Unlocking the Potential of Your Answering Service: More Than a Cost Center
For the majority of health systems today, after-hours services are viewed passively as a mandatory cost of doing business. In other words, it’s always been the case that clinics will get calls outside of normal operating hours, and some system has to be in place to handle that communication. But that’s about as far as anyone expects an answering service’s capabilities to go—it’s strictly a cost center to monitor or a basic box to check, not an asset that can be leveraged to advance strategic priorities.
This is a dated perspective that significantly undersells the potential of your answering service to bring repeatable quality, efficiency, and ease of use to important communication and collaboration processes that are executed many times a day throughout clinics within your health system. With modern technology and a more holistic enterprise approach (as opposed to a clinic-by-clinic approach), it’s possible to transform your answering service into a real strategic asset that consistently delivers results using a sustainable and more scalable cost model.
This means you can use technology to build an intuitive and tightly connected communication web across all of your practices that benefits patients, providers, and supporting staff while serving as an enabler of strategic growth.
What’s Wrong with the Current State?
Considering the accelerated pace of clinic acquisitions in recent years, it’s not uncommon for health systems to be faced with an array of answering service vendors. This adds up to unpredictable costs, variable quality and reliability, siloed communication, and other negative downstream implications. What about the disparate, disconnected ambulatory sites that don’t live on the same system? How can critical alerts, scans, and chart updates be sent in a timely manner for the hospitalist? The complexity only grows with each merger or practice acquisition.
But even if your system only uses a couple different services, or perhaps just one service with limited or dated capabilities, you’re still missing out on the benefits of a single-solution approach that uses modern technology. Healthcare technology has advanced far too much in the past decade to settle for solutions—whether powered by humans or tech—that create more problems than they solve.
Answering service effectiveness is also based far too often on what we’ll call 20th century metrics. Think about the complexity of care delivery: A patient might engage with multiple sites and multiple providers throughout your system over the course of time, and depending on your virtual care strategy, they may even engage with you from the comfort of their home. An answering service aimed at supporting and facilitating this kind of patient journey should be focused on workflow benefits, clinical benefits, and patient experience rather than hold times, dropped calls, or personnel concerns about background checks and the daily moods of operators who aren’t on your payroll.
A Future-Proof Approach
The table below contrasts these two perspectives of the answering service—one as a “set it and forget it” cost center with limited opportunities for strategic impact, the other as a strategic asset enabled by modern technology that can enhance care, reduce costs, and automate common workflows.
Typical Answering Service Model
Future-Focused Model
Scope
Services are fully outsourced
Staff collaborate with vendor to build, customize, and automate workflows
Value
Strategy
Minimally acceptable service quality at the lowest cost
Optimal service, low (and predictable) cost
Expectations
Answer phones to avoid disasters
Enhance care and aid providers
Reliability
Prone to error, especially when live agents are involved
Functions as designed with accurate and repeatable processes
Scalability
Not scalable, dated/limited technology
Scalable, poised for growth
Performance
Management
Better performance requires micromanagement of operators
Better performance requires simple workflow tweaks, easily standardized across all sites
Quality Control
Little ability to control quality of operators and decisions
Highly controllable and customizable
Patient Impact
Patient outcomes are unclear and hard to track
All activity is fully trackable, including care decisions and outcomes
KPIs
20th century process KPIs
21st century process AND outcome KPIs
The ultimate goal here is to convert something that’s traditionally seen as a “table stakes” support service with limited potential into a real strategic asset for the entire health system. It may seem implausible because of the way the answering service has traditionally been handled, but it’s not. We can show you how.
The Importance of Shared Goals
The key to accomplishing this shift is goal alignment, and that’s why you should ask yourself a simple question: What does your answering service vendor care about most? How closely do their priorities align with our health system priorities?
The provider of these more robust capabilities should certainly perform well on the historically tracked operator performance measures like hold times and dropped calls, but they should also be driven by shared goals that form the basis of your partnership: clinical quality, speed to care, patient experience, provider experience, and financial performance, among other examples. Legacy answering service vendors mean well, but it will be tough for them to support the latter group of goals effectively.
PerfectServe: A Better Answering Service Formula
PerfectServe exists because its founder wanted to fix the problems associated with a manual, human-centric approach to handling inbound patient communication. His wife was a nurse who managed calls and messages for a private practice, and his experience in the telecommunication industry showed him that the process could be vastly improved with thoughtfully designed technology.
We have teams of clinicians and clinical workflow & communication experts who help to design our products and roadmaps. Informed by more than 25 years of experience and deep knowledge of the unique needs of healthcare organizations both large and small, their express purpose is to build technology that tamps down burnout and care team toil by optimizing medical staff workflows.
PerfectServe currently counts more than 500 hospitals and 30,000 medical practices as customers, so rest assured that no workflow, no protocol, no org chart is too complicated for our technology to navigate. We bring as many as 20 practices live with our answering service each week, and at the same time we may be working with a 20-site health system to replace their current answering service vendor after two outages caused corresponding upticks in ED visits. While we haven’t literally seen it all, we’ve seen a lot, and we’re always prepared to work with customers to try something new.
And while we can help you outperform on the traditional after-hours metrics we mentioned before—things like wait times and dropped calls—our service actually allows your leaders to “retire” this dashboard as the sole indicator of effectiveness to broaden their focus on higher-level, mission-critical performance metrics that impact the entire organization.
Telling the Full Answering Service Story
If we tried to break down all of the ways a modern answering service solution would benefit your health system in a single blog, we’d lose you in a wall of text. That’s why we’ve broken this up into a more digestible, multi-part series aimed at challenging current answering service perspectives. With this series, we’ll demonstrate how taking a tech-focused, enterprise approach to your answering service will benefit patients, providers, and the health system at large. Stay tuned for more!
If we’ve already piqued your interest, you’re always welcome to contact us to get a conversation started. You can also browse the site to read more about our medical answering service. If you’re an existing PerfectServe customer and want to discuss our answering service solution in greater depth, click here.
We could try the approach from “Scrubs” and dump kittens on patients—but there are probably better ways to treat a patient with heart failure and sadness.
As we discuss implementing good bedside manner, let’s take a look at the history of its practice and implications for the 21st century, and how healthcare communication software can play a role.
History and Trends of Bedside Manner
One definition of bedside manner is “the way a health care professional handles a patient in a doctor-patient relationship.”2 Other medical dictionaries define it as “the attitude and conduct of a physician in the presence of a patient”3 or “behavior of a health care professional toward a patient, client, or resident of a facility.”4
Fast forward to 18th century Europe, and Thomas Percival influenced a codification of “Medical Ethics” and guidelines for best practices in medicine for pharmacists, surgeons, and prescriptive physicians.5 In the 19th century, medical leaders like Victor Vaughn and William Olser agreed there should be a standard focus on evidence-based medicine, and this approach placed emphasis on physiology over social and psychological disciplines.6
To deal with medical and ethical controversies in the US, the American Medical Association (AMA) was founded in 1847. The intention behind AMA’s founding was to build more accountability and define best medical practices. By the 20th century, a unified directory was created for licensed physicians. It included specific criteria with an emphasis on physical needs over emotional and psychological ones. In the 21st century, the AMA also displayed willingness to acknowledge past flawed practices when its leadership apologized for over a century of policies that excluded African Americans.7
Medical organizations in the 21st century need to take steps to address current healthcare disparities, which includes taking a more holistic approach to practicing medicine. Bedside manners today can include a hybrid of face-to-face, digital interactions among physicians, patients, and their families. With 97% of patients carrying mobile devices, this provides an opportunity across socio-economic barriers to leverage technology that improves health equity gaps.
Is Bedside Manner a Lost Art?
Watch this Conversation with Dr. Martínez on the topic of Bedside Manner
In a clinical landscape where resident burnout and primary care burnout8 are increasing, patient demands and organizational policies can sometimes shackle physicians and nurses. While speed to care is important, especially in more time-sensitive scenarios, we shouldn’t underestimate the importance of the minutes spent talking with patients to thoroughly understand their concerns—no matter how serious.
