Improving patient satisfaction and care with better communication

With the rise of value-based care, patient health outcomes are more important than ever. Healthier patients make a significant contribution toward increased reimbursement rates, but health outcomes are only part of the equation—patient satisfaction matters, too.

But that’s often easier said than done. With declining patient loyalty and the advent of consumerization in healthcare, patient satisfaction is difficult to achieve. It means your organization must make every effort to earn and retain a reputation for quality care that builds patient trust.

Technology plays an important role in keeping patients satisfied with their care. Dated solutions or disjointed patient care experiences can send them searching for smoother, more accessible, and more modern interactions.

In 2019, Hospital for Special Surgery (HSS)—America’s premier academic medical center focused on musculoskeletal health—wanted to elevate patient outcomes and experiences by improving care team communication across the organization. To do this, they implemented PerfectServe’s enterprise Clinical Collaboration solution.

PerfectServe brought significant improvements to care delivery workflows while also reducing stress and frustration among care team members. Not surprisingly, better clinical communication, more efficient care delivery, and happier clinicians contributed to improved patient satisfaction.

In fact, Press Ganey survey results from the quarters before and after PerfectServe’s go-live showed increases in the following categories (on a 0-10 scale):

  •  “Hospital rating” increased by 2.3 points.
  • “Hospital recommend” increased by 0.9 points.
  • “Staff address emotional needs” increased by 1.2 points.
  • “Response to concerns” increased by 1.2 points.

Faster Clinical Response Times

Critical Lab Results

Before PerfectServe, HSS relied on a manual process for delivering critical lab results—the lab tech had to call the ordering provider and ask them to log in to Epic. Leaving a voice message was not permitted, as a live verbal exchange was required to satisfy HSS’s internal protocols.

But physicians’ hectic schedules and fluctuating workloads meant delays in this process were common. Precious time was lost, and the risk of patient harm increased.

But now, once a critical result is verified, PerfectServe automatically delivers an alert to the appropriate provider using its proprietary Dynamic Intelligent Routing® technology. With all relevant information and patient context in the message, the provider can acknowledge and act upon the message right from their PerfectServe inbox—no phones, no callbacks, no delays.

After implementation, HSS looked at 1,100 critical lab alerts and noted an average 42% improvement in acknowledgment times. The quickest turnaround—from verification in the Laboratory Information System to provider acknowledgment—was just seven seconds. That’s less time than it takes just to dial a provider’s phone number.

PerfectServe also tracks when each result is received, read, and either accepted or declined by the recipient. Accepting closes the loop, while declining sends a message back to the lab for follow-up. Messages that are unacknowledged after six minutes are automatically escalated to the next provider in line.

Specialty Consult Requests

HSS also relies on PerfectServe’s Dynamic Intelligent Routing to automatically direct requests for neurology and stroke protocol consults. Regardless of who’s on-call or what kind of schedule changes have happened at the last minute, the right provider receives the request almost instantly.

Since implementation, PerfectServe has helped contact preoperative medical doctors over 8,000 times, with 80% of urgent messages read in less than five minutes. Similarly, HSS’s neurology department has received over 500 consult requests, with 85% retrieved in five minutes or less.

Sepsis Notifications

HSS uses PerfectServe to send out sepsis alerts using a two-part workflow:

  • The nurse alerts a physician assistant (PA) about a possible case. Then, if necessary, the PA alerts the responsible physicians (Modified Early Warning Score [MEWS] and Pediatric Early Warning Signs [PEWS]).
  • If needed, an alert is sent to the Sepsis Response Team and automatically escalated every minute until a doctor responds.

Since going live, nearly 700 messages have gone out to the MEWS and PEWS groups, and only nine of those have been further escalated to the Sepsis Response Team. PerfectServe’s ability to quickly and preemptively initiate the MEWS and PEWS teams is largely credited for keeping the sepsis alert number low.

Rapid Response Teams

Additionally, PerfectServe reduced HSS’s rapid response wait times to less than two minutes. These are scenarios when a patient’s clinical condition may be worsening dramatically, so fast intervention is critical. A review of the “signal one” alerts (similar to code blue) determined that PerfectServe reduced the median response time from two and half minutes to just 40 seconds— an improvement of 73%.

Staff Response Times

Additional analysis found that PerfectServe enabled HSS PAs to read 96% of initiated conversations from the PACU and inpatient floors in under 15 minutes. These were part of 8,000-10,000 monthly conversations where the average response time was less than 3.5 minutes.

These efficiency gains freed clinicians’ time and contributed to HSS’s improved Press Ganey survey results. Scores for both the “Response to concerns” and “Staff address emotional needs” categories rose by 1.2 points on a 10-point scale.

Reducing Readmissions

Because PerfectServe also provides HSS with a system-wide answering service, covering roughly 175 clinics, all the organization’s clinics have a built-in workflow for post-operative patients.

When one of these patients calls an HSS clinic, PerfectServe enables an immediate connection to a clinical nurse practitioner with the press of a button. Regardless of the reason for the call or the level of urgency, giving post-operative patients quick and easy access to a provider is a key part of care plan adherence and avoiding potential problems.

Better Communication, Better Care

Reducing obstacles that impede fast, accurate communication can go a long way toward improving patient care and satisfaction. Manual, inefficient workflows have been around for so long that they can sometimes seem like the only option. But for every delayed communication cycle, misdirected consult request, or unactioned critical lab result, there are countless potential ramifications that can negatively impact patient outcomes.

Thankfully, technology exists today that can automate clinical workflows, remove error and confusion from the communication process, and ensure that care team members are free to focus on keeping patients happy and healthy. Isn’t that the way it should be?

Reach out to learn more about how PerfectServe can transform the way your organization cares for patients while making your clinicians’ lives significantly easier. You can also download the HSS case study to learn more about their experience with PerfectServe.

