The January 2013 Issue

Smile…or Not

By Peter Lyle DeHaan, PhD

Author Peter Lyle DeHaan

I recently renewed my passport, which required an updated photo. I went to a local store to take care of this so I could complete my renewal application.

I placed my toes on the line, looked into the camera, and put on my best smile. The technician scowled. “You’re not supposed to smile for passport photos.”

“Why?” I scowled back. Ten years ago I smiled; the picture wasn’t too bad.

“Facial recognition software doesn’t work as well when you smile.”

At this point I discovered when someone is about to take your picture and says, “Don’t smile,” it’s almost impossible to keep a straight face.

There was more scowling as she waited for me to look sufficiently dour. Then she snapped my picture.

When I picked up the photo a few minutes later, the results horrified me. However, since I don’t enjoy traveling, that’s probably how I look when I’m at the airport. The facial recognition software should have no problem matching me.

And for those who want to minimize the chance of airport security scanners from recognizing them, be sure to smile.

As we move into the new year, with uncertainties over the healthcare industry, the economy, and a host of other concerns, I offer the same advice: Be sure to smile.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of Medical Call Center News. He’s a passionate wordsmith whose goal is to change the world one word at a time.


Language Line Services Acquires Pacific Interpreters

Combined resources will provide the healthcare industry with efficient and well-trained interpreter services.

Language Line Services, a provider of interpretation and translation services, announced it has acquired competitor Pacific Interpreters, a nearly $50 million provider of language services to the healthcare industry. The combination of these two organizations, with total annual revenue approaching $300 million, will form the nation’s largest interpretation provider for hospitals, medical practice groups, clinics, and emergency rooms.

“With almost 6,000 combined interpreters working around the clock, 365 days a year, we are uniquely qualified and prepared to help our healthcare clients deal with the many changes hitting this critical-to-life industry,” said Scott W. Klein, president and CEO of Language Line Services. “The acquisition of Pacific Interpreters and its outstanding team helps fulfill our mission of enhancing communications and empowering relationships as the fully responsive, client-focused partner our clients have always received and deserved.”

Language Line Services now has more than 10,000 clients across a number of industries, including healthcare, insurance, banking, government, manufacturing, utilities, communications, and information technology.

“Our growing team of professionals has dedicated itself to supporting our clients in their efforts to save time, money, and relationships. For our healthcare clients, we help save lives,” Klein said. “As the population of limited English speakers continues to grow rapidly, we are here to make sure they have access to all of the goods and services available in the United States, Canada, and the United Kingdom.”

For more information, call 800-752-6096 or visit


AAACN Announces Annual Conference

The American Academy of Ambulatory Care Nursing (AAACN) will host its 38th annual conference at the Las Vegas Hotel & Casino in Las Vegas, Nevada, April 23-26, 2013. The conference presents speakers with a focus on ambulatory care and nurse care coordination competencies. Specialty sessions and personalized tracks will occur throughout the conference.

The AAACN conference attracts a broad range of healthcare providers who work in ambulatory care settings, including military and telehealth. Attendees include RNs who are administrators, directors, managers, educators, care coordinators, and clinicians interested in advancing their practice and improving patient care.

Attendees can earn continuing nursing education (CNE) contact hours, view posters, visit the exhibit hall, and network with colleagues. Participants may also register for the telehealth nursing practice core course (TNPCC) and the ambulatory care nursing certification review course.

The keynote address, by Virginia R. Beeson, MSN, NEA-BC, will focus on the importance of courageous leadership in a session entitled “Why Courage?” Nurses’ actions and decisions require strong responses and sometimes, unpopular choices. Beeson will explore what courage as a leadership skill means and how to become a more courageous leader.

Complete conference information and registration is available online at


New Book Guides Nurses in Growing Practice of Telephone Triage

Carol Rutenberg, RN-BC, C-TNP, MNSc, and M. Elizabeth Greenberg, RN-BC, C-TNP, PhD, released a book many nurses will want to keep close by their side. The Art and Science of Telephone Triage: How to Practice Nursing over the Phone delves into a topic that has scarcely been outlined in detail before in a textbook.

According to the forward by Suzanne Wells, MSN, RN, president of the American Academy of Ambulatory Care Nursing (AAACN), which endorsed the book, it has been twenty years since a book has covered this topic.

The book outlines the evolution of telephone triage and presents clinical issues, program design, quality and risk management topics, and real-life examples. The text is designed for anyone who provides nursing care over the phone, as well as ambulatory care nurses, nurse leaders, managers and administrators, physicians, front-line staff nurses, and anyone interested in the design and practice of this challenging form of patient care.


Don’t Make Shoveling a Marathon Event

With winter snowfall in many parts of the United States, residents will break out their snow shovels to clear driveways and sidewalks. For most people, shoveling snow may not lead to any health problems; however, the risk of a heart attack during snow shoveling increases for others, warns the American Heart Association.

“One of the reasons heart attacks can occur during snow shoveling is the combination of colder temperatures and physical exertion which increases the workload on the heart,” said Vishal Gupta, MD, MPH, Borgess Cardiology Group, of the Borgess Heart Institute, Borgess Medical Center in Kalamazoo, Michigan. “As a result, too much strain on the heart during these conditions can cause a heart attack.”

