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March/April 2020 Issue of Connections Magazine

The March/April 2020 Issue of Connections Magazine, covering call centers and the teleservice industry

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March 2020

Why You’re Not Getting the Most from Your Training Dollars



By Kate Zabriskie

Each year, organizations waste thousands of dollars on training that doesn’t deliver what the people who bought it thought it would. Consequently, remorseful purchasers determine that either training has no value to their employees, training facilitators don’t know what they’re doing, program designers are out of touch with reality, or all three.

If only the root causes of training failures were as simple! Even with willing learners, great content, and strong facilitation, you can still encounter problems that will keep you from realizing strong returns on your training investment. If your training isn’t delivering what you think it should, you may be suffering from one of three major problems that plague all organizations.

1. Training Isn’t Part of a Larger Learning Ecosystem

Just because people participate in a workshop doesn’t mean they’ll change their work behavior. In fact, even if they demonstrate an ability and willingness to apply what they’re learning in class, all may be lost once they exit the classroom.

For example, if turnover is an issue, a learning organization wants to know why and may ask several questions. Click To Tweet

Why does this happen? Good workshops usually fail to deliver because they’re treated as a training solution instead of a component of one. In other words, a workshop isn’t the answer. Rather, it should be part of a larger apparatus or ecosystem.

Solution: Start small. Creating a strong learning ecosystem is an ongoing and often complex endeavor. It takes time to build a holistic structure that supports continuous development. Ask yourself: 

  • Prior to training, do managers explain to people why they will be attending a course and what the expected application will be?
  • Will someone with authority (other than the facilitator) launch the session by explaining how the workshop ties into the bigger picture?
  • Are there check-in opportunities after training to ensure participants are implementing new behaviors?

If you answer no to any of these questions, do what you need to do to shift those answers to yes.

Next, think about the incentives you can put in place to encourage behavior change, the barriers you need to remove to encourage success, and the corrective action you’ll take if what’s happening in the classroom isn’t replicated on the job.

Once you start thinking holistically and view courses and workshops as a component of learning versus learning in its entirety, you will have taken the first step in getting the most out of your training dollars.

2. Continuous Learning Isn’t Part of the Culture or a Priority

You have great content, and you have a skilled facilitator, but half the people scheduled to attend don’t make it a priority.

When training occupies a position of “nice to have” versus “need to have,” getting the most from it becomes problematic. This most often happens when people are in survival mode instead of on a growth trajectory. In other words, they scramble to get through their work instead of thinking mindfully about the work they’re completing and how they’re completing it.

In practical terms, if people are always putting out fires and don’t regularly ask “What have we learned?” and “How can we improve?”, why should they care about learning new skills?

Solution: Start by asking the right questions. Shifting from a reactive culture to one that is deliberate about its activities takes months or even years. However, it’s not difficult to make big strides over time when you begin by asking the right questions throughout the organization.

Start the improvement conversation at multiple levels and at various times. Frequently ask after training: 

“What have we learned?”

“What do we need to do better next time?”

“What do we wish we’d known earlier?” 

In the rare instances when something goes perfectly, remember that there are still questions to ask: “How can we replicate what we just did?”; “Why did that work well?”; and “Is there any reason this approach won’t work again in the future?”

When questioning becomes the norm, the solutions offered via training should have stronger importance and value. For example, if turnover is an issue, a learning organization wants to know why and may ask several questions: 

“Are we hiring the wrong people?”

“Are we expecting too much?”

“Is there something better for the same money somewhere else?”

“Do our managers not manage well?”

“Do we need to provide people with better tools?”

Then, when learning and improvement are a priority, you’ll hear such things as, “Today is a training day for me. I’ll be unavailable until 4:00. If you have an emergency, please see my supervisor, Melissa. The workshop I’m attending is of top importance and part of my effort to reduce turnover.”

Who can argue with that? The logic sounds right and ties into big-picture improvement goals.

To get larger returns from training, use questioning to drive improvement. The answers will help people connect the dots and understand why training is a priority and not just something they do because their schedule tells them to show up in a classroom.

3. Few Annual Development Plans Exist

The world doesn’t stagnate, and your employees shouldn’t either. If they’re doing their work the same way they were five years ago, and nobody is encouraging or demanding change, why should they care about training or think you care about them?

Solution: Regardless of level, every employee should have a development plan and some learning and growth goals that connect to the big picture and enhance their skills.

“I want to improve XYZ skill to drive ABC result, and 123 is how I plan to grow” is a quick and easy format to follow when setting development goals. Three to five goals is a suitable number for most people.

