Tag Archives: contact center case studies

State University of New York Upstate Medical University Case Study

1Call

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

By Nicole Limpert

State University of New York (SUNY) Upstate Medical University, located in Syracuse, New York, has a campus that is comprised of hospital, clinical, academic, research, residential, and campus facilities. The Upstate University Health System includes Upstate University Hospital, Upstate University Hospital at Community Campus, Upstate Golisano Children’s Hospital, and multiple offices to serve 1.8 million people. The care they provide extends from Canada to Pennsylvania and includes a robust telemedicine program to assist rural communities.

The origins of SUNY Upstate Medical University stretch back to 1834 and today is the only academic medical center in Central New York. The University includes four colleges: College of Nursing, College of Medicine, College of Health Professions, and College of Graduate Studies, with a total enrollment of over 1,500 students. SUNY Upstate Medical University is the region’s largest employer with 9,460 employees. With a $600+ million payroll and numerous facilities, Upstate is a powerhouse for the economy of Central New York, generating $2.3 billion for the region.

Identifying Areas for Improvement

SUNY Upstate Medical University wanted to improve their healthcare call center performance and reduce caller wait times, shorten the time spent on each call, lower the call center’s abandonment rates, and provide a better caller and patient experience.

When looking at the call answering process, they discovered the time it took for operators to obtain information from callers could be improved. “We realized operators had to ask a series of questions to figure out which patient they were talking to,” says Jody Williams, call center systems administrator for Upstate. “Right now, they answer the calls with, ‘Thank you for calling, this is Jody, may I have the patient’s date of birth?’ and they search for everyone by birth date.”

The call center operators needed more information about each caller sooner, to reduce the overall time of the call, and to handle calls more efficiently. Staff from Upstate’s IT and call center departments realized that integrating with the Epic electronic medical record (EMR) software used by the hospitals and clinics would save valuable time.

Healthcare Communication Partners

Healthcare organizations and their patients rely on good IT partners to help with fast and accurate communications. However, most healthcare facilities use a mix of disconnected technology, and sharing information among healthcare IT systems has traditionally been a challenge.

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

Upstate contacted their contact center software vendor for guidance, and they confirmed it was possible to use the guided scripting solution to bridge the communication gap, while making sure calls would look the same to operators. For incoming calls, the automatic number identification (ANI) would be sent to Epic’s EMR database. Jody explains, “When the call comes in, the caller ID is pushed out to Epic, and then Epic returns the patient’s record on the operator’s screen. Operators can verify who they are speaking with using a shorter list of questions that are related to everyone who’s associated with that caller ID.”

Testing the Integration

Integration testing began between Upstate, their vendor, and Epic. The vendor worked on the scripting piece and Upstate’s in-house Epic staff worked with experts located at Epic’s Verona, Wisconsin campus.

“For this project we collaborated with vendor staff, several members of our IT group, and one of our Epic experts on site who worked with an expert from Epic’s home office,” says Jody. “Before the integration was a success, we had several calls between all parties to identify system requirements and build the scripts using suggestions from Epic. The staff from our vendor did virtually all the scripting, and they’ve been outstanding to work with.”

Evaluating Results Using Detailed Reporting

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

“We implemented the Epic integration nine months ago, and as of now, it looks like we are saving an average of about 15 seconds on each call. We’re hoping we can cut 10-20% off the duration of each call. That will make a huge difference over the course of the whole day,” Jody explains. “The integration was first used with our ambulatory call center because they handle virtually all of the incoming calls for about fourteen of our ambulatory departments, which includes general medicine, dermatology, pulmonary, etc. They do some appointment scheduling, a lot of message taking, transferring calls to a nurse, and various requests that come from the patients. Any time a patient dials the main number for each of those departments, it goes to this call center and the wait time had been extremely high.”

Future Integration Plans for Efficient Workflows

There are plans to use this technology throughout more of Upstate’s call center departments. Some of the call center groups rely heavily on scripts which are used for appointments, physician referrals, prescription renewal, scheduling, crises and emergencies. These areas hope to also save time on calls and serve patients more efficiently by taking advantage of the Epic integration.

