The Net Impact of Poor Patient-to-Provider Communication

Poor communication between patients and providers is, unfortunately, all too common.

Poor patient-to-provider communication leads to suboptimal outcomes, including poor health results for patients and wasted resources for providers.

Studies show that patients misremember or completely forget roughly 80 percent of the medical information they receive.

Here’s how poor communication affects both patients and providers and how a text-first strategy can improve overall outcomes.

Why patients miss appointments

The rate of appointment no-shows varies widely, from five to 55%, according to some estimates.
But why do patients cancel as many as 55% of appointments?

Sometimes there are actual logistical reasons for a patient to miss an appointment. If a patient can’t get off work or is too sick to travel, for example, it’s not unusual that he/she would miss an appointment.

But, as one study highlighted, some patients miss or cancel their appointments because they’re afraid of the potential diagnosis, they feel that the provider has disrespected them and they are confused because of miscommunication regarding their provider’s scheduling system.

Poor communication between patients and their providers can cause more frequent patient delays as well as appointment cancellations.

Avoidable delays and cancellations

Interestingly, many of the patient-related delay and appointment issues—ranging from perceived disrespect to lingering fears or worries—could be easily addressed by increased communication efforts on the part of a healthcare provider.
For instance, a mix of tailored education, instructions and alerts can be sent to patients before their appointment, and since more than three-quarters of American adults text regularly, text messaging can be an ideal resource for providers who are looking to improve communication with their patients.

Treatment plans and medication adherence

Keeping open lines of communication — like provider-to-patient texting — can help patients avoid bungled treatment plans and poor medication adherence.
One healthcare study estimated that roughly 25% of Americans don’t follow the treatment plans outlined by their providers. Their reasons varied, but 39% of patients didn’t agree with their clinicians about the diagnosis, 27% had concerns about the cost of treatment, 20% felt that the treatment went against their beliefs and 25% thought the treatment plan was just too complicated to follow.

Better communication between providers and patients can help this 25% of patients understand and follow their treatment plans better.

Miscommunication also leads to poor medication adherence: one study noted that 50 percent of chronically ill patients don’t take their medication properly. When patients fail to follow their treatment plans, they usually hinder their chances for a successful recovery.

Providers have to try to explain their treatment plans clearly and succinctly—failure to do so can lead to suboptimal outcomes. Mobile technology – more specifically text messaging – can play an important role in improving medication adherence by supporting those initial conversations. A “text-first” mobile patient engagement platform can be used to support much more than reminders and actually help provide a touch point that improves their overall health.

Poor health outcomes

Patient delay, missed appointments, and poor medication adherence — these issues are all directly related to poor patient-to-provider communication.
When providers fail to check in with patients or when they fail to fully explain a treatment plan to a patient, this typically leads to suboptimal outcomes.

When patients don’t follow through with their treatments, they usually fail to recover successfully, which oftentimes leads to avoidable readmissions.

Hospital readmission is a critical issue in the United States: one in five Medicare patients in the U.S. each year is readmitted within 30 days of leaving a hospital. However, a recent Harvard Business Review article pointed out that a “hospital would, on average, reduce its readmission rate by 5 percent if it were to prioritize communication with the patients in addition to complying with evidence-based standards of care.”

Suboptimal outcomes lead to poor health results for patients, and repeated hospital readmissions eat up costly and critical provider resources. In order to improve outcomes and avoid patient-to-provider miscommunication, providers must focus on improving their overall communication efforts with patients.

A cost efficient and effective way to reach patients is through text messaging. The right platform not only support automated and on-demand messaging, but it also provides tools for provider staff that help them manage this critical communication channel.

Text messaging holds great promise for improving provider-to-patient communication and, most importantly, outcomes for all.

What physicians need to do to change patient behavior

Changing patient behavior is easier than you think

Engaged patients have better outcomes, but healthcare providers often struggle to find effective — and scalable — ways to empower their patients to play a role in their care.

As the number of patients grows, physicians, nurses and other care team members are more stretched for time than ever and have less time to spend on face-to-face patient care.

Patient and family communication tools give providers more opportunities to answer patient questions, send educational material and keep them engaged with their wellness plans between appointments.

Here’s what physicians and other care team members need to know about how a patient and family engagement tool can change patient behavior.

Driving healthier communities

Healthier communities help drive down the cost and waste in healthcare.

When communities are healthy, they clear out emergency departments, make it easier for individuals to access care and help hospitals avoid costly readmissions. Simple automated text messages with appointment reminders can make a huge improvement in patient show rates, regardless of the patient’s age and socioeconomic status.

For Ridgeview Rehab Specialties, automated text messages with appointment reminders, including scheduling and location details, helped the department reduce its no-show rate by 12.6% over two years, a cost savings of more than $138,000.

Inspiring patients to manage their healthcare

Consumerism in healthcare is driving some patients to be active participants, and patient engagement programs can empower even more patients to become more involved in their care. This kind of patient engagement is especially important for those who live with chronic health conditions.

