Access 24 provides telephone health information to patients, carers and health professionals. It acts on behalf of private medical insurers, pharmaceutical companies and a number of community pharmacies. Pamela Mason visited the company's recently. Her report follows
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Telephone helplines are currently one of the United Kingdom's fastest growth areas, and their influence on health care is increasing. Moreover, the concept of health information lines, although not new, does represent quite a significant change in the thinking behind health care provision. The advent of NHS Direct has raised the profile of this type of service, but private companies also provide health information on the telephone. Access 24 is one of these. It is a subsidiary of PPP Healthcare, the health care arm of Sun Life and Provincial Holdings, of which the parent company is AXA.
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A staff of between 60 and 70 provide a 24-hour helpline service [Access 24] |
The company's current clients include pharmaceutical companies such as Bayer, Merck Sharp & Dohme, Pharmax, SSL, Roche Pharmaceuticals, and Roche Diagnostics, as well as the private medical insurance company, PPP Healthcare. With pharmaceutical industry clients, Access 24 often focuses on their over-the-counter portfolios, mainly because these are in general less well supported in terms of information than prescription products. Thus, Access 24 delivers the entire medical information service for Bayer OTC products. So, if a person buys a tube of Canesten cream, the telephone helpline number on the patient information leaflet is routed to Access 24's offices, not Bayer's. Other industry clients might ask the company to provide telephone information on just one or on a selected range of their products. Xenical, one of Roche's prescription only, anti-obesity drugs, is supported in this way.
Access 24 provides all the telephone health information to PPP members, of whom there are about one million, but it is not linked to, and does not get involved with claims nor does it pass on information about individual patients gathered during telephone calls to the insurance department.
About 30,000 people call every month, and there is approximately a 50/50 split between calls from PPP Healthcare members and those related to Access 24's other clients. Callers include not only patients and carers but also health professionals, and representatives working for the various pharmaceutical company clients.
A team of between 60 and 70 staff works on a shift basis to provide a 24-hour-a-day, seven-day-a-week service. The team consists of registered nurses, health visitors, midwives, pharmacists, dietitians, counsellors, psychologists, lawyers and customer service agents.
The customer service agents direct calls to the different professionals on the basis of the caller's query and the professional's area of expertise. Thus, calls on medication are directed to pharmacists, those on symptoms and medical conditions to nurses, and dietary queries to a dietitian, and so on. However, no distinction is made between calls from PPP members and those related to other client's products. It is the professional's area of expertise that matters.
In practice, this means that one call can be split between two professionals. Thus, if a caller's initial query is about symptoms, a nurse will provide information, but if the call then moves on to the subject of medication, a pharmacist takes over. Call details are recorded in an electronic record so the professional taking over the latter part of a call can see what has been said already.
One of the four pharmacists on the team, Mr Greg Barnes, says that medication queries can be related to side effects or health scares, people wanting information on how specific drugs work, travel health information, and so on. Clearly enjoying his job, Mr Barnes says that it is "intellectually stimulating and professionally rewarding, allowing plenty of space for updating knowledge and looking into things in detail".
Access 24's marketing account manager, Mr Nigel Trevithick, says that the service is not in any way promotional, even though many callers obtain the telephone number from a product information leaflet. The service focuses on providing health information and education and aims to "empower patients to go and consult their GP if necessary". This means that it is not aiming to replace a proper GP consultation, nor provide a diagnosis of health problems.
The main aim of the service for client companies is to increase customer loyalty and compliance. Thus, if an individual buys one of a client's products, the help and information given by the staff at Access 24 is perceived by the customer to be part of the product service. In other words, it is intended to create added value.
The service works in essentially the same way with PPP Healthcare members, although calls in this case are not always related to pharmaceutical products. About 69 per cent of these calls are related to medical conditions, 22 per cent to drugs and 10 per cent to infant care for new parents. Once again the aim is to enhance customer loyalty, but, in this case, in the form of health insurance policy renewal.
Customers' questions are answered using the health professionals' knowledge and expertise and are also guided by protocols agreed with the client. Essentially, guidelines rather than straightjackets, the protocols are non-scripted and offer flexibility, allowing the professional to use his or her own knowledge to answer the query. Cases can include a series of follow-up calls to provide the support that the caller requires. The caller may also be sent additional health information by post, fax or e-mail. Follow up is a particularly important part of the support for Xenical, where patients are called at frequent intervals to discuss, among other issues, their progress towards weight loss.
Staff training is thorough and extensive. Many new staff may be computer literate and used to handling medical information databases, while others are not. So, apart from training in basic company policy and culture, staff are given as much other training as they need.
The aim is to make sure that every member of staff has enough information to answer customers' queries. In addition to the British National Formulary, Mims, a medical dictionary and the Merck manual, which are kept in hard copy form on everyone's desks, there are a number of databases on each computer. Patientwise is in frequent use, providing information to discuss queries verbally - information that can then sent by post to the caller in the form of a fact sheet. Other databases include Drugdex, Infotac and Traveller, and also a database which provides information on the availability of doctors, dentists, home care agencies and care homes, which is used to help customers who have recently moved house.
Every call is recorded, allowing for both generation of aggregate data for clients and also quality assurance. A team of three, one of whom is a pharmacist, handles quality assurance. It involves setting standards, which can be either specific to a client protocol or general Access 24 standards. One such standard is that 90 per cent of all calls are answered within 15 seconds. Professionals answering the calls are monitored individually for telephone manner and the clinical content of the information they give.
The concept of health care helplines is gaining momentum, and is believed to offer convenience and flexibility to patients. The survey mentioned above showed that 85 per cent of patients wanted information on medication available on the telephone, and Access 24 is one of the private companies which has started to provide this and other information on health.
Pamela Mason is a pharmacist and writer from Sydenham, South London