The Promise of Telephone Triage and Physician Locator Services

By Peter L DeHaan, Ph.D.

Peter DeHaan, publisher and editorTelephone triage is a great solution that meets the healthcare needs for many patients. However, though I write about telephone triage, I have no first-hand experience. Alas, there are no telephone triage services available to me—or at least none that I’m aware of. I wish there were.

It may shock you to know I don’t have a primary care physician. But it’s not for a lack of trying. Here’s the short version: Years ago I called my doctor’s office to make an appointment when I was down with a cold. The doctor wouldn’t see me because I hadn’t recently seen him when I was well. When I was better I called to schedule an annual check-up. They declined. My paper records were in storage and apparently it was too much hassle to retrieve them. I suggested they treat me as a new patient, but my doctor wasn’t accepting new patients. Apparently he had fired me. That was ten years ago. I haven’t had a primary care physician since.

Over the past five years I’ve required medical attention four times. Once was a trip to ER for stitches. The other three times were to urgent care to snag a prescription for antibiotics. On my last visit they encouraged me to find a primary care physician. I agreed. After recovering, I went online searching for a conveniently-located doctor.

I ended up at the website of a large healthcare provider. I entered my ZIP code and asked for doctors nearby. The closest match was .06 miles away. That’s 317 feet, but this doctor was actually over twenty miles away, a thirty-five-minute drive. I checked the next fifteen providers, all of whom were reported to be within five miles. None were. I gave up.

I wish I could call a physician locator service, but there aren’t any in my area, at least none that I know of.

I’m convinced healthcare call centers can fill a vital need in the provision of healthcare services, both telephone triage and doctor locator services. If only they were available in my area. Hopefully the reality of what is will soon catch up with the potential of what can be. Until then I hope I don’t get sick.

Peter DeHaan is the publisher and editor of Medical Call Center News and AnswerStat.

The September 2017 Issue



The Promise of Telephone Triage and Physician Locator Services

By Peter L DeHaan, Ph.D.

Peter DeHaan, publisher and editorTelephone triage is a great solution that meets the healthcare needs for many patients. However, though I write about telephone triage, I have no first-hand experience. Alas, there are no telephone triage services available to me—or at least none that I’m aware of. I wish there were.

It may shock you to know I don’t have a primary care physician. But it’s not for a lack of trying. Here’s the short version: Years ago I called my doctor’s office to make an appointment when I was down with a cold. The doctor wouldn’t see me because I hadn’t recently seen him when I was well. When I was better I called to schedule an annual check-up. They declined. My paper records were in storage and apparently it was too much hassle to retrieve them. I suggested they treat me as a new patient, but my doctor wasn’t accepting new patients. Apparently he had fired me. That was ten years ago. I haven’t had a primary care physician since.

Over the past five years I’ve required medical attention four times. Once was a trip to ER for stitches. The other three times were to urgent care to snag a prescription for antibiotics. On my last visit they encouraged me to find a primary care physician. I agreed. After recovering, I went online searching for a conveniently-located doctor.

I ended up at the website of a large healthcare provider. I entered my ZIP code and asked for doctors nearby. The closest match was .06 miles away. That’s 317 feet, but this doctor was actually over twenty miles away, a thirty-five-minute drive. I checked the next fifteen providers, all of whom were reported to be within five miles. None were. I gave up.

I wish I could call a physician locator service, but there aren’t any in my area, at least none that I know of.

I’m convinced healthcare call centers can fill a vital need in the provision of healthcare services, both telephone triage and doctor locator services. If only they were available in my area. Hopefully the reality of what is will soon catch up with the potential of what can be. Until then I hope I don’t get sick.

Peter DeHaan is the publisher and editor of Medical Call Center News and AnswerStat.


Reduce Unnecessary ER Visits with Telephone Triage

By Charu Raheja, PhD

Telemedicine has been gaining acceptance as a means of lowering healthcare costs and decreasing the unnecessary use of the ER. Telephone nurse triage has become part of the telemedicine solution. By using standardized protocols to advise patients on their symptoms and indicate the appropriate care, triage nurses decrease unnecessary ER visits, resulting in significant annual healthcare savings. In addition, having nurses as the first line of care encourages patients to call since patients aren’t sure if they need a doctor to evaluate their symptoms.

Unnecessary ER visits cost patients, hospitals, and insurance companies approximately 4.4 billion dollars a year according to the RAND Corporation. This problem has become such an issue that earlier this summer Blue Cross Blue Shield of Georgia told patients with individual policies that they will not cover ER claims if the patient doesn’t have a legitimate emergency. They recommend patients use urgent care centers, retail health clinics, and 24/7 telehealth services.

