Tag Archives: technology articles

How Technology Can Help During Nurse Shortages

1Call

By Nicole Limpert

We have all seen reports and heard stories about how nurses have left the medical field amid the pandemic. In truth, the United States healthcare system has been experiencing a series of nursing shortages for decades—studies dating back to the 1920s point to low wages and undesirable working conditions.

Federal regulation 42CFR 482.23(b) requires hospitals certified to participate in Medicare to “have adequate numbers of licensed registered nurses, licensed practical nurses, and other personnel to provide nursing care to all patients as needed. There must be supervisory and staff personnel for each department or nursing unit to ensure, when needed, the immediate availability of a registered nurse for bedside care of any patient.”

However, the regulation does not provide a clear nurse-to-patient staffing ratio. It is the responsibility of each state to determine appropriate staffing needs. What is clear is that fewer nurses are helping more patients, and their excessive workloads are linked to higher patient adverse outcomes, including patient mortality.

Useful Technology to Streamline Workflows

Any technology that automates and simplifies nursing duties will free nurses to spend more time with their patients which leads to better patient outcomes. According to an article by Katherine Virkstis, ND and Karen Drenkard, PhD, RN, NEA-BC, FAAN entitled, “It Is Time to Focus Digital Strategy on Supporting Nurse Workflow,” there are many technologies healthcare organizations can leverage to improve nurse workflows. Some of the solutions they list include:

  • Technology-driven pumps and monitors that automate the collection of information needed for care.
  • Smart devices, including automated beds and vital sign monitoring.
  • Wearables that provide clinical data to the provider.
  • Electronic white boards integrated with the electronic health record to keep patients and families up to date.
  • Centralized data command centers that integrate multiple systems into a single monitoring center, including coordination of care, requests for services, and discharge tracking.
  • Tele-technology that enables virtual inpatient care models, including virtual sitter and virtual expert RN models.
  • Mobile apps that enable bidirectional communication between patients and clinicians across all levels of care.

Tapping into Remote and Part-time Workforces

Currently, the average age of a nurse is around 52, and there are concerns that 4 million nurses will retire by 2030. This will only exacerbate future nursing shortages. However, technology can provide a way for retired nurses, or those who are on their way to retirement and want to work less hours, to provide non-traditional care and support to patients.

Virtual nursing is a newer model of care that provides nurses with a flexible, less demanding schedule. Virtual nursing can include anything from nursing triage or nurse on-call via telehealth, to overseeing alarms and alerts in a command center.

Nurses can use telehealth to prescreen patients for virtual appointments. Depending on the patient’s needs and if the nurse is advanced enough, virtual nurses can even meet with patients for their telehealth visit and avoid handing off the appointment to a physician.

Instead of the traditional bedside nurse capturing patient health data while also trying to care for patients, health systems can dedicate virtual nurses to conduct pain assessments and data collection remotely. They can look at lab values, alarm notifications, and other monitor alerts and escalate when appropriate.

Where Are the Next Generation of Nurses?

Another contributing factor to the nursing shortage is the scarcity of nursing school instructors. It has been common for nursing programs to use a lottery system for selection into their programs for years. The 2020-2021 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing report (also here) from the American Association of Colleges of Nursing (AACN) states, “U.S. nursing schools turned away 80,521 qualified applications from baccalaureate and graduate nursing programs in 2020 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints.” The report further says most universities cited a lack of qualified teaching faculty as a key reason for having to reject the qualified nursing applicants.

When instruction doesn’t require teachers and students to be physically present in a classroom, technology can play a role in addressing the educational needs of students by using online education. Virtual learning won’t completely replace traditional instruction, however Virtual Reality (VR) simulation and high-fidelity simulation that uses realistic, life-like manikins (a full-body patient simulator) to mimic human anatomy and physiology can teach clinical skills and help alleviate the instructor shortage.

Overcoming Negative Aspects of Technology

Sometimes, you can have too much of a good thing. One of the major challenges of using multiple technologies is when they are not interoperable or don’t function smoothly in a clinical setting. Health systems must avoid having a scenario where the nurse becomes a human interface between disparate and clunky technologies. If nurses are recording data from one system into another or logging in and out of multiple technologies, inefficiencies take up their time and keep them away from patients.

Ideally, design thinking principles are part of the process when creating tech solutions. Input from the people who are going to use the technology from the beginning, during usability testing, and throughout implementation will ensure the technology works smoothly in real-world application.

It’s essential for technology companies to have this usability component to make sure their designs won’t negatively impact nurses and other clinicians.

How Contact Center Software Fits In

Hospital contact centers are the communication hubs for the hospital enterprise. They not only handle a multitude of different calls, the same communications integration engine software used by a hospital call center can also integrate with technologies being used to address the nursing shortage. With the right integration engine acting as a bridge between software solutions, contact centers, and other devices, hospitals can be sure the solutions they are using to streamline nursing workflows speak to each other to communicate quickly and seamlessly.

These systems, leveraging standardized communication protocols like HL7, eliminate the chaos of moving information between systems and between people. Integration engines act as the glue that holds these many IT systems together and translates a variety of different inputs in such a way that other solutions can interpret the data and react accordingly.

