Category Archives: Issues

The current issue of Medical Call Center News. (Scroll down to see past issues.)

The June 2010 Issue

The Challenge of Elderly Callers

By Barry Spiegelman

Delivering and receiving critical information by telephone is an especially challenging proposition when an elderly caller is on the other end of the line.  Whether the impediments are technological, physiological, or psychological, or a combination of all three, telephone communication with seniors requires an elevated level of skill, attention, and patience.

While the younger generation is busy applauding the convenience, mobility, and personalization new technology brings, this is often viewed quite differently by seniors.  As a rule, older people are less at ease with technology.  To most seniors, smaller, faster phones with their buttons and gizmos can present a daunting challenge.

BlackBerries and iPhones are just one of the communication challenges that face older people today.  The perceived benefits of new technology are negligible to many elderly persons whose telephone needs are very simple.  In addition, seniors can also find the telephone challenging because of physical or sociological factors.  These could include:

  • Hearing loss, which may interfere with both speech and comprehension.
  • Diminished vision and mobility, which may create obstacles to dialing, following phone prompts, and writing or reading notes.
  • Strokes, foreign accents, or even ill-fitting dentures, which may complicate even the simplest verbal communications.
  • Memory loss, dementia, and age-related attention disorders, which may cause a caller to lose the thread of conversation, forget to ask important questions, become frustrated and angry, repeat themselves, or even fall asleep during the course of a call.
  • Loneliness and isolation, which may cause callers to engage in lengthy conversations.
  • Social or cultural norms, which may lead the elderly caller to avoid discussing problems directly.

Frustrating as they are to the older people themselves, these issues also create daily challenges to unprepared call center agents at the other end of the connection.  Learning and practicing effective communication techniques is one of the most important skills for all call center personnel, especially those in the medical industry.

Based on nearly two decades of experience answering more than 15 million calls, many from the elderly, here are four essential ingredients to communicating with seniors over the phone:

1. Patience: Patience means listening carefully, empathetically, not rushing the speaker or jumping to conclusions, not interrupting, and never finishing the caller’s sentences for them.

2. Careful, thoughtful speech: Speak slowly and enunciate clearly, and also pay special attention to vocal quality.  If an elderly caller is agitated, their voice may rise in pitch and volume.  Unconsciously mirroring that tone or being drawn into the caller’s agitation can quickly turn a helpful call into a confrontation.

3. Special probing skills: Questions may need to be asked, rephrased, and asked again, and the answers paraphrased and reconfirmed.

4. Respect: Using titles such as Dr., Mr., and Mrs. is particularly important.  At the same time, be careful to avoid patronizing language or tone.

Medical call centers can do their part to aid in the communication process by providing their agents with special training specifically focused on speaking with elderly callers so they can be better prepared to be of true service to this important segment of the population.

Barry Spiegelman is cofounder and chief customer officer of The Beryl Companies.


Your Call Center’s Role in a Disaster

By Peter Lyle DeHaan, PhD

Author Peter Lyle DeHaan

A few years ago, Dr. Maurice A. Ramirez recommended “Five Questions to Ask Your Hospital Before Disaster Strikes.”  Be it a natural disaster, a manmade catastrophe, a terrorist attack, a pandemic, or any other large-scale emergency, it is critical for all medical personnel to be trained and ready, including the call center.

Dr Ramirez’s five questions were:

1) What has been done to prepare?

2) Who is grading the drills?  It should be an independent evaluator.

3) Does the ER door lock?  Many ERs have easy access, so the ER and everyone in it can quickly be contaminated.

4) Who is being trained?  It is shortsighted to only train ER staff.

5) What decontamination facilities are available?  In a disaster, 80 percent of the victims arrive in something other than an ambulance, which means they show up potentially contaminated.

Now apply these thoughts to your call center – regardless if it is part of the hospital or not.

1) Be ready.  Have a plan for your call center and test the plan.  During an emergency, priorities change – or at least should change.  Making adjustments on the fly is never a wise idea.  Determine these changes ahead of time.

2) Seek an independent review.  Then implement and test the recommendations.

3) If the ER is locked, expect panicked calls.  Know what to tell callers and how to reassure them.

4) Include all call center agents in disaster training.  While they will not be offering in-person assistance, they could very well become the first line of defense – via the telephone.

5) Train call center on decontamination protocols.  They will need to know the options and processes so that they can knowledgeably inform callers.

Now that the basics are covered, ask what else your call center can do.  In addition to handling an influx of incoming calls, outbound notification calls can also be placed on behalf of other departments or organizations.  Several vendors offer automated emergency notification systems so that key personnel can be quickly informed.  Also, include a calling list for your agents; some of them may need to come in or be prepared to work from home or a remote location.

While no one wants a disaster to occur, if it does, your call center could be the hero – if you do some advanced planning.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of Medical Call Center News. He’s a passionate wordsmith whose goal is to change the world one word at a time.


Hospital Smartphone Messaging with Android Support

Amcom Software, Inc. announced that Amcom Mobile Connect now offers smartphone messaging for the Android.  This enables physicians and other staff members at technology-driven hospitals to receive all messages on a single smartphone, negating the need to carry multiple devices for different types of messaging.  The solution provides a full audit trail of activities, including date and time stamps for messages sent, received, and acknowledged to ensure traceability and accountability.  The result is improved patient care and staff efficiency through a highly streamlined unified communications process, making it clear how to reach the right staff members at all times.

With smartphones as the basis for their pager replacement strategy, healthcare organizations are able to capitalize on devices already in widespread use to simplify the process of contacting highly mobile staff.  Amcom Mobile Connect gives hospitals the flexibility to incorporate smartphones without worrying about which telecom carrier provides service.  This solution is already in place at several hospitals using BlackBerry smartphones, and the new Android compatibility increases the options for communicating with highly mobile staff.

Hospital operators and others can use Amcom Mobile Connect to deploy critical messages to staff members through a variety of inputs, including a simple Web portal.  In addition to this stand-alone deployment option, the solution also integrates with Amcom’s unified communications suite.  This provides solutions for contact center automation, online employee directories, on-call schedules, and event notification systems.  Integration with related communications systems means that everything pulls contact and schedule information from a central database, improving administration, accuracy, escalation procedures, and speed.

“There is a clear need in hospitals for a solution like this,” said Chris Heim, CEO, Amcom Software.  “Adding support for Android smartphones is just one of many enhancements our development team will be making to the product over the next several months.”


Many Elderly Patients Lack Decision-Making Capacity

More than one in four elderly Americans lacked the capacity to make their own medical care decisions at the end of life, according to a study of 3,746 people published April 1 in the New England Journal of Medicine.

Those who had advance directives – including living wills or durable powers of attorney for healthcare – received the care they wanted most of the time, says lead author Maria Silveira, MD, MPH, physician scientist at the VA Ann Arbor Healthcare System’s Clinical Management Research and assistant professor of Internal Medicine at the University of Michigan.

“Prior to our study, no one knew how many elderly adults might need others to make complex medical decisions on their behalf at the end of life,” says Silveira.  “Our research shows that a substantial number of older adults need someone else to make decisions about whether aggressive, limited, or comfort care should be provided at the end of life.  This study underscores the need to prepare oneself and one’s family for the often emotional and difficult medical decisions that can arise at the end of life.  It also suggests that the time spent to craft a living will and appoint a durable power of attorney for healthcare can be worthwhile.”


Virtual Monitoring Reduces Hospital Readmissions

Patients discharged from the hospital with congestive heart failure (CHF) often are readmitted to the hospital because it is difficult to manage their condition.  A home-monitoring pilot program available through Spectrum Health in Grand Rapids, Michigan, has helped to significantly reduce hospital readmissions for these patients.  Priority Health, Spectrum Health Heart Failure Clinic, Spectrum Health Visiting Nurse Association (VNA), and West Michigan Heart worked together to develop a program that involves “virtual monitoring” of eligible patients.

“Telehealth has provided just-in-time daily information that helps our members and providers respond quickly to changes in clinical condition.  Interventions based on this information have contributed to improved health outcomes for patients,” said Dr. Jim Byrne, chief medical officer, Priority Health.

The telehealth program, which began last June, is being used by CHF patients receiving care from VNA nurses at home.  The patient’s biometric readings, such as weight, blood pressure, and symptom presentation, are transmitted daily by equipment provided by VNA.  The patient data is automatically sent via the telephone to a heart failure registered nurse at VNA who reviews the patient’s condition.  This allows the nurse to contact the patient at the first sign of a change in the condition.  Daily phone conversations or home nursing visits are part of the program.