The improper use of ER places a high financial burden on the entire US healthcare system. With the US healthcare system in serious need of cost-cutting, there is increased pressure to minimize unnecessary use, while ensuring people who truly need care receive it in a timely manner, thereby reducing the potential for life-threatening conditions.

One important, but often overlooked aspects of nurse triage is the human aspect of the service. Most callers are truly concerned about their symptoms, and having access to a triage nurse provides reassurance and guidance. It’s difficult to put a price on peace of mind. In addition, some callers may not realize the severity of their symptoms and may fear being responsible for the ER bill, thus delaying care for potentially life-threatening conditions. About one in fourteen callers thought their symptoms weren’t serious prior to the nurse sending them to the emergency room. Providing patients with a qualified telephone triage nurse prevents these patients from improperly self-diagnosing and ensures that they get the treatment they need.

As telemedicine expands into new services, providing innovative and cost-effective care, it’s important to remember that the benefits reach beyond budgetary significance. Nurse triage saves lives and provides comfort to callers worried about their symptoms and would have otherwise gone to the ER. However, a significant portion of the US population lacks access to telephone nurse triage. Implementing telephone medicine to a greater population can save lives and improve health outcomes.

Charu Raheja, Ph.D., is the CEO of TriageLogic and Continuwell. Both companies focus on telehealth by integrating communication solutions with medical expertise. TriageLogic is a leading provider of quality, affordable triage solutions, including comprehensive URAC accredited after-hours call center services and innovative online systems for use in both institutional and private practice settings. Contact TriageLogic to get a quote or set up a demo.


Is it Time to Consider Hospital Call Center Outsourcing?

By Keith Slater

“Patient experience,” “customer service,” “patient satisfaction scores,” and “value-based performance” are part of hospitals’ and healthcare providers’ everyday vocabulary. Value-based care pushes them to achieve many more financial objectives and improve the patient experience. Providers who lose patients because of poor customer service or inefficient physician referral processes feel a direct hit on revenue and, ultimately, on the bottom line.

Plus, there’s another financial incentive to improve customer service. The Centers for Medicare & Medicaid Services (CMS) requires hospitals subject to the Inpatient Prospective Payment System (IPPS) annual payment update provisions to collect and submit data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to receive their full IPPS annual payment update. If they don’t, their annual payment update may be reduced by two percent. The HCAHPS survey measures patients’ perceptions of their hospital experiences, which include responsiveness of hospital staff and other service measures.

Balancing Customer Service and Clinical Care: Many hospitals and healthcare providers struggle to focus on the patient experience and customer service because of competing priorities. Value-based care; clinical, quality and safety initiatives; mergers and acquisitions; integrating employed physicians; software conversions and migrations; and supply management often monopolize their attention. Too often, they ignore call centers.

C-suite executives and leaders responsible for the patient experience are overburdened. Staff members often wear too many hats, leaving customer service and call centers to suffer. In most cases it’s not intentional. Healthcare organizations with in-house call centers don’t always monitor calls or track call metrics from a patient access or experience perspective. Many don’t realize they have a problem until revenue shortfalls and patient satisfaction scores show otherwise.

Signs of Medical Call Center Vulnerability: Perhaps the biggest reason in-house healthcare call centers fall short is because they’re not run like true call centers. It’s typical for a hospital or healthcare system to put existing front desk or scheduling staff in a central location to try to gain efficiencies and improve service. Many times they don’t emphasize the importance of excellence in customer service skills or invest in the rigor required to run a true call center.

Then they end up with unhappy employees, high staff turnover, and frustrated patients. Healthcare executives may not know when it’s time to pull the plug on a deficient call center and outsource those hospital call center services to a professional firm.

Why Medical Call Center Outsourcing Works: Running a call center requires specialized expertise—even more so when the calls entail patient questions about health issues and possible financial challenges. Outsourced medical call centers know how to hire representatives with good listening skills, a calm demeanor, a service mentality, and empathy for patients. They provide agents with ongoing, in-depth training on the medical aspects of the job and how to represent healthcare providers as if they were members of their clients’ staff. Good call center providers have advanced technology and tools to help ensure quality and report results.

Since 70 percent of all patient care occurs in a physician office setting and patients must call for appointment scheduling or to get their questions answered, why would you risk putting inadequate resources in place to manage your call center? Why not outsource to a professional healthcare call center that can get the job done?

