Tag Archives: telehealth articles

Send Your Call Center Back to School

Now Is an Ideal Time to Enhance the Skill Level of Your Telephone Staff 

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan

We live in interesting times, to say the least. Too often the healthcare call center industry spends much time focusing on the crisis of today that it squashes all thought about planning for tomorrow. Once we slip into crisis mode out of necessity, it’s too easy to stay there out of habit—even if there is no longer any justification for it.

We may stand at that juncture now. This means it’s time to balance our work for today with taking initiative to prepare for the future. If we don’t, we won’t make forward progress; we’ll merely survive. Though survival is necessary, we need more if we hope to find success and enjoy fulfillment. I’m talking about ourselves, our staff, and our organization.

One aspect of future preparation is education. This can be formal or informal, structured or ad hoc, and mandated or self-determined. Though the application relates to everyone in the call center from new hire to director, let’s—by way of example—consider this for your telephone representatives. I’ll leave it to you to extend this throughout all staff in your operation.

Refresher Training

When we think of our call center staff going back to school, consider refresher training for the first initiative. It never hurts to revisit the basics. Though it may feel as though our existing staff has moved beyond this elementary teaching, the basics can atrophy over time. 

Agents will forget some of this instruction. Or maybe they never fully grasped other skills to begin with, even though they seem to be doing well in their jobs overall. The problem is the specifics of what teaching to refresh varies from one person to another. Therefore, it’s good to review everything.

Yes, I already hear your staff complaining. But this refresher initiative doesn’t—and shouldn’t—take as long as the first iteration. It should go much faster. Perhaps you can condense a day’s worth of training into an hour—or even less. The important thing is to make sure these basic skills don’t slip away over time.

Application Instruction

A second option for going back to school is to look at application instruction. When new software or an app enters your call center, agents need to receive instruction to know how to use it. Too often the urgency of the moment cuts this training short; it’s sometimes even omitted. This forces your phone representatives to figure it out on the fly. Though this may seem pragmatic or feel necessary, on-the-job-training frustrates employees who want to provide excellent service, and it’s disrespectful to callers who expect to receive it.

Go back and provide complete training on new software applications, as well as for major updates. Everyone will appreciate receiving this much-needed instruction.

Skill Enhancement

After reviewing the basics and mastering call center software apps, we can go back to school to enhance our skills. Your telephone staff receives initial onboarding training when they’re hired. 

As they go about their daily work, they apply that training and build upon it to increase their skill level. But this isn’t enough to ensure excellence, let alone produce successful outcomes. Your seasoned staff is ready for more. They need more. And you can provide it for them by teaching advanced call center service techniques. 

This may relate to customer service skills, problem resolution techniques, or de-escalating angry callers. It could also cover the seldom-used but much-appreciated advanced options available on your software platforms and databases. Staff won’t use these skills often, but when the situation arises possessing the knowledge of these advanced techniques can make the difference between an unsuccessful interaction and a positive outcome.

Conclusion

As students everywhere return to the classroom this fall, do the same thing for your call center staff: send them back to school. Providing refresher training, application instruction, and skill enhancement will help them do their jobs with greater efficiency and produce higher quality outcomes. 

Don’t let another year go by without giving your staff this much-needed support. The result will be happier employees and better served customers—in addition to a more effective call center operation.

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

Mental Health and Nurse Triage Calls During COVID-19

By Dr. Charu Raheja

TriageLogic

According to the Kaiser Family Foundation, 53 percent of American adults estimated that the COVID pandemic had a negative effect on their mental health. We looked at data from our nurse triage service to understand how mental health may be related to COVID cases in the United States. 

Triage nurses don’t receive many mental health related calls. While there are protocols in place for such cases, nurses are not trained mental health professionals. Calls about mental health are extremely low as patients only call if they feel they have no one else to talk to. However, during the COVID pandemic, we saw spikes in the number of patients who called about mental health. 