Scripts can be shortened because much of the information the operators need will already appear on their screen as they answer the phone call. According to Jody, “Our medical messaging group currently follows and completes a script with a caller’s name, patient name if different, provider information, and then they look up the doctor on call and add that to the script. After the integration, we will be able to pull most of that info from Epic.”

1Call, a division of Amtelco

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

Case Study: MD Anderson Cancer Center

1Call

The Technical Side of Operators Working from Home

By Nicole Limpert

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

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

The Road to Remote Operators

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

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

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

IT Mobilization

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

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

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

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

IT Challenges and Departmental Collaboration

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

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

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

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

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

Remote Operator Setup, Training, and Support

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

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

Additional procedures were also established such as:

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

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

Remote Challenges

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

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

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

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

Remote Benefits

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

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

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

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

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

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

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

1Call, a division of Amtelco

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

Vendor Case Study: LVM Systems’ SOC 2 Type 2 Examination

LVM Systems Completes 2022 System and Organization Controls (SOC) 2 Type 2 Examination

LVM Systems

By Jake Johnson

LVM Systems’ successful completion of its 2022 System and Organization Controls (SOC®) 2 Type 2 Examination affirms that our practices, policies, procedures, and operations meet the SOC 2 standards for security, availability, processing integrity, and confidentiality.

Completing this examination demonstrates LVM Systems’ commitment to the security and integrity of our platform. LVM Systems selected 360 Advanced to perform the demanding third-party examination.

Throughout the examination, 360 Advanced audited LVM against the AICPA Trust Services Criteria. The examination’s outcome ensures that the company’s controls meet the criteria of the selected trust services.

These trust services criteria encompass the following five categories:

1. Security

Protects data and systems against unauthorized access, disclosure, or damage.

  • LVM has a security team that includes a security officer, a compliance officer, and an incident response team to ensure LVM is up to date with current security best practices and that LVM complies with its security policies and procedures. In addition, LVM performs annual risk assessments, evaluating every aspect of the organization for improvement and ensuring LVM policies and procedures align with current regulatory requirements.
  • Background checks are performed on all prospective employees. New employees must review and sign the LVM security agreement, ensuring employees maintain a high level of security integrity. In addition, before working with LVM systems or processes, new employees must receive mandatory security training.
  • Quarterly security training ensures employees understand LVM security policies and procedures and are vigilant about new security threats.
  • Third-party systems monitor vulnerability and penetration testing to ensure systems remain secure.
  • Development teams undergo ongoing training on secure software development lifecycles and secure coding. In addition, third-party security code analysts review the software for known vulnerabilities to ensure LVM development teams use current best practices.
  • LVM utilizes encryption standards to ensure all private data access or storage is secured.
  • For hosted solutions, LVM utilizes Microsoft Azure as the preferred cloud provider. Microsoft Azure has a security team of over 3,500 members, over ninety security certifications, and has invested over $1 billion in security R&D to ensure client systems and data are protected.

2. Availability

Information and systems are available for operation.

  • System monitoring ensures systems are running smoothly. If anomalies are detected, appropriate LVM resources are notified.
  • Backup, redundancy, and recovery standards follow industry best practices.
  • Disaster recovery development and testing ensure LVM can rapidly recover systems.

3. Processing Integrity

System processing is complete, valid, accurate, and timely.

  • Development processes include rigorous quality assurance (QA) reviews to ensure processing integrity within LVM’s software. QA utilizes automated testing tools, manual test scripts, and data comparison tools to assure all areas of code are thoroughly tested.
  • QA also tests the latest operating system patches to ensure compatibility.
  • Security and information technology (IT) teams ensure the processing integrity of LVM’s hosted solutions.

4. Confidentiality

LVM protects information designated as confidential.

  • LVM follows a data retention policy and conducts activity tracking.
  • LVM maintains an asset inventory and destruction policy.

5. Privacy

LVM collects, uses, retains, discloses, and disposes of personal information following industry best practices.

  • Notices and communication of objectives
  • Choice and consent
  • Collection, use, retention, and disposal
  • Disclosure and notifications
  • Monitoring and enforcement

As caretakers of our customer data, and as security concerns grow, healthcare organizations choose LVM Systems as their core platform and engine of growth.

LVM Systems logo

Jake Johnson is the CIO of LVM Systems.

