Getting the Most From Your Phone System
Contents
1. amp P D 10 lines without having to AH place callers on hold for more op A than a minute However this number largely depends on r3 N A R y x gt P your receptionists capabilities If your receptionist cant handle all San _ SS te February 2001 FAMILY PRACTICE MANAGEMENT 21 a Se Downloaded from the Family Practice Management Web site at www aafp org fpm Copyright 2001 American Academy of Family Physicians For the private noncommercial use of one individual user of the Web site All other rights reserved Contact copyrights aafp org for copyright questions and or permission requests SPEEDBAR lt Calling your office during a busy time will give you a good sense of whether your phone system needs improvement lt You ll also learn a lot about your phone sys tem by asking patients direct questions and fielding a brief survey lt Your local phone com pany can provide you with a busy signal report at a relatively low cost lt The phone company can also recommend how many phone lines you need based on the results of the busy sig nal report GETTING FEEDBACK Asking your patients what they think of your phone system is easy Just have them complete a short survey such as the one below while they wait for their appointment Help Us Help You We re evaluating our phone sy2. Getting the Most From Your Phone System Looking at your syten through the eyes of a patient will help you understand what you need ave you ever called your office pretending to be a patient to see how easy or difficult it is to schedule an appointment or get a prescription refilled If you haven t you should What you learn may surprise you It doesn t take long for a practice to out grow its telephone system An inadequate phone system tells patients your practice is overloaded and doesn t have time for them Patients judge their physicians in part by how easy it is to contact them A bad phone experience can color a patient s perception of the whole practice But it doesn t have to be that way Evaluating your current phone system What can you do As I suggested above call your office Be sure to call during busy times such as Monday morning and around the lunch hour If you find it difficult to get through so do your patients Dont stop there Ask Oo your patients about their experience calling your office Your invitation may uncover complaints about your phone system that patients had been too intimidated to bring to your attention You also may want to have your staff give patients a short survey to fill out while they sit in the waiting room See Getting feedback page 22 for a sam ple survey Next call your local phone company and request a busy signal report The phone com
3. ailbox extensions to people they choose No one else is allowed to give out the numbers Conley says Internet access It is becoming increas ingly important for family practices to have access to the Internet If you believe Internet access isnt part of your phone system you should probably ask yourself What phone lines am I going to use to transmit data and Will those lines have to go through my phone system and create unnecessary busy signals for my callers Phone companies will often bundle voice and data systems together One option your phone company may offer you is always on Internet access With this feature your phone line is always connected to the Internet so all you do is plug the phone line into your computer You don t have to take the time to dial into your Internet service provider ISP and you don t have to compete with other ISP subscribers for access The phone company may recommend that you use a digital subscriber line DSL which allows for faster data transmissions Expect to pay an average of 50 per month e Do we want a patient reminder system that auto matically calls patients with a recorded message reminding them of their appointments e Do we want callers to hear music on hold Do we want the ability to play messages such as informa tion about the practice or health promotion tips e Do we want an intercom system in the office e Do we want a call accounting system
4. d the calls be answered by the automated attendant We also found that the receptionist could direct the calls to the appropriate people better than the automated attendant g A Cy p AARO AEAN The receptionist could ask questions and get information from callers Weida says Some callers got confused when listening to the prompts and ended up choosing the wrong department Bob Conley a practice management consultant in Plymouth Meeting Pa thinks automation can help however An auto mated attendant can work You have to set it up properly For instance you have to make it clear exactly what the prompts are for and give callers the option of being transferred immediately to the receptionist Your decision about adding an automated attendant will ultimately come down to your practice s philosophy and your patients needs and preferences Beyond the automated attendant Your phone options don t end with an automated attendant Today s practices can choose from a long menu of phone features Check out what options and features are offered by your local phone company and other telecommunications vendors in your area What do you want out of a phone system on page 24 will give you an idea of what s available Two of the most popular features are voice mail and Internet access Voice mail Voice messaging systems are a standard feature of most phone systems today Almost every compa
