Chapter 9
Administrative
Technologies
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Review Tip
Complete the chapters on Communication (Chapter 7) and Patient
Education (Chapter 8) before beginning this chapter. Many of the
principles discussed in those chapters also apply to administrative
techniques. This chapter lends itself to lunchtime reading and other
“learning moments.”
Carry the review book with you and open it when you have a free
moment.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Overview
The wired telephone and the cellular telephone are the most common but
not the only methods of electronically transmitting messages and
information. Advancing communication technology is found in all
aspects of health care. This chapter also covers some of the
technologies found in the medical office, such as computers and
facsimile machines.
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Telephones
Despite the increasing use of advanced technology, the telephone
remains the number one technologic method for patients and
health care providers to communicate with each other. Although
the medical office also relies on the phone for real-time
communication with insurance companies, pharmacies, medical
supply companies, and hospitals, the primary emphasis of this
chapter is telephone communication between the medical office
and the patient. The use of specific skills and guidelines helps
ensure that telephone communication is effective.
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Telephones, cont’d.
Telephone Voice Qualities
Enunciation—speak clearly
■ Pronunciation—say words correctly
■ Volume—use normal voice level
■ Speed—use normal rate of conversation
■ Inflection—change voice pitch to avoid a monotonous tone that
implies boredom
■ Facial expression—put a “smile” in your voice by having a
pleasant look on your face while speaking even though the
caller cannot see you
■ Courtesy—speak politely, without irritation or impatience
■ Attention—focus on the caller and listen
■
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Telephones, cont’d.
Medical Office Calls
■ Attempt
to answer by the third ring
■ Use standard office greeting
• Greet caller (e.g., “Good morning”).
• Provide name of facility.
• State your name.
• Inquire “How may I help you?”
■ Use standard closing
• Thank the patient for calling.
• Allow caller to hang up first.
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Telephones, cont’d.
Direct multiple incoming calls
• Obtain permission of the first caller to be placed on hold. Explain
that you have another incoming call. Allow time for the patient
to respond before placing him or her on hold.
• Ask the second caller to wait; allow time for response before
placing him or her on hold.
• Attempt to respond to callers within 30 seconds.
• Provide options if the hold will be longer.
• Thank the caller for waiting.
■ Screen calls
• Know who and where to refer patients for appropriate
assistance.
• Manage physician’s time by referring necessary calls only and
taking messages for other calls.
■
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Telephones, cont’d.
Route calls
• Tell caller to whom you are forwarding the call.
• Provide the forwarding phone number to which you are
transferring the call in case of disconnection.
• Inform the patient that if the party does not respond, the patient
may leave a voice mail message (if available). Suggest the
patient include a time when he or she is available for a return
call.
■ Know the office policy regarding calls that should be directed to the
physician
• Forward calls from other physicians, hospital staff, and patients
to whom the physician indicated he or she would like to speak
directly (e.g., close colleagues).
• Provide the patient’s medical record (chart or file) for the
physician when transferring a call or leaving a message if he or
she does not have access to the EMR.
■
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Telephones, cont’d.
• Assure a patient who insists on speaking only to the physician,
when the physician is unavailable, that the physician will return
the call; if possible, provide a time range during which the call
will be returned.
• Inform callers who will not identify themselves that you need
their name and number to have the physician return the call.
■ Record message
• Use carbonized message pad, e-mail, or other methods that
allow the message to be forwarded but saved.
• Maintain a copy of the message in the patient’s medical record if
that is office policy.
• Record the caller’s name (confirm spelling), date, time, reason
for call, phone number of caller, and convenient time to return
call.
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Telephones, cont’d.
• Inform the caller who will return the call and give an approximate
time the call will be returned.
• Initial and forward the message to the appropriate person with
the patient’s medical record, if needed.
■ Deal with emergencies
• Notify the physician immediately.
• Activate the emergency medical system (EMS/911); if telephone
system allows, keep the caller on one line while you notify 911.
• Instruct caller to hang up and activate EMS himself or herself, if
the office phone system does not have at least two lines.
• Provide EMS or emergency facility with information, including
advance directives and other important details.
• Follow up with the emergency facility.
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Telephones, cont’d.
■
Manage difficult callers
• Keep your voice at a normal level and remain calm with angry
callers.
• Determine the problem and notify appropriate staff to help the
patient.
• Follow up to ensure the problem was addressed.
• Ensure that the physician or the administrator is aware of irate
callers or callers with unresolved problems.
• Attempt to obtain identity of threatening callers and notify the
physician or the administrator immediately.
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Telephones, cont’d.
