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:

Less Frustration

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.

Timely Communication

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)
  • Practice Management
  • 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:

  1. Comparing Spend
  2. Assessing Utilization
  3. 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.

1Vizient, 2020

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 an 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 your practice 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, pandemics, 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.

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.

How much is your answering service costing you?

medical answering service warning

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 scenarioA 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.

Tips for structuring a successful device pilot

One of the most common mistakes hospital systems make when implementing a mobile device strategy is choosing the wrong devices. Problems like devices not roaming well from access point to access point, or even simple manufacturer quality issues, can sabotage a strategy’s success.

It’s easy to assume that if a device costs upward of a thousand dollars it would meet almost any need a clinician could have, but many hospitals have found out the hard — and expensive — way that a high-dollar price tag doesn’t guarantee the best device for their user groups.

The best way to avoid this risk is to pilot any device before making a big purchase.

The importance of end-user input

The most important thing to keep in mind when piloting a new device is to conduct the pilot in real-world situations. There is a greater chance of a successful pilot if the devices are put right into the hands of end users and are used throughout the day within normal workflows.

Most end-user groups in hospital settings are very mobile by the nature of their jobs. Clinicians must be in many different places throughout the facility at many different times of day. And it’s necessary to make sure their devices roam effectively throughout your facility, without falling off the network.

For example, be sure to test the user experience at somebody’s desk, in a patient room, and in common areas of the hospital such as hallways, cafeterias and conference rooms. Don’t forget about areas outside the hospital, if personal devices are going to be included in your strategy.

Also, have a variety of end-user groups — e.g., nurses, ER directors, residents — test the devices. Apply as many variations as possible to the pilot process to increase the probability of finding a deal-breaking oddity. This will help you avoid purchasing and deploying expensive devices that aren’t going to work well within your hospital’s workflows.

Consider maintenance needs along with functionality

When it comes to workflows, test the devices against IT’s own needs. Think about the IT team’s ability to maintain the agreed-upon devices and policies, as well as manage them. The devices and the device strategy need to work just as well for IT as they do for the end user.

Another critical but sometimes overlooked element of the pilot experience is to test installation of commonly used applications. The goal here is to avoid any showstopping surprises after the devices are purchased and in the hands of hundreds, maybe even thousands, of end users. There are application limitations that are common to certain operating platforms, and if these limits are not tested before a device is selected and purchased, a breakdown in workflows and strategy adoption is likely.

For example, there’s a common assumption that by purchasing an Android device, end users will be able to run any app from the Google Play Store. The reality, though, is that some of these devices are on old versions of Android — i.e., 4.9 or lower — or they are heavily modified versions of Android that don’t support the Play Store or don’t support Google Cloud Messaging.

Since Google Cloud Messaging is used for push notifications, that’s the default push notification mechanism. If devices don’t support this feature, then extra work will be required.

You want to be as informed as possible about what you’re buying and how it’s going to work in real-life scenarios within—and beyond—your hospital walls.

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Higher MIPS scores and positive CMS adjustments

Technology helps us do so much more than we used to be able to do on our own. If there’s anything we’ve learned in the last decade of technological innovation it’s that “there’s an app for that” when it comes to just about any goal you want to accomplish.

This absolutely includes the financial goals you’ve set for your practice, which you’ve probably had to re-evaluate recently due to the uncertainty surrounding CMS payment adjustments under MACRA.

Healthcare IT (HIT) will play a major role in your MACRA compliance efforts. In addition to automating some of the more tedious processes the new regulations require, HIT can help physicians score high under the Merit-based Incentive Payment System (MIPS), which is necessary to receive positive payment adjustments from CMS beginning in 2019.