State University of New York (SUNY) Upstate Medical University


1Call, a division of Amtelco

Integrating Epic’s EMR System with SUNY Upstate Medical University’s Call Centers Saves Time and Enhances Patient Caller Experience

State University of New York (SUNY) Upstate Medical University, located in Syracuse, New York, has a campus comprised of hospital, clinical, academic, research, residential, and campus facilities. The Upstate University Health System includes Upstate University Hospital, Upstate University Hospital at Community Campus, Upstate Golisano Children’s Hospital, and multiple offices to serve 1.8 million people. The care they provide extends from Canada to Pennsylvania and includes a robust telemedicine program to assist rural communities.

The origins of SUNY Upstate Medical University stretch back to 1834 and today is the only academic medical center in Central New York. The University includes four colleges: College of Nursing, College of Medicine, College of Health Professions, and College of Graduate Studies, with a total enrollment of over 1,500 students.

SUNY Upstate Medical University is the region’s largest employer with 9,460 employees. With a 600-million-dollar payroll and numerous facilities, Upstate is a powerhouse for the economy of Central New York, generating 2.3 billion dollars for the region.

Identifying Areas for Improvement

SUNY Upstate Medical University wanted to improve their healthcare call center performance and reduce caller wait times, shorten the time spent on each call, lower the call center’s abandonment rates, and provide a better caller and patient experience. 

When looking at the call answering process, they discovered the time it took for operators to obtain information from callers could be improved. “We realized operators had to ask a series of questions to figure out which patient they were talking to,” says Jody Williams, call center systems administrator for Upstate. “Right now, they answer the calls with, ‘Thank you for calling, this is Jody, may I have the patient’s date of birth?’ and they search for everyone by birth date.”

The call center operators needed more information about each caller sooner, to reduce the overall time of the call, and to handle calls more efficiently. Staff from Upstate’s IT and call center departments realized that integrating with the Epic electronic medical record (EMR) software used by the hospitals and clinics would save valuable time.

Healthcare Communication Partners

Healthcare organizations and their patients rely on good IT partners to help with fast and accurate communications. However, most healthcare facilities use a mix of disconnected technology, and sharing information among healthcare IT systems has traditionally been a challenge.

Upstate has used 1Call’s healthcare communication software since 2006 and works closely with 1Call staff to meet their enterprise-wide communication needs. Jody comments, “We use several products from 1Call. Perfect Answer enables us to record custom greetings and automatically plays those greetings before operators answer calls. We use appointment reminders and just started using MergeComm to send SMS reminders, which people seem to really appreciate.”

Upstate contacted 1Call for help, and 1Call confirmed it was possible for their guided scripting to bridge the communication gap, while making sure calls would look the same to operators.

For incoming calls, the automatic number identification (ANI) would be sent to Epic’s EMR database. Jody explains, “When the call comes in, the caller ID is pushed out to Epic, and then Epic returns the patient’s record on the operator’s screen. Operators can verify who they are speaking with using shorter lists of questions that are related to everyone who’s associated with that caller ID.”

Testing the Integration 

Integration testing began between Upstate, 1Call, and Epic. 1Call worked on the scripting piece, and Upstate’s in-house Epic staff worked with experts located at Epic’s Verona, Wisconsin campus.

“For this project, we collaborated with 1Call staff, several members of our IT group, and one of our Epic experts on site who worked with an expert from Epic’s home office,” says Jody. “Before the integration was a success, we had several calls between all parties to identify system requirements and build the scripts using suggestions from Epic. 1Call staff did virtually all of the scripting, and they’ve been outstanding to work with.”

Evaluating Results

Over time, Upstate will use 1Call’s detailed reporting function to assess the results of the integration and determine how much time this project has saved. 1Call keeps track of the time spent on calls and they are looking forward to seeing improved statistics.

“The integration will first be used with our ambulatory call center because they handle virtually all of the incoming calls for about fourteen of our ambulatory departments, which includes general medicine, dermatology, pulmonary, etc.,” Jody explains. “They do some appointment scheduling, a lot of message taking, and transferring calls to a nurse, and various requests that come from the patients. Any time a patient dials the main number for each of those departments, it goes to this call center and the wait time had been extremely high. 