Holistic health techniques, which often place a strong emphasis on proper bedside manner, may not always align with predetermined financial incentives that necessitate efficiency above all else. Clinicians also have to spend about 50% of their time living in the EHR before and after patient visits. As physicians rigorously document their interactions according to insurance guidelines, the tedious and repetitive nature of this kind of administrative work can make them feel dissatisfied with their profession.9
With these constraints in mind, polite bedside manners might be replaced with a colder, more “strictly business” approach, similar to the protagonist physician’s character in the TV series, “House.” Do physicians get “bonus points” if they exhibit a more positive bedside manner?
For example, if “solve it in 10 minutes” becomes the standard of measurement for patient-provider interactions, practitioners will likely find it harder to provide authentic and attentive care. Despite their best intentions, this prescriptive approach can even lead to physicians becoming disillusioned and less in tune with their patient’s health. They may view patients as part of a more transactional process, using medical jargon that patients don’t understand.10
One psychologist coined the phrase “self-protective empathy lethargy” (or “SPEL”), which impacts caregivers when there is an imbalance between empathy and the extent to which they feel they have enough control to do something about a patient’s concerns.11 SPEL kicks in when providers are pushed to their limits. With SPEL, staff shortages, and changing patient expectations, what can healthcare practitioners and leaders focus on to bring about more positive patient outcomes?
Part of the answer? Kindness in bedside manner. Based on research and practicing psychiatrists, we know that kindness reduces other risks such as heart disease, diabetes, stroke, mental illness, infection, cancer, autoimmune disorders, premature death, and other comorbidities.12 When used effectively, we also know that physician-patient communication leads to better physiologic outcomes. A simple smile or sitting at eye level with a patient can go a long way, even if the visit is short.
Can Bedside Manner and Technology Coexist?
Technology and transactional encounters in healthcare may have created an unkind atmosphere. Time spent with patients may get reduced to meet financial goals. This focus inadvertently affects patient outcomes, especially when emotional connections are needed between a physician, practitioner, and patient. When triaging in an emergency, disaster, or epidemic, it places additional strain on a physician’s time with patients.
Is there a way to make technology benefit practitioners and their patients? With the right understanding, technology workflows can be applied in a way that clinicians get time back in their day while still achieving positive health outcomes.
Digital Bedside Manner
Can technology inform physicians about what they’re getting into ahead of time? Telehealth has moved bedside manner to the “webside,”15 making possible video consultations that reveal body language, tone of voice, and other visual and auditory cues. With virtual visits and mobile devices for taking notes, medical professionals can more easily remember what to discuss at their next appointment, reducing delays in care and diagnosis.
Patient engagement and secure text messaging tools also provide a conduit for genuine care and patient follow-ups. A few examples include patient surveys, wellness checks, and friendly reminders about in-person or virtual visits. If patients are aware of what to expect, it can reduce the stress typically associated with a clinic visit.
Checking in on patients post-surgery or after hours via video, in the comfort of their home, can also be a major net positive. It alleviates the need for patients to find transportation, schedule a babysitter, or worry about wound dehiscence. The video background for the practitioner can even be fashioned as a nice, warm home setting, establishing a friendlier environment for the patient.
Virtual Nursing
Jennifer Ball, a nurse and director of virtual care, advises that using technology at the bedside requires staff buy-in, along with flexibility and willingness to try new things.17 Many tasks that don’t require the nurse at the bedside can be completed by a virtual nurse, freeing up time for in-person nursing staff to focus on quality patient engagement. With this virtual assistance, patients can quickly receive information and assistance with the push of a button.18
When digital tools are deployed throughout your healthcare organization, it’s important for nurses and physicians to focus on creating authentic connections to ensure patients feel more comfortable,19 whether at home, in a community center, or at the hospital.
Virtual Avatars as Physicians?
One study found that virtual physicians can be as persuasive as their in-person counterparts, and patients readily accept their advice and care plan adherence—as long as their bedside manner is positive. Participants were presented with different physician appearances based on an “eeriness” factor. They also presented two characters to patients: one having a poor bedside manner (joking about their condition, trying to end the visit early, and other rude behaviors), and the other eliciting warmth and kindness in their bedside manner.
Whether eerie-looking (called the “uncanny valley” effect) or not, “a physician with good bedside manner prompted greater systemic processing in HSM, which increased adherence intention and exercise change.”20 HSM stands for the heuristic-systematic model, which determines how people process information and understand and evaluate its content,21 along with the trustworthiness of the source.
Emoji Use Paired with Bedside Manners
The expressions a clinician uses during an in-person visit could be supplemented by digital facial expressions—also known as emoji. 😊
Expressive emoji are a visual way to communicate quickly with children, non-English speaking patients, and those who are hard of hearing. 90% of emoji users agree that the icons make it easier to express themselves.22 Across 21 medical specialties, the “thumbs up” emoji is used the most, and internal medicine shows the highest use of all emoji among practitioners.23
Emoji usage among medical staff and patients might also be a way to improve kindness and empathy in a clinician’s digital bedside manner. These images tend to inject a bit of warmth and emotion into an otherwise cold medium (text on a screen), so any approach that humanizes communication and conveys that the person on the other side is reading, reacting, and chatting like a “normal” person can be tremendously helpful.
Not long ago, many medical school curriculums did not place a huge emphasis on teaching proper bedside manner. A few comments regarding this topic:
“When I was in med school, nope, we did not have any courses in bedside manner. My understanding is that some med schools now have ‘doctoring’ courses as part of their curriculum, which formally address the acculturation aspect of becoming a doc, presumably including how to behave and interact with patients and families.”24– Matt
“During your clinical rotations, you will see how many different doctors address patients. Honestly, I think it’s a myriad of factors that create good bedside manners and most are common sense. One, try to treat everyone with respect. Two, remember, ‘I’m not the sick/injured one in this dynamic.’ Doctors see people at their worst, frequently, and it is our job to make them feel better. 3) It’s ok to have a personality and be a doctor. It’s amazing how just a little small talk can ease a patient’s anxiety.”25 – Dave
“In nursing school, we are taught that, despite knowing the answer to everything, if your bedside manner isn’t the best, you aren’t doing it right.”26 – Jamie
Who is Teaching Bedside Manner Today?
Medical schools are now taking steps to emphasize bedside manner by interweaving teachings about its principles with clinical coursework. A few schools even teach telehealth medicine, such as how to use electronic stethoscopes and maintain eye contact with patients.24
Whether digital or in person, education programs now include lessons about empathy, communication skills, mannerisms, humor, and real-life mentorships.25 One program at Vanderbilt University School of Medicine focused on how the lighting in a room affects patients and emphasized knocking on the door and introducing oneself to the patient and family members with a handshake.26
The “Stanford 25” approach teaches medical students about the concept of “observing, examining, and connecting with patients.”28 They emphasize humility at the bedside, and propose four attributes: 1) unpretentious openness, 2) avoidance of arrogance, 3) honest self-disclosure, and 4) modulation of self-interest, along with acculturation and panel discussions with patients.29 Stanford Medicine is paving the way to establish a healthier bedside medicine culture for medical faculty members and institutions, and you can learn more in their “Creating a Bedside Medicine Culture” here.
The University of Colorado School of Medicine places a focus on learning patient bedside manner during the third year of medical studies. Students spend 10 months serving in outpatient settings related to their specialty.30 They experience a realistic picture of healthcare and are better equipped to deal with complicated people, conflicts, teamwork, and quality improvement.
Here is a list* of medical schools that emphasize bedside manner, or a variation of patient-centered care, as part of their curriculum:
University of Colorado School of Medicine
Vanderbilt University School of Medicine
Stanford Medicine
David Geffen School of Medicine (UCLA)
University of Rochester Medical Center
Herbert Wertheim College of Medicine (Florida International University)
Emory University School of Medicine
Feinberg School of Medicine (Northwestern University)
Penn State College of Medicine
Harvard Medical School
University of Minnesota School of Medicine
St. George’s University (Grenada, West Indies)
Yale School of Medicine
Weill Cornell Medicine
University of Arizona College of Medicine
George Washington University School of Medicine and Health Sciences
*Note: This list is not exhaustive. If you know a medical or nursing school that includes bedside manner in their curriculum, please email the name of the school to Matt Kothe and we’ll update the list. Thanks in advance for your contribution!