Summer Sun, Summer Fun, Summer Safety

Our skin is our largest organ.  It protects us from injury, infections, and regulates our body’s temperature.  It stores water, fat, and Vitamin D.  But for the one in five Americans who will be diagnosed with skin cancer within the next year, skin is a painful reminder of past sun damage.

More than 90 percent of skin cancer is caused by sun exposure, even though sun damage may be the easiest to prevent.  Everyone knows the basics of sun safety: wear sunscreen (at least SPF 15 or higher), cover up with hats, t-shirts, sunglasses, and stay in the shade.  If sun protection is common sense, then why is skin cancer the most common form of cancer?

Robert Miller, MD, of Wellspring Oncology weighs in: “Most people are surprised to learn that even UV exposure over short periods of time can still dramatically increase the risk for cancer.”  For those with lighter skin tones, a family history of skin cancer, and an experience of severe sunburns earlier in life, skin cancer is a very real possibility.  Miller advises, “Skin care is a relatively simple concept: if your skin burns easily – stay out of the sun!”

Due to the amount of sun damage that can accumulate earlier in life, children and teens need to be protected.  “Many cases of cancer are connected to severe burns from the adolescent stage in life,” says Miller.  “Men are also twice as likely to develop skin cancer than women.  It is the most common form of cancer in men over fifty.”

Once the harm is done, it is impossible to erase.  However, people can still make lifestyle changes now that will reduce their risk for the longer term.  Even after a diagnosis, there is still hope.  Miller says, “Newer radiation technology enables us to treat skin cancer in six days.  There is no scarring, no hospital stays, and minimal side effects.”

Miller still advises, “There is no such thing as a safe tan that involves any form of UV exposure.  Darker pigmentation is the skin’s way of protecting itself – it signifies damage.  The only safe tan is a sunless tan.”


Online Nursing Resource for People Living with Cancer

Eisai Inc. launched the NSider® Patient Education Tool, an online program that provides patients and caregivers with individualized information about living with cancer.  NSider was created by Eisai and a team of oncology nurses who have in-depth professional (and for some, personal) experience with cancer.

“As a cancer survivor, I know that the sheer volume of information available to patients can feel overwhelming and impersonal,” said Katie Sargent, RN, hematology nurse clinician at Indiana University Simon Cancer Center in Indianapolis and member of the NSider steering committee.  “NSider helps make it possible for patients to receive educational material tailored just for them, based on their individual needs and challenges.”

The NSider Patient Education Tool allows nurses to assemble patient information based on characteristics such as cancer type, stage of treatment, and type of treatment, as well as topics of interest like insurance information, end-of-life care, and eating tips.  In addition, NSider will offer specific information and tools to help educate patients about the side effects of cancer treatment, including a downloadable resource for patients to track chemotherapy-induced nausea and vomiting (CINV), and share with their cancer-care team during office visits.

Nurses can choose from three different methods when preparing information for their patients: the first method allows users to preview and select pages of content to include in one packet; the second method offers previously created packets that can be edited as needed; and the third method allows nurses to search through all available pages using key words to find the most useful information for their patients.  A video tutorial is available to help users get started.  All three methods produce a tailored educational packet that can easily be converted to PDF format and printed or emailed to the patient.


OBSI Conducts Healthcare Contact Center Best Practices Survey

Optimal Business Solutions, Inc., (OBSI) is conducting a survey to identify best practices for appointment setting in healthcare facilities, worldwide.  The survey will explore metrics, tools, and processes that drive patient satisfaction, contact center efficiency, and effectiveness.

The survey’s results will provide readers an opportunity to benchmark their operations with best practices of their industry colleagues. Results will be summarized in upcoming issues of AnswerStat and Medical Call Center News.  A full report will be provided  free to survey participants. The survey will remain open through June 30, 2010.

OBSI is a New York based consulting firm that helps businesses improve profitability and customer satisfaction by making it easier for their customers to do business with them.  OBSI tailors customer contact solutions by blending industry-specific best practices with its learnings from a broad array of other industries.



The May 2010 Issue

Meeting Intrinsic Agent Needs in the Medical Call Center

By Kelli Massaro

Retaining top agents is essential to a medical call center’s success.  The challenge is to create a positive work culture that sustains, nurtures, and engages employees – both as part of a team and individually.  While retention strategies must also address extrinsic factors (organizational or departmental systems that support employees), this article will focus on how medical call center managers can meet the intrinsic needs of their agents.

Agents have several basic needs that must be met in the workplace to feel satisfied.  As a call center manager, if you can meet these needs, you can positively influence retention.  In many cases, nurturing good relationships with your employees can override the negative effects of extrinsic organizational factors.  Here are some key areas to consider.

1) Good Relationships with Supervisors: After job fit, fair supervision is the second biggest factor in employee retention.  Supervisors and managers who use a constructive “coaching” style when delivering feedback nurture growth and learning among their employees.  Conversely, supervisors that “police” for infractions and shortfalls create fear and inhibit employees’ growth potential.

2) Belonging to a Team: A sense of belonging is created when an individual feels a personal investment in the call center’s shared vision and participates in call center decision-making.  Stay open-minded to new ways of looking at things, and take advantage of networking with other call centers to explore alternative solutions.  This will push your program and your agents to new heights.

Contribution: Agents enjoy the opportunity to make a meaningful contribution to their workplace.  Pooling their unique talents, gifts, and interests creates an opportunity for each employee to excel and have unique ownership for a project, or for the work itself.

Security: When security (whether financial, physical, or emotional) feels threatened, employees begin to experience anxiety, stress, and dissatisfaction.  Communicating regularly – and even more often during times of change – promotes trust.

Control: Employees don’t like change when they feel it is “done to them.”  Managing change poorly is a frequent cause of job dissatisfaction among medical call center staff.  Implementing change with staff suggestions in mind will achieve better staff support and results that are more positive.

Recognition and Appreciation: Recognizing a job well done and showing appreciation to employees on a regular basis goes a long way toward keeping employees satisfied.  This can be done in small ways, such as a verbal “thank you” or a written note.

Although a powerful motivator, no incentive program can replace good leadership and management practices.  The key to retention is attending to the basics because no amount of praise or rewards will keep and attract staff if their basic intrinsic needs are not met.

Kelli Massaro works as a triage nurse and is the communications director with LVM Systems; she may be reached at


The Buck Stops with You

By Danita Johnson-Hughes, PhD

Never before has it been more obvious that the medical call center world needs leaders who have the willingness to make things better for everyone.  To do that, the ability to connect with other people becomes important.  First, however, you have to understand who you really are.  And you can’t do any of these things until you begin to take responsibility for yourself and your part in the world.  If you want to create change in your call center, your community, or yourself, you have to be willing to let the buck stop with you.

There are three areas of responsibility, all of which must be addressed before change of any kind can take place: personal, proximal, and social.

Personal responsibility requires introspection.  You have to take responsibility for yourself, your actions, and what you accomplish in your life.  You have to know who you are and what you value.

When you take personal responsibility, you create worthy goals and are able to act on those goals, becoming the best you can be and creating the ability to help others in the process.

Proximal responsibility means taking responsibility to support your boss, coworkers, and subordinates by giving them honest feedback, sharing information, encouraging them when their actions positively affect you or your call center, and holding them accountable when that effect is negative.

Social responsibility is built on interlocking relationships in which everyone takes responsibility for each other as a group.  A person who takes action to make a positive difference in her department, division, or the call center as a whole understands by reaching out to affect the greater good she strengthens the bonds that tie customers, managers, and employees together, increasing the call center’s chances to not only survive but to thrive and be successful and improving everyone’s chances for individual success.

To be clear, if you really want to change yourself and your world, you must operate from all three areas of responsibility – none of the areas works well without the other two.  Taking responsibility for your life and your actions is the foundation that must be established before beginning to take on the proximal responsibility of helping others.  As a result, you will gain the skills necessary to take on greater social responsibility.  This is how responsibility works.  This is how successful organizations work, when they do work.

Danita Johnson Hughes, PhD, is a healthcare industry executive, public speaker, and author of the forthcoming book Turnaround.  In her first book, Power from Within, Danita shares the Power Principles for Success that helped her overcome meager beginnings and achieve professional, community, and personal success.  For more information, email her at


The Healthcare Debate Continues

By Peter Lyle DeHaan, PhD

Author Peter Lyle DeHaan

As a magazine and Web site publisher, all manner of articles and press releases show up in my inbox on a daily basis.  Although some of them are carefully targeted to the markets I serve, most are widespread missives that are sent to every publisher with a pulse, regardless of their beat or focus.