“We implemented the Epic integration nine months ago, and as of now, it looks like we are saving an average of about fifteen seconds on each call. We’re hoping we can cut 10-20 percent off the duration of each call. That will make a huge difference over the course of the whole day.”

Future Integration Plans for Efficient Workflows

There are plans to use this technology throughout more of Upstate’s call center departments. Some of the call center groups rely heavily on scripts which are used for appointments, physician referrals, prescription renewal, scheduling, crises, and emergencies. These areas hope to also save time on calls and serve patients more efficiently by taking advantage of the Epic integration.

Scripts can be shortened because much of the information the operators need will already appear on their screen as they answer the phone call. According to Jody, “Our medical messaging group currently follows and completes a script with a caller’s name, patient name if different, provider information, and then they look up the doctor on call and add that to the script. After the integration, we will be able to pull most of that info from Epic.”

1Call, a division of Amtelco

Epic Systems Corporation, or Epic, is a privately held healthcare software company founded in 1979 by Judith R. Faulkner and located in Verona, Wisconsin.Since 1976, Amtelco has been providing innovative communication solutions to call centers around the world. In 1997, the 1Call Division was formed to offer enterprise-wide clinical communication solutions designed specifically for healthcare organizations. 1Call is dedicated to serving the unique call center and communication needs of healthcare organizations, helping improve communications between patients, physicians, and staff by connecting people and information.

Unity Health Network’s Centralized Contact Center


TriageLogic

TriageLogic Helps Unity Health Network Enhance Patient Care and Reduce Costs

In this issue of AnswerStat we’re spotlighting the largest independent physician group in Northeast Ohio: Unity Health Network. With more than one hundred providers in thirty-two locations, Unity cares for hundreds of thousands of patient lives. Unity Health Network is also a leader in the Ohio Independent Collaborative, a statewide organization that unites other large independent physician groups to improve care and lower costs in the modern world of on-demand medicine.

Like most independent practices, Unity Health Network frequently uses telephones to connect patients and providers. Recently Unity recognized these communication channels were due for modernization. As part of its initiative to provide patients with high-quality, improved access to care, the group created a centralized call center, called the Care Coordination Center, with the help of TriageLogic.

“TriageLogic’s call center platform allows us to help guide our patients 24/7, giving them improved access to the correct facility for the care they need,” said Lisa Kilway, manager of care coordination at Unity Health Network. “By using TriageLogic, we can take care of our patients at the best location for the lowest cost, which means we’re not only providing improved care, but we’re also doing it more efficiently.”

By implementing the TriageLogic platform at the Care Coordination Center, Unity Health Network is able to build the foundation for its patient communication strategy. Only one year into the new call center, Kilway said Unity has consistently exceeded its goals month over month. “Previously, patient calls suffered an abandonment rate well over 50 percent, but since we created our Care Coordination Center, that rate has dropped to less than 10 percent.”

In addition to the call center platform, Unity Health Network also implemented TriageLogic’s secure texting feature, which allows for secure texting to a physician – eliminating the need for archaic pager systems. Each text is accessible by the physician for ninety-six hours, so they can review the text and pass it along if necessary. On the back end, the nurse can view when the doctor has received and read the text. “With a page, many times we just sent it and hoped for the best. As a nurse, I really don’t like those loose ends. Secure texting ties them up,” says Kilway.

Unity Health Network developed some key initiatives for 2016. As a starting point, the physician group began providing access and appointments without waiting for a physician’s staff to check voicemails and return calls. “We’ll be moving to do the same with all of our specialties,” says Kilway. “Our goal is to get patients from their primary care physician’s office to the specialists they need to see – sometimes even the same day. We’re able to handle their care much more efficiently and seamlessly.”

According to Kilway, Unity Health Network has even more ambitious plans for the future with technology-driven healthcare. “We’re also piloting a high-risk patient management program, which will include patient advisors who will monitor the patient through telemedicine devices and direct patient care.”

The need for greater, more immediate patient access will continue to grow in the future, and Unity Health Network is committed to being on the forefront. By using the latest technology and efficient communication, Unity will continue to provide modernized, on-demand access to the best healthcare in Ohio.

