Tag Archives: technology articles

Nine Questions to Assure Peace of Mind in the Cloud

By Richard D. Stier, MBA

“There are two ways to look at today’s healthcare contact centers,” said Mary Alice Worrell, director of call center services at Ascension Health Michigan Ministries. “You can be nervous because the market is changing. Alternatively, you can choose to grow with the industry and understand that this is a season of great opportunity. Because primary care physicians are the drivers of value-based payments, the call center is now front and center. This is our time.”

Yes! Our time is now.

Healthcare contact centers are now more relevant than ever. They are moving from a siloed support function to a critical role as a communication hub at the center of the healthcare continuum. As mentioned at the 25th Annual Conference of Healthcare Call Centers, “The contact center is the nerve center at the heart of the new structure.”

As we take advantage of this resurgent opportunity for healthcare call centers, a key dilemma demands consideration: Should we install contact center software, or should we subscribe to a cloud solution where an Internet connection is all the infrastructure we need? Here are nine questions that can help you arrive at the right answer for your organization. Your peace of mind may depend on it.

1) Does your contact center have limited access to internal IT support? Baking brownies for the IT team is still appreciated. Unfortunately, sweet treats may no longer secure the expertise of over-stretched IT professionals. Your request is one of many at a time when they are overcommitted, scrambling to support multiple mission-critical priorities. If you find yourself jockeying to schedule the high-demand time of an IT expert – perhaps to help you acquire and install hardware and software or to support software updates – then you understand the challenge.

The cloud may provide welcome relief. Leading cloud providers deliver their software with no internal IT support required. That’s none – zero. In addition, your IT team may appreciate the freedom to focus on other initiatives such as enterprise-wide EMR. Pass the brownies.

2) Is capital funding restricted or difficult to obtain? Instead of paying for software, paying for the hardware to support it and the IT professionals to manage it, cloud solutions enable clients to simply purchase an annual subscription. That means lower up-front costs. For many organizations, that also removes the need for capital funding. Avoiding the capital budget process, while still securing the functionality you need, may be an attractive option.

3) Does the proposed cloud solution manage updates and upgrades for you? Installed solutions require regular updates to remain current. Leading suppliers of healthcare contact center cloud software manage all upgrades. There are no patches for clients to download and install. There are no worries about system maintenance, operating system upgrades, database optimization, or proactive monitoring to detect issues before they become problems. Additionally, there is no need for clients to add hardware, software, or bandwidth as the user base grows. Take a breath.

4) Confirmed security: is the proposed cloud solution SSAE 16-certified? How secure is your installed solution data? SSAE 16-certification is beneficial to cloud data centers that provide services to a large client base. It is a trusted third-party attestation of meeting a level of proficiency. SSAE 16-certification applies to data centers that provide colocation and have customers who require security and comprehensive data protection. If you’re serious about a cloud solution, be serious about security. Look for a cloud solution from a provider who has earned SSAE-16 certification

5) Is the proposed cloud solution scalable to your specific environment and level of complexity? What is the solution’s historical percentage of uptime? Your contact center solution should adapt with you as your needs change and your organization becomes more complex. Whether installed or cloud-based, require a solution that can easily grow from supporting a one-person call center to an integrated contact center servicing scores of hospitals and thousands of providers. Ideally, your contact center software should integrate with key existing systems.

Uptime is a baseline requirement. If the proposed cloud provider does not have a record of delivering 99.9 percent uptime or better, keep looking.

6) Is implementation faster with the installed contact center software solution or the cloud solution? Does a proposed cloud solution provide a faster implementation than provided by the corresponding installed solution? Leading contact center cloud solution providers have refined and honed cloud implementations. For example, one cloud contact center solution offers implementation time that is 60 percent faster than with the equivalent installed solution.

7) Which clients are more current on their supplier’s software? Find out if installed or cloud clients use more current software. Often cloud clients are on more recent versions than installed software. Using the most current software allows for the newest features.

8) Does the proposed cloud solution assure untethered access to call center data? A call center connects by phone, while a contact center can utilize multiple communication modalities including telephone, Web chat, email, and text messaging. For a contact center, an application-programming interface, or API, is a vital tool. Think of an API as a machine-to-machine interface rather than a user interface. An API provides a set of programming instructions and standards for accessing a Web-based software application, whether installed or in the cloud.

An API allows programmers to automate the flow of data by developing applications that communicate with existing software applications. A key benefit is a significant decrease in internal costs by eliminating the need to reenter data that is already captured by an existing application.

APIs also make it easy to efficiently share data and processes, allowing developers to access the functionality of other software through well-defined data structures. This can assure that you have complete, accurate contact center data.

Leading contact center cloud applications include an API. Don’t consider a cloud contact center solution without this essential functionality.

9) Are value-added features available exclusively for cloud clients? Find out about cloud-specific resources and value-added services that may not be available or may be extra-cost options with the equivalent installed software. One contact center cloud solution includes concierge services. This client-specific competitive advantage includes a professional who works with clients to design, create, and support both process improvement and report generation and automation, exactly what many clients seek.

Here’s an all-too-common experience by one cloud contact center client: The call center data administrator left the organization, and suddenly no one knew how to produce key reports. Reports that had been previously automated were now produced manually. In some cases mission critical reports were not prepared at all. They needed help, and they needed it quickly. Can you relate?

Yes, this is our time. Contact centers are profoundly relevant to today’s healthcare challenges. Your decision about whether to select an installed or a cloud-based contact center software solution can be either an intentional accelerator or an unfortunate limiter of your success. Choose wisely.

Rick Stier has a thirty-year record of results as a healthcare marketing executive and consultant. He is vice president of marketing at HealthLine Systems, Inc., a provider of software and consulting solutions to over a thousand healthcare organizations across North America.

