Comprehensive Clinical Communication to Support Mother-Baby Care Delivery
Nearly four million babies are born per year in the United States.1 Obstetricians, pediatricians, nurses, case managers, discharge coordinators, and various other providers and care teams work to ensure that mothers and babies have optimal solutions for pregnancy, labor, delivery, and child healthcare.
From preconception to parenthood, PerfectServe’s comprehensive communication solutions can help your practice provide top-notch care at every touchpoint of mother and baby’s healthcare journey. Click the image below to download the infographic.
1Births and Natality, Centers for Disease Control and Prevention: cdc.gov/nchs/fastats/births.htm
To learn more about how PerfectServe can support your organization in mother-baby care delivery, contact one of our Clinical Communication Specialists.
Patient Benefits of an Advanced Automated Answering Service Solution
Patient experience is the most important factor when it comes to patient retention at any medical practice. An essential touchpoint to optimize in modern medical practices is to standardize the way your patient calls are handled. The right 24/7 answering service solution can free up valuable provider and staff resources to focus on patient care while reducing unnecessary interruptions and ensuring urgent messages reach the right provider at the right time—every time.
Removing human error and delivering an automated and reliable service for both providers and patients, advanced answering service solutions are being implemented by more and more practices to enhance both patient and provider satisfaction.
Here are just a few key patient benefits of an ideal automated answering service solution:
Your patients have busy lives but your practice is busy, too. If your practice experiences call volume congestion, your patients still need to be able to reach you without being put on hold. The right answering service solution will differentiate messages based on urgency and use your on-call schedules to accurately route communication to the right provider based on escalation policies set by your practice, speeding time to treatment.
Efficient practice operations help decrease the time patients spend waiting during appointments and on hold when they call your practice. Automation allows patients to reach your practice at any time, during any circumstances to get the answers and help they need. The best answering service solutions offer smart routing that ensures providers are only interrupted to address urgent requests that require responses in a timely manner.
24/7 Care Access
Although many answering services are only used for after-hours coverage, an automated answering service solution delivers around-the-clock coverage as needed. Just because you don’t see your patients on a 24-hour basis does not mean it shouldn’t be easy for them to manage their appointments and make routine requests such as medication refills whenever they think of them, which might not be during regular office hours. An automated answering service solution can support call volume overflow when the main line at your practice is busy and serve as a 24/7 backup during emergency events when your practice is closed.
Better Onsite Service
Your staff need to be able to do their jobs, but when they face constant interruptions and take on the additional task of call filtering, concentration is broken, efficiency is lost, and providers can become unable to best care for their patients. Implementing the right automated answering service solution can free up your team to focus more on what they do best—patient care.
If providing an excellent patient experience and running an efficient medical practice are priorities for you, an advanced automated answering service solution might be just what the doctor ordered.
Let’s discuss more about how the ideal automated answering service solution can benefit your patients.
4 Simple Steps for Reducing Third-Party Vendor Costs
In the era of nonstop mergers and acquisitions, healthcare organizations are taking on immeasurable costs in the form of third-party services. When a health system acquires a private or independent group practice, the health system inherits all the practice’s employed third-party services and systems, including:
Electronic Health Record (EHR)
Revenue Cycle Management
Medical Answering Service
Security, Maintenance, and More
When healthcare organizations merge, issues with purchased services compound as the health system takes on all existing service contracts from the practices affiliated with the previous organizations. Purchased services represent as much as 20% to 25% of an organization’s annual spend,1 so consolidating services is a valuable opportunity to save on spending.
Standardizing third-party processes and technology can be an untapped source of savings across the healthcare supply chain. To help you identify areas in need of improvement, here are four steps that can help successfully lower your organization’s purchased services costs:
Step One: Mine the data.
For many healthcare organizations, simply gaining visibility into third-party contracts and expenses can be challenging. Contracts are often managed by various people throughout healthcare organizations, or even services outside organizations, such as group purchasing organizations (GPOs).
