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.

Why secure messaging isn’t enough

In today’s health systems, secure messaging is a must-have, but it’s only one piece of a much larger clinical communication strategy.

For hospitals around the country, secure text messaging has represented a major step forward for simple care team communication. Compared to overhead paging systems and outdated medical pagers, HIPAA-compliant texting apps are much more convenient for clinician communication.

For health systems, though, secure messaging apps have always been a half measure. They make clinical communication easier and greatly reduce the risk of accidentally exposing PHI, but they aren’t robust enough to coordinate care teams and manage hospital resources.

Secure messaging is a must-have tool, but it’s only one piece of a much larger clinical communication strategy that must also interoperate with the hospital’s ecosystem, including the EHR, alerts, notifications and nurse call systems.

How secure messaging apps are like pagers

The appeal of secure texting apps is simple enough: they’re convenient, they keep all clinical conversations on a single secure platform and they have intuitive user interfaces that feel familiar for end users.

Unfortunately, secure texting platforms also carry on one of the major problems of yesteryear’s direct-to-provider pagers: lack of situational awareness. Like physician pagers, secure texting applications can’t prioritize notifications and route messages to the right person at exactly the right time.

For practicing physicians, this lack of situational awareness has real consequences. Routine text notifications become a distraction at the patient’s bedside and an annoyance at home when the physician is off-call.

Secure texting applications provide nurses with another way to get messages to physicians, but they don’t help to simplify a nurse’s complicated and fractured workflows. The nurse is still responsible for figuring out who’s on-call and how to contact that person.

In a workplace full of alerts, alarms and notifications, unprioritized secure messages simply add to the noise.

Making secure messaging meaningful

High-quality patient care depends on two things: the accuracy and timeliness of communication. In other words, every member of the patient’s care team must be able to communicate quickly and efficiently.

Secure messaging apps foster highly fragmented communications that move across complicated workflows.

Alone, secure messaging can’t account for situational variables that make it difficult to know who’s available and ready to take action to advance patient care.

Clinicians must first figure out which group is on-call, which provider within that group is managing patient issues “right now” and then relay the issue using the secure messaging app. And if that provider happens to have been called into emergency surgery, they must figure out whom to message next.

Making secure messages meaningful takes an intelligent notification routing system that organizes, prioritizes and directs messages to the right care team member at the right time. Combining secure texting with intelligent automation is the only way to reduce the noise and make notifications more useful – and reduce care delays.

Secure texting is a step in the right direction, but improving the patient’s experience and the clinician’s satisfaction requires building an intelligent communication framework  that connects clinicians to clinicians, as well as clinicians to the organization’s technological ecosystem.

Evaluating your processes and redesigning your communication strategy around a full-service clinical communication and collaboration app will give secure messages meaning and eliminate the friction that slows down your care team and gets in the way of your organization’s strategic goals.

Getting it right: 10-point checklist for mobile devices and testing in nursing

This article originally appeared in Becker’s Hospital Review on July 9, 2018.

Use of mobile devices by nurses is increasingly prevalent in hospitals and health systems. According to a 2018 survey, 72 percent of respondents reported using a program that provides nurses with devices.

Smartphones enhance speed of care by providing nurses and other clinical staff with the convenience of always-available communication tools and clinical applications. Connected nurses more easily communicate and collaborate on patient-centered care with care team members. The benefits of nurse mobility are numerous.

However, mobile devices for nurses must be rigorously tested and validated. Evaluating mobile devices is a process that should not be rushed. The consequences of purchasing the wrong device and not testing usage in real-life scenarios for thousands of nurses can be disastrous—both financially and in terms of communication breakdowns.

I am constantly surprised by how many health systems have deployed nurse mobility devices only to have them end up unused in a drawer. Getting it right can launch an integrated delivery network to the forefront of digitized care team collaboration.

This article lays out best practices and a 10-point checklist to consider when planning and implementing a mobile device strategy for nursing teams.

