Five Must-Have Features that Make a Successful Nurse Line
Some organizations see nurse line services as a simple routine requirement and offer a basic helpline. However, a well-thought-out nurse line can be a powerful resource and bring greater success to population health management efforts. I recently sat down with Ryan Croteau, Director of Client Services at Health Dialog, to gain insight into what nurse line features and capabilities can bring the most value and help augment existing population health management programs. A successful nurse line program is guided by plan offerings, unique member population needs, and integrated with effective clinical resources. I learned the following five features have the most positive impact on population health efforts and help lead each individual toward their best clinical path of care:
1. Effective Promotion of the Service to Members
Nurse line phone numbers are often only provided in the member enrollment packets, but over time these get lost or thrown away. Logically members will not utilize the nurse line and reap the benefits if they forget its purpose and how to access it. Make the phone number available in more places so availability of the service is clear to the member. For instance, put it on each member’s health insurance card and health portal home page. In addition, give your nurse line number to physicians and hospitals so they can support and promote appropriate use during visits. Well-informed individuals are more likely to use the service, choose the appropriate level of care and feel more satisfied with their health plan simply knowing the support is available should they need it.
2. Easy Access for Every Member at Any Time
Medical emergencies can happen at any time so give your members access to health advice around the clock. 24/7 direct access to a live person and no call back service helps eliminate frustration. Instead of navigating a call menu or waiting for a call back your members may resort to calling 911 or emergency room care. Provide after-hours support and staff appropriately for call volume so connection times and abandonment rates are minimized. Reduce or eliminate transfer or wait time for a doctor by staffing RN health coaches licensed in all fifty states and districts. And don’t forget, another crucial aspect of access is language. Staffing bilingual coaches or utilizing a translation service will allow you to connect with every member and help them determine the best course of action regardless of the language they speak.
3. Seamless Integration of Existing Resources
Give the nurse line health coaches access to each member’s plan specific eligibility information so they are able to triage appropriately and avoid transfer to another person for an eligibility check. This connectivity will make it easier for the caller and help ensure the medical issue at hand is addressed immediately. The health coach will be better equipped to help them overcome barriers to care and direct them to covered resources in their community, such as, financial services, Medicaid transportation services, and urgent care clinics.
4. Health Advice Consistent with Standards of Care
A nurse line health coach may be the first, if not only person, your member speaks to about their medical issue at hand before seeking care. Staffing your nurse line with highly-trained professionals is an all important first step, but you must also provide them with the most current evidence-based clinical information so the advice and education passed on from the health coaches during symptom calls is consistent and up-to-date.
5. Care Coordination and Record Keeping Procedures
It is important communication channels are setup so everyone involved with a members care is notified of changes in the individual’s health status and/or condition management. In addition, scheduled follow-up calls help reassess symptoms and determine if the member needs an ongoing care plan or if the initial symptom is resolved. Proper records maintenance and follow-up procedures will contribute to a more seamless healthcare experience for members and can lead to higher satisfaction rates.
Well-designed nurse line programs help create opportunities for health education and overall support appropriate utilization of healthcare. If properly promoted and easy to access, members will use the service and become more informed about their care needs and feel empowered to use appropriate self-care.
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