1Call Announces Major Transformer Update

1Call, a division of AmtelcoThe 1Call Division of Amtelco announced a major update to the capabilities of the Transformer data importing utility. This update features an improved user interface, along with many new capabilities, saving countless hours for new 1Call customers and current customers upgrading to newer platforms such as Genesis.

The Transformer speeds and simplifies the process of moving data by using a set of utilities to import data (including SQL, LDAP, and delimited files), directories, on-call schedules, ACD tables, agent settings, client information, greetings, and images. These utilities are run separately and include the ability for users to determine how the source data will be transformed.

Vice president of research and development, Kevin Beale, commented, “Our software engineers have spent many hours refining the Transformer tools to meet current and future customer needs. The result is a new streamlined process that has impressed many customers who have already used it.”

For more information contact 1Call at 800-225-6035 or info@1call.com.

2017 1Call Leadership and Training Seminar Wrap-Up

1Call, a division of AmtelcoThe 1Call Division of Amtelco completed another successful 1Call Leadership and Training Seminar. 1Call customers, along with prospects and Amtelco staff, gathered in Madison, Wisconsin, September 12–14, 2017, to experience sessions to help healthcare organizations enhance their enterprise-wide communications.

After the informative “Generations Collide” keynote presentation by Chad Kopitzke of NeXtGen Advantage, attendees learned about Genesis, MergeComm, and miTeamWeb, along with new features for miSecureMessages and the Intelligent Series. In addition, customers presented sessions on MergeComm, web chat, miSecureMessages, and Intelligent Series.

Attendees shared positive comments about the seminar, including, “Excellent”; “I look forward to what you come up with for next year”; “the Amtelco team has a knack for facilitating an approachable networking environment”; “Friends and family: Never change this! Too few companies understand this”; “I learned something at all the sessions”; “Intrigued by the endless possibilities of MergeComm”; and “Each session was a learning experience.”

Next year’s 1Call Leadership and Training Seminar will be held in Madison, Wisconsin, on September 18–20, 2018, in a new location at The Park Hotel, on Madison’s Capitol Square.

For more information on 1Call Seminars, contact 1Call at 800-225-6035 or seminars@1call.com.

The October/November2017 Issue of AnswerStat

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


TeamHealth Medical Call Center


Feature Content:

Video-Based Doctor Visits, by Mark DwyerVideo-based doctor visits have received renewed interest to address the shortages of primary care physicians nationwide; providing insurance to uninsured individuals was seen by many as a vital component of ACA; and the demand for healthcare has further increased due to our aging population, along with a declining supply of primary care physicians. What does this have to do with call centers? …read more >>

Vital Signs: It’s Hard to Plan When You Don’t Know What to Expect by Peter L DeHaan, PhD
Regardless of what you think about the Affordable Care Act (ACA), the fact that it’s future remains in limbo means that planning in the healthcare industry is challenging at best. …read more >>

Vendor Spotlight on TeamHealth Medical Call Center
The Need For Call Center Solutions Has Never Been Greater
TeamHealth Medical Call Center embraces partnerships with clients to provide individual service offerings, with measurable results, and develop long-term relationships. They seek to meet the needs of the changing healthcare industry while making the patient experience their primary focus. …read more >>

Guest Column: Why is Your Contact Center Essential to Your Organization? by Richard Stier
You are your health network’s senior leader for access with direct responsibility for the contact center. Your CEO asks. “We’re taking a hard look at the budget. Can you help me understand if, or why, the call center is vital to us? How would you respond? Three key criteria provide…read more >>

How Contact Centers Impact Patient Experience, by Donna Martin
As hospitals and healthcare organizations compete to gain and retain patients’ business, first impressions are critical. That’s why a modernized patient contact center is critical to differentiate your organization from the competition and prevent revenue leakage. …read more >>

Translation and Health Literacy In Telemedicine, by David Thompson, MD
“Fever” may sound different in other languages, but it means the same thing. Whether a patient says fever, fiebre, or fièvre, it’s the telehealth provider’s job to deliver the correct diagnosis and treatment. Language differences can add complexity to an already confusing situation for patients. Fortunately, healthcare professionals can…read more >>

Ten years ago: Email Protocol for the Call Center, by Dr. Julie Miller
Email has become the biggest productivity drain in businesses today. Getting a handle on this daily data dump by establishing procedures—email etiquette, if you will—will make you and your call center stand above the crowd. …read more >>

Industry News:

LVM Systems Ameridial

Call4Health TriageLogic

1Call Echo

Startel Professional Teledata

TeamHealth Medical Call Center Ambs Call Center

AAACN  Citra Health Solutions

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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.

Vendor Spotlight: TeamHealth Medical Call Center


TeamHealth Medical Call Center


In today’s world, the rapidly evolving healthcare industry has placed its focus on providing access to high quality, patient-centric care, with an unprecedented emphasis on cost containment and continuum of care. Companies, communities, and medical professionals are challenged with the overwhelming task of balancing quality care with new cost initiatives.