(Figure 1)

Figure 1 presents the number of calls about mental health that we received from January–October 2020. We include calls about both anxiety and depression. These patients who called the triage nurse line were not experiencing medical symptoms; they were calling only about mental health. Those who experienced anxiety or depression along with medical symptoms would have been categorized in the appropriate triage protocol. Figure 2 presents the total number of COVID cases in the US by month. 

(Figure 2)

We find that in the beginning of the pandemic, there was a large spike in the number of mental health related calls we received. The triage nurses received about ten times as many calls about anxiety in April compared to January 2020. After this initial surge, the number of mental health-related calls decreased, but remained elevated. We also found that anxiety increased with surges in the number of COVID cases in the US. 

Our results show that mental health became an important health concern during the COVID-19 pandemic and that patients began to reach out to medical professionals for advice. One reason may be that the pandemic disrupted mental health services even as people began to experience more mental health concerns. Nurse triage also serves as a way for patients to reach out to providers. Patients may have also called the nurse triage service because they were anxious about COVID and sought information or reassurance, even if they were not experiencing symptoms. 

For more data about symptoms and outcomes of our nurse triage during COVID-19, check out our white paper, which contains information that can help you better understand patient behavior during a major health crisis. 

TriageLogic

Dr. Charu Raheja is the co-founder and CEO of the Triage Logic Group. The TriageLogic Group provides telehealth software, mobile communication solutions, and services to large medical centers and businesses around the country. It is part of the Women’s Business Enterprise National Council (WBENC), and it covers over 25 million lives nationwide. 

Contact Amy Smith at 888-TEAMTLC for more information.

Remote Patient Monitoring and the Future of Remote Nurse Triage

TriageLogic

By Ravi K. Raheja, MD

Remote Patient Monitoring (RPM) is on track to be the future of healthcare, especially as the number of chronic care patients and the cost of healthcare increases annually. RPM is the use of technology to gather patient health data from an individual. A clinic or nurse call center electronically evaluates the information. 

RPM is starting to gain traction by many in the medical field because it improves patient care. Most of these devices can capture data that the patient does not necessarily observe. These regular readings give meaningful information that can help providers see the bigger picture when it comes to a patient’s condition and outcome. 

This technology, usually in the form of a device that can go home with a patient, can monitor important health factors such as blood pressure, blood sugar, and respiratory rate. It allows doctors and clinicians to regularly check patient vitals before a patient presents a symptom that would require an office visit. 

Remote triage nurses monitor patient data and ensure patient safety. After the patient goes home with their device, these nurses monitor all the health information it provides. Non-clinical staff make sure patients use the device properly and call then back if the data is not coming in as expected. Nurses review patient data and contact patients if they see concerning information. 

They ask patients questions to determine if physician intervention is needed. They also provide additional information or ask questions based on individualized physician instructions. Non-clinical and clinical staff are a bridge from patient to doctor and they alleviate the burden on provider.

In the United States, six in ten adults in the United States suffer from some form of a chronic disease, such as obesity, diabetes, or heart disease. Chronic diseases are responsible for 75 percent of the 3.5 trillion dollars spent on healthcare each year. Overall, it’s estimated that widespread adoption of remote patient monitoring could save the U.S. as much as $6 billion annually.

For doctors and medical organizations, this translates into improved patient care while at the same time giving providers the ability to increase their annual revenue per patient. First, the regular monitoring of patient vitals provides efficient scheduling of follow up visits when necessary based on abnormal readings. Second, CMS reimburses doctors for the cost of the RPM device and for the time it takes to monitor patient vitals. The reimbursement amount allows doctors to earn extra income each month even after considering the costs of outsourcing the monitoring. 

RPM is on the forefront of healthcare. With the ability to closely monitor chronic patients in a safe, cost-effective manner, RPM is one of the fastest growing medical technologies in the medical field. The goal is to help both patients and physicians by providing tools to improve care while decreasing the burden on physicians. 

TriageLogic

Ravi K. Raheja, MD is the COO and medical director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC accredited, physician-lead provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. Their comprehensive solutions include integrated mobile access and two-way video capability. The TriageLogic group serves over 9,000 physicians and covers over 20 million lives nationwide.

