1. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 12 Telecommunications

2. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. TPMS Data Flow TPMS and the Administrative Medical Assistant

3. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Basic Telephone Techniques First impressions are lasting whether an automated phone system answers the call or it is answered in person

4. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Basic Telephone Techniques Automated Systems –Should be user friendly Menu option list should only be one level deep –Always have an option to speak with a receptionist if desired –Begin automated message with instructions regarding emergencies

5. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Basic Telephone Techniques Answer incoming calls by the end of the first ring and certainly within three rings Guidelines to follow when conversation must be interrupted to answer another call

6. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Personality Be prepared to give the caller your complete attention Use a pleasant well- modulated voice Use same volume as when speaking conversationally

7. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Personality Keys to Good Telephone Personality –Enunciation: speak clearly and articulate carefully –Pronunciation: say words correctly –Speed: talk at a normal rate –Posture: sit up straight and use a headset –Be patient –Remain calm if call is regarding life-threatening situation

8. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Etiquette Treat others with consideration Follow basic telephone courtesies

9. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Answering Incoming Calls Answer with the name of the facility and person caller is speaking with –Use buffer words –Ask if emergency –Obtain caller’s: Full name and correct spelling DOB and street address –Complete the call efficiently by following all established protocols

10. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Answering Incoming Calls Screening calls –Purposes To be sure caller talks to person who can help most To ensure provider’s time is efficiently managed –Proper screening techniques Direct call to appropriate person who can help Be tactful and persistent

11. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Transferring a Call Guidelines that ensure successful transfer –Acquire caller’s personal information and associated data –Put caller on hold and see if the person best suited to assist is available –Follow telephone system procedure to transfer the call –Follow up to see if transferred correctly

12. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Taking a Message Use a message pad or EHR message screen List of information that should be taken with each call Repeat information to verify Attach message to patient chart before placing the message on the provider’s desk

13. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ending the Call Is as important as answering promptly End conversation courteously Repeat pertinent information back to caller

14. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ending the Call Pause for additional questions Say “Good-bye”—no slang Stay on line until caller hangs up first

15. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Routing Calls in the Medical Office Calls MA can take –Administrative MA –Clinical MA Calls referred to provider –Other providers –STAT reports –Provider’s family

16. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Special Consideration Calls Referral calls to other facilities Emergency/urgent calls –Differentiate between telephone screening and triage –Differentiate between emergency and urgent calls –Keep a list of questions near the phone to evaluate situation

17. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Special Consideration Calls Emergency/urgent calls –Office should periodically review procedures for emergency calls –Good Samaritan laws do not cover paid employees, only uncompensated situations –Post emergency numbers near phone

18. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Special Consideration Calls Angry callers –Defuse the situation –Remain calm and in control

19. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Special Consideration Calls Elderly 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

20. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Special Consideration Calls ESL callers –Bilingual employee –Do not make assumptions –Patient may be able to understand English better than speaking it –Speak at a normal volume and more slowly –Be willing to review information –Be patient

21. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Documentation Medical information request over the phone should be discouraged Use “call back” verification procedures Request caller’s name, phone number and DOB

22. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Documentation Call back and verify identity of caller Document in a log, the patient’s chart, or EMR

23. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Using Telephone Directories Medical assistant should have on hand a variety of telephone directories Contain very useful information –Emergency and nonemergency numbers –Internet guide –Information guide and consumer tips

24. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Using Telephone Directories Contain very useful information –Community pages –Phone service pages –Government pages –Index

25. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Using Telephone Directories Medical centers and hospitals produce another type of directory with phone numbers important to that facility Online telephone directory services

26. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Placing Outgoing Calls Know what information is needed and have it available beforehand Make calls from a quiet, private location Establish a routine

27. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Placing Outgoing Calls Long distance calls –Placing calls –Time zones –Long distance carriers

28. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Legal and Ethical Considerations Confidentiality Practice sensible risk management

29. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. HIPAA Guidelines Determine if caller has requested confidential communication If caller has not requested confidential communication, treat as a normal call If caller has requested confidential communication and provided an alternative phone number, be sure only the alternative number is called

30. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. HIPAA Guidelines Caller should identify self by name and from office name Do not leave any medical information or mention the purpose of the call Never leave messages containing test results

31. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Americans with Disabilities Act Requires health care providers provide effective communication alternatives to people who may be deaf or hearing impaired –Health care provider may choose the device as long as the result is effective –Teletype (TTY) and telecommunication device for the deaf (TDD) options –Any cost of alternative devices or services cannot be billed to the patient

32. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Technology Automated routing units –Manage heavy telephone traffic –Electronic mailboxes –Advantages and disadvantages

33. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Technology Answering service and machines –Take calls after hours –Answering services use a live operator and provide flexible routing services –Machines must be checked frequently for messages

34. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Technology Voice over Internet Protocol (VoIP) telecommunications –Convert a voice into a digital signal that travels over the Internet or a virtual private network –Biggest advantages are price and flexibility –Three types of VoIP services Analog telephone adapter (ATA) IP phone Computer/computer –Safeguards to protect a VoIP system

35. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Technology Fax –Used to send reports, referrals, insurance approvals, and informal correspondence –Confidentiality is an issue

36. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Technology Cellular services –Offers convenience and flexible communication –Not secure –More expensive than regular telephone service

37. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Telephone Technology Paging systems –Used by hospitals for many years –Options Voice alerts Beep alerts Digital message display –Allow one-way communication –Less expensive than cellular services

38. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Email Process of sending, receiving, storing, and forwarding messages in digital form over computer networks –Non-real-time method of communication –May be sent to multiple people at the same time Professional email etiquette must be adhered to –Not permitted to forward email messages without the permission of the original author –Caution: avoid sending information that is not appropriate in a professional setting

39. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Clinical Email Increasing method of communication between patient and PCP –Used for communication considered not urgent or when communication continues over a period of time Provider must remember the same ethical responsibilities must be adhered to as for other types of encounters

40. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Clinical Email Guidelines to minimize risks related to clinical email –Limit email communication to current patients –Limit email communication to patients within the state in which the provider is licensed to practice –Follow computer security procedures

41. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Interactive Videoconferencing Uses the Internet, computer, and real-time transmission of patient observations so the specialist can examine the patient –Special instruments digitize information required to make a diagnosis

42. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Interactive Videoconferencing A technician or PA is with the patient and performs the test, transmits observations viewed by the specialist in real time –The conference is frequently videotaped for future review by either specialist or local provider HIPAA compliance guidelines must be followed Patient must give written consent before interactive videoconferencing begins

43. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Professionalism in Telecommunications Always be courteous and diplomatic and work within the scope of education, training, and legal boundaries –Personal telephone calls, other than emergency calls, should be avoided –Do not use slang when speaking with patients and other health care members

44. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Professionalism in Telecommunications Follow appropriate guidelines when releasing information Follow confidentiality procedures Documentation is mandatory for follow-up care and has legal implications

45. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Professionalism in Telecommunications Continued education is important to stay on the leading edge of new technologies