Tag Archives: telehealth articles

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 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-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.

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-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.

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.