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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