Tag Archives: medical answering service articles

Using an Outsourced Telephone Triage Service for Suicide Prevention


TriageLogic

By Ravi K. Raheja, MD

Telephone triage nurses play a critical role in suicide prevention and serve as the first point of contact for callers in need of immediate assistance. According to the CDC, 123 Americans die by suicide every day, and for every person who dies from suicide every year, another 278 people think seriously about it but don’t kill themselves.

As the demand for mental health services grows, practices are turning to outsourced telephone triage call centers to support their practices. Call center triage nurses trained in treating patients with mental illnesses are better prepared to intervene and often alleviate lengthy interruptions to the normal call flow of a practice.

Common Warning Signs Of Suicide

  • Talking about wanting to die or to kill oneself.
  • Looking for a way to kill oneself.
  • Talking about feeling hopeless or having no purpose.
  • Talking about feeling trapped or being in unbearable pain.
  • Talking about being a burden to others.
  • Increasing the use of alcohol or drugs.
  • Acting anxious, agitated, or reckless.
  • Sleeping too little or too much.
  • Withdrawing or feeling isolated.
  • Showing rage or talking about seeking revenge.
  • Displaying extreme mood swings.

What Can Triage Nurses Do to Help?

Triage nurses need to find a connection with the patient. They combine both clinical judgment and emotional connections. Click To Tweet

In moments of crisis, connecting with a trained triage nurse can deescalate the suicidal crisis and provide immediate help. It is never easy to talk about suicide, but it is crucial for triage nurses to be comfortable talking about suicide in the same way they talk about chest pain. How they handle each call can be life-changing for the caller.

Triage nurses need to find a connection with the patient, find the patients local emergency assistance numbers, and be ready to involve all resources available to help prevent this patient from harming him/herself.

It is essential for the triage nurse to be sympathetic, non-judgmental, and accepting. The caller has done the right thing by getting in touch with another person. No matter how negative the call seems, the fact that it exists is a positive sign, a cry for help.

Triage nurses always have the caller’s safety in mind. They combine both clinical judgment and emotional connections to assess the patient’s situation to identify possible mental health issues.

Even though remote triage nurses typically can’t see their patient, they must develop that all-important trust quickly and by means other than visualization for the caller to open up and be honest with the nurse. Not all patients can accurately describe their condition, history, medical conditions, or other pertinent information. The telephone triage nurse must decipher this uncertainty.

Sometimes the patient needs emergency treatment, while other times they are reaching out for someone to talk with and work thru difficult situations like substance abuse, economic worries, relationships, sexual identity, getting over abuse, depression, mental and physical illness, and loneliness.

Just talking about their problems for a length of time gives some suicidal caller’s relief from loneliness and pent up feelings, an awareness that another person cares, and a sense of someone understanding them. Also, as they talk, they get tired and their body chemistry changes. These things take the edge off their agitated state and help them get through a bad night. Suicide calls can be difficult, but with proper training, protocols, and disposition, telephone triage nurses save lives, one call at a time.

TriageLogic

Ravi K. Raheja, MD is the CTO and medical director fo the TriageLogic Group. Founded in 2005, the TriageLogic Group is a URAC accredited, physician-lead provider of high quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. The TriageLogic group assists their clients with value based care and serves over 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com. and www.continuwell.com.

Healthcare Call Centers Help Bring Care to the Medically Underserved



By Nicole Limpert

A person medically underserved, is someone who does not have health insurance. Estimates from the Centers for Disease Control and the National Health Interview Survey cite that in 2017, 29.3 million, or 9.1 percent of the population were uninsured.

Vulnerable Populations: Multiple studies have found that vulnerable populations in the United States, including the elderly, low-income, ethnic minorities, migrants, and people who received limited education, are also medically underserved.

People with various life experiences may interpret symptoms differently, such as thinking a seizure is a spiritual issue rather than a medical complaint, or expressing concerns about depression as anger rather than sadness.

Poor Access to Healthcare: Living in a rural location and having inadequate transportation present challenges when trying to access healthcare. Rural areas are sparsely populated, resulting in a lack of available services. Rural communities comprise roughly 20 percent of the United States, yet less than 10 percent of doctors practice in these communities.

People in rural areas rely on their own transportation to and from health services. A report released in December 2018 from Pew Research Center, found the average travel time by car, to the nearest hospital for rural Americans, is about 17 minutes compared to 10 minutes in urban areas.

However, even people in urban areas have difficulty visiting their doctor’s office. Transportation can be a challenge for people with disabilities, those with chronic illnesses, the elderly, and people who are low-income. Approximately 3.6 million Americans, from both rural and urban areas, experience missed or delayed medical appointments due to transportation issues.

