Lowering costs & improving care: A case study on after hours answering services

Today, third-party purchased services represent as much as 25% of a healthcare organization’s annual spend, and with the trend of hospital acquisition of physician practices continuing nationwide, this decentralized purchasing shows no signs of slowing.

Through a project management process, Vizient consultants developed a best practice for purchased services that applies to an unlikely area of spend: physician answering services.

Using this process, Piedmont — one of Georgia’s fastest-growing health systems — consolidated more than 12 different vendors providing physicians with After Hours or 24/7 answering services with a single vendor.

In this webinar, you’ll learn how Piedmont Physician’s Group sought to improve the quality of its answering service and why they ultimately chose to consolidate and standardize on a cloud-based clinical communication & collaboration platform.

To download the webinar slides, click here.

Transcription

Carlene Anteau:  …after‑hours answering services consolidation. My name is Carlene Anteau. I am the Vice President of Marketing for PerfectServe and I will be your moderator today. Thank you so much for joining us.

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We’re very excited today to hear from Mark Ferraro, who is a Consulting Director of Purchase Services for Vizient, and Ryan Bowcut, who is the Executive Director of Operations for Piedmont HealthCare.

Now I’d like to hand it over to Mark.

Mark Ferraro:  Thank you and welcome everybody. Today I want to start our discussion with just a quick review of the current atmosphere in health care today.

As we know, purchase services represents about 20 percent of the spend of most health care facilities. When we talk about purchase services, we’re basically talking about anything that the hospital outsources to a third party for operations within the hospital.

This can be clinical purchase services, operational, or maintenance types of services, so IT, telecom, security, maintenance. All these types of services we lump together to represent overall purchase services. These aren’t always top of mind contracts that are being evaluated by the hospital.

A lot of these contracts are the type of contracts that, once they’re in place, they hopefully are happening properly and are not causing a daily issue. They sometimes are at the forefront of the supply chain manager’s daily activity.

They may get missed, or contracts sometimes automatically renewal. There’s a lot of that in these contracts, where the service may be initially brought on for a three‑year term and it may extend for multiple reissues. It may continue much longer than originally anticipated.

These contracts, again, offer a lot of opportunity for the health care individual facilities when we take a look at them and start to evaluate whether the services are still in scale to what they were initially, or whether there needs to be some changes.

They can definitely be a source of savings for the supply chain. They also present opportunities, as hospitals start to grow and make acquisitions, to go back and re‑standardize processes or technology issues.

Currently, we know that a lot of hospital acquisitions are occurring among facility to facility, but also among physician practices. As those practices are now being purchased and brought into the health care environment and into the facilities, we see that they’re also bringing, obviously, their purchased services contracts with them.

According to the Physicians Advocacy Institute, in the year between July of ’15 to ’16, 5,000 independent physician practices with over 14,000 physicians were acquired. 42% of those physicians, in 2016, are employed by hospitals. That just continues to grow.

Each one of those, if they were operating as an individual practice, had their own contracts and services, had their own after‑hours answering services. As they become part of the health care environment in the facility, this is where purchased services consulting and assessment can start to really help you look at what you’ve acquired and how to standardize going forward.

Next, I want to talk about some of the stuff that we perform when we’re looking at purchased services through engagement, and how to be successful when you’re reviewing your purchased services spend.

The first step is, obviously, to gather the data. As we discussed, as hospitals are growing and purchasing new facilities, physician practices, ambulatory surgery centers, other hospitals, the data can become a challenge and the visibility may get lost.

You’ve got different IT systems that are now talking to each other, different methods and ways to manage contracts that are now trying to be merged together. Visibility starts to become a challenge.

This is where purchased services consultants can come in and start to really make that review throughout the system, look through all the locations, and speak with the different areas of organizations to start bringing the data together.

The first step in that process is to speak to the stakeholders, going out and speaking to either the individual practices for after‑hours calls, the hospitals, whether it’s the supply chain is involved, whether the business office is involved.

Really getting out and speaking to all the individual departments to understand what do they believe is occurring for this service, what vendors do they believe they’re utilizing, whether there’s any contracts in place, and whether we can get a hold of those as we are able to go out and speak to stakeholders.

