Tag Archives: telehealth articles

Care Management and the Contact Center


LVM Systems

Traci Haynes, MSN, RN, BA, CEN, CCCTM

The need for care management continues to grow exponentially in the United States. The ever-increasing number of chronic conditions in both adults and children has placed greater demand on healthcare resources and services. US healthcare spending reached an all-time high of 3.81 trillion dollars in 2019, with a predicted growth to 4.01 trillion dollars this year. 

In a report from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary, healthcare spending is expected to grow by 5.4 percent from 2019 to 2028. This prediction will result in healthcare spending at 6.19 trillion dollars and will account for 19.7 percent of the gross domestic product (GDP), up from 17.7 percent in 2018.

The Center for Disease Control and Prevention’s (CDC) National Center for Chronic Disease Prevention and Health Promotion indicates that six in ten adults in the US have a chronic disease and four in ten adults have two or more. The CDC also estimates that about 25 percent of children in the US, ages two to eight, have a chronic health condition. They report that a concise list of risk behaviors causes many chronic diseases. These include tobacco use and exposure to secondhand smoke; poor nutrition, including diets low in fruits and vegetables and high in sodium and saturated fats; lack of physical activity; and excessive alcohol use.

Care Management

Many of the complications of the most common and costly chronic conditions such as heart disease, stroke, diabetes, COPD, obesity, and asthma could be prevented or better controlled. Also, many individuals who struggle with multiple conditions often have combined social complexities. Even the most clinically astute patients find it difficult to navigate complex and fragmented healthcare systems, especially when the responsibility falls to the individual alone without adequate support or partnering. This difficulty in navigating healthcare systems often results in inefficiencies, increased costs, and poor outcomes.

The Agency for Healthcare Research and Quality (AHRQ) states that “Care management is a promising team-based, patient-centered approach designed to assist patients and their support systems in managing medical conditions more effectively. It also encompasses those care coordination activities needed to help manage chronic illness.

In 2012, The American Nurses Association (ANA) stated that “Patient-centered care coordination is a core professional standard and competency for all nurses, and should be the foundation for all care coordination programs.” They also said, “Nurses need to position themselves within the interprofessional team to perform this core nursing process and contribute to better patient outcomes.”

Doing this involves systematic, organized teamwork, including the patient and family, and requires communication among all participants.

Currently, care coordination is one of the National Quality Strategies of the National Quality Agenda. A coordinated effort involving an interprofessional team with the patient and their family can help achieve the Institute of Healthcare Improvement’s Triple Aim goals of better care, better health, and reduced costs.

As part of their triple aim interventions, the AHRQ supports identifying populations with modifiable risks, aligning care management services to the needs of the population, and identifying, preparing, and integrating appropriate personnel to deliver the needed services.

Contact Center Support

The contact center can play a vital role in managing and improving the patient’s condition. By routinely checking on the patient at predetermined intervals and monitoring the individual’s plan of care, the contact center can communicate with the interprofessional team providing a picture of the patient’s current and recent status at that particular point in time. 

Using telecommunications can provide invaluable connectivity to monitor patients and provide a meaningful 24/7 service for clinical assessment capability and episodic care and interventions, should the need arise. And now more than ever during these unpredictable times, individuals both with and without chronic conditions, are avoiding or delaying preventative and needed care.

Nurses provide invaluable expertise in coaching, educating, and improving an individual’s self-management skills, thereby increasing the quality of care, resulting in better outcomes. They are also able to provide an assessment of symptoms and recommend interventions, often decreasing exacerbations.

The ANA, the American Academy of Nursing (AAN), the American Academy of Ambulatory Care Nursing (AAACN), and the American Organization of Nurse Executives (AONE) each contribute resources for care coordination in the form of position statements, white papers, frameworks, policy briefs, core curriculum, and courses. There are also effective models and tools, along with hospital and community-initiated programs.

Conclusion

Contact center care management is a win-win-win. It’s a win for healthcare systems, the providers (interprofessional team), and most importantly, patients.

LVM Systems logo

Traci Haynes, MSN, RN, BA, CEN, CCCTM is director, clinical services at LVM Systems.

Remote Health Monitoring and Care Management


1Call, a division of Amtelco

By Nicole Limpert

Healthcare providers can remotely manage the health of their patients thanks to advancements in monitoring and communication technologies. Telehealth technology and hospital call centers work together to bring remote care management into the homes of patients.

When the current pandemic began, telemedicine became an even more critical tool to keep both patients and medical staff safe. As more time passes and COVID-19 continues to infect more people, the need for a long-term solution to remotely monitor patients with chronic conditions has become urgent. 

Remote care management programs and hospital call centers are working together to bring much-needed care and monitoring to patients. Remote care management can also help reduce organizational costs, provide patient education, and encourage adherence to treatment, which helps reduce readmissions.

Wearable Fitness Technology

Hospitals have traditionally used health monitoring devices to track and record vital signs. Nowadays, using FitBits and smartwatches has become commonplace as more people take an active role in their health. Research from Business Insider Intelligence found that more than eighty-percent of the consumers they polled were enthusiastic about wearables. 

