Chapter 8 Communication devices and email

Communicating with colleagues

I have emphasized the importance of communication with patients. It is equally important to
communicate effectively with your colleagues, other health professionals. Miscommunication
can turn an otherwise pleasant workplace into a minefield.

 Respect – different communication styles, personalities, and expectations.

 Teamwork – backbone of any successful enterprise.
 Be positive
 Be aware of your limitations as well as your strengths
Communication Devices

 Telephone-Most important communication devices you will use in any health care
setting
 Telephone messaging and equipment (Written or oral communication)
 Computer – EMR/EHR internet connectivity.
 Fax machine, emails (Send or receive information)
 Fax machine - Use a fax cover sheet for all transmissions. Include the name of your
facility (sometimes the street address), the phone number, and the number of
pages you are sending on the cover sheet.
 All fax reports and documents related to patients must be scanned and uploaded
into your documents folder. Do not shred or discard the cover sheet. File it.
 Electronic faxing- Send online fax or documents like WCB forms, insurance forms
and doctors notes.

Attention to detail is critical to ensure reports and documents are filed accurately (EMR)

 Attach a cover sheet if you will e-fax a report. Include a short note to the recipient.
You should also add your name and the date and time on the cover sheet. 

 Emergency reports
 Operative reports
 Consultations, letters
 Hospital discharge forms
 Hospital diagnostic reports
 Histories and dictated physical examinations.

The AHP should follow the providers protocol in filling out reports.
When scanning and filing a report to a patient’s EMR, make sure you have the correct chart.

Faxed Prescriptions - Fig 8.2 pg 243

  Rx renewal - When there are no further repeats/refills authorized on an existing
prescription.
 Rx refill- The number of repeats (set of doses of the medicine) prescribed by the doctor

Messaging Equipment

 Call answer/voice mail - This service takes messages 24 hours a day, 7 days a week,
even when the telephone is in use. You can retrieve the messages at your convenience.
 Call waiting - This service allows you to receive calls while you are talking on the
telephone. You hear a soft beep. You can ask the other party to hold and press the
appropriate button.
 Call Display - You can see the name and number of the caller.
 Conference calling - This connects three or more people for a group call.
 Call forwarding - This feature allows you to transfer incoming calls from one phone to
another where you can be reached or where someone else can take a message
 Automated routing - These devices answer each call, offer the caller a selection of
options, and direct the call accordingly. An office with four doctors could separate calls
by doctor.

Answering Device-  The message that you leave on the answering machine should be friendly,
clear, and concise.

 Clinic hours / Closing messages

 Booking appointments
 Lunch- hour messages

In recording any message, speak clearly and at a moderate pace. Keep all messages as simple as
you can. Directions should be simple, clear, and concise.

Emails- Must be sent with a secured connection (Confidentiality)

Email protocols

 Use correct spelling, grammar, and capitalization

 Send a correctly formatted letter.
 Ensure you have the correct email address.
 Always use a subject line
 Keep the message short and to the point.
 Avoid slang
 Answer promptly
 Respond to all of the questions in the email
 Respond to the questions in the order they are asked
 Keep the message thread intact. Keep the original message in your email reply
  Proofread your email
 Be aware of security. Do not open email attachments if you do not recognize the source.

Communication tool –Patient Portals

A patient portal is a secure website that gives an individual 24-hour access to his or her
personal health information. To access the portal, you need a secure username and password.

 Request medication renewals; schedule, cancel, or confirm appointments; review

educational material; and make payments for services not covered by their
provincial/territorial plan.

Written communication

If you are responsible for preparing letters, reports, and other documents you need a thorough
knowledge of medical terminology, anatomy, physiology, spelling, grammar, and formatting.

All documents must be accurately reproduced, look and sound professional, and follow the
standard format used at your facility

It is a good idea to use templates -A computerized file with a predesigned and customized
format that can be designed for specific functions (e.g., letterhead, formatted letters,
instructions for tests, and other protocols)

Use Macros to simplify written communication- The use of macros saves inordinate amounts
of time when used to perform frequently used tasks. As well, macros eliminate the need to
remember multiple steps that may be required to perform a complicated function

Ex : Macros to recall pre-established letterhead, physician’s signature, sick notes, and back-to-
work notes. They are also commonly used in health care settings for medical billing and
ordering groups of lab tests. Fig 8.4 pg 251.

Signs Fig 8.5

If there is something you want all your patients to know, it makes sense to put a sign in the
reception area or at the front desk.

 Office policies
 charges for uninsured services
 Dates when the office will be closed.
 You may want to remind patients to show their health cards
 To wait in the office after an allergy injection.
Tip
 Make the sign large enough to be noticed.
 Make the lettering large enough for people with limited vision to read.
 Make the sign simple but attractive. A simple border can help, as can a little colour.
Rounded, open fonts are usually more appealing than narrow, heavy ones. Use a
simple, inornate font.
 Keep the words brief and to the point.
 Be clear. Ask several people what the sign means to them to make sure no one can
misinterpret it.
 Keep a friendly tone. Such phrases as “Please” and “Thank you” are more courteous
than simple commands or words like “must” and “don’t.”

Insurance reports

Many of these forms require detailed medical information that only the doctor can provide, but
you should fill out as much of these forms as you can, which is usually limited to demographic
information: the name, street address, date of birth, health card number, and claim number (if
there is one).

Where consent is required, do not forget to include the signed form. Dental, chiropractic, and
optometry offices have a higher number of insurance forms, because most of their services are
covered by third-party carriers.

Tip : Organization is efficiency.  Follow the doctor’s protocol for filling out reports.

WCB forms ( accident forms)

You also bill for the amount of time it takes the physician to complete the form, usually by the
half hour and in increments of 15 minutes. The payment changes if the report is accompanied
with a medical opinion versus one without. C050 code (first report) C151 code (progress
report)

You can submit WCB/WSIB claims by fax, or electronically if your office has registered to do so.
If you submit forms electronically, you should keep a copy in the patient’s file and print a copy
of the recommended pages for the patient to keep. Keep a record in the patient’s file of when
forms were completed and sent.

Personal mail- marked as “confidential”

Junk mail -  This clutters the office and, for the most part, is inappropriate for a health care
setting. Sort and discard such material as it comes in. 
Outgoing mail- Insurance claims, reminder emails (Keep and file a copy of all outgoing
documents.)

  Some providers may mail instructions for procedures instead of emailing them
  Reminder letters/calls are more common in the offices of chiropractors, optometrists,
dentists, and some specialists.
 Some primary care providers send out reminders related to preventive care, such as for
flu vaccines, stools for occult blood, and Pap smears. 

Ending a doctor-patient relationship Fig 8.6 pg 256

 If a doctor feels that he or she cannot continue to provide quality care for a patient, it is in the
interests of both parties to terminate the relationship. 

 A doctor withdrawing services must notify the patient in writing and must
continue to provide care until the patient has found another doctor.
 Send such a letter by registered mail to ensure that the patient receives it. Put a
copy in the patient’s chart.