Medical Call Centers Rise to Meet Healthcare’s Pressing Needs

By Gina Tabone

Medical call centers have finally gained recognition and credibility in the healthcare marketplace. Centralized medical call centers are rapidly emerging as the backbone of health systems because they are integral in achieving better patient outcomes. They offer a proven solution for reaching the three goals of the triple aim: improving the patient experience of care, improving population health, and reducing the per capita cost of healthcare.

Improving patient experience requires open access so patients receive the most appropriate level of care needed, in a time best determined by specially trained nurses guided by evidence-based tools. The patient learns to expect reliable advice, taking into account their current health state and consistently available day or night. Gaps in care are eliminated and delays are avoided, leading to favorable patient outcomes and higher reimbursements in a fee-for-value model. When patients’ well-being is enhanced, everyone gains, especially the patients. Medical call centers can stake a claim for making that happen.

Labor costs consume up to 70 percent of many call centers’ operating budgets. Outside partners can assume the responsibilities with greater efficiency and better outcomes for a lower cost. The choice to retain, outsource, or develop a hybrid pursuit is a multifaceted decision that organizations must thoroughly evaluate to determine which solution best aligns with their mission, future vision, and strategic plans.

Medical call centers are taking on a variety of responsibilities that are well suited to be conducted remotely and reliant on state-of-the-art technology and a dedicated workforce. Appointment scheduling is the most common task in many medical call centers and often happens in tandem with the strategy of centralization. Electronic medical records (EMR) products now have customized templates embedded with providers’ schedules used for office visits, imaging, or procedural appointments. Outbound calling campaigns are often conducted in conjunction with scheduling for appointment reminders.

Additionally, centralizing medication refill requests is emerging as a successful addition to many medical call centers. Call center technology such as CRM (customer relationship management) allows requests to be tracked, acted upon, and measured to ensure that established targets are met in a timely manner. Patients expect a standard process for their medication needs and a defined time for responses or resolution. Medication management and compliance is critical for optimal outcomes, so implementing a process that fosters this is a good idea. Patients stratified as high risk garner the most advantages, which contribute to maximum reimbursements for medical treatments.

Medical call centers have taken on the significant task of not only caring for the acute needs of primary care patients but also the chronic needs of vulnerable, high-risk patients as well. Successful coordinating and transitioning care is central to every health system’s strategy. Nurses are the clinicians assigned to figure out how to morph from case management to transitional care coordinators.

Training nurses in the fundamentals of remote patient care is imperative and is based on the standards of care used by telephone triage nurses. The practice of triaging acute symptoms will serve as the starting point for nurses involved in coordinating care.

We must continue to proclaim the unlimited value of a medical call center to the healthcare industry. In many healthcare organizations, more than 10 percent of employees spend the majority of their day doing their job on the telephone. The benefits of centralizing and consolidating the work they do are undeniable.

The task at hand is capturing the limited attention of decision-makers and educating them on the role medical call centers play in a fee-for-value system and the distinct results that are possible. The political future of healthcare may be uncertain, but there remains a need for products, services, and expertise that bring the call center to the forefront of patient care.

Gina Tabone, MSN, RNC-TNP, is the vice president of strategic clinical solutions at TeamHealth Medical Call Center. Prior to joining TeamHealth, she served as the administrator of Cleveland Clinic’s Nurse on Call 24/7 nurse triage program.

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