To help make snow removal safer, consider the following tips.

  • Consult a doctor. If you have a medical condition or don’t exercise on a regular basis, schedule a meeting with your doctor prior to the first anticipated snowfall.
  • Give yourself a break. Take frequent breaks during shoveling so you don’t overstress your heart.
  • Don’t eat a heavy meal prior or soon after shoveling since it can place an extra load on your heart.
  • Don’t drink alcoholic beverages before or immediately after shoveling. Alcohol may increase a person’s sensation of warmth and may cause them to underestimate the extra strain their body is under in the cold.
  • Be aware of the dangers of hypothermia. Heart failure causes most deaths in hypothermia. Dress in layers of warm clothing, which traps air between layers forming a protective insulation, and wear a hat.
  • Use a small shovel or consider a snow thrower. Lifting heavy snow can raise blood pressure acutely. It is safer to lift smaller amounts more times, than to lug a few huge shovelfuls of snow. When possible, simply push the snow.
  • Listen to your body. If you feel the warning signs for heart attack, stop what you’re doing immediately and call 9-1-1.

The warning signs of a heart attack include:

  • Uncomfortable pressure, fullness, squeezing, or pain in the center of the chest that lasts for more than a few minutes, or goes away and comes back.
  • Pain spreading to the shoulders, neck, and arms.
  • Chest discomfort with lightheadedness, fainting, sweating, nausea, or shortness of breath.

For more information, contact the visit the American Heart Association or call 800-968-1040.


Shifting Health Care System Fuels Changes in Nursing, Patient Care Outside the Hospital

The American Academy of Ambulatory Care Nursing releases position paper on the increasingly crucial role of the outpatient RN

The groundswell of change in healthcare delivery from inpatient to outpatient settings continues to build. The American Academy of Ambulatory Care Nursing (AAACN) has released a position paper clarifying the pivotal role of registered nurses (RNs) who practice in settings outside the hospital, also known as ambulatory care.

“The traditional outpatient model of single physicians in their own office is disappearing,” said Margaret Fisk Mastal, PhD, RN, lead author of the paper. “Today, patients’ needs are much more complicated, and their care is provided by a team of healthcare providers, not just a single doctor in an office.”

With a team approach, coordination of care is essential, Mastal said. RNs are the providers most qualified to handle that job “because of their professional skills with patient-nurse relationships, their knowledge of health systems, and their collegiality with other health professionals.”

Ambulatory care RNs work in a wide variety of outpatient settings, from the community to physician group practices to telehealth call centers. Their roles include nurse managers and administrators; staff nurses, educators, consultants, nurse practitioners, and researchers. They are highly trained and are respected as leaders and innovators in the healthcare industry. Ambulatory settings employ 25 percent of the RNs in the US, according to the US Department of Health and Human Services (DHHS).


TriageLogic Announces Secure Texting Module

TriageLogic’s new software module for call centers allows nurse triage centers to send secure, encrypted, and HIPAA-compliant text messages to their on-call providers. The on-call provider receives the encrypted message and is able to decrypt it securely and see the entire message. This allows providers to call patients back by clicking on the phone number on the screen. The module saves physicians the need to return the call to the nurse triage to get the patient’s information, thus saving time.

An important feature of the system is that it does not require the provider to download an app or have any special software on their phone. According to Dr. Ravi Raheja, founder and CEO of TriageLogic, “The system works with any smartphone and can also be accessed securely via email. During the entire process, patient information is never sent over public cell phone networks, and only the provider can decrypt the message. Therefore, the system is completely secure and HIPAA-compliant.”

“Any patient information that goes through the cell phone networks, such as Verizon or AT&T, is not HIPAA-compliant, nor is it secure,” added Dr. Charu Raheja, chair of TriageLogic.


Rub-on Pain Relievers Offer Kinder, Gentler Relief from Arthritis Pain

When joint pain cries out for relief but ibuprofen and other over-the-counter medicines upset the stomach, it may be worth trying a gentler alternative: anti-inflammatory pain relievers applied to the skin, reports the January 2013 issue of the Harvard Men’s Health Watch.

Pain relievers applied to the skin are called topical analgesics. Prescription versions, which usually deliver nonsteroidal anti-inflammatory drugs (NSAIDs), come as creams, sprays, gels, or patches. The active ingredient soaks in through the skin to reach the pain. In contrast, oral pain relievers flood the whole body with the medication after being absorbed in the gut. The most widely available prescription topical NSAID in US pharmacies today is diclofenac gel.

“Topical pain relievers can be very helpful for the more superficial joints like the knees, ankles, feet, elbows, and hands,” says Dr. Rosalyn Nguyen, a clinical instructor in physical medicine and rehabilitation at Harvard Medical School. “In those areas, the medication can penetrate closer to the joint.”

The source of pain usually determines if a topical pain reliever is appropriate. For a localized problem with just one joint causing the pain, there’s no need for medication to travel throughout the body. A topical analgesic isn’t as helpful when the pain emanates across an extended area, like the lower back.

The Harvard Men’s Health Watch is available from Harvard Health Publications.Save