Final Thoughts on Bedside Manner
In the world of medicine, there are probably more uncertainties than there are stone-cold, unimpeachable truths. We know a lot, but we don’t know everything.
One thing that cannot be argued, however, is that showing kindness and empathy will lead to better patient experiences, better outcomes, and a more positive culture for medical professionals who too frequently feel like they’re checking boxes to meet financial goals rather than providing the best, most authentic care for their patients. Proper bedside manner isn’t the only requirement for being a good doctor, but it will always make a difference.
Want to Improve Your Physician and Patient Communication?
Read how PerfectServe has helped healthcare organizations across the U.S. accelerate speed to care with better provider scheduling, efficient care team collaboration, enhanced call routing, and secure patient text and video messaging solutions.
9 Importance Of Communication In Medicine: Views On Bedside Rounding And Readmissions, Yale Medicine Thesis Digital Library, Allen F. Shih: https://elischolar.library.yale.edu/ymtdl/3448
11 The Kindness Cure, New Harbinger Publications, Tara Cousineau, 2018: p. 10-11.
12 The Rabbit Effect: Live Longer, Happier, and Healthier with the Groundbreaking Science of Kindness, Atria Books, Kelli Harding, 2019: p. 193.
13 Importance Of Communication In Medicine: Views On Bedside Rounding And Readmissions, Yale Medicine Thesis Digital Library, Allen F. Shih: https://elischolar.library.yale.edu/ymtdl/3448
14 The Rabbit Effect: Live Longer, Happier, and Healthier with the Groundbreaking Science of Kindness, Atria Books, Kelli Harding, 2019: p. 193.
16, 16, 18 Virtual Nursing: What is it?, American Nurses Association Innovation, Jennifer Ball: https://www.nursingworld.org/practice-policy/innovation/blog/virtual-nursing-what-is-it/
20, 21 Creepy, but Persuasive: In a Virtual Consultation, Physician Bedside Manner, Rather than the Uncanny Valley, Predicts Adherence, Frontiers In Virtual Reality, Zhengyan Dai , Karl F. MacDorman: 10.3389/frvir.2021.739038
How to Improve Patient Experiences and Reduce Healthcare Costs
Communication gaps can lead to negative outcomes for patients. When healthcare organizations consider the patient journey as a whole, they can reduce healthcare costs for both their clinics and patients. Fast, effective, and reliable communication often leads to a more seamless and positive care experience for both clinical staff and their patients.
A Patient Experience Story
A 57-year-old single patient named Nancy sees a new physician with complaints of painful breathing. The doctor finds adult-onset asthma to be the cause of her symptoms, prescribes an inhaler, and refers her to a free-standing imaging center for a chest X-ray.
As the day moves to night, Nancy feels her condition is worsening. She continues to have trouble breathing, and an unproductive cough develops. She calls her physician’s office after hours, but the office voicemail provides no guidance other than recommending the hospital emergency department (ED). Nancy is frantic and calls her daughter, who suggests she call 911. An ambulance arrives and rushes her to the nearest ED.
Nancy is triaged in the overcrowded ED and is put in a hallway. Her ED care team has no access to her primary care physician’s notes or the free-standing imaging report. The doctor orders a repeat X-ray and gives her another nebulizer treatment. Imaging is backed up, but after a delay, Nancy has the scan and returns to the hallway. As they wait for the results, Nancy’s condition deteriorates, and she begins spitting up blood.
The ED nurse makes multiple requests for the imaging results, and while they are waiting, the ED care team is pulled away to handle other priority patients. Meanwhile, Nancy’s daughter has been calling the ED to find out her mother’s condition, wondering whether it’s necessary to come in or not. Does her daughter make the two-hour drive to the hospital?
When the report finally arrives, the care team is not notified and only sees the results when they next open Nancy’s chart. Finally, the care team reviews the imaging results that reveal diffuse pulmonary nodules. The ED physician flags the asthma diagnosis as suspect and admits the patient for observation and additional blood tests. Nancy is now stuck in the hallway, waiting for an open bed. She is concerned, confused, and not sure what to do next.
Communication Breakdowns Increase Costs and Negatively Impact Patients
Care coordination gaps and delays similar to those experienced by Nancy are common. But the risk is higher when clinics fax reports, use pagers, or don’t have reliable processes for out-of-network communications.1
In the above case, lengthy and unpredictable communication cycles made it difficult for the ED care team and patient to make timely decisions, impacting both quality of care and patient safety. They led Nancy to call 911, followed by a potentially preventable ambulance ride, ED visit, and inpatient admission that all placed more demands on scarce—and costly—resources. With little to go on, the hospital team ordered duplicate tests, exposing Nancy to unnecessary excess radiation and duplicate treatment. Through the many delays, her condition worsened. The entire process was an unfortunate experience for the patient and her family—they’re anxious, tired, and frustrated.
Equipping patients and care teams with the right information at the right time—whether it’s about their diagnosis, the logistics of their treatment, resources available to them, or something else entirely—can improve the care experience and outcomes by removing as much confusion and ambiguity as possible.
Providers across the board struggle with the communication gaps that hindered Nancy’s care in the above story. With better communication solutions, these gaps can be mitigated, and the problems that providers and patients face can be avoided. The chart below highlights some of the gaps providers, patients, and patient families commonly face and how better solutions can alleviate their impact:
The Right Tools Elevate The Patient Experience
PerfectServe’s clinical communication and patient engagement solutions are built to equip all members of the care team—including the patient and their family members or loved ones—with the right information at the right time to make the best care decisions. When you remove communication delays and other obstacles to allow for effective, efficient care delivery, you create a better experience for patients and providers alike.
With the introductory story mentioned above, how do you think the situation could be improved? Have you ever been in a similar situation? We always appreciate the chance to learn from firsthand experiences.
Schedule a demo to share your story and learn how PerfectServe might be the right fit for your organization’s needs.
1 Effects of Poor Communication in Healthcare. HIPAA Journal. https://www.hipaajournal.com/effects-of-poor-communication-in-healthcare/
How Team Based Care Works with Primary Care Patients
Does your medical communication involve your patient’s other healthcare experts to provide team-based care? For various reasons, patients often seek treatment from different healthcare specialists, and you may not be aware of all of them.
For example, if a patient had oral surgery and was prescribed a strong painkiller that made them feel sick, they would most likely go to their primary care physician for answers. Certain painkillers and medications may have side effects that impact one’s mental health and can leave a patient feeling depressed. If that were the case, they may want to talk to a psychiatrist.
This is why physician-led team-based care is an important strategy. It enables health care practitioners to create the most effective and efficient solutions for the patient. Let’s look at how team-based care approaches are used, while exploring ideas for your medical organization.
What is Team Based Care?
‘Team-based care’ is a method of connecting multiple healthcare providers in order to meet a patient’s needs by utilizing collaborative communication. Nurses and advanced practitioners lay the foundation for this value-based care by providing necessary communication between different practices and hospitals.
A patient’s primary care provider can communicate with their cardiologist if they’re experiencing chest pain and need to be admitted to the hospital, but it’s usually nurses who tend to be on the front line of this medical communication. They bridge the gap between specialists. Medical assistants often step in and fill this gap for physicians too, giving time back to doctors so they can focus on patient care needs while unloading some of their more administrative tasks.
Team Based Primary Care Approaches
The Old Care Model
Clinical patient treatment has traditionally followed a transactional, one-and-done, provide-a-diagnosis-and-get-reimbursed approach. With this model, physicians may be incentivized to have a particular service or procedure rendered within a narrow scope. They may not receive reimbursement for time spent coaching, listening to, and educating the patient through more intangible means. With this pressure, the physician may overlook other health issues the patient could be experiencing.