Better still, if you can tie those goals to performance reviews, you’ll be amazed at the interest people develop in improvement, training, and implementing new skills. As with the other two solutions, start small. For example, if your company doesn’t have any development plans, choose one department to pilot them.

Act Now

Whether you suffer from one, two, or all three of these problems, act now. When thoughtful goals and development plans exist throughout an organization, people are conditioned to ask the right questions. With a drive toward improvement and a strong learning ecosystem that supports learning, it’s almost impossible not to realize a stronger return on your training dollars.

Kate Zabriskie is the president of Business Training Works, Inc., a Maryland-based talent development firm. She and her team help businesses establish customer service strategies and train their people to live up to what’s promised. For more information, visit www.businesstrainingworks.com.

Vision 2020



By Donna Fluss

We’ve entered the new decade with great momentum in technological innovation. Startups and large enterprises are investing billions in artificial intelligence (AI) and automation-based initiatives that will change the way we live our lives and conduct business over the next ten to twenty years. Technologies we’ve talked about for generations, such as self-driving cars, will alter the way people get around, making the argument for or against new transportation business models from companies such as Uber and Lyft merely a stepping-stone to a vastly transformed future.

DMG’s crystal ball shows an amazing outlook for the world of service and contact centers. In 2020 we’re going to see new and continued investments that will finally allow companies to decrease the number of live agent resources needed in contact centers, which is the number-one goal for these people-intensive organizations. 

This will be a major boon for contact centers and back-office operating departments, where employees are still engaged in many repetitive, noncognitive tasks. Click To Tweet

Self-service solutions—the preferred way for consumers in the more advanced economies to obtain assistance—will experience a resurgence as AI-related technologies emerge that provide omni-channel concierge-level service. (Displaced contact center employees can move into new functions, such as administering robotics and AI initiatives.)

The workforce, populated increasingly by millennials, will continue to take the reins from boomers and Gen-Xers. This will intensify the need to satisfy the lifestyle requirements of the most technically advanced generation of workers. The digital transformation will continue to take place slowly in many companies. 

Investments to replace forty- to fifty-plus-year-old solutions that remain at the core of some of the largest corporations in the world, including major banks, will finally occur, as the resources and cost required to support systems built in the dark ages of technology will be too high. This doesn’t mean that it will be easy; it just means that it will happen, as the alternative is no longer viable. 

The changing workforce will drive much of the innovation in companies. More business (and personal) activities will occur through mobility. The need for enterprise-wide workforce management (WFM) solutions to help companies find, hire, train, and schedule the resources needed to operate their business cost-effectively (not just in their contact centers) will supersede negative preconceptions. A new generation of flexible, AI-based WFM solutions will emerge to support this. Designed for real-time, omni-channel, and multifunction forecasting and scheduling, they will share only a name with the solutions of the past. 

After decades of claiming to need highly knowledgeable workers, enterprises will implement new systems, training programs, and policies, driven by the vast amount of data required to support a hybrid human and automated workforce. It’s still debatable whether every employee will have their own automated bot to assist them, as it’s likely unnecessary, but there is no doubt that many types of automation (and workflow technology) will emerge to handle tasks that do not require or even benefit from the cognitive capabilities of live employees. 

This will be a major boon for contact centers and back-office operating departments, where employees are still engaged in many repetitive, noncognitive tasks that require them to cut and paste data into multiple nonintegrated systems, manually create and enter summaries of customer conversations, place orders received via faxes (yes, this still happens), manually perform fulfillment activities, and more.

New automation and AI-enabled technology will deliver innovations that make it easier for companies to support the work/life balance requirements of millennials and, looking to the future, Generation Z. As these capabilities enhance the customer and agent experience and improve productivity, adoption will be swift.

Smart technology will position companies to improve the customer experience, provided the initiatives coincide with changes to outdated policies and procedures. One of the biggest impediments to delivering an outstanding customer experience, regardless of technology, is the conflicting goals of sales, service, and marketing. For digital transformation initiatives to succeed, enterprises must invest in reinventing their relationship with customers and employees, as much as updating their technology.

Donna Fluss is president of DMG Consulting LLC. For more than two decades she has helped emerging and established companies develop and deliver outstanding customer experiences. A recognized visionary, author, and speaker, Donna drives strategic transformation and innovation throughout the services industry. She provides strategic and practical counsel for enterprises, solution providers, and the investment community.

Use Telehealth to Extend Healthcare and Save Money



By Nicole Limpert 

The Health Resources Services Administration (HRSA) defines telehealth as “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.”

One of the most common forms of telehealth is a nurse hotline. Most U.S. health insurance companies offer a toll-free nurse advice hotline to their customers. Other types of telehealth services include virtual appointments, medical staff consults, remote health monitoring, and nonclinical services.