Patient engagement technology can keep patients focused on their wellness between appointments. Automated provider-to-patient communications — like programmed text messages — can include questionnaires that monitor key health indicators and reminders to refill medications.

Retaining information from appointments

Exam rooms are stressful places for patients, and stress tends to make people forgetful. That’s why repetition is the key to getting patients to remember the details of a diagnosis and treatment plan.

Unsurprisingly, many hospitals and practices turn to provider-to-patient text messages to deliver highly relevant educational information.

Sending text messages with links to pages on your site, PDFs, YouTube videos and your other pieces of digital content makes it easy for patients to find and refer back to them later.

How to move forward with a patient and family communication approach

1. Understand all existing patient engagement activities currently in place and assess each one’s utilization rates.
2. Research the data on your existing patient engagement activities. Then, understand how to consolidate them into a single patient path.
3. Gather the number of mobile phone numbers available to push information out to your existing patient population.
4. Develop a rollout plan for hospitals and affiliated groups / clinics, and determine what marketing efforts you’ll need to create awareness and incentivize patient engagement.

Want more information about patient engagement tools?

Our Patient and Family Communications technology is a text-first comprehensive, flexible and secure. Our solution is proven and is live in more than 10,000 care locations, facilitating more than 42,000 patient interactions every day.

4 smartphones for nurses you should have on your mobility shortlist

Smartphones have the potential to transform the workflow of nurses and other hospital care givers.  

Rather than carry around multiple devices, clinicians can use a single device as a phone, pager and scanner. Crucially, smartphones give them mobile access to the EMR, integration with nurse call and telemetry, and a secure platform for collaboration. 

As a clinical communication and collaboration platform, PerfectServe has partnered with many clients on their transition to clinical mobility with smartphones. We want to use this experience to help other health systems in their journey. 

The first question we hear is usually, “Which device should I buy?”  

The answer is, “It depends!”   

At this point, no one device has emerged as the clear best choice, but PerfectServe can share some key considerations for health systems evaluating mobile devices. 

In this article, we’ll highlight 4 smartphones that belong on your 2019 nursing mobility shortlist. We’ll also provide links to other content that can help you select and implement your clinical mobility solution. 

Zebra Technologies TC51-HC 

Zebra has been in the space for years with their previous MC40 devices, and the Zebra TC51 brings major upgrades, including an HC version targeted specifically at healthcare.  

Modern hardware and Android 7 are protected by a rugged exterior that’s built to survive day-to-day in a nursing unit.  

This hardened device can withstand repeated drops, exposure to liquids, and frequent exposure to healthcare disinfectants.  

As an enterprise device, the TC51 is available with built in telephony, barcode scanning, robust battery capabilities and many more features designed with healthcare in mind.  

Why buy it: Support.  

Zebra and its partner network are well established in healthcare, offering plenty of resources to help your project succeed.  

Apple iPhone 

This device needs no introduction.  

As a consumer-grade device, the iPhone delivers leading-edge hardware and software wrapped in a small, sleek package.  

Compared to most enterprise-specific devices, an iPhone 7 is a low-cost option. However, as a consumer phone, the Apple devices will not offer the ruggedness, battery capabilities, native IP telephony, and other enterprise grade features.  

That being said, the relative cost, form factor, and familiarity of the iPhone (or consumer Android devices) make it a good option in the current device market. 

Why buy it: iOS.  

If your organization prefers the Apple mobile operating system, your device choice is clear. 

Bluebird EF500 

Relatively unknown in the US market, Bluebird has provided mobile computing and payment solutions internationally for over 20 years.  

The Bluebird EF500 is a purpose-built rugged device running Android 6 and capable internal hardware.  

It offers a scanner, strong battery capabilities and native IP telephony. The Bluebird device doesn’t bring the same level of support or technical horsepower as some other Android devices, but it can get the job done. 

Why buy it: Value.  

The EF500 is priced significantly lower than other purpose-built enterprise devices. 

Spectralink Versity 

Spectralink has years of experience providing voice handsets running on hospital wireless networks, and they entered the smartphone market in 2014 with the Pivot. Now they have followed it up with the Spectralink Versity, which rolled out to customers in late 2018.  

Looking at the spec sheet, the Versity checks all the boxes for ruggedness/battery/telephony/etc., and its hardware and Android 8 operating system raise the bar in the enterprise device market.  

We look forward to hearing from some of the first health systems to roll it out. 

Why buy it: Form factor.  

The Versity is slim and light, as close as you will find to a consumer phone in a rugged package. 

This is an exciting time as manufacturers continue to bring improved smartphones to the market. PerfectServe is here to share our experience and help you achieve your goals for clinical communication.  

If you want more information about nurse mobility, check out our tips for how to structure a successful device pilot.  