Here’s how HIT, especially tools that enables efficient and timely care team collaboration, can boost scores in each of the four weighted MIPS performance categories:

Cost

The processes and treatment plans used by clinicians to deliver patient care are directly tied to costs. In the face of potentially negative payment adjustments, it’s more important than ever to realize cost savings, a feat that will be heavily impacted by providers’ ability to manage chronically ill populations. Success in population health management is highly dependent upon efficient communication, collaboration and care coordination across all care team members and care settings. Communication workflows and unified communication tools need to be assessed and implemented to improve the speed and efficiency with which disparate care team members can communicate with each other to coordinate care.

Quality

Clinicians have a lot of personal freedom when it comes to the quality of the care they deliver. One of the more manageable ways to improve the quality of healthcare is to overcome communication obstacles that have long degraded and delayed care. Obstacles such as not knowing who to contact for a given situation; searching for and struggling to find contact information and leaving messages with intermediaries; never knowing if the right message will be delivered to the right recipient, thus suspending and disrupting care, etc., are easily overcome with the help of intelligent communication routing and automatic escalation tools.

Advancing Care Information (ACI)

EHR functionality is a key component of ACI, but an EHR’s capabilities to support care coordination are limited. Care team members in a physician’s network may or may not share the same EHR, and the need to seamlessly communicate with them — and those outside of the network who are even less likely to have the same EHR — is equally important. There’s an increased need to implement a system of secure communications that transcend disparate EHRs to ensure timely bilateral exchange of patient information. Interoperability is an important factor for the ACI performance score.

Improvement Activities

Clinicians who utilize patient-centered approaches to achieve better, smarter and healthier care will perform well in this category. Implementing tools that enable patient-centric communications is one step toward achieving a high score in the Improvement Activities performance category.

More than 600,000 clinicians will be responsible for reporting MIPS performance criteria for at least 90 days this year. MIPS reporting is complicated, complex and extremely important to understand because it will impact CMS payment adjustments beginning in 2019.

The threshold to receive a positive payment adjustment has been set very low for 2017, so there’s less financial risk for eligible clinicians in the first year. The clinicians who want to cross the low composite score threshold to receive the maximum positive adjustment possible in 2019 need to score high in the performance measurement areas of Quality, Advancing Care Information and Improvement Activities. Reporting in the Cost category will begin in 2018.

Care team collaboration and communication platforms like PerfectServe® help clinicians decrease costs and improve quality by eliminating inefficient and time-consuming communication processes that delay treatment. Our cloud-based architecture allows clinicians to transcend the communication capabilities of the EHR and securely coordinate care with disparate interdisciplinary providers regardless of their location; and the patient-centered communication capabilities neatly fulfills all of the criteria for the Improvement Activities performance category.

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Managing the surprisingly troublesome impact of real-time healthcare on clinical decision-making

We live in an age of instant gratification. From the texts we send friends and family to the orders we place on Amazon.com, we’ve come to expect immediate results: instant responses, next-day shipping, etc.

The idea of immediacy in healthcare communications is not new. In fact, in 2015, healthcare analyst Gartner outlined a vision for what it dubbed the “real-time health system”—a landscape where healthcare professionals will be constantly aware of what’s happening within their systems and with their patients.

As a person living in the digital age, you’ve probably experienced real-time awareness in other parts of your life: the repetitive dings of received text messages, the intermittent beeps of calendar alerts, the near-constant hum as your smartphone vibrates over and over to let you know your mother, children and cousins have uploaded photos to Facebook, Instagram and Snapchat. In fact, as I’m typing this piece, I’ve heard alerts for two personal text messages that I’ve yet to look at (the temptation is maddening), four work-related emails (that I did have to stop and look at), a notification that someone commented on a thread I replied to on Facebook and more.

While there’s definitely a benefit to each of us knowing what’s happening in our expanded universe in real time—and we can easily draw a direct line to the benefits that doctors, nurses and patients would experience if they could communicate instantaneously while coordinating care—the influx of information is simply overwhelming.

And when alarm fatigue sets in, important messages get missed, the communication cycle breaks down and what was once a valuable resource becomes a liability. Overwhelmed and inundated clinicians cannot optimally use their invaluable expertise to make effective clinical decisions that deliver great health outcomes.