The value of the wearables market is expected to grow to more than 23 billion dollars by 2025. Even though wearable technology can look like nothing more than the latest consumer gadget, doctors are becoming more comfortable with using them as a clinical decision support tool.

As patients become comfortable using wearable health technology and health insurers (including the Centers for Medicare & Medicaid Services) are willing to pay for it, hospitals are going remote with their medical monitoring devices. Remote health monitoring has proven to be crucial during the current pandemic. The U.S. Food and Drug Administration (FDA) even allowed selected FDA-cleared, non-invasive vital sign-measuring devices to be used remotely. This allows medical staff to monitor patients while they are safe at home. 

Monitoring Chronic Health Conditions

According to the Centers for Disease Control and Prevention (CDC), ninety-percent of the 3.5 trillion dollars annual healthcare costs in the United States are attributed to treatment of people with chronic illness. 

Patient monitoring devices—such as scales, blood pressure gauges, and medication patches—are given to patients with chronic health conditions to collect biometric data (such as vital signs, weight, blood pressure, blood sugar, blood oxygen levels, heart rate, and electrocardiograms) and securely transmit it via a patient’s smart device back to the provider. Real-time monitoring of health assessment information alerts medical staff to changes in health patterns. 

KLAS Research partnered with the American Telemedicine Association in a study about remote patient monitoring. They found hospitals reported additional benefits from their remote patient monitoring program. These included reduced hospital admissions, readmissions, and emergency room visits, as well as improved patient satisfaction and health, along with organization cost reductions.

Hospital Call Centers Connect Remote Care

While remote patient monitoring helps to prevent hospital and emergency room visits, another goal is to enable patients to better manage their conditions on their own. 

An app or device can gather a person’s health data, but medical staff need to interpret the findings. Hospital call centers can bring patients and healthcare staff together to provide remote care via telehealth. Some hospitals route data from remote monitors to their call center, staffed in part by nurses. The nurses can use the call center software to securely connect to a patient’s electronic medical record, then call the patient to discuss the findings.

Patient education and medication adherence are also large components of monitoring a patient’s health. Depending on the call center’s nurse staff schedule, patients can receive remote care 24 hours a day, 7 days a week. 

Concerns About Remote Patient Monitoring

While remote patient monitoring is proving to offer many benefits to both patients and healthcare organizations, the technology and adoption of the technology are still new. This means there is a need to address some important challenges, such as:

  • Big Data: An immense amount of new health data is being provided by patients, which needs to be handled and analyzed. Healthcare organizations must review and update their healthcare delivery models, begin using tools and AI for analysis and diagnosis, and develop a legal infrastructure to share patient data for care collaboration.
  • Ethics: Wearable technology and mobile apps collects and measures a person’s personal health information, movements, physical activity, moods, behaviors, and more. Using devices with a global positioning system (GPS) capability records location information. Data can be misinterpreted or misused to draw incorrect conclusions about a person or population.
  • Security: Patient confidentiality is a major concern because it can be difficult to ensure a device or application complies with HIPAA regulations. Encryption key management is imperative. However, the nature of biosensors has made designing key management schemes tremendously difficult, and cryptographic schemes depend upon secret keys, so there is a need for highly secure key agreement and distribution in a hospital’s network. 

Summary

Remote health monitoring and wearable technologies enhance care management by providing detailed health readings about patients to healthcare providers, clinical practices, and to the patients themselves. This enables medical staff to provide care to patients in any location, 24 hours a day. 

This technology is still in the initial stages and there are obstacles. But working to overcome the challenges will drive productive change in care delivery models, forge new partnerships between healthcare and technology providers, and improve health data privacy.

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.

Successful Telemedicine Service Strategy


TriageLogic

Dr. Ravi Raheja

Hospitals, specialty clinics, and other healthcare organizations are no longer leery of telemedicine and are in fact expanding to provide quality services and generate revenue. With this growth and success, there are many telemedicine options available for every organization. It is important to be aware of the factors that providers must consider to make telemedicine services successful for both the patients and the organization.

Outcomes

During the pandemic, telemedicine has enjoyed widescale adoption. One study suggests that among 39 percent of people who consulted a healthcare professional, two thirds of the patients used telemedicine and 84 percent of them used telemedicine for the first time. More than 55 percent of consumers reported a satisfactory experience while using telemedicine and stated they will most likely use it again. Healthcare professionals believe telemedicine usage will continue to increase.

A survey done by the Foley & Lardner Law Firm illustrates that telemedicine provides a great opportunity for practices and medical organizations to see a financial return.

  • Over 70 percent of respondents realized cost savings or ROI from their telemedicine services.
  • Nearly one third saw more than 20 percent savings.

Considerations

Although many companies see a positive ROI, it is important to make sure that the telemedicine service provider chosen is right for them. There are a variety of options. Selecting the right telemedicine service or software will determine the level of success.