Leading up to the historical – some would say, infamous – healthcare vote in the US house earlier this year, I received an increased number of press releases against the bill.  Since I wasn’t interested in using any of them, I quickly scanned them while pressing delete; I do not recall any that were in favor of the bill.

Also appearing in my inbox were numerous “op-ed” submissions decrying either the bill or the process.  Even though I’ve never published an op-ed piece and never plan to, the submissions continued to arrive.  What amazed me was that, for the most part, there was no effort to present a thoughtful discourse or an elegant argument; the submissions were all filled with polarized perspectives and emotionally laden rhetoric.  While I might have agreed with their general point, I was repelled by their tenor, tone, and tack.

Even after the bill was passed and signed by President Obama, I have continued to receive press releases and op-ed pieces in opposition to what had happened – and fear of what might happen.  A new element was added – announcements of lawsuits being filed.

It would seem that the vote approving the bill and its subsequent signing into law will not end the debate; it will merely shift to a new venue.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of Medical Call Center News. He’s a passionate wordsmith whose goal is to change the world one word at a time.


“Avaya Compliant” Earned by Amcom

Amcom Software announced that its contact center applications are compliant with Avaya Aura™ Application Enablement Services (AES).  The Amcom contact center applications, a foundational element for its unified communications solutions, help organizations create safer and more efficient environments through fast, intelligent information sharing.  The applications now are compliance-tested by Avaya for compatibility with Avaya Aura AES 5.2.

“Companies like Amcom Software are expanding the choices available to Avaya customers,” said Eric Rossman, vice president, developer relations at Avaya.  “With a broad selection of standards-based solutions that are compliance-tested for interoperability, businesses can use communications strategically in their operations and make critical information readily available to both clients and employees.”

Amcom Software is a member of the Avaya DevConnect program – an initiative to develop, market, and sell innovative third-party products that interoperate with Avaya technology.  “Amcom is committed to ensuring seamless integration with Avaya solutions so we can continue to be a single source for customers’ end-to-end unified communications requirements,” said Chris Heim, CEO of Amcom Software.  “The fact that Avaya’s innovative solutions are based on open, standards-based platforms enables our customers to incorporate new technologies alongside their Amcom solutions easily and cost-effectively.  This helps them create forward-thinking communications infrastructures based on fast, accurate data exchange.”


Triage Seminars to Help Improve Quality and Reduce Risk

Carol Rutenberg of Telephone Triage Consulting, Inc announced the location and dates for the upcoming seminars:Telephone Triage as Professional Nursing Practice: Improve Quality & Reduce Risk.”  The goal of the two-day seminar is to train participants to:

  • Perform a risk assessment of their own program
  • Begin development of a plan to apply telehealth nursing standards to their practice
  • Recognize telephone triage as professional nursing practice
  • Identify critical program design elements for successful triage
  • Conduct a quality patient assessment over the phone
  • Perform safe, legally defensible telephone triage in their setting
  • Provide leadership and insight regarding the practice of telephone triage to others in their clinical setting

There are three dates and locations to pick from: July 14-15 in Dolce Valley Forge, King of Prussia, Pennsylvania; July 20-21 at Four Points by Sheraton BWI Airport Hotel, Baltimore, Maryland; and July 26-27 at Austin Hotel, Hot Springs, Arkansas.


Survey Results: 70 Percent of Healthcare Execs Believe Reform Will Hurt

Nearly three-quarters of healthcare executives surveyed earlier this month say that healthcare reform will have a negative financial impact on their facilities, while more than 60 percent note that reform will have a somewhat or very detrimental effect on the quality of care their facilities are able to provide.  These are among key findings from the “2010 Survey of Healthcare Executives:  Initial Response to Healthcare Reform on Cost, Quality” conducted by AMN Healthcare, the nation’s leading provider of comprehensive healthcare staffing and management services.

The survey was targeted to executives who will be among those responsible for implementing the new healthcare system put into place by healthcare reform.  “AMN’s survey signals that the initial response to healthcare reform by the majority of hospital and medical group leaders is one of concern, and it highlights the fact that many healthcare executives are apprehensive about how reform will affect their facilities,” said Susan Nowakowski, AMN Healthcare’s president and CEO.

Only about one in five of those surveyed (22 percent) were greatly or moderately pleased by the passage of healthcare reform.

In addition, the survey suggests that the majority of healthcare executives believe that reform will create more patient demand for the services they offer and therefore a need for more clinicians.  Sixty-two percent of those surveyed said healthcare reform will cause them to add more physicians, 56 percent said reform will cause them to add more nurses, and 56 percent said healthcare reform will drive them to add more allied healthcare professionals.

The complete survey is available at


Healthline Raises $14 Million for Medically Guided Search

Healthline Networks announced that it has raised $14 million in a third round of financing; it will use the proceeds to expand research and development, engineering, sales, and network services to meet the growing demand from a broad spectrum of consumer-focused media and healthcare businesses looking to improve the way consumers find, understand, and manage health-related information.

“Consumers have become increasingly engaged in their own healthcare, and smart organizations are looking to capitalize on this trend,” said Phil Dur, managing director, IGC, who led the financing; Dur has also joined Healthline’s board.  “IGC’s investment in Healthline, given its innovative search and advertising technology, is consistent with our track record of partnering with industry-leading companies.  We’re looking forward to assisting Healthline with its efforts to continue to provide products that not only help consumers but media and healthcare partners as well.”

Since its launch in late 2005, Healthline Networks has built a consumer-health destination Web site,, which is a Top 10 health information site as measured by comScore MediaMetrix.


Personal Health Records Use Growing

By Nicole Lewis, InformationWeek

Nearly one in ten adults surveyed report using a Web site to record health information.  A new survey finds that people who use a personal health record (PHR) are likely to learn more about their health, have a better understanding of the care doctors provide, and those with two or more chronic illnesses ask more questions to improve their health compared to before they used a PHR.

Published by the California HealthCare Foundation (CHCF), the study interviewed 1,849 people and found that 7 percent of adults used a PHR, which entails using a Web site to record health information online.  That’s more than double the proportion identified as users of a PHR two years ago.

The report showed that 56 percent of respondents said that using a PHR made them feel like they knew more about their health, and 52 percent said that it helped them to better understood their doctor’s decisions.  The survey also indicated that older, less-educated people who have more than one chronic illness are more likely than others to say they are more knowledgeable about their health because of using a PHR.

Sixty-one percent of respondents forty-five-years-of-age or older and 61 percent without a college degree were more likely than others to say that they know more about their healthcare as a result of using a PHR.  Additionally, 58 percent of respondents with two or more chronic conditions said they know more about their health compared to 44 percent of those with one or no chronic conditions.

“People with lower incomes, less education, and those who are living with multiple chronic illnesses have the most to gain from PHRs,” said Veenu Aulakh, senior program officer in the Better Chronic Disease Program at CHCF.  “This reinforces our assertion that getting a PHR in the hands of more consumers could positively impact the health of the country,” Aulakh added.

This article is provided by InformationWeek Healthcare.


UM Study Shows Shift Workers at More Risk for IBS

Nurses participating in shift work, especially those working rotating shifts, face a significantly increased risk of developing Irritable Bowel Syndrome (IBS) and abdominal pain compared to those working a standard daytime schedule, according to research published in the American Journal of Gastroenterology.

“We know that people participating in shift work often complain of gastrointestinal symptoms such as abdominal pain, constipation, and diarrhea,” says Sandra Hoogerwerf, MD, assistant professor of internal medicine at the University of Michigan Medical School.  “These are the same symptoms of IBS.”

“Our findings suggest that nurses participating in shift work, particularly those who participate in rotating shift work, have a higher prevalence of IBS and abdominal pain.  This association is independent of sleep quality,” the authors write.  “We know the colon has its own biological clock, and that’s what increases the likelihood of having a bowel movement in the first six hours of the day.”

The researchers say their study suggests that sleep disturbances do not completely explain the existence of IBS or abdominal pain associated with shift work.  Meanwhile, the researchers suggest, “Practicing gastroenterologists should be aware of this association and educate patients with IBS on the possible impact of their work schedule on their symptoms.”

The April 2010 Issue

Create a Call Center Culture of Optimism

By Ozzie Fonseca

Working as a customer service supervisor can be challenging for many reasons.  It is not rare to encounter low morale and a lack of enthusiasm for the job.  However, dwindling motivation should not be an inevitable attribute that all call center operations share.  It is possible for contact center supervisors and managers to create an environment where optimism can flourish.  Supervisors can accomplish this by consistently modeling desired behaviors, enforcing policies, and instituting appropriate reward systems.