5. e based on the combination of the num ber of lines you have and the system you re leasing Expect to pay 15 to 20 a month per line for both dial tone service and the use of a standard system that includes voice mail and an automated attendant Typically phone companies charge 10 to 15 a month per line just for dial tone service Maintenance fees may not be included in all lease agreements Be sure to get in writ ing what the phone company or your third 26 FAMILY PRACTICE MANAGEMENT u February 2001 Dedicated lines for computer modems and fax machines Support a contract making the vendor responsible for chances are they are fighting each other for market share That means they may be willing to give you equipment for free or a year s lease for free just to get you as a customer Be sure to ask them what free services and products they ll give if you sign a long term agree ment You may have to deal with a third party vendor if the tele communications regulations in your area prohibit your phone company from selling or leasing you the necessary hardware Whether you buy or lease you may also want to negotiate to withhold part of the purchase price or lease payment until the system is properly installed and has been oper ating without glitches for a month Don t forget training Even the best designed phone system will be useless if your staff doesn t know how to use it Your vendor should prov
6. eeds Keep in mind that a typical phone system should last five to 10 years Again your local phone company can be a great resource and can help you determine your needs You can also work with an independent practice management or communications consultant Consider sending a request for proposal RFP to a numberof D vendors Having written pro posals will help you compare k Even the best designed phone system will be useless if your staff doesn t know how to use it features service and price Evaluate the proposals in light of your practice s needs Each vendor will tell you what you need We took that information and educated ourselves then came up with a prioritized list of criteria for our new phone system Weida says see Sample criteria for a new phone system page 26 You ve got to design the phone system for the practice and keep thinking about the preferences of your patients Given the importance of selecting and maintaining a phone system you may want to appoint a system administrator in your practice This person would be responsible for maintaining the system and serving as a resource for other staff members Conse quently this person should be involved in each step of the selection and installation of the system Update or start over Once you ve determined what features you want in your phone system check with your current vendor to find out if you can add them to yo
7. eplaced you should consider whether leas ing or buying would be best for your practice gt In addition to compar ing purchase vs lease costs you need to factor warranty and maintenance costs into the equation gt If you lease make sure you get in writing what maintenance fees the phone company is responsible for paying February2001 FAMILY PRACTICE MANAGEMENT 25 SAMPLE CRITERIA FOR A NEW PHONE SYSTEM gt As a rule your phone company should fix large repairs in 24 hours and minor repairs the same day gt You may also want to negotiate to withhold part of the payment until the phone system is up and running for 30 days gt Your phone system is only as effective as the people using it so be sure to provide adequate training gt Ask your patients how they like the practice s new system Their feed back can be invaluable Here s the list of must have features that Thomas J Weida MD medical director of the Penn State Community Health Center in Hershey Pa and a member of the FPM Board of Editors and his partners in private practice came up with when they wanted to update their phone system 1 Capacity to grow with the practice for example to add phone lines when necessary and new features when available Voice mail an automated attendant a prescription refill line an intercom paging system three way calling and call forward party vendor is responsible f
8. gt Even if your phone company provides your DSL you can continue receiving Internet service from your current provider gt An integrated services digital network ISDN can transfer data even more quickly than a DSL gt Once you think you know what you want to change about your phone system you may want to send a request for proposal gt One way of ensuring that your phone system is used effectively is to appoint a phone system administrator 24 FAMILY PRACTICE MANAGEMENT February 2001 As you think about updating or replacing your phone system consider the plethora of options that might benefit your practice Start by asking yourself these questions e Do we want high speed data transmission lines for access to the Internet e Do we want a telephone at each station and in each exam room e Do we want an automated attendant Will it answer all calls or only calls the receptionist can t answer e Do we want all of our calls to be forwarded to an answering service when the office is closed e Do we want a voice message system voice mail Who will have mailboxes on the system e Do we want to have a prescription refill line that allows patients to leave voice mail messages requesting refills e Do we want to have a test result line that allows patients to call in and enter a password to hear a recorded message with their results ual voice mailboxes The physicians give out their voice m
9. his survey to the receptionist the calls you may want to add a second person during peak hours Or you may want to consider automating the phone system Of course adding phones lines means adding cost You want to make sure you re not paying for lines that aren t necessary One way to avoid this pitfall is to add new lines in batches So for example if the phone company suggests that you add six lines start with four at first After they re 22 FAMILY PRACTICE MANAGEMENT February 2001 Difficult Easy E m Very easy J Dr Adams installed ask the phone company to provide another busy signal report And ask your patients again if they have had any trouble getting in touch with your office Use this information to decide if you really need the other two lines Is automation the answer We re all familiar with how an automated attendant works It answers incoming calls with a recorded greeting that prompts callers to Press 1 to make an appointment press 2 to talk to a nurse press 3 for prescription refills and so on This feature is a very pop ular and cost effective solution for many practices In addition adding an automated attendant function is relatively easy provided that your current phone system will support it Check your phone system s user manual to find out or ask your current vendor Before you make the decision to go with an automated attendant though think about how your patients w
