The August/September 2018 Issue of AnswerStat

Read the August issue of AnswerStat, the information hub for healthcare contact centers.



Feature Content:

August 2018-Peer ReviewUtilizing Peer Review to Minimize Risk in a Medical Call Center, by Mark Dwyer
Following a nurse peer review process enables the medical call center to minimize its overall risk…. read more >>

Vital Signs: A Brand is Only as Good as the Company and Staff Behind It, by Peter Lyle DeHaan, PhD
Though rebranding offers excitement and commands attention, don’t pursue it until you’ve addressed the service behind your brand and the staff who provide it.… read more >>

Vendor Spotlight on Pulsar360
Pulsar360, Inc. is one of the oldest VoIP service companies in the United States and Canada and an early proponent of cloud technology for the communications industry.… read more >>

Guest Column: Why Hackers Target Your Medical Records Instead of Your Credit Cards, by Nicole Limpert
Cyber criminals increasingly target electronic protected health information (ePHI) because hackers can get a premium price for this personal information on the dark web.… read more >>

Four Steps to Minimize Risk in a Healthcare Call Center, by Janet Livingston
Follow these four tips to help ensure your operation functions as it should and provides the high-quality service callers expect.… read more >>

Three Tactics for Transforming a Call Center into a Care Center, by Gina Tabone
We need to develop training that helps call center caregivers convey interest, concern, and competency to callers. Here are three suggestions to begin the transformation of a call center team.… read more >>

Seven Tips to Minimize Risk and Improve the Patient Experience, by Bronson Tang
The medical call center is a crucial component within healthcare to improve the patient experience, while minimizing risks…. read more >>

Ten years ago: Using IVR to Improve Post-Discharge Patient Care, by Gary Hannah
An array of IVR options exist with a range of prices. A healthy, due diligence process will help to find the right solution for every environment and telephone triage model.… read more >>

Industry News:

        

Call4Health      TriageLogic

1Call      Startel

TeamHealth Medical Call Center      Ambs Call Center

AAACN       Citra Health Solutions

Call Center Sales Pro, providing proven healthcare call center solutions      Pulsar360


About AnswerStat
AnswerStat is the information hub for healthcare contact center news and resources, published specifically for hospital and medical contact centers and distributed free to qualified readers, decision makers, and influencers at hospitals and healthcare contact centers worldwide.

For more information, email Peter DeHaan.

Seven Tips to Minimize Risk and Improve the Patient Experience


Pulsar360: strategic partners with the TAS industry


By Bronson Tang

According to Statista, the percentage of businesses worldwide using a call center in the Americas is 66 percent. However, according to the Global Contact Center satisfaction index, the level of caller satisfaction dropped five points from 2010 to 2018. Medical call centers are now looking for ways to improve patient experience, while minimizing risk. The goal of a call center typically includes:

  • Increase patient satisfaction
  • Reduce readmission
  • Improve patient safety
  • Reduce missed appointments
  • Increase patient retention
  • Increase patient referrals
  • Resolve complaints and disputes
  • Increase patient lifetime value

In general, the medical call center should be tailored to increasing the satisfaction of the individual patient and not just the efficiency of the call. In addition to patient satisfaction, there is an overall feeling that many call centers focus too much on efficiency when they need to focus on effectiveness.

Here are seven ways you can minimize risk in a medical call center.The medical call center should be tailored to increasing the satisfaction of the individual patient and not just the efficiency of the call. Click To Tweet

1. Call Center Etiquette Matters: The need for proper etiquette is essential. This includes how calls are answered, how the patient is treated during the call, and how well issues and questions are addressed.

2. Hire the Right People: Hiring experienced call center agents is critical to the success of any medical call center, as this will significantly reduce the likelihood for agent turnover as well as the costs incurred in training. When you hire the right people, the agent will be able to achieve first call resolution, resolve disputes quickly and effectively, assure quality and security on every call, and reduce wait times.

3. Use the Right Technology: The technology that both your agents and patients use is important. From an agent perspective, having the right technology includes agent desktops, call monitoring, queue callback, intelligent dialers, and CRM integration with screen pops. From the patient perspective, having the right technology includes various ways the patient can easily interact such as emails, SMSs, video chats, tweets, and Facebook posts.