1Call, a division of Amtelco

Nicole Limpert is the marketing content writer for 1Call, a division of Amtelco.

Scripting Helps Hospital Call Center Manage 850,000 Calls per Year

1Call

By Nicole Limpert

One of the United States’ oldest pediatric hospitals, recently recognized by the News and World Report, and named one of Healthcare’s “Most Wired” for several years for their dedication to leading the way in children’s health through technology and innovative research, receives thousands of calls every day.

Calls from worried parents concerned about their child’s health to specialists looking to connect with other experts through the Physicians Priority Link. Managing all of these calls every hour of the day, 365 days a year, is the Customer Connections call center in the hospital’s Access Services Department.

Customer Connections handles 850,000 calls per year from people nationwide—with as many as 4,500 calls in one day. With only six or seven operators on the phones simultaneously, the Customer Connections call center must be highly efficient, organized, and accurate to route the calls to the right person immediately.

Call Center Software Is Key

This small but dedicated team handles several types of calls: general incoming calls to the hospital, direct-to-department calls, after-hours answering service, and physician-to-physician consults. They also manage contacting the Medical Response team.

Customer Connections has been using its communication software to handle these calls since 2006. “Our call center software does everything we need,” says the access services manager. “We haven’t found another platform that does everything. It’ll route your calls—plus you can do scripting. The flexibility of the system is the beauty of it. Whenever a department requests that we support them, we build a script. To me, the script is the best thing. It 100 percent keeps us from making errors.”

An individual operator averages 450 calls daily, with no two calls being the same. The organization uses its scripting software to automatically detect call flow and determine the scripting options based on the hospital’s protocols, ensuring that the correct information is gathered and communicated.

The Customer Connections team at this Midwest hospital regularly creates custom scripts for the many departments whose calls they handle. Scripts significantly reduce the time needed to train operators to answer and route calls for new departments. They also help operators manage tense situations, such as emergency calls, which helps the callers and operators feel more at ease and ensures that medical response teams receive sufficient information.

“We’ve got multiple departments that have departments within departments, and so the scripting can get quite involved, but it’s what saves us,” explains the manager. “We support so many departments and take so many different phone calls that there’s no way we could do this job accurately without the scripting.”

Agent Scripts Save Time and Reduce Errors

Accurate and easy-to-follow scripts are essential, with phone calls averaging 8-10 seconds. A staff member was hired and trained to build, write, and maintain the scripts. The team’s scriptwriter makes customized scripts for any type of call (even emergencies) in as little as 20 minutes by using the drag-and-drop scripting tool and easily edits phone numbers, doctors’ names, and any other custom information as requested by the departments.

Keeping these scripts up to date helps reduce operator errors, improves efficiency, ensures professional call handling, and provides accurate information.

The access services manager further states, “The script building is a lifesaver, and we do it all ourselves. Our script writer is the ‘who’s on-call’ guru for the hospital. He is what makes this department go.”

Remote Access

The Customer Connections team maintained its high call volume when the operators moved to work remotely from home. All the operators needed were phones, headset adapters, and computers loaded with the call center software.

They can sign in from anywhere and work remotely because the software enables any computer to act as a fully functioning, professional operator workstation, just as if they were working from the call center. They still reached all their goals for call-answering time, hold time, and other audit scores.

Physician Referral Capability

The ease with which the Customer Connections department handles the wide variety of calls—especially the Physicians Priority Link (PPL)—has captured the attention of other hospitals that want to implement a similar physician-to-physician referral line.

“I get a lot of calls from different hospitals asking about PPL, how we take the information, and what we do with it,” says the Access Services manager. “I’m always surprised when I realize their software doesn’t allow them to do the scripting and take messages.”

Customizable Scripts

Agent prompts, lookups, and navigation can be customized and built into database-driven call scripts that automatically guide operators through:

  • Main number calls
  • Patient and medical staff appointments
  • Physician referrals
  • Nurse triage
  • Patient transport
  • Code calls
  • Paging
  • Physician answering services
  • Prescription renewals
  • Scheduling
  • Consultations
  • Admissions
  • Complex care calls
  • Crises and emergencies
  • Facility directions
  • Messages for physicians, staff, and departments
  • Patient satisfaction surveys

The look and function of the attendant console are also customizable, and various locations or departments can use assorted colors or layouts to reduce communication errors. Color-coding helps agents instantly identify call types, and time-of-day and day-of-week messaging and dispatching ensures the correct navigation script and dispatch options are displayed.

Conclusion

When a phone call is one of the first personal connections a patient makes with a hospital, the operator’s ability to handle the call professionally and accurately plays a prominent role in the patient experience. In support of this hospital’s vision to lead the nation in innovative technology and continued improvements in patient care, the Customer Connections department excels at answering and routing all calls correctly and efficiently. 

1Call, a division of Amtelco

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

Addressing Healthcare Workplace Violence with Integrated Contact Center Software and Secure Messaging

1Call

By Nicole Limpert

When you think of the most dangerous careers in the United States, it’s understandable to think of farmers, loggers, law enforcement, and construction workers. But would you consider adding nursing to that list?