Presenting the new PerfectServe family

The last three weeks have been some of the most eventful in PerfectServe’s 20-year history. Let’s do a quick recap:

• On January 16, we announced the acquisition of Telmediq, which was recently named the 2019 KLAS Category Leader for Secure Communications Platforms for the second consecutive year.
• One week later, we announced that 2018 was the best year in PerfectServe history, with new records being set for sales bookings and year-over-year sales growth. As a bonus, 2018 also saw the completion of the largest individual agreement in company history.
• This morning, the PerfectServe portfolio grew yet again as we announced the acquisitions of Lightning Bolt, a cutting-edge physician scheduling platform, and CareWire, a text-first mobile patient engagement platform.

So, what does all of this activity mean? To start, PerfectServe – driven by Dynamic Intelligent Routing® – is the solution of choice for healthcare providers looking to solve their most complex clinical workflows. This powerful capability is the foundation of our platform.

But now, there’s more to the story – a lot more. Each brand joining the PerfectServe family is a standout healthcare technology solution in its own right, and we’re bringing them all together under one roof.

The possibilities are endless.

As PerfectServe CEO Terry Edwards noted in his Q&A with Telmediq CEO Ben Moore (now PerfectServe’s Chief Product Officer), combining these best-of-breed platforms is part of a larger goal to ramp up innovation as we bring to market the care team collaboration platform of the future.

To illustrate why these additions are so significant, here’s a quick introduction to each of PerfectServe’s new family members, including some of their distinct capabilities:

• Telmediq, as previously noted, is the top KLAS-rated vendor for secure communications platforms in 2019. With its call center solution, nurse mobility strategy, advanced alert and alarm management capabilities, mass notification functionality and strong customer relationships, this platform brings unmistakable value to the PerfectServe portfolio. Together, PerfectServe and Telmediq offer the most comprehensive set of clinical communication and collaboration (CC&C) capabilities on the market, with the two platforms counting more than 500,000 clinical users across 250 hospital sites and 27,000 physician practices and post-acute care organizations.
• Lightning Bolt optimizes physician scheduling workflow with automation technology that brings balance to complex scheduling variables. The company has developed deep domain expertise in the areas of physician workflow, hospital operations, artificial intelligence and professional balance. Lightning Bolt automatically generates more than three million physician hours each month and is the trusted solution for hospitals and health systems working to align the interests of their physicians and facilities to promote work-life balance, productivity and patient access.
• CareWire uses SMS texting – the most widespread communication method – to drive patient engagement. By using text messages, the solution reaches patients and family caregivers of all ages and socioeconomic statuses without requiring an app download or a password. With its encounter navigation assistance and tailored messages that use social determinants of health data, CareWire drives reduced cost and readmissions, improved chronic care management and better clinical outcomes. This accessible approach to care coordination also boosts patient satisfaction. CareWire is currently deployed in 10,000 care locations, where it optimizes the care experience across 42,000 patient interactions per day.

With Telmediq, Lightning Bolt and CareWire, PerfectServe has assembled vital pieces of a puzzle that will take shape over the coming months . The end game is actually pretty simple: Provide healthcare organizations with a patient-centric care team collaboration platform that streamlines and automates workflows to expedite care delivery among all care team members and across all care settings.

In short, by remedying the care coordination challenges that have long existed in the healthcare industry, we want to free clinicians up to do what they do best – treat their patients.

Stay tuned for more news about our journey to build the care team collaboration platform of the future. If you’re coming to HIMSS in Orlando from February 11-15, make sure to visit PerfectServe (booth #1113), Telmediq (booth #6643) and Lightning Bolt (booth #2393).

How to capture positive online reviews for your practice

Whether they’re about restaurants, hotels, service providers or everyday products, online reviews are ubiquitous.

Consumers place a great deal of trust in online reviews because they’re more likely to believe the candid words of a fellow consumer than the curated sales pitch of a business. In fact, what customers write about companies online can have a bigger impact on buying decisions than traditional marketing methods.

But reviews aren’t limited to restaurants and hotels – consumers also use Healthgrades, Google and Yelp to research healthcare providers before scheduling appointments.

Why online reviews have to be a priority

The number of internet-savvy consumers looking to online reviews for healthcare providers might surprise you.

According to a Pew survey, one in five internet users have consulted online healthcare reviews before deciding where to go for healthcare services.

A separate study from the Brookings Institution shows that patients take online reviews very seriously. In fact, patients believe online reviews are just as credible as ratings provided by the government.

With the prevalence of online provider reviews and their role as a key resource for patients who are seeking care, providers should think not only about treating patients for their medical ailments, but also providing excellent customer service.

How to manage your practice’s reputation

It’s never easy to receive negative feedback, but in today’s digital world, it’s inevitable.

A proactive strategy begins with rigorous  monitoring of your practice’s online reputation to understand how your patients perceive your care experience; this understanding can help you formulate an improvement plan.

Bad experiences tend to prompt more online reviews than positive ones, but with the right plan in place, you can encourage your patients to write about their positive experiences as well.