A lot of times, this is the best method because sometimes those contracts are held in their actual office, especially if it’s a physician practice that was a standalone at some point. The business manager there may be maintaining all of those contracts. Depending on when the transition occurred, they may not have gotten into a central repository for the hospital, for the supply chain office.

We would review those contracts, trying to look at this point for the termination, the auto‑renewals, or anything that had to do with the actual contract terms. We want to be able to get a good picture of all the vendors that they’re currently utilizing, when those services either start or stop, and to understand quickly if there’s any that may be getting ready to auto‑renewal in a short term.

Now that we’re engaged in working on this process, we may be able to give some notice to hold off on that automatic renewal so that we can have time to review and provide an overall system strategy to how to move forward.

In addition to the contracts, we would want to gather the financial data. This is reviewing accounts payable, AP systems, getting a report from the finance folks to show us all the vendors with spend. Also, utilizing the general ledger or the purchase orders system to start to dig into where the spend is and which vendors are being utilized.

The reason why we look at AP and purchase orders is because many of these services, in many organizations, services are not put onto a purchase order. They’re paid through a different method, whether a check request or a P‑Card even. Utilizing the AP spend allows us to see more of the vendors and more of the spend that we believe would be around these vendors.

Then we can start to aggregate that spend so that we can begin to tell a much bigger story. Looking at after‑hours calls and after‑hour vendors at individual facilities, many times the spend is not significant, especially if it’s maybe a pediatric office or something that doesn’t really require 24/7 service or something that doesn’t get a lot of after‑hour call‑in.

Individually, the spend may not be significant, but, when you do this kind of research and really gather the data from every angle, the spend starts to add up and it becomes a much more significant opportunity.

Now that we’ve gathered all the data, at this point is where we would suggest to get the executive buy‑in. This is a key part of the process. In order to move along the engagement properly and to be able to truly have success at the end, we need to get the executive buy‑in as close to the beginning of a process as we can.

Obviously, it’s very important to have the data as we go into that executive meeting. We want to be able to show them through aggregating spend that this is a significant enough opportunity to spend some time and utilize some of the facility’s resources towards. Also, we want to start to have that conversation on, “Who are the vendors, and what are the relationships of those vendors?”

We want to understand the sacred cow. It doesn’t matter how big or small the vendor is. In my experience doing purchase‑services consulting for many years, it’s almost impossible to know which vendor may be the one that is going to cause you a roadblock at some point, is a sacred cow with the executive team, or, of course, some form of the organization.

It may be that they just provide other services in other areas that you need to be delicate in approaching making any changes from that vendor because the issues will have repercussions on other services.

Also, an important part of this is to provide coaching on building the business case. We want to understand at this point as well, especially at the executive level, is after‑hours calling something that you just want to leave as after‑hours? Is there a broader strategy to start to build the communication model between the hospitals and the physician practices?

What other possible communication links are out there that the executive team is working to move forward in the future so that, as we’re going through this process, we’re not just renewing a new contract on something? Personally, I’d rather not just renew contracts.

I’d rather make sure that we’re building a successful strategy around the service that we’re working on ‑‑ in this case after‑hours ‑‑ that’s going to leave the facility in a better spot going forward so that they’re prepared for the future and it’s not merely a contract renewal.

That is certainly something that can be done on your own very easily. With auto renewals, it automatically happens, but the way we would like to work it is that we’re building a future for that service that will grow with the organization.

Now that we’ve gathered our data and we’ve gotten, hopefully, some strategy and some direction from the executive team, it’s really now time to look at those individual vendors that we collected, to analyze the performance of those vendors, and also analyze the performance of the contracts. Are they set up to grow with the organizations?

Again, when we look at vendors, we see that some may be large multi‑state companies, national companies, regional, but there also might be some of those “mom and pop” vendors that are there that have been working with the practice, maybe since the practice opened. We want to be able to understand how the services are being provided and what can be done to move them forward.

When we’re looking at spend, we’re also, from the consulting side of it, looking at historical spend, trends, durability, and benchmarks and trying to look at how the spend is being categorized so that we can determine if it fits into a benchmark. With many engagements, we find that the contracts are not easily matched.