Violence experienced by healthcare workers in the United States has been a major concern for years and unfortunately, it is getting worse. The U.S. Bureau of Labor Statistics published a fact sheet about workplace violence in healthcare between 2011-2018 that showed the industry’s workplace violence was on the rise. It found that “healthcare workers accounted for 73 percent of all nonfatal workplace injuries and illnesses due to violence.”

A more recent survey from Perceptyx, an employee insight platform, found that over a 30-day period in early 2022, 92 percent of health workers experienced or witnessed workplace violence. It also reported that “Three in four (health workers) have also experienced verbal and physical assaults in the past month and almost half of them had to call security or a colleague to assist them.”

Understanding Healthcare Workplace Violence

According to research published in May 2022 by JAMA Network Open, patients and visitors were the most frequent source of violence towards healthcare staff. Occupational Safety and Health Administration (OSHA) includes the following reasons as risk factors that contribute to violence in a healthcare setting:

  • Working alone
  • Lack of means of emergency communication
  • Lack of training and policies for staff
  • Under-staffing in general, and inadequate security staff
  • Lifting, moving, and transporting patients
  • Presence of firearms
  • The perception that violence is tolerated, and reporting incidents will have no effect

There are numerous studies that show many incidents of violence are not reported by healthcare workers even though formal reporting processes are in place. Verbal abuse and bullying are especially prone to under-reporting.

Reasons for under-reporting include lack of faith in the reporting system, fear of retaliation, and because the people who have chosen healthcare as a career path feel they have an ethical duty to protect patients—even when the patients cause harm to their caregivers.

Include Contact Center Scripting in Emergency Action Plans

On June 1, 2022, a shooter opened fire in the Natalie Building, part of the Saint Francis Hospital in Tulsa, Oklahoma. The gunman was a patient who blamed his surgeon for pain following back surgery. He injured an unspecified number of bystanders and killed four people, including himself and three others who were hospital staff.

The U.S. Department of Homeland Security (DHS) states active shooter incidents are commonly over within 10 to 15 minutes. During the Saint Francis Hospital shooting, officers responded within three minutes when the initial call was received by 911. Their fast action undoubtedly saved more lives.

It is imperative that hospitals include their contact centers as part of their emergency action plan (EAP). According to the DHS, an effective EAP includes, “Contact information for, and responsibilities of individuals to be contacted,” and “an emergency notification system to alert various parties of an emergency.”

Handling calls quickly and correctly is of utmost importance. Scripting software can be customized to efficiently guide operators through scripts for any type of call, including emergency, crisis, and code calls. Contact center scripting software helps to streamline enterprise-wide hospital communications and processes by:

  • Speeding up call processing
  • Providing accurate information
  • Reducing operator errors
  • Improving efficiency and productivity
  • Supplying detailed call analytics and reporting

Integrate Emergency Notifications with Secure Messaging

Every healthcare facility has unique security risks that can affect patients, visitors, and hospital staff. Most organizations have a security management plan that is designed to identify and manage security risks.

Security teams manage and mitigate risks they find on a hospital campus and are supported by local police departments. The security teams often work together with a hospital’s telecommunication center because hospital call center operators also handle calls for security assistance and can monitor emergency phones and other security technology at the hospital.

When a security team needs to communicate an alert to the staff of a hospital campus, it is common for the hospital’s call center operators to send the notification because their call center software contains a complete personnel directory.

Contact groups are built in advance, so notifications occur with one click. Seconds matter and so do the number of keystrokes it takes for them to send out emergency notifications to multiple contacts and devices.

An efficient way to communicate these alerts is via the secure messaging app employees use on their smart devices for work. Many hospitals have replaced their outdated pager technology with secure messaging apps to improve notification speeds and response times. These apps are used by providers, lab techs, building maintenance, environmental services, contact center, security, and other departments within an organization.

Notification systems can integrate with a hospital’s secure messaging app and use automated notifications to communicate critical alerts and security instructions to reach more people in less time.

Some apps can also track message activity, complete with message histories, indicating whom messages were sent to and when messages were read so an organization can have confidence in knowing critical messages were delivered and read.

According to OSHA, healthcare workplace violence is preventable when an effective program is in place. They cite five key program components:

  • Management commitment and worker participation
  • Worksite analysis and hazard identification
  • Hazard prevention and control
  • Safety and health training
  • Record keeping and program evaluation

Technology used by a healthcare organization’s contact center should be included in a violence prevention program. As the hub of communication for a hospital system, their call center already has updated contact information for departments and employees and uses highly effective communication tools to get critical alerts to staff members.

1Call, a division of Amtelco

Nicole Limpert is the marketing content writer for 1Call, a Division of Amtelco.

Use Secure Texting to Send Emails from Your Call Center


LVM

Mark Dwyer

Are you incorporating technology into your communication plan? Today’s consumers, patients, and physicians have expectations about the way you communicate with them. However, be careful. In all electronic communication, be sure to meet HIPAA and HITECH standards. Regardless of the communication method you use, you must encrypt any Personal Health Information (PHI).