Model Desired Behaviors: Call center representatives must follow strict policies regarding attendance, breaks, etc.  In contrast, supervisors may have more lax requirements, which permit them to attend to duties such as coaching, meetings, and administrative tasks.  The difference between the phone agent’s level of freedom and that of a supervisor can be grounds for discontent if not properly managed.  Such paradoxes are always detrimental to employee motivation because they reinforce the notion that supervisors are paid more but are held to a lower standard of conduct.

Enforce Policies And Guidelines: Successful call center operations require stringent requirements for call handle time, up-sell or cross-sell quotas, and quality scores – all managed and enforced competently by proficient supervisors.  Without this ability, a supervisor’s actions can undermine a key component of employee motivation: clear expectations.

Institute Appropriate Reward Systems: While the definition of what is appropriate can vary from one call center to the next, the basic characteristics of a good reward system remain constant.  In order to achieve their objective, rewards must appeal to various motivators, encourage only desired behaviors, and provide incentives that are of value to the agents.  Successful reward systems begin by appealing to the various motivators that compel people to action.  It is important for call center managers to identify and consider the most prevalent motivators within their groups before finalizing any type of incentive program.  Assuming that money is the best or only way to motivate call center representatives can prove to be a very expensive and counterproductive proposition.

Call center supervisors have the responsibility as well as the privilege of creating a positive atmosphere in their call centers – a culture of optimism that allows their agents to flourish.

Ozzie Fonseca is a veteran of the customer service industry turned cartoonist.


Virtual Agents to Capture and Report Student Illness Symptoms for CDC Pilot Program

David Kirsh, a professor of cognitive science at UC San Diego, working with a grant from the Centers for Disease Control and Prevention (CDC), has chosen SmartAction virtual agents to capture and report on student illness symptoms at an elementary school in 4S Ranch, California.

Smart Action Company LLC is a provider of automated virtual agents powered by artificial intelligence that answer and make calls for contact centers.  The system also features the best natural language speech recognition and synthesis technology available, making user interaction open and easy.

The pilot project was established to determine if increased information about medical absences reported to schools would lead to improved intelligence about contagious diseases, possible biological attacks, or other notable trends in student health.  According to Kirsh, “This type of system greatly improves information quality and enables more rapid analysis, allowing us to detect trends in symptoms and disease.”

When parents call the school to report children absent or ill, the virtual agent answers the call and asks a number of questions about symptoms.  Information provided goes into a database for later reporting and analysis.  The virtual agent automatically identifies parents or relatives based on Caller ID and remembers yesterday’s symptoms for speedy reporting.

The system also gives callers the option to provide additional information, which is then recorded.  The system reports the results to the researchers in three ways: 1) by email with a summary of information captured, including the recorded parts; 2) with a real-time database update to the university system; and 3) with a web-based report with a click-to-listen feature.

David Kirsh added, “After a poor experience trying a conventional interactive voice system, it was clear we had to find something more advanced to do the job.  We needed a technology that would provide an optimal caller experience and capture the needed information.”

“This was an ideal project for our artificial-intelligence-based virtual agents,” added Peter Voss, CEO of Smart Action.  “Not only is the necessary information captured quickly and easily, but it is available immediately to the school district and the CDC in a database.  They have real time access to current health trends and will be able to mine growing historical data to uncover longer-term trends.”

At the conclusion of the pilot program, Kirsh and other researchers will present their findings to the CDC with hope that it will be adopted as the new way to gather such information in school districts across the state and country.


Making the Best of Healthcare Reform

By Peter Lyle DeHaan, PhD

Author Peter Lyle DeHaan

As 2009 ended, I speculated that President Obama would doggedly pursue healthcare reform as an ideology (which, for better or worse, could become his legacy).  In February, I pointed out that the House of Representatives could do an end-run on the whole political process, merely passing the bill that the Senate had already approved.

This is one time when I am sad to say that I was right.  It’s not that I am against healthcare reform.  There is a definite need for it, which I heartily support; unfortunately, my ideas for healthcare reform didn’t make it into the bill:

  • Each person has a responsibility to take control of their health, lifestyle, and healthcare, treating it like we do everything else, as a cost/benefit consideration.
  • Place limits on medical liability and reasonable caps put on settlements; penalize those who file frivolous lawsuits.
  • Cut back on unneeded procedures, tests, and treatments, evaluated on their cost/benefit.

While it remains to be seen if this law will result in substantive, positive improvements, I personally expect that my healthcare costs will go up and the quality of my care will go down.  I hope that I am wrong but fear that I am right.

Aside from a present shortage of doctors, the threats that more will choose to leave the field, and a growing shortage of nurses, the reality is that millions of new patients will soon be added to the system, putting additional strain on already stretched personnel.

Now that President Obama has signed the bill, it’s a done deal – except for the lawsuits – so the most effective thing we can collectively do as a nation is to be supportive of our president and make the best of the situation.

Let’s not fixate on what did and didn’t happen – let’s just move forward.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of Medical Call Center News. He’s a passionate wordsmith whose goal is to change the world one word at a time.


The World Congress Customer Centric Solutions Expo – June 24-25, 2010

As health plans implement strategies to transform their business into customer centric organizations, essential to their success will be new customer service models supporting marketing, communications, and benefit design strategies.  To remain competitive in the changing healthcare landscape, The World Congress Customer Centric Solutions Expo will discuss how health plans should reassess their customer service practices to ensure they implement “new” service models that meet the needs of their members.

The World Congress Customer Centric Solutions Expo will be held June 24-25, 2010, at the InterContinental, New Orleans, Louisiana.  Attendees will learn strategies for improving their customers’ experience, satisfaction, brand loyalty, and retention.”

Registrants can save $200 on the current rate by mentioning Promo Code: FTK743 and Priority Code: HL10018-88441 (not valid for government rate).

For more information, call 800-767-9499 or visit


Rady Children’s Hospital Selects Amcom Software for Unified Communications

Rady Children’s Hospital is implementing unified communications solutions to support information sharing throughout its facilities.  The San Diego-based hospital will use Amcom Software solutions for contact center operations, on-call scheduling, and staff messaging in concert with its Cisco PBX and phones.  At the heart of the project is Rady Children’s goal of enhancing the patient experience through more seamless communications among staff, patients, and their families.

Rady Children’s is replacing a system that limited its ability to communicate efficiently.  Going forward, Rady Children’s will rely on a common, centralized framework that hinges on automation and interconnected applications to eliminate the difficulties of managing separate systems.

“The children and families who enter our facilities every day trust us to provide the best possible care.  An effective communications blueprint is essential to our ability to achieve this,” said Albert Oriol, CIO, Rady Children’s Hospital.  “Amcom’s unified communications solutions will allow us to serve our patients’ needs better, with a more nimble staff and the ability to incorporate changes in the way we need to communicate over time.”


IBM Fosters Creation of Health Information Exchanges

At the HIMSS10 Conference, IBM introduced Initiate Exchange, a new service that enables health systems to exchange patient data with physicians.  The company also announced that Initiate client CareSpark has been awarded a Social Security Administration contract through the American Recovery and Reinvestment Act.

IBM desires to enhance its ability to help healthcare clients draw on data from hospitals, doctors’ offices, and payers to create a single, trusted, shareable view of millions of individual patient records.  Widespread adoption of electronic medical records (EMRs) is anticipated with the availability of stimulus funds set aside through the Health Information Technology for Economic and Clinical Health Act (HITECH Act), part of the American Recovery and Reinvestment Act of 2009 (ARRA).  According to the legislation, healthcare providers seeking funds must be “meaningfully using health information technology, such as through the reporting of quality measures.”

While EMRs are essential to improving care and reducing costs, EMRs alone will not meet the requirements of meaningful use and, more specifically, will not improve the quality of care or reduce costs.  A gap still remains in the ability to connect healthcare participants with effective sharing of health information.


Dangers of the Graveyard Shift

Chronobiology International has published a fourteen-year study of more than 7,000 subjects which concludes that shift-work constitutes an independent risk factor for impaired glucose metabolism.

Modern industrialization, consumer expectations, and globalization have led to the widespread adoption of round-the-clock operations in many industries throughout the world, including call centers.  This has resulted in an increased proportion of the population routinely engaged in shift-work.

An association between shift-work and cardiovascular disease has been widely reported.  Disturbed circadian rhythms, sleep and lifestyle problems, and increased stress have been implicated as possible risk factors for many serious diseases.  This study highlights a previously unrecognized risk for the millions of people who work atypical shift schedules.