The Need For Call Center Solutions Has Never Been Greater: The TeamHealth Medical Call Center (THMCC) is a premier provider of safe, professional twenty-four-hour medical call center solutions. THMCC provides its client partners with a wide range of cost-effective healthcare services, including:

RN Telephone Triage:

  • Services are branded to each practice with the ability to gather pertinent data and customize a documentation system that allows practices to drive specific directives for both pediatric and adult populations.
  • Another key feature is the ability to integrate patient information into EMRs to meet patient centered medical home and ACO requirements.
  • THMCC registered nurses use Schmitt/Thompson Clinical Content Triage Guidelines for both pediatric and adult populations.
  • Services also include post-triage appointment scheduling and a wide range of post-discharge transitional care initiatives.

Pediatric Triage: Providing high quality pediatric nurse triage requires a special skill set beyond standard care provisions. TeamPeds addresses this need by directing pediatric patients to an RN staff specially trained in pediatric telephone triage.

The TeamPeds program includes:

  • Specialized RN pediatric training and competency testing
  • Ongoing required monthly pediatric in-service requirements for RNs
  • Ability to email care advice
  • Error-free provider on-call system
  • A TeamPeds RN supervisor
  • A pediatric medical director
  • A pediatric QI program

Phone Support: Nurse advice lines and community lines can direct your patient population to the most appropriate level of care while promoting your services. Nurse advice lines can offer branded healthcare and program information that promotes a healthy community and creates an awareness of an organization’s centers of excellence and specialty programs. Their reporting and data collection features also provides you with valuable information about the healthcare needs of your population.

Additional benefits of a THMCC community or nurse advice line include:

  • Readmission prevention and appropriate care utilization
  • Patient acquisition
  • Revenue reconciliation reporting
  • Branded EXITcare or customized health information emailed to callers
  • Web-based branded online self-triage program
  • Appointment scheduling
  • Physician referrals

A dedicated ED nurse advice line or triage service helps hospitals respond to calls from patients with inquiries concerning their need for emergency care. THMCC ED nurse advice and triage line services:

  • Offers access for callers questioning their need for an ED visit
  • Promotes appropriate ED utilization
  • Prevents unnecessary readmissions
  • Provides opportunity to refer other services within system
  • Eliminates the risk of ED handling clinical questions
  • Allows clinical ED staff to stay focused on in-house patient care
  • Refers all real-time call records on callers to the ED

Transitional Care: In many cases, the provision of care is not complete when the patient visit or hospital stay ends. THMCC partners with healthcare providers to develop relationships with patients that support care plan compliance long after they return home.

Transitional care management means preparing patients for their first visit and then accompanying them through post-visit follow-up and post-hospital care. THMCC’s post-discharge call-back services are fully customizable to the needs of specific patient populations. Services include:

  • Outbound daily call campaigns for both clinical and non-clinical populations
  • Specialized scripting utilized for high-risk patients
  • Inpatient and ED patient population coverage
  • EMR access availability
  • All calls performed twenty-four to forty-eight hours post-discharge
  • Optional callback line for patients experiencing symptoms

The value of these transitional care efforts can be measured in the following ROI areas:

  • Readmission prevention
  • Rise in HCAHPS scores
  • Improvement in daily escalations or interventions
  • Enhanced monthly reporting, such as core indicator analysis (medications, discharge instructions, and follow-up appointments), positive or negative trending items, recognition, and patient satisfaction

Avoidable readmissions are a major financial problem for the nation’s healthcare system. Click To TweetAvoidable readmissions are a major financial problem for the nation’s healthcare system. For patients, hospitalizations alone are stressful, even more so when they result in readmissions.

THMCC’s outbound call campaign services are specifically designed for high-risk patients. This includes:

  • Initial post-discharge call within twenty-four to forty-eight hours, with an additional four calls at weekly intervals
  • Assessment of patient’s understanding and compliance for medication, discharge instructions, follow-up appointments, and current symptoms
  • Optional callback line for patients experiencing symptoms

Physician Answering Services: With ever-increasing workloads and patient care responsibilities, physician burnout is a real concern for hospitals, healthcare organizations, and private practices. The stress of a work/life imbalance can lower physician job satisfaction and hinder physician recruitment.

Delegating the workload to a specialized team of medical professionals can significantly reduce physician burnout. They realize that to take care of your patients, you must first take care of your providers. Partnering with the TeamHealth Medical Call Center and their staff of telephone triage RNs can provide the proper work/life balance for your physicians, which in turn, will mean the best possible care for your patients.

THMCC offers physician and practice answering services to provide seamless access for clinical and non-clinical calls. Patient coordinators deliver a high level of customer service and are supervised by an RN.

Features include:

  • After hours, daytime support or 24/7 options
  • Emergency backup for unscheduled closures
  • High volume overflow
  • Translation services
  • Branded services, including customized scripting, directives, and protocols
  • Error-free paging system
  • Secure electronic messaging through TeamDoc Mobile, a web-based application
  • All calls recorded
  • Robust reporting

Consulting Services: Another area of business focused on the call center industry is their consulting services, which can help organizations implement cost containment and provide high quality to new or existing call center services.

Their consulting team is led by vice president of strategic clinical solutions, Gina Tabone, MSN, RNC. Gina came to THMCC after spending nineteen years with Cleveland Clinic’s world-renown Nurse on Call program.

