Jan 25 2022

As Healthcare Modernizes, Cloud-Based Communication Systems Take Over

As healthcare organizations look to update legacy systems, a focus on upgrading essential voice telecommunications offers better connections for patients and staff.

Island Health, formerly Island Hospital in Anacortes, Wash., planned to upgrade its aging phone system in 2019. The organization provides healthcare in a rural, seaside area in northwest Washington state and recognized the need to improve its telecommunications system to better serve its community.

“Our population is older,” says Network Engineer Shane Taylor. “They tend to want to use the phone to talk to someone, not use digital communications like email or patient portals. The availability of our phone system is a big deal. Even if it’s down for a short time, it’s a problem.”

Island Health used an older Nortel system that was installed in the late 1980s and early 1990s, Taylor adds. “Since then, we bolted on new technology to get more modern features, but we got to a point where the system didn’t support it.”

As the phone system began to experience hardware failures and outages, the hospital recognized the need to revamp this crucial infrastructure. 

“We’re a hospital, so 24/7/365 communication is critical. Ambulances and other emergency services primarily use the phone to communicate with the hospital,” Taylor says. “We have backup communication channels, like radio, but it’s jarring when the primary channel isn’t working and you have to switch to the backup.”

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Phone System Upgrade On Hold, But Still Needed

Island Health intended to upgrade to a new Cisco Unified Communications System, but the project was put on hold when the COVID-19 pandemic hit in 2020, and strategies such as supporting a remote workforce and telemedicine became priorities.

The system was not alone in shifting priorities during this time. Due to the pandemic, healthcare organizations dramatically stepped up their digital communications, increasing the availability of telemedicine by 42 percent and patient portals by 50 percent compared with 2019,  corporate advisory firm BDO reports in its 2021 Healthcare Digital Transformation Survey.

Island Health’s project resumed in the summer of 2020 with the goal of deploying the upgraded system remotely before the end of the year.

During the planning phase, Taylor and his team involved a wide range of stakeholders, including members of the call center and department directors. With their feedback, the planning team created a proof of concept for the system and decided on Cisco as the most stable choice.

“In a healthcare environment, the name of the game is stability. That’s the guiding star for us,” Taylor says. “Cisco UCS was very well developed over several iterations, and it hasn’t made too many acquisitions, which can sometimes affect stability and availability.”

Overcoming Phone System Implementation Challenges

Island Health already relied on Cisco for other products, such as IP phones and access point switches. The call center staff also preferred Cisco’s user interface.

The transition to the new phone system, however, wasn’t free of challenges.

“Obviously, there is staff turnover, things get forgotten, you drop blocks of IDs, there are old circuits — it gets quite messy,” Taylor says. “We had to go through that with a fine-toothed comb.”

In November 2020, when the hospital finally threw the switch on the new system, there were issues related to transferring phone carriers and porting numbers. There were also growing pains among the staff, some of whom had a tougher time than others in dealing with the new technology.

    Source: Kyruus, 2021 Patient Access Journey Report, November 2021

    But as carrier problems smoothed out and people became more familiar with the system, both the IT and administrative staff saw an improvement in productivity.

    “Collaboration systems and software-based functionality provide great benefits,” Taylor says. “With this foundation, we can plug in other communication technology. We have Webex and visual voicemail. We don’t even need physical phones for much of our communication.”

    Michael Lee, principal and senior client executive at BDO Digital, views these advantages as essential for healthcare organizations.

    “In the past, the phone system provided one basic function: to make and receive calls,” Lee says. “In the modern workplace, it still fulfills that function. However, it’s simply one important part of a broader business need for collaboration and communication.”

    Next-Gen Connections With Upgraded Telecom

    In Texas, Harris Health System was preparing to upgrade its legacy phone system before David Chou joined as senior vice president and CIO in 2020.

    “In healthcare, telecom isn’t always top of mind. It either works or it doesn’t work,” Chou says.

    The organization’s foresight to replace the legacy system ahead of the pandemic offered a much-needed base. “We need our telecom to be next-generation. We’ve already been able to recognize some of the benefits, like supporting an off-premises workforce,” he adds.

    Harris Health also chose solutions from Cisco. The healthcare system experienced similar challenges when implementing its new system.

    “The technology was the easy part,” Chou says. “The difficult part was keeping an accurate inventory of the phone numbers that are active, or inactive, and what is connected to what. It’s important to find those stumbling blocks, which can cause a bigger impact down the road.”

    EXPLORE: Learn how clinical collaboration has evolved and why it matters.

    Flexible and Reliable Telecom for Healthcare

    With more than 40 office locations across New York and New Jersey, ENT and Allergy Associates (ENTA) already employed several Voice over IP vendors for its call system before the pandemic. But with issues such as weather-related outages and the shift to widespread remote work, the specialist clinic explored more flexible and reliable options to overhaul its telecom system.

    Serving more than 90,000 patients a month, the ear, nose and throat, allergy and audiology health practice upgraded to cloud-based RingCentral to support more than 220 physicians and staff members across its multiple locations.

    When ENTA shifted to remote work during the pandemic, John Monreal, senior director of purchasing and call center operations, says the need for mobility helped guide the change.

    “Our old VoIP system wasn’t exactly remote-friendly. It was clunky and represented clumsy tech,” he says. “We needed a solution that only required Wi-Fi and a laptop. We pulled the plug on what we had and decided to go into the cloud.”

    ENTA relies heavily on voice-based communication. About 95 percent of calls are inbound, with patients calling to schedule appointments, refill prescriptions or ask questions.

    Michael Lee
    Healthcare providers are shifting to modern, cloud-based intelligent solutions to leverage multiple modes of communication seamlessly.”

    Michael Lee Principal and Senior Client Executive, BDO Digital

    The call center, which used to be 100 percent on premises, is now 70 percent remote, with staff located all over the country. ENTA leans on the multitude of RingCentral cloud-based options, something that BDO Digital’s Lee has seen in other healthcare organizations.

    “Healthcare providers are shifting to modern, cloud-based intelligent solutions to leverage multiple modes of communication seamlessly,” Lee says. “They’re able to use more flexible communication and collaboration, such as instant messaging, voicemail transcription, video messages and real-time language translation.”

    Such technology also allows frontline staff to use any device, such as a smartphone, desktop computer or tablet, instead of a specific device, Lee adds.

    RELATED: Find out how to keep optimization at the forefront of your cloud environment.

    Using RingCentral’s advanced features, ENTA has been able to create an efficient, productive call center environment with low turnover.

    For example, Monreal and his team analyze RingCentral data to determine which kinds of calls employees excel at and automatically direct those calls to them. They also used an internal messaging feature to create a help desk that allows their remote agents to access chatrooms during calls to ask questions — a faster and better solution than putting a caller on hold.

    “Our call center employees are engaged and can use the call center as a springboard to either grow within the call center or move to other areas of the company,” Monreal says. “Having staff now working remotely and across the country has allowed us to take advantage of time zones. West Coast staff can still enjoy an early shift, which is effectively a late shift in New York. All of these benefits have led to strong employee retention, a testament to the technology and to the culture we’ve created.”

    Editor's note: This story has been updated to reflect the change in Island Health's name, which was formerly known as Island Hospital.

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