[From the June/July 2014 issue of AnswerStat magazine]

Creating a One-Stop Shop with Cloud-Based Technology

By Charu G. Raheja and Ravi Raheja

The landscape of medicine is changing. As healthcare dollars become less available or are distributed differently, hospitals and organizations are consolidating their practices to create a network of primary care physicians and specialists. Larger groups provide economy-of-scale, a good referral source, and established branding in the community.

However, an increase in size presents a challenge in terms of providing a uniform patient experience throughout the system, as well as helping callers navigate the system effectively. Organizations want to help patients as much as possible on the first phone call, regardless of the reason for the call. Patients may call to talk to a triage nurse about a symptom, an appointment for a physician referral, a medication refill, or a billing question. How do you manage these requests without transferring the caller three times only to be sent back to the initial operator?

Call center consolidation and cloud-based technology may be the answer.

What Is Cloud-Based Technology? The cloud is simply the latest term for a concept that has been around for a while. Web-based email and online banking are examples of cloud-based technology.

Cloud refers to applications, services, or resources made available to users on demand via the Internet from a provider’s servers. Companies typically use cloud-based computing as a way to increase capacity, enhance functionality, or add additional services on demand without having to commit to potentially expensive infrastructure costs or increase or retrain in-house support staff.

Providers can offer end users immediate access to new, always-on features from nearly any device in any location. They also provide the business with a predictable, subscription-based, pay-per-use way to fund IT.

So How Does This Apply to a Healthcare Call Center? Imagine this scenario. A diabetic patient is concerned because he has high blood sugar readings even though he has been using his medicines as directed. He has a primary care physician, an endocrinologist, and a cardiologist. He has the number for the cardiologist handy, so he calls him first. Near the end of the day, the office calls back and tells him to call the endocrinologist instead. He calls, but it is already late and he gets the answering service. The patient may have to wait until the next day to get a response to his medical question.

Now, what if patients could call a single number for all their providers? The operator taking the call could see that a patient has a medical symptom – in this case, high blood sugar. The operator puts the caller in touch with a triage nurse who determines that the situation is not an emergency, but the patient needs to be seen in a week. The nurse can see that the patient has an endocrinologist, a cardiologist, and a primary care physician. The nurse makes an appointment with the endocrinologist and advises the patient about what to do while he or she is waiting for the appointment. A triage note is put in the system for the primary care physician so he or she knows the patient called and has an appointment with the endocrinologist. The nurse triaging the patient can also see that the patient has a cardiologist, but it has been a year since the last visit. She schedules a cardiology appointment as well and emails the patient information about nutrition classes provided by the hospital.

Is This Technology Available Now? The answer is yes. To reach this level of service, the organization needs:

  • A Single EMR System: A single EMR system lets providers and operators across the system access the entire patient chart to provide coordinated care. Many EMR systems are Web-based (that is, cloud-based) and can be accessed securely from multiple locations and devices.
  • A Centralized Call Center: There should be a single point of entry into the system, where the operators have scripts and training to handle a variety of caller needs and can answer questions or direct callers to the most appropriate person.
  • Cloud-Based Call Center Technology: Web-based systems have a more flexible design to interact and exchange data with other Web-based systems. The traditional call center platform with a single vendor may no longer be the most efficient way to get the functionality required to perform all operations. The call center can build a robust platform by obtaining components from multiple vendors with specialized products and have them work together. This approach enhances functionality because the most appropriate product can be selected for the organization. Components can be changed or added over time, depending on the evolving needs of the call center.

Conclusion: Coordinating healthcare among different providers has been a struggle and an issue for several decades now. New, cloud-based technology along with a centralized call center is a viable solution to help providers and patients stay coordinated, while at the same time improving patient care and decreasing costs.

Charu G. Raheja, PhD, is the CEO and chair of TriageLogic. Ravi Raheja, MD, is the COO and medical director of TriageLogic. TriageLogic is a URAC-accredited company offering Web-based telephone triage software and nurse triage services. With a national footprint, TriageLogic has been providing affordable triage solutions for almost ten years for use in institutions and private practices.

[From the June/July 2014 issue of AnswerStat magazine]

Four Strategies for Improving Health Literacy with On-Hold Messaging

By Kara Tarantino

To move our healthcare system forward, we need a consolidated effort to tackle the problem of health literacy head-on and remove complex, difficult-to-understand messaging throughout the entire spectrum of the patient experience. Relevant messages with a call-to-action should be delivered to patients and consumers where they need it most: when they call a hospital or healthcare facility. On-hold messaging provides the perfect gateway for providers to connect with callers, using easy-to-understand health-literacy messaging. The most impactful messaging can help improve patient satisfaction, as well as the overall patient and employee experience – providing it is informative, current, and easy to act upon.

Information from luminary sources that is branded on a local level and feedback garnered from focus groups with hospital and physician practice patient-and-family committees are two examples of good ways to source valuable content. Armed with this information, marketers are better poised to create captivating messages in context with the needs and listening skills of their audiences. Messages that tell people what they need to do and where to get help empower them to ask questions that increase the likelihood that they will take action.

When people act, they are assimilating, absorbing, and retaining information. They are changing their thoughts and behaviors. This transformation is the desired result of effective communication and is evident in a higher level of audience connection and increased trust.

Improve health literacy and elevate caller engagement with these four strategies:

1) Use plain language to explain how to do things and why they should be done: Breaking down communication barriers helps prevent avoidable hospital re-admissions. Patients who know and understand a physician’s instructions feel empowered to act in their own best interest. Examples of messaging that can help support physician communication include demonstrating how to properly take medication, explaining why not refilling a prescription can have severe consequences, and why following a physician’s discharge instructions is critical to recovery.

2) Alleviate anxiety with entertaining and other unique audio formats: Patient education presented in dialogue and “skit” formats easily connects callers to your message and helps to increase message understanding, even if people are only half listening. Callers tend to tune in when they are being entertained with humor. Using comforting and supportive messaging is also helpful in reducing caller frustration when conveyed with empathetic voices.