TriageLogic

TriageLogic is a URAC accredited, physician-led provider of high quality telephone nurse triage services, triage education, and software for telephone medicine. Their triage solution includes integrated mobile access and two-way video capability. For more information visit www.triagelogic.com.

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Case Study: Saving Lives with Telephone Triage



By Charu Raheja, PhD, and Carla Price, RN, BSN

Numerous studies and countless articles have been written about the improper use of emergency rooms and the resulting high financial burden on the U.S. healthcare system. One study by the RAND Corporation indicates that unnecessary trips to hospital emergency rooms cost approximately $4.4 billion a year.

With the U.S. healthcare system in serious need of cost cutting, there is increasing pressure to minimize unnecessary use of the emergency room. In doing so, it is critical to ensure people who truly need care receive it in a timely manner, thereby reducing the potential for life-threatening conditions.

Over the years, telemedicine has been gaining acceptance as a means of lowering healthcare costs, and telephone nurse triage has become part of the telemedicine solution. By using standardized protocols to advise patients to get to the right place at the right time, telephone nurse triage can decrease unnecessary emergency room visits, resulting in significant healthcare savings annually.

However, one of the important aspects of nurse triage that is often overlooked is the profoundly human aspect of the service. Most callers are truly concerned, and having access to a triage nurse provides reassurance and guidance. It is difficult to put a price on peace of mind. In addition, several patients may not realize the severity of their situation.

This real life case highlights the importance of nurse triage in improving health outcomes.

Telephone Nurse Triage Case: It was a weekday morning when telephone triage nurse, Linda G. RN, received a call from the mother of an eight-week-old infant. The baby had been fussy for several days, was not eating well, and had a fever of 100.7. Nurse Linda used the Schmitt Thompson pediatric protocols, which prompted her to ask the mother if the baby had any recent immunizations.

“No,” she replied.

“When is the last time he saw the doctor?” Nurse Linda asked. The mother indicated that the baby had been to the pediatrician the week prior for vomiting, diarrhea, and fussiness, but no fever.

“Have you given him any medicines?”

The mother replied, “No.”

At that point, with the baby having been sick for over a week and now presenting with a fever, the guidelines recommended that Nurse Linda call the child’s pediatrician to inform him of the baby’s decreasing health status.

Concerned about sepsis and other potentially life-threatening problems, the doctor instructed the nurse to call the mother back and advise her to take the baby to the emergency room. The mother was genuinely surprised when Nurse Linda called back and relayed the pediatrician’s instructions, as she was completely unaware of the potential seriousness of her baby’s condition.

Without the guidance provided by telephone triage, protocols, and the nurse, the infant may have experienced delayed treatment, leading to potential increased morbidity, and even death, if the baby had been septic.

Life Saving Calls: As telemedicine continues to expand into new services, providing innovative and cost-effective care, it is important to remember the benefits reach beyond budgetary significance. Cases, such as the one described above, are a lot more prevalent than what one would expect.

For example, in a recent study, we found that as many as 7% of the patients who did not consider their case an emergency (and responded that they would have stayed home if they did not have access to a nurse) were actually told by nurse triage to seek emergency care. Even more alarming, about 1% of the patients who did not think they required emergency care were told to call 911.

This means that a large number of patients are at risk of serious health issues because of not receiving timely medical attention. Every call answered by Linda G., and other telephone triage nurses, may be the difference between life and death. Fortunately, for one eight-week-old baby who wasn’t feeling well, a telephone triage process was in place, and he received the care he needed.

Conclusion: While this is one case of many, a significant portion of the population does not have access to telephone nurse triage. Implementing telephone medicine to a greater population can save lives and improve health outcomes.

Charu G. Raheja, PhD, is the chair and CEO of Triage Logic. Carla Price, RN, BSN, is the nurse trainer for Triage Logic. For more information and related articles, email Charu.

[From the October/November 2013 issue of AnswerStat magazine]

Meeting Today’s HealthCare Challenges Through Contact Center Excellence



By Patty Maynard

Healthcare contact centers have been given an increasing amount of responsibility to help their organization meet critical goals related to health reform and patient engagement. With this added responsibility also comes an opportunity to shine – and play an even more valuable role in both your organization’s success and your community’s health. RelayHealth’s RelayCare™ provides the tools and technology to help contact centers achieve excellence in this expanded role.

