1. Chapter 12
Telecommunications

2. Basic Telephone Techniques
First impressions lasting whether automated phone system answers the call or it is answered in person

3. Basic Telephone Techniques
Automated systems
Should be user friendly
Option to speak with administrative medical assistant should always be offered
Message instructing caller what to do if call is emergency
List of menus

4. Basic Telephone Techniques
Answer incoming calls by end of first ring and certainly within three rings
Guidelines to follow when conversation must be interrupted to answer another call

5. Basic Telephone Techniques
Telephone personality
Be prepared to give caller your complete attention
Use a pleasant well-modulated voice
Use same volume as when speaking conversationally
[Figure 12-2]

6. Basic Telephone Techniques
Telephone personality
Enunciation: speak clearly and articulate carefully
Pronunciation: say words correctly
Speed: talk at normal rate
Posture: sit up straight and use a headset
Be patient and in control
Remain calm if call is regarding life-threatening emergency

7. Basic Telephone Techniques
Professional telephone etiquette
Treat others with consideration
Follow basic telephone courtesies

8. Basic Telephone Techniques
Answering incoming calls
Preparing to take calls
Answering calls
Name of facility clearly identified
Name of person with whom caller speaking
Obtain caller’s full name and correct spelling
Ask if emergency call
Ask for caller’s telephone number, street address, date of birth
Determine how you can be of assistance
(See Procedure 12-1: Answering and Screening Incoming Calls)

9. Basic Telephone Techniques
Answering incoming calls
Screening calls
To be sure caller talks to person who will be most helpful
To ensure provider’s time efficiently managed
Tactful persistence to get information needed to direct caller
Be polite and professional at all times

10. Basic Telephone Techniques
Transferring a call
Acquire caller’s personal information and situation-associated information
Determine best person to assist with situation
Place caller on hold and see if person best suited to assist is available
Follow telephone system procedure to transfer call
Follow up to see if transferred correctly

11. Basic Telephone Techniques
Taking a message
Use message pad or TPMS screen
List of information that should be taken with each call
Repeat information to verify
Attach message to patient chart before placing message on provider’s desk
(See Procedure 12-2: Taking a Telephone Message)

12. Basic Telephone Techniques
Ending the call
Is as important as answering promptly
End conversation courteously
Repeat pertinent information back to caller
Pause for additional questions
Say “Good-bye”—no slang
Stay on line until caller hangs up first

13. Routing Calls in Medical Office
Types of calls MA can take
Established and new patients
Scheduling appointments and patient tests
Billing questions
Insurance information
Requests for prescription refills
Receiving routine progress reports
General information about practice
Sales people
(See Figure 12-5)
(See Procedure 12-3: Calling a Pharmacy to Refill an Authorized Prescription)

14. Routing Calls in Medical Office
Types of calls referred to provider
Other providers
STAT reports
Provider’s family
Request for test results (positive)
(See Figure 12-5)

15. Routing Calls in Medical Office
Special consideration calls
Referral calls to other facilities
Emergency/urgent calls
Direct caller to call 911 if caller believes they may be experiencing life-threatening emergency
Evaluate urgency of medical situation and prioritize call
Urgent condition requires medical intervention and can be handled at ambulatory care center

16. Routing Calls in Medical Office
Special consideration calls
Emergency/urgent calls
Standard screening questions can determine nature of emergency
Practice periodically review procedures for emergency calls
Good Samaritan laws do not cover paid employees, only uncompensated situations
Post emergency numbers near phone

17. Routing Calls in Medical Office
Special consideration calls
Angry callers
Defuse the situation
Remain calm and in control
(See Procedure 12-4: Handling Problem Calls)

18. Routing Calls in Medical Office
Special consideration calls
Older adult callers
Do not make assumptions
Be aware of hearing impairments
Ask if patient has any questions
Repeat and simplify information if needed
Communicate with family members if needed

19. Routing Calls in Medical Office
Special consideration calls
English-as-a-second-language callers
Bilingual employee
Do not make assumptions
Patient who does not speak fluent English may still understand as well as anyone
Speak at a normal volume and more slowly
Be willing to review information
Be patient

