Tag Archives: medical answering service articles

Effective Call Center Software Improves Patient Transfer Center Workflows

1Call, a division of Amtelco

By Nicole Limpert

There is a lot of coordination involved when getting a patient from point A to point B. That is why hospital systems will have a dedicated patient transfer center to coordinate inpatient-to-inpatient, emergency department-to-emergency department, and hospital-to-hospital transfers for adult and pediatric patients. Communication occurs between medical staff and the call center agent.

Patients may be admitted to a hospital from their home, workplace, other hospitals, or clinics. They can arrive a variety of ways including via ambulance or helicopter, or they may already be within a hospital but need to be moved throughout the facility for tests, treatment, surgery, recovery, and visits with other medical personnel located on a hospital campus.

Patient Transfer Call Center

Patient transfer centers are dedicated call centers that provide a way for medical personnel to reach an appropriate hospital or specialist for their patient’s needs when they must transfer a patient from an outside hospital or residence, or within their healthcare organization. Typically, a referring physician calls one number that directs them immediately to the patient transfer center.

The operators at these centers are experienced professionals and are often registered nurses or EMTs with critical care experience. They are available 24/7 and have access to vast hospital and clinical networks. They conveniently and efficiently coordinate:

  • Emergency transfers or direct admissions.
  • Securing an accepting physician.
  • Bed assignments.
  • Paramedic and ambulance arrangements.
  • Transfers for critical care such as burns, cardiac, or stroke.
  • On-going communication with referring physicians.

Patient Transfer Centers and Call Center Software

Calls come into a patient transfer center in a variety of ways including via two-way radio, web, phones, and various apps. The workstation of one of these operators often has the same layout as a 911 dispatcher with at least three computer monitors, multiple keyboards, mice, and sometimes foot pedals while also using a radio.

This mixture of components from different vendors all have their own software. It is paramount that the call center software they use can seamlessly integrate with the different technologies to streamline communication and workflows.

When a call comes in the agent will immediately ask for the accepting and referring physician’s name, the patient’s name, the current location of the patient, the patient’s diagnosis, and specific medical needs. This information helps operators assess the patient’s needs and arrange for the transfer.

Patient transfer centers must ensure that their call center software can provide conference bridges and conference joins for physician consults, offer customizable scripting options to help walk operators through a dizzying array of calls, and is supported by a reliable, single source of truth directory to ensure that all updates propagate to the entire system without duplication.

Connecting with On-Call Medical Staff

Patient transfer centers give their agents the authority to access and view on-call schedules in real-time. To connect with on-call medical staff, many centers use a HIPAA-compliant secure mobile messaging app to ensure security when communicating about a person’s health. 

These apps provide end-to-end encryption and can integrate with the center’s software to send secure texts, photos, videos, and audio files. Operators can use the app from their desktop or any smart device.

Once a message is sent, agents can see if it was delivered and read. If they don’t receive a response from the person on-call, they can escalate it to another physician. These apps usually provide a way to track message activity, including a message log, message histories, indicate to whom messages were sent, when messages were read, who replied to a message, and so forth. The apps can present the data as reports for hospital and call center managers. 

The Importance of Recording and Reporting

The patient transfer center must keep reports for hospital leadership. Reports such as physician transfer choices, number of transfers, and call logs provide data to help protect callers, operators, and hospital systems in litigious situations. Calls, screen capture videos and images, messages, and more can be recorded, tracked, time-stamped, and stored.

Call analytics also help the patient transfer center improve workflows and increase caller satisfaction. It is important that reports can be customized, however, there are common reports that provide helpful information such as:

  • Agent Activity: Analytics about an agent’s activity including number of calls, holds, conference time, dispatch activity, and events such as login/out and ready/not ready.
  • Billing: Centers that need to charge departments or facilities for services can use billing codes to track accounts and their call activity for invoicing.
  • Call Details: Detailed call information including dispatch jobs, dial-out activity, messages, message history, events by agent, speech recognition events, and live call information.
  • Call Traffic: An interval-based assessment of live call traffic to help gauge call volume and agent staffing.

Every patient transfer center is different and has different needs. However, they all require an enormous amount of coordination. Transporting patients can be a life-saving effort and is an integral part of patient flow, patient care, and the patient experience. It is critical that patient transfer centers use a robust call center software program that readily integrates with other products to increase efficiency.

1Call, a division of Amtelco

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

How to Safely Redirect Patients Away from the Emergency Department

LVM Systems

By Mark Dwyer

One of the most significant challenges hospitals faced over the past two years was handling the heightened number of ED calls and visits due to the COVID-19 pandemic. In many areas of the country, staff had to perform at heroic levels. And due to the ongoing variants, some are still facing tremendous challenges.

Having spent my career in the healthcare call center industry, I was pleased to see call centers across the country step up and field calls from millions of concerned individuals. However, much more is possible. 

Today’s call centers efficiently handle both clinical and non-clinical inbound and outbound calls. In addition, many accept text messages and bi-directional chats to facilitate patient access to care. These expanded communication options provided much-needed additional contact points during the pandemic. So, what other opportunities exist for the call center to play an even greater role? 

