While regulation does not require hospitals to record calls, the benefit from and use cases for recording in Hospitals and other medical centers are significant. These facilities are under constant scrutiny and need to protect their operations and employees. Unique requirements and applications for medical facility recording include:
Nurses Triage Contact Center – This is a nurse that helps direct or advice callers on medical concerns; should they drive to hospital, call an ambulance, or schedule an appointment with a specialist. Recording these nurses protects the hospital from disputes or claims of mal-practice. Due to the nurses providing medical advice on behalf of the hospital, recordings provide a review capability to ensure best practices are being followed. Primary regulatory concern would be HIPPA.
Pharmacy – Recording calls in the pharmacy includes doctors calling in prescriptions, verifying insurance, patient consultations, and patient care. Pharmacies frequently take the hit when a prescription is wrong. Instant playback of recordings allows the pharmacy to verify they followed the doctor’s orders. If the insurance company has approved a claim and then refuses to pay it, then the pharmacy will have back up documentation to dispute the denial. This will easily pay for the licenses in claims recovery. The primary regulatory concern would be HIPPA, so recorded calls should be encrypted with limited access.
Telemedicine- As doctors work to reach patients in remote areas or provide high level specialists for unique medical issues; tele-medicine is making a rise. Recording the audio call and video transaction documents the interaction and can be included in the patient medical records. The recordings also allow for confirmation of medical directives from the doctor. Should a negative outcome result, having a recording of the directive can help protect against mal-practice concerns. Reviewing the diagnosis can also provide opportunities for training and improve patient outcomes. The primary regulatory concern would be HIPPA.
Doctor Paging- Overhead paging is typically through the phone system and on a specific set of extensions, so it is available for recording through traditional call recording methods. Once recorded, they can be played back along with the original call to the nurse’s station and the doctor’s response to ensure protocols were followed. This would also document the effort on the part of the nurse and time stamp and document the specific page request.
Patient Discharge Instructions – Improper following of discharge instructions is a leading cause for re-admittance. While patient discharge conversations may not take place by phone, they should always be recorded. A simple direct dial recording is possible and a copy of the recording could be made available to the patient. Recordings could be emailed to the patient or accessed through a patient portal for best results. This protects the hospital and supports Affordable Care Act compliance.
Accounting – Billing and collections calls include patient and insurance payment promises. When discussing finances with past patients, discussions can get tense. Proper training of agents is critical to ensure proper collection of debts, without creating negative patient experiences or breaking collection laws. The recording provides protection against legal action claiming improper collection practices. Without a recording, the patient’s statements are considered enough to prosecute. There are several regulatory concerns in this area and include HIPPA, PCI, and FDCPA. FDCPA assumes the consumer’s statements are valid and they must be disproven. PCI compliance secures credit card information from potential theft or fraud.
Air and Ground Ambulance Services – Phone calls and radio dispatch communications should always be recorded. Recording both telephony and radio on one platform allows for time sync playback to review timelines and ensure following proper procedures. The primary regulatory concerns are HIPPA and FAA regulations regarding emergency flight safety. Recording also assists in protecting against any mal-practice claims.
Security – The phones going to security desks and the security team’s radios are important to record. Recordings can document calls and radio communications regarding emergencies, threats, or calls that lead to a disturbance or arrest. The security desk may also receive email copies of emergency related calls to notify of an issue on the grounds.
Patient Rooms – It is important to note that patient rooms should never be recorded lines. However, if the patient is called by or calls a phone in the hospital that is recorded, then it is appropriate and acceptable to record. It should be added to admittance documents that the hospital has recorded lines and calls may be recorded.
If a hospital does record calls and they take Medicare and/or Medicaid there are a few guidelines they must follow:
- HIPPA compliance and PCI Compliance
- Must keep calls for at least 90 days
- Must delete calls once they are no longer being stored for a valid purpose
- Must be able to provide 5 calls for each line of business in their jurisdiction quarterly as examples of good customer service. These are reviewed by the governing agency. So a method to effectively deliver a selection of calls is a nice feature (CXM Advanced Archive). They are due the first day of March, June, September, and December.
- Must have a Performance Evaluation process and attend Calibration training. Calibration training is provided by the http://www.cms.gov