Virtual Office Phone Answering

Continuing with the theme of the last post, we're taking a closer look at one of the main challenges faced by medical practices according to the 2011 MGMA member survey. For the past few years, operating costs have been rising faster than revenues for the average medical practice and this trend is expected to continue. 

For additional information, please visit Webley. 

Wait times are a key source of patient dissatisfaction. Press Ganey, a health industry survey firm, looked at hospital satisfaction scores and found that keeping patients informed of delays can increase patient satisfaction.  They also found patients were equally dissatisfied with wait time in the exam room vs. the waiting room. You can boost patient satisfaction by making a few changes that reduce wait times.

Phone wait times


Practices that have adopted patient check-in technologies (e.g., electronic check in using a kiosk or tablet PC) have dramatically reduced check in times. For example, Vanguard Urological Institute in Houston, TX, a 4 member practice, adopted a check-in kiosk - the average wait time at Vanguard in 2010 was 2.44 minutes while the national average is 21.3 minutes. 

Offering forms on your practice website that patients can print out and fill out ahead of time is convenient for patients, inexpensive for the practice and effective at reducing office wait times. 

While few patients like wait times, sometimes they are inevitable.  The best way of dealing with long wait times when they occur is to keep the patient informed and apologize for the delay. Also make sure you have a wide variety of current magazines in your waiting room to help pass the time.

For additional information on how medical office automation technology can help your practice, visit Webley.

* Source: 2009 MGMA cost survey

The median wait time at U.S. emergency rooms is 2.6 hours. The average wait time is 4 hours. Experts are predicting that wait times will only get worse. If those statistics aren't enough reason to avoid unnecessary ER visits, then patients should try, when possible, to go to the same emergency room.

A report published in the Archives of Internal Medicine found that adults in Massachusetts who visited ER at different hospitals paid almost twice as much than adult patients who went to the same hospital. By visiting multiple hospitals, patients were exposed to a greater risk of medical errors, delays in treatment and duplicate tests. Provider to provider communication across organizations, is still poor.

USA Today recently published an article highlighting the popularity of retail clinics. There are about 1,250 retail clinics in the US. The largest, Minute Clinic, has 600 clinics in CVS stores. These retail clinics will continue to be popular because of their convenience and affordability. 

Patients can't wait to see family physicians, if they have them. Not all patients can wait weeks for the next open appointment. They may not be facing a life threatening condition, but they may be in considerable discomfort.

A growing number of people do not have primary care providers. Half of those who visit Minute Clinics fall in this category. With the shortage of primary care physicians, many are not accepting new patients.

Retail clinics have better technology, affordable pricing, and increased convenience. The longer hours and greater number of locations make retail clinics a good, convenient choice for many. Most retail clinics use EHRs while the EHR adoption rate for office based physicians just crossed 50% in 2010. The per cost visit (typically under $100) appeals to those without insurance. Many insurance companies reimburse retail clinic visits, so they appeal to those with insurance as well.  

While clinics can't provide the range of services of a family physician and they may see patients that otherwise would not have visited a family physician, they can handle routine acute conditions, as well as provide vaccinations and physicals. Urgent care facilities can take care of others, leaving complex, chronic conditions to family physicians. 

The following is an excerpt from a review posted on Insider Pages:

I wanted to give a shout out to a blog that I found that seemed particularly helpful for medical practice managers. It's called Manage My Practice and the author is Mary Pat Whaley, a practice administrator in North Carolina. If you're a practice administrator, you're sure to identify with her and if you're not, you can learn what the life of a practice administrator is like. 

One recent blog post contained many helpful pointers for practices that are struggling with answering patient phone calls. Mary Pat writes: "The only answer to understaffing is technology. Use a patient portal to allow patients to request refills, schedule appointments and chat with billing staff or nurses. Replace paper charts with EMR. Use efaxing to eliminate paper faxes. Use the cloud to store information and collaborate."

The key themes are (1) centralizing your information to make it easily accessible to others at your practice, (2) reducing paper - it's eco-friendly, saves money and makes it less likely that something will get overlooked/lost, (3) increasing the accessibility of your staff to your patients - maybe this means that it's time to let your patients email your staff, (4) offering self-service features for patients.

Automated patient messaging systems, aka reminder call software, save time and money for your practice. They make it easier for the practice to communicate with patients, whether it's sending appointment reminders or telling patients that their lab test results are available. They make it easier for patients to confirm their appointments. And the system tracks patient responses, creating an electronic report that can be accessed from any computer with an Internet connection. 