During that time, Tabone served as triage nurse, senior resource nurse, education and protocol specialist, manager, and ultimately administrator. Under her direction as administrator, ED utilization declined, continuous care coordination improved, performance metric targets dropped from 33 percent ABD to less than 5 percent, URAC accreditation was achieved, and the call center grew from covering 350 physicians to the integration of more than 1,500 employed and affiliated providers.

It is this breadth of operational and administrative experience, along with being an industry thought leader that makes Tabone an invaluable resource and distinguished leader for THMCC.

In her role as vice president, Gina partners with organizations to fine-tune and optimize operational and clinical performance, as well as supporting organizations that want to improve their own in-house medical call centers, ensuring processes are aligned, and contributing to overall goals and strategies. She conducts on-site, comprehensive assessments that identify strengths while pinpointing areas of opportunity for improvement.

Some considerations include:

  • Workforce Management: Are you utilizing your human resources to exceed customer satisfaction? Have you deployed remote staffing?
  • Post-Acute Care Outbound Call Initiatives: Hospital discharges, outpatient procedures, ED visits, and wellness checks.
  • Managed Care and Population Health: Does your care coordination model address care gaps? Have you been able to reduce unnecessary ED utilization? How does your organization move from a culture of acute to preventative care? Is your organization positioned to accommodate planned and unexpected growth opportunities?
  • Hospital Readmission Penalty Prevention: Acute MI, CHF, pneumonia, total knee, total hip, and COPD
  • Key Goals: Are you on target to achieve the goals of the triple aim?
  • Attract, Hire, and Train Caregivers for Success
  • Current Technological Capabilities: Are you achieving first call resolution? Does it drive intelligent data that reflects your call center’s value? What self-service tools will eliminate unnecessary calls to your nurses?
  • Quality Assurance: Does your quality program provide meaningful data?

Creating Successful, Long-Term Client Relationships Is Their Goal: The TeamHealth Medical Call Center enters into true partnerships with clients to provide individual service offerings, with measurable results, and to develop a long-term relationship. Their technology allows them to meet the needs of the changing healthcare industry while they continue to make the patient experience their primary focus.

TeamHealth Medical Call CenterFounded by a team of physicians more than twenty-one years ago, the THMCC has the unique advantage of having a provider perspective in each aspect of the services they provide. They understand the special bond between physician and patient. Like their clients, they value each caller as an individual who deserves a clinically correct and caring response from their staff to ensure a positive experience, which adds value to their relationship with their clients. With more than twenty-one years of experience and ten million triage calls, the TeamHealth Medical Call Center’s medical call center solutions can serve a vital role in your patient care coordination efforts. Call 888-203-1118 or visit them online at www.teamhealthcallcenter.com to learn more.

It’s Hard to Plan When You Don’t Know What to Expect

With the state of Obamacare still unknown, forecasting the future of healthcare remains a challenge

By Peter L. DeHaan, PhD

Peter DeHaan, Publisher and Editor of AnswerStatRegardless of what you think about the Affordable Care Act (ACA), the fact that it’s future remains in limbo means that planning in the healthcare industry is challenging at best. Last week, what initially appeared as a final effort to repeal and replace Obamacare turned into another failure. Then opponents quickly pledged to try again. The result is that no one in the healthcare industry has a clue about what rules we’ll be playing under in the months and years to come. This makes strategic planning next to impossible.

As politicians play politics and posture themselves in the name of political expediency, the rest of us are left to wonder what the future holds.

If the Affordable Care Act remains in place and unscathed, the industry will continue its current trajectory. While the slope of that trajectory remains open to conjecture, at least the general direction is known.

Alternately, if the Affordable Care Act is repealed, then we’re left scrambling to find a reliable basis on which to move forward. If this occurs the winners, from a business standpoint, will be those who can adapt the quickest and fill the vacuum that results. Being nimble, flexible, and quick will be the surest path to success.

However, rather than a straight-out repeal, a more likely scenario will be to tweak what is already there. The only sure thing about this path is knowing that things will change, but no one knows what will change or how much. What’s likely is that there will be winners and losers, those who gain from the changes and those who give up some of what they currently enjoy. Again, organizations that can adjust the quickest will be the ones that have the best chance of coming out ahead.

Specifically for the healthcare contact center this means being prepared to take several actions. One is being ready to quickly scale a workforce to take advantage of new opportunities and meet increased patient demand. Coupled with this is the need to train new agents quickly, as well as to teach new skills—perhaps not yet identified—to existing contact center staff. Last will be determining creative ways to meet patient needs and be appropriately compensated for doing so.No matter what happens with Obamacare, healthcare contact centers can be the hero. Click To Tweet

Contact centers with an entrepreneurial-minded leadership will emerge as the ones who can best navigate these changes to meet critical needs among patients and serve the healthcare industry.

The one thing I am sure of, no matter what happens, is that the healthcare contact center has the potential to be the hero.

Peter L. DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat and a passionate wordsmith. Connect with him on his blog, social media, and newsletter, all at www.authorpeterdehaan.com.

How Contact Centers Impact Patient Experience



By Donna Martin

Hospitals and healthcare organizations are competing more fiercely to gain and retain patients’ business. And first impressions are critical. That’s why a modernized patient contact center is critical both for differentiating your organization from the competition and for preventing revenue leakage.