1. Consider the usability of the device. First and foremost, make sure the devices you put into your users’ hands are well received. Form factor, battery life and performance all play into user acceptance of the devices. Shortcomings in any of these categories will have a negative impact on adoption.
2. Verify the compatibility between the device and your user applications. While the most obvious application to consider is the mobile app for your EHR, it isn’t the only application you should test. Be sure to create an application inventory on a role-by-role basis—a helpful guide to your app testing.
3. Consider the durability of the device. Review the durability in three key areas. First, how rugged the device is from a drop perspective. Ideally you should consider devices that pass repeated four-foot drops. Second, how well the device can tolerate liquids. Users don’t control when and where they inadvertently drop devices, and at some point one will end up in a sink or toilet. Finally, how well the device handles the common sanitization agents used by your facility. Good infection control practices include regular disinfection of the devices—make sure they won’t disintegrate as a result.
4. Test the reliability of the device on your wireless network. Not all devices seamlessly transition between wireless access points when the user walks through a hospital. As hospitals have added more access points to improve coverage, devices interact with more access points, which increases the frequency of network issues on the device. This instability is one of the most common contributors to device failures.
5. Validate the voice quality of the device. In most cases, the device is used primarily as a phone. Test the voice quality of the device when paired up with your wireless network and PBX. If it can’t be a good phone, then the rest doesn’t matter.
6. Ensure your device will support a secure operating system. Pay attention to the operating system shipped with the device, as well as future plans during the course of the device’s lifecycle in your organization. Specifically, make sure the device will always have the ability to run an operating system that continues to receive security patches from the vendor. Guard against an end-of-life operating system.
7. Purchase during the first half of the device lifecycle. In short, make sure the devices you deploy have enough horsepower to last at least three years. Purchasing devices early in the lifecycle will help maximize usable life. If you purchase too late in the lifecycle, users will complain about performance long before you plan to retire the devices.
8. Plan for organizational change required for device deployment. Change is hard and it’s human nature to resist change. Make sure you consider your training program, how you will overcommunicate with end users, and who can become your “change champions” to help evangelize for the change.
9. Consider the manageability of the devices. Use a mobile device management (MDM) solution to deploy and manage your devices. If you don’t currently have an MDM, bundle that decision in with the device selection. Do not try to deploy devices enterprise wide without an MDM.Pilot the device in real-world situations. Your device evaluation needs to go beyond hands-on sessions in conference or training rooms. These environments can help narrow your devices down to a short list, but they do not represent the environment in which your users will use the devices. After all, most clinical users move all over the unit, if not the entire hospital. Plan to have users in various roles use the devices in their everyday workflows. This is the best way to identify the strengths and weaknesses of the device in your environment.

Getting your mobile device strategy right is crucial. Informed leaders will make sure nursing professionals are part of a thoughtful, rigorous and structured process. Before making a purchase, ensure the device you choose meets the needs of your nursing team.

To download the article as a PDF, click here.

Is your answering service disaster-proof?

Is your answering service disaster-proof?

It’s tempting to think natural and manmade disasters can’t happen here.

Until they happen here.

By the time a wildfire, flood, earthquake, snowstorm or explosion happens, it’s too late to make a plan. Disasters put your community under tremendous stress, especially its healthcare infrastructure.

Fortunately, healthcare doesn’t stop for disasters.

While hospital emergency departments become the frontlines during a disaster, physician practices play an important role, too.

Timely communication between providers and patients plays an essential role in preventing exacerbation of illness during these times of emotional stress and resource challenges.

Physicians and practice managers have to identify communications risks and create policies to minimize those risks.

Open lines of communication

When an emergency happens, your first line of defense is your answering service.

Even if your office doors are closed, your answering service can still take your patient’s messages, route emergency calls and help you stay in contact with your most vulnerable patients.

Unfortunately, not every answering service is capable of helping you virtually operate your office during a disaster.

Pitfalls of human-centric answering services

Human-centric medical answering services and call centers aren’t immune to disasters, especially if they’re provided locally.

If you’re having trouble opening your practice, it’s a safe bet that operators from your local answering service are having trouble, too.

The answering service’s call center could be damaged during the wildfire, snowstorm or flood. And if the roads are out, the operators might not be able to get to their office to field your calls.Alternatively, your human-centric answering service might be located in another city and state entirely. It could experience an unforeseen disaster that makes it impossible for them to operate.

Suddenly, your answering service isn’t taking your overflow and overnight calls. Your in-office receptionist is overwhelmed and can’t keep up with your call volume.

Considerations for a 21st-century answering service

When you’re identifying your communications risks and evaluating your current answering service’s performance, consider the following:

Power outages

Power outages are common. That’s why many companies use backup generators to offset temporary outages. Unfortunately, in the case of a natural disaster, the power could be out for days or even weeks.