Medical Assisting and Medical Administrative Specialist Calls
The following are telephone calls that a non-physician may handle if
he or she is the designated person in that office:
■ Appointments (scheduling, rescheduling, canceling, reminding,
recalling)
■ Patient financial statements, insurance, fees, and service
questions
■ Prescription refills verified by the physician
■ Diagnostic testing and other procedural preparations as written
■ Satisfactory test results if reviewed and approved by physician
following Health Insurance Portability and Accountability Act
(HIPAA) guidelines
■ Routine and satisfactory progress reports from patient if office
policy allows
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Telephones, cont’d.
■ Reinforcement of patient educational plan
■ General information regarding office policies, locations, or
appointment preparation
■ Schedule procedures at other facilities
■ Record diagnostic and other procedural results telephoned from
health care facilities (within the continuity of care or with patient
consent)
■ Activate answering service
■ Retrieve messages from answering service or voice mail
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Telephones, cont’d.
Telephone Confidentiality
The HIPAA confidentiality standards, expected in all health care
activities, also apply to the telephone:
■ Give information only to authorized persons. (Note: Spouses,
friends, parents of adults, or adult children of patients are not
generally authorized unless specifically approved by the patient
in writing.)
■ Verify that you are giving information to an authorized person
(e.g., the patient’s insurance carrier).
■ Ensure telephone conversations are not overheard or that
messages are not seen by unauthorized persons.
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Telephones, cont’d.
■ Avoid discussing telephone conversations except in carrying
out medical assisting duties with authorized persons.
■ Avoid leaving information on the patient’s voice mail; only state
the name of the office and the phone number. Ask the patient
to return the call, and leave the name of the party he or she
should request
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Other Technological Devices
In addition to the telephone, you may use or come in contact with
other technologic devices. It is your responsibility to keep up with
advances. The exams will continue to incorporate new
technologies.
Computers
The computer is an electronic device programmed to take in,
store, retrieve, and process data.
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Other Technological Devices,
cont’d.
Figure 9-1. Basic components of a computer.
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Other Technological
Devices, cont’d.
■
Hardware—the central processing unit, motherboard, hard drive,
disk drive, keyboard, and monitor of the computer
• Motherboard—the fiberglass plank of the computer that contains
the central processing unit, memory, and other circuitry
- Central processing unit (CPU)—circuit on a microchip that
processes data; microprocessor
- Random access memory (RAM)—main memory bank of a
computer located on the motherboard; the more RAM the
computer has, the more data and the faster the data
manipulation; memory is measured in bytes (e.g.,
megabytes—1 million bytes; gigabytes—1 billion bytes)
• Hard drive—a box containing the computer’s programs and data
files
• Keyboard—a set of typewriter-like keys that plugs into the
computer and allows input of data
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Other Technological Devices,
cont’d.
• Monitor—visual display terminal that allows data to be seen on a
television-like screen
• Disk drive—a device that allows information to be accessed
from a floppy disk or compact disc
■ Accessories
• Mouse—a device that plugs into the computer and allows the
user to control the cursor (pointer) as viewed on the monitor
• Modem—a device connecting the computer to a telephone line
and allowing data to be transmitted over telephone wires
■ Software—computer programs that tell the computer what to do
■ Floppy disks—diskettes; magnetic discs that can be inserted in the
disk drive; they allow for storage of data outside the computer and
for transmission of data into and out of the computer
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Other Technological Devices,
cont’d.
■ Compact disc (CD)—a disc that can be inserted into a CD-ROM
(compact disc read-only memory) drive and read by a laser beam,
allowing storage of data, including audio and visual programs,
outside the computer and transmission of the data into and out of
the computer
■ ZIP drive—a drive that allows several megabytes of data to be
saved to a special disc; can be internal or external to the computer
■ Digital video disc (DVD)—a high-density optical disc the contents of
which can be displayed on a computer or television screen
■ USB (universal serial bus) drive—small, lightweight, removable data
storage device; also called USB stick, USB key, memory stick,
flash drive, or thumbdrive
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Other Technological Devices,
cont’d.
Figure 9-2. Compact discs and USB drives.
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Other Technological Devices,
cont’d.
Common File Formats
A file format is a mechanism used by the computer to save and
retrieve specific computer information, such as text or
photographs.
DOC—document files (DOCX is a more current version, but the
general recommendation is to save files in DOC for ease of
opening from all senders)
■ GIF—Graphics Interchange Format
■ JPEG—Joint Photographic Experts Group
■ RTF—rich text file
■ PDF—portable data format
■
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Other Technological Devices,
cont’d.
Common Computer Networks
A computer network is the ability of two or more computers
to communicate.
LAN (local area network)—a router is used to connect
computers, generally of a single organization and all its sites
■ WAN (wide area network)—using telephone systems, coaxial
cables, or satellites, connects the computers of a geographic
area; the Internet, which contains the World Wide Web (www),
is the largest example of a WAN
■
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Other Technological Devices,
cont’d.