Removing Barriers to Healthcare

Telehealth not only makes access to healthcare easier for the public, it also has proven to be a necessity for both large organizations and niche markets.

Members of the United States military and their families are stationed all over the world. The Department of Defense’s (DOD) Military Health System (MHS) provides healthcare to more than 9.4 million people through a network of fifty-six hospitals, 365 clinics, and other facilities worldwide. Telehealth programs connect military patients to providers across the world to deliver direct access to quality healthcare, tele-radiology, and tele-pharmacy services.

The United States Department of Agriculture (USDA) is heavily involved with providing telehealth services to rural communities and administers telecommunications telehealth grants through two major programs: the DLT Program and the Community Connect Program. Similarly, the United States’ Indian Health Service uses telehealth to assist with accessing health services for American Indian and Alaska Native populations living in outlying communities.

Other isolated niche markets use technology to improve healthcare. Alaska’s maritime industry uses a telehealth platform to enhance access to care for those who work in the dangerous waters off Alaska. Internet connections are unreliable, so they primarily use a phone-based system to instantly connect with doctors. The Federal Bureau of Prisons (FBOP) uses telehealth to expand their internal healthcare program by consulting with external healthcare providers via collaborative practice agreements. 

Telehealth and Medical Call Centers

Regardless of where people are located, telehealth is a critical tool that brings the best possible care to patients. Medical call centers play a significant role by providing the technology and medical expertise needed to bring remote healthcare to patients.

Technology enables medical call centers to effectively become an extension of a hospital or medical center’s operation. The communication software used by medical call centers can securely access a patient’s electronic medical record (EMR), update EMRs with notes, and record calls needed for insurance claims and workers’ compensation. Because everything is documented, detailed reports can be generated for reporting purposes.

Medical call center operators can coordinate care, make follow-up calls, schedule visits, contact on-call medical staff, and manage referrals. Some healthcare call centers staff licensed medical professionals who are qualified to make health assessments, give medical advice, and escalate critical concerns.

The services provided by medical call centers are available twenty-four hours a day, seven days a week. Medical operators can work different hours and be located anywhere in the world, in any time zone. For example, if a medical center on the East Coast of the United States is closed, operators on the West Coast are still available.

Telehealth services may become more of a healthcare necessity rather than a convenience. Click To Tweet

Telehealth Benefits Hospitals

In the 2017 American College of Healthcare Executives’ (ACHE) annual survey, hospital CEOs ranked their ten biggest challenges for the year. Telehealth services can address six of these ten concerns—specifically, financial challenges (first), personnel shortages (third), quality of care (fourth), patient satisfaction (fifth), access to care (seventh), and population health management (ninth).

Multiple small- and large-scale studies cite the use of telehealth as a cost-effective method to deliver quality care, improve outcomes, enhance the patient experience, and expand access to healthcare. The patient’s experience with their healthcare team plays a critical role in their satisfaction. Patients are asked to provide information about their care experience via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Unacceptable survey results can result in hospitals losing some reimbursements. In 2017 alone, approximately 1.7 billion dollars in reimbursements were withheld from hospitals. 

The cost savings are also passed along to patients. Call center data from Health Navigator cites that the top five reasons for calling a nurse hotline are fever, vomiting, stomach pain, cough, and head pain. Less than 10 percent of the cases were high-risk. On average, telehealth appointments for nonemergency reasons cost approximately forty-five dollars, as opposed to one hundred dollars for an in-person visit at a doctor’s office or 160 dollars at an urgent care clinic.

The Future of Telehealth

The population growth for the United States from 2008 to 2030, is estimated at 20 percent, totaling 363 million people. This spike in population will exacerbate an already strained shortage of healthcare professionals. Telehealth services may become more of a healthcare necessity rather than a convenience.

As technology advances, telehealth can become more complex by not only connecting patients with expertise in real time, but also by enabling computer-assisted medical procedures in remote locations by specialists thousands of miles away, thus creating global care teams for patients.

Amtelco

Nicole Limpert is the marketing content writer for Amtelco and their 1Call Healthcare Division. Amtelco is a leading provider of innovative communication applications. 1Call develops software solutions and applications designed for the specific needs of healthcare organizations.

Mitigating Medical Call Center Risk



By Traci Haynes

Does the word risk evoke an emotional connotation? Regardless of the inference and based on life experience, the word can carry an emotive element. There are uncertainties in risk, which may be associated with hobbies, tasks, or employment. 

Calculated risk is an action taken after careful consideration and estimation of the probable outcome. Healthcare organizations employ risk managers to identify and evaluate risks to reduce injury to patients, staff, and visitors within the organization. 