Start gathering the actualities by creating an inventory of all third-party vendors used throughout your organization, as well as the associated stakeholders and contracts. It’s important to speak with each stakeholder and review each contract thoroughly.
Next, collect all financial data for your vendors. Check with your accounts payable department and take a look at current and past purchase orders. While purchase orders won’t tell the whole story, they are a good place to start to get an idea of total cost. Many third-party vendors have variable costs that make it difficult to get an accurate account of how much they’re really costing. Reviewing your general ledger will help you uncover variable costs.
There are a few key questions to consider when reviewing your service contracts:
What rate is this vendor currently charging me and how often?
Is there an auto-renewal in place? If so, when?
What are the scaling terms and are there fees associated with scaling?
Are there termination clauses? If so, what are they?
Place vendors into categories to get a more accurate picture of how much your organization is spending in specific areas. You may find that the individual costs of many of your third-party vendors are relatively small, but when aggregated by category, the numbers compound quickly.
Step Two: Gain Executive Buy-In
Equipped with your data, it’s time to engage your decision makers. Engaging organizational leadership early in the process is a great way to build a case to move forward. Speaking with executives can help you understand the different viewpoints and situational nuances in your organization, which helps you navigate roadblocks and build the business case to make changes.
Step Three: Evaluate Performance
Analyze vendor and service performance in three key areas:
Evaluating the Quality and Effectiveness
Some vendors charge hidden or variable fees, so looking at one month’s service charges can be misleading. Look at each vendor’s historical cost, trends, and variability. Then, consider local benchmarks: What prices are other vendors in your area offering for a similar service?
Another important aspect to consider is utilization. Here are a few simple questions that can help you assess your organization’s use of a particular service or vendor:
Who is actively using the service/vendor?
How is the service/vendor being used?
Could the service/vendor be used more efficiently?
Finally, do some digging to find out your staff’s level of satisfaction with the third-party service/vendor:
What level of results is the service or provider currently delivering?
Are your stakeholders satisfied with the performance?
What kinds of performance metrics can the service or vendor provide?
Does the service or vendor meet your organization’s performance metric needs?
Does the service or vendor make your staff’s job easier?
Step Four: Consider Standardization Options
Completing steps one through three will give you a firm grasp on the types of vendors you have and the services you’re paying for, how they’re being used throughout your organization, and your staff’s readiness to try new solutions.
If you consider replacing multiple similar vendors with a single standardized solution, make sure the solution you select does the following:
Addresses all stakeholder needs and goals.
Decreases (and if possible, helps to standardize) your organization’s overall spend.
Contributes to your organization’s strategic objectives.
When your organization undergoes a merger or acquisition, it’s more important than ever to conduct a high-level review of the spending and operating efficiency of the larger organization. At the end of your evaluation, you should be better prepared to make specific service and vendor selections based on your analysis and your organization’s strategic priorities.
5 Warning Signs Your Answering Service Might Be Hurting Your Practice
Medical answering services are essential to modern practices for triaging patient calls, delivering urgent messages at night, and allowing receptionists to focus on imperative tasks during business hours. An effective answering service solution can help practice managers, providers, and staff improve the overall patient experience and increase patient satisfaction.
Unfortunately, some medical answering services are susceptible to manual errors and environmental challenges. Routing mistakes and connectivity issues can negatively impact both patient and provider satisfaction.
Here are five warning signs your medical answering service might be negatively impacting your practice:
1. Poor Provider Satisfaction
Your providers’ wellbeing is essential to their satisfaction, livelihood, and ability to best care for patients—yet provider burnout is on the rise. Key contributors to burnout include receiving non-urgent calls after hours, getting unnecessary interruptions while caring for patients, and dealing with other communication challenges that interfere with providers’ daily workflows.
Contacting providers at the wrong time is a common mistake. When the answering service makes an error and contacts your provider at midnight on their Saturday off or interrupts their time with a patient for a non-urgent or routine message, it brings down the provider’s satisfaction and makes it more difficult for your practice to retain top talent.
