Tag Archives: Healthcare Call Center Articles

How Can Your Contact Center Help the Homelessness in America?

By Traci Haynes

Homelessness in America occurs in every state and has many causes. According to the January 2017 Point-in-Time (PIT) count by the National Alliance to End Homelessness, the most recent national estimate of homelessness in the United States identified 553,742 people experiencing homelessness. The PIT count is a count of sheltered and unsheltered homeless persons on a single night in January. Like all surveys, the PIT count has limitations. Results are influenced by the weather, availability of overflow shelter beds, the quality of the volunteers, and the level of engagement of the people being interviewed. 

Most of this population lives in some form of shelter or transitional housing. However, approximately 35 percent live in places not meant for human habitation. The nature of homelessness makes it difficult to quantify the true size of the homeless population, not to mention the PIT methodology (although generally acknowledged to be the most accurate way to establish valid trend data). It is challenging to calculate the exact number of individuals who are homeless, because many live in hidden areas in parks, vehicles, or abandoned houses, and because numbers fluctuate based on weather.

Health Problems Faced by the Homeless

Homeless individuals are at a relatively high risk for a range of acute and chronic physical and mental illnesses. Some health problems precede and may contribute to homelessness, while others are often a consequence of being homeless. And homelessness complicates the treatment of many illnesses. 

One example of a health problem that can cause homelessness is a major mental illness, such as schizophrenia. Without therapeutic interventions and supportive housing arrangements, such an individual may become homeless. 

Another example is an accidental injury, including job-related injuries. Even with benefits under employer programs, these individuals may experience major economic costs leading to loss of housing.

Diseases of the extremities, skin disorders, malnutrition, degenerative joint diseases, dental and periodontal disease, communicable diseases, and the possibility of trauma are other health problems that may result from, or frequently occur in, the homeless population. Medical care and treatment for acute or chronic illness can be extremely difficult. 

Bed rest may be nonexistent for a homeless individual who has no bed or only has a bed in a shelter at night. Special diets and medication adherence are impossible to maintain for a person who is homeless.

Contact centers have long been known for assisting their organizations in offering triage, coaching, remote patient monitoring, and care management for an identified population. Some contact centers have also assisted other community agencies or services in filling a need or gap. 

Triage Call Centers Can Help Address Health Concerns of the Homeless

So, we all know homelessness exists, and it is a tremendous problem, but what does that have to do with triage call centers?

A community triage contact center at EvergreenHealth in Kirkland, Washington, implemented a program around 2000, in which they began to offer low-level acuity triage for their regional 911 dispatch centers. The dispatchers would go through their algorithms with the caller, and once they ruled out any emergent or urgent issue, the caller was offered the option of speaking with a nurse. If the caller preferred, she or he could be connected with an appropriate unit or the individual could be transported to the Emergency Department (ED). This program proved a tremendous success in both caller/patient satisfaction and dollars saved.

A study was published in 2015 for a comparable 911 program in two cities with similar outcomes. MedStar in Fort Worth, Texas, provided nine months of 911 call data, and LMEMS in Louisville, Kentucky, provided thirty-four months of 911 data. The study reported that the 911 program had a significant reduction in callers routed to the Emergency Department (ED) at a cost savings of 1.2 million dollars in payments, as well as a decrease in emergency ambulance transports resulting in a cost savings of $450,000 and a resultant increase in access to alternative care. Overall, patient satisfaction was 91.2 percent.

As a result of the involvement with the regional 911 dispatch centers, the contact center was asked to become involved with yet another identified need: the growing population of homeless individuals. County shelters and housing facilities for the homeless population needed a resource for individuals with low to moderate acuity symptoms, when medical or nursing personnel were not on-site. The fire department was handling 90,000 incidents per year, which resulted in overuse or misuse of the emergency medical response (EMR) system. And while the county shelters were not most of the calls, they were a contributor. 