The five basic steps of risk management include: 

  1. Establish the context.
  2. Identify risks.
  3. Analyze risks.
  4. Evaluate risks.
  5. Treat/manage risks.

Risks exist in a medical call center too. There are employee risks and patient risks. These can include risks from the physical environment, clinical management, and technology. What can organizations do to help mitigate these risks? They can strive to be calculative, carefully considering and estimating probable outcomes. Even doing so, however, will not eliminate all risk.

A medical call center’s number-one asset is its staff. Click To Tweet

Risk Resource

An excellent resource that covers information on risk is The Art and Science of Telephone Triage: How to Practice Nursing over the Phone. It is a book written by two industry leaders in the field of telehealth nursing practice, Carol Rutenberg, RN-BC, C-TNP, MNSc, and M. Elizabeth Greenberg, RN-BC, C-TNP, PhD. The book also documents the history of telephone triage and its subsequent evolution, provides real-case scenarios, and contains chapters onFAQs, best practices, and other topics. 

Minimizing risk is essential in the medical call center environment. Consider your potential for risk. Then analyze, evaluate, and manage it. Also essential is focusing on ways the medical call center can support the organization’s risk avoidance. Of utmost importance to every organization is supporting the Institute for Healthcare Improvement’s Triple Aim initiative and optimizing health system performance of better outcomes, lower costs, and improved patient experience. 

Hospitals throughout the country are aggressively tackling performance improvement within their own organizations, and evidence shows their efforts are helping to reduce risk. The recent addition of a fourth aim emphasizes the importance of improving the experiences of those in the workforce who provide healthcare. The Quadruple Aim focuses not only on better outcomes, lower costs, and improved patient experience, but also on improved clinician experience. 

A medical call center’s number-one asset is its staff. Employees need to feel recognized for the work they do. Their working environment should encourage respect and foster a sense of belonging and purpose. They should have the ability to influence their work, as well as be given opportunities for professional growth.

Medical Call Center Risks

Let’s drill down a little further on potential risks in a medical call center. Please note, this is not an all-inclusive list and not listed in order of importance. However, it is valuable information to consider. 

Clinical Management

  • Clinical oversight (such as the medical director): approval of clinical content, decision support tools, educational material, medications, and orders.
  • Job descriptions: title, clear description of work duties, purpose, special skills, and qualifications for the position
  • Scope of service: what type and for whom 
  • State Board of Nursing Nurse Practice Act: follow standards of practice
  • Licensure: state license, Nurse Licensure Compact 
  • Orientation/training/preceptor: defined program with monitoring, feedback, and evaluation
  • Policies and procedures: associated with call handling and call scenarios
  • Performance monitoring/evaluations: formal approach using call records and/or call recording
  • Continuous quality improvement: process to identify issues, implement/monitor corrective action, and evaluate the effectiveness

Technology 

  • Electronic Health Record (EHR): access and by whom
  • Computers: hardware/software, latest recommendations, updates, backup, and archiving
  • Database: decision-support tools and functionality for a standard method of documenting the encounter, optimizing the intake of information, and supporting a consistent approach to provision of information and directions for care; reporting of outcomes
  • Telephone system: supports call handling that may include auto-attendant, call routing, tracking average speed of answer, time in queue, abandonment; real-time monitoring, reports, and recording of calls
  • Chat/email/texts/photos: accept and save as part of EHR
  • HIPAA-compliant: protecting health information

Physical Environment

  • Outdoor surveillance monitoring
  • Lighting: internal measurement, general, task, emergency, external
  • Security locks: after-hours or 24/7
  • Parking: on-site, off-site, monitored, lighting
  • Security personnel: on-site, off-site
  • Sound: acoustics, masking, privacy 
  • Workstation ergonomics: standing/sitting, monitor height/distance, keyboard/mouse position, adjustable chair with height/arm and height/back support, headset, and so forth. 
  • Repetitive stress injuries: most commonly affects injuries to the upper extremities (wrists, elbows, and hands) due to repetitive keyboard activities

Patients and Families

  • Medical call center access: 24/7, after-hours, business hours, community service, or provider/payer service
  • Reason for call: emergent, urgent, semi-urgent, and nonurgent
  • Language and culture: linguistically and culturally appropriate and using an individual’s primary language
  • Age-specific or all age groups
  • Social determinants of health: influences an individual’s quality of health
  • Past medical history: health status prior to encounter and effect on the reason for call/disposition
  • Chronic conditions: type, number, effect on the reason for call/disposition
  • Medications: routine, PRN, effect on the reason for call/disposition
  • Preventive health: effect on overall health
  • Disabilities: type, effect on reason for call/disposition
  • Disposition: collaborative decision, access for care as needed

Addressing risk potential in medical call centers will benefit all stakeholders and improve healthcare outcomes.