10. ide the ini tial training and be available to provide addi tional training in the future Allow your staff a little time to become familiar with the new system For example the day after the system is installed consider opening your office an hour later than usual so your employees can have time to experiment with the new system Ask for feedback Once you have your new system up and run ning ask your patients how they like it They may have some useful ideas on how you can still improve it Keep reassessing your phone system periodically and make changes as nec essary Remember that as your practice grows so do your communications needs You want to make sure your phone system is keeping oars
11. ill react Pamela J Vaccaro a time management and organiza tion consultant in St Louis Mo and a member of the FPM Panel of Consultants says practices often switch to an automated attendant with the hopes of managing their calls more efficiently only to revert back to having a live person answer every call The practices get too much negative feedback from their patients about the auto mated attendant Patients are often resistant to change But if you think about it elderly patients who resist automated attendants the most probably have a difficult time hearing and understanding the prompts Vaccaro says Busy professionals also do not like automated attendants They don t want to take the time to listen to all of the options Remember that your patients time is just as important as yours If you dont care for being put on hold and listening to a number of prompts then neither will your patients Vaccaro points out Thomas J Weida MD medical director of the Penn State Community Health Center in Hershey Pa and a member of the FPM Board of Editors agrees When I was in private practice we some times complained about the time it took to get through by phone to other physicians And even our patients com plained about our automated attendant So we opted to have calls answered by a live person as often as possible If there were too many calls for the recep tionist to handle only then woul
12. ith your phone company and you acquire a digital sub scriber line through the ISP expect to pay a few more dollars The ISP essentially leases the DSL from the phone company and then charges you extra In return for that extra payment you may get better service from the ISP than from the phone company After all you can always save a little money by leaving the ISP and using the phone company as your ISP Another option is an integrated services digital network ISDN connection This uses your existing phone wires to deliver up to three channels of digital service ISDN allows you to transfer more data in less time than DSL However as with the DSL your existing line must be clean enough to sup port the ISDN If not new wiring will have to be installed Expect to pay an average of 100 per month for unlimited use plus any long distance charges and around 250 for installation Again you may have to sign a one or two year contract Rates vary by city and by how far your office is from the phone company s central office When your re ready to make a change Feel like a kid in the candy store Wondering how you pick just the features you need Start by getting a clear picture of the prob lems you have with your current system and the improvements youre looking for with an updated or a new system Talk to your staff about what they want the phone system to do Try to think ahead plan for the practice s growth and future n
13. ny has voice mail but not everyone uses it the same way Weida and the other physicians in his group did not have their own voice mailbox es Our office manager and the other staff in the practice had mailboxes but not us Weida says We didn t want the patients to find out the extensions for the doctors and then leave them messages We asked our selves What happens if a patient P leaves a very urgent voice mail eo in the morning and the physi Remember that your patients time is just as ont important as yours cian does not check his messages until the end of the day We didn t want to run the risk of missing urgent messages so we elimi nated that possibility The physicians Conley works with unlike Weida and his partners have individ PHONE SYSTEM SPEEDBAR lt Before adding lines you should evaluate how many calls your receptionist will be able to handle and whether you need to add staff lt Automated attendants get mixed reviews from patients and physicians and if used should be carefully designed lt Voice mail is at the top of a long list of telephone features available to physician practices gt Your phone company can also provide always on Internet access and a digital subscriber line DSL for faster data transmission February2001 FAMILY PRACTICE MANAGEMENT 23 SPEEDBAR WHAT DO YOU WANT OUT OF A PHONE SYSTEM
14. or and what you are responsible for pay ing Look at how long the phone company or vendor is allowed to take to make repairs As a rule large problems with the equipment should be fixed in no more than 24 hours from the time you report them Minor repairs should be fixed within the same day If your community has more than one local phone company ing 3 A phone line separate from the main system that will work when the system is down 4 An emergency ring feature All phones have a distinctive ring to signal an emergency call received by the automated attendant A dedicated outside line for each phone unit Two or three phones at each station in the clinic Co N O Ul getting the system back up and operating as soon as possible if it goes down if you lease Whether you buy or lease this box you will still need to purchase the individ ual phone units and wiring for your office A phone system s purchase price is based on a combination of the features it offers and the number of phone lines it supports New phone systems can cost anywhere from 5 000 to 10 000 You can pay for the sys tem in one lump sum or you can finance it over two or three years Most vendors will offer a two year warranty on the equipment with an optional extended warranty Expect to pay 200 to 400 annually for an extended warranty If you lease the system from your local phone company your monthly phone bill will b