PerfectServe’s Clinical Collaboration Solution Reduces Care Team Toil

To meet patients’ rising expectations and the growing demand for value-based care, healthcare organizations must support care team members at every turn. Limiting their stress and frustration in daily tasks can go a long way to reduce feelings of burnout and costly turnover.

But, cumbersome workflows often hinder clinicians’ performance and make a difficult job even harder. Inefficiencies limit their satisfaction by taking up time that would otherwise be spent on patient care, which is their most important job—the job they do best. Over time, this promotes burnout and even lower satisfaction levels in a cycle that can lead to less-than-optimal patient care.

This has all been exacerbated by the pandemic, which has added even more stress and uncertainty to clinicians’ daily lives. As a result, more clinicians than ever are leaving the profession entirely.

Improved Communication at Hospital for Special Surgery

In 2019, Hospital for Special Surgery (HSS)—America’s premier academic medical center focused on musculoskeletal health—decided to improve their clinical communication workflows. The processes they had in place were effective but time consuming, and the inefficient or suboptimal workflows were a drag on care team productivity and morale.

With 3,500 users spread across 175 clinic locations going in and out of surgery and using a mix of owned and shared devices, fast and effective communication wasn’t always possible. HSS wanted to make communication more efficient and less frustrating for care team members.

Since PerfectServe’s automated answering service was already successfully deployed in HSS’s owned clinics, the organization decided to expand the system footprint to their acute care setting by implementing PerfectServe’s enterprise Clinical Collaboration solution. After implementation, results were carefully monitored and reported in two primary categories: provider satisfaction and nurse satisfaction.

Improved Physician Satisfaction

Before PerfectServe, contacting another care team member meant physicians had to log in to the HSS intranet, search for the correct pager number, send the page, and then wait for a response. To put it simply, efficiency isn’t guaranteed when a process has this many manual steps.

But with PerfectServe, all a user needs to know is the name—or perhaps the role—of the person they want to contact (e.g., Sports Attending On Call). PerfectServes’s Dynamic Intelligent Routing® handles everything else automatically, providing almost instant communication between care team members.

Dynamic Intelligent Routing allows physicians to quickly contact the right clinician at the right time by accounting for multiple variables like date, time, service line, urgency, and more. Physicians no longer waste time sifting through directories and call schedules looking for pager numbers—they only need to follow PerfectServe’s simple guided workflows.

Each month, PerfectServe now seamlessly and dynamically references 1,819 users, 5,915 schedules, 7,060 notification rules, 3,069 contact rules, and 6,863 routing rules to deliver all clinical communications quickly and accurately—all while freeing up physicians to focus more on patient care.

Improved Physician Satisfaction

Before PerfectServe, contacting another care team member meant physicians had to log in to the HSS intranet, search for the correct pager number, send the page, and then wait for a response. To put it simply, efficiency isn’t guaranteed when a process has this many manual steps.

Improved Nurse Satisfaction

By using the PerfectServe app on their smartphones, nurses can reduce the number of devices and hardware in their toolbelt. At HSS, they use it primarily for texting since that’s less intrusive than initiating a phone call, but they also use it for sharing photographs securely. In any given month, HSS nurses send several hundred messages with attachments—predominantly images—from shared iPhones.

Nurses at HSS still utilize workstations on wheels (WOWs), but because PerfectServe is embedded directly within the EHR environment, they can send messages without jumping between applications. In terms of real-world results, another large hospital that uses PerfectServe’s EHR embedded messaging functionality has seen a 322% decrease in the time required for nurses to initiate communication.


The functionalities of PerfectServe allowed HSS to eliminate more than 1,700 pagers. Before, when pages were received, there was no way to triage them based on the level of urgency. But now, clinicians can prioritize their responsibilities at any given moment with urgency designations included with every message. A page also keeps the sender in the dark about delivery status. With PerfectServe, it’s easy to see if a message has been delivered and read—nothing falls through the cracks.

Pager replacement also helped HSS realize a cost savings of over $200,000 the first year and will prevent another $80,000 from being spent every year moving forward (attributed to the recurring costs of pager maintenance and upkeep).

HSS now uses PerfectServe as the single source of truth for on-call schedules. The platform enables clinicians to quickly update their availability and preferences, and changes are visible to all users in real time. This allows communications to be routed according to the up-to-date schedule being referenced. Out of roughly 10,000 unique communications between HSS nurses and physicians assistants each month, the average time for message acknowledgment is just 3.3 minutes. If messages weren’t being routed quickly and correctly, this communication cycle time would surely increase.

Reducing or eliminating the friction that makes it difficult for care team members to do their jobs is a critical part of improving their overall satisfaction. Manual workflows that lead to costly delays have been baked into care delivery for far too long. But the good news is that smart technology can help—and it already exists today.

Reach out to us to learn more about how PerfectServe can improve your care teams’ satisfaction to reduce costly burnout and turnover. You can also learn more about the results HSS has seen with PerfectServe by downloading the full case study.

Clinical Communication Tools Governance Guidelines

As clinical communication tools continue to evolve, governance around:

  • Which users use each system for each message type,
  • Acceptable response times and standard deviations, and
  • Non compliance

…measures are critical. Learn a few best practices for applying governance around your platform.

PerfectServe Accelerates Speed to Care with Faster Delivery of Critical Lab Results

When minutes—or even seconds—can mean the difference between optimal care and patient harm, critical lab results must be delivered to the responsible party as fast as possible. But delivering crucial information quickly can also create a positive ripple effect throughout your organization.

When results come in quickly, patients receive the care they need sooner, and they’re more likely to see positive outcomes and have a satisfying experience. That’s significant because as value-based care becomes more prevalent throughout the industry, these metrics can have a powerful financial impact on your organization. Simply put, better care means higher reimbursement rates.