Aggregating, analyzing and managing the distribution of clinical information

Managing the flow of data and alert fatigue is a real challenge that clinicians and the IT teams that support them need to understand. Clinicians need “just the facts, ma’am,” so to speak, and they need to know which set of facts pertain directly to them and the patients for whom they are caring. Receiving more than enough information is not always a good thing, especially when the situation calls for fast thinking and quick decisions.

Investments made in technologies implemented over the past several years have enabled healthcare as an industry to generate very large amounts of digitized clinical information. The challenge is to aggregate this patient data in real time to generate new knowledge about a patient and distribute it in a way that does not inundate the clinician recipients with unnecessary information. Physicians and nurses should receive information they need in order to act in that moment. Everything else is noise.


Learn how a care team communication solution can enable your clinical integration strategy. Get a demo.


Implementing communication-driven workflows

Once new knowledge is made available and deemed relevant to a given clinical situation, it’s important to enable workflows that drive this information to the right care team members, who can take action in that moment. Hospital-based communication workflows must encompass all modalities, adhere to strict security mandates and facilitate reliable exchanges among clinicians across boundaries (e.g., acute, pre-acute and post-acute care settings). This kind of clinical integration is the future of healthcare communications.

If clinicians are inundated with unnecessary information, messages and alerts, combined with a communication workflow that creates barriers to a) finding the right care team member to contact, b) finding the contact method that the clinician prefers and c) knowing whether the intended recipient received the message, the workflow is flawed and is inhibiting the decision-making that leads to higher standards of patient care.

Leveraging clinical expertise

The personal judgment of experienced healthcare professionals is irreplaceable in effective, real-time decision-making. Technological advances are no doubt improving healthcare, but human intuition can never be replaced by a new device or software. However, that intuition can be inhibited by technologies if they are not strategically implemented and managed. In this sense, real-time healthcare could, ironically, be eroding quality.

To truly leverage the hundreds of collective years of clinical expertise housed in the minds of your hospital’s medical staff—the expertise that yields great outcomes—you must remove the barriers to effective communication. Collecting patient data in real time is an important part of that. But analyzing and aggregating that data into digestible, valuable pieces of information that can be easily shared and collaborated on is the follow-through that is often overlooked.

The gravitation toward instant gratification isn’t going away. And it’s important to understand that the concept doesn’t apply simply to generating patient data as healthcare events are occurring, but also to the ability to extract the significant portions and begin collaborating with the broader care team to interpret the data and derive a plan to deliver high-value care.

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How to increase the impact of smart mobile devices

Post originally published on HIT Think from Health Data Management.

For the usage of smart mobile devices to make a real impact on clinical care, hospitals and health systems must extend their concept of enterprise mobile communications to a holistic strategy—one that evolves around the end user, workflow, data, applications and other factors.

Tough challenges lie ahead for IT departments tasked with refining their enterprise mobile device strategy to grow with future needs.

Here are 10 “tried and true” recommendations to support greater levels of mobility, care team adoption and efficiency, and patient care.

1. Request the certified communications/smart device list from your electronic health record vendor

Most EHR vendors can provide this as a starting point to build or refine your enterprise mobile device strategy. The list ideally ranks the computing power of the device and its ability to access clinical data within the EHR.

2. Understand the market for shared mobile smart devices in the acute care setting

This market is in its infancy, with less than 10 percent of U.S. health systems having deployed shared mobile smart devices in their patient care settings. Be aware that many devices designed for healthcare are first-version releases and will rapidly evolve pending real-world clinical experience.

Two challenges commonly experienced by early adopters include learning to operationally deploy and manage devices exclusive of evidenced-based best practices and proven tools; and discovering that your expensive device investment is unexpectedly outdated and financially unfeasible due to the rapid technology evolution.