It is more important than ever to interact using current technology. Texts and emails play an increasingly important role in sending patients both secure and non-secure communications. These include reminders for appointments and medication refills, health information, care advice, confirmation of referrals, registrations, and other notifications. Not only does this increase consumer, patient, and physician satisfaction, but these electronic methods increase the efficiency of the call center.

Advantages

Some of the advantages include:

  • Electronic communication—whether text or email—arrives quickly, usually within one to two minutes.
  • The message contains clear, direct written communication and instructions.
  • Patients and consumers can refer to the information or instructions, which they can review whenever needed.
  • Reduces repetitive phone calls or relying on memory or recall of the instructions.
  • Eliminates the consumer’s or patient’s need to write down the instructions or information given.
  • Reassurance for the consumer or patient as they can read and refer to the information at their leisure.

Applications

More and more physicians and medical staff are requesting that call centers text them with answering service requests and patient callbacks and updates. These are becoming key areas for the call center to use secure texting or messaging to communicate with patients or medical staff.

Another growing use is to send secure emails or texts to the patient regarding the care advice given during a triage call. When doing so, remember these transmissions must be HIPAA compliant. Therefore, require the physician or patient to enter their last name and a password or challenge word before receiving the message.

An application often used in triage call centers is sending health information to a patient when they are not calling about a symptom-based issue but instead have a general health question, for example, chickenpox. In this scenario, the triage nurse can send the information via secure text or email to the caller.

Call center staff can also text the physician via the software when the provider needs to call the call center or to inform the physician that they need to call a patient. These outbound messages also work with answering services and on-call scheduling.

Hospitals are also using texting and email for nonclinical reasons. As an example, if there is a valid email address on the consumer record, many will email class registration and physician referral confirmation letters to their consumers. If the email address is not valid or if there is a misspelling in the email address, the software can send the confirmation letters to a generic email address that a manager reviews daily. In these cases, the manager prints the attached pdf version of the confirmation letter then sends it via postal mail.

Finally, creative call centers equipped to handle calls from the hearing impaired are now using secure text messaging. In this application, the triage nurse can send care advice associated with the guidelines used to the patient. One call center reported that a hearing-impaired patient cried upon receiving the care advice in a readable format.

Communication continues to change, and we must embrace it. We are a text and email society. And texts and emails not going away. So embrace this valuable resource.

LVM Systems logo

Mark Dwyer is a veteran of the healthcare call center industry and serves as COO of LVM Systems.

Voice AI in the Healthcare Call Center



Should We Embrace Technology in Our Medical Contact Centers or Fear It?

 By Peter Lyle DeHaan, PhD

Author Peter Lyle DeHaan

Throughout the history of the call center industry we’ve looked for ways to help our agents be more effective. In the pre-computer days this often meant physical solutions and electromechanical devices that allowed staff to answer calls faster, record information easier, and organize data more effectively.

Then came rudimentary computers that provided basic call distribution and CTI (computer telephony integration). Computer databases allowed us to retrieve information and store data. Following this we experienced voicemail, IVR (interactive voice response), and automated attendant. More recently we’ve encountered speech-to-text conversion and text-to-speech applications. Then came the chatbots, computerized automatons that allow for basic text and voice communication between machine and people.

Computers are talking with us. Smart phones, too. Consider Siri, Alexa, and all their friends. Technology marches forward. What will happen next?

I just did an online search for Voice AI. Within .64 seconds I received two million results. I’m still working my way through the list (not really), but the first few matches gave me some eye-opening and thought-provoking content to read and watch.

In considering this information, it’s hard to determine what’s practical application for our near future and what’s theoretical potential that might never happen. However, my conclusion is that with advances in chatbot technology, artificial intelligence (AI), and machine learning, we aren’t far from the time when computer applications will carry on full, convincing conversations with callers, who will think they’re talking with real people.

While many pieces of this puzzle are available today, I submit that we’re not yet to the point where we can have a complete, intelligent dialogue with a computer and not know it. But it will happen. Probably soon.

Voice AI in the Healthcare Call Center

What Does Voice AI Mean for the Medical Call Center?

Just like all technological advances since the inception of the earliest call centers, we’ll continue to free agents from basic tasks and allow them to handle more complex issues. Technology will not replace agents, but it will shift their primary responsibilities.

Or maybe not.

With the application of voice AI, might we one day have a call center staffed with computer algorithms instead of telephone agents? I don’t know. Anything I say today will likely seem laughable in the future. Either I will have overstretched technology’s potential or underestimated the speed of its advance.

I think I’m okay talking to a computer program to make an appointment with my doctor. And it wouldn’t bother me to call in the evening and converse with a computer as I leave my message for the doctor, nurse, or office staff. However, what concerns me just a tad would be calling a telephone triage number and having a computer give me medical advice.

Yet in considering the pieces of technology available to us today, this isn’t so far-fetched. Proven triage protocols are already defined and stored in a database. Giving them a computerized voice is possible now. And with AI and machine learning, the potential exists for an intelligent interface to provide the conversational bridge between me and the protocols. And this could be the solution to our growing shortage of medical practitioners.

For those of you actually doing telephone triage, you might be laughing right now. Perhaps you’re already implementing this. Or maybe you’re convinced it will never work.