Automated voice answering services answer the phone for your practice and direct your callers - connecting them to the right person or organizing messages when no one can answer the phone. By connecting the caller to the right department or person, messages are organized, saving response time and the potential for lost or incorrectly relayed messages.

The virtual office receptionist answers the phone during lunch, breaks and after hours.  The automated answering service can be easily turned on or off whenever the practice feels it is necessary or when everyone is away from the office.

The crisis with emergency rooms, where the average wait time is 4 hours, has spawned a new trend, making appointments for emergency room visits. The Los Angeles Times reports that 8 Southern California hospitals now offer ER appointments using a system called InQuickER. Patients pay $14.99 - $24.99 to make the ER appointment. They're guaranteed that if they show up at their assigned time, they will be seen in 15 minutes or get their money back. InQuickER says that 95% of these appointments have been kept. Hospitals may still ask that the appointment be made several hours in advance but the system reduces the amount of time spent in the waiting room.

In a recent study published in the Canadian Medical Association Journal, researchers found that physician displays of empathy in clinical settings led to higher levels of patient satisfaction with the care received, higher motivation to follow treatment plans and fewer malpractice complaints.

Another study published in the July/August 2009 issue of the journal, Family Medicine, found that patients with colds whose physicians showed empathy towards them during an office visit got over their cold one day faster than a patients with physicians who took a just-the-facts approach.

What is empathy? 
"Empathy is the ability to understand another's experience, to communicate and confirm that understanding with the other person and to then act in a helpful manner," writes Dr. Robert Buckman,  of Princess Margaret Hospital and the Faculty of Medicine, University of Toronto. 

How do you display empathy in a clinical setting?

Understanding someone else's experience involves good communication skills, including asking the questions, listening to the patient, making the patient feel comfortable, communicating clearly and making sure that the message is understood. The empathetic physician shows care and compassion.

Empathy shouldn't stop with the physicians. The staff should show empathy as well. Has the patient had to wait longer than usual to be seen? Are you unable to see a patient right away because your schedule is full? Has the patient on the phone been unable to get through because the line is busy? Be empathetic and patients will be more understanding. Apologize for the delay. Offer alternatives if the patient can't be accommodated. Consider using an automated phone answering service (aka, automated virtual office receptionist) to field calls, eliminate busy signals, and direct callers to the right department.

* Canadian Medical Association Journal. "Showing empathy to patients can improve care." ScienceDaily 24 January 2011. 28 

Increasing number of physicians are being compensated for on-call coverage at larger practices
Being compensated for on-call coverage isn't as uncommon as you might think. According to the Medical Group Management Association's 2010 Medical Directorship and On-Call Compensation Survey, 43.4% of primary care providers received additional compensation for on-call coverage, typically a daily or annual stipend. The amount of compensation varies greatly by specialty. And as more physicians are compensated for on-call coverage, more physicians expect to be compensated.

Hospitals faced with the difficulty of having an adequate number of on-call physicians are increasing on-call compensation, reducing service levels, using non-physician providers and relying on wireless telehealth. While telemedicine has its challenges, videoconferencing, patient monitoring systems and specialized equipment are helping overcome previous challenges, allowing physicians to "see" the patient from the comfort of their own homes. 

Smaller practices form call sharing groups
For smaller practices, on-call coverage may mean that the solo physician feels the need to provide on-call coverage 24/7. In these situations, physicians should consider forming or joining physician call-sharing groups. Ideally, members would belong to the same specialty. For advice on how to form and structure a call-sharing group, read the Physicians Practice article.

In addition to increasing the convenience and accessibility of care, technology makes patient information more accessible and easier to share with others. It can also make it easier for providers and practices to collaborate and share schedules. There are plenty of free online group scheduling tools, e.g., Google Calendar that can help. 

Technology increases accessibility of 24/7 care
Physicians may also want to consider offering e-mail consultation hours or finding other ways to make themselves more accessible, e.g., using a virtual office phone answering system or offering patient self-service tools, as these can reduce the number of after hours clinical calls. 

Looking for a way to offer greater convenience to your patients, increase their loyalty and make life easier for the medical office staff? If you haven't adopted patient self-service features yet, consider this:

A consumer survey commissioned by NCR Corp., conducted in March 2010, found that 79% said they were "more likely to choose a healthcare provider that allows them to manage various elements of the healthcare experience over the Internet, on a mobile device or at a self-service kiosk."

