Tag Archives: telehealth articles

What Healthcare Leaders Should Know About Contact Centers

1Call

By Nicole Limpert

It’s important for healthcare leaders to know that their contact centers can help improve patient and employee satisfaction, reduce costs, and provide critical communication tools within the hospital setting.

A Quality Contact Center Helps Retain Patients

An organization’s contact center serves as the communication hub for the entire enterprise. The operators perform several important and diverse tasks including answering the main switchboard, communicating with patients and their families, handling emergencies and disaster response, and contacting on-call medical staff. 

One of the most significant functions of a hospital call center is serving as a virtual lobby. Often, speaking with an agent is the first contact a patient has with the organization and their impression needs to be positive. Patients have options and can always find another provider if their experience is lacking in some way.

The patient’s experience with call center agents plays a critical role in their overall satisfaction with care access and the health services they receive. When asking patients to provide information about their health care experience via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, their interactions with hospital contact center agents may influence their responses. Any unfavorable experiences could lead to unacceptable survey results and cause the organization to lose some reimbursements.

Addressing Physician Pain Points

One of the biggest pain points for physicians and clinicians is trying to provide excellent patient care while dealing with staff shortages. There simply isn’t enough administrative staff to efficiently operate. Another challenge in healthcare is ensuring fast, accurate communication. Contact center operators and the software they use can help address both these issues.

Hospital call center agents are increasingly supporting medical staff by relieving some of their administrative burdens. Operators can assist patients during intake with insurance, registration, and other services over the phone or via video using a tablet. Shelley White, director of patient access services for State University of New York (SUNY) Upstate Medical University explains how her team is assisting hospital staff, “During this coronavirus crisis, our ER registration is sometimes short-staffed, but we are able to help by watching our track board, which is tied into the EMR system with Epic. 

“When a COVID-19 patient is admitted, we can call the patient to register them and verify insurance information over the phone. This process would normally be done in-person by ER staff, but we can do it remotely and ease some of their workloads.”

Communication can be improved within the hospital or clinical setting by leveraging the integration engine software used by contact centers to connect disparate healthcare software to interface with alarms, nurse-on-call, automated alerts, and critical lab results to work together and add functionality to improve workflows and patient care.

Alicia Wise, former IS project coordinator for AnMed Health in Anderson, SC explains how they used their call center integration engine software to automate their nuclear medicine program and procedures, “When a test is ordered for a patient, the night before we’re able to automatically email or fax that information to the vendor that provides us with our isotopes and different things needed for that procedure for the next morning. Having that information relayed automatically helps to speed up the process for the patient and save the cost of having things put on hold or standby because the communication didn’t happen.”

Virtual Consolidation Results in Real Life Cost Savings

Large healthcare systems with multiple locations, buildings, and contact centers can run on a single virtual server located anywhere in the country. Everything can function together seamlessly even if they all use different PBX telephone systems.

This enables hospital contact centers to be agile during weather events, crisis situations, and other calamities such as the current pandemic. Call center leaders can also grow their staff and provide more services without adding additional server hardware. 

Virtual servers provide cost savings to an organization because less physical equipment needs to be maintained. This is crucially important considering many organizations face a budget crisis. 

Other benefits of running call centers virtually include:

  • Re-routing calls to another center during peak times, staff shortages, or emergencies.
  • Offering flexible work schedules to operators to achieve 24/7 coverage by using agents located in different time zones.
  • Allowing supervisors to tap a larger pool of staff to use as fill-in operators if an agent is sick or pursue alternate labor markets such as retired staff or students. 

Keeping Staff Safe While Working from Home

When the pandemic was declared in March 2020, The University of Texas MD Anderson Cancer Center required non-direct patient care personnel to work remotely. This included the operators for the askMDA line. “Before April 2020, our operators had never worked remotely,” says Ninette Thomas, askMDA operator manager. “We began to look at the resources we already had to develop a hybrid remote call center and realized we were not harnessing the full capability of the technology available to us.”

Web-based communication is fast, secure, improves communication times, adds efficiencies through remote access, and reduces the number of potential errors caused by miscommunication and absences. Ninette comments, “What was surprising to me was that I anticipated having a problem with performance when my operators went home, but what I found was that our productivity actually went up.”