Yet it’s important that we talk about technology and its application in healthcare call centers. Regardless of what happens, the future will certainly be an interesting place.

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.

Interoperability in the Call Center: A Natural Solution


1Call, a division of Amtelco


By Matt Everly

The call center in a healthcare organization preforms a number of very important and very different functions. One of the most significant is serving as a virtual lobby, when processing internal and external calls. It may be the initial touchpoint a patient has with the organization, so the experience has to be positive. As the saying goes, “You only have one opportunity to make a first impression.” Also the call center serves as the nerve center for ongoing communications.

Modern healthcare call centers need to be able to handle all types of calls quickly and efficiently. To ensure the virtual lobby experience is positive, the call center operators need immediate access to accurate data using modern technology. To accomplish this, information systems need to be able to share, pass, and store usable data from system to system. Interoperability is a term used in healthcare to describe the idea of different technologies and systems communicating to share data.

To handle calls effectively and efficiently, the call center system needs to use data that may reside in external databases on other systems. As an example, if a caller wants to talk to an admitted patient, the operator needs to know which room to send the call to. Most patient admission, discharge, and transfer (ADT) information resides in a database that is external to the call center system.

Without interoperability, the operator would have to bring up a second screen to view the ADT information, go back to the call center system screen, manually enter the room extension, and transfer the call. With interoperability the call center system would automatically download the ADT information from the external database and present it to the operator on the call center screen, eliminating several steps and decreasing the chance of error. Interoperability works behind the scenes to automate data exchanges and sharing.

Making sure the hospital call center is interoperable with other systems is the safe way to make sure call center operators communicate with callers in a timely and effective manner. A few of the important IT systems and technologies that should be interoperable with the healthcare call center system include:

  • Electronic health records (EHR)
  • Messaging applications (paging and secure messaging apps)
  • Alarms and monitoring systems
  • Nurse call systems
  • Scheduling systems

Many healthcare call centers routinely use outdated technology. Binders with paper call schedules, non PC-based PBX consoles, fax machines, data access terminals, and sticky notes are used by operators to access the information they need to handle calls. These makeshift solutions lead to inefficiency and mistakes.

Interoperability Works Both Ways: Hospital call center systems store information as administrators and operators input data or create schedules. This information may be valuable to other departments or used to augment an external document.

As an example, when an operator takes a message from a patient for a clinician, that message can be automatically sent to the EHR system and be posted to that patient’s individual electronic health record. By using interoperability, information from numerous databases can be combined in one area to form a master record for a particular patient.

Not All Systems Allow Interoperability: Legacy systems and technologies were not designed with data exchange in mind. There are several ways to connect IT systems to the healthcare organization’s larger digital ecosystem, but these can be costly and potentially unreliable.

Health Level Seven (HL7) is a set of standards used to transfer clinical and administrative data between software applications. Many present-day IT developers design products with HL7 in mind, helping organizations move toward interoperability throughout the enterprise. The healthcare call center can use HL7 to populate patient, clinician, and employee directories for operators. Also HL7 can be used as a way to post information from the call center system to a patient’s EHR.

Reducing Costs: Interoperability will make your call center operators more efficient, eliminate mistakes, and reduce costs by automating processes that are currently handled manually. As healthcare providers look to reduce expenses, interoperability in the call center is a natural solution.

1Call, a division of Amtelco

Matt Everly is the marketing director for Amtelco’s 1Call healthcare division. Matt has worked at Amtelco for over twenty years and has held numerous positions, including southeast regional sales manager, executive suite market development, and marketing manager.

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Top Tips for Protecting Patient Documents in Call Centers



By Mia Papanicolaou

Healthcare call centers play a vital role in servicing patients, improving patient-practitioner communication, and leveraging operational efficiencies to contain healthcare costs. The steady digitization of patient records has brought about significant improvements in service efficiency and patient care. While inevitable, this digital transformation introduces new challenges associated with safely storing, processing, and sharing documents containing personally identifiable information (PII) and protected health information (PHI).

The healthcare sector holds the unfortunate position of having the “highest number of data breach incidents compared to other industries.” Incidents such as the LA hospital ransom attack and the database breach at Anthem Inc prove that healthcare data presents an attractive target for cyber-criminals, allegedly fetching a ten to twenty times higher premium in the black market over commonly hacked credit card data.

Despite the risks, healthcare providers and their outsourced call centers are compelled to make documents easily accessible in order to provide quality customer service. In addition, patients themselves are demanding the ability to access their own records through channels such as email, web, and mobile apps.

However, moving to digital documentation should not pose an automatic risk of breaching highly confidential patient information. In fact, if implemented correctly, a digital document management solution offers significantly more security and control than traditional document management systems.

Patient documents need to be protected at all points in the digital journey, whether stored in a document repository, accessed at the call center, travelling via the Internet, or sitting on the patient’s own computer. This can be achieved using a combination of encryption technologies, password protection, access control, and education.

Here are five top tips for protecting patient documents:

Tip 1) Control access at the document level: A digital document management solution should offer multiple layers of access control that enable a healthcare call center to compartmentalize and restrict access to different patient documents. Agent clearance should dictate what functions staff can perform on a document: view, download, or share. As an example, certain private patient records can be password protected so that the only access within a call center is the ability to send the document to the patient when requested, rather than let the agent view the details of that document.