Addressing the Concerns of the Homeless

A critical concern to the homeless individual is whether they will lose their shelter bed for the night if they are transported. The fire department is not authorized to make a medical diagnosis on the scene, to provide advice or guidance about disease management, to make a referral to other medical resources, such as a primary care doctor, or to provide transportation anywhere except an ED. 

The contact center had the system and tools in place to assist the RN with the individual at the county shelter’s assessment and make recommendations of care. “Right care, right place, right time” is the fundamental premise of contact center RN triage. Their service provided a much-needed solution to an ongoing gap in care. They currently support five dispatch centers in providing contact center RN triage for thirteen shelters.

The contact center educated the staff at the shelters and facilities. They provided training on when to call 911 (a red flag list) and when to call the contact center’s health line. Each homeless individual received HIPAA information that included “understanding and agreement that a copy of the information discussed during the call interaction would be shared with the residence so that they may further assist the individual with their care.” 

The workflow included one number for all facilities to dial into the Healthline contact center. The case manager and the resident had to be available at the time of the call. The RN in the contact center triaged the individual, and then the case manager determined the best non-EMR transportation based on the disposition. The triage note was then faxed to that facility. 

Challenges included the individual wishing to remain anonymous, the individual being a vague or poor historian, individuals declining triage or the recommendation, availability of OTC meds, and individual psych/social needs.

The Results

Eighteen months after the start of the program, the facility staff was queried, and all were either very or somewhat comfortable in knowing what situations required 911. Over 85 percent of the staff felt the service was especially important to the facility. 

By far, the majority felt that the nurses at Healthline were very knowledgeable (83.33 percent). More than 85 percent also felt that the nurse line process was easy to use and felt that the residents were satisfied with the service. Most of the staff felt very satisfied once the resident had talked with the nurse, and 100 percent indicated the importance of having the service available 24/7, adding that it was practical and helpful to the residents in the facility.

Traci Haynes MSN, RN, BA, CEN, CCCTM, is the director of clinical services at LVM Systems, Inc., and has been involved in the contact center industry for over twenty-five years. (Traci thanks Cheryl Patterson, BSN, RNC—TNP, clinical manager—quality and education, Healthline, for her contributions to this article.)

Secure Texting Helps Create Effective HIPAA-Compliant Communication

By Ravi K. Raheja, MD

Once a call center triage nurse has done an initial evaluation on a patient, there are times when the protocol or circumstances require a physician to get involved. In these instances, it is critical for the nurse to get in touch securely and effectively with the provider who is on call to communicate the needs of the patient. This requires relaying protected health information, or PHI, securely.

Traditionally, the nurse will page the doctor to call their phone number. The physician calls back, and the nurse verbally relays the relevant information. There are several drawbacks to this option:

The messages and secure chat for the nurse are documented in the triage system for future reference. Click To Tweet
  • It is time-consuming for the doctor. They must call back and verbally listen to each case.
  • There is no confirmation that the provider received the page, which can lead to a delay in care if the nurse does not follow up closely.
  • The doctor may be involved in a critical procedure or another call and does not know how urgent the request is from the nurse.

Secure texting was created to overcome these drawbacks and provide an efficient way to transfer information that does not hinder daily workflow.

With secure texting, the provider gets a notification from the nurse. The nurse can send protected health information securely. The provider can read the message, and the nurse gets a notification confirming that the message was received and read. This approach supplies the provider with detailed written information as well as allowing them to evaluate the urgency for the call so they can determine the proper callback time and plan before they contact the triage nurse.

While there are many secure messaging platforms available, almost every one of them requires the provider to install and set up an app on their phone. It also requires ongoing support for the app. When the doctor changes phones, the operating system or app needs to be updated.

Providers who are looking for secure texting methods should find platforms that allow for all the features of secure texting and chatting with the nurse, but without an app required on the doctor’s phone. With these types of platforms, nurses can auto-populate the patient information and send the provider’s cell phone a link (with no patient data). 

The provider follows the link and securely accesses the confidential message from the nurse. The provider can then call the nurse back, call the patient back, or securely chat with the nurse. The nurse receives a notification both when the message is delivered and when it is read; this provides continuity of care and prevents any lapse in communication. The messages and secure chat for the nurse are documented in the triage system for future reference.

