The May 2019 Issue

LVM Systems

The Weak Link of Medical Call Centers

Advances in Agent Performance Can’t Overcome Deficiencies in Backend Systems

By Peter Lyle DeHaan, Ph.D.

Whenever I place a phone call to a business, I carefully observe what happens. After spending most of my adult life in some aspect of the call center industry, I can’t help it.

Author Peter Lyle DeHaan

Based on my observations, I’m happy to say that I’m encouraged by the quality of the agents I interact with. They are more personal and professional than agents who used to answer the phone even a few years ago. They have a positive, can-do attitude. Most of the time, I enjoy talking with them.

Unfortunately, quality agents don’t automatically make for satisfying phone calls. The technology that’s supposed to help them do their job better continues to hamper their work. Based on my experience, this is most pronounced in the healthcare industry.

Other industries appear to be dealing with this frontend/backend disconnect with varying degrees of success, yet healthcare—for all its technology—still struggles to produce satisfying outcomes for their patient callers.

I wish I could say this article is the result of one bad experience. Unfortunately, that’s not the case. This is a result of several bad experiences. It’s a saga of multiple calls without resolution. At this point, I’m prepared to never experience a satisfactory outcome. In case you’re wondering, it’s a billing snafu.

Part of it hinges on faxes sent multiple times but never received—or at least never connected with my account. In the day of digital communications and electronic health records, why are we still using faxes anyway?

In case you’re interested, faxing started in the mid-1840s, only a decade or so after the telegraph. Yet we’re still using fax technology today. (Thankfully we’re not using the telegraph. Can you imagine looking to hire agents who know Morse Code?)

Anyway, how can agents do their job with excellence when they’re using technology that’s over 170 years old? While other technological hurdles agents face aren’t as old, these obstacles still present a cumbersome challenge and thwart attempts at customer service.

Today’s call center technology can integrate incoming channels, but in the healthcare industry, it’s still challenging to integrate the various information silos with any degree of success.

Let’s applaud our call center agents for the job they do, despite technological roadblocks. Then let’s work at fixing backend system integrations so agents can do the job they want to do and serve patient callers the way they expect—and to do it on one phone call. It’s first call resolution (FCR), and it’s time for the healthcare industry to embrace it.

Imagine what your healthcare call center traffic would look like if you could achieve first call resolution on every call. It would change everything.

Peter Lyle DeHaan is the publisher and editor of Medical Call Center News and AnswerStat. Read more of his articles at

The Golden Rules of Telephone Triage

By Rose Moon, RN, BSN

Successful triage nurses live by the following golden rules of the telephone triage process:

  1. Every call is life-threatening until proven otherwise.
  2. Complete an ABCD assessment with every telephone encounter: Airway, Breathing, Circulation, Deficit (Neuro).
  3. Assessing patients over the phone is high risk; therefore, take the callers word as truth.
  4. Follow your sixth sense: protocols are decision support tools; nursing judgment determines outcomes.
  5. Know your patients’ medical history and current medications.
  6. Assess your callers as well as your patients. Be a patient advocate.
  7. Never provide a dosage of a medication without a complete patient assessment.
  8. Always confirm the labeled dosage of medication as well as the means in which the caretaker plans to administer the drug.
  9. Always assess the caller’s level of comfort with the established plan of care before ending the call.
  10. “Are you comfortable with these recommendations?”
  11. “Now tell me what you plan to do next.”
  12. If it is not documented, it didn’t happen. Use defensive documentation. Paint a picture.
  13. Regardless of the reason for the call, always obtain a rectal temperature on an infant under the age of three months.
  14. Document the exact mechanism of injury.
  15. Be alert for red flags. Any time a caller uses or implies one of the following phrases be sure to clarify the underlying meaning. Carefully analyze your disposition and recommendation for follow-up care:
  16. Grunting or moaning
  17. Lethargic or listless
  18. Sleeping more than usual
  19. Just doesn’t look right, act right, or is fussy
  20. Sleeps through a rectal temperature
  21. High pitched cry or unusual, funny cry
  22. History of sickle cell or immune deficiency
  23. Frequent caller
  24. The caller that expresses anxiousness or numerous questions after discussing a plan of care
  25. Patient symptoms of headache, dizziness, disorientation, nausea, fatigue, or irritability; flu versus carbon monoxide exposure
  26. At the conclusion of the patient telephone encounter, instruct callers to call back or seek medical evaluation if current symptoms become worse or additional signs and symptoms of concern develop.

Learn more about telephone nurse triage and how to implement successful triage nurse centers by downloading the free e-book: Telephone Nurse Triage Handbook.

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A Thought for Today

A timid question will always receive a confident answer. -Charles John Darling