Providers who are unable to work at their best due to unnecessary interruptions and complicated communication workflows may experience burnout and decide to leave your practice. Losing providers reduces patient satisfaction, lowers revenue, and increases your recruitment and onboarding costs.
2. Declining Patient Experience
It’s important to let patients know they are being heard and cared for, not ignored, yet missed and lost messages are another common issue with medical answering services.
If your answering service loses patient messages, fails to take thorough notes during a call, delays sending urgent messages, or sends messages to the wrong provider, your patients will begin to feel frustrated and undervalued.
3. Negative Impacts on Your Practice’s Reputation
To your patients, your answering service is a representative of your medical practice. Errors and poor patient encounters with live answering service can be harmful, and even detrimental, to your practice’s reputation in providing quality patient care.
It is imperative to ensure that your answering service—which many patients do not know is a third-party service—is delivering the quality of care and experience you want your patients to expect from you. Keeping your patients satisfied and confident in their care is the key to patient retention.
4. Fluctuation of Practice Operating Costs
Your medical answering service may be costing you much more than you originally intended. Many answering services have hidden fees and charges based on call volume and duration, causing practices to spend much more on the service than was budgeted. For a more accurate account of how much your medical answering service is really costing you, look at your month-over-month charges and take note of the fluctuations. Hidden fees can add up quickly when practices don’t pay close attention and consistently follow up on billing.
5. Inability to Support Patients During Emergencies
Healthcare can’t stop when inclement weather, natural disasters, or other emergencies happen. Keeping lines of communication open between your providers and your patients is essential, especially during times of uncertainty. Your medical answering service must be available and connected to take patient calls and route messages correctly and quickly at all times.
If your medical answering service depends on live operators, a natural disaster or similar emergency could make it impossible for agents to receive or answer your patients’ calls. You can learn more about identifying risk to prepare for unprecedented circumstances from our related blog post and our Medical Practice Disaster & Emergency Preparedness Checklist.
Not all medical answering services provide the same level of service and support.
Use the factors above to assess your current medical answering service vendor and decide if it’s time to look for another solution that can better protect your medical practice.
Consider how an automated medical answering service solution can help strengthen your practice.
The right answering service solution will provide a consistent patient experience, reliable connectivity, accurate message routing, and appropriate escalation while supporting work-life balance for your providers and eliminating variable costs.
Let’s discuss how your practice can benefit from the right answering service solution.
Sometimes, traditional medical answering services come with hidden costs that could be undercutting the success of your practice. Costs associated with human error—such as lost and delayed messages, negative patient interactions, inaccurate symptom descriptions, and more—carry significant risk for your patients and your practice.
Mistakes that were once par for the course with answering services have become largely avoidable in a modern healthcare environment. Since quality communication between patients and providers (before, during, and after business hours) is a fundamental pillar of patient care, it would be wise for any organization using a live medical answering service to ask yourself the following questions:
Are your patients being served a positive experience with your practice?
Any negative encounters with your practice (including over the phone) can begin to erode the trust and positive relationships you have built with your patients. Many patients perceive the answering service as an extension of your practice—not a separate, third-party service. That makes live call agents a contributing factor to your overall patient experience, a factor you have limited control over.
If a patient feels at any time as though their medical needs are not met with the level of urgency they feel is necessary, their trust in your practice quickly dissolves into frustration, fear, and motivation to seek care elsewhere. Whether or not a patient leaving costs you any recurring revenue, word of mouth can impact your organization’s reputation for care quality and, therefore, your ability to bring in new patients.
Is your staff empowered to use their time as efficiently as possible?
It’s tough to assign a dollar amount to the frustration of having to resolve a breakdown in patient care caused by miscommunication. It’s impossible to quantify the impact of anxiety your staff can develop when they feel unable to deliver the best patient care due to issues with the clinical communication process. But if your communication process isn’t optimized to help providers focus on delivering proper patient care, you may wind up calculating costs in terms of turnover and other negative effects of low provider satisfaction and burnout.