The Future of Hospital Contact Centers

1Call, a division of Amtelco

By Nicole Limpert

Even though the Oxford English Dictionary first published and recognized the phrase “call center” in 1983, the origins of call centers date back to the 1960s with the use of answering services. 

Doctors have used medical answering services for decades. During normal business hours, answering services can take some of the workloads off medical office staff so they can focus on patient care. After hours, these services take messages from callers and relay them to the covering doctor.

Traditionally, medical answering service operators would contact doctors via pagers. The agent would alert the on-call doctor with a page, and the doctor would call back to the answering service to find out more details.

Hospital Call Center Evolution

As technology developed, the healthcare industry began to establish its own call centers. Hospital call centers not only help with on-call needs, but they can also assist hospital systems with managing billing, collections, and patient communication. Healthcare call centers have proved to help streamline communications, improve efficiencies, enhance the patient experience, and even reduce expenses.

Medical call centers have become the hub of communications for health systems. The call center software they use is becoming more advanced and turning call centers into contact centers. While call centers primarily focus on voice calls, contact centers provide additional communication services by allowing people to contact the organization via live support/chat, social media, instant messaging apps, direct website interfaces, and email. 

Contact center agents receive training to use each communication channel to engage patients and adhere to a healthcare system’s best practices. Reporting and agent performance metrics are adapted for each channel depending on its functions and capabilities.

Automation Technology

Some contact centers use automation technology to bolster their services with bot agents and chatbots. The most common contact center automation trends include:

  • Chatbots and conversational interface tools.
  • Active listening tools such as natural language processing, natural language understanding, and natural language generation.
  • Robotic process automation to replace tier 0 caller support and other uncomplicated interactions that are task-oriented and programmable. 
  • Statistical machine learning that uses algorithms to mine data and find patterns to continuously improve systems.

However, bots can’t process unique requests, handle complex situations, or express empathy. Therefore, some medical contact centers prefer a hybrid automation solution. Used strategically, hospital contact centers can use automation to streamline communications and workflows by:

  • Escalating complex calls to the most qualified agent.
  • Providing a self-service interactive voice response (IVR) option for common or routine requests.
  • Using automated forecasting to help interpret massive quantities of data gathered by their software to understand trends, make predictions, and schedule staff.
  • Program agent scripting protocols to ensure the most updated information is given to callers and to guide operators through complicated calls.

Omnichannel Contact Centers

The combination of different communication channels, multiple healthcare departments, and possibly many hospitals and clinics within one healthcare system means that communication needs to be a seamless, singular experience for callers.

In healthcare, miscommunication can be life-threatening. Omnichannel contact centers are the most advanced type of contact center. They avoid the pitfalls of working in silos by optimizing technology across all channels, so the entire caller journey is visible. Leveraging this data helps to enhance the patient experience, improve agent efficiency, and better meet organizational goals.

Virtual Contact Centers

Medical contact centers are an extension of a hospital or healthcare center’s operations and are available 24 hours a day, 7 days a week. They have become especially crucial during the current pandemic and many operators are working from home. Web-based virtual agent software makes remote work possible by turning any personal computer into a professional agent workstation accessible via the internet or a hospital’s local intranet. All the tools used by an agent in a contact center are accessible to the virtual agent.

Establish a virtual private network (VPN) connection for remote operators to ensure their connection is secure. Once agents connect to the VPN, they can create their remote agent connection for data and audio. Options to establish the data connection can occur via direct connection, remote desktop, thin client, Citrix, and VDI, and an audio connection via integrated audio or external audio.

The digital tools that on-premise agents use are also available to agents working remotely. Any updates made to those tools, the software, or scripting language happen instantaneously for all agents, so they have the exact information they need to provide the best patient experience and reduce error rates.

Digital Future

Engaging with patients and community members across multiple channels, and using that data to better serve them, requires forward-thinking strategies. In the future, successful hospital contact centers will evolve to keep up with other healthcare technologies and become digital-first communication hubs for their patients.