How is your organization leveraging this critical contact point? What success are you having getting patients through your front door and retaining them as loyal consumers?

Assessing Your Patients’ Needs: Just like you, your health system’s patients are consumers who shop at Amazon, purchase airline tickets, and stay at hotels. They’ve grown accustomed to a concierge-level of customer service, and this has altered their perceptions of what a high-quality healthcare experience should look like.

The retail world has decades of experience providing this level of service and has leveraged modern technology to make constant improvements to help differentiate their brand, as well as retain and grow their customer base. The healthcare industry is just starting to catch on—not just because it makes good business sense, but also because they are now being incentivized to implement value-based care throughout the patient experience and and penalized if they fall short.

Let’s explore how to measurably improve patient experiences and engagement in ways that are realistic and based on the unique requirements of healthcare delivery.The goal of contact centers should be to make the patient experience as easy as possible. Click To Tweet

Phase 1: Establish the Foundation: From your patients’ perspective, even small hospitals can be difficult to navigate via telephone. Partial or full automation of inbound phone calls from patients allow providers to create a “single front door” for patients. This creates a unified patient experience and reduces needless call transfers. Adding automated patient identification and authentication not only personalizes the interaction and ascertains the primary reason for the patient’s call, but it also leads to complete resolution for a host of common inquiries such as appointment confirmations, directions, hours, and payments without ever needing to engage an agent.

With this streamlined foundation in place, providers can begin to continuously and consistently track patient interactions to build intelligence for future interactions as well as gather communication preferences where possible. Every new element of data collected builds on previous elements, fostering a holistic portrait of patients. This creates the foundation for predictive intent and provides a better patient experience. In addition, as you develop a performance baseline, you can leverage patient experience surveys to use actionable data to make targeted improvements.

Phase 2: Build on Your Success: One goal of value-based care is keeping patients in your health system but out of the hospital. Why not pursue a similar goal with patient engagement? By applying dynamic decision-making to the data collection efforts established in phase 1, you can begin to develop proactive patient engagement strategies to reduce the need for patients to call you.

For example, with the right automated inbound solution, you identify patients calling from a mobile device and then take that opportunity to drive them to alternative, lower cost channels, such as text communications and patient portals. These elements will further the productivity of your access center, drive cost from your business, and maximize the patient experience. This will also provide you with a steady stream of valuable patient data to continue to enhance and optimize your solution.

Phase 3: Patient Preferences: This segment includes all components of phases 1 and 2, layering in patient communication preferences and cross-channel patient interaction data. In this scenario, you could see that a patient accessed the patient portal to find a specialist and is now calling into the access center for help. An intelligent self-service solution recognizes the patient, confirms they are looking for a specialist, and sends the patient directly to the appropriate scheduling agent. This happens without the patient having to make a single menu selection. Again, this provides an effortless and loyalty-building patient experience.

Finally, with all three phases offered in a cloud-based, self-service environment, you will achieve maximum scalability, reliability, and flexibility for agents who work in either a brick-and-mortar setting or through a business process outsourcing partner. This ensures your access center will always be available to support patients and providers.

The goal of contact centers should be to make the patient experience as easy as possible through both personalization and self-service. The intent is to strive for that perfect balance between automation and live, human-touch interaction.

Your health system has invested considerable time, energy, and money to provide value across the continuum of care. Why squander it over a bad first impression? By taking practical steps toward patient-centric engagement, providers can create a high-quality, intuitive, and effortless consumer experience that has elements of a world-class retail service, while meeting the unique needs of the healthcare setting.

Donna Martin is senior vice president, Global Health Services, at Hinduja Global Solutions (HGS).

Video-Based Doctor Visits


LVM Systems


By Mark Dwyer

Video-Based Doctor VisitsVideo-based doctor visits (e-visits) have received renewed interest to address the shortages of primary care physicians nationwide, especially in rural areas. The healthcare industry is ripe for a strategy to address what many believe to be one of the greatest challenges of the Affordable Care Act (ACA)—providing government subsidized insurance coverage to thirty million Americans while struggling with a major shortage of primary care physicians throughout much of the country.

Providing insurance to uninsured individuals was seen by many as a vital component of a successful ACA. Unfortunately, most individuals initially receiving government subsidized healthcare were without a primary care provider. These early enrollees were also those with serious health issues related to the costliest health conditions. Consequently, the already over-crowded emergency departments across the country became even more congested only now with newly insured individuals who had nowhere else to go to receive the healthcare they needed.

The demand for healthcare has further increased due to our aging population, along with a declining supply of primary care physicians. According to the Association of American Medical Colleges, by 2030, the United States will have a shortage of as many as 43,100 primary care physicians.

What does this have to do with call centers?

Since their inception, healthcare call centers’ mantra has been to get patients “the right care—at the right time—at the right place.” Video-based doctor visits are a logical source for patients to be served as an extension of the call center. The most successful organizations that offer healthcare triage call center services may be those who devise a strategy to integrate video-based physician visits as a triage end-point for immediate, real-time appointments. Video-based doctor visits are a prime example of how patients can connect with providers. Click To Tweet

According to the American Telemedicine Association, “as the US healthcare environment continues to evolve due to changes in reimbursement, legal issues, and shrinking healthcare resources, the expanding role of telehealth nurses will continue to evolve.” In distant, rural, small, and sparsely populated areas, telephone triage nursing can remove time and distance barriers between providers and patients. Video-based doctor visits are a prime example of how patients can connect with providers to make better use of shrinking healthcare resources.