Front-Ending Clinical Calls

One such option is to position non-clinical agents to front-end clinical calls asking a brief set of questions to determine severity. Then, if the call meets any of four to five critical conditions pre-defined by the hospital, the front-ender passes the call off to a live Triage Nurse. If the call is determined to be less critical, it is placed into the nurses’ call-back queue for the next available nurse to process.

For decades, Triage Call Center nurses have used clinically proven protocols to guide callers, based on the severity of their symptoms, to the appropriate sources of care. In addition, the same clinical authors who wrote the Gold-Standard of triage protocols have added and revised multiple COVID-19 protocols and Care Advice over the past two years, enabling call center nurses also to triage COVID-19 patients. 

Now, the call center nurse can triage COVID-19 patients directing them to “call 911,” “go to the ED,” “Go to Urgent Care,” “See their PCP,” or provide home care instructions (among other endpoints). Doing so can redirect numerous patients to less urgent care options before they arrive at the ED unnecessarily. 

Follow-Up Options

After completing the triage portion of the call, if appropriate, the nurse can pass the call to a non-clinical call center agent to share directions to the referred facility, hours of operation, information on where to park, rules regarding caregivers accompanying the patient, and so forth.

If the patient requires admission to the ED, through integration to the hospital’s EMR system, the call center agent can keep the caregiver advised of the patient’s progress. This way, the agent can text the caregivers to update the patient’s status and discharge plans. In addition, when appropriate, the agent could either fax, text, or send by secure message any follow-up instructions for the patient.

The next day, the nurse or agent should call the patient or caregiver to make sure the patient filled any prescriptions they received, scheduled a follow-up appointment with their PCP, and followed other discharge instructions. Not only does this engender tremendous goodwill, but it often can be all that is needed to keep the patient from returning to the ED. 

Summary

To provide an effective integrated solution, the call center must work across the healthcare delivery system. It needs to team not only with its ED but also with area hospitals, emergent and urgent care centers, wellness and preventive care facilities, PCPs, and other services often needed by patients seeking care post-ED. If so, by creating a network of healthcare providers willing to accept and treat patients within reasonable timeframes, call centers can build trust in patients, so they are confident in the information and resources provided.

LVM Systems logo

Mark Dwyer is LVM Systems’ chief operations officer. He has more than a quarter century of experience in the healthcare call center industry.

1Call & Vocera Enhance Care Team Collaboration; Improve Patient Experience

1Call, a division of Amtelco

1Call, a division of Amtelco, now integrates with clinical communication and workflow solutions from Vocera Communications, Inc. Interoperability between 1Call and Vocera solutions, including smartphone applications, hands-free communication devices, and intelligent middleware, ensures that crucial messages are distributed with contextual information to the correct care team members on their device of choice.

“Every healthcare organization strives to provide the best care for patients,” said Tom Curtin, president of Amtelco and 1Call. “Whether it’s a phone call to a clinic or during a patient’s hospital stay, each patient expects to receive fast and accurate answers, along with timely and proper care. The 1Call and Vocera collaboration provides mutual customers with a best-in-industry interface designed to provide better outcomes for patients.”

The interoperability of the 1Call and Vocera solutions eliminates manual data entry and helps eliminate errors in contacting the wrong personnel. In addition, 1Call and Vocera solutions help speed up response times by ensuring an entire healthcare facility has instant access to current information while also safeguarding data.

When used in conjunction with 1Call, users of Vocera solutions can:

  • Access on-call schedules, status, and messages to easily view, edit, and create on-call schedules through 1Call’s miTeamWeb app.
  • Use 1Call’s scripting module in hospital contact centers to guide agents through each call, including code calls, with ease.
  • Access real-time medical staff status and on-call schedules so the correct team members are contacted when personnel receive a message or notification about a patient.
  • Access patient data, securely, so care teams can view recent labs, diagnosis information, and help streamline the process of handling critical events.
  • Track everything that happens on calls, changes to on-call schedules, status updates, and more to generate various reports that help organizations monitor and optimize performance, easily spot trends, and focus on areas that need attention. 

“The integration between the Vocera and 1Call systems makes it easy for clinicians to contact the right team members and securely communicate about patients,” said Brent Lang, chairman and CEO of Vocera. “We look forward to seeing the positive impact of this collaboration and how this integration simplifies workflows and eases the cognitive burden for care teams.”

1Call, a division of Amtelco

The 1Call division of Amtelco is a leader in developing software solutions and applications created for the specific needs of the healthcare call center marketplace. 1Call features a complete line of modular solutions specifically designed to streamline enterprise-wide communications, save an organization’s limited resources, improve efficiency, and help bring wellness to their patients.

The mission of Vocera Communications, Inc. is to improve the lives of healthcare professionals, patients, and families. Founded in 2000, Vocera provides clinical communication and workflow solutions that help protect and connect team members, increase operational efficiency, enhance quality of care and safety, and humanize the healthcare experience.

