Tag Archives: medical answering service articles

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.

Peter DeHaan, Publisher and Editor of AnswerStatLast 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.

Medical Call Centers Are Here to Stay


TeamHealth Medical Call Center


By Gina Tabone

Changes to the United States of America political scene are upon us and most certainly will have an impact on the provision of healthcare. Regardless of party affiliation, several healthcare reform objectives need to remain in the forefront by future government leaders. Examples include enhancing quality of care, improving interdisciplinary coordination and collaboration, and better utilization of available resources.

Focusing on these concepts will contribute to the goal of improved outcomes for both individuals and the patient populations we serve. The benefits achieved from the implementation of the triple aim must continue, regardless of who is leading the country. Nurse triage, as a component of an integrated medical call center (MCC), is a pivotal—and no longer optional—intervention.

The world of medical call centers has finally gained the recognition and credibility in the healthcare marketplace that many of us have been trying to expound for two decades. Centralized medical call centers are rapidly emerging as the backbone of health systems because they are integral in achieving better patient outcomes.

The new administration has wisely sought healthcare advice from the most innovative physician leaders in the United States. For example, Toby Cosgrove, of Cleveland Clinic, and John Noteworthy, of the Mayo Clinic, were invited to meet with President Trump to share their thoughts on the Affordable Care Act (ACA) and offer ideas to plot out the best plans for the future. Improving patient experience of care requires open access channels. Click To Tweet

Concerns were expressed that the current model needs to focus more on patient health and wellness and less on the avalanche of paperwork. This has negatively impacted the day-to-day responsibilities of clinicians who are held accountable for reporting on hundreds of quality indicators. These points of contention are agreed upon by most caregivers. Cleveland Clinic and Mayo Clinic have improved patient access, outcomes, and satisfaction by integrating state-of-the-art integrated call centers with clinical access across their multi-state enterprises.

Hopefully, their example will resonate and continue to motivate other organizations to rapidly integrate outsourced or optimized in-house MCCs as a proven solution for reaching the three goals of the triple aim: improving the patient experience of care, improving population health, and reducing the per capita cost of healthcare.

Improving patient experience of care requires open access channels. Access means that patients can receive the most appropriate level of care needed, in a timeframe best determined by specially trained nurses guided by evidence-based tools. The patient learns to expect reliable advice that takes their current health state into account and is consistently available day or night. Gaps in care are eliminated, and delays are avoided, leading to favorable patient outcomes and higher reimbursements in a fee-for-value model. When patients’ wellbeing is enhanced, everyone gains—especially patients. MCCs can stake a claim for making this happen.

The year 2017 will have many organizations taking a close look at their operations and making tough choices about what functions are best accomplished internally and which ones can be entrusted to an outside partner. IT departments are now being outsourced by some of the largest hospital systems in the country. IBM is, by far, the vendor of choice. Patient Financial Services is another service with options for outsourcing where the benefits to an organization outweighs the cost incurred. Incentives for meeting targets are common. Last, there is a surge by strategic decision makers to explore nurse triage services being performed by an outside call center partner.

The common denominator in all three areas where outsourcing is increasing is the fact that there is a reliance on human capital and all the contingency costs that goes along with being an employer. High labor costs often consume up to 70 percent of many call centers’ operating budgets. Outside partners can assume the responsibilities with greater efficiency, better outcomes, and lower costs.

There is also the possibility that many vendors are willing to assume some of the risks associated with the successful attainment of goals. The choice to retain, outsource, or develop a hybrid of both is a multi-faceted decision that is reserved for leaders at a higher level than the call center. Organizations must evaluate which option best aligns with their mission, vision for the future, and strategic plans.

Medical call centers are branching out and taking on a variety of responsibilities that are well suited to be conducted remotely and reliant on state-of-the-art technology and a dedicated workforce. Once the technological infrastructure is created, the MCC can be enhanced to take on additional functions.

The task of appointment scheduling is the most common function of many MCCs and often happens in tandem with the strategy of centralization. Electronic Medical Records (EMR) products have customized templates embedded with providers’ schedules that are used for office visits, imaging, or procedural appointments. Outbound calling campaigns are often conducted in conjunction with scheduling for appointment reminders.

Centralizing all medication refill requests is emerging as a successful addition to many MCCs. Call center technology such as CRM allows for requests to be tracked, acted upon, and measured, ensuring that established targets are being met in a timely manner. Without measurement, there is little possibility for improvement.

Patients can expect a standard process for medication needs and defined timeframes for responses or resolution. Medication management and compliance is critical for optimal outcomes, so implementing a process that fosters it is a good idea. Patients stratified as high-risk garner the most advantages, which contribute to maximum reimbursements for medical treatments.

MCCs have taken on the significant task of not only caring for the acute needs of primary care patients, but also the chronic needs of vulnerable high-risk patients. The successful coordination and transition of care is central to every health system’s strategy for sustainability today and growth tomorrow.