3) Provide a call to action so callers can act upon information in real time: Call-to-action messages grab attention and encourage callers to make note of numbers to call for physician and screening appointments. Let people know about your on-site services, such as pharmacies, and provide numbers for prescription refills. If you offer discounts or coupons for nutritious meals in the hospital cafeteria, let people know before they come to your facility.

4) Clarify insurance terms and connect people to the right coverage: Studies show that not understanding basic insurance terminology makes it difficult for people to select the right coverage under the Affordable Care Act. Help people become more insurance literate by shedding light on terms like premiums, deductibles, and coinsurance. As you expand the types of messages your callers hear, they will see you as a more comprehensive and trusted health resource.

Callers placed on hold at healthcare facilities provide unique opportunities to initiate thoughtful and engaging communication. Easy-to-understand health literacy-focused messaging can encourage much-needed conversation between patients and providers and go a long way towards breaking down walls of confusing medical jargon and ineffective communication.

A results-driven strategic marketer with twenty-five years in the healthcare industry, Kara Tarantino is passionate about bringing health literacy messaging mainstream and developing content for diverse healthcare audiences that can be acted upon in order to positively affect patient behavior. Kara is a board member at the Georgia Alliance for Health Literacy and has led marketing at Vericom (a Spectrio company). Email Kara at karat@spectrio.com.

[From the April/May 2014 issue of AnswerStat magazine]

Learning from HealthCare.gov’s Botched Launch: History Repeats Itself and Lessons Remain Unlearned

By Matthew Ainsworth and Jeff Dell

The botched Affordable Care Act launch has faded from the daily news cycles, as stories inevitably do as fresher fare emerges. If history is any indication, the analysis and hand-wringing that generated so much news won’t amount to anything except another spectacular website or call center failure in the future. The technology industry hasn’t shown any sign of learning anything from its previous flops, so why would this time be any different?

What they haven’t learned – and this applies to government and private sector IT operations – is the value of testing websites and call centers under real-world conditions before they go live. Don’t believe it? Think that testing is too basic for anyone to ignore? Then dial back to October 2005 when the federal government launched the Medicare Part D prescription drug program. It was a smaller-scale fiasco than the ACA rollout, but otherwise they were depressingly similar.

The Medicare site, meant to help seniors pick benefit plans, was supposed to debut October 13, 2005. It didn’t go live until weeks later in November. Even then, “the tool itself appeared to be in need of fixing,” the Washington Post reported at the time. Visitors could not access the benefit enrollment website for the first two hours it was supposed to be available. When it finally went online at 5:00 p.m., it performed poorly. Once enrollment began, seniors had problems finding necessary information.

Things weren’t much better on the call center front. Call centers provided by the Center for Medicare and Medicaid Services underestimated call volumes and under-trained service representatives.

So what’s the lesson, besides “history repeats itself”? Or perhaps “the government doesn’t learn from its mistakes”? Both of them, sure, but in a large sense, the ACA website and call center failures were just business as usual in the tech industry, whether you’re talking government or private sector.

Political dimensions aside, there’s a persistent curiosity about how such a high-profile project could have failed so spectacularly. It was possibly the world’s most important IT project to date, yet it performed as if it were rolled out the door without so much as a cursory kick of the tires. That’s because it probably was – and that’s far from unusual.

A recent survey by LinkedIn and Empirix found that at most companies and public agencies, full pre-deployment testing is rare or doesn’t exist at all. When IT organizations do test, they don’t test the system the way customers will interact with it. They test components – Web interfaces, fulfillment systems, interactive voice recognition systems (IVRs), and call routing systems – but not the system as a whole under real-world loads.

The survey of more than 1,000 executives and managers in a variety of industries uncovered contradictory results. On the surface, pre-deployment testing rates are high: 80 percent or better. The deeper picture, however, isn’t as rosy. More than 80 percent of respondents said their companies do not test contact center technology under real-world conditions before go live. They do some form of testing, but it doesn’t mirror how customers actually will interact with the system.

Sixty-two percent use comparatively inaccurate manual testing methods. While this is better than not testing at all, manual testing does not reflect real-world conditions. Manual tests are so resource-intensive that they often occur only during off-peak times, and usually only once or twice. That makes it harder to pinpoint problems – and ensure they are resolved – even if they are detected pre-deployment.

Voice quality can be a significant drag on short- and long-term call center ROI. Contact center agents who must ask customers to repeat themselves because of poor voice connections – or worse, ask customers to hang up and call in again – are less productive than those who can hear customers clearly. In the long term, repetition and multiple calls erode customer satisfaction levels.

The majority of professionals who responded to the survey (68 percent) reported that their companies never monitor contact center voice quality. Only 14 percent continuously monitor voice quality, while the remaining 17 percent periodically monitor it on a daily, weekly, or monthly basis.

With misdirected efforts and testing rates like these, it’s no wonder people aren’t surprised when a major initiative like online healthcare enrollment goes off the rails or customers calling a contact center are funneled down a blind alley in the IVR system.

This kind of neglect isn’t necessary when there are end-to-end monitoring solutions that offer deep visibility into complex customer service technology environments. Business and government agencies have the means to quickly and economically reduce the time it takes to understand the source of a problem and fix it before customers ever notice the glitch.

Or they can let history repeat itself again.

Matthew Ainsworth is senior vice president, Americas and Japan, at Empirix. He has fifteen years of experience in contact centers and unified communications solutions. Jeff Dell is preempt product manager for Empirix.

[From the April/May 2014 issue of AnswerStat magazine]

Cloud Service Considerations for the Call Center

By Ray S. Naeini

These days we hear a lot about “cloud services,” which may mean managed services, hosted services, software as a service (SaaS), platform as a service (PaaS), or infrastructure as a service (IaaS). Although each term has a distinct definition and application, they all have a similar theme: “You focus on the core, and we will do the chore.”