Improving workflows for critical lab results can also elevate provider satisfaction. It’s no surprise that cumbersome processes take a toll on care team morale. Tasks that involve switching between applications, searching through provider directories, and a seemingly endless number of clicks are a drain on their time, energy, and patience. Reducing the administrative workload and “click fatigue” can go a long way toward decreasing burnout and its wide-ranging effects on your organization.

One such workflow that simply isn’t up to snuff for many organizations is the delivery of critical lab results. Manual processes cause frequent delays, which makes it hard to close the loop efficiently.

Needed Delivery Improvements at Hospital for Special Surgery

In 2019, Hospital for Special Surgery (HSS)—the premier academic medical center in the United States focused on musculoskeletal health—decided it was time to target exactly this kind of workflow for improvement. With 3,500 users spread across 175 clinic locations going in and out of surgery and using a mix of owned and shared devices, fast and effective communication was not always easy.

Since PerfectServe’s automated answering service was already successfully deployed in HSS clinics, the organization decided to expand the system footprint to their acute care setting by implementing PerfectServe’s enterprise Clinical Collaboration solution.

The need for improvements was especially poignant when it came to delivering critical lab results. In the previous workflow, once a result was verified, a message was sent through PerfectServe asking the ordering provider to call the lab, at which point the provider would be verbally asked to review the results in the EHR. HSS policy dictates that providers must get live verbal confirmation that critical results are available, meaning a lab tech could not simply leave a voicemail and move on.

The process could take anywhere from a few minutes to a few hours, depending on the provider’s schedule and availability when the message was received (e.g., during surgery, which would cause a delay.) If the requesting provider was unavailable, the lab would have to use the call schedule to track down the attending, hoping that there hadn’t been any last-minute changes to the schedule.

HSS is an innovative, forward-thinking institution known for providing exceptional patient care, but this scenario highlights a common problem in healthcare, whereby nuanced or complicated workflows are either not integrated into the larger technology ecosystem or integrated in a way that doesn’t make the clinician’s life any easier.

Patient risk is always a concern when vital information isn’t delivered, consumed, and actioned in an efficient manner. Lengthy delays can lead to sentinel events that might otherwise have been avoided. But beyond the worst-case scenarios, delayed treatment can lead to further issues down the line that require even more care.

Manual workflows also mean your team might have to spend several hours each week looking up phone and pager numbers while trying to track down the correct physician—all to relay a simple message. That’s time they could otherwise spend on responsibilities that improve patient outcomes and organizational performance.

It’s also frustrating for providers who are most fulfilled when they’re allowed to perform at the top of their licensure. The longer staff are forced to deal with these types of inefficiencies related to administrative tasks or inefficient workflows, the more likely it is they will experience some level of burnout.

A manual process can have a detrimental impact on your organization as well. Productivity slows when staff members are sidelined with inefficient communication methods, which can lead to adverse outcomes, including lower-quality care and longer lengths of stay.

Clinical Collaboration Creates Astounding Results

HSS saw—or worried about—those same consequences stemming from their imperfect critical labs workflow. But by tightly integrating their Laboratory Information System (LIS) with PerfectServe, HSS now delivers critical lab results to the most appropriate provider almost instantly.

Lab technicians no longer have to search through the internal system for phone or pager numbers to contact the right provider, and there’s no more waiting around for a return call (that may not come). Now, once a result is returned in the LIS, PerfectServe automatically delivers it to the responsible party who can take action.

The workflow is simple. After a result is verified in the LIS, it’s automatically flagged and sent to the appropriate physician via Dynamic Intelligent Routing®. The recipient varies, but it might be the requesting physician, the scheduled on-call, or the sub who’s filling in thanks to a last-minute schedule change. Because communication is linked with scheduling, Dynamic Intelligent Routing sends the message to the correct physician the first time, every time. If the first recipient doesn’t acknowledge the message within six minutes, it’s forwarded to the next provider in line. This process continues until the message is acknowledged.

The lab is also equipped with two tracking monitors that update in real-time so lab personnel can easily discern whether each result has been received, read, accepted, or declined.

Overall, PerfectServe’s Clinical Collaboration solution transformed the delivery of critical lab results at HSS from a manual process that took minutes (or hours) into an automated process that’s completed in just a few seconds.

Now, in the amount of time it might have taken a lab tech to dial a provider’s number, PerfectServe automatically determines who the appropriate provider is and sends them the alert—all within one screen, and in a message format that gives the provider all of the relevant patient context they need.

After implementation, HSS looked at 1,100 critical lab alerts and noted an average 42% improvement in acknowledgment times. Further analysis showed a 92% compliance rate for 2,685 results. The fastest turnaround time for this process—from appearing in the LIS to being acknowledged in PerfectServe—was just seven seconds. Similarly, hematology saw 84% compliance for 856 results, with the fastest turnaround time of eight seconds.

Beyond Critical Labs

Taken as a whole, PerfectServe’s role in clinical communication and care coordination reduces time to treatment in many areas—not just critical lab results. This improves the quality of care and patient satisfaction across the board while also reducing care team toil .

By integrating with other systems and applications to create automated workflows, PerfectServe allows nurses and lab technicians to focus on patients by removing the burden of tracking down physicians.

Similarly, providers’ days don’t have to be interrupted with pages, phone calls, and tedious searches through the EHR for information. Instead, they can quickly access the lab results they need from their PerfectServe inbox and take any necessary action. This eliminates common obstacles and frustrations to help reduce burnout and turnover.

Reach out to us to learn more about how PerfectServe can help your organization transform its communication and provider scheduling practices. You can also learn more about the results HSS has seen with PerfectServe by downloading the case study .