3. Compare iOS-based devices to Android-based devices 

Key differences exist between the iOS and Android device landscapes. Apple’s iOS devices are consumer devices, whereas some Android devices are built purposely to support healthcare and other rugged environments. Notable differences are also found between consumer-grade and enterprise-grade devices.

4. Review devices that include VoIP phone capabilities

Ascom, Motorola and Spectralink are three such manufacturers.

5. Explore adding VoIP capabilities to a smart device lacking native VoIP support

Some ruggedized device manufacturers do not include native VoIP phone capability, including the Caterpillar CAT s50c and Honeywell Dolphin CT50H. VoIP phone capabilities can be added to devices by using an app offering “softphone” capabilities.

6. Consider the product lifecycle of a smart device

Purchasing a device in the first half of its lifecycle enables an organization to maximize its usefulness and longevity. For instance, if a device is in its fourth year of a five-year product lifecycle, the device most likely has a processor architecture that is four years old. In its second year of use, that processor architecture will be more than six years old. This may result in care team users decrying the devices are slow to use—especially as more apps are added through the years. Before making a significant investment in an older processor, research the timing of the next release.

7. Examine the performance of the device roaming across wireless access points

Most healthcare organizations have a high volume of wireless access points situated across multiple facilities. As a result, a device’s usability and performance in managing patient handoffs between access points is influenced significantly. To prevent problems, providers can question the device manufacturer for details on the work completed to ensure frequent access point transfers do not disrupt care operations. For example, find out how often device access points are checked for changes, as infrequent device polls increase the probability of certain access points being no longer in range. Likewise, count the number of access points in a 15-second walk in the facility.

8. Understand the difference between Android apps in the Google Play Store and Android devices

Several device manufacturers have modified their operating systems such that some functionality has been removed. Both the Motorola MC40 and the Ascom Myco, for example, offer custom versions of Android that no longer support the Google Play Store or Google Cloud Messaging capabilities. Thereby, apps leveraging push notifications can fail to work unless the app developer adds those capabilities. Question those differences, including the device’s Android consumer version.

9. Determine if your Android device choice supports Android for Work

Android for Work is a new enterprise program enabling consistent IT management and secure app distribution through an ecosystem of MDM vendors. It provides IT with a unified way to secure enterprise apps, manage disparate devices, and separate work and personal data at the OS level. Android for Work is the industry standard for app vendors providing capabilities to leverage a facility’s MDM and requires the Android device to be version 5.x or greater. For those device versions 4.x or less, the app installation and subsequent future upgrades must be completed manually.

Manufacturers that develop Android devices built purposely for commercial settings have a device lifecycle that better aligns with health enterprise expectations as opposed to consumer expectations. Consequently, while most consumer Android devices in use are version 6.x, the healthcare purpose-built devices are typically 4.x.

10. Make a well-researched device choice

Providers do not have to choose a single smart mobile device for enterprise-wide adoption among all care team members. In making your device selection decision, consider the care team member’s role and respective needs such as workflow. For example, deploying a device featuring VoIP phone capabilities for nurses—and other direct care personnel—may make more sense for accommodating workflow, as does selecting a less expensive device without VoIP capability for clinical support service staff.

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Mobile charge capture: A simple change to your business practices with significant outcomes

While there are conflicting perspectives on the physician shortage, there is resolute agreement that the demand for primary and specialty care is growing due to the expanding older population. Concurrently, the challenges for physician practices, which are needed to provide that care, are also increasing. Older patients require 2–3 times the amount of specialty and primary care to treat and manage chronic conditions and age-related illnesses. Unfortunately, in today’s ever-changing healthcare environment, many practices are struggling to survive.

As has never been experienced previously, practices are facing daunting obstacles to care delivery due to rising operating costs, regulatory burdens and barriers to receiving pay/reimbursement. The cost to operate a practice has increased at twice the rate as the consumer index due to increasing rent, malpractice insurance, liability coverage, health insurance and personnel expenses. Mounting regulatory requirements have not only served to increase overhead, but have also consumed valuable patient care time with oppressive documentation and administrative requirements for HIPAA, Meaningful Use, prior authorization and quality mandates.

