The November 2013 Issue

Does Your Call Center Provide Quality Service?

By Peter L. DeHaan, PhD

Peter DeHaan, publisher and editorDoes your call center make the caller and patient a priority? I expect it does. In fact, I suspect the phrase “quality service” is in your mission or vision statement, or even on your bulletin board. But do you actually provide quality customer service or just talk about it? Has quality service been mentioned so often that everyone falsely believes that quality service is a reality?

Most call center staff would say they provide great customer service, but the basis of this is their own opinions – after all, they work hard and do their best. (And if they don’t work hard and do their best, why are they still working for you?)

Many call centers try to measure quality using their system’s reporting metrics, such as speed to answer, wait time, call length, and so forth. But these only consider things that management thinks reflect quality. For me, I don’t care if my wait time is six seconds or one minute, as long as the reason for my call is handled to my satisfaction. I don’t care about “no transfer” initiatives. I’d rather talk to two people, even re-explain my situation, if I can get a quick and correct answer, as opposed to one rep that muddles through the call and leaves me confused.

Other call centers do an automated, post-call survey, seeking answers to intangible issues based on callers’ perceptions. This gets closer to identifying true quality, as it comes from the caller’s perspective. Other methods are mailed, emailed, and online surveys, as well as follow-up phone calls. Here’s the main thing: If the caller is pleased, then quality service is likely a key reason why.

Customer service needs to be more than just a slogan. It needs to be a strategy, one that is fully implemented – and verifiable – with the callers’ and patients’ best interest in mind.

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

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Patient Portal Concerns: Myths and Facts

By Julia Goebel

A Patient Portal (PP) is becoming a vital tool that doctors employ to enhance communications with their patients. Patients using an online portal can check their test results, receive messages from their providers, register online for their first appointment, schedule appointments, make and schedule payments, and a host of other options. The effective use of patient portals can also help to meet the federal requirements of Meaningful Use Stage 2.

Five Requirements of Meaningful Use Stage 2

  • Offer secure messaging
  • Share clinical summaries
  • Promote educational content
  • Provide the ability to download, view, and transmit information
  • Remind patients of some key care components

Meaningful Use Stage 3 (a set of requirements not finalized yet) will undoubtedly require portals to have even more extensive functionality – for example, offering patients the capability of requesting amendments to their health records online, giving patients the ability to submit patient-generated information and include name and contact information about caregivers, and other enhanced features.

Patient Concerns about Online Portals: Understandably, all of this increased functionality has created a long list of patient concerns about using online patient portals. Earlier this year Carestream Health, a provider of medical imaging technology, commissioned a study to explore – and possibly debunk – some of the myths surrounding the use of online patient portals.

Some of those myths include:

  • Patient access to portals will have no impact on satisfaction.
  • Security will be the primary obstacle to prevent patients from accessing portals.
  • Age will be a hurdle for adoption.
  • Patients will be more likely to use portals for their children’s records.
  • Patients who are currently online users will be more likely to use portals.
  • Patients will look for some key test results on a portal and not others.
  • Patients with a history of re-testing will be more likely to use a portal.

Conclusion: Patient portals take time to roll out and integrate with wider messaging and call strategies. It’s essential to pay attention to patient outreach during portal rollout and maintenance and to keep focused on improved communications with patients about their medical records and care.

Julia Goebel is director of marketing at NotifyMD and a frequent blogger.

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HIPAA Compliant Secure Messaging and Call Centers

By Darryl G. Glover

On September 23, the world changed for healthcare. The new Omnibus regulations made organizations “guilty until proven innocent” in cases of a HIPAA breach. During the past twelve months, there have been many high profile cases where something as simple as not clearing a photocopier of patient records have resulted in millions in fines.

On a daily basis, medical call centers and telehealth providers deal with Protected Health Information (PHI), and all those working in this industry have become acutely aware of their responsibility to ensure HIPAA compliance and protect themselves in the case of a breach.