It is clear there are not enough primary care physicians to handle patients physically able to be seen in the office setting. But that is not the only concern resulting from the shortage. There are an estimated two to four million people who need doctors, nurses, and healthcare providers to make house calls. Unfortunately, the number of physicians and health practitioners who make house calls has also greatly decreased over the years.

In an August 8, 2017 article by Elizabeth Whitman titled “When patients need house calls, there may be no doctors nearby,” the author referenced a study by Aaron Yao, an assistant professor at the University of Virginia School of Medicine. Yao’s study cited findings that showed more than half of Americans live over thirty miles away from full-time providers of home-based medical care. These centers limit how far they send doctors, nurses, physician assistants, or other primary care providers. Consequently, the healthcare system needs to expand ways to get care to these homebound patients, many of whom suffer from chronic diseases.

“These are the high-cost, high-need people,” Yao said. “We live longer, but we also suffer for longer years,” he added, noting that if doctors can get to patients’ homes and manage their symptoms, they could help prevent emergency room visits and hospitalizations.

Despite the study’s limitations, Yao said his findings drove home crucial points about the need for more, and more widely available, home-based medical care providers in the US. That said, Yao admits, “It’s not a high-paying job,” and comes with related challenges making it less appealing to many healthcare providers. This challenge also lends itself to the use of video-based doctor visits.

So how do e-visits work in conjunction with triage call centers? First, it is important to understand that not all e-visit programs are the same. Like any system that uses patient data, e-visit programs need to be HIPAA compliant. Strong e-visit programs are designed around optimal provider workflows with simple to navigate virtual waiting rooms. E-visit technology allows a physician to connect with a patient via secure, high-resolution video. These connections can be used for a remote visit, to share medical images, to send text messages or online chats in real-time, and to submit prescriptions to the patient’s pharmacy. E-visits help keep patient flow moving with flexible, on-demand virtual visits. When the triage disposition calls for an urgent care referral or to see one’s doctor immediately, patients can get quick “walk-in” care without leaving their house, eliminating long wait times at the urgent care facility.

In addition, a strong e-visit program can increase patient satisfaction by quickly addressing patients’ needs. With e-visits, you can quickly offer patients 24/7 care without the commute or long wait at the clinic. Access to high-quality, convenient care keeps patients happy. According to survey data, 37 percent of parents would choose a virtual care option for their child in the event of a minor illness. That percentage more than doubles for parents in rural areas with minimal access to pediatric specialty care.

How does one monetize the e-visit? Many insurance companies now allow reimbursement for telemedicine services, especially remote visits done via two-way video. As of January 2017 Cigna, Aetna, United Healthcare, and thirty other payors put telemedicine in plans nationwide. In order to be reimbursed, each telemedicine visit needs to be well-documented. Whether stored in the call center software’s triage transaction notes or in the patient’s EHR, everything must be saved in one place and be up-to-date. Some e-visit programs may also integrate with an EHR system for seamless record-keeping. The top telemedicine software solutions allow healthcare providers to easily document the patient encounter and then submit the record for reimbursement.

In addition, through use of e-visit programs, unbilled work also gets reimbursed. From refilling a prescription to treating an illness, some e-visit programs can collect payment from patients and provide a detailed medical chart to submit for reimbursement. E-visits also help to reduce costly no-shows. Missed appointments can cost a provider’s practice thousands in lost revenue. When the visit is real-time via an e-visit program, the service is paid for at the time of care. This creates a more profitable practice further aligning the provider to the facility hosting the call center to which the e-visit program is associated.

Telemedicine solutions come in various configurations. The sophistication of the technology, equipment, training, set-up, and number of users required will all affect the cost of a telemedicine service. Healthcare providers should evaluate their budget for an e-visit program and make sure they consider how much training and staff resources they will need to implement the telemedicine software. Since telemedicine providers offer solutions for single-provider practices all the way to huge health systems, it is imperative to do your homework.

E-visit solutions have the power to change the way we provide and receive healthcare for the better.

LVM SystemsMark Dwyer is a thirty-year veteran of the healthcare call center industry and the COO at LVM Systems, which provides healthcare call center software.

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Translation and Health Literacy in Telemedicine

Are we speaking the same language? How telehealth can help

By David Thompson, MD


TeamHealth Medical Call Center


“Fever” may sound different in other languages, but it means the same thing. Whether a patient says fever, fiebre, or fièvre, it’s the telehealth provider’s job to deliver the correct diagnosis and treatment. Language differences can add complexity to an already confusing situation for patients. Fortunately, healthcare professionals can help bridge this gap using digital health tools to capture symptoms in the patients’ own language.

Language Translation: So, how can healthcare systems reach the broadest patient base possible and ensure telehealth options benefit everyone? One answer is offering an e-visit intake process (rapid medical history) to patients in multiple languages.