Medical call centers play a critical role in helping to serve the medically underserved. Click To Tweet

Support from Healthcare Call Centers

Technology enables medical call centers to effectively become an extension of a hospital or clinic’s operations. The communication software used by medical call centers can securely access a patient’s electronic medical record (EMR), update EMRs with notes, and record calls needed for insurance claims and workmen’s compensation. Because everything is documented, detailed reports can be generated for reporting purposes.

Medical call centers can provide or facilitate healthcare-related services 24 hours a day, 7 days a week. They play a critical role in helping to serve the medically underserved, by addressing two of the biggest barriers to healthcare: language and transportation.

Language: Healthcare staff work with an enormously diverse patient population. Understanding a person’s language leads to better healthcare. Multi-lingual call centers hire operators to assist non-English speaking patients or use confidential over-the-phone interpreting (OPI) services for access to hundreds of different languages.

Transportation: Patients with mobility challenges or who live in rural areas don’t have to leave home for some services. Operators can coordinate care, make follow-up calls, schedule visits, contact on-call medical staff, and manage referrals.

Some call centers staff nurses or multidisciplinary teams (such as a resident, pharmacist, and social worker) who are qualified to make health assessments, give medical advice, and escalate critical concerns. These call centers can offer nurse call helplines, emergency mental health counseling, and other critical support.

Helping Hospitals that Help the Underserved

Reduce Penalties: A recent study done by Harvard suggests that hospitals located in low-income areas are more likely to receive penalties due to Medicare and Medicaid’s survey-based reimbursement programs. Patients are asked to provide information about their healthcare experience via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Unacceptable survey outcomes can result in hospitals losing some reimbursements.

The American Medical Association Journal of Ethics reports that the Centers for Medicare and Medicaid Services (CMS) can currently withhold one percent of Medicare payments—30 percent of which are tied to HCAHPS scores. When Medicare and Medicaid account for more than 60 percent of all care provided by hospitals, the possible amount of dollars lost due to poor patient experience is a significant number. In 2017 alone, approximately 1.7 billion dollars in reimbursements were withheld from hospitals.

Healthcare call centers play a critical role in patient satisfaction surveys, because they function as a virtual lobby for a hospital and are often the first point of contact with a patient. The patient’s experience with coordinating their care via call center agents can positively affect their feedback on the survey.

Reduce Readmissions: The CMS reports that nearly one in five Medicare patients are readmitted to a hospital within 30-days of discharge, yet a recent study from the University of California San Francisco (UCSF) and published in JAMA Internal Medicine found that twenty-seven percent of all 30-days hospital readmissions are preventable.

Medicare’s Hospital Readmissions Reduction Program (HRRP) lowers payments to Inpatient Prospective Payment System (IPPS) hospitals who report too many readmissions. According to the CMS, 2,573 hospitals received penalties in 2018 and had around 564 million dollars in payments withheld.

Studies indicate that a post-discharge call program can help hospitals reduce their readmission rate. IPC Healthcare (IPC) tested the effect of post-discharge calls on readmission rates from October 2010 through September 2011. The IPC call center contacted 350,000 discharged patients to check symptoms, review medications and treatment plans, and remind patients of follow-up appointments. Successful contacts occurred with thirty percent of patients, with an estimated 1,782 avoidable readmissions prevented over that year.

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.

Balancing Patient Care with Data Security and Privacy Starts with the Contact Center



By Tim Critchley

The stakes have never been higher for healthcare providers to deliver a positive patient experience. According to a recent study by Prophet, 81 percent of consumers are unsatisfied with their healthcare experience, while only 40 percent believe providers are best meeting their needs. At the same time, data breaches in the healthcare sector are at an all-time high—occurring at a rate of more than one per day in the United States.

These security incidents not only jeopardize patients’ privacy but also put both patient trust and brand reputation at risk.

All the while, medical practitioners, hospitals, and insurers are pressed to keep up with the ever-evolving regulatory compliance landscape. This not only includes the Health Insurance Portability and Accountability Act (HIPAA) but also the Payment Card Industry Data Security Standard (PCI DSS), the EU General Data Protection Regulation (GDPR), and a long list of individual state regulations and data breach notification laws.

With HIPAA violations alone incurring fines as high as 50,000 dollars (for each violation or exposed record), healthcare organizations are finding themselves wedged between conflicting objectives: how do you protect patient data and maintain compliance, without losing sight of providing the best possible patient experience? Data security and privacy are key to providing positive interactions with your customers and patients. Click To Tweet

Contact Center Security

While you can’t please every patient, you can strike a balance between care and data security. The first place to address this is your contact center.