Are you legally or financially at risk?
Some unlucky practices have discovered a best-kept secret of certain deceptive answering services: subcontracting. In some cases, live “medical” answering services turn out to be subcontracting their work out to other answering services that don’t always have a medical focus or adhere to HIPAA compliance standards.
Few medical practice leaders would knowingly risk placing subpar answering services between their patients and their providers or practice. In fact, a practice in this situation is at risk for fines and penalties associated with breaches involving PHI and unsecure communications.
Another scenario in which a practice using a live answering service may be at risk includes one where the answering service is referencing an outdated provider shift schedule.
Consider this worst-case scenario — A patient, unknowingly suffering from a stroke, calls your practice after hours to report blurred vision and confusion. The medical answering service, operating off of an inaccurate on-call schedule, fails to deliver the patient’s message to the correct on-call provider for another hour. Due to the time-sensitivity of this ailment, your practice could be at risk for a malpractice suit.
An unforeseeable and adverse incident like the one above could become a substantial loss for your practice.
Are you safeguarding your reputation?
Imagine another unfortunate scenario — A critical care surgeon with his own practice routinely performed emergent consults for a local hospital. But then, the hospital stopped calling. They felt the surgeon’s medical answering service was unable to deliver messages in a timely, efficient manner. The hospital now works with other providers instead.
Don’t let the above scenario happen to you. Your credibility and reputation in the healthcare community can be negatively affected if outside consultants and hospitals cannot reach you quickly in times of emergency. The impact of an unreliable reputation can be detrimental to your providers and your practice. It may seem easier to stick to the status quo with a live answering service, but is it worth letting avoidable lapses in communication tarnish your reputation?
Have you uncovered all hidden fees?
Most medical answering services are upfront about their fees, but practice leaders and managers seldom realize how many fee-based events they’re actually being charged for on each single after-hours call or message. Varying types of hidden fee-incurring events include:
Taking the call or message.
Relaying that message to the right clinician.
Relaying the clinician’s instructions back to the patient.
Recording and logging the conversation as a whole.
Recording and logging each communication.
These events can incur minute fees that can account for an unexpectedly substantial amount of overtime.
What is the real cost of your answering service?
Take a skeptical look at your answering service’s monthly invoice to understand the hard costs. Think through how your current answering service effects patient safety and satisfaction, as well as your providers’ satisfaction. Is your answering service a compliance risk? Can it harm your professional reputation? At the end of the day, these are the costs that put your practice, providers, and patients at risk.
What is the best solution to eliminate the costs and risks of your answering service?
In the age of digital communication, automated tools are commonly used to eliminate human error, simplify communication processes, and streamline accurate connections. These advantages are perhaps most valuable in a clinical environment. An ideal medical answering service solution can sync with the most up-to-date shift schedules, protect providers’ caller IDs, escalate urgent messages, and save non-urgent messages for regular business hours.
Let’s discuss how your practice can benefit from the right answering service solution.
MACRA legislation passed in April 2015. When the initial version of the rule came down, the industry collectively braced for declining revenues, the avalanche of administrative paperwork and the increase in overhead costs that would be required to comply.
When the final rule was issued in October 2016, the tempered requirements seemed to point toward fewer projected negative payment adjustments in 2019, the target year for MACRA’s first Quality Payment Program distributions, and the tension subsided a little.
Even with the new allowances in reporting and threshold scores, the MACRA structure makes clear that there’s an abundance of work to be done, especially around efforts to promote care coordination and communication.
Year 1: 2017-2018
Now that we’re already into 2017, the first official reporting year, tensions are rising again because, even though most physicians acknowledge they are going to participate, the majority have not yet plotted their course or defined a compliance strategy.