Keith Slater is vice president of business development at Change Healthcare. Contact him at performanceinfo@mckesson.com. Download their new e-book to learn more about industry insights into patient satisfaction and key strategies to improving the total patient experience. For more information visit www.mckesson.com/callcenter.


Healthcare Call Center News

Ambs Call Center Honored For Excellence

Ambs Call Center received the ATSI 2017 Award of Excellence. This annual award is presented by the Association of TeleServices International (ATSI). Call centers from across North America and the United Kingdom take part in the program, which uses independent judges to place test calls to participating call centers. These secret-shopper calls occur over a six-month time frame. “Companies that earn this award are continuously focusing on delivering excellence in customer call handling,” said ATSI president Doug Robbins.

The award started twenty-one years ago to improve the quality of the telephone answering service industry. Now a fourteen-time winner Ambs Call Center earned the Emerald Award. “I am extremely proud of our team for earning this year’s award. Making sure that we deliver an exceptional customer service experience to our customers 24/7/365 is no small feat,” said Aaron Boatin, president of Ambs Call Center.

The healthcare division of Ambs Call Center provides medical answering service, patient satisfaction, physician referral, and class registration. Ambs Call Center is family owned and has been in business since 1932.

Schmitt-Thompson Clinical Content Joins the Air Force

Schmitt-Thompson Clinical Content (STCC) announced they have been awarded a ten-year agreement by the Air Force Medical Operations Agency (AFMOA) for the delivery of electronic triage protocols for telehealth nursing to medical treatment facilities enterprise-wide. This would entail a deployment over the next twelve months of the Office Hours content to all seventy-six Air Force military treatment facilities.

Each of the Air Force bases has a military treatment facility. Patients are seen in their walk-in clinics. Supplementing this is a triage telecom service (medical call center) with nurse staff ranging from as few as four telephone triage nurses per site (Air Force base) to as many as eighty-five nurses.


A Thought For Today

“An expert is a man who has made all the mistakes which can be made in a very narrow field.” -Niels Bohr

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The One Sure Thing About the Future of Healthcare

By Peter L DeHaan, Ph.D.

Peter DeHaan, publisher and editorI don’t like to write about politics, but politicians in the United States are once again messing with healthcare. Some call it repeal, and others view it as repair. Some are for it and others oppose it. No one knows for sure how things will shake out or when it will happen, if anything happens at all.

Whether you view the status quo as good or bad, the maneuverings of the politicians and the soundbites of the pundits are disruptive. This makes it hard to plan: hard for healthcare providers, hard for healthcare insurance companies, and hard for healthcare consumers.

Regardless of the outcome, however, there is one thing I’m sure of. Medical call centers will continue to play a key role in the provision of care now and a bigger role in the future. Healthcare call centers stand in the healthcare gap, improving patient care, enhancing population health, and reducing per capita healthcare costs. No group is better positioned to achieve these three goals.

Yes, the one sure thing in healthcare today is that medical call centers will play a key role in providing quality, cost-effective solutions tomorrow. The only variable is how big that role will be.

Peter DeHaan is the publisher and editor of Medical Call Center News and AnswerStat.

The July 2017 Issue



The One Sure Thing About the Future of Healthcare

By Peter L DeHaan, Ph.D.

Peter DeHaan, publisher and editorI don’t like to write about politics, but politicians in the United States are once again messing with healthcare. Some call it repeal, and others view it as repair. Some are for it and others oppose it. No one knows for sure how things will shake out or when it will happen, if anything happens at all.

Whether you view the status quo as good or bad, the maneuverings of the politicians and the soundbites of the pundits are disruptive. This makes it hard to plan: hard for healthcare providers, hard for healthcare insurance companies, and hard for healthcare consumers.

Regardless of the outcome, however, there is one thing I’m sure of. Medical call centers will continue to play a key role in the provision of care now and a bigger role in the future. Healthcare call centers stand in the healthcare gap, improving patient care, enhancing population health, and reducing per capita healthcare costs. No group is better positioned to achieve these three goals.

Yes, the one sure thing in healthcare today is that medical call centers will play a key role in providing quality, cost-effective solutions tomorrow. The only variable is how big that role will be.

Peter DeHaan is the publisher and editor of Medical Call Center News and AnswerStat.


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The Receptionist Model for Telephone Triage Calls

By Mark Dwyer

Many triage call centers employ non-clinical staff to frontend the triage calls. This process is often referred to as the receptionist model. Hospitals that use this model typically provide the non-clinical staff with a predefined set of criteria to rank the acuity level of patients’ symptoms. These acuity levels are determined by key symptoms and terms used by patients when describing their symptoms.

