Table 1

Representative Automated Calling Systems and Specifications

Vendor

Description

Comments

Voicent

(http://www.voicent.com/)

BroadcastByPhone: Automated dialing software can reach people by phone or by voice mail with personalized messages the auto-dialer uses a computer to deliver personal calls or leave answering machine messages in a human voice or a computer-generated voice. Calls are delivered either through a VOIP channel, such as SIP or Skype, or through regular phone lines.

Once purchased, there are no additional monthly or per-call fees to pay. Product features include live-call transfer, automated messages, touch-tone opt-out options and an easy-to-use, Excel-like interface. In addition, this product features:

1. Save/restore call list, import or copy-paste call list.

2. Detects human pick up, answering machine, busy, no answer, disconnected line.

3. Automatic retry for busy line or no answer

4. Built in calendar for advanced call scheduling.

5. Daily, weekly, monthly, and yearly recurring calls.

6. Call until confirm (for emergency alert escalation).

7. Automatically schedule call for next day if calls are not finished.

8. Multilingual Text-to-Speech (optional) for customizing each phone call.

Call-Em-All

(http://www.call-em-all.com)

This product features voice broadcasting and text messaging technology.

Month-by-month plans are available or users can opt for a "pay-per-call" basis.

All setup is accomplished online.

Features of this product also include:

1. Calls can be made online via VOIP or directly from landline phones.

2. Record message via the vendor's toll free number or upload user-created audio.

3. Text messages and audio messages can be combined in a single broadcast.

4. Uploading patient contact data is simplified.

Voice Broadcast

(http://www.callfire.com)

This product features:

1. Ease-of-use allows message recording and uploading phone lists and scheduling times and dates for outbound messages.

2. Speeds of over 50 calls-per-minute (increased speeds available by request).

3. No contracts.

Other useful features include:

1. Ability to schedule for specific times.

2. Answering machine detection.

3. Different messages for machines and people

STEP 9 - DETAILED STRATEGY DESIGN and ACTIVITY IMPLEMENTATION PLANNING

The strategy design for the initiative envisioned herein will proceed in a step-wise fashion as set forth below:

1. Analyze the results of the administration of the questionnaire (see proforma copy at Appendix a) to identify the extent and scope of the missed appointment problem that represents the focus of this initiative.

2. Communicate the goals and requirements of the automated calling system initiative to all of the stakeholders (especially the chiefs of information and resource management and purchasing) to solicit feedback and identify unexpected constraints to implementation;

3. Conduct cost analyses to identify the optimal choice of automated calling systems for the purposes of the ENT department.

4. Acquire automated calling system.

5. Coordinate integration of patient contact data with hospital's information and resource management (IRM) department.

6. Begin outbound calls to remind patients of upcoming appointments using the data developed from the administration of the questionnaire (if applicable).

7. Regularly evaluate the effectiveness...

There is also the question whether to purchase an automated calling system that requires a contract, a pay-per-call payment or a one-time purchase. Based on the available products reviewed in Table 1 above, the superior approach would appear to be the BroadcastByPhone product offered by Voicent. Not only does this product have a number of desirable features that make it suitable for the purposes of the ENT department including a user-friendly interface, it provides a number of useful analytical reports that can be used to evaluate the effectiveness of the automated calling system as described further below.
STEP 11 - HIMS STRATEGY MONITORING and EVALUATION (M&E)

Monitoring and evaluating the effectiveness of the initiative is an essential element in its successful implementation and administration. For this purpose, Cyr et al. (1999) recommend that healthcare organizations follow the steps below:

1. Develop logical indicators to monitor the quality of the services provided. Pay particular attention to the linkages among suppliers, providers, and customers, and to indicators for high risk, high volume, and problem-prone service areas.

2. Develop and test thresholds for the indicators chosen, using both internal analysis and benchmarking methods as appropriate. Decide how frequently to carry out the environmental scan for each indicator.

3. When first setting up the model, the ENT department may want to focus on developing indicators for only one or two principal functions or processes. Alternatively, the ENT department may find it more useful to focus on finding one or two good indicators for several principal functions or processes.

References

Cyr, F., King, M.C. & Ritchie, P.L. (1999). Quality management for psychology services in health care facilities. Canadian Psychology, 36(3), 201-204.

Tidwell, R. (2004). The 'no-show' phenomenon and the issue of resistance among African

American female patients at an urban health care center. Journal of Mental Health

Counseling, 26(1), 1-3.

Weiss, G.G. (2008, March 7). When patients cancel, you're on the line. Medical Economics,

85(5), 22-24.

APPENDIX a

Proforma Copy of ENT Department Questionnaire

Will a call remind the day before help you prepare for your doctor's appointment?

Yes

No

What time of day would be best to receive a reminder call?

Morning

Afternoon

Evening

Would you prefer to receive a text message reminder?

Yes

No

If so, in what language?

Were you late for your appointment today?

Yes

No

If you were late, how late were you?

(minutes)

What can the ENT department do to help you when it comes to keeping your scheduled appointment?

____