These hubs will play an even bigger role in helping healthcare organizations improve patient care by connecting patient experiences from across their enterprise for a more complete understanding of a patient’s journey. 

1Call, a division of Amtelco

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

Video-Based Doctor Visits, Revisited

LVM Systems

By Mark Dwyer

Three years ago, I wrote an article for the September 2017 issue of AnswerStat titled Video-Based Doctor Visits. At the time, I proposed video-based doctor visits as a solution to address the shortages of primary care physicians. Little did I know it foreshadowed a much greater need for virtual visits in 2020 due to the Coronavirus pandemic. COVID-19 made scheduling face-to-face doctor visits nearly impossible. 

Not only has the pandemic increased the need for video-visits, but our aging population and a declining supply of primary care physicians have also increased our healthcare shortfalls. According to the updated 2020 projection from the Association of American Medical Colleges (AAMC), by 2033, the United States will have a shortage of as many as 54,100 to 139,000 physicians, with primary care representing between 21,400 to 55,200 physicians.

In many areas of the country, there are not enough primary care physicians to handle the patients physically able to come into an office setting. However, that is not the only concern resulting from the shortage. An estimated two to four million people need doctors, nurses, and healthcare providers to make house calls. Unfortunately, the number of physicians and health practitioners who make house calls has also significantly decreased over the years. According to the Health Resources & Services Administration (HRSA), telehealth is especially critical in rural and other remote areas that lack sufficient healthcare services.

Telehealth to the Rescue

A recent HHS report found that virtual visits accounted for over 43 percent of Medicare fee-for-service primary care visits in April 2020. That compared with far less than 0.1 percent in February 2020. The HHS reported that virtual visits continued to be frequent even after in-person primary care visits resumed in May of 2020. The continued use of virtual visits indicates that they are likely to be a more permanent part of the healthcare delivery system.

Telehealth visit solutions have the power to change the way we provide and receive healthcare for the better.

An article in Becker’s Hospital Review, January 20, 2021, further supported telehealth’s permanence. “We have been talking about telehealth for nearly thirty years, and in the year 2020 especially, the need for virtual health services has escalated globally.”

The recent actions of Amazon bear this out. Another article in Becker’s Health IT on March 17, 2021, stated, “Amazon is launching its virtual medical service Amazon Care for its employees in all fifty states and Washington, D.C., this summer, with plans to expand the offering to other employers later this year.” Amazon would not pursue virtual visits if they did not believe they were here to stay and sure to be profitable.

A McKinsey’s survey in April 2020 found consumer adoption of telehealth has skyrocketed, with almost 70 percent of in-person visits canceled in the United States. Canceling in-person visits has helped in decreasing the transmission rate of COVID-19 and limiting exposure to patients. Patients are rapidly transitioning to telehealth, with 76 percent of survey respondents suggesting that they were highly or moderately likely to use telehealth going forward.

According to a Mayo Clinic article on May 13, 2020, even before the COVID-19 pandemic, video technology helped doctors connect with people in rural locations. More than half of U.S. hospitals and medical centers now use telehealth in some way. The Mayo Clinic found that most people report a positive experience with online visits. 

Mayo further identified that many people also say the real-time consultation can be just as effective as an in-office visit. In addition, while social distancing remains needed during the COVID-19 pandemic, video visits for medical care offer a way to access timely care without leaving home.

The Call Center’s Role

So how can the call center play a vital role in offering telehealth services?

Triage call centers focus on getting patients “the right care—at the right time—at the right place.” Adding virtual visits as a triage endpoint for immediate, real-time appointments expands the call center’s services while providing enhanced customer service. The most successful organizations that offer triage call centers will be those with a strategy to integrate virtual visits. Telehealth benefits include convenience, access to care, better patient outcomes, and a more efficient healthcare system.

Finally, during his recent Senate confirmation hearings, Mr. Becerra indicated his support for permanent telehealth expansions. According to a February 25, 2021 article in Politico, Mr. Becerra said he wants to boost technology accessibility and is committed to permanently expanding payment policies that have increased virtual health during the COVID-19 pandemic.