Medical Answering Services and Telephone Triage

By Nicole Limpert

1Call, a division of Amtelco

Doctors in the United States first began using answering services in the 1920s so they would be made aware of patient emergencies. At that time, operators were basic message-takers and would pass along patient concerns and contact information to the doctor.

Today’s medical answering services provide a much wider range of services to lighten the administrative workloads of medical offices, and not only assist doctors, but also surgeons, hospice, home health, dentists, orthodontists, and even large healthcare systems. Medical organizations that use an answering service can experience increased appointment setting rates, better patient-doctor communication, improved patient satisfaction, and provide their patients with reliable access to care 24 hours a day, 7 days a week.

Some medical answering services can even provide telephone triage if they employ licensed professional staff members trained to give an accurate assessment of a patient caller’s concerns.

Telephone Triage

The use of triage originated during World War I to avoid focusing resources on victims with fatal injuries. Sometime in the early 1970s, health maintenance organizations (HMOs) instituted telephone advice services which led to hospital emergency departments establishing 24-hour telephone advice programs. Telephone triage is now a sophisticated practice usually performed by nurses and other highly trained medical personnel.

Telehealth, telemedicine, and telephone triage may all sound similar, but each are quite different. Telehealth focuses on the actual delivery of care (both preventative and curative). Telemedicine involves the diagnosis of a patient’s health compliant and recommended treatment by a physician via any form of telecommunication. Telephone triage is the assessment of a patient’s symptoms and the urgency needed to quickly get that patient connected with the correct doctor or department. 

Telephone Triage Communication Model

Effective communication is critical in telephone triage. Typical models of communication include three parts:

1. Data Collection: The answering service agent gathers data from the patient caller about the problem and asks open-ended questions to encourage more information about the symptoms.

2. Confirmation: The agent repeats the information using some medical terminology but in a way that the patient can understand. The patient confirms and redefines the symptoms if necessary.

3. Disposition: The agent may give advice about treating symptoms, but the main outcome is to quickly connect the patient caller with an appropriate doctor, clinic, or hospital department. 

To assist operators with remembering which questions to ask during the assessment, it is common for them to use a mnemonic device called OLD CART:

O (onset of symptoms): When did the symptom(s) first occur? Has it happened before?

L (location): Where on the body is the symptom occurring?

D (duration): How long has the symptom(s) been present and is it constant or does it come and go?

C (characteristics): Describe what the symptom(s) feels like.

A (associated factors): Are there any other signs and symptoms that occur?

R (relieving factors): Does anything make it feel better or reduce the severity?

T (treatments tried): What has been tried to relieve the symptom? Has anything worked?

Advantages and Disadvantages of Telephone Triage

There have been many studies published about telephone triage and how they help reduce a healthcare organization’s costs while helping patients experience better health and greater satisfaction. BMC Health Services Research conducted a review of existing body of research about telephone triage and advice services (TTAS) and found that, “TTAS was examined either alone, or as part of a primary care service model or intervention designed to improve primary care. Patient satisfaction with TTAS was generally high and there is some consistency of evidence of the ability of TTAS to reduce clinical workload. Measures of the safety of TTAS tended to show that there is no major difference between TTAS and traditional care.”

The primary disadvantage of telephone triage is liability. Lawsuits can be filed if a patient call was mishandled. For example, a negative health outcome can be attributed to a miscommunication, because a patient was on hold for a long time, or due to a lack of information about the patient.

If the situation is serious enough and becomes a legal issue, the courts may even hold a doctor responsible if they find the person assisting the patient via telephone triage lacked skill or training. In the unfortunate event of a serious medical problem or death because of mistakes made by a triage service, anyone connected with the case (such as nurses, physicians, other medical personnel, the healthcare organization, and the patient’s health plan) could be sued.

Importance of Call Center Software for Effective Telephone Triage

Medical answering services who also offer telephone triage systems can safeguard against liabilities for themselves and their medical clients by using a robust call center software. All-inclusive, highly interoperable healthcare software can integrate with electronic medical record (EMR) systems and use artificial intelligence (AI) to help ensure operators are talking to the correct patient; customized scripting ensures operators are asking and giving correct information; and they also offer critical call priority and improved call routing.

Effective contact center software also provides a customizable reporting function to keep track of metrics that enhance accountability with call logging and video screen capture, connect remote agents, and manage on-call scheduling. Because calls, messages, screen capture images, and more can be recorded, tracked, time-stamped, and stored, data from call centers can also help protect themselves, hospitals, and patients in litigious situations.

Medical answering services can also take advantage of running their call center software in a virtual server environment or in the cloud. This enables their staff to work from home by turning any personal computer into a professional agent workstation. All the tools used by an agent in a medical answering service call center are accessible to the virtual agent.

Secure Messaging and Telephone Triage

A secure mobile messaging app can help keep both medical answering service providers and their healthcare clients HIPAA-compliant in the event an agent needs to contact on-call medical personnel about a patient caller.

If an agent determines a patient’s doctor needs to be notified immediately about a critical situation, a secure messaging app that’s integrated with the agent’s call center software and on-call software can quickly contact the correct physician. End-to-end encryption ensures all communications are secure and protected.