The message is clear. Patients are interested in self-service features. The good news is that there are many inexpensive ways to offer self-service features to your patients. 

Your practice website can range from simple (e.g., a place where patients can access forms and directions to complex (a patient portal).

Potential patient self-service web-based features:

• Bill pay
• Directions to the business
• Appointment requests
• Forms (e.g., medical history questionnaire)
• Directions and hours
• Lab test results
• Send and receive secure messages with your physician

Hiring a virtual office receptionist can transform your phone to a self-service tool. Many calls that a medical practice makes and receives can be handled by a good virtual office answering system. 

Potential patient self-service features for callers:

• Get directions to the practice and hours of operation
• Request an appointment or prescription refill
• Check lab test results
• Leave an urgent message
• Access information on insurance, eligibility, and benefits

Self-service kiosks are also growing in popularity but they're usually not economical for smaller medical practices. 

For additional information on virtual office phone answering systems, visit Webley.

Just about everyone owns a cell phone and has an email address these days.  These new technologies have markedly changed how most people communicate today.  Patients expect greater convenience and they're used to self-service features such as ATMs, check in kiosks at airports, online banking and more.  It's certainly time to consider how your practice can start or enhance its use of technology to provide greater convenience and better service to your patients.

Just think about it.  Does your patient really want to spend more than 20 seconds on hold?  Moreover, do you want your patient spending more than 20 seconds on hold?  Do you want patients getting a busy signal when they phone your office? Is your staff too busy to spend much time with patients?  Technology makes it possible to avoid these situations.

As a patient, it is nice to be able to phone your doctor day or night and know that you will get a message to them.  Sure you could use a live answering service, but how confident are you that they'll treat your patients with the respect and compassion that they deserve on every call and that they'll get the message to your on-call physician in an accurate and timely manner?  A quick response to an urgent after hours call increases patient satisfaction and shows that you really care about your patient's health.

It may be time for you consider an automated healthcare call center because this type of service can:

1. screen calls
2. send new message notifications to an on-call doctor right away
3. let your practice quickly and easily change the on-call doctor without relying on someone at a live answering service to make the change
4. eliminates inaccurate transcription problems that you have with a live answering service
5. organize your messages by creating different voicemail boxes

You'd be surprised by how many patients love the automated answering service.  It's convenient and it can reduce hold times.  

A virtual office phone answering service also helps doctors make their patients feel safe and secure as the messages are recorded and conveyed correctly to the doctor. Technology enables automated answering services to provide greater convenience and reliability than live answering services and this technology is affordable for practices of all sizes. 

Using a virtual medical receptionist to answer calls to your practice will make the calling experience much more pleasant and convenient.  How?  With a virtual medical receptionist, callers never hear a busy signal.  There is nothing worse than calling an office and being put on hold for a long time and then being told you should be speaking to a different person.  This happens all the time and it's very frustrating for callers.

Callers are directed to the right person to speak to through the automated menu, so they're less likely to spend time waiting to be transferred and explaining their reason for calling multiple times.  Even if the person they need to isn't available at the time of the call, they can leave a message for the proper person. 

Unlike a live receptionist, the virtual medical receptionist continues to answer calls and help patients when the practice is closed for the day.

Calling the medical office after hours when not feeling well is uncomfortable enough and dealing with a live call center operator might not be reassuring for the patient.  Leaving a message with the virtual medical receptionist ensures that the caller's voice message reaches the on-call physician immediately. 

Call centers face some of the same issues your practice does.  That is, physicians and patients may call the live answering service only to find that the line is busy and they're unable to get through.  This would never happen with a virtual medical receptionist.  A virtual medical receptionist is the best solution for any busy practice.

More than any other business, it is vital that a medical office has 24/7 phone coverage.  Good phone coverage after hours is as important as phone coverage during business hours.  Patients do not decide when they will become ill and they need to know that their physician's office is responsive to their needs at any time.  All medical practices can benefit from an automated answering system.

With phone coverage around the clock, you can save money, improve customer service, speed up response times (and reduce wait times), and communicate more effectively.