Providers love this type of service because it does not require any setup on their part and takes less than five minutes to train on the system, which can quickly be done by the practice manager at the provider’s convenience. There is no impact to the service if they change phones or have updates to their device. Setup is quick and easy since there is no app to download and register.

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 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com and www.continuwell.com. 

The Critical Role Hospital Call Centers Play During and After a Catastrophe

By Nicole Limpert

The ever-increasing threats from natural and human-caused disasters have made the use of disaster response systems a necessity. Nearly two-thirds of U.S. residents live in areas rated as having a moderate to very high risk of experiencing a natural disaster: hurricanes, tornadoes, floods, hail, wildfires, and earthquakes.

The Federal Bureau of Investigation’s report titled “Active Shooter Incidents in the United States in 2018” identified twenty-seven shootings as active shooter incidents, which resulted in eighty-five deaths and 128 people wounded (excluding the shooters).

When disaster strikes, both local and national call centers provide critical communication services to help coordinate first responders and rescue teams, organize relief efforts, enable communication between loved ones, and support communities during recovery.

Hospital call centers in a coordinated call center system is crucial when developing a disaster preparedness and recovery plan. Click To Tweet

Disaster Planning

Disasters often occur without warning. Weather events, mass violence, and other incidents can cause an outage or strain communication systems. However, organizations can formulate a disaster preparedness and business continuity plan in anticipation of a catastrophic event. Hospital call centers are a critical component to any disaster preparedness plan because they often become a communications hub during an emergency.

National, state, and local agencies often work with hospitals to develop a plan for coordinating call centers. They identify partnerships with organizations such as 9-1-1 and Emergency Medical Services (EMS) to determine how to integrate each call center into a larger communication network for efficient allocation of services and dissemination of public health information.

The use of technology enables call centers to execute their disaster preparedness and business continuity plans quickly and efficiently. Automatic call distribution (ACD), interactive voice response (IVR), uniform call distribution (UCD), and other communication software can automate call routing systems. Leveraging automatic notifications and critical alerts helps to speed communications and shorten reaction times.

Disaster Communications

Methodist Medical Center of Illinois, part of Unity Point Health Methodist, located in the heart of Peoria, Illinois, includes a 330-bed hospital with almost 600 board-certified physicians. 

To ensure the safety of patients and staff, the technology used by the call center at Methodist helps to prepare them for any type of situation. By using a customizable critical alert system, operators can quickly contact multiple people when various disaster and code calls come through their center.

When an emergency notification is needed, an operator triggers the alert by simply selecting a group to notify and typing in the alert message. This broadcasts the message to the appropriate personnel via each recipient’s preferred contact method. This helps ensure that hospital personnel can respond to each situation as quickly as possible.

The flexible system allows the call center manager to determine whether each type of notification requires a response from the person who receives an alert. While a reply and estimated time of arrival is required from someone responding to a disaster, a reply may not be needed from a staff member on the leadership team who is using their real-time monitor to oversee the situation. Managers can view the estimated time of arrival for each person and determine if additional personnel need notification. Access to their web-based, real-time monitor can even occur from home should an alert occur in the middle of the night.

Cloud Technology and Virtual Servers

Communications failure is not an option during a disaster. Having the ability to route calls to another center in the event of an emergency is crucial. For example, if a call center is physically located in an area that has become inaccessible or damaged due to a catastrophe, calls can route to operators off-site, using cloud technology on a virtual server. A single virtual server, located anywhere in the country, can bring call centers together to operate seamlessly, even if they all use different PBX telephone systems.

Using web-based call center communication software, any computer may become a secure, professional telephone agent station accessible from the internet. Operators located in a different center or home-based agents handle the calls, and all the tools used by in-house operators are accessible to these virtual agents.