Develop a Clinical Communication Governance Strategy

Ensure the investment you’ve made is used and adopted as intended

Governance is an important tool organizations use to ensure that software implementation and adoption aligns with business goals and complies with external regulations. A good governance program offers a framework for achieving measurable progress toward organizational objectives and maintaining compliance standards.

Adding to operational complexity, organizations now operate in an environment defined by distributed networks, distributed teams, and cloud-based everything, and a rapidly expanding big data ecosystem that’s becoming increasingly difficult to control.

A good governance system addresses these issues and is designed so that assets such as clinical communication tools provide maximum value to healthcare organizations and patients.

To make governance work for your organization, we’ve developed a checklist to help you manage your Clinical Communication Governance Strategy.

5 Ways Clinical Communication Technology Reduces Clinician Workload

A clinical collaboration platform can make it easier and quicker for physicians to coordinate care inside and outside the organization, giving physicians more time to focus on patients.  With increased demands for documentation, streamlined communication can help reduce click fatigue and better support physician work-life balance. Click on the image below to get the infographic!

Ready to see what PerfectServe can do for you?

Accelerating Speed to Care with Unified Healthcare Communication

A unified healthcare communication and scheduling platform to improve patient care, enhance provider satisfaction, and give time back to nurses.

Variability and inefficiency in clinical communication decrease patient safety and provider satisfaction.

When providers lack the clear, fast communication they need to collaborate effectively:

  • The entire treatment process risks being delayed, and lengths of stay are often extended due to slow communication cycle times between providers.
  • Patient safety decreases, making things like medical errors and readmissions more likely while also exposing your organization to financial risk.
  • Nurses waste precious time tracking down physicians to share or retrieve information.
  • A dangerous disconnect is created between home care patients and their caregivers.

On top of all that, providers become frustrated when poor communication hinders them from performing at the top of their license, contributing to feelings of burnout—a serious issue affecting 55% of frontline healthcare workers that has been greatly exacerbated by the COVID-19 pandemic.

PerfectServe Unite is on a mission to change all of that.

We eliminate variability to enable the instant communication your team needs to offer the best care for your patients and the highest satisfaction for your team.

It All Starts With Scheduling

When schedules are incomplete, unbalanced, and difficult to manage, communication suffers. Your team can’t communicate effectively if they’re constantly forced to reference the EHR, whiteboards, binders, intranet sites, and phone lists.

Think about it. How many hours do nurses waste tracking down the right on-call physician? When a critical lab result comes in, how long before the attending physician knows it’s ready?

It’s not your administrators’ fault. They’re doing their best, but the scheduling system slows them down. They need a faster method for creating schedules that enables communication rather than impeding it.

Provider Scheduling Powered by Lightning Bolt™

PerfectServe Unite’s Clinical Collaboration solution comes with native on-call scheduling capability built right in. But for some organizations, scheduling needs require a higher level of functionality and sophistication.

That’s why we offer our industry-leading Provider Scheduling solution.

With Provider Scheduling, your administrators don’t have to spend their days accounting for hundreds of rules, preferences, and time-off requests for every provider group. The scheduling process takes only a matter of hours.

Our sophisticated machine-learning algorithms automatically generate gap-free schedules that allow providers to swap shifts from any device, showing all changes in real-time from desktop and mobile applications.

And since everything is managed on one platform, there’s no need to shuffle between different programs or juggle unique scheduling requirements for various departments.

Provider Scheduling is the single source of truth your organization can count on to help balance operational needs with growing patient demand.

Communication with Intelligent Routing

Real-time, optimized schedules serve as the foundation for PerfectServe Unite’s Dynamic Intelligent Routing®—the industry’s most capable rules engine.

It solves communication workflows that other solutions up by accounting for variables like time, day, urgency, service line, and contact preferences, making sure all messages are instantly delivered regardless of circumstance.

No matter who’s scheduled, who’s available, or how the schedule might have changed, all calls, texts, and notifications are sent instantly to someone who’s able to respond and take action.

For instance, a surgeon can designate her PA to receive urgent messages while in surgery. If the PA happens to be unavailable when a message is sent, it will be delivered to his colleague instead. And all non-urgent communication will be held until the surgeon is out of the OR.

Having an integrated, real-time schedule means PerfectServe Unite instantly knows who’s working, whether or not they are available, and how they prefer to receive communication.

And the whole process only takes a few seconds.

Moving Beyond the Walls of the Hospital

So you’ve got optimized schedules and a powerful rules engine that drives accurate communication. That’s a great start, but to meet the evolving needs and expectations of patients and providers, a platform like this needs to extend beyond the walls of the hospital.

The amount of communication surrounding acute care patients is vast and understandably garners much of the focus. But patient care also happens in provider offices, ambulatory surgery centers, outpatient lab and diagnostic centers, and even patients’ homes. If your technology can’t flexibly support care across all of these locations, it’s no longer good enough.

With Unite, PerfectServe is bringing all of its assets together to fundamentally transform healthcare communication by quickly and effectively connecting people—physicians, nurses, ancillary staff, patients, and patients’ families—without bounds.

Patient at the Center

Patients and their families should always be at the center of the care process. Optimizing care should involve engaging the patient in many meaningful ways, both scheduled and unscheduled.

PerfectServe Unite offers a variety of patient engagement methods that make it quick, secure, and easy to maintain consistent communication between provider and patient: virtual appointments via video, text updates to family, automated appointment reminders and post-encounter follow-ups, calls that mask the provider’s cell phone number to protect privacy, and more.

More importantly, Unite also ensures that when something isn’t going well, the appropriate care team member is immediately notified.

Engaging your patients in their care is vital. Bringing your care teams into the communication process to proactively engage and circumvent poor outcomes created by delays in care is essential. Keeping it all in the same platform for all types of communications is simply … smart.