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

How Telephone Triage Call Centers Can Help Reduce Physician Burnout



By Shannon Bays-Crockett

When studying worrisome symptoms among physicians and mental health workers in the 1970s, Herbert Freudenberger, a German-American psychologist, coined the term burnout. HHS described professional burnout in 2017 as an occupational hazard that could lead to high-quality healthcare professionals leaving the practice of medicine. By 2017, physicians reporting frequent or constant feelings of burnout totaled 51 percent—up from 40 percent in 2013.

The Center for Treatment of Anxiety and Mood Disorders reports that physician burnout is growing in the United States. One in three physicians experience physician burnout at some point in time. Compared to other professions, physicians are fifteen times more likely to experience burnout. About 45 percent of physicians report that they would quit the profession if it weren’t for the money. Approximately 400 physicians commit suicide each year. Those numbers emphasize the need to quickly address the burnout issue.

Physician burnout symptoms seem to mirror indications of other stress disorders, but there are also distinct differences. Dr. Dike Drummond, author of the blog The Happy MD, talks about physician burnout in his article “Physician Burnout and the Four Phases of Compassion Fatigue” (blog post #297) when he says, “Losing the ability to feel empathy, sympathy, and compassion for your patients is a constant risk for all of us.” 

Nurse triage call centers help physicians achieve work/life balance by reducing or eliminating after-hours and on-call requirements. Click To Tweet

Physician burnout symptoms might include:

  • Physical and emotional exhaustion that leaves physicians worn out and unable to recover during downtime
  • The development of a cynical and negative attitude regarding work and patients
  • A reduced sense of purpose along with a feeling that what they’re doing has little to no meaning or value

Ashley Altus, a writer for The DO, the online publication of the American Osteopathic Association (AOA), reported on Dr. Octavia Cannon’s talk to the January 25, 2018, AOA LEAD (Leadership, Education, Advocacy & Development) Conference in Austin, Texas. Dr. Cannon challenged physicians to instruct students and residents about the importance of life outside of medicine. “Encourage them to take time for themselves,” Dr. Cannon said. 

Dr. Cannon continued to discuss how stress for young physicians is at its peak during training in medical school and residency, citing Medscape’s 2018 National Physician Burnout and Depression Report in which data suggested that 42 percent of physicians reported symptoms of burnout. 

Addressing Physician Burnout 

Imagine the pediatrician attending a daughter’s dance recital or a son’s football game when the phone rings. The caller is the worried parent of a child who is spiking a fever. The physician is torn away from the family activity to advise the child’s parent. The doctor becomes frustrated by missing his own child’s big moment in the spotlight and can’t get that back. Somebody loses out, and the choice between duty, frustration, and guilt is not an easy decision. 

Healthcare Call Centers

One popular solution—after-hours telephone triage—works well to both address physician concerns and serve the needs of anxious patients. Nurse triage call centers help physicians achieve work/life balance by reducing or eliminating after-hours and on-call requirements by offering patients telephone access to advice that is based on guidelines established according to preferences of each provider’s practice. All patient calls are triaged using evidence-based guidelines and are directed to the appropriate level of care. All call records are forwarded directly to the patient’s care provider so they are available the next business day.

By partnering with accredited health call centers for after-hours telephone triage, providers can enjoy their professional as well as their private lives. Other benefits of after-hours nurse triage are reflected in improved physician recruitment and retention and a more satisfying patient/physician encounter when the physician is rested and refreshed. 

Shannon Bays-Crockett is a strategic communications specialist with AccessNurse.

Don’t Compromise on Security When Selecting a Vendor



By Ravi K. Raheja, MD

The average cost of a data breach in the United States has hit an all-time high of 7.35 million dollars. Just this year, there have been more than one hundred hacker attacks on healthcare organizations, according to the U.S. Department of Health and Human Services. Despite better awareness among healthcare organizations, data breach costs average 408 dollars per record. Cybercriminals use weaponized ransomware, misconfigured cloud-storage buckets, and phishing emails to attack.

Hidden costs in data breaches are difficult and expensive to manage, resulting in customer turnover, reputation damage, and increased operational costs. Knowing where the costs lie and how to reduce them can help companies invest their resources more strategically and lower the huge financial risks at stake.

While looking for cost-saving solutions is important for any business, it is critical to make sure your vendor partners also meet the same stringent criteria on data security. This extends to your outsourced after-hours services as well. Not doing the proper due diligence can lead to a significant risk in terms of data loss and security.