And if you’re in the group that hasn’t figured it all out yet, the good news is you’re not alone.
According to a recent poll conducted by The Health Management Academy, almost half of the physician and practice leaders who participated are not moving very quickly toward adopting value-based payment models. In fact, only 4% claimed to be moving “very quickly” while almost 40% admitted to moving “very slowly” toward value-based care.
Somewhat surprisingly, the same is true even for large hospital systems. These organizations are perceived to be the driving force, the ones moving the fastest toward the end goal of value-based care, and yet, per a similar poll, few of the large systems are moving very quickly.
The Quality Payment Program, however, is going to be the catalyst for healthcare organizations, both large and small, moving more aggressively toward these models in the next couple of years.
The MACRA structure and how you fit in
By now, you know that reimbursements are going to be variable based on performance, even if you’re still practicing in a fee-for-service structure and, like most, have not yet begun practicing in the more advanced tracks.
There are four participation categories, which fall underneath two broad tracks—the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) track.
The two categories in the middle of the chart are bridge areas, and won’t apply to many providers right now, but they can be considered as stepping stones from MIPS to the Advanced APM track.
The MIPS track equates to fee‑for‑service, and most physicians will, at least initially, fall into this track. They’ll balance their steps toward embracing more downside risk by continuing to practice fee-for-service medicine, and so they must prepare to report performance metrics and have payments adjusted based on those metrics in 2019.
On the other end of the spectrum is the Advanced APM track. To reach “Advanced APM Qualifying Clinician” status, physicians must engage significantly in certain downside risk-bearing payment models. In this track, participating physicians will enjoy fewer reporting requirements and more financial incentives, while still being held accountable for delivering high-value care. The only way to sustain a profitable practice in this track is to eliminate wasteful workflows that result in inefficient and unreliable communication processes among all members of the broader care team, even if they are not directly affiliated with your practice.
Year 2: 2018-2019
In the first months of 2018, physicians practicing in the MIPS track—again, that will be most of you—will be required to report metrics in three performance categories based on at least 90 consecutive days of work. This should come as more good news, because if you haven’t started measuring yet, or you’re not impressed by your initial metrics, you still have time to pivot before the data is due in early 2018.
CMS will use that data to give each physician a composite score, which will determine the payment adjustment he or she receives in 2019.
The Quality Payment Program’s initially proposed rule was accompanied by disheartening projections in terms of payment adjustments, particularly for solo physicians and small practices. While the finalized October 2016-issued rule basically guaranteed that all physicians who submit any performance data will receive at least a neutral payment adjustment, physicians are still bracing themselves for less-than-average profit margins.
As MIPS is largely a budget-neutral program, less risk equals less reward. Since fewer physicians will be subject to negative payment adjustments in 2019 (see Image 3 below), fewer dollars will be available to distribute to those who perform well.
Simply put, the best way to ensure your adjustment is as high as possible is to garner a high composite score.
Effectively coordinating care with your patients’ broader care teams as accurately and efficiently as possible to reduce waste and unnecessary overhead costs is a good first step toward achieving high scores in all four MIPS performance categories.
Back to the present
One of the goals of MACRA is to drive the costs out of treatment while still providing high-value care. Physicians will be in a much better position to deliver this dichotomy, and advance to a more rewarding reporting track, when the barriers to real-time care coordination have been broken down.
Seamless care team communication and collaboration among interdisciplinary, and often disparate, providers will be a foundation on which you can lay the groundwork for improved care coordination, which leads to less waste, improved efficiencies, and ultimately better outcomes, all of which underlie value-based care and the successful reduction of healthcare costs.
Source: “Making Sense of MACRA” webinar. The Health Management Academy and PerfectServe. March 2017.
Safeguarding security: 4 tactics for secure clinical communication and collaboration
I had the honor of speaking at the 2016 Becker’s Hospital Review Annual CIO/HIT + Revenue Cycle Summit, discussing the elements needed to truly secure clinical communications with some of the best minds in the healthcare world. With a number of recent high profile news stories announcing ransomware attacks in hospitals and health systems, security and the ability to secure clinical information is top of mind for many.