Any personal computer can transform into a professional agent workstation. All the tools used by an operator in a contact center are accessible to the virtual agent. “All we need is a power source to work. We can literally work from anywhere,” states Ninette.

Michael Wolf, principal applications system analyst and technical and support lead for the IT team that supports the operators adds, “Now that the operators have the ability to work remotely, the IT department has experienced benefits such as decreased overhead to maintain the equipment or perform quarterly tests, reducing our support time.”

Summary

Contact centers use technology and well-trained teams to assist patients and medical staff in meaningful ways to play an even bigger role in improving a patient’s journey. Healthcare leaders can help their organizations do more with less by ensuring their organization is leveraging the capabilities of their call center staff and software.

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.

Provide Multi-Channel Access

Be Sure You Deliver the Options Today’s Consumers Expect

Author Peter Lyle DeHaan

By Peter Lyle DeHaan, Ph.D.

For years we’ve talked about the need for healthcare call centers to become contact centers. This name realignment shifts our attention from telephone calls to embrace other forms of contact as well. This is a multi-channel mindset, and we provide multi-channel access to deliver the contact options that today’s consumers expect, which we must do if we’re to remain viable. 

Some people call this omnichannel, which implies all channels, while multi-channel more realistically looks at many channels. We’ll not debate which name is more appropriate. Instead, we’ll focus on the concept of moving beyond the telephone. 

Here are some multi-channel access points to consider.

Telephone

The telephone remains key for most people in most industries. In our push for multichannel access, let’s not forget the telephone as it will continue to be the foundation for what we do. The telephone has been around for a long time, longer than any of us. 

The first healthcare call centers started nearly a century ago in the form of medical answering services, often called doctors exchanges. The telephone is proven, ubiquitous, and dependable. It’s not new or exciting, but it is stable. 

And most consumers expect you to answer their telephone calls.

Email

Email has been around for several decades. It’s no longer novel, with naysayers long claiming that email is dead. It’s not. It’s very much alive. When you consider growing your call center beyond the telephone, the first multi-channel access option to consider should be email.

Email integrates smartly into call center activity. Unlike the telephone, where callers expect a timely answer with minimal delay, their expectation with email is less demanding. This doesn’t mean you can sit on a pending email message for days and should aim for a same-day response, but most people accept a reasonable delay as normal. This provides the opportunity to set email aside when call traffic is high and to process email messages during slow times.

Email agents should be able to read and absorb typed information quickly. They should also be able to type fast and accurately, without the need for editing.

Text Chat

A third multi-channel access option to consider is text chat. This common, and increasingly popular, communication option is how many people communicate with their family and friends. It’s no wonder that they expect businesses—including the healthcare industry—to embrace it too. 

Text chat agents, like email agents, must be able to quickly process typed messages and respond with accuracy. Unlike email, however, texting carries with it the expectation of minimal delay. In comparing chat with telephone calls, where multitasking doesn’t work, experienced chat agents can effectively handle multiple simultaneous chat sessions.

Social Media

Next consider social media. If patients try to contact you on social media, be prepared to respond. If you ignore them or take too long, they’ll be sure to vent their frustration to everyone on their platform of choice.

Social media agents need many of the same skills as email and chat agents. In addition, they must understand and be comfortable using each of the social media platforms that people could use to contact you.

Other Channels

This list is a great start, but it’s not conclusive. If people want to contact you by mail or fax, be ready to handle those interactions. Also watch for emerging communication technologies so you can prepare for them before your patients ask.

Multi-Channel Access Conclusion

If your call center is already providing multi-channel access, that’s great. Look for ways to make your channel offerings more effective. 

And if your call center focuses exclusively on the phone, explore how you can move decisively and methodically forward to offer multi-channel access to your patients and customers.

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.

Physical Safeguards Your Cybersecurity Needs to Protect Patient Data in Telehealth

TriageLogic

By Ravi K. Raheja, MD

The past year and a half has redefined the healthcare industry. Not only have hospitals and practices quickly adapted to an emergency pandemic and a heavy demand for telehealth, but they’ve also seen an increase in cyberattacks. These have placed medical organizations on high alert to review their network security, as well as their patient data and the vendors who collect it. 

According to a recent article in Forbes, “The number of hacking incidents reported in healthcare climbed for the fifth straight year in 2020 … [comprising] more than half of all last year’s patient data breaches—62%—up from 2019.”