Here are a few simple ways to encourage patients to post about their experiences with your practice:

• Ask. This one’s often overlooked, but simply ask your patients to rate their experience on Healthgrades, Google or Yelp.
  
• Email. If you have current email addresses for your patients, send a brief email with a clear request and easy-to-follow instructions about how to post an online review.
  
• Survey. After appointments, send follow-up surveys to gauge how your patients felt about your practice, and include a link to prompt them to share their feedback on Healthgrades, Google or Yelp.

How PerfectServe makes gathering online reviews easy

If you’re having trouble gathering online reviews, consider using PerfectServe’s patient and family communication functionality.

Our solution automatically triggers a post-visit survey based on activity in the patient’s EMR record. Once the survey is completed, follow-up occurs based on your patient’s feedback.

Here’s how it works:

• If a patient responds with a negative satisfaction score, PerfectServe sends a text message asking him or her to connect with the office for further discussion.
  
• If a patient responds with a positive satisfaction score, PerfectServe sends a message asking him or her to share their experience online, complete with a link to your preferred online review platform.

Our clients have found that 40-50% of patients respond to our online survey when they receive it the day after an appointment, and 15-20% of patients who respond to the survey post a review on Healthgrades, Google or Yelp when asked to do so.

If you’d like more information about how PerfectServe can help you survey your patients more effectively and generate more reviews for your practice, contact us.

Building healthcare’s most advanced care team collaboration platform: An interview with the CEOs of PerfectServe and Telmediq

Since its founding nearly 20 years ago, PerfectServe’s mission has remained the same: to help clinicians provide better care. To service that goal more effectively, both the platform and its range of capabilities have evolved significantly over the last two decades, and the company now stands as a leading provider of cloud-based clinical communication and collaboration (CC&C) solutions.

With that focus on creating better patient outcomes in mind, PerfectServe announced today that it has acquired Telmediq, the top-rated KLAS vendor for secure communication platforms in 2018.

Amidst all of the excitement, we sat down with Terry Edwards, President and CEO of PerfectServe, and Ben Moore, CEO of Telmediq, to get their thoughts on the announcement and why it represents such an important step in the march toward true care team collaboration.

Terry, this is obviously a landmark announcement. What’s PerfectServe’s vision moving forward?

Terry Edwards: It all goes back to the concept of “care team collaboration,” a term you’ll hear from us a lot in the coming years. What it means is that we’re trying to eliminate the waste inherent in care delivery workflows and make it easier for clinicians to overcome the care coordination challenges that have existed in the healthcare industry for years.

CC&C—the space that PerfectServe and Telmediq occupy—is a foundational component of this care team collaboration platform strategy. Our vision is to leverage the strengths of these two CC&C solutions to begin building the care team collaboration platform of the future – one that serves all care team members, including the patient.

Ben, it was also announced today that you’ll be joining the PerfectServe leadership team as Chief Product Officer. What excites you about bringing these companies together?

Ben Moore: I’m excited that I won’t have to compete with PerfectServe anymore!

To be serious, though, pursuing the vision Terry outlined will allow our combined companies to have a tremendous impact on the way clinicians care for their patients. Helping to shape the future of products that make such a positive difference is an extremely rewarding opportunity.

From a product standpoint, we’re bringing together two established leaders in the CC&C space, so we have a lot of capability under one roof. Because PerfectServe and Telmediq have different strengths, our strategy is to support both platforms and integrate them such that the strengths of one can be transferred to the other.

Why is now the right time to acquire Telmediq?

TE: Telmediq is widely recognized as a top CC&C vendor, and as Ben points out, its platform has strengths that nicely complement the strengths inherent in the PerfectServe platform. It will bring great value to the PerfectServe portfolio, and as we visualized the pieces of the larger care team collaboration puzzle, Telmediq was really a natural fit.

We also announced today that K1 Investment Management, a private equity firm based on the West Coast, recently became a PerfectServe investor. Their strategic and financial support, coupled with the excellence of the Telmediq platform and the team that built it, make us confident that now is the right time to start executing on our vision of care team collaboration in a deliberate way.

How will this integration of products impact PerfectServe and Telmediq customers?

BM: Integration will take time, and we’re going to be very thoughtful about the process, but the key is that PerfectServe and Telmediq are both cloud-based solutions built on a Service Oriented Architecture (SOA).

In layman’s terms, this is a huge win for our clients, because they’ll be able to maintain the functionality of their current solutions with the option to add new capabilities over time.

TE: This is a theme we’ll be repeating time and time again – no disruptions for clients. We’re incredibly excited about what the future holds, but we’ve also gone to great lengths to ensure that our existing clients experience no lapses in the performance of the product they’ve invested in or the level of service they receive. Clients will always be priority number one.

You’re both very passionate about the role communication plays in providing quality patient care. Does this come from personal experience?

TE: That’s something I really love about how these companies started – Ben and I were both motivated by the experiences of our loved ones.