Although online interaction tools and patient portals are gaining in popularity, you can’t underestimate the value of the voice channel. Research by PatientPop shows that 58.5 percent of patients still prefer to schedule an appointment via phone.

As such, your contact center is often the go-to point of interaction for your patients and can set the tone for their entire experience. But this also means that your contact center intrinsically holds, processes, and stores copious amounts of personally identifiable information (PII), from medical records to payment card data. This makes the contact center an alluring target for fraudsters and hackers.

However, it’s not only devious cybercriminals who threaten your patients’ data. Company insiders, such as rogue patient service representatives (PSRs) or contact center agents, pose a massive threat, especially if they have access to patient data given over the phone or stored in desktop applications. In fact, 58 percent of all healthcare data breaches and security incidents are the result of insiders, according to Verizon’s Protected Health Information Data Breach Report.

Security Best Practices

With inside and outside threats, as well as vulnerable legacy systems serving as entry points for enterprise-wide breach incidents, contact centers are undoubtedly a weak link in your security chain. But protecting PII, maintaining compliance, and providing a positive patient experience first involve a hearty dose of security best practices:

  • Treat all data as potentially toxic: The more information that is available in the event of a breach, the easier it will be for a malicious insider or cybercriminal to steal a patient’s identity or access their private medical records.
  • Train all employees and always perform thorough background checks: Go beyond basic employee vetting and background checks, especially when hiring for your contact center environments. Educate PSRs and customer service agents on data security best practices and how to spot social engineering and phishing tactics.
  • Prepare your response management policy: Have an incident response management policy and process in place, preferably as part of an information security management system. Prepare for a worst-case scenario, and test your incident response plan at least annually.
  • Tokenize data: Replace PII with a meaningless equivalent, so even if a breach is successful, the hacked data will be of no value to the cybercriminal. This approach can also assist in the event of a social engineering attack, which can put even the most trustworthy employee at risk for exposing PII.
  • Enforce the principle of least privilege: Give employees the minimum level of access required to perform their job function at the appropriate time. Introduce exception procedures for when emergency access is needed.
  • Authenticate the user to authenticate the service agent: Prevent PSRs and agents from accessing patient data until the PSR has received the right data from the user. This means that until the caller has been successfully identified using the appropriate secure authentication approach, deny access to detailed PII.

Descoping Technologies

With these tactics creating a foundation for security in your contact center, you can introduce descoping technologies. Such technologies not only strengthen data security and compliance by removing sensitive data from your infrastructure, but they also garner a positive patient experience and journey.

For the voice channel, in particular, dual-tone multi-frequency (DTMF) masking solutions hold great promise, allowing patients to discretely enter numerical PHI, such as payment card, insurance, or account numbers, using their phone’s keypad. The keypad tones, however, are masked with flat tones, so they are not exposed to anyone but the patient. The data collected is encrypted and sent to a compliant third party, bypassing the contact center’s environment completely.

While this process may invoke notions of automated interactive voice response (IVR) systems, it is not quite the same. Here, agents and PSRs can remain on the line in full voice communication with the patient, guiding them through the transaction, answering questions, and even handling wrap-up tasks. There are no challenges with misheard or miskeyed data, which can lead to premature hang-ups and abandoned calls. In addition, patients have full control over inputting their information and can enjoy peace of mind that their data is protected. This makes for a better overall customer experience.

Conclusion

Data security and privacy are key to providing positive interactions with your customers and patients, and there really is no longer any need to compromise in either area. A combination of security best practices, strategies, and emerging descoping technologies are ideal solutions to achieve both. No matter which route you take, the less PII you hold and handle, the better off you’ll be. Remember, no one can hack the data you don’t hold.

Tim Critchley is the CEO of Semafone.

Should Your Answering Service Be a Generalist or a Specialist?



From MedConnectUSA

Most telephone answering services take on a wide range of clientele, from roofer, to funeral home, to property management company, to consultant, to attorney. Oh yeah, they’ll handle healthcare too.

These answering services try to be all things to all people. They’re generalists. Some do okay at it and others not so well. As the saying goes, “They’re a Jack (or Jill) of all trades but a master of none.”

Other answering services are specialists. They focus on one industry, such as healthcare.

Do you want your answering service or call center to be a generalist or a specialist?Do you want to be a general answering service (or call center) or a medical answering service specialist that focuses on healthcare? Click To Tweet

A Generic Answering Service

All answering services that want to stay in business know they need to grow. They realize that with growth comes increased economy of scale. This helps them serve their clients with greater efficiency and increase their bottom line. Because of this push for growth, some are willing to handle any type of business or situation.

Sometimes they end up taking on some strange accounts. Such as a clown or a rock star or an entrepreneur with a questionable business ethic. Add the medical field to their eclectic mix of clients. For them, every call is completely different because every client is completely different. Sometimes they handle this client-multitasking challenge well and other times, not so well.