The New and Expanding Role of the Contact Center: Last year, the Centers for Medicare and Medicaid Services (CMS) implemented its first round of reimbursement penalties for excessive readmissions, which led to more than 2,000 hospitals forfeiting about $280 million total in Medicare funds (Centers for Medicare and Medicaid Report, “Readmissions Reduction Program,” August 1, 2012).

As the penalties increase for excessive readmissions, contact centers can help solve this challenge. Leading healthcare organizations are taking positive steps to avoid CMS penalties and improve patient outcomes. Here’s one example.

Readmission Management Success Story: Wake Forest Baptist Health: Wake Forest Baptist Health, a nationally recognized academic medical center, had been making post-discharge calls to orthopedic patients for several years but saw the need for a more robust readmission management program. Beginning with general medicine and hospitalist patients, they later added cardiology and other patient groups.

The RelayCare Readmission Management protocol-driven workflows enable contact center staff to efficiently manage inbound and outbound readmission management calls, while giving patients a single access point for any questions or concerns. The surveys associated with each patient call are specific to his or her conditions, with an easy-to-follow interface that keeps users from having to scroll through questions that aren’t relevant. The workflow queues also include reminders for tasks, such as “Patient could not be reached; follow up again.”

Post-discharge patient outreach has added about 100,000 outbound calls to the contact center’s annual call volume. The thirty-nine full-time employees handle about 400,000 total calls. Overall, RelayCare facilitates easier, more consistent documentation across multiple touch points. Its reports track discharged patients through the readmission program and cross-references them against readmissions, enabling contact center staff and clinical leadership to view the program’s successes and identify areas for improvement.

The Emerging Importance of Care Management: While hospitals have a powerful incentive to reduce readmissions, a care management program is also important. Nearly 133 million Americans, or half the population, suffer from chronic diseases or conditions (Wu, Shen-Yi, et al, “Projection of Chronic Illness Prevalence and Cost Inflation,” RAND Corporation, 2000). Plus, their ongoing care management represents 85% of healthcare spending (Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2004). An outbound communication program managed by the contact center can yield many benefits:

  • Promote self-care and a more proactive role among chronically ill patients
  • Facilitate better care coordination
  • Support a patient engagement strategy
  • Reduce inpatient treatment when possible (to optimize utilization of hospital clinicians) by avoiding admission or readmission
  • Provide care management resources for patients, caregivers, and the community at large

Top healthcare organizations use care management software to engage with patients and help them better manage their health. In addition to improving patient outcomes, they are realizing cost savings through reduced readmissions and ED visits.

To read more customer success stories, visit the case study section in the resource library at www.relayhealth.com or learn more by contacting a RelayHealth solutions advisor at 888-743-8735.

[From the June/July 2013 issue of AnswerStat magazine]

Case Study: Medical TAS Advances



By Samantha Walley

Comcepts is a Mississippi-based answering service assisting physicians and their practices nationwide since 2004. The software we were using could not keep up with our company’s growth. In some ways, it was actually holding us back, designed with a limited, one-size-fits-all set of features. However, we take a very hands-on approach with our clients. We provide an answering service experience that is more like an extension of their office than a generic call center. Plus, each of our clients would like their calls processed in a different way.

A few years ago, we began searching for new answering service software. From the moment we saw the client screen of one particular system, we knew we were close. It already had many of the features we were seeking, customization was possible, and ongoing development meant new features and updates would be available in the future.

Getting Up and Running: We implemented a training program well before the cutover so operators would be familiar and comfortable with the system early in the process. With our database switched over and the equipment tested, it was time to cut over. I won’t lie – I worried a lot before the switch, but it proceeded as smoothly as I could have hoped. We sequenced down the old system, and the new one took over.

Features and Benefits: The fun part started when we were able to use the system, experience the features, and customize each client’s screen for their practice’s needs. All the information our operators need is right in front of them, leaving no need to search for information on other screens or in multiple documents.

This gives operators the ability to complete calls faster. The information our clients deem important is gathered and delivered in the manner they wish without putting a strain on our operation. The same number of operators can now complete a greater number of calls in the same time, which translates into happier callers, pleased clients, and a more prosperous bottom line.