Type of Telemedicine: While people think of telemedicine as mostly doctors available remotely to patients, often a telephone triage nurse can resolve patient issues and provide a path to care. In fact, a triage nurse can resolve three-quarters of all patient calls. Triage nurses can determine which patients need further care or to see a physician, saving both time and money. Organizations can have a complete telehealth system with a triage nurse as the first line of care to further increase ROI.

Integrated: The telemedicine software should be able to integrate seamlessly with current workflows. To ensure that work is not doubled by adding a new technology to the mix, the telemedicine software needs to be cohesive and allow for easy data transfer.

Support: As with any technology, issues may arise. A successful telemedicine service should have training and support available to troubleshoot any concerns. 

Adaptive: The healthcare industry is always evolving and transforming. Whether it is regulation, new discoveries, inventions, or patient expectations, the only way to be successful is to adapt. Telemedicine service and software should do the same. Look for a company that listens to their clients and makes upgrades to what they need.

Measure Success: The best way to determine the ROI of a telemedicine service is to establish a way to measure results. Choose a platform that includes different portals for clients to look at data and analyze it.

Conclusion

The telemedicine field has exploded and doesn’t seem to be stopping. Above are only a few factors to consider when implementing or expanding telemedicine services, but it is important to do the research to find which solution will be best for the organization.

TriageLogic

Dr. Ravi Raheja is the medical director at TriageLogic, a leader in telehealth technology and services. Contact TriageLogic for a live demo.

Healthcare Customer Engagement



4 Steps to Charting an Empathetic Experience

By Srikanth Lakshminarayanan

Imagine you are in the hospital after an emergency appendectomy, and you have a simple but urgent question about the payment of this just-delivered health service. Your physical and mental stress is a load made only heavier with that pending insurance coverage conversation. You are in no mood to struggle with an exasperating app or digital exchange, you want a straightforward reassuring dialogue—one delivered with good, old-fashioned empathy. 

From another perspective, the expectations are higher for your engagement team. The right customer service agent must deliver on several levels as an empathetic advocate who can listen, relate, and resolve the issue at hand. Simply put, with all the renewed digital efforts toward optimized customer experience (CX), healthcare customer service remains highly challenging.

The recent COVID-19 surge exposed CX teams to an all-new type of issue, one which no bot or digital channel had ever dealt with. What’s needed is a fresh approach to empathy-based engagement as part of the healthcare customer experience. 

Now is the time for healthcare to learn a few lessons from technology-retail elites like Apple, which is renowned for its low-tech empathy focus. Apple aims for Geniuses to walk a mile in someone else’s shoes and recognize the emotions their customers feel and change those, to make them feel better. The Apple manual advises the “Three F’s: feel, felt, and found.” This means connecting, relating from personal experience, and consoling with issue resolution. Healthcare would do well to borrow from this model and reduce friction points to result in more effortless, empathetic problem-solving.

Ultimately, there is still a solid foundation for every contact in healthcare to chart a basic blueprint for compassionate issue resolution. An optimized experience, delivered by an agent empowered to provide empathetic customer satisfaction, should comprise this flow.

Express Empathy

Empathy begins with active listening. From the first word spoken by the customer, the agent must focus 100 percent on the communication. This point in the conversation is critical as an opening to bond and win immediate customer trust. Agents shouldn’t make notes while listening. Unless they listen properly, they cannot react to the situation of the customer. 

Reduce any miscommunication with follow-up questions.

Acknowledge the Customer

Address the caller with a member or patient name and personalize the communication with a concierge touch to earn trust and loyalty. By using unified desktop and disparate systems, today’s agents can preemptively acknowledge the issue without spending time on a longer intake process. There are also opportunities to track prior visits to eliminate abrasion with unnecessary restating by the member or patient.

Express Compassion 

Show understanding. Remain calm. The adage is that you never truly know what a person is going through, but with healthcare, it’s even more critical. This is because one thing is clear with healthcare customer calls, and this is that a health issue affects the member or patient’s life. Empathy at this stage might mean a reassuring tone with, “I understand this is difficult. I’m here to help.” 

Do not interrupt the customer, instead show attentiveness.

Seek Resolution 

Demonstrate intent to resolve the issue, with the understanding that it won’t necessarily be the case, since not everything is within our control. At this stage, it’s key to let members and patients know that empathetic customer care means trying their best to help, with the understanding that some conditions or procedures may not be covered. Aim for authentic communication, with an added personalized touch, and “thank you” or expression of gratitude for patience.

Conclusion

Over the past fifteen years clients have evolved their metrics focus from a quality, first call resolution and call center customer satisfaction (CSAT) to net promoter score (NPS). One emphasis that has remained the same, however, is empathy, as the leading attribute in every single interaction that drives all these metrics. And while empathy is required for all customer service, in healthcare, even more so, the mission is to address the critical, personal impact related to health, finance, and often-raw emotions. 

Helping customers resolve their issues is a delicate balance of all three of these things. That’s what makes healthcare customer service as uniquely fulfilling as it is challenging.