When an operator at a generic answering service answers the phone for a medical practice, imagine what type of account they handled just before that, how the caller acted, and the way they responded. Does this prepare them to talk to the patient with excellence and treat them precisely the way they should be treated? Some telephone answering service operators can make this mental transition, whereas others struggle.

A Medical Answering Service Specialist

Seeing the downside of these generic, one-size-fits-all answering services, some answering service leaders realize that trying to be all things to all people doesn’t work out so well. They decide to specialize. When they specialize, they become experts in their niche. This allows them to provide a higher level of service then what would be possible if they remained a generic answering service, taking all types of clients.

They decide to specialize in healthcare. They become a medical answering service—a medical answering service specialist, if you will. This allows them to focus on things that are important to their clients in the healthcare field. This includes being empathetic to callers and their health situation, knowing how to handle health emergencies and on-call personnel, and the importance of taking appointments to maximize provider effectiveness.

The result of this is a high level of patient-centric service that meets the needs of the healthcare industry, including medical practices, clinics, hospitals, and healthcare networks.

Summary

When it comes to handling the communication needs of healthcare providers, do you want to be a general answering service (or call center) or a medical answering service specialist that focuses on healthcare? How does this answer apply to the strategy you have for your answering service or call center?

Should you be an answering service generalist or specialist?

Kurt Duncan is the director of operations at MedConnectUSA, a leading provider of medical answering services, that specializes exclusively on the communication needs of the healthcare industry.

Secure Text Messaging and Email Security for Healthcare



By Aaron Boatin

Most healthcare providers send text messages and emails throughout their day. Unfortunately many choose unsecured methods of transmission. This is bad news for protecting patient data and worse yet, a clear HIPAA violation.

Embracing technology to increase the speed of healthcare is a good thing, but only if it’s done right. This means encrypting protected health information (PHI), to ensure the privacy protection mandated by HIPAA and HITECH.

Managing Protected Health Information with Secure Text Messaging

Standard texting on cell phones and alpha/text pagers is not HIPAA compliant. However, implementing secure text messaging for providers is a painless process, and allows users to receive HIPAA-compliant, secure text messages using a smartphone.

Secure messaging apps allow medical practices to stay on top of their customer service, anywhere they may be, and remain HIPAA compliant. App capabilities vary, but look for one with powerful enterprise paging and messaging application built for Apple iOS and Android mobile phones and tablets. This can replace or supplement current paging technology and enables instant two-way communications.

It’s ideal for organizations where HIPAA compliance is a necessity or when sensitive data needs to be securely delivered to mobile devices. When the recipient receives a new message alert, the secure message can be viewed instantly using the secure messaging app. The secure messages are kept separate from email and text messages.

Many apps allow staff to acknowledge they’ve received the call without having to speak to a call center agent. This saves time, money, and improves response time to patients. Faster response can have a big impact on patient satisfaction scores.Embracing technology to increase the speed of healthcare is a good thing, but only if it’s done right. Click To Tweet

Socket Layer (SSL) Technology

Call centers that serve the medical community should seek solutions that offer compliance, privacy, and sender/receiver authentication, using 256-bit encryption SSL technology. This exceeds compliance standards and is the same technology that protects sensitive information on major websites that offer secure online transactions.

Other ways that most secure messaging apps are useful to medical practices complying with HIPAA and increasing efficiency include:

  • Reporting with an audit trail of all messages with all message events.
  • Issuing persistent alerts to the recipient’s mobile device, helping ensure immediate action.
  • Allowing users to designate high priority messages, displayed at the top of the message list.
  • Providing encrypted message delivery and message read receipts, indicating that the device received the message or the recipient opened the message.
  • No need to add a text messaging plan; the app bypasses traditional SMS messaging.
  • Free secure messaging between devices; no text charges apply.
  • Ability to send secure broadcast messages to a group.

Management of Secure Text Messaging for Medical Practices

The management of secure text messaging users is easy. For some apps, the management of devices is done through a web portal so that staff can add, delete, or change user settings. If a device is lost or stolen, the data on the phone can be deleted using the remote wipe function.

Secure text messaging solutions work by hosting the encrypted PHI on hosted secure servers. The phones then access this secure data via the secure texting app. This is a great solution for medical practices where most providers use their own phones. It fits in perfectly with BYOD policies in place at large healthcare organizations.

The best apps mimic the ease of use of regular text messaging, making adoption easy and intuitive. They also bring several nice enhancements and integrations. For example, the ability to send and receive images (x-rays for example) and audio files saves an enormous amount of time.