In a contact center industry, this means that you can focus on the core of your business: sales, marketing, staffing, managing the call center, delivering the services, billing, and taking care of your clients. Chores are delivered by the cloud service and the provider takes care of the chores – the technology-related elements you need to run your operation: your call center’s hardware and software, IT personnel, system rack space, telecom services, technical support services, system upgrades, and expansions.

Cloud services offer a variety of solutions in computing and storage, enterprise and CRM applications, IT hosting, telecom and hosted PBX, email, and Web hosting. According to industry analyst IDC, the overall cloud market will experience 130 percent annual growth and grow to $43 billion by the year 2016.

How Does the Cloud Work for a Call Center? The call center system that handles your services is owned and operated by your cloud service provider and is installed in the provider’s datacenters. The provider routes your numbers to the system installed in its datacenters. These calls are then routed through the network to your in-house or remote agents. Most providers use a voice over Internet protocol (VoIP) network to distribute calls – in which case, your staff can simply use softphones directly connected to their desktop computers or through an adaptor to a local area network (LAN).

You need to have high-speed Internet service when VoIP is used. The provider remotely stores all messages, records, client information, and operational data for your business. Messages such as fax, email, and SMS will be sent from the provider’s datacenter. You remotely access the provider’s system for administration, billing, reports, and other data.

The key advantage is that your provider – not you – is responsible for maintaining the system, keeping it running, replacing faulty or old hardware, upgrading the software, paying the utilities, and hiring IT personnel.

Benefits of Cloud Services: The popularity of cloud services is straightforward due to the benefits they deliver:

Low Upfront Investment and Monthly Payments: This benefit is the most popular delivered by cloud services. Instead of a major upfront investment in a call center system, you pay a much smaller amount, often less than 5 percent of the price of a full system. Granted, you have to pay an ongoing monthly fee, but this model can better accommodate monthly cash flow.

No Software or Hardware Maintenance Expense:Another financial benefit is that there are no costs related to system support services, replacing outdated or faulty hardware, or upgrading your system.

Reductions in IT Expenses: Monthly expenses for maintaining the system, as well as office space and related utilities, will be eliminated. However, you might still need to provide support for your local desktops and other IT equipment used in your office.

Integrated PBX and Call Management Features:In addition to the call center application, if your provider also offers call management features (such as PBX, IVR, auto-attendant, and call screening), you will have a complete solution from a single provider, avoiding PBX equipment and support expenses.

Built-in Redundancy and Disaster Recovery: With a cloud service provider, you will no longer worry about system downtime, redundancy, or maintaining continuity in disasters, such as major storms, hurricanes, or power outages. Your provider’s system is located in a different location, and your agents can access it from home or any other place. Additionally, reputable providers operate multiple datacenters in geographically dispersed locations that can maintain the services even if one of their sites experiences problems.

Operate from Anywhere, Anytime:Cloud services are available to your agents from anywhere with high-speed Internet service. You will have the opportunity to staff from a better pool of talent, schedule agents more effectively, and reduce overall payroll costs.

Rapid Scaling and Feature Deployment: Cloud service providers are capable of quickly adding or removing positions and seats, enabling you to scale up or down much easier. New features can be rapidly deployed without on-premise installations, testing, and implementation. Therefore, your time-to-market with new features and capabilities can be significantly reduced.

Can You Still Use Cloud Services If You Already Own a System?

The answer is “yes” if you need one of the following add-on capabilities:

  • You are expanding and considering buying another system.
  • Your system is old, and you need a new system.
  • You desire better redundancy and disaster recovery.
  • You need to provide additional services that are not present or available on your system.

When you mix your own on-premise system with add-on cloud services, it is called a “hybrid cloud” solution.

Evaluation Criteria: Though there are numerous benefits with cloud services, there are drawbacks as well. You should carefully evaluate cloud services before committing. Here are some considerations:

Provider Longevity, Reliability, and Competitiveness: The most important consideration is which provider you choose. You need to select a reputable provider with a sound business, as well as the means and resources to remain a reliable provider. Your provider should offer duality in systems and datacenters for redundancy and disaster recovery. The provider should be able to continuously offer competitive capabilities and features so you can stay competitive. If you need call management features for your business, look for providers that can reliably offer a turnkey solution, including PBX and call management solutions.

Legal and Contractual Issues: There are many contractual issues to carefully study before signing up with a cloud service provider. You want to sign an agreement that is reasonable in length and includes options to purchase or extend with comparable rates and prices. Ownership of your data and the restrictions applied to prevent the improper use of your data by the provider or its affiliates must be clearly defined in your agreement with the provider. If your services must comply with state or federal regulations (such as HIPAA or PCI-DSS), make sure you select a compliant provider and receive a signed compliance statement.

Data Security: In a survey recently conducted by LinkedIn, fifty-four percent of respondents cited security as a major concern when moving to cloud services. You need to make sure your data is secured and protected by your provider and you have access to your backups and replication data. You should frequently back up your information and keep a local copy yourself. As already stated, if you are dealing with sensitive customer medical or financial information, your provider must comply with security standards.

Network and Technical Issues: If your provider delivers calls through digital T-1 or PRI, you need to carefully study your on-premise configuration, especially if you have a key system or a PBX. Usually there are good solutions, but they need to be thoroughly evaluated. If your provider uses VoIP, you must make sure agents have access to high-speed Internet; otherwise, they will experience delays, dropped calls, or choppy audio.

Business and Financial Analysis: Although one of the compelling advantages of cloud service is its cost savings and smaller up-front investment, you must carefully evaluate the cloud option against your business and financial models to make sure you can recognize the benefits. Some business and financial models may not lend themselves to recognizing the cloud benefits. The availability of long-term and low interest rate leases, sharing of IT resources and facilities among multiple businesses lines, or cost-effective access to software and engineering resources may not render cloud services to be the better choice.