Does your human-centric answering service have a protocol for an extended power outage? Are there back-up protocols in place to prevent failure?

If the answer to either of those questions is “no,” your patients won’t have any way of reaching the right on-call provider during a disaster.

Call and message routing

Even if your answering service doesn’t lose power during a disaster, what happens if your on-call provider can’t answer his or her phone?

Make sure your answering service has a plan for routing emergency messages when the on-call provider doesn’t answer. There should always be a protocol in place for automatic message escalation.

Infrastructure

Damage to communication infrastructure is common during disasters. Power outages, for example, can affect landline phone service, especially if you depend on broadband connections, like Voice over Internet Protocol.

If a wildfire, hurricane or some other kind of disaster compromises your landline phone and internet connection, how would your answering service contact your physicians?

Staying connected

No matter who you are or where you live, the chances are, a disaster will happen eventually. Make sure your practice is ready for the inevitable.

We’ve created a disaster and emergency communications checklist to help you identify risk so that you can start building a contingency plan to help you continue to provide support to your patients in critical moments.

Download our disaster and emergency communications checklist here.

HIMSS18 and the future of clinical communications

What I learned about the future of clinical communications at HIMSS18

I spoke to a number of healthcare leaders at HIMSS18 about their collaboration strategies and the tools they use to make care coordination easier, and it was obvious that clinicians are still struggling with the friction inherent in today’s communication infrastructure. This friction comes from our industry’s complex workflows and outdated, disconnected communications technology.

Solving this conundrum requires that we reimagine the role and function of clinical communications in care delivery. This means rethinking how we might leverage advances in technology and mobility to make it easier for clinicians to quickly connect with one another — and to deliver actionable information to them so they can better manage care.

The communication technologies that got us where we are today will not get us where we need to be tomorrow, and tomorrow is all about timely patient-centered collaboration that allows clinicans to speed time to care and treatment.

Why is healthcare communication so complex?

Healthcare communication is complex because clinicians employ workflows in which situational variables must be considered to determine whom to contact and how to do so. Figuring this out places a tremendous burden on the clinician who initiates communication to another care team member — a burden that takes the clinician away from value-added patient care activities, is error prone and contributes to delays in care.

We have asked clinicians to solve an extremely complex puzzle amidst an already very busy day. It’s easy to understand how mistakes are made.

How did communication technology become so fragmented?

Over the past three decades, technological innovations in virtually every sector have helped us solve problems and become more efficient, and the same is true in healthcare.

Telephone-based answering services were created to simplify the relay of messages to physicians. Pagers were created to streamline direct-to-provider notifications. Nursing devices were developed to communicate patient needs and facilitate conversations across care team members. Secure texting applications, alerts and alarms systems, real-time location tracking and the like were all created for a specific purpose.

The problem we now face is an inherently disconnected portfolio of communication tools. We are starting to feel the pain of these siloed systems, and we must take steps to bring them together.

How do we prepare for the future of communications in healthcare?

As I observe the movement of healthcare to outpatient settings and the home, it becomes clear that communication processes must overcome geographic and organizational boundaries.

Value-based care and population health management require care team collaboration across providers and care settings that extend beyond the four walls of the hospital or clinic, and so too must our communication solutions.

I spoke with several leaders at HIMSS18 who have come to realize their electronic medical record (EMR) system is incapable of supporting the urgent, time-sensitive communication that occurs outside the EMR. An effective solution needs to transcend the EMR and facilitate collaboration across clinicians in disparate organizations.

Organizations that rely on their EMR as their clinical communications and collaboration (CC&C) platform are building a communications “island” that limits collaboration. The ability to facilitate timely communication across an entire patient-care ecosystem requires a completely different approach.

We must eliminate the friction in clinical communication

The next leap in clinical communication will help our frontline clinicians speed time to care through efficient, patient-centered, cross-continuum collaboration.

I really believe that the healthcare market is ready for a purpose-built CC&C platform that helps clinicians coordinate care inside and outside the four walls of a facility by bringing together a wide range of siloed communication tools. Tomorrow’s care requires a CC&C platform that facilitates intercommunication between these compartmentalized systems and eliminates the friction in patient care.

It is our duty to empower the clinical community with CC&C solutions that support their quest to improve the efficacy of treatment and quality of life for the patients they serve.