Feature Stories - July 2000

1-800-Health-Care

Nevada's medical firms are dialing into technology

by Tony Illia

Spending time in a doctor's waiting room can be an ugly, unpleasant experience. Typically they are overcrowded, stuffy places filled with bad magazines, screaming children and, worst of all, sick people. If asked, most folks would rather not spend time there. Unfortunately, there has never been a choice -- if you felt bad or had a question, off you went. But today, thanks to some sophisticated telephones, things are changing.

For instance, St. Mary's Network in Reno has implemented an IP telephony system, which connects the telephone to their database. "Someone can call in and access their HMO and discover which doctors are covered by their plan, or check on their account status," said Tom Donohue. His consulting firm services St. Mary's elaborate communications network. "The IP telephony gives people the option of scheduling an appointment or asking a medical question over the phone." The system is set up to handle calls 24 hours a day, seven days a week. While it is primarily an automated service, there is an option for those who still wish to talk to an actual person.

In addition to the IP technology, St. Mary's has a phone system connecting the main hospital to its satellite branches. "A doctor or nurse in Reno could talk to Carson City by dialing a four-digit extension," Donohue said. The internal phone networking has allowed for improved routing, such as transferring calls, and better communications, including teleconferencing. A future technology will enable "smart chip" phones to plug into St. Mary's system from any phone jack and be connected to its network.

"St. Mary's has made a big commitment in its telecommunications system," said Donohue. "They have made it a priority." And with good reason. The hospital feels telecommunications provides yet another avenue to improving customer relations. Furthermore, it has freed up a considerable amount of manpower which St. Mary's has been able to direct to other services. It has also enabled them to handle more calls.

With 2 million calls per month, Washoe Health System in Reno understands the importance of telecommunications all too well. "We maintain at least 10 miles worth of wiring," said Eugene Spoon, Washoe's manager of telecommunications. "We employ a hub and spoke system." Their system, similar to St. Mary's, has a center that extends to 18 satellite sites. According to Spoon, the trick is to make the transitions as smooth as possible. "Anyone who reaches our health system is someone we can transfer to the appropriate person, oftentimes in a different building or miles away, without their knowledge. The trick is to make it as seamless as possible. We don’t want to lose that opportunity with the customer." That is an impressive feat considering there are 5,400 extensions to manage.

And to help implement that objective, Washoe has installed a fiber optic network, sharing utility poles around Reno and even performing underground work. It has meant a $2 million investment in software and infrastructure. "The local telephone provider couldn't meet our growing needs, so we went out and learned telecommunications and provided our own service," said Spoon. Washoe began looking at the possibility back in 1984 when the industry underwent deregulation. The investment has subsequently lowered their rates and improved both their accessibility and reliability. "We see communications as a very crucial issue," he said. "During the past two years alone, our growth has jumped from 1.5 million to 2 million plus callers." Spoon says keeping pace with technology is the biggest challenge he faces.

Thankfully, there are companies such as Janeva Interactive in Las Vegas which specialize in developing business applications for the Internet. According to company president Bert Levins, there have been significant changes in the way doctors, hospitals and pharmaceutical companies interface. "Doctors are going to be able to log-in and request drugs or samples, putting them closer to pharmaceutical companies and creating a real time atmosphere." As a result, delivery and sales will become more efficient and faster, driving down acquisition costs. "In the end, it will make pharmaceutical companies more competitive," said Levins.

At present, there are pharmaceutical companies with a web data base providing clients with such information as their co-pay amount, where they can get prescriptions filled, the ingredients in their medicine, what drugs they can get and the prescription cost. Ultimately, it allows the company to become closer to the end user. In the future people will log on and find out if they will have an allergic reaction to a drug. There will even be HMO cards that hook-up to a disk drive to allow total privacy. "Novell has this type of product right now -- it's a smart card technology that cannot be replicated," explains Levins. "If someone were to get in an accident, the doctor could swipe the card and discern all the vital health information immediately."

Another technology involves imaging x-rays and health charts. Ideally, doctors would be able to e-mail the images to one another around the world. There is also real-time video showing surgeries, and conferencing. "The lines between technology and telephones have become more and more blurred," explains Matt Brazier, chief technology officer for Sierra Health Services. "We set up interfaces for that information to be fed over an Integrated Voice Response (IVR) platform. I think it's important that the IVR database and Internet technology all become one data source."

However, differences between the two remain: The telephone is immediately accessible to everyone, whereas the Internet is still a relatively technology. "They are two platforms we have to support," said Brazier. "The adoption rates for the telephone is higher, and the Internet is just getting off the drawing board for many businesses."

Sierra Health has made a tremendous commitment to constantly upgrading and improving their telecommunications. "We wanted something that could handle double our current volume. Without customer service, we're nothing," said Anne Smith, Sierra's director of telecommunications. That meant doubling the number of telephone ports to access their data information, and updating their software.

With 60,000 calls per week and 200,000 members, Sierra Health routes requests to 13 clinical locations throughout Southern Nevada. They have one number for scheduling and another number for members. There is also a number staffed with a telephone nurse 24 hours a day. "All of our member service calls are answered with our IVR. It allows callers to retrieve information from a database through the telephone touch pad," said Kerry Engleshart, administrator of Sierra's aspect call center. "The information they can receive back includes whether a member is eligible for healthcare and the effective date if they have been terminated. It can also tell them co-payment information, lab and x-ray payments, and offer an itemized list."

Sierra even features a point-of-service product, where callers can receive a fax confirmation for every number entered through the telephone. Engleshart says it has been more popular among physicians than among members. In particular, it has been helpful with claims inquiries or deductible information. Additionally, Sierra has an intelligent call cue; if someone wants to speak to a person, call cue tells him how long he'll have to wait. In the meantime, they can pre-enter account information so the operator can have it on his screen by the time they talk.

In a growing health care market, the telephone can service clients at their convenience, providing a myriad of turnkey services. It both cuts human resource costs for companies while acting as an ambassador to their customers. The technology speeds things up, avoiding superfluous questions and travel time. Now more than ever, people can reach out and touch someone from the comfort of their own couch. But perhaps more importantly, it avoids any undue trips to the doctor's waiting room.

Tony Illia
Tony Illia is a freelance writer based in Southern Nevada.