Cloud services will continue to grow and provide compelling justifications. When carefully evaluated and executed, they offer a faster and more cost-effective strategy for growth and business continuity. You owe it to your call center to consider cloud services. The best approach is to find a trusted advisor (if you do not have one in-house) to assist you in a thorough evaluation of the financial, technical, and operational aspects of your call center using cloud services.

Ray S. Naeini is the CEO and chairman of OnviSource, Inc.

[From the December 2013/January 2014 issue of AnswerStat magazine]

The Successful EHR: Provider Input is an Integral Part of Development, Selection, and Implementation

By Ravi Raheja

A recent nationwide survey of physicians revealed that many believe the benefits of electronic health records (EHRs) and electronic medical records (EMR) do not overcome the high investment of finances, time, and frustration. The survey, conducted by athenahealth, found that while 68% of physicians believe that EHRs improve patient care quality, only 49% believe that the financial benefits of implementing EHRs outweigh the costs.

The federal government has spent more than $15.5 billion in EHR incentive program payments to adopt EHR technologies, and money continues to drive EHR initiatives. However, there are three main areas that keep them from being fully adopted and accepted by healthcare providers:

  • Lack of provider centric design
  • IT complexity
  • High initial investment

Provider Needs: Scientific and informal surveys of physicians using EHRs indicate common complaints regarding the usability of EHR programs. This is because many systems were initially developed as billing or practice management systems instead of full EHRs. Every office has a unique workflow and specific needs. Most companies do not have the flexibility, or the expertise, to understand the practice workflow and configure the system to meet their needs. As a result, the practice is forced to adapt to the infrastructure of the EHR, which leads to frustration and inefficiency.

One of the key benefits EHRs are supposed to bring to healthcare is the efficiency of having patient health information readily available to all appropriate healthcare practitioners. Unfortunately, due to the incompatibility of various systems and the lack of standardized integration capabilities, we are a long way from reaching this goal. Many EHRs were developed based on billing needs and, therefore, do not take into account the workflow of the physicians and providers using them.

In addition to the lack of interoperability, HIPAA is a big responsibility for any practice that has electronic information. Ensuring that the company providing a hosted solution or maintaining their own in-house servers requires a lot of time and expertise. This adds another expense to practices that are already allocating resources to billing, referrals, and patient management.

Business Needs: EHRs do not come cheap. Hospitals can expect to pay millions. Large systems, such as Duke University Health System, are shelling out up to $700 million for their EHR programs. Consequently, during the initial implementation of a new EHR system, which can last more than a year, most providers need to reduce their patient appointments and either increase staff time or bring on additional staff. From a business perspective, EHR integration is not something to take lightly.

Unfortunately, even the most prudent planning cannot take into account all potential obstacles. Some providers have found themselves stuck with EHRs that have lost their credentials, leaving the hospital with a system that is no longer qualified to receive government incentives. Other providers are stuck with EHRs from companies that have gone out of business. The only solution available is to invest in another EHR.

Starting Right: The road to a perfect EHR is a long one, but it is not an impossible goal to achieve. The natural development of technology will take care of some of the current issues. However, there is also much that can be done to increase the friendliness of EHRs by both the manufacturers and the implementing providers.

Engineers and End-Users: Great software and technology companies understand the importance of designing with the end-user in mind. Doing that correctly involves bringing together the software engineers and the people they are developing for, the end-users. EHRs created with input from physicians and other program users could minimize, if not eliminate, the common usability issues that have many providers complaining.

Input Teams: EHRs require adjustments in multiple areas of a practice. As such, creating a multi-discipline team with clinical and non-clinical representatives can help select, review, and implement a system that will be more likely to address the needs of all involved. In addition, the added input helps create support for the changes in procedures and can help reduce employee aversions.

Champion Providers: With initial implementation of EHRs lasting up to one year, it is helpful to have some providers from the selection team who serve as champions of the project. Their position is to help roll out the new program, introducing it to other team members and serving as a liaison between staff and administrators, as well as between administrators and the EHR company. Selecting a team of project champions who can rally the rest of the troops through the trials and tribulations of learning and using a new EHR system is an integral part of EHR acceptance and success.

Conclusion: All frustrations, finances, and growing pains aside, EHRs have the potential to revolutionize healthcare on numerous levels. While there are many obstacles to overcome, focusing on the benefits of the completed project and creating working partnerships to productively address issues, we can continue to move EHRs in the right direction.

Ravi Raheja, MD, is the director of sales and technology at The TriageLogic Group. He can be contacted at 855- 887-4243.

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

Strengthen Relationships, Deepen Understanding, and Drive Revenue with Effective On-Hold Programs

By Kara Tarantino

Healthcare providers and hospital call centers rely on the phone to connect people to their services, so it is important to consider the impact the phone has on the total patient experience during times when people wait on hold. The experience patients have with their hospital begins with the first phone call and is colored by every phone call after that. Now, more than ever, hospitals are being evaluated on the perception of the quality of care they provide, and this perception is measured by patient satisfaction surveys and then displayed on Medicare’s Hospital Compare Website.

It is conceivable that one bad experience while waiting on hold, no matter how short, could change a patient’s perception of how she was treated during her entire hospital stay. This, combined with other less than optimal experiences, can ultimately affect hospital reimbursement and the bottom line. Hospitals now know that every voice counts – and so does every ear.

What can hospitals do to provide a better caller experience? The answer lies in twelve simple steps to maximize caller engagement with the right on-hold messaging. Ensuring callers are informed, entertained, and valued will go a long way towards providing a positive and satisfying total patient experience.

  1. Establish a rapport from the first call by demonstrating you value your callers’ time.
  2. Provide relevant and current information that encourages behavior change.
  3. Give your callers something to do, like make an appointment or register for a screening.
  4. Keep your callers interested to prevent hang-ups and drive them to your competition.
  5. Educate your community on your other services. They may be unaware you provide these services.
  6. Establish trust that you are a valuable health resource and not just a place to go to in times of sickness.
  7. Adapt your messaging to audiences who call in frequently, such as employees.
  8. Use messages to achieve specific goals, like recruiting for clinical trials.
  9. Track response by using dedicated phone numbers and targeted Website addresses.
  10. Spark interest with humor and entertaining audio formats.
  11. Have your leadership personally speak to callers to demonstrate that your commitment to quality care begins at the top.
  12. Measure results via your call center when you gather new patient information and ask how they heard about you.