Ensuring that nonverbal messages and files are adequately protected and meet HIPAA requirement is a daunting task. A secure messaging solution that communicates in real time and provides peer-to-peer encryption with separate public/private keys that work on all devices (smartphone, tablets, desktop) and platforms (iOS, Android, Windows) is something that many of your clients could use. Additionally, it must have an ability to trace messages, recording when they were received and acknowledged and, in the case of a lost device by one of your clients, the ability to remotely wipe everything on the device and lock it out while giving you a record of when the message was last accessed.

Secure text messaging provides benefits to medical call centers and telehealth providers by allowing them to do the following:

  • Confidently assure their clients that they are 100 percent HIPAA compliant, enabling them to avoid penalties and fines since they can provide evidence if a breach actually occurs and identify which patients might be affected
  • Allow clients to use the devices they are most comfortable with
  • Gain a unique competitive advantage with secure communication
  • Create new revenue opportunities with value-added services
  • Facilitate provider-provider, provider-patient, and provider-caregiver communication

Darryl G. Glover, PharmD, MBA, is executive VP strategic marketing at qliqSOFT, Inc.

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Five Affordable Care Act Scams

With the Affordable Care Act (aka Obamacare) in effect, there has been a significant increase in scammers taking advantage of those confused by the new changes in American healthcare policy. The FTC has found healthcare fraud to be on the rise and is expecting it to increase in the following months, leading to both fraud and identity theft for consumers.

Scambook, an Internet complaint resolution platform, offers tips to spot these scams:

1) The Fake “Obamacare Card”: Victims receive a phone call from a scammer who claims to represent the government, informing them that they need an “Obamacare Card” to be eligible for the Affordable Care Act. Other scammers may offer an insurance discount card or even a discount plan for prescription medications. Potential victims are asked to pay upfront via Western Union or prepaid cards, or the scammer may tell them the card is free if they provide their social security number or other personal info. Consumers need to be aware there is no such thing as an Obamacare Card or Affordable Care Card.

2) The Information Update Scam: Fraudsters posing as Medicare officials call consumers to update or verify personal information, with consequences if they don’t comply. However, nothing in the Affordable Care Act threatens existing benefits for Medicare enrollees. Senior citizens are common targets, as they are more likely to give away their social security number and personal information, putting them at higher risk of identity theft.

3) Fake Navigators: To assist consumers with their transition into healthcare plans under  the Affordable Care Act, the government is sponsoring the training and certification of “healthcare navigators” to help consumers purchase insurance. Unfortunately, scammers are cashing in by impersonating these navigators and stealing the consumers’ money or personal information. Don’t give any personal information to a “navigator” who cold-calls, and verify a potential navigator by thoroughly researching their organization before you deal with him or her.

4) Fake Coverage and Mandatory Payments: This scam has a variety of sub-versions, including selling fake healthcare coverage, manipulating consumers into to paying upfront fees for the Affordable Care Act healthcare benefits soon to take effect, and even the threat of jail if fake enrollment fees are not paid.

5) Fake Health Exchange Website: Watch out for fake health exchange websites, designed to mimic real sites but instead stealing users’ personal information or infecting their computers with malware. Don’t click links from unsolicited spam emails or download any unsolicited email attachments.

For more information about signing up for healthcare under the Affordable Care Act, visit www.healthcare.gov.

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HealthCare.Gov Experiences Security Issues

Healthcare.gov launched on October 1st, and Americans across the country quickly grew frustrated with the website’s slow response, error messages, and lack of security. The Associated Press reported that programmers working on the healthcare.gov website were overwhelmed by the short deadline to launch the site and thus incapable of handling heavy traffic expected to visit the site.