Tip 2) Provide ongoing agent education: The easiest way for criminals to breach security and access a repository of confidential documents is by tricking or compromising an employee. In a call center environment, which suffers from high employee turnover, this fear is compounded. Be sure all agents understand and operate by the security guidelines when it comes to accessing and sharing patient documents. Constantly reinforce that one should never click on links or open documents from an unknown source as this is a common method used to install malicious software that effectively puts the hackers inside the secure network.

Tip 3) Use multiple layers of protection: As cybercriminals continue to get smarter, traditional network and database security is not sufficient. To truly secure patient documents, multiple security layers are required, to the point of encrypting and protecting each individual document even if it resides on a secure network. This also ensures that information sent via email between a call center agent and patient cannot be compromised if intercepted or sent to the wrong recipient. It also protects the document               1) against unauthorized access from someone inside the network; 2) if a call center agent doesn’t have sufficient rights to view patient information; and 3) if a compromised employee or a hacker is using stolen, but valid, credentials.

Tip 4) Help patients secure their documents: Make it a policy to never send or store unprotected documents containing confidential information. An emailed or downloaded document is saved automatically on certain devices and if unprotected, it becomes vulnerable if the device is hacked. Assist patients with safeguarding their information even when it resides on their own computer by distributing only encrypted and protected files; train call center staff to let patients know the importance of this protection.

Tip 5) Enforce a strong password policy: In order to secure patient documents from all vulnerabilities, a strong password approach is essential. This applies to the password an agent uses to access internal systems, the one a patient uses to log onto a self-service portal, or even the password used to open an individual document. If the password is weak, all other security is bypassed. Educate agents and patients on the value of using only strong passwords and the risks of using easily cracked passwords such as “123456,” “abc123,” or “password.”

The demand for anytime, anywhere access may be patient driven, but digital transformation is highly beneficial for a healthcare call center seeking to boost efficiency, improve communication, and enhance the patient experience. By taking advantage of these simple security tips, a call center will not only be able to deliver a strong customer service experience, but also provide the technologies needed to safeguard their information.

Mia Papanicolaou is chief operations officer for document security specialist Striata Inc. Mia joined Striata in 2006 and having worked in Africa and the UK, now heads up North, Central, and South American operations. Striata provides strategy, software and professional services that enable digital communication across multiple channels and devices. Striata technology secures, sends, and stores confidential documents.

Achieving Healthcare Data Security in the Contact Center



HITRUST CSF certification will become the standard for contact centers in the healthcare market

By Brandon Harvath

Data security breaches are rampant in today’s complex technological environment. According to the Office of Civil Rights (OCR), healthcare data breach numbers are staggering. In 2015, 253 healthcare breaches affected more than 112 million records. Healthcare industry players are increasingly concerned about their ability to achieve and maintain the highest levels of data security. The sobering truth is that most healthcare organizations, including contact centers, are one data breach away from a catastrophe.

Global data attacks continue to be extremely sophisticated and, faced with a steady stream of hacker headlines, the public is becoming more concerned about its own personal data. Is our industry taking all precautions to safeguard personally identifiable information (PII) and protected health information (PHI)? Progressive contact centers are working diligently to address the challenges.

A Stringent Approach to Protecting PII and PHI: In transacting daily business, consumers share a great deal of personal data with unknown persons who answer the phone as the voice of a trusted business entity. Consider how many times each of us has called a company’s contact center and shared personal information. This practice has become so routine that most of us barely give it a second thought.

The security of PII and PHI is only as strong as the chain’s weakest link. Toward this end organizations spend millions of dollars annually on anti-hacking software and other privacy and security programs. Unfortunately it takes just one click of a spam email for the fragile system of data security to be shattered.

Health insurers and their vendor partners face a tremendous challenge today in complying with the mandates of a multitude of federal and state agencies, including the regulations put forth by the Health Insurance Portability and Accountability Act (HIPAA) and its complex privacy and security rules. Many of today’s privacy and security issues were not even envisioned when HIPAA was enacted in 1996, so it is incumbent upon the industry to be progressive in its achievement of data security. This requires a holistic approach that encompasses not only HIPAA, but also complex standards formulated specifically to mitigate broad-ranging privacy and security risks. One organization has emerged to require healthcare organizations implement this sophisticated set of standards: Health Information Trust Alliance (HITRUST).

At the foundation of HITRUST’s offerings is the common security framework (CSF), a certifiable infrastructure that provides organizations with a comprehensive, flexible, and efficient approach to regulatory compliance and risk management. Developed in collaboration with healthcare and information security professionals, HITRUST CSF merges healthcare-relevant regulations and standards into a single overarching security configuration. HITRUST CSF has become the most widely adopted security framework in our nation’s healthcare industry as it helps organizations via an efficient, prescriptive framework for managing the security requirements fundamental to HIPAA.

Attention is turning toward achievement of the level of security HITRUST CSF demands. In June 2015, for example, HITRUST announced that a growing number of major healthcare organizations, including key health insurance companies, would now require their business associates (BA) to obtain CSF certification within the next twenty-four months.