Don’t be afraid to dig deeper and ask vendors questions if you have any concerns. Click To Tweet

Here are fourteen critical questions you should consider when selecting your partners in healthcare:

  1. Do you have a chief information officer (CIO) who oversees the security program?
  2. Do you have a formal security compliance program in place with yearly audits?
  3. Is the vendor URAC-accredited so a third party is auditing the triage call center policies and procedures to ensure they are followed?
  4. Does the vendor subcontract services? If they do, are the proper BAAs (Business Associate Agreements) and contracts in place?
  5. What is their data breach insurance policy limits?
  6. Is the data center infrastructure set up to maximize data protection along with regular scanning of the software and servers?
  7. Does the vendor have an intrusion detection system to alert potential threats?
  8. Does the vendor have adequate IT resources to monitor all systems and to respond quickly to any potential threats?
  9. Do the products meet HIPAA, HITECH, and other security requirements?
  10. Do the security reports meet all auditing and HIPAA-reporting needs?
  11. Do you have a formal HIPAA training program for all staff members?
  12. Does the data center where the data is stored have proper security certifications?
  13. Is the patient data secured at all times and in all modules of the product? (This must include strong password protection or other user authentication, data encrypted at rest, and data encrypted in motion.)
  14. Is the patient’s data secured when accessed via handheld devices, such as through secured through SSL websites, iPhone apps, and so forth?

If the answer is no to any of the above questions, then it may be an indication that you should look deeper and compare vendors before selecting one that will protect your patient data properly. Don’t be afraid to dig deeper and ask vendors questions if you have any concerns. Remember, it is harder to change vendors once you implement a program than to ask questions beforehand and make sure that you have the best system in place for your needs.

Ravi K. Raheja, MD, is the COO and medical director of the TriageLogic Group. Founded in 2005, TriageLogic is a URAC-accredited, physician-led provider of high-quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. The TriageLogic group serves over seven thousand physicians and covers over 18 million lives nationwide. For more information, visit www.triagelogic.com and www.continuwell.com.

Cyber Security and HIPAA in a Medical Contact Center


Startel, Professional Teledata, Alston Tascom

By Bobby Bennett

Regardless of size, medical contact centers must take steps to protect against cyberattacks and ensure HIPAA compliance. These two issues warrant intentional and proactive attention.

Ways to Prevent Cyberattacks

With cyberattacks on the rise, what steps should a contact center take to prevent falling victim? The first is to recognize that it could happen to anyone. Do not equate small with safe. According to a 2017 Trend Micro online survey, 45 percent of small business owners believe they will never be targeted. The cyber security firm 4iQ states in its 2019 Identity Breach Report that cybercriminals targeted small businesses with cyberattacks at an inordinate rate in 2018—up 425 percent over the previous year. Here are some ways to prevent such an attack: 

  • Install, use, and regularly update antivirus and anti-spyware software on every computer used in your business.
  • Use a firewall for your internet connection.
  • Download and install software updates for your operating systems and applications as they become available.
  • Make backup copies of important business data and information.
  • Control physical access to your computers and network components.
  • Secure your Wi-Fi network and make sure it is hidden.
  • Require individual user accounts for each employee.
  • Limit employee access to data and information. Also limit authority to install the software.
  • Regularly change passwords.
  • Consider two-factor authentication such as a password and a PIN.

The Federal Communications Commission provides a Small Biz Cyber Security Planner on their website. 

A business associate is also liable and subject to civil and criminal penalties for making uses and disclosures of PHI not authorized by its contract or required by law. Click To Tweet

HIPAA and Protected Health Information

Another factor to be mindful of as a call center that takes calls for healthcare providers and clinics is that you are a business associate of the covered entity. A HIPAA business associate is a contractor or vendor to a HIPAA-covered entity that creates, maintains, or transmits protected health information in performing a function or service to the covered entity.

If a covered entity engages a business associate to help it carry out its health care activities and functions, the covered entity must have a written business associate contract or other arrangement with the business associate that establishes specifically what the business associate has been engaged to do and requires the business associate to comply with the [HIPAA] Rules’ requirements to protect the privacy and security of protected health information. In addition to these contractual obligations, business associates are liable for compliance with certain provisions of the HIPAA Rules. (HHS.Gov)

A business associate contract serves to clarify and limit, as appropriate, the permissible uses and disclosures of protected health information (PHI) by the business associate. They may use or disclose PHI only as permitted or required by its business associate contract or as required by law. 

A business associate is also liable and subject to civil and criminal penalties for making uses and disclosures of PHI not authorized by its contract or required by law. It is important that employees are trained and understand the HIPAA rules required of a business associate. You can find sample Business Associate Agreement Provisions and training resources on the HHS.gov website.