“It has long been known that sleep debt has a harmful impact on carbohydrate metabolism and endocrine function,” says Michael Smolensky, coeditor of Chronobiology International.  “It is therefore reasonable to expect that shift-work may influence glucose tolerance.  Alternating between day and night shifts – resulting in continuous disruption of the body’s circadian rhythms – has been shown by this study to be damaging to the health of workers.”


Ambulatory Care Nurses to Convene at Annual Conference

Focusing on leadership, research, and innovation, the American Academy of Ambulatory Care Nursing (AAACN) will convene its 35th Anniversary Conference May 4-7, 2010, in Las Vegas, Nevada.

A broad range of healthcare providers who work in ambulatory care settings, including military and telehealth, are expected to attend.  Attendees will earn continuing education nursing education (CNE) contact hours, enjoy special events, network with colleagues, and meet with vendors in the exhibit hall.  The conference also features an interactive Town Hall on resources developed by AAACN on the RN’s role in ambulatory settings.

Many topics will be covered, including interviewing techniques in the telehealth arena and using social networking sites for professional communication and development.  Participants may earn up to 18.25 CNE contact hours during the conference, with additional hours available for pre-conference events, the post-conference certification review course, and for courses completed through AAACN’s online library.


High Hospital Occupancy Linked With Higher Risk of Death

Admission to a hospital when most of the beds are already full can be deadly for patients, according to a new University of Michigan Health System study that shows high occupancy increases the risk of dying in the hospital by 5.6 percent.  For the study, published in the March issue of Medical Care, researchers evaluated a set of critical factors that can affect hospital deaths: hospital occupancy, nurse staffing levels, weekend admission, and seasonal influenza.

Having more nurses made patients safer, decreasing the risk by 6 percent, but weekend admission raised the risk by 7.5 percent, and admission during widespread seasonal flu had the greatest impact by increasing the risk of death by 11.7 percent, according to the study.

Because of the size of the study – which included 166,920 adult patients admitted to thirty-nine Michigan hospitals over three years – the findings can be generalized to hospitals nationwide, the authors say.


The March 2010 Issue

Employee Trauma in the Medical Call Center: How You Can Help

By Arny Alberts

You’ve just learned that a coworker at your call center has suffered a serious trauma in their personal life.  The details made the local news the night before and further information concerning this individual was sent via email by the human resources department.  The ensuing gossip around the water cooler led to a meeting with your manager and coworkers to discuss the current situation.  Everyone in the call center has questions and concerns about this individual.  What really happened?  What are they going through?  Are they coming back to work?

All of us experience, witness, or hear about trauma in our everyday lives – a death in the family, fire that destroys a home, natural disasters, or serious injury from a traffic accident.  Trauma can also impact someone going through mental, physical, or emotional experiences over an extended period.  Most medical call centers have documented processes and programs to deal with internal issues that affect call center personnel, and the human resource department works to provide assistance.  However, while the steps to take might look great on paper, what will actually happen when that agent returns to the call center?  What do you say upon your first encounter?  When you see them from a distance, what will your initial reaction be?

Here are some suggestions:

  • Communicate: If you know a coworker has been through a traumatic experience, the only wrong decision to make here is not communicating at all when they return to the call center.  The affected individual will acknowledge the attempt, even though their own emotions may inhibit any sustainable response.  The short list below provides a few types of communication media:
         – Verbal
         – Card/Ecard/Email/Written Letter
         – Phone Call
         – Warm Smile
  • Follow Your Heart: Remember that this agent is the same person you knew before their trauma was disclosed.  Be honest and sincere.
  • Find Facts: Search the Internet for information about the type of trauma your coworker has endured.  Gaining knowledge and understanding of what they went through, what they are currently going through, and what could happen to them in the future will help to eliminate fear of not knowing what to say.
  • Share an Experience: Relaying a similar traumatic experience with a coworker will not relieve their problems, but it will provide some sense of hope for their future.
  • Listen /Don’t Try Fixing: Just listen.  Let them talk and get any part of the story off their chest.  Your colleague is probably not looking for suggestions for how to cope with what happened; they just want to make an earnest connection with you.

Individuals who have experienced trauma of some kind need the help of their coworkers when they return to work; uncomfortable or not, a compassionate conversation, a thoughtful card or email, or just a heartfelt smile can help your colleague get back into the call center routine.


Get Rid of Those Unwanted Pounds: Try the Liquidation Diet

By Dale Anderson, MD

The average person gains seven to ten pounds between Thanksgiving and Christmas.  And according to a report in The New England Journal of Medicine, most people don’t ever lose those holiday pounds.  Repeat this cycle over a three-year period, and you could be carrying an additional thirty pounds.

Currently 60 percent of the U.S. population is overweight and 30 percent are obese.  Being overweight has become a huge health problem for our country – a serious drain on our medical finances and work productivity.  Additionally, those who are overweight die sooner.  Think about it; how many overweight or obese people do you see in their 80s and 90s?

Extra pounds are often the behind-the-scenes culprit contributing to diabetes, hypertension, heart problems, fatigue, and muscle weakness.  Too much weight contributes to most orthopedic problems, especially pain and stiffness in the back and lower extremities.  Added to this is the fact that so many of us – medical call center employees included – spend our working hours hunched over our desks.  Many agents overeat (or eat the wrong things) and don’t make time for regular exercise.

The Liquidation Way of Life: Fortunately, there is an easy way to keep excess pounds off and lose the ones you’ve already accumulated.  Quite simply, stop drinking calories for thirst.  If you can spill it, don’t swill it!  By following this one simple rule, you will painlessly shed unwanted pounds.

Consider this: If you drink one eight-ounce glass of milk a day, you ingest the caloric equivalent of one “fat” pound each month – more than ten pounds in a year.  The same holds true if you drink one can of sugared soda or one small glass of fruit juice a day.  If you just stopped drinking these three items each day and made no other changes in your diet or exercise, you would drop over thirty-six pounds in a single year!

To make the most of the liquidation way of life, follow these guidelines:

  • H2O is the Way to Go: Drink eight to sixteen glasses of calorie-free water every day.  If you’re overweight, your liquid calories should only come spoonful-by-spoonful as soup or on cereal, but never gulped from a glass, cup, can, or bottle.
  • Avoid “On-the-Go” Drinks: Call center employees are a hard-working bunch.  Many agents overlook the added calories of shakes and smoothies they consume as breakfast or lunch “on the go.”  Avoid beverages that act as a substitute for food, because they only provide a temporary feeling of having eaten.  Within an hour or so, you’ll be raiding vending machine, only adding more calories to your day.
  • Dilution Is the Solution: If you just can’t stomach drinking plain water, you can dilute any flavored drink – even diet soda – by at least 50 to 90 percent and still get the sweetness and taste you crave.
  • Make Time for Tea: Tea comes in a multitude of flavors, from citrus to berry to herbs, meaning that you don’t have to add any sweeteners to have a great taste.

Liquidation Is a Lifelong Investment: The real skinny on looking and feeling younger and more energetic is choosing a way of life that features whole grains, fruits, fish, lean meats, green veggies, and lots of water.  Deprivation is not the answer.  By making some simple, healthy choices about what you consume each day, you reduce your health risks, and you may even add five, ten, fifteen, or more productive and fruitful years to your life.

Dr. Dale Anderson is an author and speaker who practiced medicine for nearly fifty years as a family doctor, board-certified surgeon, and board-certified emergency physician.  Contact him at 651-484-5162 or visit


President Obama’s Real Goal for Healthcare Reform

By Peter Lyle DeHaan, PhD

Author Peter Lyle DeHaan

January marked a historical senate vote in Massachusetts of near epic proportions.  Essentially, this became a referendum on the President Obama’s first year in office in general and the healthcare debate in particular.  The result of the contest did not bode well for our president.  I wonder if he’s listening, really listening, to what the people have said.  What I do know is that his demeanor is more subdued, and he has lost a bit of his swagger.

In politics, our elected officials, including President Obama, have one of three primary goals, which becomes the focus for what they do and say:

  1. Their job is to serve the will of the people.
  2. Their goal is be reelected. 
  3. Their intent is to advance an ideology.

They can’t do all three; ultimately, only one will be their true and overarching focus.  That means:

  1. If President Obama views his real job as serving the people, he will respond to their message and do an about-face on healthcare.  He may not drop it completely, but at the very least, he will reverse course, providing what the people want.
  2. If President Obama’s true goal is to be reelected, he will distance himself from this hot potato in order to avoid committing political suicide.
  3. If President Obama’s genuine intent is to advance an ideology, then he will doggedly stay the course.