Certain keywords together with certain known related conditions shape a likely emergent disposition. This is often done by providing the non-clinical staff with a list of key symptoms and conditions. If they exist, then direct the individual processing the call to interrupt a nurse currently on a call with a less acute patient. In this scenario, the nurse parks the current call, freeing her line to accept the potentially urgent call. If the call is deemed non-emergent, it is added to the nurses’ follow-up outbound call queue with the appropriately assigned acuity.

The best way to verify that each call added into the nurse callback queue has been assigned an appropriate acuity level would be to have all calls reviewed, assessed and, if needed, adjusted by acuity. To facilitate this, many sites have a charge nurse responsible for managing the queue throughout the day, making sure the highest acuity requests remain listed at the top of the “requests received for nurse callback” queue. Generally, callbacks should be made within thirty to forty minutes of receipt of the initial request.

Mark Dwyer is a 30-year veteran of the healthcare call center industry and the COO at LVM Systems, which provides healthcare call center software.


Healthcare Call Center News

Hospital CIOs Surveyed about Data Security and Clinical Mobility

Over the past twenty years, the avenues for sharing protected health information have multiplied, and data breaches have become much too common. In March 2017, Spok surveyed over 100 hospital CIOs to see how pressing the data security concern is for IT executives. They compiled the results and some interesting ones include:

Hospital secure texting:

  • 41 percent do not currently support HIPAA-compliant secure texting on any device but are planning to do so in the future.
  • 39 percent have secure texting only for personal devices.
  • 35 percent supply secure texting only on hospital issued devices.
  • 26 percent provide secure texting on both personal and hospital issued devices.

Secure communication methods used by clinical staff:

  • 88 percent use encrypted email.
  • 48 percent use HIPAA-compliant secure texting.
  • 48 percent use in-building Wi-Fi phones.
  • 17 percent use encrypted pagers.

Top four reasons why hospitals use pagers:

  • Most appropriate device for specific employee groups or departments
  • Reliability
  • Cost and time savings
  • Easy workflow integration

To underscore the severity of this data security issue, 95 percent of hospital CIOs are concerned about their data being compromised, but 26 percent are unsure how much PHI (personal health information) is being shared using unsecure technology.

Mobility and clinical process improvements are important to hospital leaders, and CIOs plan to make impactful changes,” said Spok. “However, the execution remains a work in progress. Greater than 30 percent of clinical staff cannot receive messages from colleagues on mobile devices.” This and other findings are presented in a revealing info graphic.


A Thought for Today

“We all have our time machines. Some take us back, they’re called memories. Some take us forward, they’re called dreams.” -Jeremy Irons

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Uncertainty is the Only Thing That’s Certain in Healthcare

By Peter L DeHaan, Ph.D.

Peter DeHaan, publisher and editorI don’t like to write about politics, but politics is once again affecting the future of healthcare. With all the bluster about repelling and replacing the Affordable Care Act (aka Obamacare), I was quite sure, that by now, we would have a new direction in place to chart our industry’s future. Alas, the bluster turned out to be no more than bluster.

It seems it’s much easier to criticize than to find workable solutions.

So, for now, Obamacare is the status quo. Whether we like it or dislike it, the Affordable Care Act is the framework in which we must work. All the while, we still hold our breath wondering if Obamacare might one day be replaced or more likely, amended. But will this make our jobs easier or harder? Uncertainty looms.

Regardless, the essential task is to ensure we keep our organizations viable so that we’re around to do our primary task of caring for people.

In this the call center will play a vital role. Of that, I am certain

Peter DeHaan is the publisher and editor of Medical Call Center News and AnswerStat.

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The May 2017 Issue



Uncertainty is the Only Thing That’s Certain in Healthcare

By Peter L DeHaan, Ph.D.

Peter DeHaan, publisher and editorI don’t like to write about politics, but politics is once again affecting the future of healthcare. With all the bluster about repelling and replacing the Affordable Care Act (aka Obamacare), I was quite sure, that by now, we would have a new direction in place to chart our industry’s future. Alas, the bluster turned out to be no more than bluster.

It seems it’s much easier to criticize than to find workable solutions.

So, for now, Obamacare is the status quo. Whether we like it or dislike it, the Affordable Care Act is the framework in which we must work. All the while, we still hold our breath wondering if Obamacare might one day be replaced or more likely, amended. But will this make our jobs easier or harder? Uncertainty looms.