Text messaging (SMS) has become the preferred method of message delivery for both the contact center and healthcare providers. With this growing trend comes the risk associated with the transmission of PHI. 

Standard forms of SMS could mean that text messages may remain on a device for an extended time. If the device is recycled, lost, or left accessible to unauthorized persons, HIPAA violations may occur. You must provide safeguards to reduce your exposure to these risks. 

Secure messaging is a HIPAA-compliant way to safely exchange sensitive information via text. Most contact center system vendors have developed secure messaging applications for use with their systems. However, quite often it is difficult for a contact center to convince a large medical group to make changes and convert from their current secure messaging provider to one offered by the contact center. 

Conclusion

Don’t ignore the risks of cyberattacks and HIPAA-noncompliance in your medical contact center. Take essential steps today to reduce bigger problems tomorrow. 

Startel

Bobby Bennett is the western regional sales manager for Startel, Professional Teledata, and Alston Tascom, leading providers of best-in-class contact center solutions for healthcare and medical telephone answering service call centers. Startel’s Alston Tascom Division has created a stand-alone, vendor-agnostic secure messaging gateway that has integrations with some of the most popular secure messaging providers. Contact Bobby at bobby.bennett@startel.com or 800-782-7835. 

Build Robust Customer Relationships by Being Proactive



By Jill J. Johnson

While today’s online sales process can appear streamlined, it creates complexities and confusion for consumers who have many options in a global marketplace. The internet has blurred traditional sales territories because consumers can now search the world for the products and services they want or need. Finding the right one requires them to weed through many alternatives so they can make optimal purchasing decisions. 

Proactively building robust and trusting relationships with customers provides opportunities to become their top advisor and go-to vendor. Anticipating potential customer service challenges will help develop a framework for resolving issues in a manner that protects customer relationships. Software applications and marketing automation also create opportunities for enhanced customer insight and relationship development. 

Team Efforts Build Strong Customer Relationships

The most successful salespeople develop strong and lasting relationships with their customers. They focus on solving problems, not just making a transaction. They become an advisor their clients rely on for accurate information and solutions to address their needs. They are responsive and do not leave their clients waiting for answers. With this approach, you can anticipate opportunities for your customers and present new ideas when they are most likely ready to consider them.

Successful sales and marketing team members work closely together to create synergies among all communications used to connect with customers. Service teams must also work in sync with sales to deliver the quality that sales promised. There is nothing worse for the client relationship than a salesperson making a promise that service can’t deliver. In most organizations, service delivery stands separate from sales. Each department has its own evaluation metrics, with little communication between the two groups. When that happens, the entire customer relationship can be at risk.

Companies that effectively calibrate and coordinate their ability to supply the services the customer expects will be the most successful over the long-term. Sales relationships strategized throughout the organization provide the best opportunities for gaining accurate customer intelligence. 

You must move from passive order-taking to developing a customer relationship focused on knowing their interests and requirements. Click To Tweet

Maintaining Customer Relationships Requires Trust

When working with clients who have a long-standing relationship with your organization, it can become easy to take them for granted. Personal relationships often develop among the various parties on both sides. Frequently this evolves into a high-trust relationship.

When there is a glitch in service, client relationships can be jeopardized. If something significant interferes with the trust relationship, the entire account can be at risk. It may be service glitches or price points that are too high. When this occurs, it can be easy for everyone to assume that the relationship will resolve the issue. But when it doesn’t, everyone must remember that business is business. Personal relationships developed with care over time can vanish when mistakes occur. Both parties have their own jobs to protect and their own internal political challenges.

Often the best approach is for a call center to operate on a “no surprises” basis with clients. When you know there might be a service issue, the sooner you alert the customer, the more options you have to maintain the trusted relationship. Understanding the latitude and flexibility you have when there is a problem can move you faster to finding a resolution. No matter what, resolve client problems before they become a social media nightmare or result in lost business. 

Effective Client Relationship Management 

Building and managing relationships with your prospects and key referral sources require effort. It’s more than simply having them on your mailing list or emailing them newsletters or updates. More personal and consistent one-to-one relationships are necessary to achieve your goals. 

You must move from passive order-taking to developing a customer relationship focused on knowing their interests and requirements. Then you can match your outreach and communications to move them through their decision-making cycle. Reassess your prospect management to determine if you are relying on stale efforts that do little to move the sale forward or deepen your relationship. 

Years ago, salespeople tracked customer information on index cards. Today, robust customer relationship management (CRM) software has changed how we manage interactions with current and potential clients. CRM integration with email marketing applications can enhance sales productivity and offer options for customer personalization.