I suspect we will likely see him continue his unrelenting push for a healthcare overhaul – even if it’s not what the majority want or if renders him a one-term president.

Parkland Health Improves Care, Cuts Costs with Unified Communications

Parkland Health & Hospital System recently implemented a unified communications solution from Amcom Software, Inc., that has enabled them to enhance patient care through creative uses of technology, which in turn has reduced costs.  The Dallas-based organization also uses integrated Amcom solutions for its contact center operations, Web-based employee directory, on-call scheduling, and emergency notification.

Round-the-clock agents field more than one million internal and external calls annually, including requests to activate critical medical and nonmedical notifications throughout the organization.  The tight process developed for Heart Cath Team activations has notably reduced the hospital’s treatment time for heart attack patients (door-to-balloon time).  The efficient use of the technology has helped Parkland achieve recent accreditation as a primary stroke center.

The system’s emergency notification capabilities have also helped Parkland send alerts to key groups outside the hospital for time-sensitive situations.  This has included notifying staff at the nearby children’s hospital of incoming critical patients.

Internally, Parkland’s 8,000 employees have come to rely on the system’s Web-based employee directory and on-call schedules, which logged 2.5 million hits since 2005.  Together, these efficiencies have generated ROI for Parkland in the form of reduced workload for the contact center.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of Medical Call Center News. He’s a passionate wordsmith whose goal is to change the world one word at a time.


Nurse Practitioner Conference to Cover Clinical Care and Health Reform

This year’s national conference for nurse practitioners, the Conference for Primary and Acute Care Clinicians, which provides workshops and sessions for nurses, will be held May 19-22, 2010, at the Hyatt Regency Chicago, in Chicago, Illinois.  The conference is sponsored by The Nurse Practitioner journal, a Wolters Kluwer Health publication that provides information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

The conference is designed for nurse practitioners and advanced practice clinicians practicing in primary and acute care settings.  Attendees will participate in hands-on workshops on such topics as suturing and orthopedic splinting and attend educational sessions on pharmacogenetics, heart failure, and skin cancer.  Participants will earn continuing nursing education (CNE) contact hours and pharmacology credits, enjoy networking and special events, meet with vendors in the exhibit hall, and view poster presentations.


CPM Marketing Group Gained Strong Momentum in 2009

CPM Marketing Group Inc., a provider of healthcare customer relationship management (CRM) and strategic marketing solutions, announced that it experienced one of its most successful years in 2009.  This success was underscored by launching new CRM products and services, winning fifteen national and international awards for healthcare marketing initiatives, purchasing a larger corporate headquarters, opening a call center, expanding its workforce, and boosting its community involvement.

CPM’s new call center supports inbound and outbound call marketing services for hospitals and health systems.  Inbound campaign services include class registration, event registration, and physician referral communication.  Outbound services include new city movers recruitment, market research, customer surveys, and appointment reminders.  The call center uses behavioral targeting technology to enable CPM’s agents to tailor phone call communication based on individuals’ past and present medical indications or their risk for developing future conditions.


FCC Pushing Telemedicine in Upcoming National Broadband Plan

The Federal Communications Commission is readying its national broadband strategy to present to Congress on March 17, 2010, and it will highlight the need for broadband to support telemedicine, reports Alice Lipowicz of Federal Computer Week.

“The commission recommended that federal authorities expand reimbursement for telemedicine and other e-health care; conduct pilot projects; deliver a plan to Congress on how to advance telemedicine and health information technology; and clarify regulatory requirements, licensing, and credentialing,” she stated.  “The FCC also recommended that the federal government work to expand interoperability between clinical, research, and administrative health care data and to make sure that patients have access to their own health data.”  The FCC asserts that electronic health records could save $513 billion over fifteen years.


Poll Confirms One of Four Healthcare Dollars Spent on Unnecessary Care

One in four dollars spent on healthcare in America pays for unnecessary tests and treatments that physicians order to keep from being sued, according to a new Gallup poll of the nation’s doctors released by Jackson Healthcare and the Center for Health Transformation.  The poll, conducted by Gallup for Jackson Healthcare, showed that of physicians surveyed nationwide, 73 percent said that they had practiced some form of “defensive medicine” in the past twelve months to protect themselves from frivolous lawsuits.

That means that patients are paying more so doctors won’t be sued.  “Healthcare would be cheaper for every American if we could slash the cost of defensive medicine,” said Newt Gingrich, founder of the Center for Health Transformation.  “Think of how often each of us gets sent for extra lab work or tests that seem so unnecessary.  Meaningful health reform must address these unnecessary costs.”

Gallup conducted the six-week, nationwide survey across all specialties of physicians.  Those doctors reported that 26 percent of overall healthcare costs can be attributed to the practice of defensive medicine.  According to just-released data by the Centers for Medicare and Medicaid Services, healthcare in America now costs $2.5 trillion annually.

Additionally, in a recent online poll by Jackson Healthcare, 64 percent of Texas physicians report that tort reform measures (enacted in 2003 in Texas) have not decreased their defensive medicine practices.  According to Jackson Healthcare chairman and chief executive officer Richard Jackson, “We need a balanced, commonsense approach that guarantees patients their rights without undermining their care.”

The January 2010 Issue

Managing a Successful Medical Call Center Team

By Kelli Massaro

Individuals have several basic intrinsic needs that must be met in the workplace to feel satisfied, no matter what industry they are in.  As the manager of a medical call center, you can positively influence staff retention if you can meet these needs for your staff.  In many cases, nurturing good relationships with your employees can override negative effects of extrinsic organizational factors.  Different things motivate different people, and you may need to use multiple strategies to achieve individual employee satisfaction and improve performance.  In general, call center employees seek a mutually supportive relationship with their supervisor, a sense of belonging and security, a feeling of contribution, control over or input into decisions regarding their work, and authentic appreciation.

Good Relationships with Supervisors: Employees desire good, fair supervision.  This is the second biggest factor in employee retention after job fit.  Supervisors and managers who use a constructive “coaching” style when delivering feedback will nurture growth and learning among their employees.  Conversely, supervisors that “police” for infractions and shortfalls will create fear and inhibit employees’ growth potential.  Feedback should be timely and include both praise for things done well and suggestions for improvement.

Belonging to a Team is more than working together with a group of people; it’s an individual’s personal investment in the call center’s shared vision and a desire to better one’s self and the department.  In a collaborative culture, team members participate in call center decision-making.  Trust your employees enough to delegate projects and explore their ideas.  Promote the feeling of “our” call center.  Stay open-minded to new ways of looking at things, and take advantage of networking with other call centers to explore alternative solutions.  This will push your program, as well as your employees, to new heights.

Contribution: Employees enjoy the opportunity to make a meaningful contribution to their workplace.  Pooling the unique talents, gifts, and interests of team members creates an opportunity for each employee to excel and have unique ownership for a project or the work itself.

Security is an individual perception regarding “safety,” whether it’s financial, physical, emotional, or a combination thereof.  When security is threatened due to lack of managerial support or lack of communication, employees experience anxiety, stress, and dissatisfaction.  Communicate regularly, especially during times of change, to promote trust and provide a sense of confidence.

Control: Employees don’t like change when they feel it is done to them.  A leader’s inability to manage change well is a frequent cause of job dissatisfaction among call center staff.  Seek ways to offer your employees some input regarding decisions that affect them.  Implementing change with staff suggestions in mind will achieve better staff support and results that are more positive.

Recognition and Appreciation: Recognizing a job well done and showing appreciation to employees on a regular basis goes a long way toward keeping employees satisfied.

The key to developing a strong call center team is focusing on the basics: hire right, create an engaging “team” workplace, provide opportunities for employees to stay challenged and make a contribution, involve staff in decisions, communicate effectively, and coach with timely feedback.

Kelli Massaro, RN, works as a triage nurse for The Children’s Hospital of Denver.  She is also the communications director with LVM Systems; she may be reached at


Web-based Portals Improve Call Center Communications

By Chris Heim

According to a recent study by the Joint Commission, poor communication is the leading cause of death and serious injury to hospital patients.  A communications system that gets the right people to the right place at the right time can mean the difference between life and death.

There are three important steps to a good communication system.  Each is important, and today’s leading Web-based communications systems put the solution within reach of every health care organization, from hospitals to long-term care facilities, from research clinics to first-response providers.

1) Make Sure Your Data Is Accurate: Key to a Web-based communication system is a single, centralized personnel information and scheduling database.  All data resides on one robust system, saving the expense and hassle of buying, maintaining, and using multiple electronic and physical databases.  Paper systems or static off-line documents can become almost instantly out-of-date.  A Web-based system can integrate numerous calendars and address books, making updates quick and accurate.  Without a single data source, contacting staff can cause confusion in the smallest facilities and compound delays in larger ones.