Many medical practices that have implemented secure text messaging have seen boosts in productivity. Aside from HIPAA compliance, the speed of communications accelerates dramatically. This has a direct positive effect on patient care.

Encrypted Email

Standard email is not HIPAA compliant. Without email encryption, email sent from one user to another is vulnerable at any point along that transfer route. Using unencrypted email not only puts the content of the information at risk but also the identities of the sender and receiver.

To provide additional protection for email communication in transit and keep electronic communication from prying eyes, companies often apply encryption methodologies to their electronic communication. Encrypted email refers to the process of encoding email messages in such a way that eavesdroppers or hackers cannot read it, but that authorized parties can.

There are two popular options for encrypting email. They are TLS and Secure/Multipurpose Internet Mail Extensions (S/MIME) encryption methods.

TLS Encryption: Transport Layer Security transcription (TLS) protocol prevents unauthorized access of emails while they are in transit. TLS is a protocol that encrypts and delivers email securely for inbound and outbound email.

It helps prevent eavesdropping between email servers. It’s worth noting that email messages are encrypted only if the sender and receiver both use email providers that support transport layer security.

Not all email providers use TLS. Not sure if an email server has TLS enabled? Use this online tool to test an email address.

S/MIME Secure Email: S/MIME (Secure/Multipurpose Internet Mail Extensions) is a widely accepted method for sending secure email messages. It allows users to encrypt emails and digitally sign them. It gives the recipient the peace of mind that the message they receive in their in box is the exact message that started with the sender.

It also ensures the person receiving the email knows it really did come from the person listed in the “From:” field. S/MIME provides for cryptographic security services such as authentication, message integrity, and digital signatures.

Conclusion

Putting it all together is a challenging endeavor, but doing nothing is risky for your organization and the patients’ PHI that is vulnerable for interception.

Aaron Boatin is president of Ambs Call Center, a virtual receptionist and telephone answering service provider, that specializes in medical answering services. His passion is helping clients’ businesses succeed. Melding high tech with high touch to provide the best customer service experience for clients is his core focus.

A Proven Solution to the Top 3 Challenges Facing the Medical Practices of Today and Tomorrow


TeamHealth Medical Call Center


By Matt Miller

 Navigating the ever-changing landscape of healthcare is becoming increasingly difficult. Rising patient demands, growing administrative requirements, and high operating costs are only a few of the many obstacles medical practices face as legislation continues to evolve and outside influence on care decisions continues to grow.

In some cases, these challenges prove to be too much for independent practice staffs to handle, so they end up selling to larger healthcare organizations or hospital systems. According to a recent study, three of the top challenges facing medical practices today include:

1. Patient Satisfaction

All healthcare providers want happy patients, because happy patients return for services, make recommendations, and are likelier to comply with post-care recommendations. However, patient satisfaction has become directly linked to financial performance through federal and private insurers that link reimbursement directly to patient satisfaction scores.

A main indicator of satisfaction is the perception that a provider has communicated effectively with the patient, and the patient received the appropriate treatment. The key word is communication. If patients feel they aren’t being heard—or that the overworked staff simply doesn’t care—satisfaction can drop significantly.

Not only does a practice need enough clinicians to handle the increasing patient loads, but these clinicians must also possess the training and skills to communicate effectively with patients to ensure the treatment is correct and the patient is ultimately satisfied. Not having adequate staffing to handle the resulting administrative paperwork can have significant effects on the business. Click To Tweet

2. Administrative Requirements

Even if a practice has a staff that has mastered the communication skills required to provide excellent patient care and maintain positive satisfaction scores, not having adequate staffing to handle the resulting administrative paperwork can have significant effects on the business.

Documentation and recordkeeping requirements are on the rise, and often practices must use clinical personnel to handle these administrative chores, leaving revenue on the table. By having staff dedicated to staying on top of these requirements, practices can free up clinicians to do more of what they do best: treat patients.

These first two obstacles can be managed successfully with the right staff. Unfortunately, the process of recruiting and maintaining such a staff often requires more time, money, and effort than a practice can afford. It isn’t only about hiring enough “warm bodies” to handle the workload; it’s about having the right people in the right places to successfully handle all the different external practice challenges, while continuing to provide the highest quality patient care and compliance. This is where the third challenge comes into play.

3. Staffing Turnover

According to a 2015 study in the Journal of the American Medical Association, employee turnover in healthcare had reached an all-time high of 19.2 percent. The same study revealed that nearly 40 percent of clinical and non-clinical healthcare workers were planning to leave their job within the next two years, and a staggering 69 percent were planning to leave within five years.