Language-specific documentation checklists support healthcare providers by capturing a detailed history of the patient’s symptoms at the beginning of the medical encounter. Language localization also makes it easier for non-English speaking consumers to use e-health tools and applications to ensure greater accuracy when they use virtual care. Language differences can add complexity to an already confusing situation for patients. Click To Tweet

The most recent National Assessment of Adult Literacy (NAAL 2003) found that 89 million Americans have limited health literacy. It’s fair to say a significant percentage of those have English as a second language or speak no English at all. This highlights the need for global health literacy guidelines and healthcare options for all languages. Consider the following reasons to offer multilingual telehealth options.

Improve patient engagement: By using a multilingual telehealth platform, clinicians can help patients of all language backgrounds—even if they, themselves, don’t speak the same language. In addition, more tech-savvy patients can choose their language preference when using e-health applications. The simple ability to communicate health information in their preferred language can improve patient engagement and satisfaction by:

  • Providing easy-to-understand information;
  • Making patients feel they’ve received customized, personal attention;
  • Offering flexibility for individual situations; and
  • Giving patients control over their healthcare, regardless of language.

The bonus is that health systems using flexible telehealth platforms can also see improved retention due to patient engagement and satisfaction.

Support communication along the care continuum: Not only can telehealth technology offer engagement solutions, but it also has the benefit of connecting providers and patients along the care continuum. Patients can see health information in their preferred language, while the telehealth platform provides data coding and translates it into medical terminology. This data can then be shared among medical call center nurses, telemedicine providers, hospitals, and primary care providers. There’s never a need for patients to feel they have less access to quality care because of language barriers.

With advancements in translation technology and digital health platforms, the future of healthcare will be measured by how well organizations and providers appeal to a broad patient audience; capture health information; share data with other providers; and leverage that data to improve medical care, speed up care delivery, and reduce costs.

Consider the case of John Gomez, a twenty-two-year-old, whose primary language is Spanish. John has had knee pain for two days and contacts a telemedicine provider.

Step 1: The initial call: John calls a service representative who works with his doctor. This service representative does not speak Spanish. Using a symptom-checking engine that offers symptom options for “knee pain” in Spanish, she collects information about the patient’s condition. The representative then obtains John’s demographic information, transcribes his chief complaint and helps him complete an online “rapid medical history” for knee pain. The telehealth platform lists recommended care options based on John’s symptoms, his availability, and doctor preferences. The service representative then arranges a telemedicine encounter.

Step 2: The telemedicine encounter: John can speak with a Spanish-speaking doctor or an English-speaking doctor because his information has been transcribed and coded as data in medical terminology. The doctor reviews the medical history, validates the information during the telemedicine encounter and provides treatment recommendations.

Step 3: Follow-up: A nurse in a centralized call center contacts John in two days to make sure he is following treatment recommendations, getting better, and has no further questions.

Serving a broad population: Healthcare is confusing, but fortunately, patients are increasingly becoming more involved in their care. As healthcare and technology continue to evolve, healthcare systems and providers must adapt to serve a broad patient base with consumer-friendly tools and information.

David Thompson, MD, FACEP is CEO and chief medical officer at Health Navigator. A part-time faculty attending in the Northwestern Memorial Hospital Emergency Department, Dr. Thompson also works as an author and partner with Self Care Decisions, LLC and Schmitt-Thompson Clinical Content, LLC. He is board-certified in both internal medicine and emergency medicine, having completed a dual residency at Northwestern Memorial Hospital at Northwestern University. Dr. Thompson is a Fellow in the American College of Emergency Physicians. He can be reached at david.thompson@healthnavigator.com.

Why is Your Contact Center Essential to Your Organization?

Echo Access provider directoryBy Richard Stier

You are your health network’s senior leader for access with direct responsibility for the contact center. This morning your CEO asked you a question that has dominated your thoughts. “We’re taking a hard look at the budget,” she said. “The contact center represents a significant line item. Can you help me understand if, or why, the call center is vital to us? Why should it remain in our budget?”

How would you respond? Three key criteria provide the foundation for your effective reply.

Criteria 1: Structure the Framework: Align your contact center’s priorities with C-suite imperatives.

You have an ongoing conversation with your vice president about the organization’s driving priorities, and you’ve focused your contact center to support three of them:

  1. Reduce avoidable readmissions to eliminate a recent fine from CMS,
  2. Improve CAHPS scores for patient satisfaction to improve reimbursement, and
  3. Fill practices of newly employed physicians to accelerate the revenue cycle.

Because reducing preventable readmissions is an organization-wide priority, you’ve made it a contact center priority. At discharge, a contact center ambassador asks patients for permission to contact them and their caregivers when coordinating follow-up appointments. Your contact center receives discharge reports every morning from each member hospital. The ambassador calls, emails, or texts the discharged patient and the authorized caregivers to coordinate a day and time for the follow-up physician appointment.

After the scheduled day and time, a contact center ambassador calls the physician office to see if the patient kept the appointment. If the appointment was not kept, they reconnect with the patient or the patient’s approved caregiver to reschedule.

The results have been substantial. The readmission rate declined from 25 percent to 15 percent, and a fine from CMS was reduced by two million dollars over the past two years. Kept appointment rates for post-discharge physician visits have climbed to over 85 percent.