We now have the ability to add new services and features, which gives us an advantage in winning new customers, as well as retaining the loyalty of current clients. We have since added nurse triage services to our business offerings, and these services have been integrated into the system.

About Comcepts: Founded in 1999, Comcepts began as a medical transcription company based on the Mississippi Gulf Coast. In 2004, a client expressed his desire for an answering service that served “physicians only.” After much research and plenty of dead ends with existing answering services in the area, we decided to fill the niche ourselves. Comcepts has grown from a husband and wife team working around the clock to a dozen part-time, full-time, and reserve operators working in our offices. The addition of nurse triage services complemented and enhanced our answering service operation and is seen as an “added value” by our clients. For the next step, we are testing some operators working from home.

Samantha Walley is the president of Comcepts, LLC, which uses nCall answering service software developed and supplied by nSolve.

[From the December 2012/January 2013 issue of AnswerStat magazine]

The Gift of a Lifeline



By Tony Stramandinoli

The mission of Julie Valentine Center, in Greenville, South Carolina, is to raise awareness and help victims of child abuse and sexual assault. Its staff of seventeen includes educators, therapists, advocates, and coordinators, which is further extended by volunteers and community partners. To say that the Julie Valentine Center relies heavily on its communications systems is an understatement. In fact, you could say that the community of Greenville and its nearly 500,000 residents rely heavily on the communication system at the Julie Valentine Center.

The Challenge: Voices Matter: Email and texting don’t cut it for crisis hotline communication, and missed connections are lost opportunities – and often lost lives. With families in need of help, hotline callers, donors, referrals, and volunteers, the Julie Valentine Center was struggling to keep their lines of communication open. “The phone system we were using was antiquated,” said Shauna Galloway-Williams, Julie Valentine Center’s executive director. “It was hard to use. There were frequent problems, none of which we could resolve on our own, so we were constantly needing to call the phone service company to reset it.”

“We were struggling with the system we had, but we weren’t shopping for a new solution; we had no budget for that,” she added. “We were fortunate to come to know Sean Robertson, who is part of the Leadership Greenville Alumni Board of Directors. He understood our needs and knew how to help.” Robertson knows telecommunications systems; he is the chief technical officer at a distributor of telecommunications solutions.

Roberston’s relationship with the Julie Valentine Center began in 2010. “I became involved while acting as a mentor for one of last year’s Leadership Greenville service project groups. This group was remodeling the exterior and entranceway to Julie Valentine Center’s building, so I was onsite with them for their meetings a couple of times a month,” explained Robertson. “During that time, Joyce Smart, their development director, asked if I could take a look at their phone system because it was failing to route calls properly some of the time and was difficult to use.”

The Solution: Round the Clock Reliability – and Usability: Crisis lines have to be available 24/7. There’s no way around that. Robertson’s company, CTD (Computer Telephony Distributing) took up the cause. They approached LG-Ericsson, USA, who agreed to provide the telecommunications system. And their Greenville reseller, Atkins Data and Telephone Services, would help with installation and setup. All three companies worked together to make things happen for the center with an installation that included the central unit, digital phones for every desktop, and IP phones for remote use.

Moving to the new technology was easy. “The transition was our smoothest technology move ever,” said Galloway-Williams. “It took just a couple of days to set up – and, with no break in service. The new phone system was easy to get used to.”

There was not a lot to worry about in making the switchover. All of the information programmed up-front. Not only was the transition smooth, but also the new system is easier for the staff to use, which makes the center more accessible to those who need of help. “For example, we can easily set greetings and other outgoing messages – whether universally or individually – and we were easily able to ensure that our hotline rings in two locations: here and in another after-hours location with no gap,” concluded Galloway-Williams.

The fact that the system “has full-function digital and full-function IP phones meant that we could use their existing infrastructure and provide them with the remote phones and other IP functions that they needed to further enhance the services that the offer to their clients,” added Robertson.

The Results: Enhanced Communications: The new system solves the Julie Valentine Center’s telecommunications problems today by providing an easy-to-use, easy-to-manage, and reliable voice communication with all of the functionality of a traditional PBX. It manages calls within the walls of the Julie Valentine Center, out to clients, and to the 24-hour crisis line’s after-hours call center. Some of the new features include unified communications for voice and video conferencing, data collaboration, remote and roaming user support, and scalability. These serve to deliver a seamless communication experience for the Julie Valentine Center now and hold the potential to enhance their communications options in the future.