To be clear, patient health has always been a top priority in the medical field. However, the old model mostly makes room for “traditional” healthcare practices like meeting the patient, rendering a diagnosis, and giving treatment. In the new team-based care model, doctors focus on coming together to take a more holistic approach versus a single, isolated diagnosis and treatment for their patients. However, under this model, several challenging factors can arise, such as reluctance to communicate due to the inconvenience and potential time constraints among multiple providers.
“The five most common challenges that face healthcare teams relate to accountability, conflict management, decision-making, reflecting on progress, and coaching. These challenges were similar across both clinical and administrative team types.”1
Patients who don’t proactively share the full scope of treatment they’re receiving can cause challenges for clinicians and medical practice leaders. Patients may not share with their primary care doctor that they are also seeing a psychiatrist, neurologist, or other specialist. When each physician flies solo without collaborative communication, they’re not able to make the most informed care decisions based on the patient’s complete treatment regimen.
The New Team Based Care Model
The new team-based care approach requires a holistic change in workflow management that improves the value patients extract from the care they receive. With the patient’s permission, it can provide an environment where multiple practitioners and specialists share information, responsibilities, and delegate tasks. Having a medical assistant, nurse, physician, or specialist assess and gather patient information ahead of time and during patient intake can help improve a patient’s experience.2
Consider updated digital workflow tools to improve the patient experience. Gone are the days of passing around clipboards and sticky notes for room rotations and patient updates. As one example, sending follow-up messages, educational materials, and other information via modern technology systems that use text messaging can accelerate speed to care and improve patient engagement.
Physician Led Team Based Care: What Works?
When healthcare executives involve physicians, physician assistants, and nurse practitioners in the decision-making process, patient satisfaction increases. The main priority should be the patient’s satisfaction and comfort. How is this accomplished?
It’s only natural for some providers to feel like their own practice and field is “the best.” However, when it comes to the patient, their health and wellbeing are the main priority. If the opportunity presents itself, it’s vital for all providers involved in the patient’s care to communicate with one another, because one medication or method for diagnosis may affect another symptom the patient is experiencing.
In this skit, the specialists let the real issue escape them because they’re more concerned with who’s right.
Although team-based care provides patients with multiple professional opinions and solutions, it can still be confusing. When healthcare professionals from different fields come together to focus on one issue, there is a shared level of responsibility they must accept. Having this responsibility can sometimes lead to irrelevant disagreements, which takes attention away from their main focus—the patient’s needs.
What Performing Team-Based Care Providers Are Doing
Organizations like Health Advocate take a look at all factors that may affect their patients. Instead of focusing on the diagnosis alone, they take the time to show empathy. It’s not just about finding a quick and easy solution—it’s about asking questions that dive deeper into the patient’s issues which could include other factors like finances, mental health, and overall stress.
“Our Health Advocacy service serves as the integrator for all healthcare and benefits needs. Our Personal Health Advocates will direct people to other experts on our team or coordinate with your benefit vendors to create a seamless transition.”3
Solutions like HealthMap focus on bringing multiple providers together to help those with Chronic Kidney Disease. They may incorporate dieticians and skilled practitioners to align with the nephrologist. Since each patient is unique with comorbidities, their care must be customized to fit their specific needs.
“We partner with patients’ providers, such as primary care physicians, nephrologists, cardiologists, and endocrinologists, to support and manage the ‘whole’ patient in our Kidney Population Management program.”4
Other healthcare teams might take a few minutes each day to align medical staff around that day’s priorities and incoming patients. Here is one example of a medical group aligning priorities and communicating effectively:
Team-Based Care Strategies for Your Organization
Is it time to rethink your patient care model? If ensuring optimum collaboration across all specialists in a patient’s orbit isn’t on your radar, it should be.. A few benefits of rethinking and optimizing your patient care strategies:
An organized process leads to true valued-based care.
Having balanced, professional opinions benefits the patient.
Patient education initiatives get them more involved in their own care.
Regular, updated communication between provider and patient builds mutual trust.
Better processes and technology lead to decreased workloads for medical staff.
Read how other medical practices are teaming up to deliver exceptional patient care outcomes.[/vc_column_text]
The HDM KLASroom Series is a virtual eLearning series from Health Data Management and KLAS Research. The series aims to share insights that can advance the healthcare industry and educate healthcare leaders and their teams about the industry’s latest technological processes and trends. In the first HDM KLASroom episode, PerfectServe’s Kelly Conklin and Gabrielle Eagles—Chief Clinical Officer and Sr. Director of Marketing, respectively—spoke with Sue Armentrout, who serves as VP of Nursing Informatics and Evidence-Based Practice at Bon Secours Mercy Health, about best practices in software development and deployment that can help to improve the clinician experience. You can watch the episode below or keep reading to get an overview with main takeaways.
When it comes to best practices for software development and deployment in healthcare, improving the clinician experience should always be a central consideration. Whether you’re a manager, a member of the care team, or both, you know these practices matter long before implementation has occurred. This was true for Bon Secours Mercy Health, a large health system based in the Midwest with 50 hospitals worldwide under its umbrella. Bon Secours Mercy Health first implemented PerfectServe’s clinical communication platform in 2018, and the two organizations have been close partners ever since. In this episode, Armentrout spoke with the PerfectServe team about the support the company provides and shared some best practices about implementing and continuously improving communication tools. According to Sue, establishing effective workflows and positive practices at the start will set a system up to achieve successful outcomes. What are those best practices, then? Let’s take a look.
Pick the Right Vendor
A successful software deployment starts with the right software—and therefore, the right vendor. The right vendor solves or nearly eliminates the issues the organization is facing, which in turn decreases frustration across the care team. In the context of clinical communication, frustration is most often caused by inefficient software design, click fatigue, lack of interoperability, siloed deployments, and a lack of insights from end users, all of which contribute to a negative experience and burnout for clinicians. The right vendor should address these core issues by working to remove communication barriers based on the client’s guidance, but the vendor’s team should also offer novel solutions and new workflow suggestions to widen the lens of what powerful communication can accomplish. Bon Secours Mercy Health chose PerfectServe to remove communication barriers, consolidate its software footprint, and improve clinical communication and collaboration between providers.
“A good vendor will involve users in both the development and deployment process,” said Eagles. “They will be a true partner and work well with others. They will offer policy and governance best practices, and they will have an eye on the future so they can scale and continuously improve along with you.”
Create a Continuous Improvement Cycle
Creating a continuous cycle of improvement relies heavily on the first best practice mentioned above: picking the right vendor. The right vendor should be a partner who supports longevity, has experience in the field, and is willing to innovate to keep up with the pace of change. As technology changes, so does innovation. Health systems have to juggle new guidelines, changing patient expectations, evolving priorities, and many other variables, and a good technology partner will be there every step of the way. Armentrout noted that it’s important to work with a partner who has “eyes for growth,” meaning the partner will have experience working with customers and end users to identify pain points, is comfortable exchanging ideas, plays nice with other vendors, and has throughput initiatives. With these traits, your partner will always be willing to tackle new issues that arise, creating a cycle of continuous improvement and growth.
A continuous improvement cycle is also deeply reliant on identifying pain points through deliberate listening. Bon Secours Mercy Health experienced nurse and provider dissatisfaction with desktop-based communication workflows and is now working with PerfectServe to do away with a setup that, according to end users, can sometimes inhibit a clinician’s ability to provide patient care. In particular, nurses felt tied to their computer and laptop screens and expressed how this limited their ability to flexibly communicate and provide bedside care. After identifying this pain point, Bon Secours Mercy Health worked closely with PerfectServe to roll out a Care Mobility program that puts smartphones in the hands of nurses. This mobile-first approach gives nurses the full power of PerfectServe at their fingertips no matter where they’re located, and the rollout is the product of a system and partner working together to continuously solve problems and improve the clinician experience.
Armentrout said a good partner is one who is “willing to walk that innovation with us and continue to change as technology changes and as the organization changes.”