Those who oversee organizational data and IT systems recognize the importance of securing communication channels containing ePHI as they build a unified communications strategy. While security and regulatory mandates are essential elements of a clinical communication strategy, to create a truly successful strategy, the needs of those who provide care: physicians, nurses, therapists and others on the care team – in any setting – at any time – must be addressed flawlessly and securely.
To do so, there a few tactics to keep in mind:
Understand what the HIPAA Security Rule actually states
There’s been a lot of confusion in the industry when it comes to HIPAA compliance and communication. I often notice that many organizations think this is all about secure text messaging, which is incomplete. The Security Rule never speaks to a particular technology or communications modality, application or device. It is technology neutral.
HIPAA compliance is about the system of physical, administrative and technical safeguards that your organization puts in place to to ensure the confidentiality, integrity and availability of all ePHI it creates, receives, maintains or transmits. Because of this, there is no such thing as a HIPAA-compliant app.
Understand care team dynamics
Care team members are mobile and they employ workflows to receive communication based upon situational variables such as origin, purpose, urgency, day, time, call schedules, patient and more. The variables determine who should be contacted and how to do so for every communications event.
For this reason, third parties (hospital switchboards and answering services) and disparate technologies are used in organizations’ clinical communication processes. Understanding this variety of technologies and actors is key to accurately assessing your organization’s compliance risk. And, coming up with strategies to effectively address that risk is key.
Secure text messaging is essential, but it’s not sufficient
While secure messaging is an essential component of your overall strategy, it’s not sufficient because:
it requires the sender to always know who it is they need to reach—by name.
it requires the recipient to always be available to other care team members 24/7.
These requirements are inconsistent with the complexity inherent in communication workflows that enable time-sensitive care delivery processes, because they don’t address the situational variables I described above.
Secure messaging is only one piece of what should be a much larger communications strategy—one that should address clinician workflows and multi-modal communications channels for all care team members.
Your goal should be to enable more effective care team collaboration
Organizations often focus on achieving HIPAA-compliance. This is a flawed objective. The focus should be on achieving more effective care team collaboration. If this is done effectively, achieving HIPAA-compliance will come along for the ride.
Six essential capabilities
An effective secure clinical communications and collaboration strategy will include the following six elements.
It will facilitate communication-driven workflows that enable time-sensitive care delivery processes. An example of a communications-driven workflow is stroke diagnosis and treatment. When a patient with stroke symptoms presents in the ED, one of the first things the ED physician does is initiate a communications workflow to contact the neurologist covering that ED at that moment in time, while simultaneously notifying and mobilizing a stroke team to complete a CT scan to determine if it is safe to administer tPA, the drug that arrests the stroke. Time is critical. Healthcare is chock full of these kinds of workflows, executed every day in every hospital by the hundreds and thousands.
It will provide technology that automatically identifies and provides an immediate connection to the right care team member for any given clinical situation—this is nursing’s greatest need! Your strategy should be to bypass third parties and eliminate all the manual tools and processes used to figure out who’s in what role right now given the situation at hand. Ignoring this need means you won’t achieve adoption, which means your organization will still be at risk.
It should extend beyond any department and the four walls of the hospital. It should enable cross-organizational communication workflows. This is increasingly important under value-based care where care team members must collaborate across interdependent organizations to deliver better care.
It should secure the creation, transmission and access of ePHI across all communication modalities—not just text messaging. Enough said!
It should integrate with your other clinical systems to leverage the data within those systems to facilitate new communication workflows. This is key to enabling “real-time healthcare.”
It should provide analytics to monitor your communication processes and continuously improve those processes over time.
With these capabilities in place, secure clinical communication simply becomes another positive result of implementing a broader care team collaboration strategy, designed to address clinical efficiency and improve patient care delivery.