An internal government memo written just days before the start of open enrollment for Obamacare warned of a “high” security risk because of a lack of testing of the healthcare.gov website. Earlier in the week, CNN Money profiled an Arizona software tester who said the system was vulnerable and could easily be hacked. The Arizona software tester was able to reset users’ passwords without much difficulty, leading lawmakers to argue that the system should have been more thoroughly vetted, since it asks purchasers of health insurance to provide personal information.

Rep. Mike Rogers, R-Michigan, reprimanded Health and Human Services Secretary Kathleen Sebelius, who testified that the website was ready to be rolled out, saying, “You accepted a risk on behalf of every person that…put their personal and financial information at risk because you did not even have the most basic ‘end-to-end’ test on security of this system.”

The premature launch of the healthcare.gov website and the obvious glitches, including lack of security, can provide a learning experience for American businesses, according to Ken Wisnefski, president and CEO of WebiMax. “When a client base is expecting a simple way to comparison-shop for health insurance or any other product or service and are met with website security issues, this not only puts the client at risk, but it can result in some serious legal consequences. As demonstrated with the healthcare.gov site, launching a website before it is ready can do irreparable damage to the credibility and reputation of a brand.”

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Triage Call Center Pursues URAC Call Center Accreditation

TriageLogic, a telephone nurse triage company, has applied for the health call center accreditation from URAC, a Washington, DC-based healthcare accrediting organization that establishes quality standards for the healthcare industry. URAC health call center standards assure that registered nurses, physicians, or other validly licensed individuals perform the clinical aspects of triage and other health information services in a manner that is timely, confidential, and includes medically appropriate care and treatment advice.

“We invested a lot of time and effort to ensure that our services meet high-quality standards for nurse triage,” said TriageLogic CEO, Charu Raheja, PhD. “The URAC accreditation exemplifies our commitment to competence and quality.”

“TriageLogic should be commended for its decision to be reviewed under URAC’s strict quality standards,” said URAC chief operating officer William Vandervennet. “It is critically important for healthcare organizations to make a commitment to quality and accountability.”

TriageLogic provides telephone nurse triage service, receiving over 150,000 nurse triage calls per year for subscribed medical facilities and physicians. All calls are handled by registered nurses and utilize Schmitt-Thompson’s evidence-based clinical protocols for providing comprehensive nurse triage.

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URAC Launches Accreditation Programs for Clinical Integration, Accountable Care

Recent healthcare reform focuses on transforming care delivery while controlling costs. URAC, an independent accreditation organization advancing quality and value throughout healthcare, announced two new accreditation programs to address the changing healthcare landscape.

URAC’s Clinical Integration and Accountable Care Accreditation programs cultivate cooperation among providers to control costs, ensure quality, and improve health outcomes. These programs are part of URAC’s Provider Suite, building upon the Patient Centered Medical Home program. Together these programs provide a flexible, educational approach to assist provider organizations as they move from physician practice groups to fully functioning medical homes, from loosely organized networks to clinically integrated networks, and from clinically integrated networks to providing population-based health through accountable care entities.

“URAC’s new accreditation programs are a road map for providers to successfully navigate the complex structural and cultural changes required under the Affordable Care Act to succeed in a new environment focused on quality and accountability,” said Kylanne Green, president and CEO of URAC. “Accreditation provides a competitive advantage for healthcare organizations by distinguishing themselves in the market while meeting industry needs at a crucial time of change.”

To earn the accreditation, providers are independently evaluated, ensuring the achievement of accountability and quality under industry-vetted standards. URAC’s clinical integration standards also align with Federal Trade Commission (FTC) antitrust regulations. The accreditation works for a variety of health providers, from small to large, including specialty groups.Save

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About Peter DeHaan

Peter DeHaan is the president of Peter DeHaan Publishing, Inc., (http://peterdehaanpublishing.com) the publisher and editor of Connections Magazine and AnswerStat, and editor of Article Weekly. Peter DeHaan’s personal website (http://peterdehaan.com) contains information and links to his blogs, newsletter, and social media pages.