Know the Power of Consultative Deployments
PerfectServe has worked with clinicians, care teams, and healthcare systems for over two decades. During this time, we’ve learned what needs to be in the library of best practices for successful software implementations, and one of the most powerful tools from which a health system can benefit is a true consultative deployment. This was the case for Bon Secours Mercy Health, as consultative deployments allow for a firsthand and up-close look at pain points experienced by care team members. While implementing and deploying the Care Mobility program, providers, management, PerfectServe team members, and stakeholders participated in active bedside simulations. This allowed all parties to consult on what solutions were working, what issues or communication functions were causing delays, and where other features or functionality could be added or simplified. This collaborative effort makes deployment smoother and surfaces real-time issues that need to be addressed.
Bon Secours Mercy Health had a strategic plan built out for their Care Mobility program, and with a consultative deployment, PerfectServe was able to assign a team to the project to learn the ways of the system. Armentrout noted that pushback from both parties during a consultative deployment is also a part of best practices, as pushback strengthens the necessary program components and highlights what functionalities are most critical for success. These practices all work in tandem to facilitate a solution deployment that will ultimately make the experience better for clinicians, as pain points will already have been diagnosed, discussed, and rectified.
“[Bon Secours Mercy Health] has structured ourselves to be more of a shared service that is interested in standardizing across the ministry,” Armentrout said. “If we have to work with separate teams on every implementation, it’s reliving and then reinforcing, and we’re bound to get off track. Having that one team that is, oftentimes, coming to tell us, ‘this is where somebody else wants to get off track,’ then we can follow up with that. It’s been great working with a single team like PerfectServe.”
Decrease Variance in Software Use with Governance
Another best practice in successful software deployment is the use of governance and strategic policies. Armentrout and Conklin agreed that governance and other policies should be discussed regularly in work groups and oversight committees to advance initiatives. At Bon Secours Mercy Health, governance is an important part of establishing standards for different jobs within the health system. Having key stakeholders in the room where decisions are made drastically improves the flow and implementation cadence of software deployments, which ultimately moves the system toward the goal of better clinician experiences.
Governance is essential to addressing key issues and expectations during software development and deployment. The PerfectServe and Bon Secours Mercy Health teams were able to use governance strategies to address policies related to the Care Mobility program, including expected time frames for communication functionalities, compliance measures for communication response times, and more. Governance strategies should also take note of insight from the end user, who will help to drive innovation if they’re invited to participate in policy creation.
“What we find to be most successful in all of our implementations—and then supporting our customers afterward—is having a multidisciplinary approach,” said Conklin. “This happens when everybody who is going to be impacted has a seat at the table to make those decisions on what gets implemented, how it gets implemented, who is going to be mandated to use the platform, how those communications are going to flow, and how things are going to work, day-to-day, within the organization.”
Identify Opportunities to Consolidate the Tech Stack
Reducing the number of applications a provider needs to log in and out of is another way to improve the clinician experience. Many healthcare organizations have an overwhelming number of technology applications to manage, forcing members of the care team to use a variety of systems to communicate and otherwise do their jobs. A project team from the right vendor will put themselves into clinicians’ shoes to understand where communication is lacking and how inefficiencies related to siloed, ineffective technology are contributing to burnout.
During a software deployment, look for ways to reduce an organization’s tech stack by asking the following questions:
How can this system integrate with key solutions already in use?
How will this solution be used differently than existing solutions?
Does this solution reduce our portfolio of applications and resources?
What functionalities can be added, removed, or combined to reduce clinician frustration?
How will this leverage the communication process inside of the EHR? Does it leverage this primary platform?
These questions almost invariably lead to answers that can shape what to integrate with, or replace, to improve operational efficiencies and reduce burnout, increase collaboration, and improve communication.
“The ability to get the right alert or communication to the nurse or patient care tech helps us reduce some redundant systems in the background,” Armentrout said. “That will have a huge impact for many within our organization.”
Remember the Keys to Success
Remembering these best practices for your next technology deployment is essential to enhancing the clinician experience. Here are some key takeaways:
Partnership matters! Find the right partner for your system by choosing a flexible, innovative, and experienced vendor.
Establish clear policies and instill ongoing governance to enforce.
Prioritize—and be an active participant in—consultative deployments.
Work with your vendor to establish a cycle of continuous improvement.
Burnout is real! Bring provider needs and pain points to the forefront, and find ways to address these issues with your vendor partner.
Listen to end users—they drive innovation.
Having key stakeholders in the room when decisions are made is essential for policy and software decisions.
“When you’re selecting a vendor, look for someone who is in it for the long haul, has a keen eye on the future, involves end users, plays well with other vendors, and has a strategy to scale and for continual improvement,” said Eagles. “We know communication workflows can be really complex, and our goal as a vendor is to manage that complexity for you so that clinicians can focus on patient care.”
Want to learn more? Check out the 8-step process hospitals and health systems are using to upgrade their clinical communication strategy.
Medical Answering Services: After Hours Voicemail Menu Script
Do your patients tend to rush through phone prompts by selecting “urgent” for non-urgent matters, such as prescription refills?
When you plan what to say ahead of time for your medical answering service, you can easily route patients appropriately for any given situation—based on their needs and who’s on call that day.
What are After-Hours Medical Answering Services?
Also referred to as ‘after hours,’ medical answering services accept or handle patient calls outside of normal office hours, such as overnight or during the weekend. However, modern solutions can also be used during work hours when, for example, staff are busy and cannot come to the phone. With these solutions, establishing an accurate menu prompt that is easy to understand improves the patient experience for inbound patient and hospital calls, especially when your team isn’t immediately available.
Using HIPAA-compliant voicemail services versus general voicemail services is a best practice for healthcare organizations. In general, there are two kinds of medical answering services in the marketplace: live agents and voicemail greetings.
Live Agents
With this setup, an inbound call comes through to the medical office, and it’s routed to a call center with live agents. Typically, these agents are not medically trained to handle complex patient requests. On occasion, it’s possible that an agent without extensive medical training may not fully understand the patient’s needs, and a non-urgent call could get routed as an urgent call. They might even end up giving out the clinician’s personal contact information, even if they’re not on duty.
Another issue might be agents using an unprofessional tone. This creates a negative impression for the patient, perhaps leading them to rush to the Emergency Department or make other drastic choices. In some instances, the patient may even decide not to come back to your organization for future care needs.
Medically trained live agents are better equipped to handle inbound calls, but many of these answering services have variable costs that fluctuate based on number of calls and minutes logged. In this case, it’s also not guaranteed that agents will always be professional and empathetic. With medical staffing shortages nationwide, finding reputable live agents can be expensive with variable answering service levels and costs.
On a positive note, there are hybrid live agent options, where non-medically trained agents take simple notes, transcribe the data, and send the message via text to the medical office or doctor on call. With this setup, the trained medical professionals can decide next steps and whether to call back immediately or during regular office hours.
Voicemail Menu Routing
With medical answering services like PerfectServe, guided prompts and other built-in workflows are used in concert with physician schedules to route calls accurately. Prompts can be given to clearly explain next steps to the caller. For example: “If this an emergency, hang up and dial 911.” Other common call prompts might include: “Press one if this is an urgent, non-life threatening manner. Press two for prescription refills. Press three to leave a message for Dr. Cervantes’ office.”
When you build an effective communication process for your medical practice, it saves time for both the physician and the patient. An optimized patient answering service educates patients on next steps and provides peace of mind that their message reached the right destination. If routed correctly, critical alerts and updates can be sent to the patient’s primary care physician or medical office specialist.
After-Hours Voicemail Templates for Medical Offices
We put together two examples of menu scripts that might work for your medical practice.
Basic Call-Flow Automation
Here is one standard voicemail template.
Note: These options are customizable. Especially for “Press 3,” you can change it to say “prescription refill requests are not handled by our office. Please contact your pharmacy for routine prescription refills.”
Don’t have time to set this up yourself?
To have someone else build out a call flow for you, and to take full advantage of accurate routing based on physician schedules, book a discovery call with a PerfectServe specialist.
This is a text-style version you may use for your medical practice.
Step 1 – Thank you for calling [name of medical group office]. Our office hours are [time/day]. If this is a medical emergency, please hang up and dial 911. Otherwise, please stay on the line for further options.