2) Make Your System Broadly Available: Web-based systems are often referred to as self-service portals because they allow authorized members to contact others without switchboard operators or other intermediaries.  Self-service portals have been remarkably successful, placing the database in the hands of the people who most need to use it, allowing secure but easy access using a standard browser.

3) Make Your System Easy to Use: Tracking where physicians, nurses, or other staff are working in a fast-paced environment can be frustrating and difficult when operators have to log all their movements.  New Web-based communication and scheduling systems do a simple thing – remove the operator.

Web-based self-service portals help create efficient, patient-centered, and high-quality calendar and paging systems.  Medical facilities with Web-based communications experience increases in accuracy, faster response times, increased worker satisfaction, telecommunications savings, and increased patient care quality.

Chris Heim is CEO of Amcom Software in Eden Prairie, Minnesota.  For more information, call 800-852-8935.


Autodial System Keeps Members Informed

By Mario Ochoa

Are you aware of the importance of flu shots?  When was the last time your child had their annual wellness examination?  Have they received their latest immunizations?  While these questions and their answers may not have come to mind before, health industry leaders have stressed the significance of keeping their members and patients informed about these issues, including addressing any other health care needs.  To do so, they have utilized state-of-the-art technology in combination with their progressive health care solutions.

Telemessaging – sending prerecorded, auto-dialed messages – can be personalized and targeted to a specific population.  It is used by many health care experts as an additional touch point for patient education as a part of their ongoing communication efforts.  The system offers highly personalized, cost-effective, efficient solutions that have been identified by many professionals as ideal for resourcefully communicating messages to a wide audience.  Telemessaging is one key in providing members from different areas of the health care industry with unmatched industry knowledge and support.

CareNet, a Texas-based health care call center, utilizes the system and has found success in its application.  According to CareNet executive vice president Vikie Spulak, “It is flexible in that our clients can record their own messages.  As an example, the medical director of a health plan may want to deliver a personalized message to their 100,000-plus members, welcoming them to their health plan.”

“The use of telemessaging often includes notifying members of pharmacy changes, such as a new generic drug that is currently on the market or reminding members to have their children’s immunizations kept up-to-date,” said CareNet president John Erwin.  “Overall, it allows for more productive communication in that it conveniently and efficiently delivers messages that are important to the recipient.”

Through telemessaging, companies are able to create targeted campaigns to ER frequenters, informing them that there are other convenient resources (such as local urgent care facilities) available to help them with their health care needs.  Through its functionality, members can be kept up-to-date by trusted industry professionals quickly and efficiently.  They can be informed of the benefits of the flu shot or notified where to locate them.  Parents can be kept current on the necessary vaccinations needed for their children.

Telemessaging has the capacity to enhance customer relationship management by keeping companies in touch with their customers on important matters.  The personal, targeted messages therefore offer an additional level of support.  Traditionally deployed to provide after-hours customer contact for professionals, telemessaging can be utilized as another means for staying in touch with members in order to proactively educate and engage.

“Providing compassionate and knowledgeable health care solutions should be the mission of every health care provider,” said Erwin.  “Telemessaging is just another means of allowing everyone to consistently help members manage and maintain better health.”


Ambulatory Care Nursing Conference to Focus on Breakthroughs, Quality Care

The American Academy of Ambulatory Care Nursing (AAACN) is offering educational sessions at its 35th Anniversary Conference, May 4-7, 2010, in Las Vegas, Nevada.  Each year the conference attracts a broad range of health care providers who work in ambulatory care settings, including military and telehealth.  Attendees include RNs, LPNs, LVNs, administrators, clinicians, directors, managers, educators, nurse practitioners, and clinical nurse specialists.

Conference participants will attend educational sessions taught by the industry’s leading experts.  They will also earn continuing education nursing education (CNE) contact hours, enjoy special events, network with colleagues, and meet with vendors in the exhibit hall.

Pre- and post-conference sessions will also be offered; visit for details and registration.


Retired Nurse Proposes Solutions to Nursing Problems in America

In American Nursing and the Failed Dream: A Critical Assessment of Nursing Education in America, author June M. Harrington seeks to prove that the chronic problems existing in American nursing today are the result of the manner in which student nurses are educated, not the manner in which nurses are treated in the workplace.

Harrington believes that, without change, a new type of health care worker will emerge and usurp the role of the nurse.  Additionally, she feels that there is a misconception regarding the cause of the issues she notes, and she disagrees with the view that nurses are victims of a hostile work environment, inadequate financial compensation, or poor working conditions.  Instead, she sees them as victims of failed leadership.

Intending to inspire reform in the education of American nurses, Harrington recommends significant modifications in the leadership structure and education of nurses as a means of correcting ongoing concerns.


What about Those Prerecorded Messages?

Michele Shuster of MacMurray, Petersen, and Shuster LLP, reminds us that, “On September 1, 2009 the FTC’s prohibition against sending prerecorded solicitation messages without the express written consent of the call recipient became effective.  This new requirement, contained in the FTC’s amended Telemarketing Sales Rule [TSR], does not apply to purely informational messages, health care messages, or calls made by entities exempt from the TSR.”


Marketing via YouTube

Gretchen Godwin, RN, is excited to announce that Corridor Medical Answering Service is on YouTube.  Check out it out at

If your call center is on YouTube, let us know.


Cold Weather and Your Health 

Is cold weather good or bad for your health?  It depends.  Cold weather can be hard on your health in some ways, but it also be good for it, reports the January 2010 issue of the Harvard Health Letter.

Most of us spend the winter trying to stay warm, but a little bit of exposure to cold may not be such a bad thing.  There are two types of fat in the human body: white fat and brown fat.  Brown fat is the heat-producing, calorie-burning fat that babies need to regulate their body temperatures.  Most of it disappears with age, but adults retain some brown fat.  Dutch researchers reported findings last year that showed that moderately cool temperatures of 61° F activated brown fat in 23 of 24 study volunteers.  This is a good thing, because brown fat burns calories more efficiently than white fat and so may help control weight.  When we are chilled this winter, we may take some consolation that at least we’re firing up those brown fat cells.

The November 2009 Issue

Improved Patient Care Through Telehealth Nursing

Medical call centers utilizing telehealth nursing services have found it to be a cost-effective and vital method of patient care delivery.  However, nurses (and the call centers associated with them) often face legal risks when speaking to patients calling from states in which they are not licensed.  The American Academy of Ambulatory Care Nursing (AAACN) has released a position statement endorsing the Nurse Licensure Compact (NLC), which recognizes multistate nurse licensure and encourages all states and U.S. territories to introduce legislation supporting uniform adoption of the NLC.

“Uniform adoption of the Nurse Licensure Compact (NLC) would benefit ambulatory care nurses who provide care via telecommunications technology and organizations that provide telehealth nursing services.  Adoption would ultimately serve to improve patient care and safety.” -AAACN NLC Position Statement

In 1999, the National Council of State Boards of Nursing (NCSBN) proposed the NLC, which allows nurses from a Compact member state to have one license (in their state of residence) and practice in other Compact member states (both physically and via telecommunications technology), subject to practice laws and regulations in that state.  The Compact began on January 1, 2000, when four states passed legislation; currently, twenty-three states participate in the NLC.

According to the position statement, AAACN believes that the lack of uniform adoption of the NLC among all states and U.S. territories poses significant risks to nurses involved in interstate practice, and it also raises the question of patient abandonment if care is declined.  The statement also illustrates the benefits of being a Compact state and provides documentation in support of legislation or regulation adopting the NLC.

“The position statement is meant to provide telehealth nurses and their employers with the information necessary to encourage and support their state to join the NLC,” says AAACN President Kitty Shulman, MSN, RN,C.

For more information, contact AAACN’s national office at 800-262-6877 or

The American Academy of Ambulatory Care Nursing (AAACN) is an association of registered nurses and other health care professionals who identify ambulatory care practice as essential to the continuum of high quality, cost-effective health care.  As the premier nursing organization for this specialty, AAACN is devoted to advancing the art and science of ambulatory care nursing.


Chronically Ill Patients – The Dark Side of Hope

By Mary F. Masson

It’s not unusual for medical staff, including call center nurses, to encourage patients not give up hope.  But in surprising new research, physicians at the University of Michigan and Carnegie Mellon University have found that holding on to hope may not make patients happier. 