Some contracts may be working on a term basis, so a 28‑day cycle, where they’re charging up to X number of calls, which is a flat rate for that amount and then an additional rate above that. Some are charging a monthly rate, which is not exactly the same as a 28‑day cycle. How do we compare those?

Some are charging a per‑call model, where they’re charging for per‑minutes for referrals or transfers, patching. All these other options that you have with an after‑hour call service may be individual fees in that contract.

This piece of the puzzle probably takes a fair amount of time to really level everything out so that we’re comparing, as best as we can, apples to apples to understand who is giving the best price maybe in this situation and who’s also giving the best service. This is a point where we would most likely go back to the stakeholders and ask them.

Instead of just, “Who is providing your service?” “How is your service? What do you like about it? What do you not like about the service?” Wherever they had gaps, wherever there’ve been issues. If there have been issues, how have they addressed them? “Have they fixed the issues for you? Are they working on a solution?” How does that all play out?

Again, continuing along that path of setting up a proper strategy for the health care system to go forward. The other thing is utilization, comparing the utilization. Again, once we can level out how this is pricing, then we can begin to figure out, “Is the hospital facility utilizing that service to the best?

“Could there be additional utilization or additional ways to benefit from the current contracts, or does it need a new vendor to be brought in to really give that option?” This is also a phase that I found to use instead of an RFP.

Every time a request for a proposal, there’s also the opportunity to use a request for information at this phase to just get your questions answered in a less formal way without the requirement of picking a specific vendor. It allows you to really get the information, compare, and ask questions about either the contractor or the spend.

In a formal RFP, it would take you a long time probably to get through those questions. You’ll get the same answers, but, in an RFI, you can be more direct and just say, “If you were to get additional business, how would handle it?” and, “Currently the business you have has grown. How are you handling the expansion?” It’s a good way to grab additional information.

Now that we’ve evaluated the contracts, the spend, talked to our executive team, and we’ve now been able to analyze the data to get it into a better opportunity, we would start to evaluate those standardization options. Again, we’ve talked to the stakeholders at this point. We should know their needs and goals.

At that point, we need to look at the current group of vendors and those that are not providing service to see who would be a company that can provide a spectrum of services that will really meet the strategy of the enterprise. Then, how would any changes impact overall spend and service standards. How should they change to meet the growing needs of a hospital?

In any cases, it’s none of the current vendors can really meet the new strategy of what the hospital needs. It’s truly to move to a full communication plan to where the hospitals can talk to the physicians and the physician practices are able to quickly identify on‑call staff.

What we’ve found is that many of the current companies, and maybe some of the smaller companies, their systems are doing the job, but they’re not doing it as effectively and as efficient as possible. That also can add to some of the additional cost.

It’s not because of the number of calls, but because of the inefficiency of the vendor to be able to manage the volume that’s maybe keeping the call longer, causing more transfers, more additional fees. That’s actually costing more money. Not because of really influx of volume, but because of the inefficiency of the ability to get the work done.

We take those things, the contract opportunities, whether, again, it’s new or current contract, identify the best practices within, how that marries up to the corporate direction, and then make that recommendation on how to move forward based on the analysis and strategic imperatives.

We’re being able to help the facility move along this path at a much quicker pace, probably, than it’ll be able to be done on their own. Also, we’re providing a solution that will not only fix the current issues, if there are any, potentially save money, and also provide a way to grow as the facility continues to move on.

That is pretty much the purchased services consulting strategy and steps that we will take on any initiative, especially an after‑hours answering initiative. At this point I want to turn it over to Ryan for him to talk about Piedmont.

Ryan Bowcut:  Thanks, Mark. Good afternoon, everybody. I appreciate the opportunity to just tell our story a little bit. We just recently went through this experience. Hopefully, I can give you a little bit of background of how that worked for us.

Piedmont HealthCare is a health care system that’s located in Georgia, founded in 1905. The main hospital is in Atlanta, Georgia. Over the last number of years, we’ve really grown a lot and expanded through acquisition of both hospitals and physician practices to where we now have 11 hospitals spread throughout the state.