An automated answering service handles incoming calls

An automated answering service works like a virtual office receptionist.  When there is no one available to answer the call, the answering system will pick up and lead the patient through a menu that your practice has customized to its own needs.  So for example, many practices will set up a phone tree that connects patients to billing, appointments, insurance, etc. By connecting the caller to the right department or person, messages are organized, saving response time and the potential for lost or incorrectly relayed messages.

Your staff can now leave for lunch without worrying about phone coverage.  The virtual office receptionist answers the phone during lunch, breaks and after hours.  The automated answering service can be easily turned on or off whenever the practice feels it is necessary or when everyone is away from the office.

When you use an automated medical answering service to handle after hours calls, the on-call physician receives the message quickly and is able to listen to the patient's message, think of a response and call back.  Patients who call after hours looking for clinical advice are usual anxious and waiting hours for a return sends the signal that their call is not valued.  Don't let your patients think your practice doesn't care.

An automated patient messaging service calls your patients for you

There are other ways to improve your phone coverage.  You can reduce the number of incoming calls and outgoing calls by using an automated patient messaging service.  For example, rather than have anxious patients calling in for their lab results, you can use an automated messaging service to send lab results to patients.  Appointment reminder calls can take hours a day if they're made by your staff, but an automated messaging service can deliver these messages for you.  Some services can even automatically retrieve your patient appointment information, so all your staff would need to do is to view reports to see how many patients were reached, how many confirmed their appointments and how many cancelled their appointments.  

When you use automated patient messaging, you free up phone lines so patients who need to speak to a live operator are more likely to get through.  It's incredibly frustrating for a busy patient to be put on hold or not be able to get through when calling - and it creates a bad impression.  They now feel that it's inconvenient and difficult to reach their practice.  

Automated medical communication technologies make it easy to provide comprehensive, round the clock phone coverage. 

Many medical practices simply accept the pains of after hours call coverage and live call centers because they're used to the suboptimal and don't realize that things can be better. Call centers can be rude or untrained at times, forward too many messages or not enough, and take hours to send important messages. Unfortunately, this means that the on-call physicians sometimes are the ones to take the heat from patients when they don't return calls in a timely manner, or the feel guilty when the situation has turned into an emergency and the message wasn't received in time.

The after hours experience doesn't have to be so horrific. Making a change for the better can be as easy as "A-B-C" when you use a virtual answering system to take care of your office phones.

Answer

When a patient calls in, there is no disgruntled, exhausted call center employee to take down her message. Instead, her call is immediately answered and a custom greeting created by the practice is played. She then is guided through a simple menu that helps determine the reason for the call and separate the messages that can wait till morning and the calls that require immediate attention.  She can even tag the message as urgent.  Calls that require immediate attention can be automatically forwarded to the on-call physician.  The on-call physician can answer or let it go to voicemail - or choose to have all calls go straight to voicemail. 

Beam

As soon as the patient successfully leaves her message, the virtual answering machine “beams” a message to the on-call phone number. The physician can pick up his messages through his phone or online from his office computer.  He can consult medical references before responding. His response is on his terms.

Complete

When the physician has gathered his thoughts and constructed an answer, he can complete the cycle by returning the patient's call in a timely manner.   The patient is satisfied that her message was received and responded to with the attention it deserved.

It's simple and efficient. Using a virtual office answering service to man your phones once your office is closed for the day will turn your nightmarish after hours service into a sweet dream. 

Automated answering services aren't free but they are worth far more than their cost because of the compelling benefits they provide to patients and physicians.

Benefits to patients
With live call centers, operators decide which calls to forward to the on-call physician and which messages can wait till morning.  Customer service skills can vary and the operator may not be the reassuring voice your patients need when they call after hours looking for clinical advice. 

An automated answering service basically mimics the phone answering, call forwarding and message taking abilities of a live operator, only it reduces the number of steps it takes before the message or call gets to the on-call physician.  And it handles each call courteously.  End result?  The patient feels "listened to" and reassured that he was able to leave a message that will go directly to the on-call physician. 

Benefits to physicians
Making the after hours experience less stressful for on-call physicians helps them enjoy their work more.  An automated answering service can weed out calls that can wait till morning from urgent calls that require the on-call physician's attention.  

If you use your own staff to handle after hours calls, it also makes their lives easier.  They can take evenings off rather than answer patient calls.  

Benefits to the bottom line
How much are you paying the call center you hired ten years ago? Has the price you originally signed on the contract gone up, and you weren't even aware of it? Do you get nickel and dimed?