Persistent alert settings can be set so important messages won’t be missed, and full reporting functions available via the app tracks messaging histories including if a message was received, opened, and replied to.

With today’s technological advances and secure HIPAA-compliant communication options, medical answering services can provide outstanding telephone triage services that result in better patient care while protecting against liability issues.

1Call, a division of Amtelco

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

Modernizing Your Contact Center: The First Step Toward a More Engaging Patient Experience



By Donna Martin 

While healthcare has traditionally been more reactive in nature, consumerism is driving a shift toward a model that is more proactive and puts patients at the center. As providers compete ever more fiercely for less revenue due to the financial crisis brought on by COVID-19, we fully expect to see a heavier focus on the consumerization of healthcare this year, and a major boost to patient experience as a result.

In fact, consumerism has already changed patient-facing communications for hospitals and health systems. This shift has been so major that many healthcare leaders are looking to other industries—such as banking and retail—to uncover best practices to adapt to the healthcare setting. After all, the people who shop at Amazon.com are the same people who shop for healthcare—and the experience of the former informs their expectations for the latter.

As a result of consumerism’s influence, delivering an exceptional patient experience is more important than ever, and first impressions are critical. That’s why a modernized contact center—measured by value-based benchmarks—is integral both for differentiating your healthcare organization and for preventing the loss of valuable customers.

For example, if a patient makes a basic inquiry, such as to schedule an appointment, ask a question about a treatment plan, or request a referral, are they confronted with a myriad of questions, outdated, legacy options, and poorly automated selection menus? Are they routed and rerouted among multiple call service operators and forced to relay the same information repeatedly? For a patient living in the gig economy and accustomed to a seamless customer experience, a painful interaction such as this isn’t likely to make a good first impression.

Contact centers measure quantitative benchmarks, such as how fast calls are answered, average handle time, the rate of first-call resolution, and the number of agent-to-agent transfers. All those measures are important, but these traditional, quantitative benchmarks fall short of the innovations and requirements of the industry’s transition to patient-centered, value-based care delivery.

Patient contact centers should offer seamless patient engagement, reducing frustration and time spent by caregivers and patients seeking answers to their questions. If airline carriers know their customers’ preferred seating arrangement and hotels know their guests’ floor and room preferences, then healthcare provider contact centers should strive to anticipate the needs of their patients in a much more proactive manner.

The shift toward an initiative-taking approach requires that patient records are in the patient portal and can be effectively routed to care coordinators. This allows agents to reference and make decisions based on what is known about that patient at that time, including personalization criteria, such as a patient’s preferred channel of communication.

Today’s consumers demand a healthcare ecosystem that offers self-service channels to help them get the right answer quickly. Provider organizations must invest in hyper-personalized, unified, and frictionless experiences with cross-channel integration to create a holistic and engaging patient experience. 

To support these modernized contact centers, health systems will turn increasingly to the next generation of data analytics and cognitive artificial intelligence (AI). Providers have a phenomenal amount of data at their disposal—from claims, labs, and other sources—but using it to effectively anticipate patient needs with razor-focused accuracy remains a challenge. 

From tracking and screening of biometrics and preventive care based on personalized data, organizations should deploy analytics to enhance personal profiles and gain a comprehensive understanding of how to best guide an individual’s health requirements. This will raise the bar on optimizing patient experience. 

As the industry continues to shift toward a patient-centric, proactive model, business process management (BPM) providers can assist with addressing these changes and shorten the learning curves that may exist. The fact that most BPMs have existing relationships with clients who have long emphasized customer experience, such as retail and e-tail, makes them the perfect resource to tap for providing guidance and implementing these new strategies.

Donna Martin is senior vice president, healthcare business development at HGS

Finish Strong and Don’t Coast into the New Year

How We Conclude This Year Will Prepare Us for What Happens Next Year



By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan

This year continues to be a challenging one, more so than most others—perhaps any other. As we look forward to a new year in our healthcare call center, we turn the calendar with expectations of a better future, along with a wondering about how much things will change. Whether we find ourselves forced into a new normal or can return to an old normal looms as a huge question. But what we do know for sure is that what we do today in the remaining months of this year will influence what we encounter in the next.

Here are some things to consider.

Make Flexible Plans 

As you look forward to the new year, develop a strategy with contingencies. Do it now. Factor in options. This means developing a plan A and a plan B and even a plan C. It means considering tactics in how to do things in person and remotely. Look to implement technology that can adapt to accommodate expectations as needed, regardless of what path the future takes. Assume that what you’re doing today in your call center will change as you move throughout the year.

Don’t Coast

The understandable temptation, after an especially grueling year, is to relax. It might be you’re worn out and want a break. Another thought is that you’ve worked hard and deserve to take it easy. Though resting has its merits, that’s not justification to check out and coast through this year’s remaining days. 