Other Common Computer Terms
Blog—a type of website, generally maintained by an individual
who posts regular commentary or other material such as
graphics or video
■ Electronic social network—a group of people interconnected by
the web for the purpose of interacting on a specific topic or
multiple topics of common interest such as Facebook and
Twitter
■ HTML (HyperText Markup Language)—the language used to
transfer documents on the Internet
■ HTTP (HyperText Transfer Protocol)—how messages are
formatted and sent over the Internet
■ Browser—software that locates and displays web pages on the
computer; an example is Internet Explorer
■
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Other Technological Devices,
cont’d.
■ Search engine—an extensive program allowing searches for
information and websites by using key words; examples are
Yahoo and Google
■ Spreadsheet—values arranged in columns and rows that may
be electronically manipulated using formulas or other
processes
■ URL (Uniform Resource Locator)—identifies the global address
and domain to access web pages
■ Website—a collection of screens with text, images, videos, or
other digital information with a common domain
■ Word processing—one of the most common computer
applications used to create, edit, and produce text documents
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Other Technological Devices,
cont’d.
Common Computer Uses in the Medical Office
■ Appointment
and procedure scheduling
■ Patient statements
■ Day sheets
■ Financial ledgers
■ Requisitions
■ Payroll and other personnel functions
■ Reports
■ Correspondence
■ Online patient registration
■ Electronic medical records
■ Insurance billing and claims
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Other Technological Devices,
cont’d.
■ Research using the Internet
■ Digital imaging
■ Patient educational materials
■ Patient reminder and recall notifications
■ Staff training
■ Inventories
■ Electronically operated patient tests and procedures
■ Website information regarding the practice
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Other Technological
Devices, cont’d.
Computers and Confidentiality
The health care standards for confidentiality and release of patient
information also apply to computers. Computer-specific
requirements and guidelines have come about through standard
practice or HIPAA. One of the significant components of HIPAA is
the filing of Medicare claims through a secure electronic database
exchange. To ensure compliance:
Require authorized persons to use an exclusive “electronic
signature” or password to view patient records
■ Change passwords frequently
■ Ensure computer screens are not in view of unauthorized
persons
■ Turn off computers when not in use
■
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Other Technological Devices,
cont’d.
■ Install privacy filters on monitors to prevent passersby from
seeing the screen
■ Protect computers from illegal access with appropriate security
devices such as firewalls
■ Shred confidential copied materials when no longer in use
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Other Technological Devices,
cont’d.
Figure 9-3. HIPAA standards also apply to computers.
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Other Technological
Devices, cont’d.
Medical Transcription and Equipment
Transcription is basically a written copy of dictated or recorded
information. Although generally done by a person specifically
trained in this field, medical transcription may be the duty of the
medical assistant or the medical administrative specialist.
Common information transcribed for the medical office is:
■ Patient history and physicals
■ Admission and discharge notes
■ Surgery and other procedural reports
■ Consultations
■ Correspondence
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Other Technological
Devices, cont’d.
The equipment used includes:
Transcription machine with earpieces and foot pedals
■ CDs or audiocassettes
■ Computer and monitor
■ Keyboard
■ Specific software (e.g., medical terminology spell check,
pharmacology reference)
■
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Other Technological Devices,
cont’d.
Other Common Electronic Devices
Facsimile machine (fax)—an electronic machine that sends
copies of documents over telephone wires (fax confidential
information only to secured areas; fax cover sheets should
include a confidentiality statement)
■ Scanner—software-required device that reads documents (text,
graphics, photos) and transfers the image to the computer
■ Automated routing unit (ARU)—programmable device that
answers calls and plays prerecorded telephone messages to
prompt a caller to choose options based on needs; the ARU
automatically directs the caller to the chosen option; some
ARUs are programmed to telephone patients and leave
appointment reminders or other messages (these messages
should not be left without patient consent)
■
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Other Technological
Devices, cont’d.
■ Electronic mail (e-mail)—a system of communicating electronic
messages, images, and sounds via the computer through a
modem and the Internet (e-mails should not be sent to patients
without their consent)
■ Cellular telephones (cell phones)—portable, wireless telephones;
their use should be restricted in health care facilities because they
may interfere with electrical medical devices or the noise may
impede patient care; medical assistants should not use personal
cell phones during working hours
■ Personal digital assistant (PDA)—a palm-sized, handheld, wireless
computer that may be synchronized with other computers; an
example is a Palm Pilot
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Other Technological
Devices, cont’d.
■ Pagers—battery-operated devices that alert a person to a message
left through a telephone or wireless source; pagers may also
display other information, such as news bulletins
■ Digital camera—a camera that uses a memory card instead of film,
allowing pictures to be viewed, altered, or printed through a
computer
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