Using CRM tools helps you stay on top of customer follow-up. This requires an investment of time in capturing information into the system. Once you do this, you can take advantage of opportunities to use its robust capability for data capture and market segmentation options. These efforts will help you more effectively manage your client relationships and provide options for efficient and appropriate outreach.

Final Thoughts 

Take time to review the effectiveness of your approach to customer relationship management. Don’t take your client relationships for granted. As with any relationship, they must be nurtured to preserve and grow. Actively managing your customer and prospect interactions creates more opportunities for engagement. Each engagement takes you one step closer to closing another sale or selling a bigger deal than you can currently imagine. 

Being your customers’ subject matter expert, anticipating their needs before they do, and doing their homework for them are essential to successful and lasting customer relationships. Improving your customer’s experience will build word of mouth about your effectiveness as a sales professional—rather than just someone who manages transactions.

Jill J. Johnson is the president and founder of Johnson Consulting Services, a highly accomplished speaker, an award-winning management consultant, and author of the bestselling book Compounding Your Confidence. Jill helps her clients make critical business decisions and develop market-based strategic plans for turnaround or growth. Her consulting work has impacted more than four billion dollars’ worth of decisions. She has a proven record of dealing with complex business issues and getting results. For more information, visit www.jcs-usa.com.

Responding to Call Traffic Fluctuations



You Can’t Schedule for the Unexpected, but That’s No Excuse to Be Unprepared

By Peter Lyle DeHaan, PhD

Author Peter Lyle DeHaan

Traffic at many call centers fluctuates with the weather, affecting some centers more so than others. Of course, non-weather-related events can also impact call traffic. This includes natural disasters, pandemics, riots, the threat of violence, media-produced frenzies—and the list goes on with as much variety as our imaginations can conjure up.

Although some traffic fluctuations occur with predictable regularity, other call traffic spurts strike with little warning. What’s a call center to do?

Deal with It the Best You Can 

The first impulse in responding to higher traffic than you’re prepared for is to work faster, cut out all nonessential tasks, and answer calls with greater intention. This helps . . . a bit . . . for a while. You may tap non-phone staff to put on a headset and get to work. Cutting breaks and shortening lunches emerges as a tempting thought, but don’t give in to that temptation. Asking staff to extend shifts and work overtime is another approach many call centers pursue. Sometimes this becomes mandatory. It helps to get calls answered, but employee morale takes a hit.

An optional strategy is to ignore the escalating number of calls in queue and just process whatever calls you can while working at your normal pace. If the call is important, the caller will hold or call back . . . at least you hope so. Regardless, customer sentiment will take a hit.

Don’t wait until you’re in the middle of a crisis to consider solutions. Click To Tweet

Intentionally Overstaff 

Given this situation, call center managers may intentionally over-hire and overschedule. That provides a nice buffer to deal with traffic peaks and longer-term surges. The side effect of this well-intended strategy is that during times of normal traffic levels, you’re either paying for unproductive work or your staff isn’t getting as many hours as they wish. Neither outcome is a good one.

Throttle Incoming Calls 

A third solution entertained by anxious call center managers is to reduce the number of incoming calls during high-traffic situations. One method is to provide a busy signal to callers. A second approach is to play a recording asking them to try later. A third possibility is to allow them to schedule a callback. Of course, for the callback solution to work requires that you’re not still dealing with the high-traffic situation when it comes time to make that return phone call.

Overflow to Another Location

If you’ve concluded that the first three options aren’t good ones, you’re right. If your call center is part of a multilocation operation, an easy solution is to send excess calls to another center in your network. For this to be a viable solution, however, requires that the other location is not suffering from the same malady.

Some multilocation call centers automatically route calls from one location to another based on incoming traffic and agent availability. In these cases, the overall traffic is self-regulating, which means that unexpected high call volume coming into one center will impact all call centers in the network. One center, therefore, can drag all the others down.

Outsource to Another Call Center

Another consideration is to form an arrangement with an outsource call center to take your overflow calls. Not only is this a great solution for high-traffic scenarios, but it also works well for understaffing. You can establish whatever events you want to trigger an overflow situation. It might be the number of calls in queue, the current wait time, or number of abandons.

Just as with sending overflow calls to another call center within your organization, select an outsource call center that’s geographically separated from your location to reduce the risk of them suffering from the same scenario as your call center. 

Conclusion

Though there is no ideal way to deal with unexpected call traffic, there are steps you can take to reduce the negative impact on both callers and staff. But don’t wait until you’re in the middle of a crisis to consider solutions—plan now before you’re swamped with calls.

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