Bringing Joy Back to Caregivers

When you put these pieces together, the result is technology that enables doctors, nurses, and all other care team members to do their jobs without the roadblocks, delays, and frustrations that have been part of care delivery for far too long.

And for patients, the care process becomes more interactive and accessible than ever before. No matter the issue at hand, seeking care can be frightening and confusing, and this is made worse when communication between patient and provider is difficult or infrequent.

PerfectServe Unite removes barriers and challenges that have long been a hindrance to optimal outcomes. We want to bring joy back to caregivers so they can focus on what they do best—providing excellent care for patients.

A Single, Standardized Platform

Instead of cumbersome workflows across dozens of disparate applications, PerfectServe Unite provides an end-to-end platform for all of your provider scheduling and communication needs, featuring four integrated solutions:

  • Providers can instantly communicate and coordinate care across all departments, including acute care sites, ambulatory facilities, and call centers. PerfectServe Unite can also be embedded with your EHR with no loss of functionality.
  • Our scheduling solution optimizes resources and ensures proper staffing levels across your organization. Schedules are equitable and gap-free, and providers can request time off or swap shifts from any device with all changes shown in real-time.
  • Providers can engage with patients and their families throughout the treatment process with offerings like a pre-appointment virtual waiting room (including curbside check-in), built-in video visits, follow-up surveys, family updates, and more.
  • Whether during or after office hours, our automated answering service solution uses dependable call and message routing, provider settings, and on-call schedules to direct all communication to the right place. Improve provider satisfaction and give patients at your medical practice an easier, more reliable point of access with an intuitive platform that streamlines communication and automates time-consuming manual tasks.

High Adoption

To help you get the most from all that PerfectServe Unite has to offer, we’ve developed a unique and highly effective methodology to get as many users on the platform as possible.

We’ve found that a human-centered approach is the most effective way to ensure a successful implementation. That’s why we meet with every provider individually—we take the time to answer their questions, address their individual concerns, and walk them through the registration process.

Download our white paper or schedule a demo to learn how our solutions can address use cases across the care continuum and help your organization accelerate speed to care.

Dynamic Intelligent Routing® Delivers the Right Message to the Right Person at the Right Time—No Matter the Setting

Executive Summary:

  • Getting important information to the right member of the care team in a timely manner is a critical part of patient care
  • PerfectServe’s Dynamic Intelligent Routing® is the industry standard for encompassing workflows, both routing and scheduling—it automatically references any number of variables in real time to accurately direct communications
  • With its guided workflows and comprehensive mapping, Dynamic Intelligent Routing is better equipped to handle the depth and complexity of real-world clinical communication than role-based routing
  • Dynamic Intelligent Routing is also a valuable gatekeeper in the outpatient setting, giving providers the ability to respond to communication from patients in a structured and manageable way
  • Much like a car engine with many interconnected parts that starts up with the simple push of a button, it’s not required for the end user to manage the complexity of Dynamic Intelligent Routing to reap its benefits

PerfectServe’s Dynamic Intelligent Routing® is proprietary message routing technology that factors in different variables to determine who should be sent each message or call at any given time. To illustrate how this works, we’ll walk through some relevant clinical scenarios, starting with a simple example—one that usually doesn’t give clinicians trouble in their current environments—and progressing to a more complex example that often leads to delays and frustration in the real world.

A basic example is a nurse trying to reach the provider on call. The system pulls in data regarding the patient in question, the department, and available schedules to ensure the message is routed to the correct on-call provider. It then references the provider’s preferred contact method to ascertain if the nurse should call or send a text message.

ABOVE: An example of a basic Dynamic Intelligent Routing workflow. Real-life workflows typically involve many more variables.

This simple example shows a bit of Dynamic Intelligent Routing’s capability, but when we look at more complex examples like reaching the right hospitalist, contacting a surgeon in the OR, or sending messages to providers outside the walls of the hospital, the true power of Dynamic Intelligent Routing shines through.

To understand how Dynamic Intelligent Routing accomplishes this, it’s important to understand the value of integrations. For instance, when PerfectServe pulls in patient data from the EHR, it can then see both the patient’s dynamic care team and their room number, which fuels part of the routing. When a critical lab result or sepsis alert comes through, Dynamic Intelligent Routing can reference this data along with the physician schedule and routing rules to determine who the current, covering provider is, which may be necessary if the ordering provider is no longer working. Once these factors are accounted for, the appropriate person receives an instant alert.

Dynamic Intelligent Routing has long been an integral part of PerfectServe’s DNA, and it remains one of the primary features that sets our technology apart from the competition. It is core to PerfectServe’s functionality and essential for efficient communication and collaboration.

So how does Dynamic Intelligent Routing work in practice, and more specifically, how does it differ from simpler role-based routing? This is a common question, and the answer is about addressing the depth and complexity of real-life clinical communication in both the acute and ambulatory settings.

Tackling the Complexity of Care Team Communication in the Hospital

Let’s use routing rules in a hospital as a reference point. What if you want to message the orthopedic surgeon on call? With basic role-based routing, the message is sent to the surgeon’s phone. But what if the surgeon has more nuanced contact preferences depending on the scenario? While in surgery, he or she may want the PA to cover their calls; during clinic hours, this responsibility may switch to the office nurse, and for the rest of the time, the surgeon may want calls routed directly to his or her cell phone. Dynamic Intelligent Routing supports—and even encourages—workflow complexity of this nature and ensures that the person receiving the message is equipped to immediately address the issue at hand.

Dynamic Intelligent Routing can also route based on schedules or user logins. Role-based routing works well when, for example, you’re looking for the hospitalist on call and they’re logged into the system. But what if there are ten hospitalists rounding today and you’re not sure which one is covering your patient? The EHR says it’s Dr. Smith, but it’s now 6 PM and he’s no longer working. Or, what if the wound care nurse is performing a sterile dressing change and can’t reply to messages being sent? What if the surgeon covering consults for the house isn’t responding?