 Srikanth “Sri” Lakshminarayanan is vice president, center of excellence for healthcare engagement services. Sri is a domain expert supporting the deployment, stabilization, and growth of capabilities in voice and related services in HGS’s healthcare programs.

Remote Patient Monitoring: A Worthwhile Investment


TriageLogic

By Dr. Ravi Raheja

Remote patient monitoring is part of a new era of medical technology. In the wake of the COVID-19 pandemic, remote services and technology have been extremely valuable to patients, doctors, and healthcare organizations. Remote patient care typically means helping patients over the phone. Remote patient monitoring (RPM) takes care one step further and helps doctors collect and evaluate data from patients who use an electronic medical device.

RPM is starting to gain traction by the medical field because it improves patient care. Many of these devices can capture data not observed by the patient. As a result, providers can monitor important vitals and intervene before a patient even presents a concerning symptom. This cuts down on both morbidity and mortality while saving costs and decreasing Emergency Room (ED) visits.

A recent article in the Center for Technology and Aging asserts that the healthcare industry “could reduce its costs by nearly 200 billion dollars during the next twenty-five years if remote monitoring tools were used routinely in cases of congestive heart failure, diabetes, chronic obstructive pulmonary disease (COPD), and chronic wounds or skin ulcers.”

There are many questions for providers and hospitals to ask themselves as innovative technology continues to become available. Technology is an investment, and changes to existing systems require effort. Is remote patient monitoring worth it, and will it soon be the standard of care for chronically ill patients? What are some requirements to consider while setting up an RPM program?

Which Patients Benefit Most from RPM?

According to the CDC, six in ten Americans have a chronic condition such as heart disease, lung disease, or diabetes. Four in ten have two or more chronic conditions. These chronic patients help make up more than eighty five percent of the 3.5 trillion dollars in healthcare costs across the nation annually and are responsible for eighty percent of all hospital admissions. It costs 3.5 times more money to treat chronically ill patients than those without these conditions, and they make up many of the leading causes of death in Americans.

RPM is especially effective for these types of patients. Continuous management of chronic conditions is burdensome in traditional office or clinic settings. Patients bring in notebooks or phone apps filled with notes, self-assessments, and symptoms.

The onus is on the patient, and the reliability of that data falls into the hands of individuals, which can result in inconsistent or partially inaccurate information. RPM takes this burden from patients and relies on accurate, consistent technology. It also allows providers to measure additional important vitals and to receive the information daily.

Chronic health patients have been on the rise. We need solutions to help treat these patients in an effective and economical way. RPM addresses these needs.

How RPM Helps Manage Chronic Care Costs

A study published by the National institute of Health in 2016 by doctors Usha Sambamoorthi, Xi Tan, and Arijita Deb states that “The presence of MCC [multiple chronic conditions] has profound healthcare utilization and cost implications for public and private insurance payers, individuals, and families.”

These conditions require detailed, comprehensive care that can prove challenging. RPM allows for nurses and doctors to have access to health information of a patient in real time, and makes it possible for clinicians to issue health orders that can curb unnecessary emergency department visits by reacting to changes seen from a patient’s monitoring device.

It also gives doctors more access to their patients and creates opportunity for early education in patient behavior and an overview of patient participation in their treatment plan. Doctors can get a look into a patient’s activity and use nurses for check-ins to encourage the patient to comply with health orders.

It gives doctors the power to give quality care outside of clinical settings and increases health outcomes. RPM gives doctors the information they need on a timely basis, which allows for swift intervention for high-risk patients.

Benefits to Providers

One concern for doctors when implementing RPM is the possibility of an increased workload, with doctors having to monitor patients regularly even when the patient is not receiving direct care. Doctor burnout is common, and its alleviation has its own value.

An Ernst and Young’s 2018 survey on digital health showed that almost sixty five percent of physicians believe that “technology that captures consumer-generated data will reduce the burden on doctors and nurses specifically.”

However, there are solutions for providers to cut down on their work while providing better patient care through RPM. First, most monitoring devices have their technology programmed to inform the provider when there are anomalies or potential patient problems. Second, doctors can also use an outside remote nurse service to monitor the data coming from the devices. An efficient RPM company who provides this service can improve patient care while decreasing the workload on the physicians.

Industry Willingness to Implement RPM

According to a Spyglass Consulting Group report in 2019, at least 88 percent of healthcare organizations have an interest in investing in some form of remote patient monitoring technology to pivot to value-based care.

Eighty-nine percent of practices surveyed in Spyglass’s report say that they are actively drafting strategies to get patients to take an active, continuous role in managing their chronic health issues. RPM as a prong to this strategy gives a continuous link between patient and doctor, and it supports these kinds of initiatives.

Health insurance companies have shown an interest as well. In 2019 the Centers for Medicare & Medicaid Services proposed several amendments designed to increase remote patient monitoring programs by improving reimbursements.