Holding on to hope may not make patients happier as they deal with chronic illness or diseases, according to a new study by University of Michigan Health System researchers.  “Hope is an important part of happiness,” said Peter A. Ubel, MD, director of the U-M Center for Behavioral and Decision Sciences in Medicine and one of the authors of the happily hopeless study, “but there’s a dark side of hope.  Sometimes, if hope makes people put off getting on with their life, it can get in the way of happiness.”

The results showed that people do not adapt well to situations if they are believed to be short-term.  Ubel and his coauthors – both from U-M and Carnegie Mellon University – studied patients who had new colostomies; their colons were removed and they had to have bowel movements in a pouch that lies outside their body.

At the time they received their colostomy, some patients were told that the colostomy was reversible – that they would undergo a second operation to reconnect their bowels after several months.  Others were told that the colostomy was permanent and that they would never have normal bowel function again.  The second group – the one without hope – reported being happier over the next six months than those with reversible colostomies.

“We think they were happier because they got on with their lives.  They realized the cards they were dealt, and recognized that they had no choice but to play with those cards,” says Ubel, who is also a professor in the Department of Internal Medicine.  “The other group was waiting for their colostomy to be reversed,” he continued.  “They contrasted their current life with the life they hoped to lead, and thus they didn’t make the best of their current situation.”

The research was published in this month’s edition of Health Psychology.  Ubel was joined in the research by Dylan M. Smith, PhD, a research specialist at the Ann Arbor VA Health Services Research and Development Center and a U-M psychologist; Aleksandra Jankovic, of U-M’s Center for Behavioral and Decision Sciences in Medicine; and George Loewenstein, professor in the Department of Social and Decision Sciences at Carnegie Mellon University.

Loewenstein said these results also may explain why people who lose a spouse to death often recover better emotionally over time than those who get divorced.  “If your husband or wife dies, you have closure.  There aren’t any lingering possibilities for reconciliation,” Loewenstein said.

Ubel said health professionals find it easier to deliver optimistic news to patients even when they believe the prognosis is unfavorable, justifying it by assuming that holding on to hope was better for the patient.  Said Loewenstein: “It may be easier for a doctor to deliver a hopeful message to a patient, even when there isn’t much objective reason for hope, but it may not be best for the patient.”

“Hopeful messages may not be in the best interests of the patient and may interfere with the patient’s emotional adaptation,” Ubel says.  “I don’t think we should take hope away.  But I think we have to be careful about building up people’s hope so much that they put off living their lives.”

For more information, contact Mary F. Masson at or Margarita Bauza at, or call 734-764-2220.


Timely Tips for Telephone Triage Nurses

While use of computerized guidelines is the standard of care in telephone triage, nurses can sometimes rely too heavily on these decision support tools and miss essential elements of a patient’s problem.  In her article in the September/October 2009 issue of AAACN ViewPoint, Carol Rutenberg notes that these tools should be used as blueprints, and that the nursing process should be used just as it is in other types of nursing.  She offers tips to adjust the nursing process for telephone triage nurses.

“During assessment, the nurse can glean key information not only from the caller’s words but also from listening to the patient’s breathing and speech,” Rutenberg said.  Callers can also provide objective measurements such as temperature, blood pressure, and weight – as well as describe lacerations and amount of bleeding.  Rutenberg writes, “A good rule of thumb is that anything nurses can do with their eyes, hands, or nose, callers can do with adequate direction from the nurse.”

During each call, the telephone triage nurse must identify a problem as emergent, urgent, or routine, develop a plan of care that the patient is likely to follow, and implement that plan.  This continuity of care is an essential part of the telephone triage nurse’s role.

Finally, to evaluate the interaction, the nurse must have a plan to determine if the patient got better.  If not, the nurse must reassess the patient, revise the plan of care, implement the new plan, and reevaluate.  Rutenberg says that doing a thorough assessment, anticipating the worst possible scenario, and erring on the side of caution are key to successful telephone triage.

Taken from Telephone Triage: Timely Tips by Carol Rutenberg, RNC-BC, MNSc, September/October 2009 AAACN ViewPoint;


Microsoft Health Care IT Video Series Debuts November 10

By Nicholas Kolakowski

On November 10, Microsoft introduced a new online video series, Health Tech Today.  Hosted by Bill Crounse, Microsoft’s senior director of worldwide health, the show focuses on how health and information technology intersect.

Although products such as Windows 7 and Xbox dominate most of the media’s attention, Microsoft has been working to make health care IT a pillar of its overall corporate strategy.  Microsoft’s cloud-based repository for patient information, HealthVault, is just one of its health care IT-related applications.  Released in October 2007, HealthVault is an encrypted repository where patients can store their medical information online.

In February 2008, Google debuted Google Health, its own resource for storing personal health information online, as well as sending their medical data to their doctors.  The federal government sees cloud computing as a way to help streamline the U.S. health care system.  In a keynote address at the CEA Line Shows conference in June, the nation’s first-ever chief technology officer, Aneesh Chopra, talked about the need to “bring innovation platforms” and the cloud to bear on issues such as health care IT.

“I’m fascinated by the idea that we can interconnect all sorts of things that we never connected before,” Chopra said.

Companies ranging from Intel to Oracle have also inserted themselves into the health care IT space, either through acquiring smaller start-ups or introducing their own products, demonstrating in the process that the tech sector views health care as a potentially lucrative revenue stream.


Microsoft Launches H1N1 Response Site

By Roy Mark

On October 7, 2009, Microsoft announced a new Web site, the H1N1 Response Center, which provides users with relevant content and allows consumers to gauge symptoms and receive guidance using an H1N1 self-assessment service licensed from medical and public health experts at Emory University.

If a person decides to see a provider after taking the assessment, a prepare-for-visit tool allows him or her to compile an organized health history for providers by combining the self-assessment answers with health information stored in the user’s account in Microsoft HealthVault, a personal health application platform designed to put consumers in control of their health information.

“Any pandemic has the potential to create major disruptions in society,” David Cerino, general manager of Microsoft Health Solutions Group, said in a statement.  “Now more than ever, we are in a position to implement solutions to help people make better decisions during these outbreaks, such as social distancing, because of the technological advancements that companies like Microsoft have made over the past few years.”

The Emory University self-assessment is based on a SORT (Strategy for Off-site Rapid Triage).  The assessment reflects current public health and clinical science, vetted by a national network of experts from public health, clinical medicine, health education, and infectious disease.  It is grounded in a clinical strategy endorsed by the American College of Emergency Physicians, the leading organization for emergency medicine in the United States.


Finally!  Patient Registration Emerges as an Online Service

Thanks to the rise in consumer health electronics and online services, the health care vision of the future is being built around the premise of patients receiving continuous health care from any location.  Gone will be the hours spent wasted in the doctor’s office; these will now be replaced by the ability to utilize convenient online patient services to streamline trips to the doctor, dentist, etc.  EMG Productions recently introduced as a simple, effective solution for the secure digital capture of patient medical records that decreases patient wait-time and improves the quality of the health care experience.

The Health Information Technology for Economic and Clinical Health Act (HITECH Act) is intended to “advance the use of health information technology” – in large part so the U.S. will be able to move to e-health records by President Obama’s 2014 deadline.  However, in spite of HITECH stimulus incentives, many medical practices have not yet acquired one key element required to implement such a transition: digital patient health data.

Now, however, provides a simple method of digitally capturing data directly from patients completing forms in the comfort of their own home, where they have full access to all their medical records.  ePatientHistory is a much more convenient and efficient alternative to sitting in a waiting room, clipboard perched in the lap, trying to remember the dates of that last surgery.  The value of this service focuses on the convenience offered to patients, but the immediate capture of digital data will clearly enable physicians and nurses to provide more efficient health care services.  Once data is captured and securely stored, patients can rely on a higher quality of care that comes with full and accurate disclosure of their medical history prior to appointments with their health care providers. employs the latest technology for secure online data capture, validation, encryption, storage, and backup for 100 percent restoration in full compliance with the Health Insurance Portability and Accountability Act (HIPAA).  HIPAA mandates industry-wide standards for health care information during electronic processes, as well as the protection and confidential handling of protected health information.  Patients using ePatientHistory gain a level of trust imparted by the simplicity of site use and the transparency of security measures employed to protect their sensitive health data, and they perceive a higher level of care and service.

EMG Productions, Inc. is an experienced Web design/development and production studio that has offered a variety of online services to national clients for over fifteen years.  EMG specializes in creating affordable custom online services that meet the specific needs of their clients, which include rich media, data capture, product/service presentation, video production, and Web design.  You can learn more by contacting president Pamela Alford at or visiting