It doesn't cost thousands to sign up for an automated answering service. It's much less than what you'd pay for a live call center. To find out more about automated after hours answering services, visit Webley.

For the typical medical practice with several physicians who share on-call responsibilities, after hours care on-call scheduling can be a challenge. On-call schedules can change at the last minute, and it may be the case that no one is ever sure who is on-call and who is not.  A study published in the Archives of Internal Medicine found that 14% of in-hospital pages were sent to an off-duty physician.  This confusion behind the scenes does nothing to promote your patient care. Relying on call center operators to change the physician on-call schedule adds an extra layer of complexity to the process. 

If you're thinking of automating the handling of your after hours calls, you can choose between a generic virtual PBX/ virtual receptionist or a medical virtual receptionist.

A generic virtual receptionist can answer your calls, take messages and send out message notifications but doesn't offer features tailored to the needs of medical practices.

A medical automated answering service offers features specifically created for medical practices.  For example, the physician can change his on-call status by phone rather than wait for the call center operator to make the change.  Your practice is also in charge of call handling and can create its own rules for new message notification.  Message notifications can be sent to a pager, any phone number (landline, cell phone, home, office, etc.), email address, etc.

Automated answering services increase control over messages by offering a library of greetings, notification rules, voicemail boxes, call forwarding and so forth.  What's more, physicians are in control of when they receive their messages as well. They can pick up their messages as they arrive, not when a call center decides to send over their messages. This control makes for a far less stressful on-call experience, as well as dramatically reforming customer service.

Our health is a highly personal matter.  Consequently, it can also be one of the most difficult subjects to discuss with others.  Anyone who deals with patients knows this to be true.  And yet many physicians think little of using a live answering service to handle after hours calls.   How many of the patients who call after hours enjoy talking to a stranger, a call center employee?  When the patient calls after hours looking for clinical advice, he wants reassurance.  He wants to hear a friendly, familiar voice.  He may feel awkward about describing his symptoms to a stranger.

If asked, your patient would probably prefer to have the on-call physician's home phone number and expect him to answer the phone when called.  But this would be too much to ask of physicians.  While many patients might respect the privilege of having the physician's phone number, a few could abuse the privilege.

An automated voice answering service can provide a good next best solution to having the doctor's home phone number.  First, the service may offer the ability to record your own custom greetings - so the voice of someone at your practice can greet after hours callers.  Second, a clear greeting that thanks the caller, stresses the importance of the call, asks the person to leave a message and gives the person who is calling for clinical advice a sense of how long it will take for the call to be returned can be extremely reassuring and satisfying to your patients.  New message notifications go immediately to the on-call physician and the physician can call in to hear the patient's message as well as have that audio file sent to an email address.

An automated voice answering service functions as a virtual office receptionist.  When you think about it, most after hours calls are about a handful of issues, so an automated answering service can easily take messages, organize messages and send out message notifications, while offering the convenience of reliable, courteous phone coverage no matter what time of night the patient calls. 

To learn more, visit Webley.

Your on-call physician might be thinking of each evening that she's on-call as a potential battle.  This on-call physician has to be ready at a moment's notice to deal with patient calls.  

And the opponent is...the live answering service that stands between the physician and the patient.

There are several ways the answering service can harm the physician and the patients.

1. Poor call screening.  Some services let almost all calls go through, even when they do not require the physician's immediate attention.  Proper training and detailed protocols can help if the operator follows those protocols.  But if the service isn't properly screening calls, ask yourself how much value they are providing?  An answering machine can easily record messages.  Perhaps even worse than lack of screening is the potential of the call center employee to not connect a patient who needs immediate attention to the on-call physician.  By the time the physician receives the message, it could already be too late for the patient in question.

2. Forgetfulness.  Human error is bound to occur when the message takers are human.  Messages can get lost for a variety of reasons.  The call center may forget to change the on-call schedule.  

3. Poor customer service.  While some call center operators may show patients the compassion they need when they are experiencing discomfort after hours, some might not.  And with high turnover rates, it's hard to be confident that your patients will be treated with respect on every call.

By using a call center, you place control in the hands of the call center.  They are the ones that have immediate access to your patients and their calls, and they can do with them what they please. 

You should seriously consider an inexpensive automated answering service to handle after hours calls. An automated phone answering system will provide your physicians the support they need and remove the middleman.