4. Measure Success with Call Center Metrics: Measuring quantitative performance such as call quality, first call resolution, patient satisfaction, average speed of answer, abandonment rate, and wait time are some of the ways medical call centers can have a visible eye on the success of their operation.

5. Reward and Motivate Agents: How agents deal with patients is in direct proportion to how well they are dealt with in their own company. Rewarding and motivating agents can go a long way toward producing a pleasant experience for the caller. This also includes empowering agents so they feel confident in their ability to do the job.

6. Ensure Agents Adhere to Regulations: Every organization has their own regulations, and medical call centers are no different. It’s vitally important that agents are well informed and follow the rules outlined by the call center. The medical call center needs to put in place proper measures to ensure those expectations have been communicated and understood by the agents. Proper training is the key.

7. Evaluate Agents: A method for evaluating agents is important to any medical call center, as it keeps the organization up to date with what is actually going on with each employee. Depending on the organization, having daily meetings with agents can help reduce potential risks that can take place on live calls.

Conclusion: The medical call center is a crucial component within healthcare to improve the patient experience, while reducing risks. Ultimately the decision is yours as to how you go about minimizing risks in your call center. The key is creating a positive experience for the patient.

Pulsar360: strategic partners with the TAS industryBronson Tang is the marketing manager at Pulsar360, Inc. He has ten years of experience in digital marketing and has worked in the Telecommunications sector for four years. He’s the author of the book, The Tao of Business.

Four Steps to Minimize Risk in a Healthcare Call Center


Call Center Sales Pro, providing proven healthcare call center solutions


By Janet Livingston

Running a call center is challenging, but mastering one in the healthcare industry carries an added set of concerns. People’s health and even their lives are at stake. Make a mistake and effect someone’s future, even their life. Although it’s impossible to eliminate all risks, a few simple steps can greatly minimize it.

Hire the Right Skill Set

Determine what credentials you want staff in each position to carry. Then hire to meet those requirements. Don’t skimp or settle for someone less than ideal. With so much at stake you don’t want to have an underqualified employee attempt to handle too big of a responsibility. This starts with hiring the right people for each position.

Provide HIPAA Training

Everyone in healthcare knows you must provide HIPAA training on a regular basis to all employees. However, finding time to do this may present a challenge. Every day in the call center is a busy one. This makes it easy to push off nonurgent tasks to tomorrow, to next week, and to next month. When it comes to HIPAA training, don’t delay. Make it a priority, and then do it. Provide HIPAA education as part of new employee onboarding. Then, provide HIPAA instruction for every employee each year.

Insist that Staff Don’t Exceed Their Capabilities

Many medical call centers have a mix of staff, some with medical training and others without it. Though those without a healthcare background will quickly pick up medical jargon, processes, and even some protocols, make sure they don’t attempt to provide a level of service they aren’t trained to do. Nurses should provide nurse triage, while non-nurses shouldn’t offer any degree of medical advice. It’s that simple. This is one time to keep everyone in their place.

Have a Good Errors and Omissions Insurance Policy

Having a good errors and omissions (E & O) policy is important for outsource call centers and especially essential for healthcare related operations. However, don’t view this as an excuse to take shortcuts. Instead strive to run your call center so that you’ll never need to file a claim. Consider E & O insurance as a backup in case the unthinkable happens.

Conclusion

Though there’s a lot that can go wrong in a healthcare call center, there’s no reason to let it cause you to lose sleep. Follow these four tips to help ensure your operation functions as it should and provides high-quality service that your stakeholders expect.Provide high-quality service that your stakeholders expect. Click To Tweet

Call Center Sales Pro, a full-service healthcare call center consultancyJanet Livingston is the CEO of Call Center Sales Pro, a premier consultancy and service provider for healthcare call centers and medical answering services. Contact Janet at contactus@callcenter-salespro.com or call 800-901-7706.

Rebranding a Medical Call Center



A Brand is Only as Good as the Company and Staff Behind It

 By Peter Lyle DeHaan, PhD

Peter DeHaan, Publisher and Editor of AnswerStatA company I do business with just announced a name change. They’re rebranding themselves. Their new name is supposed to better align with their core values, culture, and corporate vision. It’s also intended to dispel some confusion associated with their current name.

I get all that. And I think it’s a mistake. They’re going to lose a lot of momentum and confuse people in the process.