Hospitals and clinics that are part of a larger healthcare enterprise use this technology to provide backup call handling within their own system. Rossi Fraenkel, business analytics team lead for Allina Health in Minneapolis, Minnesota, comments, “In the event that any of our other clinics were to have a power outage or go down, those calls roll to us at the contact center. We provide our organization with a really good, strategic value. It’s absolutely critical that we take calls no matter what.”

Disaster Recovery and Relief

Hotlines managed by agencies such as the Federal Emergency Management Agency (FEMA) provide callers with assistance related to government disaster aid, insurance claims, and home repairs.

Hospital call centers experience an influx of calls from people inquiring about hospitalizations of loved ones, safety advice, and help for themselves. Individuals who witness or experience a catastrophic event often face negative effects from it. Coping with the shock of a disaster can make someone fearful, confused, and suffer from anxiety.

Call center agents can connect callers with disaster crisis counseling to help people affected by traumatic events. Callers who are patients of a healthcare organization that participates in telehealth may be able to take advantage of instant, secure video access to mental health professionals.

Summary

Including hospital call centers in a coordinated call center system is crucial when developing a disaster preparedness and recovery plan. Establishing a comprehensive policy may require a considerable time commitment and thoughtful input from a variety of agencies and organizations. However, the effects of organized communication and efficient use of community resources during a crisis help save lives and speed recovery efforts.

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.

How Telephone Triage Nurses Act as An Extension of Physicians and Practices



By Ravi K. Raheja, MD

In an era where there are multiple sources of medical advice and people frequently use Google to get answers, telephone triage nurses need to be mindful that they play a critical role in ensuring that patients get the customized care directed by their physician. This is vital for consumer-focused patient care. That is why sophisticated triage systems have custom instructions and standing orders. These tailored directions are based on physician or practice preferences for triage nurses to follow once the appropriate care for the patient has been determined.

Telephone triage nurses are important in establishing that the patient’s doctor cares about their problem. Click To Tweet

What Are Custom Orders?

Custom orders are additional instructions that physicians and practices add to existing protocols. An example would be telling the patient to take ibuprofen over Tylenol or sending them to a certain ER or urgent care facility. Custom orders are designed to help the triage nurse function as an extension of the doctor without having to always call the on-call doctor. With custom orders, patients are provided continuity of care, reassurance, and the ability for the physician to follow up with their patient the next day.

How to Properly Represent the Physician and Group

Through the triage process of assessing the patient and choosing the highest acuity protocol, disposition, and advising the patient per protocol guidelines, triage nurses need to keep in mind that they represent a specific physician or practice.

Since they never see the patient in person, it is important that triage nurses provide the empathy and care that will make patients feel better. Patients are not just a voice over the phone with a problem for nurses to solve. Every phone call has an impact, and one of the best ways nurses can care for patients is to establish and affirm the trust they have in their provider.

When giving the protocol advice, triage nurses should first check for any specific practice orders that apply to the situation. Then, as they advise, they should use phrases such as, “Your doctor would like you to . . .” or “Your doctor cares very much about his patients and would want you to . . .”

Summary

Telephone triage nurses are important in establishing that the patient’s doctor cares about their problem. They are a crucial link to the patient trusting the care and advice of their physician. Since triage nurses are only with a patient for a few moments, it is vital that they gain their trust and provide the best care possible. 

When the patient call ends, their continuity of care is in the hands of their physician. Telephone triage nurses help the patient beyond the call when they nurture trust in the doctor they represent.

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 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com.

The Future of Healthcare is Here with Help from Telehealth and Hospital Call Centers



By Nicole Limpert

Those in the healthcare communication field already know the value of telehealth and virtual care. As the COVID-19 pandemic evolved, telemedicine gained worldwide recognition as a critical healthcare tool to keep both patients and medical staff safe.

Telehealth has been used to bring healthcare to rural areas or isolated populations, such as overseas military personnel and those who work in the maritime industry. Until recently, the Centers for Medicare & Medicaid Services (CMS) placed certain stipulations on telehealth providers and would only reimburse for services provided in rural areas with specific audio-visual equipment.