Resist the temptation to tell yourself that you’ll make up for taking a break now by promising to hit the ground running on January 2. By then inertia will have set in, and it will take too long to get back up to speed. Breezing through work for a few weeks may seem like an attractive option, but the big-picture perspective is that you run the risk of not being able to embrace a new year.

Be Intentional

Instead, be deliberate in how you wind down the final days of December. This doesn’t mean accelerating at full speed, but don’t hit the brakes either. Look to wrap up projects so that you don’t have to carry them into a new year. Pursue small initiatives now to form a foundation you can build on to produce success faster when you return to work after the holidays.

Make Time for Family and Friends

Speaking of holidays, this year your celebrations may look different than in the past. Even so, seek safe ways to connect with family and friends. Don’t take unnecessary risks, but don’t be a hermit either. We need each other, we crave connection—whatever that looks like today, and we require interaction if we are to stay mentally fit and emotionally healthy.

May you finish strong this year and move with confident preparedness into the next.

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

Care Management

By Terri Hibbs, BSN, RN, CCCTM



The healthcare system has a large population of elderly patients, many with multiple healthcare issues or chronic conditions. Taking part in a care management program can help these patients become healthier by educating them about their disease processes and the importance of medication compliance, regular blood work, annual tests, and preventative measures such as flu and pneumonia shots and mammograms, and colonoscopies. 

Care management services provide patients with contact to inform them of their conditions in terms they understand and to involve them in personal healthcare goals. In this way, patients are more likely to want to be involved in reaching their goals and becoming healthier. The intent is to keep these patients out of the emergency room and hospital as much as possible. 

What is Care Management?

“Care Management programs apply systems, science, incentives, and information to improve medical practice and assist consumers and their support system to become engaged in a collaborative process designed to manage medical, social, and mental health conditions more effectively. The goal of care management is to achieve an optimal level of wellness and improve coordination of care while providing cost effective, non-duplicative services.” (“Care Management Definition and Framework,” Center for Health Care Strategies, Inc., 2007.)

Two Types of Care Management

1. Transitional Care Management is a Medicare service that became effective Jan. 1, 2013, per cms.gov. The care management team or nurse navigator will call a patient or caregiver within two days of inpatient discharge to discuss medication, a new diagnosis, or important follow up appointments with the purpose of reducing and preventing readmissions and medical errors. 

2. Chronic Care Management (CCM), according to The Centers for Medicare & Medicaid Services (CMS), is a chronic care management services, which are a critical component of primary care that contributes to better health and care for individuals. The goal is to provide the patient and family with the best care possible to keep them out of the hospital and emergency room and to minimize overall medical cost. The program is used to help patients achieve a better quality of life through continuous care and management of their chronic conditions. Patients collaborate with healthcare providers to set healthcare goals, thus making it more likely they will accomplish those objectives.

Case Study

One patient I worked with is a successful participant in the CCM program. He initially visited the emergency department because of unstable vital signs, weakness, dizziness, and uncontrolled hypertension. He had been out of his medication for three months, was admitted for congestive heart failure and atrial fibrillation, and spent four days in the hospital. He also had uncontrolled diabetes with a Hemoglobin A1C of 10.7 percent and his average fasting blood sugars at home were running in the 300s. 

The patient consented to the CCM program for his chronic conditions of atrial fibrillation, congestive heart failure, chronic obstructive pulmonary disease, diabetes, hypertension, and obesity. He was very eager and willing to learn about his disease processes and to take his medication on a regular basis. He was given information on Medicaid services to help with medication expenses and was educated on Metformin titration and use of his insulin. 

I also regularly contacted him for a report on his blood sugar and blood pressure readings. In just two short months the patient has stopped smoking and his fasting blood sugars are now running in the low 130s. He has a better relationship with his son and granddaughter, is more physically active, and is making better food choices. He is due for a repeat Hemoglobin A1C level next month. 

This is just one of many examples of what care management can do for a patient. As a nurse navigator, my patients become like a part of my family. I am blessed to be able to educate and support our patients and their families and to help them to make better healthcare choices that can potentially save their lives. 

Terri Hibbs, BSN, RN, CCCTM is a care navigator for Baptist Health Hardin Family Medicine.

Virtually Consolidate Large and Multi-State Hospital Call Centers to Work from Home


1Call, a division of Amtelco

By Nicole Limpert

According to a survey published by the American Hospital Association (AHA) in 2016, there are 3,231 community hospitals in the United States that are a part of a larger hospital system.

The AHA defines these enterprises as either a multihospital system where two or more hospitals are owned, leased, sponsored, or contract managed by a central organization; or a single, freestanding hospital that includes membership of three or more, and at least 25 percent, of non-hospital healthcare organizations. These sizable healthcare systems are often the result of mergers. Hospitals announced a total of 115 merger and acquisition transactions in 2017 alone and this trend is on the rise.

No matter how large the hospital enterprise, call centers are often the first point of contact when a patient or prospective patient contacts a healthcare organization. It’s essential that callers have a helpful, positive interaction with the operators they speak with because medical call center representatives often serve as the face of a health system.