Now in the wake of the time-consuming and costly protracted transition to ICD-10 and EHR implementation, physicians are struggling to get paid. In part, this is due to the ACA which has introduced reimbursement cuts and increased penalties. Last year, the Centers for Medicare & Medicaid Services (CMS) began to apply the value-based payment modifier to adjust reimbursement amounts to reflect the quality and cost of care provided. Those practices not meeting performance standards will receive less reimbursement. In addition, this year, the penalty for non-participation in the Physician Quality Reporting System (PQRS) increased to a 2% reduction in the CMS market basket update. Further, the increased number of patients with insurance provided through state exchanges or the Federal marketplace has exacerbated the payment problem. These patients typically have very high deductibles, along with a 90-day window to pay premiums, posing more obstacles to the collection of co-pays and out-of-pocket expenses. Notoriously, it should be noted that the CMS also takes longer to reimburse physicians as compared to private payers. Moreover, the ICD-10 transition has resulted in increased claims denials, resulting in labor-intensive, time-consuming efforts to overturn the same.

Confronted with these challenges, paradoxically, many physicians have had to reduce the number of patients they see, further eroding financial return. However, for those struggling practices, indiscriminate cost slashing is not the answer as physicians must finely balance improved operational efficiency with the achievement of the aims of quality patient care. This is where innovative technology can play a key role. Smart investment needs to target technology that is able to:

  • Reduce operational expenses
  • Ease regulatory compliance and the documentation demand
  • Facilitate physician workflow
  • Increase patient care time
  • Generate more revenue

One such technology that meets the above criteria is mobile charge capture functionality within a secure messaging application. This would enable physicians to quickly and easily capture charges at the point of care and automatically and securely communicate this information to billing staff or a billing application.

To ensure there is no increased burden to physicians, this process must only take a couple “clicks” or a matter of seconds. For example, the application must have immediate accessible “favorite” codes composed of those services and diagnoses used most frequently and denoted by the terms most familiar to that particular practice, rather than formal codes and code definitions. Additionally, when needing to find a rarely used code not contained within favorites, the application should provide decision-support enabling the easy selection of the right ICD-10 code to be associated with the CPT code. Also, there should be code bundles available so multiple code combinations can be assigned to a patient in a single click.

This prompt and speedy process replaces the manual paper-and-pencil method in which physicians retrospectively attempt to make a note of the procedures performed —sometimes days or even weeks after the encounter. Consequently, quite often, not all services that were provided are recalled. These “notes” were then provided to the practice billing team who then must interpret the right procedure and identify the correct codes for billing purposes. Often because of the lack of detail within the notes, the specific details of the procedure are lost, reducing the amount of reimbursement received on top of the lost charges due to poor memory.

These issues could be virtually eliminated with smart mobile charge capture functionality. Additionally, this functionality enables the ability to easily add and document PQRS codes while facilitating patient rounding, with a customized patient list and direct access to previous charges, and with the ability to rapidly “clone” them for the day’s visit. This information would also be visible across the entire group of physicians, if desired.

By automating and expediting the charge capture process, there is a direct impact on the practice’s financial homeostasis:

  • The elimination of lost charges and improved coding specificity directly translates into higher revenue.
  • The coding decision support and the inability to mismatch CPT and ICD-10 codes mean reduced potential for costly and time-consuming audits and claims denials.
  • The easy documentation of PQRS avoids the 2% CMS penalty and facilitates compliance.
  • The immediate transmission of charges to billing staff speeds the time to billing, reducing the amount of time to payment received.
  • The number of FTEs required to support the coding and billing process can be dramatically reduced markedly decreasing operational expenses.

Most importantly, such technology can allow physicians to spend more time doing what they want to do and what we need them to do—caring for and treating patients.

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3 “must-haves” for simplifying complex clinical communications

Part 3 of a 3-part series in conjunction with our nurse leadership webinar series.