You’ve used tools in your contact center software to document and improve first experience satisfaction scores, and your overall CAHPS scores have been steadily rising. And, you have documented the stream of patients for whom the contact center has made appointments with newly employed physicians at eight practices.Your healthcare contact center is the virtual front door for personalized support and referrals. Click To Tweet

Criteria 2: Place the Rebar: Hardwire your contact center to strengthen your organization’s patient experience (PX) advantage.

You’ve shared with internal colleagues that healthcare currently has a 29 percent patient experience failure rate (per research by Hospital Compare). Only 71 percent of inpatient patients report they received the “best possible care.”

You’ve challenged your peers to ask, “In what universe is a 29 percent failure rate acceptable? Could we miss our revenue projections by 29 percent? Be over budget by 29 percent? Could we even conceive of missing our quality metrics by 29 percent—we only drop 29 percent of newborns, so we meet the standard?” Seriously.

You’ve communicated your belief that “best possible care” experiences begin before a patient receives care and continues after the patient returns home. You explained that your contact center is uniquely positioned to serve as the virtual front door for personalized support and referrals—whether on the website or on the phone—before using a clinical service and for individualized follow-up and coaching after discharge.

You’ve taken several actions to strengthen patient experience advantage:

  • You now include patient ratings and comments in your online provider directory. This key information for prospective patients increases the probability of a good match with one of your providers. Better alignment between patients and providers results in higher patient satisfaction.
  • Your contact center conducts pre-CAHPS patient satisfaction surveys to identify areas for improvement before the CAHPS surveys are conducted. The contact center leverages relationships with callers as a conduit of opportunity to improve CAHPS scores across the enterprise.
  • You place contact center ambassadors in your emergency department to capture patients without a primary care physician. This has resulted in less congestion in the ER, patients being re-directed to more appropriate sites or levels of care, and incremental patients being referred to in-network providers.
  • You have a pre-admission patient hotline where contact center ambassadors work with patients to keep them in-network, secure financial clearance, and arrange for a deposit prior to their visit. Ambassadors add value by providing patients with information about directions, location, and parking.
  • You shift your team culture to celebrate “phone hugs,” redirecting the focus from processing transactions to building relationships with patients through empathic conversations.
  • You launch digital patient experience journey mapping to document experiences from patients’ perspectives starting with the first online or phone contact to handoff of care to post-discharge connections.
  • You recognize the maturation of contact centers to require super agents whom you call “senior ambassadors.” They serve as indispensable personal coaches. They have a proven ability to calm difficult callers and help them with their most challenging situations. For example, they may coordinate pre-visit scheduling for multiple tests that need to be completed before the patient has their physician appointment.
  • You’ve integrated your contact center’s provider data into a single master provider database as a source of truth. The benefits include a comprehensive and more accurate database, reduced data errors, greater data security, increased provider satisfaction, and an improved caller experience.
  • You took two important steps to strengthen your organization’s patient experience advantage:
  1. You recognize your contact center’s role to deliver differentiating, memorable first experiences. In collaboration with your chief patient experience officer, you pulled together a team of first touchpoint and access leaders to multiply your impact.
  2. Your first touchpoint team understands the first three seconds of that initial interaction influences hospital selection and preference (SHSMD 2012). The team identified a shared metric for targeted improvement: first experience satisfaction score. You regularly monitor this and have ongoing first touchpoint team challenges across several departments to improve it. Your first experience satisfaction score has moved from 58 percent two years ago, when you implemented this initiative, to 84 percent last quarter. Future metrics considered by your first touchpoint team are: improved CAHPS scores and improved patient satisfaction with specific handoffs of care targeted for improvement.

Criteria 3: Pour the Concrete: Confirm your contact center as an investment, not an expense.

Expenses are cut. Investments are funded. You understand that if your contact center is perceived as an expense, you must be prepared for tough questions.

You’ve collaborated with your CFO to develop and publish a quarterly one-page contact center executive dashboard report for your leadership team. The metrics in this report are reviewed with your CFO annually and revised as needed.

Your contact center executive dashboard report includes three columns:

1. Executive Briefing on Strategic Priorities: The left column includes a bulleted list of metrics aligned to support Criteria 1 priorities.

In this case, you’ve provided a list of indicators under heading “Reduce avoidable readmissions.” Those indicators include: baseline, target, and current readmission rate; baseline, target, and current kept appointment rate; and baseline, target, and current percentage of PCPs with patient follow-up appointments within seven days of discharge.

The next indicator in the “Executive Briefing on Strategic Priorities” column is improve CAHPS scores. Your indicators are baseline, target, and current score for first contact satisfaction, and the number of pre-CAHPS patient satisfaction surveys completed by the contact center.

The third indicator is “Fill practices of newly employed physicians.” Indicators are baseline, target, and current number of referrals and appointments made to employed physician practices and the baseline, target, and current number of referrals and appointments made to all participating physicians for this quarter.

2. Strengthen PX Advantage: The center column includes metrics aligned with Criteria 2 priorities. Your indicators include: number of click throughs on patient ratings and comments in the online provider directory; number of unattached ER patients referred to in-network PCPs; number of patients served this quarter with the pre-admission patient hotline; and baseline, target and current patient satisfaction with handoffs of care from the contact center to employed practices.

