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Blog | On Call Central

As one of the largest independently owned primary care groups in Central Kentucky, Family Practice Associates of Lexington has been a leader care delivery and practice management for many years. The practice, consisting of 9 physicians 2 mid-level providers, and one licensed family therapist, was an early adopter electronic health records—implementing these information systems more than a decade before most of its peers. Family Practice Associates’ expertise and willingness to embrace technological change has allowed it to become one of the only Level II Patient Centered Medical Homes (PCMH) in Lexington, Kentucky. Download this On Call Central case study to learn how Family Practice Associates modernized the manner in which they handle after hours patient calls, and how they used their improved process to help secure Level II PCMH recognition. Get the case study here.

At On Call Central, we take security and patient privacy seriously. One of the questions we frequently receive relates to the manner in which we send SMS notifications to providers. On Call Central SMS notifications are conspicuously absent of protected health information (PHI) for one simple reason: it is illegal. While we grant that many answering services will (in our view, very foolishly) send providers SMS messages containing sensitive health information, it is almost certainly a HIPAA violation for them to do so.  While many view the risk of jail time for violating HIPAA as being low, it is certainly not unheard of.  Just ask this guythis physician and two employeesthis LPN, and this nurse.  Not only is SMS an unencrypted protocol, but several other fundamental problems–ranging from network design and physical security to eavesdropping and interception risks–make SMS an entirely inappropriate means by which to transmit PHI. The smart folks over at qliqsoft have done an excellent job of summarizing exactly why SMS is not HIPAA compliant.

It’s worth understanding the penalties for knowingly violating HIPAA.

Per section 1177 of HIPAA, a person who knowingly

  • uses a unique health identifier, or causes one to be used;
  • obtains individually identifiable health information relating to an individual; or
  • discloses individually identifiable health information to another person;

is in violation of HIPAA regulations. Such persons are subject to the following penalties:

  • a fine of up to $50,000, or up to 1 year in prison, or both; (Class 6 Felony)if the offense is committed under false pretenses, a fine of up to $100,000, up to 5 years in prison, or both; (Class 5 Felony)
  • if the offense is committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, a fine up to $250,000, or up to 10 years in prison, or both. (Class 4 Felony)
  • HIPAA also provide for civil fines to be imposed by the Secretary of DHHS “on any person” who violates a provision of it. The maximum is $100 for each violation, with the total amount not to exceed $25,0000 for all violations of an identical requirement or prohibition during a calendar year. (Class 3 Felony)

HIPAA violations are felonies that are tried in Federal court.  As such, you can be stripped of the following rights if you are convicted of a HIPAA violation:

  • The right to vote
  • The right to run for office
  • The opportunity to serve in the military
  • The right to own or use a firearm

While the constraints imposed by HIPAA may be inconvenient, any rational person will agree that hearing about the details of Ms. Smith’s carpal tunnel via SMS isn’t something for which you should risk a felony charge.  

Message acknowledgement is something customers have been requesting, and which will be delivered in the forthcoming release of On Call Central. Preview below.

Several practices recently have approached us as part of an initiative to achieve Patient Centered Medical Home (PCMH) recognition.  For those who may be interested in learning more, the below presentation from a recent NCQA standards workshop is a great way of learning more about PCMH, the expected standards, and what is involved (original link is here).  On Call Central can help you meet the guidelines in PCMH 1 Element B.

Download (PDF, Unknown)

On Call Central clients recently have contacted us stating that messages from On Call Central have not been received in their Gmail accounts.  The issue is the very erratic Gmail spam filter, and the video below shows you how to fix the issue.

A common question from people interested in On Call Central is, “How does an automated system determine if a call is urgent or non-urgent?” This is a great question that is on the mind of many people.

As with any system (live or automated), decisions are ultimately based on caller self-report. If you think about it, even when callers talk to a live operator, they can almost always get the operator to page someone if they are VERY motivated. In the case of On Call Central, to distinguish between urgent calls and non-urgent calls, we go through a process whereby we design a voice menu system specific for your practice. We place all items the user deems non-urgent first. For example, office directions, hours of operation, appointments, billing matters and calls regarding non-urgent medication refills can be dealt with without contacting the on call provider. Only after hearing these options do we present the option to contact an on call provider.

So how does On Call Central handle these non-urgent calls? When callers select any non-urgent option, On Call Central can handle these callers in two different ways:

  • Forwarding – On Call Central can take a caller’s non-urgent requests and forward them directly to a back line in your office, or an internal voice mail box in your practice.
  • Email – On Call Central can confirm the callers callback number, and accept a voice message. As soon as the patient hangs up the phone, On Call Central attaches the voice message audio file (.wav format) along with the callback number to an email, and sends that to a destination email address – For example: nonurgent@yourdomain.com or billing@yourdomain.com.