However, due to the COVID-19 pandemic, on March 6, 2020, CMS relaxed restrictions and removed many of the conditions to which clinicians had to adhere in order to supply telehealth services to patients across the entire United States. Later, CMS expanded its telehealth adoption to include eighty-five new telehealth services to their covered list and set provider reimbursement rates for telehealth visits to be the same as in-person services.

Are We Ready for Telemedicine?

Many people are new to the concept of telemedicine. On July 31, 2019, J.D. Power reported that nearly three-quarters of Americans weren’t aware of telehealth options or didn’t have access to technology to partake in telehealth. Yet the American Hospital Association states that 76 percent of U.S. hospitals were already using telehealth before the coronavirus pandemic. Currently, forty-eight states require telehealth coverage in insurance plans.

Healthcare-related industries already had infrastructure in place and were prepared for the use of telemedicine and telehealth. However, few, if any, expected how quickly the use of these virtual tools would grow or how they would be used in new ways when COVID-19 began to spread. 

The coronavirus pandemic has dramatically accelerated the adoption of telemedicine usage. Telehealth visits skyrocketed by 50 percent in March 2020 according to data from Frost and Sullivan. Analysts at Forrester Research estimates that virtual healthcare interactions will reach more than 1 billion by the end of 2020.

Hospital Call Centers Experience Increased Telehealth Calls

The use of telehealth has undeniably shown what a critical tool it is in supporting a healthy population.  Click To Tweet

The pandemic has affected call centers in every industry. Most business websites have placed a message at the top of their home page warning of long hold times and delays in service. In healthcare, communication setbacks can mean life or death. Understandably, hospital call centers experienced a substantial increase in calls early in the pandemic. Many healthcare call centers help with telehealth efforts, and they also serve as a hub for their healthcare organization during a crisis.

“We played an immediate role in the hospital’s corporate response to the coronavirus pandemic,” explains Shelley White, MS, CHAM, FACHE, director of patient access services for State University of New York (SUNY) Upstate Medical University. “A COVID-19 hotline was established, and we took calls from multiple counties in our area. Within two weeks, our call volume drastically increased, and we needed more space in our call centers to work while practicing social distancing. We used free operator licenses from our vendor to set up more remote operator workstations so more of our agents could work from home. This kept our staff safe while serving the community.”

Running a call center in a virtual server environment, or in the cloud, is giving hospitals the ability to stay flexible and available by using remote operators. These tools are scalable and result in fully functioning call handling to transform any personal computer into a professional telephone agent station.

Call Center Software Assists Telehealth Communication

Using telehealth for virtual appointments with medical staff and patients has been essential during this pandemic. But there are other ways healthcare systems use telehealth communications. Hospital call centers tap their communication software, often in new ways, to provide their communities and staff with correct information, quick responses, and in some cases, hope.

Nurse Triage Centers: Agents use a customized script to triage calls.

Improved Navigation Menus: Callers are directed to additional, updated information.

Nonclinical Services: Telehealth also refers to remote, nonclinical administrative uses such as establishing and maintaining on-call shifts for COVID-19 volunteer pools and even creating announcements using a song, tone, or message to broadcast throughout the hospital when a coronavirus patient is released. It’s a wonderful way to spread hope and encouragement to patients and staff.

Many telehealth agents are working from home, and it is crucial for them to have access to the IT support they would normally use when working in the call center. Jennie McWhorter, information services operations manager for Ephraim McDowell Health in Danville, Kentucky, explains how the system can help here as well. “We have entered a telehealth support hotline in the call center software that allows the operators to connect to our help desk directly,” says Jennie. “This is very important, as our main help desk line is usually a voicemail-only system that creates a ticket in our help desk software.” 

Remote Operators Help Medical Staff

Shelley White’s team has also been able to aid staff who still work in the hospital. SUNY Upstate Medical University is the only ACS-certified Level I Trauma Center in the region and serves about 1.7 million people and twenty-eight referral hospitals. Shelley says, “During this coronavirus crisis, our ER registration is short-staffed, but we are able to help by watching our track board, which is tied into the EMR system with Epic. When a COVID-19 patient is admitted, we can call the patient to register them and verify insurance information over the phone. This process would normally be done in person by ER staff, but we can do it remotely and ease some of their workload.” 