Evaluating your vendors and security systems are paramount to data protection from these increased ransomware and malware attacks. But an often-overlooked part of that process is the training your staff needs on the physical safeguards they should use. If you aren’t sure what those are, here’s a good place to start.

Portable Data

Do you rely on flash drives or mobile devices to share and review data? Make sure to lock those up when they aren’t in use, both while you’re at work and when you leave for the day. Taking them outside of the office not only risks a breach in compliance, it also increases the chances for that equipment to be stolen, as was the case for this unencrypted laptop.

Passwords

Remind staff not to use the same password for all of their devices, and don’t be like more than half of surveyed workers who write them down on sticky notes. Even if your team trusts each other, there’s always the chance that someone will take advantage of another’s access and leave them footing the bill in damages. 

If they juggle a lot of passwords between different programs, have them use a password manager that stores and encrypts them online for convenient access. Some to consider include LastPass, Dashlane, Bitwarden, or 1Password, among others.

Keycards

Institute keycard access for sensitive areas and avoid holding the door for tailgaters, as this defeats the purpose of this physical safeguard.

Paperwork

Have a lot of hard-copy paperwork? Consider housing it in a secure, offsite location. This allows you to maintain HIPAA compliance for file retention while protecting those documents from damage that an on-site fire or natural disaster could cause.

When it’s time to dispose of those hard copies, make sure to shred them first. Shredded papers won’t give thieves much to leverage, especially when they’re all mixed together.

Contracting with a document disposal service can certainly help, but keep in mind that locked trash bins still have the potential to be accessed between the time you drop a file in them and the time the disposal service arrives. 

Disposal of Hardware

Getting rid of computers, mobile devices, or digital copiers? Make sure to use software that wipes all patient data from them first. Simply sending a file or folder to the trash bin doesn’t automatically delete it. And you may also find it necessary through HIPAA to destroy those media tools once they’ve been wiped. 

Multi-Factor Authentication

Use multi-factor authentication to log into your user accounts and file sharing services. This reduces the chances that an outside intruder will be able to hack your credentials and gain access to more—or all—of your network.

Staff Training

Train everyone on your staff about these physical safeguards. Even employees who can’t review sensitive patient or company information should still be aware of corporate policies on data management and how to respond to a potential breach in security. For more on what that includes, review the FTC’s guidelines.

TriageLogic

Ravi K. Raheja, MD is the CTO and medical director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC accredited, physician-led provider of high-quality telehealth services, remote patient monitoring, nurse triage, triage education, and software for telephone medicine. Contact them if you need help with telehealth nurse triage, telehealth appointment-setting, or nurses to manage data for remote patient monitoring.

How Call Center Technology Helps Hospitals, Staff, and Patients

1Call, a division of Amtelco

By Nicole Limpert

Hospital call centers provide a critical service to both patients and healthcare organizations. In previous articles we’ve explored how call centers are supporting emergency departments during the pandemic, help patients connect remotely with their care teams via patient monitoring devices and telehealth, and how medical answering services have grown to include telephone triage as part of their support.

Healthcare communication is complex and notoriously disconnected. Different departments rely on different systems to perform their job and these technologies typically don’t talk with each other. It may surprise some, but some call center software is highly interoperable, which hospitals and clinics leverage to bridge communication gaps between disparate technology to streamline communication. This improves hospital workflows and both patient and staff satisfaction.

Integration engines, also called middleware, used in hospital call centers can streamline inbound and outbound communications, trigger scripting, and automate dispatching. Integration engines are the interoperable piece that connects different technologies, so they communicate with each other. A robust middleware is completely scalable and works with software from other vendors. 

Using Integration Engines to Enhance Patient Care

Here are some common applications:

Hospital Admissions: When a patient is admitted into a hospital, they may be moved from one room to another while waiting for tests and procedures, and during recovery. It can become difficult to locate and communicate with a patient once they are receiving care within the system. 

An integration engine with an HL7 interface can assign a fixed phone number to each patient, which will follow them for the duration of their stay. Associating each patient with one phone number helps:

  • Ease the stress of family and friends who are trying to find their loved one when they are transferred to a different room.
  • Streamline the communication process for anyone on the patient’s care team.
  • Reduce the number of calls to the hospital’s call center.