For the first scenario, Dynamic Intelligent Routing is capable of organizing any combination of rules, schedules, message types, points of entry, and other information to appropriately direct a message to the right recipient, even if ten different hospitalists are on call. And, even better, it removes the cognitive burden from the sender—all parameters are already built into the system, so directing the message is as easy as answering a few automated prompts to complete the guided workflow.

For the second scenario, Dynamic Intelligent Routing can use a built-in escalation protocol to automatically route any message to the next available team member after a predetermined amount of time has passed. Once the time threshold is met, the message immediately hits the next person’s inbox.

Workflow rules can be created with role-based routing, but they are typically associated with predefined groups, such as “all surgeons can elect to cover calls for another surgeon.” The goal of Dynamic Intelligent Routing is to build these specific coverage scenarios during implementation. This means the surgeon prepping for a procedure doesn’t have to ask a colleague to cover for them for the next four hours—rather, the surgeon’s PA is the first escalation point for urgent calls, the PA’s colleague is the second escalation point, and all non-urgent communication is held until the surgeon is out of the OR. There is no risk or uncertainty, and time spent trying to determine coverage on the fly is reclaimed because these workflows are established in PerfectServe right from go-live.

Additionally, Dynamic Intelligent Routing isn’t only meant for hospital departments covering unassigned consults. PerfectServe’s implementation methodology includes workflows for all provider groups. This allows clinicians to not only engage providers for new patient consults, but also connect with providers regarding established patients who have a new issue. This comprehensive approach allows all communication workflows to be mapped at both the hospital and practice level. This level of standardization is the foundation for automating critical results.

Dynamic Intelligent Routing also extends beyond the four walls of the hospital, supporting communication across affiliated and employed providers, as well as care settings like dialysis or rehab. The patient’s entire care ecosystem is accessible on the platform, meaning effective communication and care coordination doesn’t stop where the hospital walls end.

A Helpful Gatekeeper for Patient-to-Provider Communication

Healthcare organizations are working diligently to make their patient engagement tactics more closely resemble the modern, efficient, and intuitive experiences that patients have in consumer or retail situations. If you can text your veterinarian to set up an appointment or request a medication refill for your dog, you’re probably going to be disappointed if your doctor’s office doesn’t offer similar functionality.

But according to a recent study, doctors say they’ve been overwhelmed by the volume of digital messages received from patients during the COVID-19 pandemic. It’s not good enough just to enable patient-to-provider communication—you have to ensure that patients get timely and helpful responses without unleashing a deluge of messages into providers’ inboxes.

Once again, Dynamic Intelligent Routing is here to help, and we’ll set up another hypothetical scenario to demonstrate. This time, a patient is experiencing stomach pain, but it’s after hours and their primary care provider’s clinic is closed. Because the clinic uses PerfectServe, the patient calls and is met with several prompts from the Interactive Voice Response (IVR) answering service solution. The patient’s answers tell the system if the call is routine or urgent.

Because the patient has a serious clinical issue, they are prompted to leave a voice message for the physician on call. Dynamic Intelligent Routing immediately routes the message by referencing schedules in the system, and the on-call physician then receives a push notification. The message in PerfectServe is easily retrieved by the physician and already includes all necessary patient information.

The physician then sends a text message to the patient and asks if they’d prefer to speak on the phone, via video chat, or in a secure messaging session that allows private information to be exchanged in an encrypted environment. The patient prefers a video visit, so the physician sends a link via text message, and within minutes they’re talking in real time to determine next steps.

In this scenario, Dynamic Intelligent Routing is an important gatekeeper. Because the issue is serious, the patient is immediately connected to help, but the provider has complete control over how and when to engage in live conversation. Additionally, because the system can reference schedules in real time, physicians who aren’t on call will not be disturbed by errant messages. The patient gets the help they need, and the provider receives the message in an organized, controlled manner.

If a patient calls after hours with a routine issue or question—perhaps they want to reschedule an appointment or request a medication refill—Dynamic Intelligent Routing can hold the message (and associated push notification) to be delivered to office staff the following morning when the office opens.

In the near future, PerfectServe will also enable this kind of Dynamic Intelligent Routing-driven workflow with chat bots—both on the provider organization’s website and via SMS text message. The result will be the same, but for patients who prefer visiting a website or sending a text to making a phone call, this will add more paths for structured and efficient communication.

Dynamic Intelligent Routing: Making Complex Workflows Seem Easy

For over 20 years, our mission has been to improve clinical communication by removing the obstacles, delays, and frustrations that patients and care team members face every day. Dynamic Intelligent Routing is core to this mission—it’s the foundation upon which PerfectServe is built. But when you read language like “complex routing algorithms” and “proprietary technology” associated with Dynamic Intelligent Routing, just know that the simple purpose is to make sure that messages, calls, alerts, alarms, and all other forms of communication are directed to an appropriate person who is available to help.

Dynamic Intelligent Routing is capable of ingesting and processing thousands of rules and variables, and the workflow possibilities are endless. At one provider organization, PerfectServe—by way of Dynamic Intelligent Routing—dynamically references 1,819 users, 5,915 schedules, 7,060 notification rules, 3,069 contact rules, and 6,863 routing rules. That may sound like a lot, but it helps to think of it like a car’s engine. Under the hood, there are a variety of intricately connected parts that are overwhelming if taken piece by piece. For the driver, though, a simple push of a button is all that’s required to start the engine.

Making complex workflows seem easy is what PerfectServe does best, and the result for the end user is fast, consistent, and accurate delivery of all communications. It’s all thanks to Dynamic Intelligent Routing.