We also have 24 urgent care centers, 28 retail centers ‑‑ quick care locations, and about 179 physician practice locations. We serve two million patients across Georgia and have 22,000 plus employees providing not only uncompensated care, but regular care, too, to the residents of Georgia.

The next slide I just want to show you quickly some of our growth. Mark highlighted early on in his presentation a little bit about the climate in health care and how many acquisitions are taking place. I mentioned our hospital acquisitions. Over the last four years we’ve gone from a 4‑hospital system to 11 hospitals.

With that, we’ve acquired those physician practices. We’ve also had a lot of organic growth. You can see from this chart, in 2015 we’ve gone from 416 employed physicians to, this year, 592. We anticipate having 647 next year. The same with the practice locations that you can see there at the bottom.

That growth just tees up why we experience this problem. With all of that growth, Mark talked a lot about the acquisition of new contracts. Every system, every practice has a little bit of a different vendor that they use for different services.

We’ve looked at these services, particularly the after‑hours answering services, and had a goal of reducing the variability that we had. We wanted to go from 13 different vendors down to a single vendor.

One, for cost, but, two, we also wanted to improve our quality of care and the consistency of care that we were providing to our patients and the level of service that our physicians were receiving when those patients were calling after hours.

We noticed, again, variability in the rate that we were experiencing, the usage, the quality and type of type of service that we were receiving from all of these different vendors, and also the patient experience. We felt that moving towards a central provider would help with that.

In Mark’s presentation, he talked about executive buy‑in being step two. For us at Piedmont, it was actually step one. We approached this from two different perspectives. First, on the supply chain side, we recognized that this may be an opportunity to be a better steward of our resources.

We have a process in place here at Piedmont called Strategic Transformation and Resource Stewardship Program, which the acronym is the STARS Program. Basically, that’s an opportunity to look for waste in the system, an opportunity to be a little bit more efficient. We have a number of projects that go on to eliminate waste and gain efficiencies.

After‑hours services was one of those services that was identified as an opportunity, and so that was sent to our executives from that avenue. Also, from an operations standpoint, we had identified the need to fix this problem.

We had had a number of complaints from our physicians that they were frustrated in getting calls that they shouldn’t be receiving, that patients were having a difficult time navigating our system. You call one practice and you’ll get one level of service and call a different practice and get a different level of service.

We really needed to streamline that and have the same look and feel across our system. That’s when we engaged Vizient to help us through this navigation to gather the data, help us through the RFP process, and identify a single vendor.

There’s not a bullet on here, and this is jumping ahead just a little bit, but one thing to keep in mind that we were sensitive to when we were looking at this. We had a number of different vendors and some of them were vendors from different avenues.

Mark talked a little bit about the mom and pop vendors. Those physician practices that had mom and pop vendors, a lot of them were very happy with those mom and pop vendors. They were providing a good level of service to them.

We recognized quickly that change was really hard for them, to change from something that they felt and perceived was a good service, from their perspective, to something that was different. When we talk about sacred cows, one of those big challenges for us and opportunities for us was to help educate the physicians.

That while, from their perception, those mom and pop vendors might be really good, that there is a wide variety of services available out there that can enhance the experience and provide even better customer service than what they were experiencing from their small mom and pop vendor.

Not only executive buy‑in is important, but, in this situation and this type of service, getting the physicians on board was critical for us to help them understand and embrace the change.

Step two for us was gathering the data. Usually this is pretty straightforward. We should have all that data readily available for us. We experienced a few challenges that primarily centered around our growth because we were growing so quickly. We were adding physicians to existing practices. We were acquiring new practices.

The total number of employee practices was changing very quickly. The number of physicians in each employed practice and practice location was changing quickly. We had to be pretty nimble in how we were gathering the data.

These are the key points that we wanted to identify on gathering the data. Number of practices. Which practice has an answering service or is not utilizing an answering service? The names of the services currently being used. Are they human‑centered? Are they automated?

Then, getting a handle around the fees and the fee structures, which varied widely from a permanent charge to a flat rate. Gathering all that data and putting in an easily digestible format was one of the hurdles for us, again, just because of our growth.