Some of these amendments include reimbursements for RPM setup and patient education, which is a big incentive to providers who are thinking of implementing this technology. Revisions to who may monitor these devices have also occurred. This allows registered nurses (RNs) or medical assistants to do the bulk of the monitoring, freeing up physicians and nurse practitioners.

Conclusion

Remote patient monitoring offers a way for practices, hospitals, and health insurance companies to lower their costs, deliver continuous quality care, and alleviate doctor workloads. As we move forward, the value of remote patient monitoring will continue to evolve for healthcare organizations and implemented into care plans for the chronically ill.

TriageLogic

Dr. Ravi Raheja is the medical director at TriageLogic, a leader in telehealth technology and services. If you have any questions on how to implement remote monitoring for your patients, contact TriageLogic at info@triagelogic.com.

Telehealth in Uncertain Times


LVM Systems

By Traci Haynes

The COVID-19 pandemic has placed telehealth at the forefront in providing healthcare services. It has forced changes in the environments in which clinicians typically practice. Individuals who, under non-COVID-19 conditions, would seek access in an emergency department (ED), urgent care, or healthcare providers’ office are now avoiding these settings.

And with community spread, the Centers for Disease Control and Prevention (CDC) recommends alternatives to face-to-face triage and visits in an office setting if screening can take place via telehealth (that is over the phone, through patient portals, or online self-assessment tools). A recent report from Frost and Sullivan suggests that telehealth will increase by over 64 percent nationwide this year and continue to increase in the years ahead.

The Agency for Healthcare Research and Quality (AHRQ) defines telehealth as “the use of telecommunications technologies to deliver health-related services and information that support patient care, administrative activities, and health education.” It typically consists of a two-way, real-time interaction over distance between a patient and a clinician using audio or visual technology. 

Telehealth or Telemedicine?

Many consider the terms telehealth and telemedicine synonymous and interchangeable. However, telemedicine can describe a more limited set of remote clinical services such as diagnosis and monitoring.

In recent years, telehealth has become more recognized, especially in the aftermath of natural disasters (such as hurricanes, tornados, earthquakes, floods, and blizzards), when seeking routine care can be dangerous for both clinicians and patients. There was a tremendous uptick in telehealth interactions following Hurricanes Irma, Maria, and Harvey in 2017. Crises tend to increase the urgency of telehealth needs. 

Using telehealth in rural communities to bridge the healthcare gap delivering routine care or providing access to specialists that typically exist in more urban areas is well known. Telehealth also makes services more readily available or convenient for individuals with limited mobility, time restrictions, or transportation issues.

Furthermore, telehealth can help communicate with and coordinate care for individuals with chronic conditions in supporting self-management as well as assist with earlier interventions in the face of impending exacerbations. 

Social Distancing

The critical need for the recent social distancing between providers and patients has driven increased demand for telehealth. In response to the pandemic, the Trump administration has expanded access, albeit temporary, with changes to telehealth reimbursement policies. 

Beginning March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) allowed more than 80 additional services through telehealth. Clinicians can bill immediately for dates of service on or after March 6, 2020. According to CMS, it will now pay for telehealth services under the Physician Fee Schedule at the same amount as in-person services. 

Healthcare providers, including physicians, nurse practitioners, clinical psychologists, and licensed clinical social workers, are now able to offer telehealth to Medicare beneficiaries, including standard office visits, mental health counseling, and preventive health screenings. Medicare often is the early adopter for changes in reimbursement, with other health plans following their lead. 

A May 9, 2020 report in Modern Healthcare, said that Providence went from 700 video visits a month to 70,000 a week. New figures from Blue Cross Blue Shield of MA reported that daily claims for telehealth grew from approximately 200 to more than 38,000 in May. A May 26, 2020 article in FierceHealthcare reported experts predicting 1 billion telehealth visits by 2021, and currently almost half of practicing physicians are now using telehealth appointments. 

With this shift in practice, healthcare providers will increase their use of telemonitoring devices to measure blood pressure, pulse oximetry, heart rate, temperature, and weight readings. Telemonitoring also will assess EKG tracings and views of the retina and tympanic membrane, as well as other data to diagnose patients.

Emergency Department

There is growing concern about the decreased number of ED visits for emergent situations such as acute myocardial infarctions, cerebrovascular accidents, and other life-threatening situations. Recent statistics, as reflected in emergency medical system calls, offer evidence of increased deaths at home. EDs also report that patients are waiting too long to seek care, and as a result, have often suffered irreversible damage. 

An article in HealthDay News on May 20, 2020 reported that U.S. EDs are seeing about half as many heart attack patients as usual. The data from Kaiser Permanente Northern California included 4.4 million patients. In looking at records from January 1 through April 14, they found that the weekly rate of hospitalizations for heart attacks decreased 48 percent. Moreover, fewer individuals with pre-existing cardiac conditions went to the ED from March 4 through April 14, when compared to pre-COVID-19 timeframes from the year before.

Telehealth Nursing Practice 

Telehealth, in support of the Institute for Healthcare Improvement’s (IHI) triple aim has shown improved access, quality, and cost-efficiency of healthcare delivery and has resulted in an increased demand for telehealth nursing practice (TNP). 