Physician Engagement: What It Is and Why It’s Important

In healthcare, the impact of workforce engagement has similarities with other industries such as productivity, turnover, and financial performance. However, physician engagement significantly impacts the health, safety, and well-being of the patient experience and outcomes. The good news is clinical communication and collaboration solutions can address those common denominators while improving the quadruple aims of patient outcomes, experience, cost reduction, and clinician satisfaction.

Why is Physician Engagement Important?

Physician engagement is critical for a successful patient care experience. When physicians feel a lack of association, it manifests itself in ways ranging from physician burnout to a poor patient experience.

Engaged physicians are 26% more productive than those less engaged, adding an average of $460,000 in additional patient revenue per year.

Physician employment does not automatically equal engagement. Communication and collaboration skills are a must-have regardless of the number of employed physicians. High levels of physician engagement have been correlated to increased productivity, generate more referrals, expand influence amongst peers and medical staff, and drive organizational strategy and change. When medical practitioners are engaged, patients and the local economy reap the benefits. 

“Patient experience impacts revenues, referrals, adherence, safety, and the credibility of an institution with the community.” – Forbes

What is Physician Engagement?

Engaged physicians take greater care of their patients, reduce medical costs, and are more efficient than their unengaged counterparts. The Health Care Advisory Board states that creating organizational alignment is one of the most challenging initiatives, but the most crucial to success—impacting cost, quality, and experience initiatives.

A strategy that focuses on streamlining communication, building relationships, and aligning physicians with the values, vision and mission of their organization and with other healthcare stakeholders to continuously improve care and the patient experience.

  Reduced referral leakage.
  Increased in-network referrals.
  Higher engagement of patient population.
•  Improved patient care delivery.
  Enriched physician development and performance.
  Decreased burnout and turnover rates.

Effective engagement strategies require a multifaceted approach. One that includes retention, clinical and cultural fit, onboarding, benefits, leadership development, formal recognition, and physician burnout.

Measuring Physician Engagement


Consistently measure and invite physicians to share their needs and challenges to gauge physician sentiment and identify gaps within care teams and workflows.

Run monthly engagement surveys for insights into how physicians perceive your organization and its services. Using that information, closely examine the factors that contribute positively or negatively to engagement and create a plan to improve physician’s everyday experience.


Help physicians understand what is expected of them in a transparent way while measuring productivity and performance metrics.

“We feel transparency is extremely important in order to change behavior. The scorecard gives a comparison of provider to provider within the same specialty. And then it’s a provider to their individual practice. And then it’s that provider to the network.”

 Travis Turner, Mary Washington Healthcare

Dashboards & Reporting

Employ platforms that enable your organization to visualize sufficient, real-time data. This drives organizational initiatives and empowers physicians to have the autonomy to course-correct quality to improve care delivery.

Develop an in-house practice transformation dashboard to show overall movement of your practice through the phases of your organizational initiatives. Here’s an example of a dashboard used in the special report Practice Transformation Analytics Dashboard for Clinician Engagement, published by Annals of Family Medicine.


Accountability Tools

Implementing a solution that provides your organization and physicians to practice accountability enables both personal, peer-to-peer, and clinical autonomy. Solutions that use read receipts, automatic escalations, and self-managed scheduling can foster opportunities for meaningful dialogue and potentially reduce burnout.

There are hundreds of ways to slice your data. Look back to your guiding questions to determine the most important KPIs for your organization’s unique goals and priorities.

Check out this snippet from our webinar with Mid-Atlantic Nephrology Associates to learn how they utilize our tracking and reporting capabilities for transparency and accountability across their organization.

Mid-Atlantic Nephrology Associates reduced operational costs by over $9k by modernizing practice communication for a network of more than 52 facilities, 50 providers, and 1,700 patients.

Improving Physician Engagement

Provide Pathways to Influence

Create physician-led channels to the executive suite to share their voice in decision-making. This reframes the narrative of physicians from employees to partnerships, creating a forum for open dialogue between executives and physicians.

Invite physicians to join leadership in roundtable discussions. This fosters an environment where physicians know their voice is heard, helps identify leadership opportunities, and shows commitment to invest in formal and informal opportunities to develop physician leaders and influencers.

Launch a ‘North-Star’ Initiative

Workflows and systemic factors are universal and aren’t limited to one group of care providers. By demonstrating the intent of how multiple initiatives interconnect, it streamlines the number of things physicians are asked to do on top of their patient care routines. As an example, Figure 1 shows how the factors and behaviors that build a safer culture, drive positive outcomes.


Note: Figure adapted from Bisbey et al. (2019)


Create a Data Strategy

Data should be applied and not simply collected. An effective way to drive physician engagement is to build a comprehensive data strategy that improves transparency and helps physicians understand the objectives their organization is driving.

North Memorial Healthcare adopted an enterprise data warehouse (EDW) with visualization capabilities to enable physicians to get near real-time answers to their clinical quality improvement questions. The physicians could then see how their decisions affected length of stay (LOS) and how specific changes in clinical processes would improve LOS. By accessing the data, it was easier to convince physicians to make the needed changes.

Form Leadership Development Programs

Physician relationships with staff, background, future planning, and training differ among hospital leaders. This creates challenges in how rapidly physicians are able to respond to marketplace and regulatory change. Adopt intentional leadership development programs for physicians who are both formal and informal leaders.

•  Hold annual leadership summits with executives and the c-suite.
•  Establish physician champions to present peer-selected awards.
•  Kick off meetings with peer-recognized moments of excellence.
•  Form topics of interest or medical specialty groups for collaboration.

How Does Technology Improve Physician Engagement?

Physicians are trained to be patient care providers, not data-entry administrators.