According to numbers reported from Becker’s Hospital Review on April 7, 2020, employees from 243 hospitals have been furloughed during the pandemic. Hospitals are taking steps to save supplies, suspend elective procedures, and focus on treating COVID-19 patients. 

To avoid layoffs, some healthcare organizations are reassigning their medical staff as remote call center operators. “We were able to redistribute existing staff from other departments and tap into their skills to cross-train them to work for the switchboard,” states Shelley. “In our situation, patient access staff and medical answer teams were trained on easy calls and were then able to work from home as remote operators. These staff members are now even more valuable to our organization.”

Kathleen Kerrigan, BSN, RN, and manager of medical communications center, radiology contact center, and pager services for Nebraska Medicine, mentions her experience. “Nebraska Medicine has created a Flex Pool for employees that work in areas of the organization that have closed or severely cut their workflows due to COVID-19. I was able to add nineteen of these employees to my team, including both nurses and agents.” 

Telehealth as the New Normal

Telehealth has suddenly become crucial for patients and healthcare organizations. The use of telehealth has undeniably shown what a critical tool it is in supporting a healthy population. 

Hospital call center and healthcare professionals have already shown agility in adapting communications software in new ways to improve telemedicine applications while enhancing patient care, even during a pandemic. Advances in technology and our ability to use it could soon make the use of telehealth a standard healthcare practice. 

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.

The Importance of a Secure Messaging Platform



By Nicole Limpert

COVID-19 has made huge impacts on our health and day-to-day life throughout the world. The virus has been overwhelming to all, but particularly among the teams who are supporting and caring for those who are sick. Now more than ever, secure messaging platforms are critical to ensure communications are sent securely and quickly across these care and support teams. Here are the top three reasons why a secure messaging platform is an essential tool during these unprecedented times.

1. Communicate Sensitive Information Quickly

Whether you’re an operator relaying an important message or a doctor tending to a patient, fast and reliable communication is critical to ensure the safety and well-being of those involved.

Hospitals should consider updating their pager system to a secure messaging platform. Pagers have been shown to waste a considerable amount of time among healthcare teams. Compared to legacy paging technology, secure messaging can save staff up to two minutes per message.

Secure messaging offers features such as persistent alerts, event-driven notifications, critical alerts, and high-priority settings Click To Tweet

When it comes to the safety of sensitive information, a secure messaging platform is paramount. Most secure messaging platforms use end-to-end encryption, which can ensure that personal health information (PHI) in the form of text, photo, video, and audio stays secure. Look for a secure messaging platform that doesn’t store messages on the device. Also critical is being able to remotely disable the app on lost or stolen devices to prevent unauthorized access.

2. Accountability with Time Stamps and Reports

It can be difficult to stay organized and keep a level head when things are moving quickly and staff is getting overwhelmed. Imagine that you’re a doctor, and you just sent a message to a lab tech via a secure messaging app requesting some lab results for an ICU patient. With the app, you can see if your message was sent successfully and when the lab tech read the message. Time stamps add an extra level of reassurance and accountability to your team, which is critical in times of crisis.

Most secure messaging apps also keep track of all message activity. This should include an audit log and a message log, complete with message histories, showing to whom messages were sent, when the recipient read the message, and who replied.

3. Urgent and Emergency Notifications

During times of crisis, it can be easy for alarms, notifications, and messages over a public address system to overwhelm healthcare workers. Conversely, some hospital staff may fall victim to alarm fatigue. One study records an average of 1.2 alarms are heard by a nurse every sixty seconds, or as many as 359 alarms per medical procedure. In addition, recent studies estimate as many as 90 percent of alarms in critical care settings are either false or clinically irrelevant. This leads healthcare providers to believe that many devices are crying wolf, delaying practitioner response time when a real emergency occurs.