Your calling audience is made up of listeners. Callers to hospitals and physician practices are often stressed, anxious, and needing reassurance. Your messages should be written for the ear, relevant, and interesting so they can be easily recalled. They need to take health literacy standards into consideration so people can understand what they are hearing and easily act upon the information. When you take each caller into consideration, it is possible to alter the perception of your quality of care.

The Emory HealthConnection call center in Atlanta does an excellent job of capitalizing on the opportunity to connect with callers via on-hold messaging and change the perception of the healthcare waiting experience. They are consistently successful in recruiting candidates for clinical trials, referring callers to physicians, setting appointments, and increasing event and program registration. The marketing department’s efforts are buoyed by the cost-effectiveness of the medium, the on-hold messaging system’s ease of use and flexibility, the high visibility afforded to their services and events, and the ease of fixing mistakes with little cost (unlike print, radio, or TV advertising.)

A holistic approach to quality care that includes addressing the needs of callers placed on hold can help hospitals redefine the patient experience, which is so critical to improving patient satisfaction scores. With the right communication tools, hospitals and other healthcare providers can ensure optimal patient engagement and further their strategic initiatives when they use relevant patient education, compassionate messaging, wit, humor, and messages in the voices of leadership. When you begin by addressing the needs of your callers, the right on-hold messaging system sets the stage for communicating more effectively with every person along the care continuum. In the end, the most successful healthcare providers will be those that consider every ear and every voice.

Kara Tarantino has led marketing at Vericom Corporation for 18 of its 24 years, diligently working to help clients improve the patient and employee experience with more effective internal communication. A results-driven strategic marketer with 25 years in the healthcare industry, Kara is passionate about bringing health literacy messaging mainstream and developing content for healthcare audiences that can positively affect patient behavior.

[From the August/September 2013 issue of AnswerStat magazine]

Hospital Communications and Critical Messaging

By Ted McNaught

The past decade has seen remarkable innovation in hospital communications. While cellular technology created platforms for enhanced integrated communications, many hospitals still rely on paging for critical messaging. This is because the simulcast technology used by paging is incredibly reliable during a natural disaster or crisis when cellular networks are often disabled or overloaded. Also, in remote rural areas, paging often has superior reach compared to cellular network coverage.

These three case studies illustrate how this time-tested technology remains at the center of many hospitals’ communication and critical messaging system.

Critical Messaging in the Eye of the Storm: West Tennessee Healthcare and its 5,000 plus employees serve a sprawling swatch of the state with six hospitals, over twenty clinics, a freestanding outpatient surgery clinic, and other facilities and services. The centerpiece of the organization is Jackson-Madison County General Hospital. With 635 beds, Jackson-Madison provides services to the local population and is part of the disaster management team for the area. The facility also serves as the emergency hospital in case of disaster in Memphis, ninety miles away.

For years, Jackson-Madison relied on its own short-range radio transmitter to provide the power for its critical messaging needs. That changed in 2003 when a tornado blew down the tower supporting the transmitter. The hospital was still able to use their existing provider and system for in-house paging, but the cost of restoring the tower was prohibitive.

Kathy Mealer, telecommunications manager for West Tennessee Healthcare, brought in a vendor to provide off-campus paging. From the onset, the hospital was plagued with spotty coverage, especially in rural areas. “The paging provider threw a lot of technology at us in an attempt to improve our coverage, but it didn’t solve our problems,” noted Ms. Mealer.

In 2005, Ms. Mealer looked for other options to meet their critical messaging needs. Part of the solution was the installation of five new transmitters to build coverage based on the specific needs of Jackson-Madison Hospital. They also had a backup terminal installed to provide redundancy in case of emergency. “Pagers have been the only thing that have worked when we have tornadoes, and the backup terminal has been critical on several occasions,” said Ms. Mealer.

Today, 2,200 Jackson-Madison Hospital pagers are supported by this critical messaging system. Additionally, work was done with the hospital’s medical center EMS to create more redundancy for their system and to facilitate multi-page capabilities. The paging system also has helped improve efficiency and bed turnover for the hospital’s bed board and patient transport systems.

“Reliable communication is imperative for Jackson-Madison if we’re to provide disaster services to our community and Memphis following tornados and other emergencies,” concludes Ms. Mealer.

Local Commitment to Paging Solves Coverage Issues: For Wentworth-Douglass Hospital, one of the largest acute care hospitals in New Hampshire’s Seacoast region, the reliability of its paging network is also crucial. When team members and other staff started missing pages while on-call and away from the hospital, solving the problem became a priority.

The hospital’s telecommunications team discovered their national provider was removing transmission towers in “fringe” service areas – without notifying customers. This explained the decline in out-of-building coverage. However, a service outage and poor customer service drove Wentworth-Douglass to take action.

“We were blindsided by an unannounced service outage that knocked out more than 400 recorded pager greetings that we then had to go back and manually restore,” said Todd Johnson, telecom engineer for Wentworth-Douglass. “Not only was that incident incredibly disruptive and time-consuming, it could have been avoided with better customer communications and service.”

Wentworth-Douglass conducted a side-by-side comparison of a regional paging network with the hospital’s current national provider. The test was simple. Wentworth-Douglass telecommunication staff carried a pager from both systems. During the test phase, all pages were sent to both devices to staff covering a variety of locations. The hospital then initiated a second test, this time with their critical teams.

The results were dramatic. The regional system solved the coverage issues and outperformed on delivery time, getting messages to pagers 50% faster. For a critical team that is timed on their callback response, these additional seconds can make all the difference.