PerfectServe was actually born from the struggles of my wife, who’s a registered nurse, when she was on call for a private physician’s practice. The process of getting paged and retrieving messages from the answering service, contacting the doctor when required and then relaying necessary information to patients was frustrating and ate up hours of time.

I saw the potential for improvement, and I tapped into my background in the interactive voice messaging industry to build a better answering service solution. We’ve come a long way since the first prototype was finished in 1999!

BM: In my case, an extended hospital stay for my wife and newborn daughter served as the catalyst.

Doctors and nurses do amazing work, but throughout this experience, I was really struck by the cumbersome communication methods being used. The picture didn’t quite add up – physicians using pagers and playing phone tag while their patients used state-of-the-art tech like iPads.

To compensate for these communication shortcomings, I became the de facto care coordinator for my wife and daughter. It was a role I didn’t expect to play, and once we left the hospital, I knew I could come up with a better system. Telmediq launched just a few years later.

In that context, your role as PerfectServe’s Chief Product Officer feels like the next chapter of the mission. Where do we go from here?

BM: As Terry and I have both reinforced, the PerfectServe and Telmediq solutions are already robust in their current forms. But if we’re going to build a comprehensive care team collaboration platform, there’s more work to do.

Today, clinical communication has to overcome both technology silos and people silos. Nurses, hospitalists, primary care physicians and care coordinators may all be using different communication devices and systems in the course of treating one patient. It’s not ideal.

The work ahead of us will reduce breakdowns in communication and ensure that clinicians can collaborate from any location by connecting the siloed people, systems and locations that exist today.

Terry, for those on a time crunch, close by telling us why this announcement is important.

TE: The combination of PerfectServe and Telmediq brings together two best-of-breed platforms in service of a larger goal to bring to market the care team collaboration platform of the future. We intend to be on the front line of innovation as we build a better product for our clients.

Meeting the communication needs of today’s care teams: An interview with CEO Terry Edwards

Terry Edwards, as founder, president and CEO of PerfectServe, has played an instrumental role in evolving the company’s solution from 1999’s version one prototype to today’s product, which has become the most comprehensive and secure care team collaboration platform in the healthcare industry.

Recently, we sat down with Terry to talk about how healthcare communication is changing and how PerfectServe continues to reinvent itself to meet the needs of today’s care teams.

What is PerfectServe?

PerfectServe is a secure cloud‑based communication platform for clinicians. Its focus is to connect doctors and nurses so they can more easily coordinate care.

The thing that makes us unique is a capability that we call Dynamic Intelligent Routing.

This functionality allows us to build algorithms into the platform that automate the communications workflow. This has to do with the “if this, then that” kinds of decisions that are part of a communication process between clinicians to connect the initiator to the right person who can take action at a given moment in time.

We’re like an easy button for clinicians to connect to with each other. By speeding and easing the communications workflow process, we’re able to help them coordinate care more easily.

Communication is such a big part of care. How does PerfectServe define patient care?

The care of a patient is the work of the providers – the doctors, the nurses, the therapists and other ancillary providers. They’re the ones who are interpreting the test results. They’re the ones who are observing and talking to the patients. They’re the hands‑on care providers. Especially in a hospital setting, there’s no one provider – it’s a care team.

Even with certain types of patients, as they transition from the hospital to their home environment, there’s a care team. It may be that the spouse is part of that care team and/or a home care worker as well.

There’s a certain amount of collaboration that needs to occur amongst all of those care team members in order to provide the best care. The ability for them to communicate and connect with the right people for a given situation or a given time of day, that’s the challenge. That’s the piece that we make easy.

What’s on the horizon for healthcare communication? What’s next?

Gartner [a leading research and advisory company], several years ago, coined a term that they call the “real‑time healthcare system.” The real‑time healthcare system is really all about leveraging the increasing amount of digital information inside of a system that’s being created by all these different electronic systems.

If you think back 10, 15 years ago, there was still so much on paper. Now, it’s all electronic. There’s an enormous amount of data that’s being created, but it’s not necessarily being leveraged.

The concept of the real‑time healthcare system is to be able to extract and collect data from these various systems, and then interpret it in ways that can be presented to clinicians, in ways that are relevant to them, so they can take action.

The communications platform serves the unique role of being the engine to receive information from other systems and automatically route a given transaction appropriately based upon the “if/then” variables unique to the situation and recipient. Now, I’m moving beyond person‑to‑person communication.

I’m talking about system‑to‑person communication, where we’re receiving data and then saying, “Oh, this is a critical result and Dr. Smith is the one who needs to get this right now,” and Dr. Smith is the one who can take action. Dr. Smith doesn’t necessarily need to know a whole bunch of other stuff. He just needs to know that.

That’s our role.

As an organization deploys and gets this foundation in place, they have, then, a platform upon which they can begin to automate more and more of these communication workflows to help them provide better care, more efficient care, better quality of care.

As a company, how is PerfectServe evolving to be a platform that can deliver that kind of advanced system-to-person communication?