15. pany will monitor your incoming calls and report back to you the number of times callers received a busy signal The report a ee ILLUSTRATIONS BY JANIE BYNUM KEY POINTS Brian Torrey Brian T orrey isa nior projects editor with the American Acadeny of Family Physicians e The need to replace or upgrade your practice phone system can sneak up on you if you don t evaluate it periodically e Today s phone systems offer many features that Fee Covered in FPM Quiz may not have been available when you installed your current one e If your current system is inadequate you need to decide what features you want whether you need breaks out the peak busy signal times for each day of the week Expect to pay any where between 20 and 40 per phone number for this service If the report comes back with a high number of busy signals such as 10 out of every 20 calls you need to consider adding more incoming phone lines Even if the ratio is one busy signal per five calls overall you may have a problem although you proba bly don t have to worry if the report shows that ratio in an occasional 30 minute period Adding phone lines Based on the busy signal report your phone company can tell you the number of incom ing phone lines you need But before you decide to add phone lines consider whether your receptionist will be able to handle all of the calls Most receptionists can handle
16. stem and need your help Please fill out this survey and return it to the front desk Please base your answers to the following questions on your experiences calling our office over the past few months 1 When you called our office to make this appointment I didn t get a busy signal LI One time LI Two times 2 Was your call answered promptly I Yes the phone rang less than four times LJ No the phone rang more than four times T can t remember how many times did you get a busy signal 4 Three or four times 4 More than four times J can t remember 3 If you were put on hold did you have to wait more than two minutes before the receptionist came back on the line J No didn t have to wait more than two minutes LJ Yes had to wait more than two minutes LJ can t remember J was not put on hold 4 If you called and left a message when was your call returned LJ Within 15 minutes J In about 15 to 30 minutes LI After 30 minutes LJ After two hours CL The next day J My call was never returned T can t remember 5 Based on your telephone contacts with our office over the past few months how easy has it been for you to do the following Very difficult A Make appointments J B Get prescriptions refilled C Get lab results D Talk to a nurse E E E E E Talk to your doctor 6 Who is your doctor J Dr Smith I Dr Jones Thank you Please return t
17. to track the number of calls received the number of lost or abandoned calls the number of voice messages etc e Do we want to include cellular phones Some phone systems support the use of cell phones both analog and digital in place of or in addition to the standard desktop units Physicians and nurses can use these wireless phones in the clinic and carry them off site to stay connected to the practice for DSL service plus an initial 200 instal lation fee You may have to sign a one or two year contract A DSL uses your existing phone lines if they are clean enough meaning the lines aren t already used by other electronic equipment and static is at a minimum You ll also need a DSL compati ble modem Depending on your phone company you may also need a net work interface card that connects the modem to your computer You ll also need a splitter to sepa rate incoming voice calls from data transmissions and direct the data transmissions to your comput er instead of the phone Some areas especially remote locations don t have phone lines that are clean enough to support DSL service Check with your local phone company Also check that your ISP can support a DSL modem Most phone companies will try to bundle a digital subscriber line with their own Internet service You don t have to use your phone company as your Internet service provider when using its DSL though If your ISP isnt affiliated w
18. ur system Some phone systems that were once easily upgradeable cannot support today s technology If your system is Operating at its peak and you cannot add lines you need then you need a new system However if your system has room to grow and can support voice mail and an automat ed attendant you may not need to purchase a new system Keep in mind however that if your system is more than five years old you may want to go ahead and replace it since most systems have a life span of about five to 10 years Your phone company or a telecommunications consultant can help you make this decision Purchase or lease If you ve decided to replace your current phone system with a new one your N next decision is whether to pur H chase or lease the new system Youll want to look at the initial cost of purchasing the system and the estimated ongoing maintenance costs Compare pike these costs to those of a 5A WLA lease agreement It may be 114 cheaper for you to lease the equipment than to purchase it and have to maintain it over time Keep in mind that the brain of a phone system is actually a box that sits in a corner of a climate controlled room This box can sit either in your office if you buy or in the phone company s or system vendor s office PHONE SYSTEM SPEEDBAR lt Most phone systems have a life span of five to 10 years lt If you decide your cur rent system must be r
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