Those contact centers that have already committed the time, finances, and other resources necessary to earn such a stringent certification are on data security’s leading edge. Those that have not will need to act quickly to remain partner vendors with this growing group of certified healthcare clients.

One Contact Center’s Journey: Achieving what many view as the Holy Grail of world-class healthcare data security does not come without tremendous investment: communicated management commitment, dedicated resources and rigid processes and controls. In our experience, the contact center attempting to reach this goal must adhere to a number of controls that are focused on three mission-critical areas: technology and systems, process, and people. Because a detrimental glitch can occur within any of these areas at any time, compliance within a multitude of data security categories (HITRUST has more than sixty) must be assured.

Access to information systems, for example, is to be role based, in compliance with HIPAA guidelines, and is determined based on an intense evaluation of one’s role within the organization and within a specific program assignment.

Our management evaluates each job function to provide the minimum necessary access to information systems and data needed to satisfactorily perform individual tasks. Monitoring is strict and includes ensurance of procedural compliance in all prescribed areas. With HITRUST certification at the core of our data security program, these are a sampling of best-in-class practices that contribute to our continued compliance:

  • Zero-Tolerance Corporate Culture: All employees and associates take ownership and accountability for data, working to “protect it as their own,” and embody the core values of trustworthiness, respect, responsibility, fairness, caring, and integrity in all their actions and practices. The organization also maintains and enforces a code of conduct in which nothing less than absolute integrity is expected and accepted.
  • Compliance Training and Testing: All employees and associates are required to satisfactorily complete a range of training topics that include compliance and ethics, HIPAA, security awareness, and HITRUST. Training is conducted online and concludes with knowledge checks. The chief compliance officer (CCO) and chief technology officer (CTO) present during client and product training and are also available for team-specific training.
  • Limited and Monitored Access to Data: In addition to firewalls that block unauthorized access to specific computer-generated communications, Wi-Fi access is not accessible on company premises. Work teams have access only to the suite where they are assigned, and a strict, badge-access policy is enforced. Teams have access to all information needed to respond in a highly expert way to their customers, but they only have access to information specific to their program.
  • Maintenance of Physical Security: Physical security is ensured through the implementation of a facilities security plan, which details all security elements (doors, entryways, security cameras, desk environment, and vendor compliance) and the necessary steps to accomplish absolute security. Clean rooms and clean production suites create environments to protect PII and PHI from risk of sharing by prohibiting cell phones, cameras, and other personal electronics as well as paper and pens so that PII or PHI is not written down as calls are handled. Supervisors continually monitor production floors and individual work areas.
  • Ethics Reporting Hotline: Data security issues are paramount and the importance is consistently communicated to all employees and associates. Employees and associates at all levels within the organization are encouraged to report – anonymously via website, telephone or email – any and all data security concerns to the CCO or chief human resource officer. A strict non-retaliation policy is vigorously enforced. Senior leadership is committed to providing avenues through which ethical issues may be revised, reviewed, and resolved openly and honestly. The CCO maintains an open-door policy for employees and associates to ask questions on how to maintain ethical standards or flag a potential problem.
  • Continual Process Improvement: As part of HITRUST CSF certification, we are required to continually demonstrate improvement. Certified organizations are subject to an annual review as well as quarterly improvement updates, and they must consistently demonstrate improvement of maturity level as it relates to a multitude of privacy and security protocols.

The proliferation of technology we take for granted today, and which didn’t exist a decade ago, has necessitated the need for stringent controls and data oversight. HITRUST CSF certification and other marketplace compliance certifications will soon become the standard and the price of doing business in the healthcare market. The security of consumers’ data – and the survival of our healthcare contact centers – clearly depends upon it.

Brandon Harvath is senior vice president of operations for Corporate Call Center, Inc. (CCC), a customer interaction company specializing in providing complex, high-touch services within the healthcare insurance and other highly regulated markets. CCC, a multi-site contact center, is headquartered in Blue Bell, Pennsylvania. Harvath can be reached via email or 215-283-4202.

Should We Switch Our Mindset From Calls to Contacts?



By Peter Lyle DeHaan, PhD

Author Peter Lyle DeHaan

The first issue of AnswerStat magazine rolled off the presses over a dozen years ago. Since then much has changed. Call center technology has advanced, customer expectations have expanded, hiring and training practices have evolved, and new service opportunities have emerged. The Internet exploded into a global phenomenon that altered everything.

What hasn’t changed much is the telephone call. Call centers still answer calls, make calls, and transfer calls; we give and receive information over the phone. The telephone is the ubiquitous communication medium, and it is central to the call center.

During these years of technological transformation, there was also faxing and paging, but both were insignificant compared to the widespread practice of simply picking up the phone and calling someone to have a two-way conversation in real-time. Not too many people fax anymore, and it’s been ages since I’ve seen a pager. Yet the telephone remains.

But now we also have email, text, and social media. Some call centers have fully embraced these technologies and integrated them in to their operations. Others have persisted in focusing on phone calls. Yet the pressure remains for such centers to add these newer forms of communication and connection into their call center mix. As a result the call center becomes the contact center. To embrace this multi-channel paradigm, your call center mind-set must be about contacts, not calls.