After we gathered the data, the next step for us, of course, was to analyze the data. It’s interesting that at this point some of our goals shifted. While one of the original goals was a cost cutting initiative, when we started looking at the data and the services that were available and how our services might change, the operational goals that we had superseded the cost‑cutting initiative.

I don’t want to say that to make it seem like we were willing to take a big increase on our spend. We weren’t. We wanted to, at minimum, be cost neutral. The large cost‑cutting initiative that we were originally looking for became less important. More important were those operational goals and to get the efficiencies that we didn’t realize were out there.

Some of those things included eliminating the manual steps and identifying on‑call provider schedules. The schedule management and on‑call management was historically confusing and inconsistent.

We were getting calls to physicians that weren’t on call, and found it very difficult to quickly adjust and adapt if they were getting those kind of calls. We wanted to be able to have a more streamlined and efficient manner of identifying those on‑call providers.

If there ever were a mistake or somebody needed to step away for an hour two, that we could easily adjust that schedule on the fly and shift that to a different provider. We wanted to improve our physician satisfaction. This is one of our top goals.

Our physicians who are being bothered in the middle of the night with patient calls need to be able to handle those calls in an effective and efficient manner, getting the information quickly and reliably and a being able to return those calls.

We also wanted to address patient frustration. Calling into a service isn’t always the easiest to do. Navigating that service when you’re not feeling well, or a family member’s not feeling well, and you’re needing an answer is not easy. We were trying to really streamline that process and make it easier.

Also, for our organization and, I think, most health care organizations, managing the flow of data and making sure that we are keeping that protected health information secure was extremely important.

Lastly, as we look at the number of providers in this space, we wanted a service that was going to be able to grow with us.

One that could handle our aggressive growth of both the employed physicians but also add an ability to scale another communication venue that we currently aren’t using to help us communicate not only with our physician practices and our patients, but across our different points of care.

As we analyzed that data and thought about what we considered important and listened to the number of different vendors come in, we really broke it down to eight different categories which we felt are important. We’ve got those summarized at the bottom of the page here.

Again, a couple of those to just highlight. Eliminating errors, facilitating better collaboration, enhancing the patient satisfaction. These were all critical points that we wanted to get better at.

[silence]

Ryan:  At the end, after our process of analyzing the data, figuring out what we’ve got, what works well, what doesn’t work well, looking at the different vendors that have come in, it was time to make a decision.

We based that decision, again, on those priorities that were listed on the previous page, but also want to think about the many different ways that our physicians are going to communicate across a number of different modalities ‑‑ smartphones, web browsers, even pagers that some of our physicians are still tied to. We’re trying to get away from that, but some of them love their pagers.

We wanted to be able to scale, as I mentioned before, and have a solution that was going to meet our demands today. Also, our needs in the future.

[silence]

Ryan:  Mark, do you want to talk about the step five, maintaining the gain?

Mark:  Sure. Now that, as Ryan said, their engagement was complete, they’ve chosen a vendor to move forward with. On any initiatives, as you made your decision and started to move forward, the important part is to maintain that gain.

As we discussed at the beginning, a lot of times purchasers to these kinds of agreements get lost a little bit because of the work they find. People don’t take notice. The key is, when you put in this much effort and you’ve decided on a path for your system to move forward, you need to monitor and maintain that gain by utilizing metrics and recording.

Set that up in your new contract to really review how the contract is performing. Make sure that it’s optimized to where you wanted it to go. Making sure that as you’re growing…As Ryan said, as they’re growing and adding more facilities and more physicians, that it’s growing with you and it’s still providing that service.

Maybe there’s now additional services that need to be added. By monitoring it with metrics, by having business reviews on a quarterly basis with the vendor to check in, by reaching out to your users, whether that’d be through the patients or the physician practices, to make sure that they’re still receiving the services and the quality that you have built into your agreement.

Building upon those communication improvements that you put into that contract to go beyond just answering service, to be able to look at…In today’s environment where we’re trying to manage the patient throughout ambulatory, physician practice, hospital, wherever they access our health care facility, we’re trying to manage that care.