We’re constantly innovating. When I started PerfectServe over 20 years ago, we were in the physician‑practice office. We started by bringing a technology‑based solution to a human‑centered call answering process, which was just managing phone calls after hours. It was there that we learned about all the complexity in these communication workflows around the doctors.

As time went on and technology evolved, we went from where we were then, which actually was a technology‑enabled services company, to a pure software company. As the Internet expanded, as secure messaging became prominent, texting became prominent, mobile devices became prominent, the Web, etc., we have transformed this company multiple times over the years to take it to where it’s at today.

I expect that we’ll continue transforming into the future.

Could you ever have imagined that it would go from where it was to where it is now?

I knew that it could be a lot bigger when I started it. I had come out of a company called Voice‑Tel in the 1990s. Voice‑Tel was one of the early pioneers in interactive voice messaging. We were a fairly young company. That’s what brought me to Knoxville – starting up the Knoxville operations for Voice‑Tel.

Voice‑Tel was in probably 120 different markets around the United States, as well as into Canada, and down into Australia. We were, at that time, doing over the phone with voice messages what we do with texting and email today. It was a great time. Those were early days of pre‑Internet or when the Internet was just within government and education.

I saw how big Voice‑Tel was, and I knew that PerfectServe could be that big. I didn’t know that it would evolve or turn into what it is today, which is phenomenal.

What separates PerfectServe from other competitors in the marketplace?

I would take it back to that Dynamic Intelligent Routing capability. In most every successful business, there’s something the people in that business know, or there’s an idea they have, that nobody else knows or even thinks exists.

The thing we know is that there is inherent complexity in these communication workflows. And I’m surprised nobody else has figured this out yet, I really am. This is because physicians, departments in a hospital or care teams have ways in which they need to receive information.

It’s not just freeform, everybody’s texting each other, because we’re dealing with what can be life‑threatening information. You don’t just fling a text out to somebody. You need communication processes that are reliable, that are accurate, where you know you can get a message or a call to the right person who is going to take action.

You’ve got to understand and appreciate the workflows of these various groups, then you need software to automate it. If you don’t have that, then you don’t solve the problem. That’s one of the issues with the secure chat capabilities that the EMR companies are trying to bring to the market or some of the other secure texting mobile applications that are just too simple.

They work well for small groups of people who know each other, but they don’t work well across a large enterprise or across organizations. That’s where the process falls down and we have the messy, unsafe communication processes that we have today.

How is Dynamic Intelligent Routing different from some of our competitors’ role-based routing capabilities?

With Dynamic Intelligent Routing, we’re building algorithms that can look at multiple variables that need to be considered in a specific communication process. That differs, for example, from role‑based routing, where someone just is in a role at a given time, because the role could change based on other conditions.

For example, some of the variables that might play into a Dynamic Intelligent Routing calculation include the originating location. Where is this call or text message originating from? What organization or facility? Who is the originator? Maybe, what was that originator’s role? What is the time? What is the day? What is the department as well if it’s an acute care environment? What’s the clinical situation? Then, based on some of those things, what call schedule should we be considering? Is there more than one call schedule that needs to be considered at a given moment in time?

All of that is just to tell us ‘who’ we need to contact. Once we have determined that and we know who it needs to receive it, then the question is how do we communicate with them? Are we delivering a secure message or are we having to send a page because secure messaging isn’t going to work in this particular environment?

If a message is taken or left and it’s not read within a certain amount of time, what do we do to escalate it? That’s what Dynamic Intelligent Routing is. It’s about being able to think through and design those processes, and then being able to process those interactions in real time, automatically to get the right communication to the right person in a way that he or she should be reached.

Imagine I work at a medical group that’s considering using PerfectServe. Why should I sign up?

We’re going to facilitate or enable your communication processes and optimize those for the way in which you work. What that means to you is you’re going to get only the information you should receive, when you should receive it and upon which you should take action.

You’re not bombarded with things that don’t matter, that are irrelevant. You’re not going to be contacted when you shouldn’t be and interrupted, for example. You’re not going to have messages languish that could create a liability for you if you don’t respond, because we’ll build resilience and fail‑safe into those processes.

We’ll probably be able to save you some money, too.

5 ways your answering service is hurting your practice

After hours and 24/7 answering services are essential for modern practices. From freeing up your receptionist during business hours to forwarding urgent information about a patient in the middle of the night, answering services help physicians and their staff improve the patient’s experience.

Unfortunately, answering services with live operators tend to make mistakes, and those mistakes could be liabilities for your practice.

Here are five ways your traditional answering service might be hurting your practice’s reputation.

5. Unnecessary contacting a physician

Deciding when to contact a physician is complicated and leads to one of the more common mistakes traditional answering services make: contacting a physician unnecessarily.

Ever-changing call schedules and workflows are complicated. And with every call, a patient’s life could be on the line. In real time, your answering service must determine which messages can wait until business hours and which ones cannot.