Critical Alerts: Integration engines work together with a hospital’s event notification software system to expedite enterprise-wide critical alerts in healthcare environments. The integration engine captures requests from hospital systems such as ADT (admission, discharge, and transfer) messages, nurse call messages, smart beds, pain management, alerts, alarms, orders, or appointments. Then, emergency notification software instantly sends those messages to designated recipients using a wide variety of methods, including Vocera badges, IP phones from Cisco and Spectralink, SMS, email, and secure messaging apps.

Using an integration engine means automated notifications, customized to fit a hospital’s needs, based on configurable rules. Notifications can be sent via preferred contact methods to an individual, an entire group, or the current on-call personnel, which enables recipients to respond quickly to provide better patient care. 

Accumulated statistics for each notification provide an easy-to-follow audit trail for reporting purposes and help healthcare organizations refine their communication processes.

Patient Transfer: The Joint Commission found 80 percent of serious medical errors were the result of miscommunication between caregivers during patient handovers. Multiple studies have highlighted the need for better communication during patient transfers. 

One study states, “Some challenges transferring physicians face with communication include physician shift changes, ancillary staff changes, delays between ordering tests and receiving results, and competing attention of other active patients. Accepting physicians also face their own challenges related to patient transfers. . . . Calls back to the transferring facility are far from efficient and are often routed through emergency departments, medical records departments, and radiology reading rooms making information gathering cumbersome.”

More hospitals are establishing patient transfer centers, and integration engines are facilitating communication between clinicians and transport assets. Each staff member involved in a patient transfer needs to have the same information. Integration engines enable staff to have access to key directory databases such as on-call, hospital personnel, and patient directories (which include ADT and EMR [Electronic Medical Record] data) to ensure information is communicated accurately and efficiently to enhance collaborative care. 

Using Integration Engines for Automated, Emergency, and Mass Notifications

Automated notification and reminder communications can help healthcare organizations ensure utilization of every resource to its full potential and reach more staff personal in less time. Notifications for emergencies, events, changes in weather, and everyday reminders can instantly be sent to designated recipients using secure messaging apps, Vocera badges, IP phones from Cisco and Spectralink, SMS, and email.

The primary role of an integration engine is to facilitate automated communications. An operator in a call center can initiate dispatch scenarios. But they can also run automatically based on inbound triggers such as HL7 and email messages, scheduled to run on a recurring basis, initiated by a web user running a web script, or triggered by a third-party application.

Mass notifications make it possible for an organization to be better prepared for planned and unplanned events, such as natural disasters, emergencies, service outages, meetings, and other instances when large groups, small groups, and individuals need quick and accurate notification.

Third-Party Integration with APIs

Third-party integration happens when a vendor connects to another vendor’s application. API’s (application program interfaces) can achieve this connection. Using an API means that developers can build a new solution using existing components instead of creating code from scratch. Integrating an API into another vendor’s solution saves an incredible amount of time, is less costly, and results in a solution that best fits a hospital’s communication and technology requirements.

The same APIs used in hospital call centers to streamline communication can also enable healthcare facilities to interface with:

  • alarms
  • dashboard workforce management
  • electronic health record (EHR)
  • faxing
  • landline to text
  • nurse call and triage
  • on-call
  • short message service (SMS)
  • secure messaging
  • telehealth video conferencing 
  • wireless communications transfer protocol
  • wireless devices

Web-based Communication

Both hospital call center staff and clinicians 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. Hospital personnel can use some of the same web-based communication software used in their call center because it delivers fast, secure communications and adds efficiencies through remote access to reduce the number of potential errors caused by miscommunication and absences.

Web-based communication applications specifically developed for the healthcare industry include encrypted secure messaging, care team collaboration, and workforce management tools. Enterprise access to these healthcare communication tools improves workflows because clinical staff can find the information they need on their own, without interrupting co-workers or employees in other departments. 

Secure Messaging: Secure organizational communication is crucial for protecting patients, medical staff, and hospital organizations. HIPAA-compliant messaging apps can send secure text, photo, audio, and video content while protecting patient privacy and typically work on smartphones, tablets, and desktop computers. These apps simplify collaborative care to provide a better patient experience, and speed the process of patient admissions, lab results, and patient transport.