20. Telephone Documentation
Medical information request over phone should be discouraged
Use call back verification procedures
Request caller’s name and phone number
Call back and verify identity of caller
Documented in or patient’s medical record

21. Using Telephone Directories
Medical assistant should have on hand print and online telephone directories
Contain very useful information
Emergency and nonemergency numbers
Internet guide
Information guide and consumer tips

22. Using Telephone Directories
Contain very useful information
Community pages
Phone service pages
Government pages
Index

23. Using Telephone Directories
Medical centers and hospitals produce another type of directory with phone numbers specific to that facility
Online telephone directory services

24. Placing Outgoing Calls
Know what information is needed and have it available beforehand
Make calls from telephone in location free of distractions
Establish a routine

25. Placing Long-Distance Calls
Direct dialing calls
Operator-assisted calls
Person-to-person
Conference
International
Collect
[Figure 12-6]
(Assign or discuss the Critical Thinking box)

26. Legal and Ethical Considerations
Patient confidentiality
Right to privacy
Practice sensible risk management

27. HIPAA Guidelines for Telephone Communications
Determine if patient has requested confidential communication
If patient has not requested confidential communication, treat as normal call
If patient has requested confidential communication and provided alternative phone number, be sure only alternative number is called

28. HIPAA Guidelines for Telephone Communications
Caller should identify self by name and use official name of practice
Do not leave any medical information or mention purpose of call
Never leave messages containing test results
When patient is contacted, it is acceptable to discuss medical information over phone

29. Americans with Disabilities Act (ADA)
Requires health care providers give effective communication alternatives to people with hearing loss
Health care provider can choose device as long as result is effective communication
Teletype (TTY) and telecommunication device for the deaf (TDD) options
Cost of alternative devices or services cannot be billed to patient

30. Telephone Technology Automated routing units (ARU)
Manage heavy telephone traffic
Electronic mailboxes
Advantages and disadvantages
(Assign or discuss the Critical Thinking box)

31. Telephone Technology Answering services and machines
Take calls after hours
Answering services use a live operator and provide flexible routing services
Machines must be checked frequently for messages

32. Telephone Technology
Voice over Internet Protocol (VoIP) telecommunications
Biggest advantages are price and flexibility
Convert a voice to a digital signal that travels over Internet or virtual private network
Three types of VoIP services
Analog telephone adapter (ATA)
IP phone
Computer/computer
VoIP security and safeguards

33. Telephone Technology Facsimile (fax) machines
Used to send reports, referrals, insurance approvals, and informal correspondence
Transmission sent over telephone lines from one fax machine to another
Confidentiality is an issue
(See Procedure 12-5: Preparing, Sending, and Receiving a Fax)
(See Table 12-1)
(See Figure 12-7)

34. Telephone Technology Electronic mail (email)
Sending, receiving, storing, forwarding messages in digital form over computer networks
Non–real-time method of communication
Can be sent to multiple people at same time
Professional etiquette must be adhered to
Advantages and disadvantages
(See Figure 12-8)

35. Telephone Technology Electronic mail (email) Encryption of email
Renders transmission essentially secure
Digital ID composed

36. Telephone Technology Clinical email
Means of communication between patients and primary care provider
Communication not considered urgent
Confidentiality issues must be considered
Messages printed out and filed in chart
Written agreement of understanding
Legal and ethical issues

37. Telephone Technology Interactive videoconferencing
Uses the Internet, computer, real-time transmission of patient observations so specialist can examine patient
Special instruments digitize information required to make diagnosis
Conference frequently recorded for future review by either specialist or local provider
Ensure HIPAA compliance

38. Telephone Technology Cellular service
Offers convenience and flexible communication
Smartphones available in many models and sizes
Not secure

39. Professionalism in Telecommunications
Phone answered in professional manner
Concerns addressed promptly
Always be courteous and diplomatic
Work within scope of one’s education, training, ability, legal boundaries
Personal telephone calls should be avoided during working hours

40. Professionalism in Telecommunications
Slang terms should not be used
Use appropriate guidelines when releasing information
Follow confidentiality procedures
Documentation is mandatory for follow-up care and for legal implications
Continued education important to stay on leading edge of new technologies