In either of the above options, your on-call providers are not notified of these messages. As a practice, you have the flexibility of deciding on how you want your patients non-urgent messages handled. If you want to send billing issues to a separate “billing” voice mailbox or email, you have the freedom to do just that. The choice is yours.

Here is an example greeting from a fictitious practice:

“Thank you for calling ABC Medical Group. Our office is currently closed. If this is a life-threatening emergency, please hang up and dial 911. For hours and directions to our office, press 1. If your call is regarding a non-urgent care request such as a prescription medication refill, billing issue, or an appointment change or request, please press 2 to leave a message, and a member of our staff will return your call within one business day. If you are a doctor, hospital, or pharmacy, and you need to speak with the provider on-call, press 3 now. If you are a patient, and your call is regarding an urgent matter that cannot wait until the office reopens, please press 4 at the end of this message to contact the on-call provider. Please note that calls regarding non-urgent issues and medication refills, will not be returned. Thank you for calling ABC Medical Group.”

The above menu displays options at the very basic level and is intended to help demonstrate On Call Central’s flexibility. We also have the ability to fork menu options, and present callers with other menus. We have extensive experience in developing custom menus that simply work. We take into account your business needs, the options and messaging you require, and we develop a custom voice menu logic, that is patient-friendly and meets your expectations.

Last week we conducted our first formal customer satisfaction survey.  Customer satisfaction is extremely important to us, since a large portion of our growth is driven by customer referrals.  Though additional responses may trickle in, we now have enough data to make some pretty good conclusions regarding customer satisfaction. Overall, 36% of our customers responded to the survey—significantly higher than the response rate for most web-based surveys.  The survey asked two simple questions.  They were:

  • On a scale of ten (10 being the highest), how likely is it that you would recommend On Call Central to a friend or colleague?
  • How would you rate our customer service on a scale of ten, with ten being the highest?

The score for each of these questions was exactly the same.  Across the population surveyed, On Call Central received a 9.88 out of a possible 10 for both of these questions.  Thanks to our customers for this feedback.  If you haven’t yet had the opportunity to fill out our survey, please do so!  As always, feel free to email us with suggestions for product improvement.

SMS messaging is the most common notification method for On Call Central users, and the iPhone is the most common phone. One request we receive from our users is how to set make their iPhone play a different tone when On Call Central sends them a text message. Some users want their phone to play a tone that is particularly loud, while others simply want to distinguish SMS messages that originate from On Call Central from all other SMS messages. This brief tutorial walks you though how you can define a different SMS tone for On Call Central messages.

You will need:

  • An iPhone running iOS 4.2 or greater.
  • 5 minutes of time

Step By Step Guide

    • In your iPhone contacts, create a contact called “On Call Central.”  You can also go to your recent SMS messages from On Call Central and select “Add Contact.”

      Adding a contact from an SMS message on the iPhone

      Adding a contact from an SMS message on the iPhone

    • Add “258-27” as the mobile number for the On Call Central contact. This number is the SMS short code On Call Central uses to send you messages.
    • Scroll down and click “text tone.” You will want to select a tone that is different than the default. If you are looking for something that will wake you up at night, I’d personally take a look at “Alarm.” If you are looking for something that actually sounds like an old school pager, open iTunes on your phone and search for “pager tones.” You will see several tones (only $1.29 each!) sure to bring back memories of residency.  These tones will wake you from even the most restful sleep.  Once you have selected the SMS alert you want, save the contact.

      Old School Pager Tone will wake you from the dead.

      Old School Pager Tone will wake you from the dead.

    • Save the contact. Now when you get a message from On Call Central, it will play a tone different from that of your other contacts.
Save the contact after you have entered the SMS short code and set the ringtone.

Save the contact after you have entered the SMS short code and set the ringtone.

We occasionally get clients who are completely new to using an answering service and have a basic question: How do you forward your phones?

Forwarding Phones

To forward your phones to On Call Central, do the following:

  • Using the phone you would like to forward, pick up the handset and listen for a dial tone.
  • Dial #72 or *72.
  • Enter the phone number to which you wish to forward your phones.  You may, or may not, have to enter the “1” before your number.
  • Listen for the confirmation tone. When you hear it, hang up. Call forwarding is now enabled.
  • From your cell phone, call your office main number and make sure On Call Central is picking up.

Un-Forwarding Phones

To un-forward your phones , do the following:

  • Pick up the same phone you forwarded to On Call Central and listen for a dial tone.
  • Dial #73 or *73.
  • Listen for the confirmation tone. When you hear it, hang up. Call forwarding is now disabled.
  • From your cell phone, call your office main number and make sure On Call Central is no longer picking up.