The September 2012 Issue

The Importance of Manners and Courtesy

By Jennifer McGlothlin

“Please,” “Thank you,” “May I,” and “You’re welcome”… these are familiar phrases to all of us, yet they are words that we seem to hear less and less. As I sat at a restaurant last week, I observed people not holding doors for each other and customers demanding things of the waitstaff by saying, “I want” and “I need.”

When the waitress came to our table, she seemed almost taken aback when my husband and I ordered by saying, “May I please have…,” when we thanked her every time she helped us, and were respectful of her. When she dropped off our bill, she commented on how friendly and polite we had been; she wished that all of her customers were that way.

With call center agents, I stress the use of manners, the importance of a friendly tone, and the need for a helpful attitude. These are some of the qualities that are critical to being great call center agents. We are the face and voice of our clients. If we come across as rude, disinterested, or too busy to focus on the caller, we have potentially just lost business for our client. That is why I instill the importance of basic manners and courtesy to the call center agents. Just as the waitress in the restaurant was amazed at how polite and courteous my husband and I were, I want all of our callers to feel the same. I want them to end the call having had a genuinely great experience and a positive impression.

Manners and respect can go a long way. We all have to deal with rude and demanding people in our lives. There is no better way to respond than with respect and politeness. The old saying, “Kill them with kindness,” still rings true. Refer to the person by name, be sincere, and treat them how you would like to be treated, even in the toughest of situations. Being courteous and using proper manners not only shows respect for others, it shows respect for yourself.

Jennifer McGlothlin is a quality evaluator with Ambs Call Center.

What I Learned From Rabbits

By Peter Lyle DeHaan, PhD

Author Peter Lyle DeHaan

Although I live in a rural area, my immediate surroundings are not. My house is in a subdivision. Even so, wildlife abounds. During the non-snowy months, at any given time I can, look out my office window and see at least one animal and usually more. I’ve spent the last five months verifying this to be true.

Most often, I see birds. Squirrels come in second. Sometimes they’re in pairs: darting, jumping, chasing, climbing.

I also see rabbits. They’re common but not a daily occurrence (though I really don’t spent my time gazing out my window). When I see a rabbit, it’s always alone, which is a bit sad to mention.

But today I saw two: hopping, playing tag, just hangin’ out. Then a third one appeared. One hopped left, the other scurried right, while the third went in a circle. They were on the smaller side, perhaps siblings born this year.

Then, to my delight, a fourth one hopped into view, a bit larger and more deliberate in movement. I surmised this to be the mom. For quite a while I admired their comings and goings, their freedom, and their life.

I’m glad I took the time to watch them frolic, It was good to slow down – and to marvel.

Most people who work in healthcare are finding there are more pressures, work, stress, and changes than ever before. While there’s not much that can be done to stop that, we can periodically slow down.

What do you do to slow down?

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.

Rutenberg and Greenberg to Release Telephone Triage Book

Carol Rutenberg, RN-BC, C-TNP, MNSc, and M. Elizabeth Greenberg, RN-BC, C-TNP, PhD, announced the upcoming release of their new book, The Art & Science of Telephone Triage: How to Practice Nursing Over the Phone. This is the first book published in almost twenty years that addresses the complex practice of telephone triage nursing.

Based on current practice, nursing theory, research, and experience, Carol Rutenberg and Liz Greenberg present a balanced, commonsense, reality-based approach to the practice of telephone triage nursing. This book is a must-read for everyone working in the fields of ambulatory care and telehealth nursing, from manager to educator to frontline nurse. Physicians, administrators, and others involved in providing care over the telephone will also find this an invaluable resource in understanding the practice of telephone triage nursing. The book has been endorsed by the American Academy of Ambulatory Care Nursing and will be available September 2012.

Majority of Medicaid ED Visits for Urgent or More Serious Symptoms

Contrary to conventional belief that Medicaid patients often use hospital emergency departments for routine care, the majority of ED visits by non-elderly Medicaid patients are for symptoms suggesting urgent or more serious medical problems, according to a national study released today by the Center for Studying Health System Change (HSC).

Two kinds of information from emergency department visits generally are used to explain ED use: patients’ symptoms as assessed by ED triage staff to determine how quickly patients need evaluation and patients’ diagnoses after evaluation by a physician.

About 10 percent of non-elderly Medicaid patient ED visits were for non-urgent symptoms, compared with about 7 percent for privately insured non-elderly people in 2008, according to the study funded by the Robert Wood Johnson Foundation (RWJF). In contrast, slightly more than half of Medicaid and private insurance visits were categorized as emergent (needing immediate attention) or urgent (needing attention within an hour), according to the study, which was based on the most recent available data from the National Hospital Ambulatory Medical Care Survey conducted by the Centers for Disease Control and Prevention.

Non-elderly Medicaid patients do use EDs at higher rates than non-elderly privately insured patients. In 2008, people aged 0 to 64 covered by Medicaid had 45.8 ED visits per 100 enrollees compared with 24.0 visits per 100 non-elderly privately insured people, the study found.