To learn more about implementing a telehealth program or integrating it with your existing efforts, reference telehealth.hhs.gov/providers/getting-started.

LVM Systems logo


Mark Dwyer is a thirty-three-year veteran of the healthcare call center industry and the COO at LVM Systems. LVM provides healthcare call center solutions that support nurse triage, disease management, behavioral health intake, patient transfer, and referral/marketing services, including consumer-centered web products.

How Insurance Reimbursements Make Remote Patient Monitoring Profitable for Healthcare Organizations


TriageLogic

By Ravi K. Raheja, MD

The COVID-19 pandemic has encouraged healthcare organizations and physicians to adopt remote healthcare more readily, from telehealth visits to remote patient monitoring (RPM). The need to care for patients efficiently from their homes and to assess a potential serious health problem has ushered in the future of the industry. This improves patient outcomes and decreases morbidity and mortality. Reimbursement from commercial and government health insurers has made this shift financially possible for doctor’s offices and hospitals. 

According to a new report by McKinsey & Company, remote patient care will account for about $250 billion (about 20 percent) of what Medicare, Medicaid, and commercial insurers spend on outpatient, office and home health visits in the near future. Remote patient monitoring for chronic patients is part of this new, technological wave taking over healthcare to improve patient outcomes.

RPM devices track essential vital signs such as blood pressure, heart rate, blood glucose levels, oxygen saturation, and temperature. There are also RPM devices for weight, patient activity, and sleep. The kinds of devices are expanding and becoming more comprehensive all the time. Their goal is for doctors to be able to regularly monitor patient vitals for signs of change and be able to intervene before a patient presents a symptom that would lead them to seek care. This webinar explains the RPM model and how to non-clinical call centers can make the process efficient for doctors. 

Reimbursement for Remote Patient Monitoring

In 2017, The Centers for Medicare and Medicaid Services (CMS) published a two-year study on its Chronic Care Management program, which laid out how RPM saved Medicare millions of dollars, decreased hospital readmissions, and increased patient education about their chronic ailment. These key goals make up a broad picture of value-based care.

CMS expanded their support for RPM since the pandemic stirred up interest in remote care projects. CPT (current procedural terminology) codes are available to help doctor offices make RPM programs profitable while also improving patient care. These codes provide a financial structure for physicians to receive reimbursement for the time spent and the equipment used. 

As far as actual figures, on average, CMS approved reimbursements of $120 per patient per month. Thinking bigger, if fifty patients enroll in an RPM program, a doctor’s office can generate $72,000 a year in revenue. 

Provider and Hospital Benefits

In addition to the increase in revenue from current patients, it is important to consider how RPM can affect a practice’s patient base. Some statistics are eye-opening. Nearly 25 percent of people polled stated they would switch to a new physician to access telehealth. As remote care becomes the norm and patients begin to acclimate to new platforms, it’s worthwhile to consider if patients can be lost to practices who use RPM. Fifty-one percent of patients are in some way uncomfortable with in-office visits, in addition to 42 percent feeling uncomfortable going to a hospital for any medical treatment, and 45 percent feeling uncomfortable using an urgent care or walk-in clinic. 

There are even more cost-saving CPT codes which can maximize profits. There is a code for initial setup of the device and patient education. An additional code can be billed each thirty days for supplying the device. Twenty minutes or more of clinical staff time in a calendar month spent interacting or communicating with a patient is also reimbursed. Collection and interpretation of data brought in by the device and digitally stored or transmitted to a patient through the physician is another helpful CPT code. 

Implementing Remote Patient Monitoring 

Setting up an RPM platform is an investment towards the future. Strive to create an onboarding experience that is efficient with minimum provider time. For example, nurses can educate patients, and non-clinical staff can track device data.

TriageLogic


Ravi K. Raheja, MD is the COO and medical director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC accredited, physician-lead provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. Their comprehensive solutions include integrated mobile access and two-way video capability. The TriageLogic group serves over 9,000 physicians and covers over 20 million lives nationwide.

