managing transitions across the continuum.
For more information or a demonstration of LVM’s call center solutions contact Carol Zeek, regional VP, sales, at 480-633-8200 x279 or Leann Delaney, regional VP, sales at 480-633-8200 x286.
Mark Dwyer is a 32-year veteran of the healthcare call center industry. He joined LVM Systems in 2003 and currently serves as COO.