While it’s fun to dream, plan, and think grand thoughts about a new name, it’s more important to serve customers with excellence and provide value for the money they spend with you. Although a brand can help accomplish those things, it can also serve as a distraction.

If you’re thinking about rebranding your call center, here are some things to consider.

What’s in a Name?

Rebranding a Medical Call CenterOne big issue in rebranding is the industry label of call center. Maybe those words are part of your name or at least implied by it. But likely they appear on your website and are part of your promotional materials. Yet the phrase call center carries negative connotations and bad memories for some people. As a result, some call centers think they need to distance themselves from that label. Contact center is often suggested as a replacement. Some other quickly-conceived names include customer service facility, customer exchange center, or customer experience gateway.

Other concerns about a name include finding one that better describes what you do now or doesn’t limit you in the future. But will changing your name really accomplish anything?

What’s Behind the Name?

Let’s say you stop referring to yourself as a call center and switch to contact center. After all, you take more than calls, you handle contacts. But what will this affect? If you continue offering the same types of service, with the same degree of quality, and with the same staff, nothing has changed. Not really.

The reason the label call center holds negative connotations for much of the public is because of the frustrating experiences they’ve had when they interacted with call centers. If you start calling yourself a contact center—or make any other name change—you run the risk of transferring people’s negative image of your existing brand to your new brand. Before long you’ll need to move away from your new brand for the same reasons.

Instead of looking to rebrand your call center, you might be better off looking to improve the operation behind your brand.Focus on staff, their environment, and the quality of their work before embarking on any rebranding efforts. Click To Tweet

Do Staff Respect and Support Your Name?

Too often I’ve talked with employees in various industries who’ve disrespected their company. They’ve said negative things about their bosses, their resources and tools, and their compensation. After listening to their rant, I don’t want to do business with that company any more. No amount of rebranding will ever fix that.

Instead of rebranding your call center, maybe it’s best to start with your agents. Are they proud of the work they do and the company they work for? Are they adequately paid? (If you say “yes” and they say “no,” do some research to find out who’s right. Adjust as needed.)

Maybe you need to fix deficiencies in your management structure or operational processes. Perhaps you need to improve agent training, raise expectations, and hold staff accountable for the results. Alternately, you may need to hire a different caliber employee.

The point is to focus on staff, their environment, and the quality of their work before embarking on any rebranding efforts. If you don’t, rebranding will fail to meet expectations, and in a few years you’ll be doing it all over again.

Conclusion

Though rebranding offers excitement and commands attention, don’t pursue it until you’ve addressed the service behind your brand and the staff that provides it.

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.

Vendor Spotlight on Pulsar360


Pulsar360: strategic partners with the TAS industry


Pulsar360, Inc. is a Colorado-based company, with origins dating back to 2001. It’s one of the oldest VoIP service companies in the United States and Canada and an early proponent of cloud technology for the communications industry. Today, as an established unified-communication-as-a-service (UCaaS) provider, Pulsar360 delivers a comprehensive set of offerings including:

  • a cloud-based enterprise class IP PBX,
  • premise-based IP PBX,
  • session initiation protocol (SIP) trunking,
  • business continuity disaster recovery solutions,
  • T.38 faxing that meets HIPAA, GLBA, and other industry compliance regulations, and
  • carrier services.

Unparalleled Experience and Expertise

Pulsar360’s top-notch leadership team has years of experience serving the telecommunication needs of business customers, as well as building and managing enterprises of significant scale in the telecommunications industry. They understand that long-term customer relationships are earned, and customers will not be acquired and retained based on price and technology alone.

They require their team and their authorized partners to spend the appropriate time upfront to validate the integrity of the customers’ network. This is followed by a consultative sales process to develop customized solutions for their clients, as opposed to selling a packaged solution.

Once awarded the business, an in-depth implementation process is used to guarantee that design and features meet the customer’s requirements and expectations. The resulting smooth transition to the new services, responsive communication, and resolution of issues are paramount in establishing these long-term relationships.

As an employee-owned company, everyone has a personal stake in customer satisfaction and the company’s success. One testament to their customer satisfaction is that an outside industry consultancy (Franklin Court Partners) reported that Pulsar360 has the lowest attrition rate in the industry. They’re continually focused on providing an excellent customer experience, as well as expanding and enhancing their suite of service offerings.