Communications within these large hospital systems were already incredibly complex before the coronavirus began to spread. When the pandemic began, many hospitals sent their call center workforce home to safely handle calls while in isolation.

Call center software gives hospital organizations the flexibility to turn any computer into a fully functional operator workstation. Callers have a seamless communication experience with their provider, even if their hospital has various campuses or locations across multiple states, all while the person they are talking to is working from home.

Using a Virtual Server Brings Multiple Hospital Call Centers Together

Healthcare systems with multiple hospitals, clinics, and call centers can run on a single virtual server located anywhere in the country to function together seamlessly—even if they all use different PBX telephone systems.

This enables hospital call centers to pivot during uncertain times, such as the current coronavirus outbreak, and also grow without adding additional server hardware. Using a virtual server means less equipment needs to be maintained. This saves an organization time and money, which has become even more crucial with pandemic-related budget crises. 

To streamline call flows, hospital enterprises are combining and scaling their communication systems virtually. This allows them to take advantage of running their call centers in a virtual server environment or in the cloud, while keeping staff safe. 

Other benefits of running call centers remotely:

  • Ability to route calls to another center in the event of an emergency
  • Offering longer operating hours by taking advantage of call centers or agents located in different time zones
  • Easier for supervisors to get fill-in operators if an agent is sick
  • Ability to handle more calls during peak hours by overflowing calls to other centers during their non-peak times
  • Tap other labor markets such as retired nurses, students, or a lower-cost workforce and hire people who are located outside of expensive city areas with high compensation rates

Secure Messaging Apps Remotely Support Care Teams

Secure organizational communication is crucial for protecting patients, medical staff, and hospital organizations. Care teams use these apps to send secure text, photo, audio, and video content related to a patient’s electronic protected health information (ePHI), via smartphones, tablets, and desktop computers. 

These apps simplify healthcare communications to provide a better patient experience and speed the process of patient admissions, lab results, and patient transport within a hospital. Call center agents working from home also use cloud-based secure messaging apps to contact on-call medical staff via their computer. 

“As a healthcare system, we need a secure messaging platform for our clinical staff to share critical health information quickly and easily,” says Steven Spachtholz, director of information systems for Butler Health System in Butler, PA. “For us, the advantage of using the platform is its tight integration to our call center system that we use to provide answering services to our physicians.”

Steven explains, “We started using secure messaging with our internal answering service, but it grew to become our only secure messaging platform. What makes the secure messaging app we use different, is its integration with our call center software for on-call data and the integration engine we use which allows us to inject messages from other systems. All routine consults now flow from our electronic health record (EHR) database to our secure messaging app automatically.”

Secure texting apps can also keep track of all message activity with an audit log and a message log, complete with message histories, indicating whom messages were sent to, when messages were read, and who replied to a message. These logs can be made into reports for call center supervisors and hospital management.

Future of Web-based Hospital Communication

Hospital staff must be able to access the information they need at any time from any place. It’s a fundamental and critical part of any healthcare organization’s communication protocol. This is especially true during a pandemic since it’s more likely that both call center and medical staff may be working from home or from different hospital locations.

Web-based applications that are specifically developed for the healthcare industry have proven to be incredibly effective in providing fast and secure communication, improving communication times, adding efficiencies through remote access, and reducing the number of potential errors caused by miscommunication. 

Some hospital call centers already had a select group of operators working from home, but the COVID-19 crisis forced more hospitals to take advantage of having a virtual call center. Many studies have since been published about the benefits and cost-savings of having staff work from home. Some organizations have already decided to keep their call center staff remote, and the latest trends indicate this once temporary solution is going to be a permanent shift in the industry.

1Call, a division of Amtelco

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

A Problem—and Opportunity—for Healthcare Call Centers



By Greg Kefer

Your phone starts ringing, you drop what you’re doing, look at the screen, and see a call from some odd number from a faraway place. Or worse yet, it says “Scam Likely!” I’m rarely in the mood to listen to some foreign language robot or get rich pitch. Phone calls that matter have increasingly become the minority.

According to estimates, US mobile phone users were exposed to 48 billion robocalls in 2018, which means that every time the phone rings, there’s a 50 percent chance it’s a spam robocall.

Training the Masses to Decline Calls

There are few viable solutions available for blocking 100 percent of these annoying intrusions, so the best option when that unknown phone number shows on the caller ID is to simply hit the decline button and move on with whatever you were doing. Robocalls are creating anti-call center muscle memory across the entire mobile phone user population.

The shunning of annoying telemarketing cold calls is not a new thing. But thanks to robocall automation, the surge of incoming noise has become so intense, there’s little chance a consumer will pause and consider the possibility that an incoming call might actually matter. This is a problem for the healthcare industry.

Call centers have always been a big part of the healthcare patient experience. Challenges with being on hold, ineffective agents, and general customer dissatisfaction with call centers are well documented. But what about the outbound side?

The Challenge for Healthcare Call Centers

The healthcare industry is investing heavily in engaging patients, and call centers are a big piece of that strategy. Outbound calling campaigns help patients navigate their care, set appointments, take medicines, or check in after a visit. These are potentially important touch points. If people stop answering their phones, what happens? Email outreach is frequently intercepted by spam filters, secure messaging is clunky, and most patients don’t log into their healthcare portals.