A medical call center with TNP registered nurses (RNs) using decision-support tools provide recommendations for care at home or accessing a higher level of care based on the caller’s symptoms. RNs do not give a diagnosis, nor do they prescribe medications, although in certain situations, RNs can provide refills or e-prescribe medications based on physicians’ orders. 

The breadth and scope of TNP have advanced throughout the years. It has had a major presence in the United States since the 1960s, in Canada since the 1970s, and the UK beginning in the 1990s. 

In the last half of the 70s, health maintenance organizations (HMOs) began using telephone triage and advice services as a gatekeeper to control consumer access to care. In the 80s, hospital marketing departments used telephone triage as well as physician and service referrals, class registration, and health education and information services to attract and keep their market share. Once again, in the early to mid-90s, managed care organizations further expanded telehealth services for demand management, recertification, and referral authorization due to the ever-increasing incidence of chronic illness and multi-morbidities as well as the associated rise in healthcare costs. 

Present-day, the COVID-19 pandemic, has led to the role of telehealth nurses providing triage, surveillance, and monitoring for disease management, care management, case management, care coordination, and clinical prevention programs.

Conclusion

The use of telehealth has grown exponentially during this pandemic. It has filled a much-needed void in providing qualified medical care by clinicians without the necessity of commuting to a higher level of care. It has proven positive outcomes and high degrees of satisfaction. Telehealth is convenient and accessible, and while an option for many medical situations, it is especially important to know of its reliability during a public health emergency.

Traci Haynes, MSN, RN, BA, CEN, CCCTM is director, clinical services at LVM Systems.

The Future of Healthcare is Here with Help from Telehealth and Hospital Call Centers


1Call, a division of Amtelco

By Nicole Limpert

Those of us in the healthcare communication field already know the value of telehealth and virtual care. As the COVID-19 pandemic evolved, telemedicine gained worldwide recognition as a critical healthcare tool to keep both patients and medical staff safe.

Telehealth has predominantly been used to bring healthcare to rural areas or isolated populations, such as overseas military personnel and those who work in the maritime industry. Until recently, the Centers for Medicare & Medicaid Services (CMS) placed certain stipulations on telehealth providers and would only reimburse for services provided in rural areas with specific audio-visual equipment.

However, due to the COVID-19 pandemic, on March 6, 2020 CMS relaxed restrictions and removed many of the conditions clinicians had to adhere to in order to provide telehealth services to patients living across the United States. Later, CMS expanded its telehealth adoption to include eighty-five new telehealth services to their covered list and set provider reimbursement rates for telehealth visits to be the same as in-person services.

Are We Ready for Telemedicine?

Many people are new to the concept of telemedicine. On July 31, 2019 JD Power reported that nearly three-quarters of Americans weren’t aware of telehealth options or didn’t have access to technology to partake in telehealth. Yet, the American Hospital Association states that 76 percent of U.S. hospitals were already using telehealth before the coronavirus pandemic. Currently, forty-eight states require telehealth coverage in insurance plans.

Healthcare-related industries already had infrastructure in place and were prepared for the use of telemedicine and telehealth. However, few, if any, expected how quickly the use of these virtual tools would grow or how they would be used in new ways when COVID-19 began to spread. The coronavirus pandemic has dramatically accelerated the adoption of telemedicine usage.

Telehealth visits sky-rocketed by 50 percent in March 2020 according to data from Frost and Sullivan, and analysts at Forrester Research estimates that virtual healthcare interactions will reach more than one billion by the end of 2020.

Hospital Call Centers Experience Increased Telehealth Calls

The pandemic has affected call centers in every industry. Most business websites have placed a message at the top of their home page warning of long hold times and delays in service. 

In healthcare, communication setbacks can mean life or death. Understandably, hospital call centers experienced a substantial increase in calls early in the pandemic. Many healthcare call centers assist with telehealth efforts and they also serve as a hub for their healthcare organization during a crisis.

“We played an immediate role in the hospital’s corporate response to the coronavirus pandemic,” explains Shelley White, MS, CHAM, FACHE, director of patient access services for State University of New York (SUNY) Upstate Medical University.

“A COVID-19 hotline was established, and we took calls from multiple counties in our area. Within two weeks, our call volume drastically increased, and we needed more space in our call centers to work while practicing social distancing. We used free operator licenses from our vendor to set-up additional remote operator workstations so more of our agents could work from home. This kept our staff safe while serving the community.”

Running a call center in a virtual server environment, or in the cloud, is giving hospitals the ability to stay flexible and available by using remote operators. These tools are scalable and result in fully functioning call handling to transform any personal computer into a professional telephone agent station.

Call Center Software Assists Telehealth Communication

Using telehealth for virtual appointments with medical staff and patients has been essential during this pandemic. There are other ways healthcare systems use telehealth communications. Hospital call centers are using their communication software, often in new ways, to provide their communities and staff with accurate information, quick responses, and in some cases—hope.