Care Team Collaboration: Nurses, physicians, and other staff use mobile-friendly care team collaboration applications to remotely access on-call schedules, directories, messages, reports, telephone scripts, and even historical call management data quickly and efficiently either through the Internet or through a healthcare organization’s internal networks.

Workforce Management: Staff can view, edit, copy, override, assign, and unassign schedules in real-time; use directories to quickly find and contact staff (titles, departments, office hours, and preferred contact method displayed); and use the reporting function to track, view, and print communications (with complete and accurate statistics). 

Any authorized staff member, from any location, can schedule and manage appointment calendars, class registrations, event calendars, and workforce schedules.

Paging Extensions

Hospital call centers are the hub of communication for an organization. This includes being part of an organization’s paging system to reach on-call personnel. However, some hospitals use the same status-based messaging system without involving an operator.

Physicians and staff members can call a special paging extension and enter an identification number for the person they want to reach. This paging technique locates the requested person in the personnel directory with information about that individual’s status such as in office, making rounds, out of office, or on-call.

The system announces the individual’s name and status to the person who has called the paging extension and prompts them to enter a callback number or message. Then the message or callback number is sent via the person’s preferred contact method.

This method also provides paging reports and analytics so departments can leverage the data to improve service metrics, workflows, and to help protect both patients and hospitals in litigious situations. The reports provide useful information such as the number of pages, detailed logs that indicate if each page attempt was successful or not, and counts for email messages, SMS messages, secure messaging app messages, and other types of paging.

Conclusion

Improving communication in hospitals is paramount. Healthcare organizations can reduce many root causes of inefficient communication by using the software and technologies that may already be in use in their call centers.

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.

The Expanding World of Telehealth

TriageLogic

By Ravi K. Raheja, MD

The pandemic accelerated the use of telemedicine, and indications are that it’s here to stay. Patients and families have largely embraced it as a convenient means of medical care for concerns and questions that do not require an in-person visit, while more providers—including primary care and specialists—have continued to adopt it. As a result of the increasing demand for telehealth, the triage nurse protocols written by Dr. Schmitt and Dr. Thompson contain updated support for triage nurses to schedule telehealth visits.

In addition, the medical community faces two new challenges from COVID. First, the spread of the more transmissible Delta variant; and second, the rise in patient callers who are nervous and confused about whether their mild-to-moderate symptoms are indications of infection. One of the best options that practices can implement to offset these concerns is by coupling their telehealth with telephone nurse triage.

Leverage Gold Standard Protocols

Most telephone nurse triage relies on protocols developed by Drs. Schmitt and Thompson to assess patient symptoms and provide dispositions on whether to seek emergency medical care. Updated to address COVID-19, the protocols were particularly beneficial to callers during the height of the pandemic 

Maximize Patient Coverage

Social distancing and telehealth have created an influx in patient calls in addition to normal appointments. But in-house staff may feel limited in being able to address all of them, especially when patients call after-hours. This is where nurse triage can complement a practice’s efforts by acting as an extension of the practice to evaluate patient symptoms, schedule appointments, and offer customized orders. 

More importantly, most telephone triage services are available 24/7.

Improve Telehealth Services

Not only can triage nurses schedule patient appointments for a practice, but they can also use protocols to determine whether those appointments are eligible for telehealth. Effective telehealth documents all calls and dispositions. Then it shares all documents with the nursing staff and providers, including telehealth eligibility and the rationale for it. 

This reduces the stress on an inhouse team to manage these appointments, provides a seamless process for callers, and allows a practice to increase its capacity for seeing in-person patients with more urgent needs.

Customize Instructions for Eligibility

Telehealth and telemedicine services differ from other offerings; this requires customized instructions for triage nurses to know which ones a practice offers. When a nurse decides telehealth eligibility, that determination depends on whether the healthcare symptom can be resolved over the phone. 

Conclusion

Telehealth is expanding to fill a new and critical role in the effective provision of healthcare services.

TriageLogic


Ravi K. Raheja, MD is the CTO and medical director of the TriageLogic Group. Founded in 2007, TriageLogic is a URAC-accredited, physician-led provider of quality nurse telehealth technology, remote patient monitoring, and medical call center solutions. The TriageLogic Group serves more than 9,000 physicians and covers over 25 million lives nationwide. To learn more, call 800-723-4290 or go to https://triagelogic.com/contact-us/.

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 or his book, Healthcare Call Center Essentials.

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-led 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.