It does need to move beyond the answering service ability to a real 24/7 communication platform that, wherever the patient needs help or wherever there is a need for communication between physicians, that that can be achieved through the same platform that you’re currently using.

We talked a lot about physician practices, but as more hospitals move to using outpatient service centers, whether they’re are surgery centers, or outpatient, or standalone emergency department, making sure that those services are wrapped into this. Again, looking for additional communication abilities beyond the typical evening or weekend call centers.

Then making sure you truly are incorporating that patient and family. Looking at the current vendor and how the services you’re getting from that vendor impact your patient and family. Ultimately, they’re the ones that, as we know, impact the hospitals revenue. The hospital’s ability to serve their patient is really from that feedback from the patient and family.

Making sure that you continue to look at it, obviously, is not something you can do every day. If you can set up a quarterly business review meeting, not only with the vendor, but also with your stakeholders and be able to use surveys or something to get back some information from your patient.

Then, maybe twice a year, looking at all that data and say, “Are we still accessing service level that we need to address all of the changes and all the strategies that we’re trying to move forward?”

[silence]

Carlene:  Great. Thank you so much Mark and Ryan. That was extremely helpful case study that walked through some real‑world examples of how to standardize after‑hours communication. I do think there are a couple of really valuable takeaways here.

The first thing, that once you get the data from your GL, which is probably the trickiest part of all this, the financial analysis is actually relatively simple. For Piedmont and many others, standardizing with PerfectServe is really easy win for the organization because it re‑purposes already existing spend while achieving a lot greater value for your communication dollar.

As Mark and Ryan both articulated, the way that we are achieving greater value is by standardizing the way providers are reached after hours, by automating processes to eliminate the human error in reaching the right on‑call provider, by providing a platform that ensures HIPPA compliance with all patient‑related communications.

Also, supporting strategic imperatives to improve the overall clinical communication safety. This really is a best practice for acquiring a communication platform technology in a couple of ways.

You can change the culture with regard to patient communication processes and standards, while also simultaneously moving all providers onto a single communication platform that can be built upon later as you expand your communication standardization initiatives.

With those closing thoughts, I think I’d like to open the lines for questions. Actually, open the Q&A section. Let’s take a moment to take some questions from the audience. Just as a reminder, there is a Q&A box to the right of the slides that you can use to submit a question. We will take a look at a couple of questions here now.

The first is, ‑‑ I think this would be directed toward Mark ‑‑ why would you need to find the original contracts if we can obtain the GL, the cost data?

Mark:  OK, the reason for that is the GL of the AP data is just giving us a spend number many times. Even if we get purchase order data, most of the files that we receive either you have the spend data as one single line or may have a little bit of detail, but they don’t have the complete detail.

When we have the AP data that show the spend and we have the contract which actually lists out all the different ways they’re charging…Again, if it’s a monthly charge, is it up to a certain number of minutes and then it’s a per‑minute charge after that? We can’t see that within the AP data to be able to really get to the utilization and the usage numbers.

We can see the spend, but we don’t know what exactly makes up that spend. Having the contract and having the detail of how the pricing is laid out allows us to understand what’s being charged. Also, then allows us to determine what is the actual usage so that we are evaluating properly how much coverage that we need to provide going forward.

Carlene:  Thank you, Mark. The next question that came in is, what is the turnaround time for an assessment? What’s reasonable to conduct an assessment of current after‑hour services?

Mark:  For us it’s a typical four‑ to six‑week process. All of that is obviously dependent on how easily the information is accessed and how many facilities, whether it’s live meeting with stakeholders, what that timeframe is.

Most of this can be from data analysis to coming up with a basic strategy to go forward and meet with the stakeholders is part of that course of time, four‑ to six‑week timeframe.

Ryan:  Yeah. From the operation standpoint at Piedmont, we took a little bit longer. I think doing the actual analysis goes pretty quick in the work, but there’s always a little bit of that political maneuvering that needed to happen beforehand when we talk about getting the executives’ buy‑in, as well as the physicians’ buy‑in and helping them to feel comfortable with the change.

From my perspective on implementing and putting something into place, you don’t want to rush it too much. You want to really make sure that you’ve politically maneuvered the right way and spoken with the right individuals to help them feel comfortable with the change.