While some national paging carriers may put less focus in certain markets and remove transmission towers, regional carriers are generally more committed to local market coverage and service.

Paging: The Gold Standard for Critical Messaging: Over the past twenty-five years, Southern Maine Medical Center (SMMC) has seen steady growth in the number of employees, programs, and facilities. Today, SMMC is a dynamic healthcare provider with more than 1,500 employees – approximately 200 of those are active physicians. In addition to a 150-bed full service medical center, SMMC also provides services at sixteen facilities located throughout southern Maine.

During this period of growth, SMMC made it a priority to maintain a critical messaging system that can meet their standards for fast, reliable communications, both on and off campus. Given the organization’s growth, that goal has faced the challenge of reaching more employees who work and live in a larger, often rural, geographic area. More recently, the adoption of smartphones by staff has added complexity to the communications mix.

SMMC has maintained its own in-house paging system for close to forty years. According to Joan Camire, SMMC supervisor of telecommunications, “Anyone who wants to be found needs to carry a pager.” In fact, all clinical and on-call personnel are required to carry pagers. There are 400 internal pagers, including the code team, that cover this key critical messaging category. SMMC also has several common cap codes for in-house and group pages that are used for incident events.

Camire, who has been with SMMC since 1968, notes that when the organization began growing, their in-house paging didn’t cover enough range – especially with workers moving further away. They began working with a regional paging company to provide off-campus paging coverage, working to program individual pagers to make certain that critical messages are delivered, no matter where the recipient is located.

All of SMMC’s pagers are alpha numeric, and SMMC’s IT department has written and implemented a program that makes it easier for staff to send and receive pages. Utilizing the paging program, users enter the name of the person to be paged, and the pager number is automatically inserted – without them needing to memorize numbers. The user then just enters the text, and the program automatically appends the name of the person for the return call.

“Paging has proven to be the fastest, most reliable way for us to communicate with employees, both on and off campus,” stated Joan Camire. “We’ve also seen that patients respond far more positively when they see staff communicating with pagers as opposed to smartphones. The perception is that the pager is a professional device, while the cell phone is not work-related.”

SMMC also leverages paging for its nurse call system, with alerts going directly to the nurse assigned to that patient. The paging system is even tied into EKG monitoring and will act as an alarm system for assigned caregivers. Additionally, alerts from the local county emergency management administration regarding severe weather and public safety and health issues are sent to the pagers of designated hospital staff.

“There have been a lot of developments in the past twenty years in communications technology and devices, but throughout it all, paging technology remains the gold standard for healthcare communications,” said Camire.

Ted McNaught is the president and COO for Critical Alert Systems and the president of the Critical Messaging Association.

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

Sharpen Your Contact Centers’ Reflexes to Better Respond to the Unexpected

By Matt McConnell

The modern healthcare industry is a tough place for contact centers to thrive. There are more patients, specialty providers, technology systems, and constituents, as well as more competition for services than ever before.

Customer interactions are more complex, and agents must be highly skilled to handle all kinds of inquiries, from appointment scheduling and pre-certification and authorization of services to billing, insurance questions, and even patient complaints – all while remaining transparent and maintaining the highest possible level of customer service.

This level of agent knowledge and competency requires consistent, ongoing training and coaching. At the same time, no matter how efficient your center – or how much time you spend planning to ensure staff levels meet customer demand – you still have agents sitting idle every day.

In fact, the average contact center agent spends forty-nine minutes of the day in an available state, waiting for the next call. To compound the problem, these forty-nine minutes come in small chunks of just a few unproductive minutes at a time.

This presents a major challenge for workforce managers who are charged with ensuring staff levels meet customer demand. At the same time, they must find enough available time to train and develop agents, schedule mandatory off-phone activities, staff against unplanned absences, and deal with a variety of unforeseen events that quickly turn a workforce manager’s day into a nightmare.

Sometimes, managers plan for this by either operating at the status quo for occupancy or overstaffing to reduce wait times and handle more calls. Plus, training is scheduled and rescheduled based on call volume, which is both expensive and ineffective. Fortunately, there is a better way.

Intraday Management Technology: With intraday management technology, contact center managers are able to respond to unexpected events and spikes in call volume while keeping agents productive and without compromising overall service levels. The technology works with a center’s ACD to identify small pockets of idle time between customer interactions across the entire agent population that can be aggregated into larger blocks of productive time for a smaller group of agents.

Managers create an activity queue for each agent that prioritizes off-phone activities based on the agent’s individual strengths and weaknesses. When a block of time becomes available, these activities – which can include coaching, training, back office work, communications, or other off-phone activities – are delivered directly to the agent to complete.

Idle time is transformed into active wait time, and agents can complete meaningful activities that continuously improve their performance and make them better at their jobs. When call volume unexpectedly spikes or predetermined service levels dip, agents are directed to log off and return to answering calls. Managers can also use this technology to send automated offers of overtime and voluntary time off to help better manage staffing levels or to send important alerts and notifications.

Business Impact: One leading healthcare sales and account manager provider was able to use intraday management technology to dramatically improve call quality and first call resolution (FCR). The company – with more than 7,000 employees, including 2,750 claim processors and 3,250 customer service representatives – used intraday management technology to address call quality issues and focus the company around customer loyalty.

Using a proven call model, the company’s training staff created a library of short “learning breaks” and delivered them to agents based on individual performance gaps as identified by quality monitoring systems, performance systems, and supervisor feedback. The training was delivered during downtimes in call volume, and agents were provided with a scorecard to help them track their progress in the areas of quality, productivity, and average handle time.

The results were impressive. After the first year, the company was servicing one million new members, but with 10.7 percent fewer full-time employees. Average speed of answer (ASA) improved by more than twenty-seven percent, and there was a 1.5 percent improvement in quality results.