The results were that the Julie Valentine Center was able to enhance their telecommunications issues so that they can continue to provide an important service to the community. All of the enhanced functionality, usability, and reliability of their new phone system comes without any increase in ongoing cost-of-use, making this a winning solution for the Julie Valentine Center and the Greenville community.

[From the August/September 2012 issue of AnswerStat magazine]

Resurrection Health Care Tracks Revenue and Demonstrates Contact Center Value



By Patty Maynard

As hospital contact centers are tasked with being more accountable to their healthcare systems, measuring return on investment (ROI) becomes a necessity. A contact center with built-in accountability can show its worth to the organization through demonstrating its ability to generate revenue and increase market share.

For Resurrection Health Care in Chicago, change has come in the shape of hospitals bought and sold, staff realignments and reductions, and a merger with Provena Health in November 2011 that formed Illinois’ largest Catholic healthcare system. Throughout these changes, Resurrection Health Care has operated its contact center with RelayHealth products for marketing campaign management and triage since 1993. In 2007, Resurrection added RelayCare Revenue Tracker to help the contact center determine the effectiveness of these campaigns in generating revenue.

With Revenue Tracker, organizations can measure the revenue impact of direct and indirect services and calculate the financial impact of selected programs or the entire contact center. It also features intelligent technology that helps reduce the effort required to confirm partial matches and reduce the number of duplicate records.

Key Contributions and Compelling Numbers: Call Center Director Cheryl Dusenbery has worked at Resurrection for sixteen years. With Revenue Tracker, the center can follow a patient’s path from first contact to any financial service in the hospital and credit the revenue generated to the correct marketing campaign.

“If someone calls in looking for a doctor and gets a referral, for example, and nine months later they’re back in to deliver a baby, we’re able to match our call records with the hospital’s financial records and reconcile the revenue,” Dusenbery said. “Without RelayCare Revenue Tracker, it would be a totally manual process, and it would be nearly impossible.”

In fiscal year 2011, $32 million in incremental revenue at six hospitals could be correlated to contact center calls. This is an increase in revenue of approximately $330,000 per hospital when compared to the $35 million in revenue generated in fiscal year 2010 over seven hospitals.

“The average revenue per call for fiscal year 2011 was $925. That’s a nice thing to be able to say to a CEO, and it helps them understand the contact center’s value,” Dusenbery said. “They see the value in what we bring to the table. It brings credibility to the marketing team and the contact center.”

By using a file extract from an organization’s financial system to match revenue against contact center encounters, Revenue Tracker can assist contact center managers as they:

  • Generate reports showing gross and net contribution
  • Demonstrate financial value and impact resulting from contact center operations
  • Report against multiple time periods with criteria to account for multiple variables

“When I talk with other facilities, I stress how important it is to position the numbers as a correlation,” Dusenbery said. “If someone fills out a card to get a thermometer, or if you’re trying to track what you get from a physician’s lecture, that’s incremental revenue that demonstrates the effectiveness of a marketing campaign.”

Revenue Tracker has also helped with resource decisions in the contact center. Staff can be added during hours when call volumes or the average revenue per call are higher or reduced when they are lower.

“We can track callers by outcomes, by the number of calls taken by nurses or representatives, or by the percentage that generate revenue,” Dusenbery added. “We’re able to decide by looking at the results whether it’s more cost-effective to have nurses go out into the work force or to other call centers.”

Conclusion: Whether demonstrating or determining its worth to the organization, Resurrection Health Care’s contact center has received the help it needed from Revenue Tracker. Tremendous amounts of data have been processed during the time that RelayCare has been in use at Resurrection Health Care. In that time, it has also added and removed hospitals from its roster. Through it all, RelayHealth has been a partner in keeping the information flowing.

“Every time we added a hospital, we wondered, ‘What’s going to happen now?’” Dusenbery said. “Each one is a giant influx of data, and we worked hand-in-hand with RelayHealth to make sure we could handle it.”

Patty Maynard is the solution line leader for RelayCare.

[From the June/July 2012 issue of AnswerStat magazine]