99.99 Percent Reliability

Pulsar360 is one of a handful of providers with facilities and networks in both the United States and Canada. They have been perfecting their platform and network for over seventeen years. Their operating platforms are some of the most advanced in North America.

They currently operate four data centers (three in the US and one in Canada), each with redundant infrastructure for all their service offerings. In addition, they have a presence in five additional geographically dispersed data centers.

Pulsar360 provides services to over 160 call centers and telephone answering service customers. Understanding the special requirements of this industry, they have made a significant investment in their network infrastructure and solutions.Long-term customer relationships are earned, and customers will not be acquired and retained based on price and technology alone. Click To Tweet

National Network Redundancy

Each Pulsar360 datacenter has connectivity to several national networks. If there is a problem with quality or service issues with one network, calls route to another. With tier II access, Pulsar360 can re-route customer traffic away from regional carrier issues.

Trunk Redundancy

They provision each SIP trunk to two of their geographically dispersed data centers. If there is a data center issue, carrier issue at the data center, or other problem, the other data center takes over for all trunks and DIDs associated with those trunks.

Trunk Bursting

Pulsar360 provides 20 percent burstable trunking to call center and answering service clients at no additional charge. This can be adjusted even higher on the fly for seasonal needs.

Toll-Free Number Redundancy

All toll-free numbers are provisioned with two national carriers. In the event of a major failure at one carrier, all the customer’s toll-free numbers are directed to the secondary carrier.

Customer Administration Portal

This feature provides instant activation of DIDs and toll-free numbers, administrative management for all services and features, and multiple reports.

Business Continuity and Disaster Recovery Solutions

Pulsar360 provides several automatic failover alternatives, from simple automatic failover to secondary and tertiary internet connections, to automatic failover to a hot stand-by cloud business continuity and disaster recovery system.

If the customer’s premise or cloud system goes down, calls automatically failover and are delivered directly to operator desktops via softphones. Calling party ID and customer name or account number are delivered to the operator. It also includes a cloud-based IVR with multiple call queues, skills-based routing, and more when in failover mode. These options are flexible and customizable based on the customer’s unique requirements.

Quality of Service

With Pulsar’s SD-WAN offering they can provide quality of service (QoS) over the internet to their data centers. This—coupled with their 24/7 internet quality of service monitoring and issue alerting that includes scheduled VoIP quality tests with archived test results—insures they deliver the reliability to meet and exceed their customer’s expectations.

Carrier Partnerships

Pulsar360 has wholesale arrangements with numerous global carriers and competitive local exchange carriers. In addition to offering competitive rates and to alleviate finger pointing, the network services can be in Pulsar360’s name. They will receive issue notification by their circuit monitoring and will interact directly with carriers. They also interact directly with the customer’s system provider on issues. This provides one point of responsibility for their customers.

Pulsar360: strategic partners with the TAS industryOver the years Pulsar360 has received numerous awards and recognitions. They have recently been recognized as the 30 Fabulous Companies of the Year 2018, number twenty of the 150 Fastest Growing companies in the telecom sector, Product of the Year 2018, as one of the top 10 Unified Communications Solutions providers in the U.S. In addition, they received the Product of the Year Award for 2017 and the Hosted VoIP Award of Excellence in 2016.

What Does an Optimal Customer Experience with a Call Center Look Like?



By Daymon Smith

 As the healthcare landscape shifts toward a value-based care model, consumers and patients are taking more responsibility for their individual health. The combination of higher premiums, copays, and deductibles mean consumers hold the care they receive to a higher standard. They research competitive pricing, treatment quality, and customer service to make informed decisions.

This shift in focus within the healthcare sector has increased the importance of offering consumers and patients value that goes beyond quality care and treatment options. More specifically, healthcare marketers prioritize personalized engagement on an individual level. They match consumers with the resources, providers, and treatment options that offer the best overall health outcomes and highest customer experience.

In this effort, hospitals and organizations have started to optimize the role call centers play, adopting a variety of capabilities to merge disparate points of contact into one centralized, proactive call center. Also known as an engagement center, these modernized call centers, which work in conjunction with health care risk management (HCRM), enable healthcare providers to deliver the level of customer experience and personalization consumers expect.