To combat the effects of alarm fatigue, secure messaging offers features such as persistent alerts, event-driven notifications, critical alerts, and high-priority settings to ensure that vital messages receive a prompt acknowledgment.

COVID-19 has placed an elevated level of responsibility and pressure on healthcare and call center staff. These demands become easier with the help of a high-performing secure messaging platform that can meet their needs to combat the disease and ensure the safety of patients. 

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—such as their miSecureMessages secure messaging platform—designed for the specific needs of healthcare organizations.

Preparing Your Contact Center for a Pandemic



By Donna Fluss

As the coronavirus pandemic fills the news headlines, contact centers are striving to continue to deliver service to their customers. Many companies have disaster recovery (DR) and business continuity (BC) plans to address the ability to operate if a disaster—such as a hurricane, earthquake, or fire—were to occur. Some companies may even have plans to cope with the impact of a major flu outbreak, but few contact centers have a BC plan to handle a pandemic where employees are at risk if they sit closer than six feet from each other, which is the situation in most service organizations.

Business Continuity for Pandemics

Planning for business continuity in case of a pandemic is different from preparing for a natural disaster scenario. In the case of weather-related disasters, the main consideration is often employees’ safety when driving to and from the workplace. For a pandemic, however, the main issue may be people’s reluctance to leave home at all. Keep in mind that it’s not fair for companies to require their contact center staff and other service employees to report to work under these circumstances when other departments may be advised that it’s unsafe to come to the office.

Companies should prioritize keeping their employees safe and healthy so they can be there to assist their customers. Click To Tweet

Allow Contact Center Staff to Work from Home

Companies should make it as easy as possible for their contact center staff to work from home. Provide employees with PCs, headsets, and secure access to operating systems so they can perform their job in the safety of their home. This reinforces the benefit of investing in cloud-based contact center infrastructure solutions that are accessible from most locations, including employees’ homes.

Supervisors should also be set up to work from their homes. To mitigate the risk of leaving contact center agents unsupported during a widespread health crisis, it’s a best practice to establish a structure where managers and supervisors share responsibilities, and it can be especially helpful to have them in different geographies. All systems should be capable of being managed from remote locations.

Communication Is Key

It’s important for businesses to have a documented DR/BC plan that addresses healthcare emergency scenarios. A communications plan is the most essential element during any crisis situation. The plan should inform staff members how to stay in touch with the business, and to let them know what is expected of them. It’s advisable for a company to have two ways of reaching each employee, such as email and SMS, to ensure that they receive each communication on a timely basis. 

Another essential element of the communication plan is a process for interacting with customers to let them know that your company is there for them and the most effective methods for receiving assistance. The customer communication should also set expectations for customers. If service response times are slower due to an increase in volumes or decrease in staff, advise them of this.

Enhance Self-Service Solutions

To decrease the volume of interactions that require live agents, companies should enhance their voice and web-based self-service solutions by adding options that don’t require human assistance. Companies can either enhance an existing interactive voice response (IVR) system or use a next-generation intelligent virtual assistant (IVA) that can be set up to manage multiple channels, including voice, websites, SMS, and more.

Final Recommendation

Social distancing has proven to be the most effective method to date for limiting the rapid spread of the highly contagious coronavirus. Companies should prioritize keeping their employees safe and healthy so they can be there to assist their customers. For contact center employees, this means allowing them to work from their homes.

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.

Healthcare Call Centers Help Bring Care to the Medically Underserved



By Nicole Limpert

A person who is medically underserved is someone who does not have health insurance. Estimates from the Centers for Disease Control and the National Health Interview Survey cite that in 2017, 29.3 million, or 9.1 percent of the population were uninsured.

Vulnerable Populations: Multiple studies have found that vulnerable populations in the United States, including the elderly, low-income, ethnic minorities, migrants, and people who received limited education, are also medically underserved.

People with various life experiences may interpret symptoms differently, such as thinking a seizure is a spiritual issue rather than a medical complaint or expressing concerns about depression as anger rather than sadness.