When your answering service makes a mistake and calls a physician over the weekend or in the middle of the night for a non-urgent message, it has a negative effect on your physician’s satisfaction, making it more difficult to retain top talent. The costs associated with physician turnover — including recruiting, on-boarding and lost revenue — start to add up quickly.

4. Frustrated, unhappy patients

Another common drawback of using traditional answering services is missed or lost messages.

Patients want to know that they’re being heard, not ignored, and if your answering service frequently loses your patients’ messages, doesn’t take thorough notes during the call, takes too long to send a patient’s message to you, or sends the message to the wrong provider, it can make your entire practice appear disorganized and even uncaring.

Over time, poor customer experiences with your answering service can be detrimental to your practice’s reputation.

Read how Southwest Cancer Center boosted physician and patient satisfaction by replacing its answering service.

3. Poor Representation

When your office is closed, your answering service represents your practice. In fact, patients may not know they’re speaking with a third-party, so — for them — your answering service is your practice.

For patients, your answering service is part of their overall experience with the practice, so you have to ensure that it is delivering the quality of service your patients expect from you.

Keeping your patients satisfied with the key to patient retention, so go the extra mile to make sure your answering service is delivering.

2. Fluctuating costs

Practices commonly spend much more on their answering service than is budgeted.

Many answering services have hidden fees and charges based on call volume and duration. If you’re not paying attention, those fees can add up quickly, and suddenly your answering service is costing you much more than you originally intended.

To get a more accurate account of exactly how much your answering service is really costing you, look at your month-over-month charges and take note of the fluctuations. It takes time, but uncovering your answering service’s variable costs is the only way to figure out how much your practice is truly spending.

1. Disaster preparedness

You know that healthcare can’t stop when inclement weather, natural disasters and other emergencies happen. Keeping open lines of communication between providers and patients is essential during emergencies, and your answering service has to be able to take messages and route emergency calls effectively.

If your answering service depends on live operators, though, its call center could also be affected by the disaster, making it impossible for them to answer your patients’ calls.

Download our disaster preparedness checklist here.

Not all answering services provide the same level of service and support. Use these factors to assess your current after hours or 24/7 answering service vendor and decide if it’s time to look for another solution that can better protect your practice.

“Where’s my nurse?”: How to empower nurses to spend more time with patients

As a new parent, there’s nothing scarier than being in your daughter’s hospital room when an alarm goes off and you can’t find her nurse.

But that’s exactly what happened to me.

My daughter — only a few days old — was fighting for her life in a neonatal intensive care unit, and I was in the hall, trying to find her nurse.

Of course, it wasn’t the nurse’s fault, and she was always apologetic. The reality is, she had other responsibilities, other commitments that kept her away.

At the time, I was working in a hospital, so I understood her situation. I got it. But many families don’t realize that nurses are often overwhelmed and can’t always be there for their patients.

Unfortunately, these heart-wrenching situations leave patients and their families with a lasting impression of their care team and the hospital.

What keeps nurses from the bedside

Every single day, nurses are saddled with administrative tasks — looking for equipment and supplies, tracking down medications, checking for critical lab results, collaborating with the care team and documentation, just to name a few — and inefficient workflows that take them away from their patients.

In fact, a recent study found that nurses may spend less than two hours of a 12-hour shift in direct patient care. A portion of this unproductive time is spent using old, inefficient tools for communicating and coordinating with multiple points of care, both inside and outside the four walls of the hospital.

Even today, at some of the country’s top hospitals, nurses wait hours for a simple call back from a sent page.

Worse yet, nurses are continuously flipping through multiple versions of paper on-call schedules, simply trying to figure out which specialist or attending physician is on service. Often, mistakes are made in the interpretation of these paper documents, igniting a series of follow-up efforts to relay important information to the right provider.

Meanwhile, my newborn daughter’s alarm is going off, and I’m anxiously walking the halls, looking for her nurse.

What it means to empower nurses

All across the country, hospital systems are recognizing that they have to increase the amount of time that nurses can spend on the most important task: caring for patients and comforting families.

Hospitals are researching clinical communication and collaboration vendors and investing in near-real time tools for nurses so that they can get the help they need more quickly and communicate with the people they need more easily.

Empowering nurses with a mobile, secure care team communication tool means that they receive a response back from providers an average of 30 minutes faster. It also means that nurses can respond to changing patient conditions and alarms 30 minutes faster, which has a huge impact on patient and family satisfaction.

Nurses also experience an 81% decrease in the number of repeat calls to providers, as the technology has properly identified the correct on-call provider and eliminated errors.

Today, solving this problem is possible. We can remove communication barriers. We can fix broken workflows. And we can take the administrative burden off nurses and let them get back to enhancing the care quality and the patient experience.

Four simple steps for reducing third-party service costs

In the age of near-constant mergers and acquisitions, health systems are taking on tremendous costs in the form of third-party — or purchased — services.