Other areas of business improved as well. Claim rework improved by 61.3 percent. The percentage of claims processed within ten business days improved by 5.1 percent, and the percentage of claims processed beyond twenty business days was reduced by 88.2 percent. The overall accuracy of claims processing improved from 96.2 percent to 97.1 percent.

Get Control of the Unexpected: In the contact center, the one thing you can expect is the unexpected. Unscheduled events will occur, and call volume will continue to be impossible to accurately predict. But intraday management technology gives you the power to respond to the unexpected in real-time, while finding more time for agents to improve their performance.

Not only do managers gain more control, but agents also become more proficient at their jobs. And, most importantly, customers receive a better overall experience.

Matt McConnell is CEO of Intradiem, formerly Knowlagent, a provider of intraday management solutions for contact centers. For more information call 888-566-9457.

[From the April/May 2013 issue of AnswerStat magazine]

The ABC’s of Data Security

By Dr. Ravi Raheja

As hospitals and practices race to implement electronic medical record systems, their IT departments have less time to work with other technology projects. While the benefits of working with a hosted call center are abundant, call-center IT is not on the priority list of the information technology division of any organization. One way to work around this is by using hosted products or SaaS (software as a service) solutions. These hosted solutions decrease or completely remove the burden of maintaining call center functionality.

Benefits of a Hosted Solution: There are several key benefits of using a hosted solution, including:

  • Decreased cost: In general, hosted solutions have a lower up-front investment. This benefits organizations that do not have a large capital budget.
  • Increased speed of deployment: Companies that provide hosted solutions specialize in implementing their products. This enables call centers to get functions and features in a relatively short time frame. It also prevents the call center from having to get onto their own IT’s priority list to get the project started.
  • Increased flexibility: Most hosted solutions are Web-based. This inherently allows better remote access and easier updates to the system. Quality hosted solutions also provide a variety of configuration options that allow the client to customize the software to meet their individual needs.

Data Security: While using a hosted product minimizes many complications, organizations must ensure that their data is not only available 24/7, but that it is properly secure and managed in accordance with HIPAA standards. In the case of hosted call centers, the product vendor is relied upon to provide the proper infrastructure and security to maintain compliance with HIPAA. As such, it is important that medical organizations know what to look for and the questions to ask when they are considering a hosted solution or SaaS.

Hosted solutions are involved in two main aspects of security, the security of the actual server and the security of the data center. Both of these aspects have standards that can be followed to ensure that the hosting company is providing the high level of quality security required of a medical system.

The Digital Dozen of Server Security: The PCI Security Standards Council originally developed a framework of specifications and tools to certify the safe management of credit card data. At the cornerstone of this framework is the PCI Data Security Standard (PCI-DSS). PCI-DSS is comprised of twelve requirements designed to ensure the security of data hosted on a server.

As medical systems have inherently sensitive data, these same requirements are now utilized in quality medical IT systems. Medical practices interested in working with a hosted call center should verify that the twelve PCI-DSS requirements are being followed:

  1. Install and maintain a firewall configuration to protect PHI (protected health information).
  2. Do not use vendor-supplied defaults of system passwords and other security parameters.
  3. Protect stored PHI.
  4. Encrypt transmission of PHI across open, public networks.
  5. Use and regularly update antivirus software or programs.
  6. Develop and maintain secure systems and applications.
  7. Restrict access to PHI by business on a need-to-know basis.
  8. Assign a unique ID to each person with computer access.
  9. Restrict physical access to PHI.
  10. Track and monitor all access to network resources and PHI.
  11. Regularly test security systems and processes
  12. Maintain a policy that addresses information security for employees and contractors.

Certified and Audited Data Center Security: Just as there are standards for the security of the server, there are standards for the security of the data center. The data center, where all the data is housed, must have a variety of security safeguards in place in order to properly protect the data it stores.

  • Independent auditing: Annual auditing of all systems of service should be completed.
  • IT staff that is ITIL certified: ITIL is a framework for identifying, planning, delivering, and supporting IT services. Having ITIL certified staff ensures the delivery of appropriate services and continual developments to meet business goals.
  • SSAE-16 certification: A highly regarded certification for data centers is SSAE-16 certification, signifying centers that meet the qualifications and adhere to a strict set of international standards. Due to the stringent auditing involved, choosing an SSAE-16 service provider ensures the highest levels of transparency and accountability.
  • ISO 9001:2008 certified and registered: This family of standards is designed to ensure that companies meet the needs of customers while complying with statutory and regulatory requirements. Certified through an independent auditor, the certification is based on an extensive sample of its sites, functions, products, services, and processes.

Other Critical Considerations: While highly technical and management standards are vital to data safety and security, do not overlook the importance of two other security-focused standards that a hosted call center should have in place:

  • Data hosted and stored in the continental United States: Not all countries adhere to the same strict standards as the United States. If you need to follow US security standards, it is important to make sure that the data is continually hosted and stored in the US to avoid data and privacy corruption.
  • Disaster recovery plan: Make sure a plan has been developed to optimize server up time and provide a backup server that is less likely to encounter the same circumstances as the primary.
    • Backup server in another physical location on the opposite coast
    • Live database replication to backup server – within seconds
    • Daily and hourly database dumps
    • Replication logs of every data change can be re-run to rebuild databases.

Seven Questions to Ask: Medical organizations interested in working with a hosted IT solution should have a basic understanding of the standards and certifications discussed. By simply asking potential service providers the following questions, you can identify how secure your data will be.

  • Do your servers meet all twelve PCI-DSS standards?
  • By whom and how often is your data center audited and certified?
  • Is your IT staff ITIL certified?
  • Are your data centers SSAE-16 certified?
  • Is your data center ISO certified?
  • Is your data hosted and stored in the continental United States at all times?
  • What is your disaster recovery plan as it relates to data?

Dr. Ravi Raheja is CEO and director of sales and technology at TriageLogic. Please contact him with questions or comments at ravi.raheja@triagelogic.com

[From the April/May 2013 issue of AnswerStat magazine]