Medical call centers play a critical role in helping to serve the medically underserved. Click To Tweet

Poor Access to Healthcare: Living in a rural location and having inadequate transportation present challenges when trying to access healthcare. Rural areas are sparsely populated, resulting in a lack of available services. Rural communities comprise roughly 20 percent of the United States, yet less than 10 percent of doctors practice in these communities.

People in rural areas rely on their own transportation to and from health services. A report released in December 2018 from Pew Research Center found that the average travel time by car to the nearest hospital for rural Americans is about seventeen minutes compared to ten minutes in urban areas. 

However, even people in urban areas have difficulty visiting their doctor’s office. Transportation can be a challenge for people with disabilities, those with chronic illnesses, the elderly, and people who are considered low-income. Approximately 3.6 million Americans, from both rural and urban areas, experience missed or delayed medical appointments due to transportation issues.

Support from Healthcare Call Centers

Technology enables medical call centers to effectively become an extension of a hospital or clinic’s operations. 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 workmen’s compensation. Because everything is documented, detailed reports can be generated for reporting purposes.

Medical call centers can provide or facilitate healthcare-related services twenty-four hours a day, seven days a week. They play a critical role in helping the medically underserved by addressing two of the biggest barriers to healthcare: language and transportation.

Language: Healthcare staff work with an enormously diverse patient population. Understanding a person’s language leads to better healthcare. Multilingual call centers hire operators to assist non-English-speaking patients or use confidential over-the-phone interpreting (OPI) services for access to hundreds of different languages.

Transportation: Patients with mobility challenges or those who live in rural areas don’t have to leave home for some services. Operators can coordinate care, make follow-up calls, schedule visits, contact on-call medical staff, and manage referrals.

Some call centers staff nurses or multidisciplinary teams (such as a resident, pharmacist, and social worker) who are qualified to make health assessments, give medical advice, and escalate critical concerns. These call centers can offer nurse call helplines, emergency mental health counseling, and other critical support.

Helping Hospitals that Help the Underserved

Reduce Penalties: A recent study done by Harvard University suggests that hospitals located in low-income areas are more likely to receive penalties due to Medicare and Medicaid’s survey-based reimbursement programs. Patients are asked to provide information about their healthcare experience via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Unacceptable survey outcomes can result in hospitals losing some reimbursements.

The American Medical Association Journal of Ethics reports that the Centers for Medicare and Medicaid Services (CMS) can currently withhold 1 percent of Medicare payments—30 percent of which are tied to HCAHPS scores. When Medicare and Medicaid account for more than 60 percent of all care provided by hospitals, the possible amount of dollars lost due to poor patient experience is a significant number. In 2017 alone, approximately 1.7 billion dollars in reimbursements were withheld from hospitals.

Healthcare call centers play a critical role in patient satisfaction surveys because they function as a virtual lobby for a hospital and are often the first point of contact with a patient. The patient’s experience with coordinating their care via call center agents can positively affect their feedback on the survey.

Reduce Readmissions: The CMS reports that nearly one in five Medicare patients are readmitted to a hospital within thirty days of discharge, yet a recent study from the University of California San Francisco (UCSF) and published in JAMA Internal Medicine found that 27 percent of all thirty-days hospital readmissions are preventable.

Medicare’s Hospital Readmissions Reduction Program (HRRP) lowers payments to Inpatient Prospective Payment System (IPPS) hospitals who report too many readmissions. According to the CMS, 2,573 hospitals received penalties in 2018 and had around 564 million dollars in payments withheld.

Studies indicate that a post-discharge call program can help hospitals reduce their readmission rate. IPC Healthcare (IPC) tested the effect of post-discharge calls on readmission rates from October 2010 through September 2011. The IPC call center contacted 350,000 discharged patients to check symptoms, review medications and treatment plans, and remind patients of follow-up appointments. Successful contacts occurred with 30 percent of patients, with an estimated 1,782 avoidable readmissions prevented over that year.

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.

[This article first appeared on AnswerStat.]

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.

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.