Consider these forms of contact:

Calls: Phone calls represent the majority of contacts in almost every contact center. We excel at calls.

Fax: Some healthcare communication still occurs by fax. Though this channel is small, someone needs to oversee it. Why not the contact center?

Pager: Pagers have gone away in most industries, but they still have value in healthcare where reliability, speed, and disaster-adverseness are vital. Contact centers have always done a great job at sending pages, and some even manage pager inventory. There’s no reason to stop now.

Email: Processing secure email is a natural fit for contact centers. They have the network, the Internet connection, the computers, and the staff – and the ability to send, receive, forward, and screen email, just as with calls.

Text: Text is growing in most sectors. This is one more channel for the healthcare contact center to add to their arsenal.

Social Media: A growing preference for people of all ages is to interact online with others through social media. Healthcare organizations require someone to monitor all those comments, tweets, and contacts, responding in a timely manner that is professional and accurate. With the plethora of social media platforms, no organization can utilize them all, yet they must be where their patients are. The task of interacting with these social media-minded customers is ideal for contact centers.

Self-Service: A final consideration is self-service, the preferred option for most people when they have a question or problem. How, you may ask, does self-service become a contact center opportunity? Doesn’t self-service subtract from the contact center? Yes, every interaction handled via self-service is one less interaction handled by the contact center. Yet forward-thinking contact center managers see two opportunities.

The first is that contact centers are in the best position to know what issues self-service should address. Poll a group of agents, and the top ten needs for self-service will quickly emerge. The contact center should serve as the advisor for self-service topics. Better yet, the contact center could take the lead role and actually produce and administer the self-service content.

The second opportunity is providing backup for self-service. Self-service cannot help everyone, every time. The contact center should catch those that self-service drops. As a bonus, these calls, taken in aggregate, then provide fodder for additional self-service content.

Whatever channels your contact center covers, keep in mind that it’s not about the technology, it’s about the contact.

AnswerStat is here to help you maximize every contact, and our annual Buyers Guide is a great place to start.

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.

[From AnswerStat December 2015/January 2016]

What Comes to Mind When I Say Healthcare?



By Detta Donoghue

Many would first say hospitals, while others might say their primary care physician, and still others might think of the local clinic they depend on. Clearly all of these are appropriate responses, depending on the health status of the individual answering the question. Even though each of these function differently, there is one common thread that links them all: patient care. Today hospitals, group practices, and clinics are in a competitive environment, at times fighting (in a civilized way, of course) to gain the attention of new patients.

Securing new patients, however, is just the beginning. More than ever healthcare organizations are looking at technology to help them keep and retain their clientele. For example, the patient portal, unheard of five years ago, is now a standard and has made its way into private practices, dental organizations, and even veterinary medicine. Yes, you can now track Fido’s health online.

So why would any organization jeopardize all this progress and not do everything possible to make sure the patient shows up at the appointed time? I’m speaking of the standard the appointment reminder message we all get today. These messages are not just for healthcare anymore, but have become a standard business practice where applicable. I personally receive them for hair appointments, restaurant reservations, and most recently for a hotel and tour reservation.

Clearly nobody wants to lose the revenue generated from missed appointments, lose the potential downstream revenue that appointments can generate, or let resources go unused for the appointed time slots from missed appointments. Studies show that as much as $20,000 can be lost when a patient does not keep a healthcare appointment.

This happened to me recently when I failed to show up for tests that had been scheduled. Why didn’t I show up? Simple: I didn’t get the appointment reminder. To make the situation worse, when I asked why I did not receive the reminder – no call, no text, no email – I was told that the information was on my patient portal. There was just one problem: I had not signed up for the portal; I didn’t even know the practice had one. So the tests had to be rescheduled. Luckily the results were good – it could have easily gone the other way, and waiting almost a month for potentially lifesaving treatment would have been due to not receiving an appointment reminder.

The point of this little story is simple: Don’t lose sight of your audience. I’m pretty technically savvy, and I never thought to ask about the patient portal. Frankly, even if I had, I wouldn’t have thought it would replace the function of an appointment reminder.

If your organization is encouraging the use of a patient portal, be proactive in making sure your patients know how to use it. Next, if you have something that’s working well, make sure your new technology takes your facility or practice to the next level of patient care without any loss of service. Finally, when deploying new technology, ask what can or cannot be integrated with what you already have in use currently. Often you can leverage what you have already invested in by adding other levels of service and solutions.

Don’t let technology get in the way of serving patients. Don’t overlook something as simple as an appointment reminder. Your patients’ health is at stake – along with lost billing.

Detta Donoghue has been working in the technology industry for over forty years, holding a variety of positions servicing the IT and telecom disciplines. As the director of marketing and communications for CI, Detta provides branding, collateral, presentation, and educational support for both the channel sales group and company as a whole. Detta was formerly the director of marketing and vendor relations for SDC, director of channel sales for Amcom, served on Avaya’s DevConnect committee, and was president of the Siemens user group.

[From AnswerStat October/November 2015]