At call centers, human capacity has always been a constraint. When it comes to dealing with healthcare situations, there have not been a lot of viable automation options that blend a quality, well-designed engagement experience with a high-scale system. Anybody that has received a robocall doctor’s appointment reminder knows how disengaging it is.

The healthcare industry faces a challenge when it comes to reaching out to patients, often for critical issues.

  • Providers and pharma companies need to reach out and connect with patients.
  • Most patients have a mobile phone and prefer to communicate through them.
  • Robocalls have trained consumers to avoid answering their phones.
  • Healthcare mobile apps are too clunky and remain unused.
  • Consumers prefer text messaging.

Heavy investment in call center technology that’s focused on intelligent patient information and agent enablement is still key. But is there a new opportunity for call centers to reach out to patients as part of a patient engagement effort?

Digital Conversations at Unlimited Scale

Conversational chatbots that interact with people in a way similar to text messaging are finding their way into many industries. What would happen if an interactive text front end, first touch was woven into the outbound call center approach? The bot could completely handle simple tasks, such as reminders and information gathering. Or it could start on some of the more advanced workflows, such as monitoring care progression or providing drug background information in advance of a human to human interaction.

As they stand today, call center agents are premium level expenses when compared to a well-designed chatbot that can run 24/7. Imagine a call center not constrained by human capacity.

If the virtual dimension of a modern patient engagement strategy requires outreach and interaction with vast populations of patients, the answer isn’t to hire more agents. Rather, you must find a way to make the agents you already have handle an increased volume, with conversational chatbots conversing and engaging patients across a spectrum of workflows. And the entire process would be in the medium that consumers increasingly prefer—text-based messaging.

With this chatbot technology, the odds of reaching someone and helping them with their care can only increase.

Greg Kefer is the CMO at LifeLink.

Reducing Hospital Readmissions with Simple Post-Discharge


1Call, a division of Amtelco

By 1Call

Each year, approximately 16 percent of patients in United States hospitals are readmitted within thirty days of discharge. Readmissions and the additional treatments they entail are costly to both patients and insurers. Increasingly, they are costly to hospitals as well.

A portion of readmissions is unavoidable, such as a planned readmission for chemotherapy or an unexpected adverse event unrelated to the original diagnosis. However, many other readmissions are preventable through high quality clinical care and effective patient education and discharge procedures.

The Financial Impact of Hospital Readmissions

To reduce hospital readmission rates nationwide, the Centers for Medicare and Medicaid Services (CMS) began financially penalizing hospitals with higher than expected readmission rates via their Hospital Readmissions Reduction Program (HRRP) that began in 2012. The cost of those penalties across United States hospitals increased significantly from a total of 290 million dollars in fiscal year (FY) 2013 to an estimated 563 million dollars in FY 2019.

Failure to reduce readmissions has become more expensive over the program’s lifetime. In the first year of the HRRP, the maximum penalty was 1 percent of Medicare reimbursements withheld. By design, that maximum penalty has since increased to 3 percent.

National hospital readmission rates have dropped since the program launched, but not enough to decrease penalties. Of the 3,129 general hospitals evaluated in the HRRP in 2019, 83 percent received a penalty.

The increases are due in part to additional health conditions included in the program. In the program’s first year, CMS evaluated the readmission rates of patients with heart attacks, heart failure, and pneumonia to determine whether a hospital faced penalties. Today, CMS also measures readmission rates of patients with chronic lung disease, hip and knee replacement, and coronary artery bypass graft surgery. Scheduled readmissions are not counted.

Additionally, the program is set up such that CMS evaluates each hospital’s readmission rates relative to the national average for each condition. Even as readmission rates drop overall, there will always be hospitals that have more readmissions than the national average.

A 2016 study on hospital profitability published in the journal Health Affairs found that most hospitals in the United States are not profitable, and the median acute care hospital is losing 82 dollars per discharge. Given those numbers, it’s imperative for hospitals to reduce readmission rates and reduce the amount of Medicare reimbursements left on the table.

Readmission Rates and Causes in the United States

Some patients will always be readmitted after discharge. However, the wide range of readmission rates across hospitals suggests that there are addressable factors behind readmissions. In some cases, a readmission may be related to what happened during the original hospitalization. In other instances, patient readmission ties to what happens after discharge from the hospital.

A study on preventability and causes of readmissions published in JAMA Internal Medicine in 2016 reviewed the cases of 1,000 general medicine patients readmitted within thirty days of discharge across twelve United States hospitals from April 1, 2012 to March 31, 2013. Of those 1,000 readmissions, 26.9 percent were potentially preventable.

According to the study, common factors in potentially preventable readmissions were related to what happened at the time of discharge and after the patient went home. The authors cited emergency department decision making at the time of readmission, patient failure to keep important follow-up appointments, premature discharge, and lack of patient awareness about who to contact after discharge as the most common factors.