The ideal customer experience that a consumer should receive when engaging with a call center is key. Healthcare providers should strive to deliver this level of customer service through technology and training.

Customer Service Expectations in Healthcare

Today’s consumer expects quality customer service across their health journey, from first point of contact to post-care engagement. Often the first point of communication between a customer and the healthcare organization, call centers are faced with the responsibility of living up to the expectations of modern healthcare consumers. In fact, they handle around 68 percent of all customer communications, further emphasizing why consumers hold the call center customer service they receive to a higher standard.

Consumers expect:

Personalized service: When patients and consumers interact with the healthcare call center, they expect insights, resources, and interactions personalized to their unique health journey. Therefore, call center agents must understand each patient’s issues and provide solutions proactively.

Single call resolutionIt’s crucial call center agents tap caller data to provide actionable and individualized recommendations, connect them with doctors and physicians, provide useful and relevant resources, and proactively anticipate consumer needs.

Cross-channel capabilities: Traditional call center operations are siloed, resulting in a fragmented customer experience. With an HCRM-enabled engagement center, health systems deliver the seamless and personalized experiences customers want across communication channels, including the call center, patient portal, and email.

Agents move callers forward along the patient journey: Quality customer service within the healthcare sector extends far beyond one phone call. Patients expect guidance and assistance from healthcare organizations throughout their care experience. This includes communication, connecting the consumer with necessary resources and solutions, and ensuring the experience is as convenient as possible.

Here’s an example: At the start of the patient journey, a consumer submits a website form submission requesting information on shoulder pain. After receiving the requested information in an email, the customer is placed in an outbound calling queue for follow-up.

The call center agent provides additional information and offers to connect the customer with a specialist. The call center agent connects them with an orthopedic physician near their home and sends timely reminders before the appointments.

During the appointment the physician recommends physical therapy. The patient receives a call the same day from the call center to match them with a physical therapist and schedule their first appointment. The patient receives an SMS reminder forty-eight hours before the appointment.

Each interaction with the organization is recorded in the healthcare CRM to ensure continuity and enable personalization throughout the patient journey.

Technology for Optimized Healthcare Customer Service

The customer service consumers expect from healthcare organizations forces call centers to evolve into comprehensive engagement centers. With the goal of serving as a strategic tool for engagement, revenue growth, and greater visibility into return on investment, these call centers combine technology with call center agent training for optimized customer service.

For call centers looking to shift toward becoming an engagement center, a healthcare CRM program can serve as the foundation for successful engagement. With an HCRM in place, call centers can provide consistent, unified communications with patients and consumers while connecting disparate points of contact throughout the health system. Additionally, an HCRM provides call center agents with a 360-degree view into the customer data needed to facilitate personalized, efficient consumer interactions.

More specifically, call center agents can take advantage of unique customer profiles—a collection of demographic data, prior interactions with the organization, contact preferences, and appointments and medical history—to ensure they’re utilizing the best method of communication (phone, email, or chat) and delivering relevant health information.

An engagement center should also incorporate marketing automation to send reminders and resources throughout the patient journey. Marketing automation tools help call centers maintain long-term engagement to promotes patient acquisition and strengthens patient retention.Healthcare organizations need to incorporate modern marketing technology and comprehensive into their strategies Click To Tweet

Call Center Training for Optimized Customer Service

Like any job, the better the training—the greater the impact. For healthcare call center agents, training is a significant facilitator to outstanding patient and customer service. One of the most important aspects of call center training revolves around the proper use of call center scripts.

By developing scripts to guide agent conversations, healthcare organizations ensure the call center customer experience aligns with marketing efforts. Additionally, scripts can help call center agents focus on guiding customers toward a pleasant and timely resolution of their queries.

As a good practice, call centers should equip agents with at least one script for each campaign that can be tailored to the individual customer while reflecting their location within the patient journey.

Another important element to call center training is ensuring agents can handle any non-clinical queries. Given the high volume of customer interactions call center agents handle each day, it’s crucial they have a clear understanding of the healthcare organization ecosystem, as well as the capability to handle queries on the fly.

Final Thoughts

Consumers today expect more value from their care providers. Optimizing the traditional healthcare call center into a modern engagement center helps provide the efficiency, personalization, and capabilities that have become synonymous with superior customer service.