4 Ways Healthcare BPO Partnerships Deliver



By Austin Ridgeway

Healthcare has certainly made strides toward providing a member and patient experience to rival the consumer-centric disruption of other industries. But while healthcare has been slightly behind the B2C (business to consumer) curve, payers and providers lead other industries when it comes to leveraging business process outsourcing (BPO) strengths such as co-creation, design thinking, and lifecycle reference-ability of processes.

Faced with the heightened prioritization of customer needs, experience, and value stream impact, health organizations are more familiar than most industries with BPOs and the value they can deliver.

Healthcare’s History with BPOs

Over the years, the healthcare market has relied on outsourcing partners that bring strategic insights, optimization, and efficiencies to critical operations. Today’s more evolved healthcare BPO partnerships speak to the dramatic shifts in how the industry is assessing vendors and to the maturity of healthcare’s adoption of these resources.

Healthcare organizations—managing a fine and often challenging balance of front and back-office demands—have worked closely with BPO providers to adapt to changing market trends, technology, and customer demand. And the BPO approach has matured from an outsourced, single locale solution to coordinated efforts across geographies to optimize talent allocation, process efficiency, and data analysis. 

Some may say that these changes pose challenges to the outsourcing model. However, it is the opposite—and notably for healthcare’s reliance on end-to-end solutions. Over the past forty plus years of outsourcing’s history, many BPO organizations have transcended their roles as providers of labor arbitrage and consistently shown themselves to be true ambassadors of transformation.

Strategic Priorities

Today’s healthcare BPO partner builds significant client ROI from these key strategic priorities:

Capacity Augmentation: Historically, healthcare organizations have leaned on BPOs for scalability. These providers and payers don’t want to expand beyond and break an operational excellence goal, so they cocreate and rely on a BPO partner to bring additional resources, solutions, and innovation. 

Typically, when sourcing for a partner, healthcare organizations rely on vendors that can improve capacity planning and offer solutions such as robotic process automation (RPA) to augment existing resources within the process. Through these initiatives, organizations can reduce effort and close operational gaps. That in turn can help scale back some operational expenses.

Challenger Mindset: In the quest to keep bettering their own organizations, payers and providers increasingly look to BPOs for a neutral business perspective and vast domain insights, tools, and talent. To this point, healthy competition helps to shake up a cultural mindset and drive organizational change. 

Often an outsourcer is brought in to challenge the internal operations champion, driving competition to improve productivity. The net result of increased pressure to succeed can be higher quality scores, improved turnaround times, and better member and patient satisfaction.

Cultural Assimilation and Alignment: Gone are the days when offshore locales were viewed as secondary to onshore locations. With the increased focus on globalization, there has been more direct alignment—and even assimilation—of partner and client cultures. This includes the fact that BPOs can fill a niche as a brand ambassador with retail-honed customer experience skills and bring access to a wider customer base.

Market Differentiation: In recent years, there has been a shift to more consultative services rather than simply answering calls. Today’s BPOs possess best-in-class solutions, and they have the scale to launch them to a broader market. The ramp up and speed-to-market can accelerate with the right BPO, one that can best work across a client’s own internal siloes and bring positive impact to other areas of the business. Today’s BPO providers can pilot multiple capabilities to truly transform end-to-end processes and bring value outside of traditional key performance indicators (KPIs) and service level agreement (SLAs). 

Conclusion

No matter the strategy, strong BPO partnerships are built on the principles of lean operations, as well as co-creation, design thinking, and globalization. Healthcare organizations that view BPO as strictly a cost-cutting measure are missing out on the real value, which is the meaningful changes that help eliminate siloes and align objectives to achieve true operational and engagement impact.

Austin Ridgeway is director, sales support, and business development for HGS Healthcare.

Care Management

By Terri Hibbs, BSN, RN, CCCTM



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

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

What is Care Management?