Step 2 – If you are calling about a prescription refill, press one. If you would like [name of doctor/medical group office] to call you back regarding an urgent request, press two. For all other requests, press three.
Press 1 Selection: For prescription refills, please contact your pharmacy. If you have unique questions about your medication or it needs to be called in by [doctor/practitioner’s name], please leave your name, date of birth, and best callback number. Thank you.
Press 2 Selection: Please leave your full name, date of birth, and a callback number, along with a brief message of the issue you are experiencing. We will return your call as soon as possible. Thank you.
Press 3 Selection: If you are a physician or hospital, press one. Otherwise, please leave your name, number, and a brief message, and we will get back to you during regular office hours. Thank you.
Press 1 Sub Selection: Please leave your name, hospital name, reason for the call, and we will return your message as soon as possible. Thank you.
The good news is these templates may be customized and crafted to meet your unique practice needs.* So whether your specialty is nephrology, obstetrics and gynecology, pediatrics, hematology, surgery, psychiatry, orthopedics, or others, giving your patients and other physicians a map to follow reduces confusion and alleviates administrative burdens. Your office staff can then decide how to respond during and after hours.
*Note: With medical voicemail scripts or text messages, it’s important to stay HIPAA compliant and train your office staff with best practices. Implementing easy guidelines and policies for how you want to leave voicemails can help your practice avoid costly HIPAA violations.1
When a call comes in to your medical office, is the right provider alerted? What if it’s 9 PM on a Friday, and the patient needs to know whether or not they should go to the Emergency Department?
Planning ahead for these contingencies will save your medical office hours of time, and it ensures patient care is handled quickly and accurately.
Not a Traditional Medical Answering Service
With PerfectServe’s Dynamic Intelligent Routing®, you can set up call flows to accurately route to the best available practitioner on call. With a combination of voicemail and voice-to-text options, urgent patient requests don’t have to wait until Monday to hear from the on-call physician. PerfectServe syncs in real time with physician schedule changes so your patients and staff know who to contact and when.
Need a better voicemail option for your medical office? Book a discovery call to see how we can customize it for your needs.
At a recent virtual event hosted by the Office of the National Coordinator for Health Information Technology (ONC), PerfectServe CEO Guillaume Castel appeared as a featured panelist in a health equity-focused discussion titled, “Innovations in and Implementation of Equity by Design.”1The panel was organized to explore the different ways organizations around the country are working to change the status quo when it comes to health equity in the United States.
What is Health Equity?
Health equity is a broad topic, but the CDC offers the following explanation:
“Health equity is achieved when every person has the opportunity to ‘attain his or her full health potential’ and no one is ‘disadvantaged from achieving this potential because of social position or other socially determined circumstances.’ Health inequities are reflected in differences in length of life; quality of life; rates of disease, disability, and death; severity of disease; and access to treatment.”2
Technology companies like PerfectServe are perhaps not traditionally considered part of the “tip of the spear” when it comes to moving the needle on health inequalities. But in a world where care delivery and patient-to-provider interactions are increasingly facilitated by digital tools, and the makers of those tools count hundreds—even thousands—of healthcare organizations as customers, technology should be a central part of the discussion.
So, how does PerfectServe think about health equity, and what part do we play in advancing these efforts? Guillaume offered some useful insights during the panel discussion.
Learning from Stakeholders
When he spends time with PerfectServe’s customers, Guillaume says that they “tend to force me to focus on three things”:
Bringing joy back to caregivers: “It’s been hard for caregivers in the last few years, particularly since the beginning of the COVID crisis.”
Helping them strategize around how to retain caregivers: “The great resignation that is impacting all industries [has had a particularly] massive impact on the healthcare industry.”
Better patient engagement: “Helping them get smarter on engaging and connecting with patients more effectively, and helping them to do it the right way.”
Guillaume also highlights some of the troubling health inequalities PerfectServe has learned about through collaborative research efforts with partners:
“Over the last decade, infant mortality rates have been two to three times higher amongst the Black population in the United States.”
“In a study we did with one of our clients [located in] the Northeast, [we saw that] wait times [in the ER] are four times higher when English is not your first language.”
“[Healthcare] disparities and inequities cost our overall economy about $300 billion a year.”
“The average annual health expenditure is about $1,800 higher for food-insecure adults.”
This kind of feedback and insight is invaluable—it comes directly from people with firsthand experience about persistent challenges in the industry. It allows PerfectServe’s leadership team to design company strategy in a way that can alleviate some of these pain points and inequalities by equipping provider organizations with better technology.
“We’ve taken those things to heart,” says Guillaume. “We’ve spent a ton of time thinking about how we can build products that actually have an impact in these areas. And because we serve, primarily, the provider space, which are hospitals and physicians, […] it’s really forced us to think about ways to have an impact.”
Standardizing Patient Experience—Regardless of Location
Guillaume further notes that standards of care are not always uniform, even in multiple facilities within the same health system.
“We’ve noticed that care is being provided very differently, depending on where the hospital is located,” he says. “We’ve spent a significant amount of time wiring processes [guided by our technology] to ensure that care is uniform, that people can expect the same level of attention, whether they’re being admitted in New Jersey or California.”
At the root of this is facilitating effective care team communication and collaboration, which has been PerfectServe’s specialty for 25 years.
“We focus on building products that foster better coordination and engagement,” says Guillaume. “So, what does ‘coordination’ mean to us? It means that clinicians [in any setting] are going to communicate more naturally, that messages will get to the right person at the right time, that care is going to be more seamless, and that patients are going to have a better experience, regardless of who they are and where they’re coming from.”
Fostering Better Patient Access and Engagement
For many underserved populations in the United States, it’s simply not a common expectation that proper care will be readily available when it’s needed—the trust and positive experiences others can draw from are just not there. Guillaume sees two of PerfectServe’s solutions having an impact in this area.
“We’ve also [focused on] products that improve access for patients. What it means is that we’re going to build tools to optimize scheduling for clinicians so they know how to build their days most effectively,” says Guillaume. “And on the other side of the equation, that means we can optimize the patient scheduling aspect so that people can be seen more effectively. We know there’s a massive problem about believing in having access to the health system, and we know that underprivileged populations tend to be seen in the emergency room when they could probably adhere to a form of care that relies more on access to a primary care provider.”
Research has also suggested that more engaged patients tend to have better health outcomes. Along those lines, one of PerfectServe’s core products exists specifically to facilitate intuitive, multichannel, location-agnostic, and easy-to-access communications between provider and patient.[/vc_column_text]
“We’ve also built tools to engage with patients where they’re not in the hospital, or in the care of a clinician. Increasingly, care is moving outside of the hospital,” says Guillaume. “For health system administrators, it’s paramount to stay engaged with the patients, regardless of where they are. And so we’ve got engagement tools that check on patients when they’re home, or just not in the hospital.”
And although most adults in the U.S. have smartphones at this point, it’s still the case that not all patients can or want to engage with providers using an app or patient portal that requires a login. “When we think about building good products to help our clients actually connect with their patient populations, we take that into account and make sure that there are ways to communicate with patients who aren’t going to download an app,” says Guillaume.
He further notes that the care team frequently includes the patient’s family and friends: “They often play a very important role in making sure [the patient] comes back for a health visit and adheres to their medications.” For that reason, PerfectServe’s patient engagement solutions were designed from the start to support text message, video, and phone interactions that can loop in family, friends, and even other caregivers as needed.
Who Builds the Products?
Within the healthcare system, bias doesn’t just exist among providers—it can also exist among the people who build the products they use every day. Because PerfectServe is part of the latter population, Guillaume points out that diversity is key to understanding blind spots.
“We believe that diversity amongst our ranks—whether they are engineers coding the products or strategy people thinking about what to build—matters. A bias in the engineering ranks leads to bad products. And so, we spend time thinking about who should be on the team, why they should be on the team, what their perspectives are, and what biases they may have. And we believe that healthy disagreement is good for that. For instance, a tool for a male surgeon in New York may look very different than a tool that is thought through for a nurse in Arkansas. And yet, we have to build tools that all clinicians can use effectively. So, we’re being very deliberate about thinking through all those areas.”