  • Nurse Triage Centers: Agents use a customized script to triage calls.
  • Improved Navigation Menus: Callers are directed to additional, updated information.
  • Non-Clinical Services: Telehealth also refers to remote, non-clinical administrative uses such as establishing and maintaining on-call shifts for COVID-19 volunteer pools. They can even create announcements using a song, tone, or message to broadcast throughout the hospital when a coronavirus patient is released. It’s a wonderful way to spread hope and encouragement to patients and staff.

Many telehealth agents are working from home and it is crucial for them to have access to the IT support they would normally use when working in the call center. Jennie McWhorter, information services operations manager for Ephraim McDowell Health in Danville, KY explains how the system can help here as well. “We have entered a ‘Telehealth Support Hotline’ in the call center software that allows the operators to connect to our help desk directly,” says Jennie. “This is very important as our main help desk line is usually a voicemail-only system that creates a ticket in our help desk software.”

Remote Operators Help Medical Staff

Shelley White’s team has also been able to help staff who are still located within the hospital. SUNY Upstate Medical University is the only ACS certified Level I Trauma Center in the region and serves about 1.7 million people and 28 referral hospitals. Shelley says, “During this coronavirus crisis, our ER registration is 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 workload.”

According to numbers reported from Becker’s Hospital Review on April 7, 2020, employees from 243 hospitals have been furloughed during the pandemic. Hospitals are taking steps to save supplies, suspend elective procedures, and focus on treating COVID-19 patients.

To avoid layoffs, some healthcare organizations reassigned their medical staff as remote call center operators. “We were able to redistribute existing staff from other departments and tap into their skills to cross-train them to work for the switchboard,” states Shelley. 

“In our situation, patient access staff and medical answer teams were trained on easy calls and were then able to work from home as remote operators. These staff members are now even more valuable to our organization.”

Kathleen Kerrigan BSN, RN, and manager of medical communications center, radiology contact center and pager services for Nebraska Medicine mentions her experience: “Nebraska Medicine has created a flex pool for employees that work in areas of the organization that have closed or severely cut their workflows due to COVID-19. I was able to add nineteen of these employees to my team, including both nurses and agents.”

Telehealth as the New Normal: Telehealth has suddenly become crucial for patients and healthcare organizations. The use of telehealth has undeniably shown what a valuable tool it is in maintaining a healthy population. 

Hospital call centers and healthcare professionals have already shown agility in adapting communications software in new ways to improve telemedicine applications while enhancing patient care—even during a pandemic. Advances in technology and our ability to use it could soon make the use of telehealth a standard healthcare practice. 

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.

Vendor Spotlight On TriageLogic


TriageLogic

Adapting to the Demands of Healthcare with High-quality Solutions for Nurse Triage and Remote Patient Care

In 2006 by Charu Raheja, Ph.D., founded TriageLogic with the purpose of using modern nurse telehealth technology and medical expertise to improve access to healthcare. Their goal is to ensure everyone receives the same standard of care regardless of where they live. Ravi Raheja, MD, serves as the medical director and COO, overseeing all nursing and technology operations in the company to ensure patients receive the highest level of care.

Over the last thirteen years, TriageLogic has stayed true to its mission and continues to provide innovative nurse telehealth technology and mobile applications. TriageLogic also operates one of the largest URAC-accredited healthcare call centers in the United States. As healthcare has evolved, TriageLogic has continued to adapt and release new product lines to meet the changing needs of the industry.

The year 2020 has challenged our healthcare system, causing many medical professionals to work around the clock to implement emergency remote support solutions for patients. TriageLogic has been proud to assist with the COVID-19 pandemic by quickly adapting and creating easy-to-implement solutions for hospitals, medical organizations, and health centers to use for patient care during the COVID-19 crisis.

The following lists some of the solutions available for clients:

Nurse Triage On Call

TriageLogic maintains one of the most sophisticated URAC accredited nurse triage systems in the United States. Their call center software allows clients to customize orders after nurses evaluate the symptoms presented by patients. Nurses can share handouts with patients on behalf of doctors, and MDs can communicate securely with nurses using HIPAA-compliant texting. The company quickly ramped up its services and software implementation as it observed a call volume increase by as much as 35 percent due to COVID-19.

Customized Coronavirus-Trained Hotline and Patient Triage System

These hotlines include a combination of online systems and a remote call center telephony with triage protocols. By partnering with physicians, TriageLogic helps millions of concerned callers, evaluate their symptoms, and coordinate testing for thousands of patients.

Remote Call Center with a Phone System for Doctors and Nurses

TriageLogic can set up nurses and doctors to work remotely, including connecting all staff to a call center-grade, HIPAA-compliant phone system. This system allows organizations to keep their clinical staff at home and coordinate as a team as if they were in the office. From front desk staff to nurses and doctors, the entire team stays together while working remotely, including scheduling visits and conducting telehealth visits. Using secure phone lines keeps patient information confidential.