For us, three to four months, when you start talking about that pre‑work before the assessment and then the after work if you’re implementing and really put something into place.

Carlene:  Your answers are good points. Cool. All right. The next question we have is, why do you need to speak to stakeholders if you have a hard data on the finances?

Mark:  From my perspective, it’s really to get an understanding of the satisfaction level with the service, any issues, any problems that are occurring. Also, to understand how they’re utilizing the service.

We can assume, because it’s an after‑hours vendor and categorizes that kind of spend, that this is the typical way that it’s been utilized, but being able to speak to stakeholders gets the truth of the matter and truly understand how they’re using it, satisfaction levels, and if they feel like what they have is satisfactory to their needs.

It may be that, what they have is satisfactory based on the service they’re getting, but they may feel like they need additional services or they’re not necessarily upset with the current vendor because they understand that they’re getting the services that they required or that they contracted with, but their needs of change, and they need more.

None of that you can get from paper. You need to really speak to the stakeholders to understand the situation.

[silence]

Ryan:  Yeah, and for us it gets back to that point of having two different initiatives. From a paper standpoint, it’s pretty easy to make a change and to go for a clear cost‑cutting measure.

As you talk with the stakeholders and better understand their needs and also what the frustration points are, it’ll really help you in making the decision on which vendor is right and getting them to buy in on the process as you move along, and actually implement it.

Carlene:  Thank you.

Ryan:  Your goals may just shift.

Carlene:  That was good. All right, let’s take one more question that’s come in the queue. Just as a reminder, if you have any other additional questions, please use that Q&A box. Mark and Ryan, last question is, can you elaborate a little bit more on enabling effective communication with or between physicians?

I wonder if I should just bring this slide back up. Any initial thoughts on that?

Ryan:  Yes, there’s a couple things with physicians. I think, when we talk about the communication with physicians, we’re talking about primarily that patient‑to‑physician or patient‑to‑provider communication.

They can receive that communication in a number of different ways, via text message, via call. You want to make sure that that’s smooth and that the right information is getting to the provider.

Another big thing that came about with this, as we were evaluating vendors, is how physicians can communicate amongst themselves or providers can communicate amongst themselves. Whether that’s during the day and you’re asking somebody in a hospital setting to come and see a patient in one of the rooms, the services that are provided here, one thing that’s included is a secure text messaging.

Messages can be sent from provider to provider in a secure manner. From an after‑hours perspective, when that on‑call provider is taking care of a patient of one of their colleagues, we really wanted an opportunity for them to easily relay back to their colleagues the information of, “Hey, I took care of Mrs. Smith. This is what’s going on, and what I did for and how she’s being taking care of.”

The platform that we chose enables us to do that. Also, the secure text messaging enables us to do that, and became one of the highest priorities, and satisfies our physicians with that ease of communication.

Mark:  This is Mark. What I think I’ve learned in working on after‑hours services is that how communication between physicians may be occurring at some facilities now, which may not be through a secure messaging system and may just be truly texting each other on cellphones.

Being able to have a program that can resolve that issue, make it HIPPA compliant. Obviously, we’re all concerned about that.

Also, the ability for a hospital to the speaking with the physicians or a physician office during the day and being able to have the communication if there is a patient in the hospital that a physician needs to come in to see.

The way it was occurring before, making phone calls or doing manual ways of communicating to people, to then having a more sophisticated electronic method to do it is amazing. It’s something that, again, I’ve learned through managing these kinds of initiatives on the major differences that are occurring.

Being able to have a platform that can satisfy multiple areas of the needs in this area is something that is fascinating to me.

Carlene:  All right. I think we’ve answered everyone’s questions. In conclusion, I like to, first, thank our speakers. Mark and Ryan thank you so much for spending your valuable time with us today and sharing your lessons learned and strategies. I think that’s great help to many on the line. Also, thank you to all participants for spending your time with us today as well.

Please take a moment to complete a short survey and tell us how we did. You should see a survey icon button at the bottom of your screen which you can launch manually if by chance the survey does not automatically launch right now as we conclude this webinar.

Thank you so much and have a great day.