Nurses are the clinicians assigned to figure out how to morph from case management to transitional care coordinators. Regular communication between patient and caregiver is vital and is often done via telephone, text, or email. Training the newly created transitional care nurses in the fundamentals of remote patient care is imperative and is based on the standards of care for telephone triage nurses. The practice of triaging acute symptoms has branched out and will serve as the starting point for nurses involved in coordinating care.

It is up to those of us established in the medical call center world to continue to proclaim the unlimited value of a MCC to the healthcare industry. In many healthcare organizations, more than 10 percent of employees spend most of their day doing their job on the telephone. The benefits of centralizing and consolidating the work they do are undeniable.

C-suite leaders must accept the fact that medical call centers are no longer considered an expense but an investment with impactful ROI.

Initially there were call centers; then access centers came along, followed by contact centers. In 2017, we are now called engagement centers. The task at hand is to capture the limited attention of decision makers and educate them on the role MCCs play in a fee-for-value system and the distinct results that are possible. The future may be uncertain, but there remains a need for products, services, and expertise that bring the call center to the forefront of patient care.

TeamHealth Medical Call CenterGina Tabone, MSN, RNC-TNP, is the vice president of strategic clinical solutions at TeamHealth Medical Call Center. Prior to joining TeamHealth, she served as the administrator of Cleveland Clinic’s Nurse on Call 24/7 nurse triage program.

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6 Essential Technology Tools for Today’s Medical Answering Service



By Aaron Boatin

The telephone is the most popular way for patients to contact their medical practice. Whether they are a current patient wanting to schedule an appointment, a potential patient looking for information, or someone with an emergency, the practice – and its answering service or call center – needs to be equipped to handle calls during and after business hours.

The key is up-to-date technology. As a medical answering service or outsource healthcare call center, you must have the right technology to handle healthcare calls. These tools will set your healthcare call center apart from the competition and ensure your clients feel taken care of, listened to, and supported.

Here’s what you need to provide:

1) Secure Text Messaging App: HIPAA (Health Insurance Portability and Accountability Act) compliant secure text messaging is a great option as pagers are phased-out and medical offices want to streamline customer service efforts. With this app your clients can send secure text messages simply and efficiently to any member of their team from a web browser.

An enhanced option will also offer clients the ability to message multiple staff members at the same time. Plus you need to also communicate with your clients via HIPAA compliant secure text messaging. In today’s fast-paced world, secure text messaging is an excellent way to keep everyone in touch, on the same page, and on schedule.

2) Secure Client Web Portal: The two most essential elements of a medical answering service web portal are that it’s secure and that clients can update and manage information about their practice. Make sure your website portal has an extended validation certificate that verifies it’s controlled by a legal entity. This extra level of encryption makes sure your clients’ patients’ sensitive PHI (protected health information) data is safe and secure.

The risk of not having a secure website is significant. Any messages containing PHI puts your call center and your clients at risk for a HIPAA data breach violations. Not only can those violations add up to some serious coin, but they will also affect your reputation and credibility as a medical answering service.

You must have a portal that is easy to access and update. Any time a client needs to change a schedule or update phone numbers, you want them to be able to do so with ease. The information they enter in your portal should automatically link to your medical answering service platform for your team to use.

3) Real-time Access to Patient Messages and Information: Thorough, well organized, and easy-to-understand records are every medical practice’s dream. Giving your clients real-time access to their patients’ messages and information is an essential part of providing premier service.

You need to offer them a record of which physician was reached and their response time to the patient. Look for solutions that allow clients to import this data into their patient electronic health records (EHRs) to streamline the process and avoid forcing them to reenter information.

4) Online Access to Patient Call Audio: Patient experience is more important than ever. In fact, patient experience influences the level of reimbursement your clients receive from insurers. That’s why it’s a huge benefit to allow your clients the ability to listen to recordings of how their patient calls were handled. This way they can verify their callers had an optimal experience.

5) Web On-Call Software: Make sure you provide a way for clients to quickly update their ever-changing on-call schedules. This will help keep you from contacting the wrong person when they aren’t on-call and avoid mismanaged emergencies.The best web on-call tools are mobile optimized and have a secure text messaging capability. Click To Tweet

The best web on-call tools are mobile optimized, allow schedule sharing, and have a secure text messaging capability. An efficient on-call system will also keep your clients happy and allow your staff to do their job as professionally as possible.

6) Appointment Reminder Service: One of the biggest losses of revenue for many medical practices comes from patient no-shows. You should offer the ability for your clients to upload appointments to you. Then you can reach out to scheduled patients to remind them of their appointment. This provides a way for patients to confirm or cancel their appointment. By getting this information ahead of time, your healthcare clients will have a reasonable opportunity to fill vacated appointment slots. These automated reminders will no longer burden your clients’ and will help them keep their schedule full.

If you are a healthcare call center or medical answering service, your healthcare clients expect you to have these tools and offer these services. Make sure you are ready.

Aaron Boatin is the president of Ambs Call Center that services the healthcare industry.