To best leverage the potential of call centers and optimize the customer experience within them, healthcare organizations need to incorporate modern marketing technology and comprehensive training into their strategies.

Daymon Smith is the vice president, engagement center practice leader at Evariant. He focuses on leading health systems in their move to a proactive call center model that improves the overall patient experience and generates revenue for the system.

Utilizing Peer Review to Minimize Risk in a Medical Call Center


LVM Systems


By Mark Dwyer

peer reviewPeer review is a method of examining the quality of nursing care in terms of structure, process, and outcome. The American Nurses Association (ANA) describes peer review as the process by which practicing registered nurses systematically assess, monitor, make judgments, and provide feedback to peers by comparing actual practice to established standards. The expected outcomes of this process, in the context of a professional nursing practice model, include increased professionalism, accountability, autonomy, retention, improved communication skills, and quality outcomes.

Let’s look at how this applies specifically to assessing nurse triage calls in a medical call center. The process begins with selecting triage call records from a date range for peer review based on various triage data elements. Data points such as the triage date, triage nurse, guideline used, and disposition level are some of the standard selection criteria.

Once the appropriate records are selected for review, they are typically assigned to a queue for an immediate review or later when time permits. (Note: when conducting the peer review, the nurse reviewer must have access to both the written and, if available, audio call record.)

As the nurse conducting the peer review begins the process, she accesses the original triage call record to identify the nurse who handled the call, the patient’s birthdate and age, the date and time of the call, and the guideline used. This is also when the nurse reviews the original triage details, specifies the review type, and may indicate if the call is part of a quality improvement (QI) project.

Having reviewed the triage details, the nurse reviewer identifies the disposition selected during the original triage call. If the reviewer believes the disposition was under-referred or over-referred, the call is passed to QI management for the QI manager to determine the reason for the inappropriate referral. Some of the standard reasons resulting in an under or over-referral are:Following a nurse review process enables the medical call center to minimize its overall risk. Click To Tweet

  • Incomplete assessment or not enough objective data
  • Nurse did not recognize a serious symptom
  • Wrong guideline used
  • Nurse did not adhere to the guideline
  • Inadequate interventions tried at home

If the call included an audio recording, a separate set of questions is used to evaluate the triage assessment. These include, did the nurse:

  • Use two patient identifiers
  • Review the patient’s health history
  • Identify the main or most serious complaint
  • Assess the severity of all symptoms
  • Evaluate the guideline questions sequentially until reaching a positive response
  • Ask the caller if they understand the instructions

A thorough peer review of the audio recording must also include questions to assess the nurse’s level of communication and customer service, time management, and written documentation.

Assessing the nurse’s level of communication and customer service is done using a 3-point scale (3 = excellent, 2 = good, and 1 = room for improvement). The nurse should:

  • Develop a rapport with the caller
  • Demonstrate advocacy for the patient and family
  • Use open-ended questions through most of the interview

Additional considerations evaluate time management. These include:

  • Time progression of the call
  • Maintained control of the call
  • Redirected the caller as needed

The nurse reviewer then assesses the written documentation to determine if it aligns with the audio recording and is complete, and whether, in the reviewer’s opinion, the triage nurse selected the most appropriate guideline and disposition. Again, if the reviewer believes the disposition was under-referred or over-referred, the call is passed to QI management for the QI manager to determine the reason for the inappropriate referral.

Finally, to assess the outcome of any emergency department (ED) or urgent care center (UCC) referral, if the referral, in the opinion of the reviewer, was an under or over-referral, a unique set of questions enable a QI review by the medical director. For example:

  • Did the patient’s overall clinical picture suggest the need for an urgent visit to rule out serious differentials?
  • Was the patient seen within the appropriate time frame?
  • Did the patient receive interventions that couldn’t have been done at home?
  • What was the patient’s most significant diagnosis?

If the medical director agrees that the call resulted in an under or over-referral to the ED or UCC, she tracks the appropriate disposition and indicates the reason for the incorrect disposition.

Once the assessments are completed, monthly results are shared with the reviewed nurses providing feedback on ways to offer better telephone triage services. The manager also runs reports to quantify departmental results. Using this information enables the manager to conduct remedial training as appropriate.