Finding the Right Balance
As the healthcare industry evolves—sometimes rapidly, sometimes not so much—Guillaume is constantly thinking about the ways in which PerfectServe’s technology can make health systems better and communities stronger to help bridge the health equity gaps that still exist in the United States. There are many levers to pull as part of these efforts, but by building tools that make it easier for clinicians to coordinate care while improving patient access and engagement, Guillaume believes PerfectServe will continue to have a major role to play.
But clinicians are ultimately the bedrock of care delivery, so in any discussion about health equity, it’s important to find the right balance between patient needs and provider wellbeing.
“At PerfectServe, we think about patients a lot, but I must admit to you that our clinicians are exhausted,” says Guillaume. “And we have to maintain a balance, when we think about new products and new solutions, between what is best for patient populations and what is most productive, most conducive to effectiveness for our clinicians. They’re burned out, they’re underappreciated, and I think they need better tools to [do their jobs].”
Thankfully, achieving health equity is not a zero sum game. PerfectServe remains committed to finding new ways to make the care delivery process better, safer, more accessible, and more satisfying for patients and providers alike.
Medical Practice Management Ideas for Physician-Owned Clinics
“33% of Medical Group Management leaders plan to automate patient communications in some way due to staffing shortages.”1
If you’re a physician or practice manager, you’re likely tasked with medical staff schedules, bills, and patient responses.
With Hippocractic determination, you may have set out to provide value for patients and make a difference in your community. But how can you manage all these administrative duties while treating patient conditions?
Implementing effective medical practice software may improve your patient outcomes. With employee shortages and urgent requests affecting speed to care, we put together a list of ideas you can implement today. Let’s take a look at a few medical practice examples that others have found useful for improved workflows.
Medical Practice Management Examples
Larger Medical Group Medical Practices
Larger medical group management needs have a few differences compared to smaller, physician-owned clinics. They typically include multiple specialists, a large clinical staff, medical partnerships, and offices scattered throughout a city, county, or region.
For example, Mid-Atlantic Nephrology Associates (MANA) had eight office locations which served twelve hospitals in their metropolitan city. With multiple locations, managing on-call physician schedules and patient requests were a challenge. Inefficient communication resulted in providers being contacted at the wrong time. Shared logins and passwords became inaccessible due to security lockouts, and practitioners were unable to share secure images and messages to accurately treat patients.
The needs varied from communicating the latest power outage to who was on which dialysis unit, where, and when. The practice managers did not have full control over the schedules, and there was no way of knowing when a schedule was updated. They were unable to match who was on call when and at which location.
After getting everyone on a unified communication system, the nephrologists were able to see lab results right away. Group texts were sent to the whole care team and medical staff, so they knew what to expect in case of early closures or emergencies. To improve patient response times, all practice managers received a backup notification when a provider didn’t respond within 48 hours. In this way, patient messages were never missed.
By putting these medical practice communication systems in place, the providers didn’t have to worry about their schedules being disrupted while off the clock. The organization was able to get everyone on the same page. The practice managers had full control over the schedules again, allowing them to update on the fly while syncing to each location and provider.
Physician-Owned Clinics and Specialties
Building reliable systems for a small practice now can help you when it’s time to scale. Aside from medical billing and medical supply inventory, an optimized communication flow between providers and patients forms the backbone for a physician-owned clinic’s success.
Smaller medical practices often use medical answering services to inform patients and other specialties of holiday hours, weekly office times, and who to contact for which request. Much like the large group practice example, yet with fewer locations and reduced staff size.
For example, one medical clinic needed to let patients know their Monday through Friday hours, lunch break from 12-1 PM, and who was on call for the weekend. They needed a way to check messages and follow up without the doctor being paged for non-urgent matters. For inpatient and outpatient critical lab results, physicians needed to access that information quickly and get notified about it.
After implementing custom voicemail prompts for inpatient and outpatient labs, office hours, and urgent versus non-urgent requests, patient callbacks improved. Timely messages were routed to the right on-call specialist. The office manager was able to login to the system each day through a secure app or web browser to verify and track messages. Any edits to the schedule went into effect immediately with their specific medical communication software.
Medical Practice Management Ideas
Effective and updated communication is instrumental for operating a medical clinic or group practice. You can have one provider and two part-time staff all the way up to and beyond 100+ physicians, nurses, medical assistants, and locations. Large or small, you may share these medical practice communication strategies with your medical team and administrative decision-makers, and see if it leads to positive outcomes.
Fundamental Medical Practice Management Thoughts
Consider who your frequent patients are versus one-time patients. What does the patient journey look like? Are there ways to enhance your process and decrease human error, such as billing needs, messages, and phone calls?
From before check-in all the way to post-acute follow ups and pharmacy prescriptions, reminding patients, and communicating with them along the way alleviates confusion. Establish a clinical workflow plan for responding to patients, inquiries from other specialities, and care team members. Let’s take a look at a few ideas for implementing these practice management strategies.
Custom Medical Answering Service Software for Medical Practices
Use a custom voicemail message related to your type of medical specialty. Setting up automated calls and notifications can reduce nurse and physician administrative burdens, allowing them to effectively receive updates, read patient charts, and respond appropriately.
A few medical specialty examples:
An obstetrics and gynecology clinic may need to include call flow questions related to the number of weeks pregnant, patient’s doctor, and a reason for the call.
A nephrology clinic may need to ask about BUN, creatinine, and potassium levels before routing the call to the right provider. This allows time for the physician or nurse practitioner to pull up the patient’s chart or other remote patient monitoring stats.
A surgery center may need to route a call based on the patient’s surgeon, patient location, and reason for the call, such as post-acute treatment instructions. They may need to provide message prompts for an attending anesthesiologist schedule.
Providing patients and additional providers with clearly defined instructions ensures the message gets to the right person. Taking time to set up communication flows correctly can save medical practices hours of time later.
Applying Telehealth Solutions in Medical Practice Management
Does using a video telehealth visit mean I offer free medical advice? Not if you’re helping patients. Traditionally, clinics could only bill for in-person visits. The COVID-19 pandemic thrust virtual services into the forefront, changing how the Medicare Physician Fee Schedule works via telehealth.2 For billable hours and unique codes, check the most recent CMS policies regarding virtual services.
“Telehealth services can be provided to new and established patients via smartphone if the smartphone allows for audio-video interaction between the physician and patient.”3
With secure telehealth messaging, family medicine practitioners and other medical specialties can utilize video appointments for patient follow-ups. Video technologies may be used by the whole care team, and a primary care doctor and surgeon could hop on a simple video call to discuss their patient’s next steps. For a clinical psychologist or behavioral health center, this could be an effective way to form alignment between a therapist and physician.
Secure Medical Text Reminders
How do you handle patient no-shows? What if patients are ignoring your phone calls and not logging into their portal? Perhaps patients frequently call the office for non-urgent matters or office hour information—all of which could easily be automated. 91.1% of patients surveyed in one study mentioned secure medical text updates helped them avoid calling the office.
What kinds of texts are best to send?
For medical practice management, here are a few suggestions:
Appointment reminders including day and time of appointment.
Virtual check-in reminders before arriving at the medical office.
Quick ad hoc video visits as part of a patient follow-up session.
Reminder to login through the organization’s portal for the detailed physician notes or AVS (After Visit Summary).
Prescription refill reminders.
Group texts to medical staff for updated closures or emergencies.
Using a patient text solution, Ridgeview Rehab Specialties was able to reduce its no-show rate by 12.6%, generating an average of $175 per visit.4 This is one example of how streamlining medical practice communication can improve patient care outcomes and reduce hefty administrative costs.
Need more ideas? Take a few minutes to read through these customer success stories. It might be the next step in your journey to effective medical practice management.
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.