Perhaps the most concerning finding to come out of this study was that higher patient caseloads contributed to a seven percent increase in the chance of patient death. This final challenge is perhaps the most significant, as it often prevents practices from effectively addressing the initial two. So how can practices possibly deliver outstanding clinical services as they minimized costs and ensure all relevant documentation is done, while continuing to develop positive, long-lasting relationships with patients?

The Solution

The solution is closer than you think and starts with a partnership with a proven medical call center.

Partnering with a medical call center provides proven solutions to all three of these challenges. A medical call center utilizes a staff of RNs specially trained in communication and sensitivity regarding the unique needs of patient callers.

Medical call centers also offer post-triage patient engagement programs focused on care recommendations and compliance. As stated earlier, patient satisfaction directly correlates to the ability of a caregiver to focus on the needs of a patient and provide the most appropriate care advice.

Partnering with an experienced call center ensures patients will receive undivided attention and respect when they have a medical need. Call centers can document the entire triage process and enter the information in a practice’s patients’ EMR, reducing the administrative load and allowing clinicians to focus solely on patient care.

Medical call center partnerships also help practices eliminate the time, effort, and cost associated with hiring and maintaining an adequate staff. This not only frees up existing staff to focus on patient care, but it also allows more physical space within an office setting to provide care. Medical call centers can provide consistent, dedicated staff to ensure a practice never experiences a critical drop in service levels as patient loads increase.

While issues facing medical practices continue to grow and get increasingly complex, the solution to handling these challenges is easy. A medical call center partnership provides solutions to the top three challenges currently facing medical practices while remaining focused on the future state of healthcare.

TeamHealth Medical Call CenterMatt Miller is the marketing coordinator for the TeamHealth Medical Call Center. He joined THMCC in 2015 and has more than fifteen years of marketing and communications experience within the healthcare industry. The TeamHealth Medical Call Center is a premier provider of medical call center solutions. Contact them today to learn more about their daytime and after-hours telephone triage services and how they translate to solutions that address practice challenges.

Call Center Lessons from a Walk-In Healthcare Clinic



We Need to Be Ready to Learn Whatever We Can, Wherever We Can

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaanLast week I went to a walk-in healthcare clinic to deal with an itchy skin affliction that was driving me crazy. (It turns out it was poison ivy or some variation thereof.) Not only did I get fast attention and quick results, but I had a wholly enjoyable experience. I walked away from the clinic as a happy patient, but I usually don’t have that reaction after interacting with a call center.

Here are some thoughts as to what makes a difference.Too often, call center personnel view each caller as a problem to handle as fast as possible and not as a person who needs their help. Click To Tweet

Accessible Service

The brightly-lit clinic was easy to find and offered nearby parking. The relaxing atmosphere gave me assurance I could anticipate a successful outcome.

Too often call centers aren’t accessible. It seems they hide their numbers. Why is this? Don’t they want calls? And by the time I do talk to someone, I’m often doubtful if I’ll be able to accomplish my objective.

Easy to Use

When I walked in, a self-check-in kiosk greeted me (along with a medical assistant, who was checking in another patient). I entered my name, punched a couple buttons, and was ready for step two.

Contrast this to a call center, with its endless array of auto-attendant prompts that seldom fit the reason for my call. And if I pick wrong, the best solution is to hang up and call back. Though call centers should be easy to use, reality may be different.

Known Timeframe

At the healthcare clinic I immediately knew where I was in the queue. One person was being checked as another waited. Beside this visual indicator, the kiosk provided an expected wait time of 28 to 56 minutes. Anticipating this, I had my iPod to keep me company. But before I even plugged in my earbuds, the first patient was ushered into the examination room, and the man ahead of me was being checked in. In a few minutes he went on to exam room two. I was next in line, and it hadn’t even been five minutes.

I always appreciate call centers that tell me where I am in the queue and give me updates as things progress.

Provide Options

I learned I could have checked myself in online. This would have guaranteed my place in queue at the clinic. Then they would have texted me as my appointment slot neared.

This is much like call centers offering a call back option. It’s nice to have alternatives. Why don’t more call centers offer this?

Exceptional Staff

The most impressive thing was great staff. The medical assistant at the healthcare clinic was both professional and personable. Within seconds she had me checked in. A few minutes later she moved me to exam room one, when the first patient left. A positive experience continued with the physician’s assistant. She treated me as a person and not as a problem to solve. She was patient, thorough, and precise in her diagnosis and recommendation. I’m actually looking forward (kind of) to my next visit.

Too often, with the ongoing onslaught of calls, call center personnel view each caller as a problem to handle as fast as possible and not as a person who needs their help. Making this distinction is key in the overall customer experience.

Successful Results

Less than twenty minutes after I arrived at the healthcare clinic, I left with a credible diagnosis and a prescription to pick up at the pharmacy, which was less than one hundred feet away. This was the outcome I sought.