An effective peer review program allows for a formal approach to the analysis of performance and to the systematic and continuous actions that lead to measurable improvement. Following a nurse review process like this one enables the medical call center to minimize its overall risk.

LVM SystemsMark Dwyer is a 32-year veteran of the healthcare call center industry. Mark is in his sixteenth year at LVM Systems, where he serves as COO. LVM Systems provides healthcare call center software. 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.

Why Hackers Target Your Medical Records Instead of Your Credit Cards



By Nicole Limpert

Despite the care most of us take to protect our credit card information, credit card fraud is the most common form of identity theft in the United States. According to a report from Javelin Strategy & Research, 15.4 million consumers were victims of identity theft or fraud, which cost U.S. consumers more than 16 billion dollars in 2016.

However, cyber criminals increasingly target electronic protected health information (ePHI), because hackers can get a premium price for this personal information on the dark web.

Sold to the Highest Bidder

Raw credit card numbers, those that are missing PIN and user information, are worth $1 or less each on the dark web. More complete credit card records that have personal information command a higher price—up to $30 each depending on the country of origin. The most valuable prize for fraudsters is someone’s medical record. Estimates vary, but in general records consistently sell for $70 to 90 each. Some hackers claim to sell blocks of thousands of records and receive over $100 per individual record.

Historically, healthcare data breaches were the result of internal staff actions (both accidental and intentional), but the Ponemon Institute’s Fifth Annual Benchmark Study on Privacy & Security of Healthcare Data in 2015 discovered that the primary reason for healthcare data breaches was due to criminal attacks.

The report states, “Employee negligence and lost or stolen devices still result in many data breaches, according to the findings. However, one of the trends we are seeing is a shift of data breaches—from accidental to intentional—as criminals are increasingly targeting and exploiting healthcare data.”Cyber criminals target electronic protected health information, because hackers can get a premium price for this personal information on the dark web. Click To Tweet

Why ePHI is So Valuable

It is estimated that our global healthcare industry will be worth 8.7 trillion dollars by 2020. Cyber criminals are cashing in by using stolen patient data primarily for insurance fraud, medication fraud, and financial fraud.

The Identity Theft Resource Center, a U.S. non-profit that provides victim assistance and consumer education, reported there were 355 healthcare breaches in 2016 affecting 15 million records.

Information contained in a medical record is particularly useful for lucrative fraud schemes because it’s high-quality, deeply personal, and permanent. On the dark web this type of data is referred to as “fullz” (full packages of personally identifiable information). Fullz can’t easily be replaced like credit card numbers so it is more useful and provides more value to criminals.

Because the information contained in a health record is complete and comprehensive, it’s extremely versatile, and it takes much longer for fraud to be detected. The information can be used in a variety of fraud scenarios.

Sometimes personal identities are stolen to receive medical care. The Ponemon Institute provides an example where a patient learned his identity was compromised after receiving invoices for a heart procedure he hadn’t undergone. His information was also used to buy a mobility scooter and medical equipment, amounting to tens of thousands of dollars in fraud.

Why is ePHI So Vulnerable?

In response to increasing threats to patient health data and poor security, the Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted in 2009. The act provided a 27 billion dollars incentive to encourage health providers to switch from paper medical records to electronic files.

The results have been disappointing. Many healthcare organizations were slow to adopt electronic files because of struggles connecting different technologies. These disparate technologies need to work together so electronic health records (EHRs) are available to the appropriate staff.

President Obama was interviewed by Vox’s Ezra Klein and Sarah Kliff on January 6, 2017 and explained this lack of interoperability was something he and his administration didn’t expect:

“We put a big slug of money to encouraging everyone to digitalize and catch up with the rest of the world here. And it’s proven to be harder than we expected, partly because everyone has different systems. They don’t all talk to each other, it requires retraining people in how to use them effectively, and I’m optimistic that over time it’s inevitable it’s going to get better because every other part of our lives, it’s become paperless.

“But it’s a lot slower than I would have expected; some of it has to do with the fact that it’s decentralized, and everyone has different systems. In some cases, you have economic incentives against making the system better; you have service providers—people make money on keeping people’s medical records—so making it easier for everyone to access medical records means that there’s some folks who could lose business. And that’s turned out to be more complicated than I expected.”

As a result, hospitals and clinics have been operating, at least in part, with outdated technology, exposing them to the dangers of cyber-attacks.