When a hospital or health system acquires a private practice, it inherits all of that practice’s contracted purchased services, including IT and telecom, clinical services, security, maintenance and more.

When hospitals, and especially health systems merge, the purchased services problem gets compounded as the newly merged system takes on all existing service contracts from all practices affiliated with the previous organizations.

Third-party services can represent as much as 20% of your organization’s annual spend.

While purchased services are crucial to operations, they’re not always top-of-mind when evaluating costs and budgets. After all, if a system is working well, it’s typically overlooked. But when you consider that third-party services can represent between 15-20% of an organization’s annual spend, it becomes obvious that these are opportunities in disguise.

Purchased services are often an untapped source of savings across the supply chain, and they present unparalleled opportunities for standardization of processes and technology.

Here’s a simple four-step process to successfully lower your organization’s purchased services costs while improving care delivery.

Gather the data

For many healthcare organizations, simply gaining visibility on third-party contracts and costs can be challenging. More often than not, these contracts are managed by various people throughout the organization.

Start gathering the data by making a list of all third-party vendors used throughout your organization and their associated stakeholders. It’s important to speak with every stakeholder on your list and review each vendor’s contract.

There are a few key things to look for in your service contracts:

• What’s my rate?
• What are the scaling terms?
• Is there an auto-renewal in place? If so, when?
• What are the termination clauses?

The next hurdle is collecting all financial data for your vendors. Check with your accounts payable department and take a look at your purchased orders. But unfortunately, purchased orders won’t tell the whole story. Many third-party vendors have variable costs that make it difficult to get an accurate account for how much they’re really costing you. Your general ledger will help you uncover variable costs.

Use your general ledger to help you uncover your vendors’ variable costs.

You may find that the individual cost of many of your third-party vendors is relatively small, but when you aggregate your spend, the numbers start telling a larger story. Place vendors into categories to get a more accurate picture of how much your organization is truly spending.

Gain executive buy-in

Armed with your data, it’s time to earn your executives’ buy-in.

Engaging them early in the conversation is a great way to build the case for moving forward with this project and understanding the shifts in your organization’s culture that might result from a new strategy.

Speaking with your executives can help you understand the “sacred cows” in your organization, those vendors that are above reproach for some members of the health system.

With this in mind, you can navigate the surmountable road blocks and build the business case to make changes.

Analyze performance

Analyzing the performance of your organization’s purchased services has three main parts:

• Comparing spend
• Assessing utilization
• Evaluating the quality and efficacy

Some vendors charge hidden or variable fees, so looking at one month’s service charges could be misleading. Look at each vendor’s historical spend, trends and variability. Then, consider your regional benchmarks: What prices are other vendors in your area offering for a similar service?

Another important aspect to consider is utilization. Here are some basic questions that can help you begin to assess your organization’s utilization:

• Who is actually using each vendor?
• How are they using it?
• Could the service be used more efficiently?

Finally, do some digging to find out your staff’s level of satisfaction with your third-party vendors.

• What kinds of outcomes are you paying for?
• Are stakeholders happy with the performance?
• What kinds of performance metrics can the vendor provide?
• Does the vendor make your staff’s job easier?

Evaluate standardization options

Completing the first three steps will give you a firm grasp of what types of services you’re paying for, how they’re being used throughout your organization and your staff’s openness to try new solutions.

When considering replacing a multitude of similar vendors with a single standardized solution, make sure that your new vendor does the following:

• Addresses all stakeholder needs and goals
• Has a positive impact on your organization’s overall spend
• Plays a role in your organization’s strategic objectives

At the end of your evaluation, you should be prepared to make specific vendor recommendations based on your analysis and your organization’s strategic imperatives.

Third-party vendors are essential to hospital or health system operations and shouldn’t be overlooked when evaluating spend. When your organization undergoes a merger or acquisition, it’s even more important to gain the visibility you need to help the new organization operate more efficiently.

Mark Ferraro is Consulting Director of Purchased Services at Vizient, Inc. Mark brings more than 14 years of experience in the healthcare industry. Prior to joining Vizient, Mark was the Executive Vice President for a national Hospital Physical Inventory company. He has also held positions as a Senior Consultant in Purchased Services for MedAssets and a Purchased Services Consultant for Owens and Minor. Mark received his bachelor’s degree in History and Political Science from Longwood University in Farmville, Virginia and his Master of Science degree in Business Administration from Strayer University in Richmond, Virginia. Mark is also a member of The Association for Healthcare Resource & Materials Management (AHRMM), Virginia Association for Healthcare Resource & Materials Management (VAHRMM) and The Healthcare Financial Management Association (HFMA.)

Vizient, Inc., the largest member-driven health care performance improvement company in the nation, provides innovative data-driven solutions, expertise and collaborative opportunities that lead to improved patient outcomes and lower costs. Vizient’s diverse membership base includes academic medical centers, pediatric facilities, community hospitals, integrated health delivery networks and non-acute health care providers and represents approximately $100 billion in annual purchasing volume.