How often have I hung up with a call center, having fallen short of my goal? Sadly, the answer is too often. I may call back for a different rep, phone someplace else, or just give up.

Skilled Close

Before I left to pick up my prescription, I chatted again with the medical assistant. Though I didn’t need to see her afterward, she had more information for me. When she learned I didn’t have a primary care physician, she encouraged me to get one and offered to help. I shared my past frustration at not being able to find someone close by. She took this as a challenge. When I left, she handed me a slip of paper listing four nearby doctors who were accepting new patients. It’s too soon to know if she made a successful upsell, but she did an excellent job at doing everything she could to help me. I left with a positive feeling.

When done appropriately an upsell by a call center agent is both helpful and appreciated. But when done poorly, it’s an irritant and another reason not to call back. Be sure to end each call well.

The Next Step

How can you apply these observations of a healthcare clinic to make your medical contact center a shining example of success that your callers and patients appreciate?

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.

Utilizing Peer Review to Minimize Risk in a Medical Call Center


LVM Systems


By Mark Dwyer

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

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

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

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

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

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

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

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

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

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

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

Additional considerations evaluate time management. These include:

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

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

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

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

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

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

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

LVM SystemsMark Dwyer is a 32-year veteran of the healthcare call center industry. Mark is in his sixteenth year at LVM Systems, where he serves as COO. LVM Systems provides healthcare call center software. For more information or a demonstration of LVM’s call center solutions contact Carol Zeek, regional VP, sales, at 480-633-8200 x279 or Leann Delaney, regional VP, sales at 480-633-8200 x286.

Is BPO a Key Enabler in the Push for Better Patient Outcomes?



By Anand Natampalli

In the emerging value-based world, healthcare providers and payers increasingly align incentives to drive improved patient health outcomes, more patient-centric services, and reduced medical cost for individuals. BPO (business processing outsourcer) service providers can bring a neutral consultative perspective, with design thinking and innovation, to meet the provider’s complex challenges.

To solve individual provider’s specific needs, BPO organizations bring customized solutions using a service incubation approach. It incorporates the following:

  • A new breed of patient engagement and experience solutions, with a consolidated, targeted strategy
  • Data management and integration, sharing intelligence from different segments of the collective healthcare ecosystem, including payers, providers, pharmaceutical companies, and durable medical equipment (DME) providers
  • Process optimization through automation and analytics, with a population health management (PHM) focus

A New Breed of Patient Engagement and Experience

Often, consumers of healthcare services encounter confusing phone directories, difficult-to-navigate-websites, and representatives who may not have the training or resources to make a patient encounter meaningful and productive. One of the most critical areas where BPOs can contribute is by helping provider organizations improve the patient experience and drive better health outcomes.

With the added patient choice in today’s marketplace, patient engagement, and experience—an area traditionally of lesser importance to health systems—is now critically paramount to attracting and retaining patients, driving healthier outcomes, and achieving higher ratings.

Patient engagement and experience is often a critical missed opportunity for provider organizations of all sizes. Patient access centers are legitimate business departments and have an important role to play in the transition to value-based, patient-centric care. They have the potential to create new streams of revenue. They engender patient brand loyalty. Most importantly, access centers are a critical first impression that ultimately determines whether a patient chooses to purchase healthcare services.

In a patient-centric healthcare economy, BPOs offer the right balance of technology and talent for seamless, patient-experience delivery. BPOs play an effective front-line role to drive revenue and patient satisfaction, reduce no-shows, and eliminate the need for patients to fish around for answers to their questions. These partners can more effectively employ their analytics and automation expertise to make the patient experience as easy as possible through both personalization and self-service—striving for that perfect balance between automated bots and live, human-touch interaction.

Data Management and Integration

In the new healthcare landscape, PHM is a key area of focus for providers. According to a May 2017 Deloitte Center for Health Solutions survey of hospital CEOs, population health analytics investment is the highest-rated analytics priority for healthcare organizations.

The amount of data attached to every patient has grown exponentially. This must be gathered, integrated, and interpreted according to compliance guidelines and processes that can vary widely between payers and providers. Additionally, the datasets held by payers and providers can be different. For example, payers possess data on claims, financial analytics, and risk models. Providers have administrative and clinical data that includes case histories and outcomes.

BPOs with both payer and provider expertise can best assist, by bridging the data gap between these two organizations. For example, BPOs not only have claims data from provider groups but also from payers. By leveraging this comprehensive information, providers have a better, more holistic view of patient health. Armed with this intelligence, providers can positively affect a patient’s health outcomes, through PHM processes that also bend the cost curve.