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

Two Types of Care Management

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

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

Case Study

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

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

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

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

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

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


1Call, a division of Amtelco

By Nicole Limpert

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

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

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

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

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

Using a Virtual Server Brings Multiple Hospital Call Centers Together

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

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

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

Other benefits of running call centers remotely:

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

Secure Messaging Apps Remotely Support Care Teams

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

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

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

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

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

Future of Web-based Hospital Communication

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

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

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

1Call, a division of Amtelco

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

3 Steps to Improve the Patient Experience Through Contact Centers



By Donna Martin

Hospitals and health systems are competing ever more fiercely to gain and retain patient business, and first impressions are critical. This is why a modern patient contact center is essential both for differentiating your organization from the competition and preventing revenue leakage.

As we head into 2021, the healthcare industry will face continued financial distress and uncertainty. To remain competitive, it will be crucial to understand how your organization uses vital contact points to ensure patients have a seamless experience from start to finish. 

Assess Your Patients’ Needs

Just like you, your health system’s patients are consumers who shop at Amazon, go to Starbucks, and purchase airline tickets. As a result, they’ve grown accustomed to expect a concierge level of ultra-personalized customer service. The retail industry has decades of experience providing this level of service. Retail companies tap technology to make constant improvements to help differentiate their brand through predicting and delivering on the needs of their customers. This, in turn, helps retain and grow their customer base. 

The healthcare industry is just starting to catch on to this level of customer service, with providers being incentivized or penalized to implement value-based care throughout the patient experience. Let’s explore how to measurably improve patient experiences and engagement in ways that are realistic and based on the unique requirements of healthcare delivery.

Step 1: Create a Foundation

From your patient’s perspective, even small hospitals are difficult to navigate via telephone. Partial or full automation of inbound phone calls from patients can allow providers to create a “single front door” for patients. This will create a unified patient experience and cut down on a needless chain of call transfers. 

Adding automated patient identification and authentication not only personalizes the interaction and ascertains the primary reason for the patient’s call, but also leads to complete resolution for a host of common inquiries like appointment confirmations, directions, hours, and payments, without ever needing to engage an agent. With this streamlined foundation in place, providers can begin to continuously and consistently track patient interactions to build intelligence for future contact, as well as gather communication preferences where possible. 

Every new element of data collected builds on previous elements and paints a holistic portrait of your patient. This helps create the foundation for predictive intent and provide an effortless patient experience. In addition, as you develop a performance baseline, you can conduct patient experience surveys to use actionable data to make agile, targeted improvements.

Step 2: Be Proactive and Dynamic

One goal of value-based care is keeping patients in your health system, but out of the hospital. Why not apply a similar goal to patient engagement? By applying dynamic decision-making to the data collection efforts established in Step 1, you can begin to develop proactive patient engagement strategies that may reduce the need for patients to call. 

For example, with the right automated inbound solution, your organization can identify patients calling from a mobile device and then take that opportunity to drive them to alternative, lower cost channels, such as SMS, text, and patient portals. The combination of these elements will further the productivity of your access center, drive costs down within your business, and maximize the patient experience. In addition, this level of dynamic data collection and usage can also provide you with a steady stream of valuable patient data to continue to enhance and optimize your solution.

Step 3: Integrate Patient Preferences

Last, using components of Steps 1 and 2, layer in patient communication preferences and cross-channel patient interaction data. In this scenario, you could see that a patient accesses the patient portal to find a specialist and is now calling into the access center for help. An intelligent self-service solution recognizes the patient, confirms they are looking for a specialist and sends the patient directly to the appropriate scheduling agent without the patient having to make a single menu selection—again, an effortless and loyalty building patient experience. 

Conclusion

With all these steps offered in a cloud-based, self-service environment, your organization will achieve maximum scalability, reliability, and flexibility for agents who work in either a brick-and-mortar setting or through a business process outsourcing partner. Implementing these three steps ensures your access center will always be available to support patients and providers. The goal of contact centers should be to make the patient experience as easy as possible through both personalization and self-service—striving for that perfect balance between automation and a live, human-touch interaction.

Donna Martin is senior vice president at HGS Healthcare.