Are Paper Medical Records Better?

It may be tempting to think paper medical records are a safer option but according to a recent study published in the American Journal of Managed Care, they found that paper and films were the most frequent location of breached data.

Verizon’s 2018 Protected Health Information Data Breach Report also found that 27 percent of data breach incidents were related to sensitive data on paper.

The Verizon report authors wrote, “Medical device hacking may be in the news, but it seems the real criminal activity is found by following the paper trail. Whether prescription information sent from clinics to pharmacies, billing statements issued by mail, discharge papers physically handed to patients, or filed copies of ID and insurance cards, printed documents are more prevalent in the healthcare sector than any other. The very nature of how PHI paperwork is handled and transferred by medical staff has led to preventable weaknesses—sensitive data being misdelivered (20 percent), thrown away without shredding (15 percent), and even lost (8 percent).”

The Future of ePHI

While the progress is slow, it appears more hospitals are using ePHI and beginning to catch up with the technological needs to protect it.

In 2017 the American Medical Informatics Association released a report using information from an American Hospital Association survey about hospital information technology. They measured “basic” and “comprehensive” EHR adoption among U.S. hospitals and found that 80.5 percent of hospitals had at least a basic EHR system.

Data breaches in the U.S. healthcare field cost around 6 billion dollars annually. Even though the latest IBM Security/Ponemon Institute study found that in the United States, healthcare data breach costs are higher than any other industry sector, the average cost per record is decreasing. The average data breach cost per record in the healthcare industry was 380 dollars in 2017, down from 402 dollars the year before.

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

1Call Announces Brad Swift as a Contract Services Sales Manager

1Call, a leader in developing software solutions and applications designed for the specific needs of the healthcare call center marketplace, is pleased to announce that the company is entering into a contract with Brad Swift to support healthcare organizations and their growing need to quickly have access to the newest 1Call software features.

Brad will help healthcare organizations get up-to-date with current technologies, assist with projects such as acquisitions and department mergers, and help with growth and future development.

“Brad had a successful eighteen-year sales career with us in the past, serving our customers in Canada,” said Tom Curtin, president of 1Call. “Our customers will be able to outsource to 1Call to help get work done that they can’t find resources for and add even more call center processes to their 1Call call center system.”

For example, “When hospitals are unsure about the liability that comes with hiring temporary employees for their communications projects, I will be able to help,” Swift said. “I’m backed by 1Call’s resources, expertise, and personnel who are trained in accordance with HIPAA and HITRUST directives.”

1Call, a division of AmtelcoFor more information contact Brad Swift at 800-729-0752 or bswift@1call.com.

Startel & Professional Teledata Complete HIPAA Assessment

Startel and Professional Teledata successfully completed their Healthcare Insurance Portability and Accountability Act (HIPAA) assessment. This marks Startel’s fourth and Professional Teledata’s first assessment for HIPAA compliance and reinforces the companies’ commitment to protecting consumer data and privacy. SecurityMetrics performed the third-party compliance assessment.

Following an evaluation of Startel and Professional Teledata’s offices, data centers, and software solutions, SecurityMetrics determined that the companies implemented policies and procedures to fulfill its obligations under HIPAA and Health Information Technology for Economic and Clinical Health Act (HITECH). Both companies received scores of 100 percent for compliance posture of administrative, physical, and technical safeguards as well as organizational requirements.

“We are thrilled with this year’s compliance achievements,” said Startel, Professional Teledata, and Alston Tascom president and CEO, Brian Stewart. “HIPAA security and compliance are top priorities for us. We look forward to continuing to deliver contact center solutions and services that help our customers grow their business and safeguard electronic protected health information.”

“Startel and Professional Teledata successfully implemented policies, procedures, and safeguards designed to comply with HIPAA,” said Brand Barney, senior HIPAA security analyst at SecurityMetrics. “Throughout the audit, we took into account the size, capabilities, cost, and probability of risk when evaluating the security measures implemented by Startel and Professional Teledata.”

The full HIPAA report is available to customers upon request. The companies will also sign Business Associate (BA) agreements with clients who require HIPAA compliance. Next year’s audit will include an assessment of Alston Tascom’s operating environment, data center, and solutions.

For more information, call 949-863-8776 or visit www.startel.com.

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