How Remote Patient Engagement Solutions Reduce Readmissions
“Clinicians often perceive these initiatives as additive work that doesn’t seem to provide immediately obvious benefits to patient care. Executives tend to emphasize how important patient flow is to the organization’s efficiency and finances. But that doesn’t address clinician concerns, and they struggle to fully invest in these initiatives.” -Nursing Executive, Advisory Board1
Digital Patient Engagement: How to Address Challenges in Adoption
Misalignment and miscommunication of strategies lead to challenges among healthcare professionals and their team culture. A reluctance to adopt new technologies may have consequences, such as reduced patient response times, physicians being alerted or notified when they’re not on call, or non-urgent messages being delivered in the middle of the night when they should be held until normal business hours. If used well, however, these remote patient engagement tools can drive a variety of positive patient outcomes.
Medical directors, managers, and hospital leaders may grapple with physician resistance to digital patient engagement platforms. Their hesitancy might include the following questions:
How can medical practitioners engage and connect with patients outside of brick-and-mortar facilities?
Will remote patient engagement solutions actually improve value-based care outcomes and reduce patient readmission rates, or is this another technology fad?
Can virtual visits and updated monitoring systems be turned into billable hours?
A plethora of new virtual patient technologies are being introduced in the marketplace. Hospital and clinical healthcare administrators are looking for ways to reduce patient readmissions and eliminate wasted costs. Yet, providers may see these new technologies as an added burden to their daily, in-person patient engagement workflows. Swamped with increasing demands and pay-to-perform incentives, patients may get lost in the shuffle, especially those who require chronic care management or specialty visits.
Both patients and providers may have a lack of awareness when it comes to ehealth engagement technology.2 Let’s look at a brief history and understanding of patient engagement, and how you can walk away knowing what strategies you should consider implementing for your medical organization.
What is Remote Patient Engagement in Healthcare?
Remote Patient Engagement Defined
Remote Patient Monitoring (RPM) is a broadly defined term which includes a range of digital tools that track a patient’s health. The information is sent back to healthcare professionals or caregivers to determine effective treatments. A few tech examples include heart monitoring devices, glucose meters, surveillance monitors, and digital reporting logs.3
Remote patient engagement is the use of these tools and devices to communicate and follow up with patients in a secure, timely manner. These medical bands and devices are commonly used by physicians and practitioners to monitor chronic conditions and post-surgery assessments. Dieticians, therapists, and wellness coaches use these tools for preventive, proactive, and rehabilitative health plans.
Patient Engagement Before 2020
About 60 years ago, some of the first remote telemedicine technologies were developed by NASA to track the health of astronauts.4 As telehealth technology expanded, private companies and the government invested money and research into different healthcare delivery methods. Enter the Health Insurance Portability and Accountability Act (HIPAA) in 1996 and the Affordable Care Act (ACT) in 2010, which allowed more coverage for patients with chronic conditions. This opened the door for accessible and reimbursable patient visits that utilize remote patient monitoring and telehealth technology.
Patient Engagement After 2020
The consumerization of healthcare has accelerated, but the trend was in motion well before the COVID-19 pandemic. This fueled demand for healthcare organizations and providers to communicate more frequently with their patients and families. Sharing healthcare information digitally can accelerate speed to care, and 77% of patients are willing to do so if it positively impacts their care.5
In a recent interview, PerfectServe Chief Medical Officer Dr. Rodrigo Martínez shared that patient engagement technology adoption is a main need for healthcare organizations to stay relevant over the next decade:
Patient Engagement Digital Platforms
The types of digital platforms that facilitate patient engagement vary widely. Some offer niche-specific chronic care and treatment, like Health Recovery Solutions, which tracks biometric activity, such as blood pressure and oxygen levels. Amazon has even joined the game with their Halo Band, which measures movement and sleep tracking. According to one study, 69% of respondents use smartwatches for chronic care management.6
List of Common Patient Engagement Devices
Like Gene Roddenberry’s tricorder in Star Trek, new medical devices are developed every year. One company invented DxtER™, a device designed “to prove the concept that illnesses can be diagnosed and monitored in the comfort of one’s own home by consumers without any medical training.”7 It was created to diagnose up to 34 different health conditions. While it’s not fully launched in the consumer marketplace, healthcare organizations and trained practitioners do use similar medical patient engagement devices.
Medical devices typically go hand-in-hand with a digital monitoring system for patient care, and for physician and nurse communication. Common devices used for patient engagement may include:
Knowing these tools are available is one thing. Applying them in a way that enables patients to communicate with a physician or nurse is another. So how can a healthcare organization use patient engagement strategies to their full advantage?
Patient Engagement Strategies: Reach Patients Before They Get Readmitted
According to CMS, the Hospital Readmissions Reduction Program (HRRP) “encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.”8 With 6 in 10 adults in the U.S. having been diagnosed with a chronic disease, patient engagement tools and workflows will remain a priority for healthcare organizations.9 An awareness of these needs, combined with actionable foresight, may reduce these readmission events.
Do You Have a Patient Engagement Strategy?
Create a plan to measure your patient outcomes, not just quick, transactional clinic visits. Identify which remote patient engagement solution is best for your providers—something that is easy to train and implement. Being proactive versus reactive with these tools could boost physician, nurse, and patient morale.
What are the common goals your healthcare organization wants to achieve? Knowing this information can act as a filter for your patient engagement strategy plans.
Patient Engagement Example for a Chronic-Condition Specialty Practice
If you are a specialty practice, build common message templates related to your patient’s frequent needs, which, when delivered to the patient, allow them to respond and transition to a remote video visit initiated by the right on-call provider. Here is one example for a 65-year-old patient with a recent kidney disease diagnosis and low GFR:
Physician’s Office:“Thank you for calling Green Valley Nephrology Clinic. Our hours are 9 AM through 5 PM Monday through Friday. If this is an emergency, please hang up and dial 911. Otherwise, press one to leave a message, press two to schedule an appointment, etc.”
Patient: (Presses one) “Hi Doc. This is George. I’m calling about my test results and the blood draw you did for my kidneys. I can’t remember my login to look at it, and I’m not good with computers. Do I need to go to the hospital? I’m peeing more than normal and I have some swelling in my legs and feet. Let me know.”
Physician’s Office: (Call routes to the on-call physician. Message alert pings Dr. Shaeffer, the on-call nephrologist. He decides to send a text message back through a secure, front-office number that masks his personal cell phone).
Dr. Schaeffer: (Via text message) “Hi George. I received your message. Do you have a few minutes to hop on a video call? I will send you a link.”
Patient: “Yes, sure. Send me the link.”
Dr. Schaeffer: (Physician sends secure link.) “Here you go. [hyperlink]”
Patient:“Oh, there you are—got it. I see you now. Thanks for sending me the link. Wow, technology these days! So, do I need to go to the hospital?”
(Video conversation continues with patient and on-call specialist).
Scenarios like the conversion above may occur for any established, chronic-care patient and their physician. Let’s look at a few tips you could implement for your healthcare organization, so more patients like George can receive better care.
4 Ideas to Increase Patient Engagement
Send frequent—but not too frequent—text reminders that are beneficial for the patient. Some examples include appointment reminders, critical lab results, treatment reminders, and clinic feedback questions. Let them know you care by using automated touch-points which save time for both medical practitioners and the patient in day-to-day interactions.
When assessing chronic conditions, see if there is a way the patient can message you securely or log in to their health record to view the same data.
Communicate a plan for the office staff and medical practitioners so they know what messages and protocols have been set up. This includes things like lab results, inbound voicemails, and which messages are critical versus non-critical for patient healthcare outcomes.
Coordinate schedules so all patients know at least one on-call practitioner can answer their questions. Updates to these schedules can be automated from the provider or administrative staff through a simple app, without chasing down a Google calendar or paper spreadsheet at the office.
For more ideas on how medical groups are using patient engagement strategies, see a demo of PerfectServe’s solutions for your medical practice or hospital.
2Safi, S. Thiessen, T. Schmailzl, K. (2018). Acceptance and Resistance of New Digital Technologies in Medicine: Qualitative Study. JMIR Publications, 7(12). https://doi.org/10.2196/11072
