Complex Practice Improves Clinical, After-Hours Communication with Custom Solution

Premier Surgical Associates

Knoxville, TN Area




“Before PerfectServe, we had a typical answering service. They were satisfactory— but they weren’t innovating.”

That’s Matt West, Chief Operating Officer of Premier Surgical Associates. Premier is East Tennessee’s largest surgical provider, and its 28 physicians perform more than 15,000 general, vascular, bariatric, and oncology surgical procedures a year and see upwards of 1,000 patients in office visits each week.

“We perform surgeries at almost every major hospital in the area,” says West. “When our physicians are on call, they may be covering for more than one hospital. Or they may be on call for both general and vascular patients. And each doctor wants to decide how he is reached and how calls are handled. At the same time, we need our communications to be efficient, secure, and compliant.”


West notes that few physicians look forward to their time spent on call, yet all recognize the vital need for rapid and clear communications between doctors and patients after normal hours. They weren’t happy with the old system, and they were letting West know.

“As our complexity grew, so did dissatisfaction with the status quo answering service,” recalls West. “The wrong messages were often delivered to the wrong doctor—and not necessarily by the most HIPAA-compliant method. Then the doctor who received the message would have to track down the doctor on call to forward it. And I’d hear from a frustrated doctor the next day: ‘Why am I getting these messages?’”

The information provided about the calls was also seriously limited. West describes a typical morning at Premier: “The answering service would send us a fax or email listing calls from the night before, but without any detail on what transpired. The staff would have to scramble to find the doctor and confirm what had happened: ‘What did you do with that patient? Was there a consult? Do we need to follow up?’”

Even more urgent was the need to ensure compliance with HIPAA regulations and reduce Premier’s risk of a security breach. “I’m also the privacy officer,” notes West. “First and foremost, we wanted to address that risk.”

When West began evaluating vendors, he knew it wouldn’t be easy. Premier’s unique workflow couldn’t be forced into a one-size-fits-all offering: “There are a lot of idiosyncrasies to our organization. A generic solution wouldn’t have worked.”

A Solution Up to the Challenge

One of the office locations in Premier’s practice group was already using PerfectServe on a limited basis, and the facility’s office manager encouraged West to take a look. After seeing what PerfectServe had done with its algorithms and how well the company understood the requirements of Premier’s IT systems, West was convinced he’d found the right partner for the whole organization. “We didn’t see this kind of customization from any other company,” he notes.

West says his confidence proved well-founded: “[PerfectServe has] given us a system complex enough behind the scenes to meet all our needs, but with tremendous simplicity and usability. Not 8,000 different menu options, just six or seven different key functions that allow users to do what they need to.”

More Than an Answering Service

Each doctor can choose or change how he or she wants to be contacted, from any device and in real time. Users can send messages, add attachments, or make calls from within the PerfectServe app, keeping communications secure.

Instead of sending emails, PerfectServe’s streamlined web portal allows the Premier staff to easily send doctors HIPAA-compliant messages. “A lot of doctors don’t read their emails,” West says, “so this notifies physicians on their phones. Just a quick little secure message telling them, ‘You need to see Mrs. So-and-So in room 403,’ or ‘Call the lab about X,’ and the staff can see when the message has been read.”

The real test of any system is how it handles after-hours calls from patients. West notes that any patient calling after hours likely has a medical issue or concern and is anxious to hear back. PerfectServe helps Premier manage the communications workflow to ensure a rapid and effective response.

“After-hours patient calls go directly to a transcription service, and we’ve provided the transcriptionists with customized templates to ensure the proper information is captured,” West explains. “This way, we know the call details going to the physician are succinct yet complete, so the doctor has the right information to decide if it’s something that can wait until tomorrow, or if the patient needs immediate attention.”

Another valuable feature is the centralized scheduling. “It used to be that our physicians were always looking at ten different calendars to see when they were on call,” says West. “Most of our doctors now operate completely from their mobile devices. They use the PerfectServe app to look at their schedules, send and receive messages, forward them to their partners, and so on.”

Finding Answers Together

Implementing the PerfectServe platform across the entire Premier Surgical Associates organization took about four months. PerfectServe and Premier worked together closely to fine-tune the system as it was deployed.

“One of the things we struggled with for the first couple of months was that a patient would call our office after hours, get directed through the auto-attendant and then be asked, ‘Is this a general surgery issue or a vascular surgery issue?’” West says. “Well, the patients don’t know. To them it’s all just surgery. So they were routinely selecting the wrong choice, and getting routed to the wrong physician. It’s the kind of thing you don’t anticipate, but you learn as you go.”

Working collaboratively with PerfectServe, Premier came up with a plan to easily resolve the issue: now patients just select their doctor. If the doctor’s not available, the message is automatically routed to the doctor on call.

“We appreciate that once we defined the things we wanted to do differently, PerfectServe quickly made the changes, sometimes in a couple of hours,” West says. “They’ve shown an ability to adapt on the fly with things that are important to us. We never got an answer like ‘No, we can’t do that.’ They’d say, ‘OK, let’s figure it out and fix it’— and we’d work together to come up with a solution.”

Change Made Easy

Driving adoption of a new system across an organization also presents challenges. Early adopters may embrace a new technology from the start, while others resist leaving the tried and true. West notes that the simplicity and intuitive functionality of the PerfectServe app soon won over even those who were least comfortable with digital technology.

“We started implementing in February and kept working with PerfectServe to tweak the system,” West recalls. “By mid-April, I wasn’t hearing any more complaints and I even got some positive feedback. And for surgeons, that’s unheard of.”

The Results

West reports that physicians and staff especially value the detail and accuracy of information that PerfectServe puts at their fingertips. Because the Premier staff is copied on all physician after-hours messages, when they come in the next morning, they can simply review the messages and quickly decide if they need to follow up with a patient or doctor.

An added bonus has been the organization’s ability to use these detailed messages to help track and improve billing for consults and other physician tasks that the old system didn’t track. West also deeply appreciates not having to worry about HIPAA compliance.

West saves his highest praise for PerfectServe’s flexibility and its ability to customize a solution that precisely met Premier’s unique needs. “They put a lot of resources into making sure that their solution would work perfectly for Premier.”

West’s advice to other practices looking at solutions for secure communications? “You need to look for a vendor that understands that not all practices are the same. PerfectServe’s understanding of this was critical to our implementation and overall success.”

West also expresses confidence that as Premier Surgical Associates continues to grow and evolve, PerfectServe will keep pace. “I’ve been asked by PerfectServe to join strategic discussions and contribute ideas,” West says. “It feels good to know PerfectServe is engaging customers to help build a strategic road map for what kind of products and services they develop, and I appreciate being able to give input on that.”

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