3. Contact Center Investment Summary: The right column metrics support the priorities in Criteria 3. Indicators include a bulleted list of metrics after contact center interactions and clinical triage such as inpatient admissions, outpatient visits, ER visits redirected, total physician referrals, total physician appointments, incremental gross revenue, estimated net contribution (supported with attached detail), and estimated ROI.

When you meet with the executive team, you have three additional categories of metrics available to discuss, in anticipation of questions.

  1. The first is priority service line measures with indicators for each clinical center of excellence such as referrals resulting in inpatient admissions and referrals resulting in outpatient visits.
  2. You have also identified metrics for integrated access centers such as number of switchboard calls, call length, total handle time, abandonment rate, caller satisfaction, appointments scheduled by clinical service and practice, number of transfer center transactions, number of physician-to-physician consults, and gross revenue from physician-to-physician consults.
  3. Finally, you are prepared to update the group on contact center operation indicators such as total website conversions, total appointments scheduled, kept appointment rate, average seconds to service, and call abandonment rate.

Your reply: As you mind concludes this mental review, you take a breath and hear yourself respond to your CEO’s question with confidence.

“I believe our contact center is essential to our ability to achieve our strategic imperatives. We intentionally support our priorities to reduce avoidable readmissions, improve our CAHPS scores, and fill the practices of employed physicians. Our contact center strengthens patient experiences as our competitive advantage, beginning at the important first point of contact—whether online or on the phone.

“Importantly, our contact center delivers a tangible return. Our Executive Dashboard Report documents an ROI of three to one. That is, we get three dollars returned for each dollar invested. In summary, our contact center delivers a solid ROI while improving patient satisfaction.”

As your organization’s leader for access, you made the shift from managing transactions to delivering transformative experiences. The contact center team you lead builds competitive advantage by ensuring extraordinary patient experiences at the critical first touchpoint and beyond. Your contact center is vital to your organization’s mission-critical priorities.

Echo, a Healthstream CompanyRichard D. Stier is vice president marketing at Echo, A HealthStream Company. He is a results-proven proponent of delivering transformative patient experiences. Echo, a HealthStream® Company, delivers enterprise-class, innovative solutions to optimize patient experience contact centers. Echo’s solution for hospital-based contact centers, EchoAccess, enables your organization to deliver intentionally memorable experiences that mitigate risk, solidify loyalty, and reduce unnecessary readmissions.

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The August/September 2017 Issue of AnswerStat

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


TeamHealth Medical Call Center


Feature Content:

Medical Call Centers Are Here to Stay, by Gina Tabone
Changes to the USA political scene are upon us and will most certainly impact the provision of healthcare. Several healthcare reform objectives need to remain in the forefront. Examples include enhancing quality of care, improving interdisciplinary coordination and collaboration, and better utilization of available resources. …  read more >>

Vital Signs: Do You Provide Contact Options For Your Patients? by Peter L DeHaan, PhD
Have you ever had a company ask how you wanted them to contact you? Options might include phone, email, text, fax, mail, or social media private messaging. How well did they do at complying with your request? … read more >>

Vendor Spotlight on Echo, a HealthStream Company
Redeploy Your Legacy Call Center to Transform Patient Experiences
A patient experience contact center serves as a health network’s virtual front door. It delivers personalized, trust-building support, and referrals before a patient receives care and individualized follow-up and coaching after the patient returns home. Unlike a legacy call center, the EchoAccess PX Hub…  read more >>

Guest Column: Hospital Call Centers
The Vital Ingredient in Clinical Communication, by Kevin Mahoney
A robust and effective communication system is essential in any hospital, as it forms the backbone for the provision of exceptional patient care. The adaptation and growth of evidence-based medicine has led to…  read more >>

Improve the Way You Manage Patient Calls, by Charu Raheja, Ph.D.
As a practice manager or doctor, managing patient calls effectively is critical in ensuring high-quality, well-coordinated care for every patient. The first step is to make sure the people answering your phones triage patients efficiently and effectively. Establishing a consistent nurse triage system will improve…  read more >>

The Contact Center’s Role in Reducing Readmission, by Traci Haynes
Reducing hospital readmissions has been a focus of the healthcare environment for many years. Steven Jencks MD, dubbed by many as the father of readmission research, along with Mark Williams MD and Eric Coleman MD, analyzed medical claims data to describe the patterns of rehospitalization and its relationship to demographic characteristics of hospitals. They learned that…  read more >>

AAACN Conference Hits Attendance Record
More than 1,200 nurses attended the American Academy of Ambulatory Care Nursing (AAACN) 42nd Annual Conference held recently in New Orleans, a number that broke all previous records for this thriving specialty nursing association. With heightened interest in such areas as …  read more >>

Ten years ago: Disaster Recovery for the Call Center, by Jim Becker
Not every disaster is as horrific as Hurricane Katrina, but call centers can also be affected by lightning, fire, water damage, telephone and electrical outages, and other natural and man-made catastrophes. All can impact your center, but the bigger impact may be on your callers. How can you lessen the affect?  read more >>

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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.

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