Further to this point, each data set is valuable, but in isolation it doesn’t provide a holistic and contextual perspective of the patient. Providers need to leverage health plan data to move from episodic care to delivering outcomes-based care across the care continuum. Payers need access to patient information to work with providers to establish appropriate care plans for their members. Again, this is where BPOs bridge the gap for providers, as well as payers.BPOs offer the right balance of technology and talent for seamless, patient-experience delivery. Click To Tweet

Automation and Analytics with a PHM Focus

With better patient engagement and data integration to leverage PHM, there is an ideal scenario for best use of automation and analytics. BPO partners can bring the requisite advanced automation and analytics, as key drivers of business improvements or process changes. With more understanding and awareness of the data coming downstream, BPOs know how to analyze these data points and decouple nonessential activities with automation for a positive impact on health outcomes and to drive costs down.

They also can offer “automation and analytics as a service,” relieving organizations of the capital and time investment of developing these abilities in house. Today’s cognitive computing capabilities will affect more complex, judgement-based activities (like origination and underwriting) with compliance objectives, too. Agility, speed, and accuracy are all positive customer satisfaction results derived from these transformations. Most impactful may be the automation data and applied analytics that will dramatically improve outcomes, for more forward-thinking strategies.

Conclusion

Today, BPO partners take an active role in helping provider organizations manage change, internally and externally. This puts them in a better position to take advantage of the opportunities found by optimizing patient experience journeys. By selecting the right partner, hospitals and health systems can position themselves to gain a competitive advantage in the present, while setting themselves up for an even brighter future.

Anand Natampalli is a senior vice president, global business development, for HGS, a provider of end-to-end business process services for numerous Fortune 100 health insurance companies and large provider organizations.

Answering Services Can Help Medical Clinics Do More for Less


Call Center Sales Pro, providing proven healthcare call center solutions


By Janet Livingston

Everyone in healthcare knows the key challenges the industry faces: do more, do it better, and do it for less. These pressures confront healthcare providers, coming from both the insurance companies that reimburse them and the patients that they serve.

But how can providers achieve these objectives of doing more, doing it better, and doing it for less, when these goals run counter to each other? Finding a solution requires innovative thinking and doing things in new ways.

Enter the venerable telephone answering service. Today, leading answering services are stepping up to this challenge.

For decades answering services have provided telephone support to the healthcare community by answering calls, taking messages, and dispatching emergencies. They’ve done this afterhours and 24/7. When it comes to supporting medical clinics and healthcare practices, answering services can do these things. But they can also do much more.

Two Key Considerations

EMR Integration: One key way to make your answering service invaluable to a medical clinic or healthcare facility is to integrate your answering service platform with their EMR (electronic medical record) system. This allows you to automatically transfer the information you gathered from the clinics’ patients to the clinics’ EMR platform.

Without this capability, one of two things will occur. Either someone will need to manually rekey the information, or the information will forever remain isolated. Neither scenario is a good one.

The first instance requires hours of labor each day to reenter the information. Plus, as with any manual process, there’s a chance of data-entry errors. This will then put into question the reliability of the information and reflects badly on your answering service, even though the problem occurred after the data left your facility.

In the other scenario, though you’ve provided important information to the clinic, it’s of little value to them because it sequestered in an isolated database that’s not integrated with their main systems.

This is why EMR integration is so critical. Any answering service that can provide it distinguishes themselves from the competition. Plus, grateful clinics will form long-term relationships with their answering service because they don’t want to lose this valuable feature.

Smart Phone Integration: Virtually everyone in healthcare carries a smart phone (and sometimes more than one). This mobile technology has become indispensable in today’s business world, including the healthcare industry.

Leading answering services offer a data portal to their clients. This portal provides a powerful tool to access their account and the information in it. The next step is extending this functionality to the smart phone, such as with Amtelco’s miTeamWeb. This and other similar products enable answering service clients to review their answering service information, make updates, and manage their account at any time, from anywhere, using a smart phone app. This puts control of answering service accounts literally in the hands of its clients.

These apps work great out of the box and require little configuration for basic functionality. However, the most powerful answering service apps allow for customization in how the information is displayed, as well as to create widgets to accomplish specialized tasks and enhanced integrations.

For all its value and power, creating the widgets—especially the more complicated ones—requires technical knowledge and carries the need for programming skills. Not every answering service can do this, but those who can provide tremendous value to their clients.

Again, this enhanced service offering distinguishes one answering service from most others. It allows an answering service to better serve its clients in ways that the competition can’t match.

Conclusion

Most answering services can work for medical clinics and healthcare facilities. However, answering services that integrate with clinics’ EMR systems and provide sophisticated smart phone integration distinguish themselves from other less-equipped providers.

Which type of answering service do you want to be?

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