The study’s authors concluded that “High-priority areas for improvement efforts include improved communication among health care teams and between healthcare professionals and patients, greater attention to patients’ readiness for discharge, enhanced disease monitoring, and better support for patient self-management.”

CMS’s steep penalties are motivated by a desire to provide better patient care and, in doing so, to reduce healthcare costs. One of the best ways for hospitals to prevent unnecessary readmissions is by calling patients after their discharge to check in on symptoms, review medications and treatment plans, and offer patients an opportunity to ask questions about their recovery.

Post-Discharge Patient Education

Often, a patient is readmitted because they didn’t follow the correct medication regimen, lacked understanding of the treatment plan, or failed to follow up with their primary care physician after discharge.

Ideally, patients receive thorough education about medication regimens and treatment plans throughout their stay and at the time of discharge. However, literacy and comprehension rates vary across patient populations, and patients don’t always understand written or verbal discharge instructions.

Additionally, at the time of discharge, patients are preoccupied with the logistics and excitement of going home. Attempts at patient education might not be effective, no matter how well delivered. Once patients have arrived home, the complexity of managing their new medications and daily routines on their own becomes much more apparent.

Several studies have found that other factors, including the patient’s social support network, marital status, gender, and income can affect a patient’s ability to follow discharge instructions and manage their care at home.

Whether it’s addressing a lack of comprehension regarding a patient’s treatment plan or addressing a lack of support in enacting that treatment plan, a post-discharge phone call can provide a way for hospitals to help patients stay well at home.

Using Calls to Reduce Readmissions

Hospitals have many opportunities throughout a patient’s healthcare journey to reduce the chance of readmission. One commonly cited way to reduce readmissions is by improving patient education around managing their care after discharge.

Specifically, implementing a post-discharge phone call to review medication regimens and treatment plans, discuss symptoms and other concerns, and check in on home health services and follow-up appointments helps reduce readmission rates.

A paper published in the American Journal of Medicine in 2001 found that when pharmacists called patients two days after discharge to review whether they had obtained and understood how to take their medications, patients were much less likely to visit the emergency department within thirty days of discharge. Ten percent of those who received a phone call from a pharmacist went to the ED, compared to 24 percent of patients who did not receive a call.

In another program, IPC The Hospitalist Company (IPC) tested the effect of post-discharge call center outreach on readmission rates. Nurses at the IPC call center called 350,000 discharged patients from October 2010 through September 2011. During the calls, nurses talked through each patient’s symptoms, medications, home health services, and follow-up appointments. The nurses answered patient questions about discharge instructions and, if the patient had a serious medical need, contacted the patient’s hospitalist or primary care physician.

Nurses successfully reached 30 percent of patients. This program prevented an estimated 1,782 avoidable readmissions over the course of a year.

Setting Up a Post-Discharge Call Program

Research suggests that the best time for a post-discharge call is within the first two to three days after a patient arrives home. At this point, the patient has had the opportunity to settle in, fill medications, make follow-up appointments, and it is still early enough for a nurse’s call to make an impact. Many patients won’t answer on the first try, so nurses should plan to call more than once.

The first step in setting up a post-discharge call program is to ensure that call center staff have the best number to reach each patient. Sometimes the number in the patient’s record is different from their home or cell phone number. IPC The Hospitalist Company found that by asking patients for the best number to reach them or their caretaker, they were able to increase their successful call rate from 30 percent to more than 40 percent of discharged patients.

Customized Care Call Scripts

Providing nurses with diagnosis-specific scripts can help make care calls more efficient and effective, as many conditions have standard red flags nurses should check in on, such as weight gain after discharge for heart failure. Virtually any type of script is easy to create, including common scripts for post-surgery, diabetic, and pediatric post-discharge calls. Setting up a unique script with detailed questions for each, helps to ensure patients understand discharge instructions, address any medication questions, and help ensure the patients are not experiencing symptoms that would cause them to be readmitted.

Nurses should also have access to physicians’ discharge notes to review patient-specific follow-ups. Physician discharge notes must be completed in a timely manner to give nurses the information they need for the calls.

To supplement the post-discharge nurse phone call, organizations can also use HL7 integration to receive discharge notifications and set up automated appointment reminder calls. This helps increase the likelihood that patients make it to their appointments and receive the prescribed follow-up care.

Conclusion

To avoid penalties and help patients to stay healthy at home, hospitals can leverage call centers and post-discharge phone calls with customized scripts to check in on symptoms, review medications and treatment plans, and remind patients of follow-up appointments. Studies suggest that such measures reduce the rate of readmissions.

For hospitals, implementing a discharge call center program can help avoid or reduce Medicare readmission rate penalties. For patients, the program can improve their post-discharge care management and health.

1Call, a division of Amtelco

The 1Call Division of Amtelco is a leader in developing software solutions and applications designed for the specific needs of the healthcare call center marketplace. 1Call features a complete line of modular solutions specifically designed to streamline enterprise-wide communications, save an organization’s limited resources, and make them tremendously efficient, helping them bring wellness to their members and their bottom line.