Physician engagement in technology is critical for the future of care delivery, and physicians are looking for solutions that streamline clinical practice, allow more face-to-face time with patients and improve outcomes. The secret is to improving physician engagement in technology adoption is by illustrating why the technology is needed. Take time to involve physicians in the selection and implementation process, and provide data to show how it benefits them and the patients.

Achieving more balance in providers day-to-day is possible with the right technology solution. When looking for a clinical communication and collaboration platform, look for solutions that have considered end-users in the build of the user interface and capabilities. Does it have interoperability across technology, and the capabilities to streamline workflows to increase operational efficiency? Look at the processes it takes and how the platform integrates with EHR systems to improve the medical practitioner’s experience.

In a high stress environment, recognizing physician needs can empower them to implement new technologies. As a result, this can improve satisfaction levels, assist in making better care decisions, and support patient engagement and satisfaction levels.

Find out how the right solution can support your physician engagement strategy.

Nurses of Note Awards 2021: Week One


Nurses of Note Yoji Patil

PerfectServe’s Nurses of Note awards program focuses on the many nurses who deserve recognition for the dedication, sacrifice, and resilience they bring to work every day. For the inaugural Nurses of Note Awards, we have the privilege of highlighting a new level of commitment, strength, and integrity in nurses from around the country who have battled on the front lines of the still-raging coronavirus pandemic.

The actions of this diverse group of nurses highlight the extraordinary among us. Their stories give us a glimpse into the unique ways our nurses have fought this pandemic and made a difference in the lives of their patients and the communities they serve. Out of hundreds of nominations, we selected three nurses and one team of providers to spotlight as recipients of this award.

Honoree 1: Yoji Patil, MSN, RN, CNOR of Stamford Health (Stamford, CT)

Yojana Patil—who goes by Yoji—believes that nursing chose her. She accidentally stepped into her career when she took an entrance exam to support a friend who wanted to pursue nursing. Twenty-plus years later, Yoji found herself battling on the front lines of the COVID-19 pandemic. In response, she helped to launch the ICU Family Liaison Program at Stamford Health to keep ICU and palliative teams in communication with patients and their families while visitation restrictions were in place.

Yoji was nominated by her Stamford Health coworker Michelle Watson, who serves as Nurse Manager for the ICU and IMCU. Michelle wrote that Yoji’s ICU Family Liaison Program initiation felt seamless, and that Yoji deserves full credit for what the program was able to accomplish.

The ICU Family Liaison Program has kept patients and their families connected in a time when communication is more important than ever. Yoji wrote the training and communication guide for the program, which covers four intensive care units for eight hours a day, seven days a week. She individually called and updated families of patients, organized patient care across multiple specialties, and facilitated conference calls—all on top of her regular nursing schedule.

Her nominator Michelle summed up Yoji’s efforts by saying, “I am proud to work with Yoji and to be a witness to such an important initiative that provides much-needed information and comfort to families.”

Yoji’s service to her patients did not stop when she was tired. Throughout the pandemic, she worked weekends and holidays to provide continuous care. On Mother’s Day, she organized a video call with all of her female patients’ children, allowing them to see their mothers even though they couldn’t be together in person.

Throughout the pandemic, Yoji has been a caretaker and advocate for those who lost their lives to COVID-19. She has held the hands of dying patients whose families couldn’t be there to comfort them. On multiple occasions, Yoji obtained permission to allow family members to visit and say goodbye to loved ones when a patient’s outcome looked grim. Yoji was and remains a steady support system to families facing the bereavement process.

Yojana Patil’s service to her patients, her colleagues, and her community is an emphatic demonstration of character, empathy, and commitment to nursing.

What inspired you to become a nurse?

Sometimes you choose a profession, but in my case, the profession chose me. I accompanied my friend to the entrance exam for a reputed nursing school in Mumbai. The principal was walking by and asked me, “Instead of waiting outside, why don’t you sit in for the exam?” I did end up taking the test, and now I can’t imagine choosing any other profession.

What’s one piece of advice for nursing students entering the field?

Nursing is a work of heART. Nursing is a way of living for the rest of your life. It’s not just a job—once a nurse, always a nurse.

What would you like to see change for nursing in the future?

I would love to see nursing at the forefront of healthcare. I want to see nurses advocating for patients, especially the population that has no voice.

How do you combat burnout in your professional life?

I have tremendous support from my family, friends, and coworkers. I use mindfulness in my daily activities, especially on hectic days. Emotional burnout is a real thing. Nurses around the world are feeling helpless and emotionally drained as an effect of this pandemic. Most of us have PTSD from our experiences and the difficult outcomes we’ve witnessed.

Taking care of your physical and mental health is just as important as taking care of your patients. A quick five-minute deep breathing session before walking into unknowns, such as receiving a new patient or beginning a shift, goes a long way.

What’s your passion outside of nursing?

I love Zumba. I also went skydiving on my 40th birthday! I have traveled to four continents so far and would love to explore Africa next. To sum it up, I enjoy dancing, traveling, and adventure sports. I’m not the best at sports, but that doesn’t stop me from trying!

If you had to pick one song that describes you as a nurse, what would it be?

If I had to pick a song, it would be “Heal the World” by Michael Jackson. But this excerpt from a poem—which I wrote with my coworker and fellow nurse, Seema Pillai—really describes me as a nurse:

Today I feel like a soldier, waging a war,
With limited weapons, I return home each day with many a scar.
But I will fight valiantly and will not despair,
‘Cos I go to work each day with weapons invisible—faith, hope, trust, and a prayer.

Nursing is my calling
And when duty calls, I will not fail,
I know there’s light at the end of the tunnel, I know I’ll live to tell this tale.

Thank you, Yoji!

Your hard work and dedication to exceptional patient care is recognized and appreciated by your colleagues and the team at PerfectServe. We wish you all the best in your continued efforts to make life better for the individuals and families who trust you with their care.

Read the Full Winners List