Regardless, the essential task is to ensure we keep our organizations viable so that we’re around to do our primary task of caring for people.

In this the call center will play a vital role. Of that, I am certain

Peter DeHaan is the publisher and editor of Medical Call Center News and AnswerStat.


Classified Ads

Content Marketing: Need content for your blog or website? Let Peter DeHaan, editor of Medical Call Center News, provide it for you. Rates are only $150 per page or post. Themes include healthcare call centers and customer service. Other professional writing services are available. Email Peter to learn more.

Email Valerie to place your classified ad in the next issue. Only $49 for 50 words.


The Contact Center’s Role in Care Coordination and Management of Patient Transitions

By Traci Haynes, MSN, RN, BA, CEN

The need to coordinate care and manage patient transitions is growing fast. 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 $3.4 trillion in 2016. The Partnership to Fight Chronic Disease reported in 2015, 191 million Americans had at least one chronic disease and 75 million had two or more chronic diseases. It’s estimated that 15 to 18 percent of children in the US live with at least one chronic health condition.

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

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.”

Correct care coordination is systematic, organized, and involves teamwork including the patient and family; it requires communication among all participants.

Currently, care coordination is a primary concern with the National Quality Agenda and one of the six priorities of the National Quality Strategy (NQS). A coordinated effort, involving an interprofessional team with the patient and their family, can help to achieve the Institute of Healthcare Improvement’s (IHI) Triple Aim goals of better care, better health, and reduced costs.

The contact center can play a vital role in the effort to manage and improve 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 point in time. Using telecommunications can provide invaluable connectivity not only to monitor patients, but also to provide a meaningful 24/7 clinical assessment capability for episodic care and interventions, should the need arise.

Nursing organizations including ANA, the American Academy of Nursing (AAN), the American Academy of Ambulatory Care Nursing (AAACN), and the American Organization of Nurse Executives (AONE) have contributed resources to care coordination in the form of position statements, whitepapers, frameworks, policy briefs, a core curriculum, courses, and a certification in care coordination and transition management. There are also effective models and tools, along with hospital and community initiated programs.

Care coordination and transition management is a win for our healthcare system, for the providers (interprofessional team), and, most importantly, for our patients.

Traci Haynes, MSN, RN, BA, CEN is the director of clinical services at LVM Systems, Inc.


Healthcare Call Center News

New Study Examines the Challenges of Healthcare Switchboard Operators

A whitepaper by Parlance looks at the many different call handling and non-call handling duties assigned to healthcare switchboard operators, which can create difficulties in balancing service for callers with support for hospital operations and internal communications. The paper also recommends ways hospitals can better support operators to allow them to easily meet their many competing responsibilities.

Voice communications continue to play a crucial role in healthcare for both internal resources as well as external patients, vendors, insurance agencies, and other public callers. The common denominator among these disparate caller communities is the switchboard operator.

Beyond greeting callers, prioritizing their needs, and connecting them to the appropriate destinations or resources, operators are frequently tasked with a wide array of additional duties, such as announcing and tracking medical codes, coordinating emergency responses and medflights, or monitoring medical gas supplies and facility alarm panels. The workload related to these additional responsibilities, some of which are a matter of life and death, can detract from an operator’s core function of delivering excellent service that improves the patient experience and builds the hospital’s brand.

Learn more at info.parlancecorp.com/empowering-operators.

TriageLogic CEO Honored at Enterprising Women of the Year

TriageLogic CEO, Charu Raheja, PhD, was honored at the Enterprising Women of the Year Awards. The Enterprising Women of the Year Awards is a prestigious recognition program for women business owners. Dr. Raheja was recognized April 2 at the 15th Annual Enterprising Women of the Year Awards Celebration & Conference.

“The recipients of the 2017 Enterprising Women of the Year Awards represent an amazing group of women entrepreneurs from across the United States and as far away as The Netherlands, South Africa, Uganda, the United Kingdom, and Canada,” said Monica Smiley, publisher and CEO of Enterprising Women. “We could not be more proud to recognize their accomplishments as CEOs of fast-growth companies, community leaders, and role models and mentors to other women and girls.”

TriageLogic was also recently certified as a Women’s Business Enterprise and a Women Owned Small Business by the Women’s Business Enterprise National Council (WBENC).

Visit www.triagelogic.com for more information.


A Thought for Today

“To put everything in balance is good, to put everything in harmony is better.” -Victor Hugo

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