HITECH Answers and UBM Medica US Announce Partnership for

HITECH Answers, a provider of educational resources on the HITECH Act, ARRA stimulus benefits, and Meaningful Use (MU) announced a marketing and distribution partnership with UBM Medica US for its new network site, HIE Answers provides content and resources to help providers and hospitals understand Health Information Exchange and what is required to stay current with federal initiatives.

HIE Answers content will now be delivered to more professionals via the UBM Medica Partner Network. UBM Medica US, one of the largest media companies in the United States, delivers integrated and strategic communication solutions to a comprehensive audience of medical professionals and healthcare consumers through online, print, live, and custom programs.

“The goal of our ‘answers’ network is to help providers and hospitals understand how to participate in Electronic Health Record Adoption and Health Information Exchange,” said Roberta Mullin, editor-in-chief for HITECH Answers.

“We are thrilled to continue to grow our partnership with HITECH Answers with the addition of their new site, HIE Answers,” said Barron Hirsch, senior director at UBM Medica. “HIE Answers is an extension of HITECH Answers and will continue to support our efforts in reaching a practice management audience.”

Update on Prescription Costs

According to the Kaiser Family Foundation, Americans filled more than 3.7 billion prescriptions in 2010. Because the rate at which individuals developing chronic health conditions continues to increase, the expected decline in drug costs comes as little comfort to services industry employers who are largely footing the bill, as an overwhelming majority still offer prescription coverage to employees as a part of their medical plan. These increasing costs translate to higher premiums for employers and employees, as well as increasing co-pays.

“In the services industry, prescription drug co-pays have been trending upwards over the last few years, although on most plan types non-formulary co-pays have seen the largest increases,” said Amy Kaminski, director of marketing for Compdata Surveys. “On PPO plans, for example, formulary co-pays have increased 7.1 percent since 2009, while non-formulary co-pays have gone up by 14.9 percent.”

Formulary drugs are medications included on a list of preferred medications issued by the insurer. Drugs not on this list are referred to as non-formulary and generally incur higher co-pays and may require pre-authorization from the insurer before coverage is granted.

The use of value-based insurance design (VBID) has made headlines lately as a means to control prescription costs. Using VBID, services and treatments are priced based on the overall value to an individual’s health: the greater the value, the lower the cost. As a result, co-pays on medications for chronic conditions may be reduced or eliminated, encouraging people to continue taking needed medications, keeping them healthy and reducing long-term medical costs.

Silent Strokes Can Jeopardize Memory

From Harvard Women’s Health Watch

The symptoms of a stroke are sometimes obvious, like numbness or weakness on one side of the face, trouble speaking, difficulty walking, and vision problems. Some strokes, though, pass completely unnoticed. But even these can have a significant and lasting effect on memory, reports Harvard Women’s Health Watch.

These so-called silent strokes create pinpoints of dead cells in the brain. The damaged areas are smaller than with a traditional stroke and often don’t affect areas of the brain associated with movement or speech.

During a typical ischemic stroke, a blood clot blocks a blood vessel that feeds part of the brain. Without a steady supply of blood, cells in that area malfunction and may die. Symptoms that appear reflect the functions that were controlled by the affected part of the brain. A hemorrhagic stroke caused by a burst blood vessel does the same thing.

During a silent stroke, the interruption in blood flow occurs in part of the brain that doesn’t control any vital functions. Although it doesn’t cause any obvious symptoms, the damage does show up on an MRI or CT scan. Silent strokes could interrupt the flow of information in the brain needed for memory, especially if several of these strokes occur over time (which is the most common scenario). Damage from silent strokes can accumulate, leading to more and more memory problems.

Read the full-length article: “Could a silent stroke erode your memory?

EHR Adoption Rate Remains Steady

UBM Medica US’s Physician’s Practice 2012 Technology Survey, sponsored by AT&T, found that 72 percent of US healthcare providers surveyed are in some stage of EHR adoption. Despite government financial incentives rewarding physicians who adopt electronic health records (EHR) systems, adoption has leveled off, as providers continued to complain about high up-front costs and other challenges to making the transition, according to the survey of 1,300 outpatient practices, taken late in 2011 and early this year by Physicians Practice, America’s leading business publication for physicians.

Among the findings in the survey:

  • 29 percent of those without an EHR cited high cost as the reason, more than any other factor.
  • A tipping point has already been reached, whereby more doctors are using the technology than aren’t, and the holdouts are now at a competitive disadvantage.
  • Hospitals have been acquiring community practices in efforts to increase market share and achieve hospital-physician alignment, and those newly acquired practices will adopt their hospitals’ EHR systems.
  • Technology vendors are responding to physician concerns, offering access to affordable products via the cloud and adapting their products for use on mobile devices, especially the iPad, which doctors are purchasing in high numbers.
  • The days of paper-based healthcare record keeping are ending.

“The main obstacle for EHR holdouts is money,” explained Bob Keaveney, editorial director of Physicians Practice. “But among physicians, especially in private practice, there is also a deep well of skepticism – even resentment – about federal incentives programs that are designed to get doctors to behave in particular ways.