Nurse Triage Software with Up-To-Date Protocols (including COVID-19)

MyTriageChecklist is a fast-to-train, web-enabled software from TriageLogic that provides continuity in patient care and education. It takes less than an hour to implement, does not store any sensitive patient information, and offers an easy-to-use interface to ensure nurses ask and consistently document all relevant questions related to patient symptoms.

It also includes triage protocols written by Dr. Schmitt and Dr. Thompson, which are updated in real-time. For example, COVID-19 protocols receive regular updates as information becomes available.

Remote Patient Monitoring (RPM)

As monitoring technologies continue to gain traction, the healthcare industry views RPM as a way to help control the cost of care for those with chronic diseases such as congestive heart failure, COPD, asthma, and diabetes.

However, the amount of data that’s generated by monitoring technologies is vast. TriageLogic has partnered with several device companies to create a full end-to-end monitoring system. The system makes it easy for doctors to monitor their chronically ill patients without adding administrative or clinical burden to their staff. TriageLogic can also create specific protocols for nurses to use based on devices and patient conditions.

Reporting Portal

Finally, all TriageLogic solutions come with a robust reporting portal to provide in-depth analytics on the outcomes from patient interaction. TriageLogic aims to stay ahead of the demands of healthcare and create ready-made and easy to implement solutions to continue helping providers give the best possible care to their patients.

TriageLogic is a URAC accredited, physician-led provider of high-quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. The TriageLogic group serves over 7,000 physicians and covers over 18 million lives nationwide.

TriageLogic Implements Emergency COVID-19 Hotlines and Remote Care Solutions


TriageLogic

TriageLogic announced easy-to-implement solutions that hospitals, medical organizations, and health centers can use for patient care during the COVID-19 crisis. As the healthcare sector adapts to the coronavirus pandemic, many medical professionals work around the clock to implement emergency support solutions for patients who present worrying symptoms, as well as those who need help understanding the guidelines for care. 

The following solutions have minimal implementation time requirements:

  • A Coronavirus-trained hotline is available 24/7 to screen patient questions, provide information, and follow scripts on behalf of specific practices and medical groups. With a significant increase in patient calls, the ability to discern which ones require additional medical attention and which are only seeking advice is paramount to a functional office staff. 
  • Nurse triage software with Covid-19 protocols, through MyTriageChecklist, is a fast-to-train, web-enabled software that provides continuity in patient care and education. It takes less than an hour to implement, does not store any sensitive patient information, and offers an easy-to-use interface to ensure nurses consistently ask and document all relevant questions related to patient symptoms. 
  • Remote call center with phone system can enable your certified nurses to work at any location connected to a call center-grade, HIPAA-compliant phone system. This allows an organization to keep their clinical staff at home and coordinate as a team to remotely evaluate patients.

“We are working around the clock to help our current clients as well as other health centers put processes in place to help patients and concerned callers. We are also working with remote monitoring companies to have a process in place to help patients at risk, or after a hospitalization at their homes,” said TriageLogic’s Ravi Raheja, MD.

TriageLogic

TriageLogic offers easy to implement solutions for healthcare organizations to address the COVID-19 crisis. This includes setting up information hotlines, giving nurses the tools to evaluate patients over the phone, and helping set up remote call center phone systems. Visit www.triagelogic.com for more information or email info@triagelogic.com.

Implementing Virtual Call Centers with Telehealth Systems to Address COVID-19


TriageLogic


TriageLogic announced a quick-to-deploy and easy-to-use telehealth system with a virtual call center that hospitals, medical organizations, and health centers can use for patient care during the COVID-19 crisis.

As health organizations adapt to the coronavirus pandemic, they look for a system they can deploy quickly for staff and nurses to work remotely to set up doctor visits, answer patient questions, evaluate their symptoms, and determine who needs further evaluation by a doctor. Team members can communicate with their physicians and set up two-way video visits using secure, HIPAA-compliant texting options that do not require the use of a mobile app. This allows the remote hospital associates to set up and coordinate telehealth visits for doctors instead of in-person visits.

Nurses can also be included in the solution by having COVID-19 and other medical protocols available in a web-based system. The information from the phone call can be exported to the hospital’s EMR system or be integrated with Salesforce.

TriageLogic can deploy the following solutions related to sending staff home:

  • Cloud-based HIPAA compliant call center telephony system for coordination of remote staff
  • Phone system to connect remote workers with queueing and full contact center capability
  • COVID-19 nurse triage protocols for use with existing EMR or CRM such as Salesforce
  • Web-based triage software with COVID-19 and other protocols
  • Coordination of telemedicine visits between non-clinical, nurses, and doctors in client EMR
  • TriageLogic assists in recommending efficient workflow and implementation of two-way video visits

Additional solutions such as a fully staffed COVID-19 hotline and remote patient monitoring are also available. “TriageLogic was able to set up a telehealth system within a couple of days for our nurses and doctors to work remotely and continue their medical visits,” said Melinda, director of PPM business operations for a large children’s hospital.

TriageLogic

Visit www.TriageLogic.com or email info@triagelogic.com for more information.