Imagine a world where you launch the EMR, review a patient’s chart, and want to discuss it with the covering cardiologist that day. You click a link for the cardiologist within the EMR and it references that provider’s group workflow processes, reviews their schedules and monitors their momentary status to direct you to the correct provider. Then you type your message. The patient’s information is pulled from the EMR and is securely routed to the recipient based on their contact preference in that moment. It can happen – but this is not the norm in most healthcare facilities today.

Practicing medicine today is complex – clinicians need to consider an ever-changing landscape, federal and state regulations, not to mention the many different innovations designed to help streamline everything from care delivery to reimbursement. Adding to the complexity are the many different providers treating patients, working across various care settings with large care teams.

Given the vastness of these care networks, it can be daunting – albeit necessary – to coordinate care. One way to help connect clinicians in all care settings and improve care team collaboration is through a comprehensive communication solution.

It’s important to first understand why clinical communication is complex and why many of the technologies implemented today aren’t solving the issues clinicians are facing. Factors such as the patient’s reason for contact, the physician’s location, team coverage, degree of urgency and unassigned ER calls all impact the communication process.

Looking across varied care settings, people, processes and preferences also differ. Between inpatient and outpatient facilities, medical group practices and post-acute care, there are many variations in care team communication strategies and approaches that make it prone to gaps and breakdowns. In fact, one of the most frustrating parts of a nurse’s job is the daily battle to determine the correct covering provider.

In this complex environment with so many participants, the continuum of patient care demands that communication solutions span much further than the four walls of a hospital or practice. And as healthcare delivery models change, it’s imperative that care coordination, and the communication that drives it, be streamlined and efficient across all of these settings. When looking for a platform to simplify clinical communication, healthcare organizations should keep the following three “must have” capabilities in mind:

  • Span the entire care continuum: A comprehensive solution must address the needs of all care team members across all types of settings – from a single hospital to a multi-site system, as well as outpatient practices and care settings. They all have different demands and communication requirements. For example, larger practices and hospitals need advanced directory capabilities to bring the opportunity to coordinate care based on facility, group or ACOs, with the appropriate workflow processes built in. In addition, the solution should have the ability to generate real-time patient updates – such as when the patient presents to the emergency department, is discharged home, or when important results are available. This is essential to timely coordination of care. Finally, it’s imperative that the communication solution connect to the organization’s other HIT systems to maintain integration for alarms and alerts, such as if stroke team is activated. It’s critical that covering providers respond quickly and that a back-up process is in place.
  • Provide a standardized, yet flexible way to communicate: Clinicians should have flexible, yet standardized communication options that allow their messages to be routed appropriately and securely, and account for today’s technology. Gone are the days of referencing binders, faxed schedules or notes taped to the wall or desk. Once the communication process is initiated, the process should seamlessly connect you with the correct covering provider for the clinical situation at hand – whether through call, text or via a mobile app.
  • Address process complexities with intelligent routing: Schedules, workgroup rules, team mobilization requirements and escalation paths should all be configured so that you are connected to the right care team member with real-time accuracy. A solution with dynamic intelligent routing is able to deliver messages at the right time, to the right person in any given clinical situation. Clinicians should be able to customize based on their device and delivery preferences, and make changes based on their activity (e.g., what to do with a call while in the OR).

The goal is simple: Remove the variability, the hand offs and the touch points that introduce risk and opportunities for communication breakdowns. Initiate the communication in the manner you wish, and let the process connect you to the correct covering provider for your clinical situation at any moment in time.

While efficient clinical communication is a challenge, the right solution can lead to tremendous benefits for every care team member, as well as the organization. The solution must be comprehensive, providing standardization and the ability to streamline the communications process. By implementing technology that addresses these three areas, healthcare organizations will not only be able to improve clinical communication, but will ultimately improve the experience for patients, and the extended care team.


Interested in learning more? Read part 1 and part 2 of this series on nurse leadership in care team collaboration.

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