Categories
Guides Healthcare IT

Amazon Chime With Nisos Health

Use Amazon Chime for telemedicine, unified communications and more. See how you can connect medical professionals and patients over messaging and video for remote consultations during out-patient or in-facility care.

Estimated reading time: 14 minutes

Introduction to Amazon Chime

Amazon Chime, at its heart, is a communications service. It’s like Google Meet/Chat, Skype etc that we are all used to. But, in our opinion, it’s better. You will see below why we feel so.

Amazon Chime comes in a few shapes and forms. Amazon Chime has something called Amazon Chime Voice Connectors that allows enterprises to move their phone services to AWS. Phone lines and telephony costs are typically one of the largest line items in an IT budget.

Amazon Chime slashes these costs. Best part is that you can slowly move your phone lines over and don’t have to take a lift and shift strategy (from on-premises to the cloud).

This doesn’t mean that once you move your phone systems to the cloud, all your staff will have to sit with headsets on either. You can continue to use your regular PSTN as well – using the Voice Connector.

How about sensitive information? Are they stored in the cloud?

Amazon Chime is HIPAA Eligible as of 2019. Read more about that announcement here. This means, you can have entire HIPAA secure conversations over Amazon Chime. You can share PHI over Amazon Chime.

What do I use Amazon Chime for?

Quite a few things actually. With video calls, you can of course, use it for TELEMEDICINE.

Single Application: You can place and receive phone calls and send and receive text messages directly from the Amazon Chime application. This means that you don’t have to share your personal cell phone number with your patients or your staff. You can keep sharing your cell phone number and your whatsapp number with your personal network but share your Amazon Chime number with the rest of your professional “network” and don’t have to carry 2 phones around. On top of this, whatever you do on your phone with Amazon Chime, you can do on the laptop/desktop as well, so you are not tied to the phone only.

Receive Phone Calls: Calls to your Amazon Chime company phone number will ring the Chime app on all of your devices — across desktop, mobile, or web. Just answer on one device and the others will stop ringing. So, if you are seeing a patient and have muted Amazon Chime, it is going to mute you everywhere. If you have unmuted it, you will be available to answer your calls anywhere. You can answer your desk phone even when you are on your way to the office or let it ring and retrieve your voicemails without having to punch in any numbers or codes.

Voicemail: When you are unable to answer an incoming call, Chime voicemail will answer it for you. Voicemails are captured and can be accessed directly in the Chime application. It usually looks like a audio file thing and you just click on it to listen to it. That’s it. Then you can choose to text the caller back or call the caller back. Either way, your personal phone number is not revealed to the patient, pharmacist, vendor or physician calling you.

Place Phone Calls: While you can make calls to over 100 countries around the world from any of the applications using a keypad, call history, or any contacts with a phone number saved in your Amazon Chime applications, you probably never will. Instead, you will probably use it most to dial patients and other medical professionals from your cell phone without actually calling from your cell phone itself. Your phone number will show up as your office phone number. So, you will probably get a voicemail from a patient, get the phone number or name of the patient, look that patient up in your mobile EMR, look up your last visit note, make clinical decisions and then call the patient back without sharing your cell phone number. That’s it.

Mask your phone number: Don’t even want to share your phone number with the person you are calling? Amazon Chime SDK allows you to do that as well, with something called Proxy Sessions. Amazon Chime proxy sessions allows you to connect with your patients, and also ensures that they cannot call you back. If the patient calls back your number, the call can be redirected to your front desk.

Switch Between Devices: You know when you picked up a call on your way to your desk and during the call you arrived at your desk? But you still have to cradle the phone on your neck? No more.. From the Chime application, you can switch active calls between mobile and desktop devices without interrupting your conversation. Just pick up the call from the desktop and drop the call from the mobile. Save yourself the neck pain.

In all seriousness, the way you would actually use this is where you move from one room to another between machines and computers to access patient charts, patient diagnostic images without having to drop off the patient call.

Turns Calls into Meetings: You will never understand how important this is until you actually need to use it. You call and ask someone for help and then they say “show me”. You have to then do some magic of sharing your computer or phone screen to show that person you called, so they can help you further. That involves creating a meeting, sharing the link, having that person join the meeting blah blah etc…

No more.. With Amazon Chime, you can turn your current call into a meeting and can continue sharing your screen.. and get the help you needed. You can add additional participants to your 1:1 phone call to turn it into a group Amazon Chime meeting, regardless of whether they are using the Chime application or their telephones. Seriously, get the group help you need. In reality, you will be consulting with medical professionals sharing images or sharing your screen zooming in on images to show them patient diagnostic images and getting second opinions on patient cases.

Text Messaging: Patients love texting. You like texting. But you don’t want to share your personal cell phone number with patients. We all get that. With Amazon Chime, you can send and receive text and picture messages with more than 100 countries.. right from your office phone number.

Video conferencing: Those company wide meetings you have these days? You can have them all on Amazon Chime. You can use high-quality wideband audio and high-definition video conferencing for up to 16 people on your desktop, or 8 people on mobile devices. Amazon Chime allows you to have up to 250 participants in an online meeting when not using video.

Incoming webhooks and Chatbots: OK, we know this sounds geeky, but think of the uses of it. You got a new Google my business message or a facebook book now appointment request. No problem, as your IT team can post that message into your Amazon Chime message and you can be notified that you have to go answer that patient. Your healthIT team can also create chatbots to answer those Google MyBusiness and Facebook patients via a chatbot itself.

How do I reduce costs for handling faxes with Amazon Chime?

You know how our fax servers use up paper and precious real estate in our offices? Not to mention the ink we keep purchasing? With Amazon Chime’s T38 support we no longer need to keep doing that. In fact, ask your IT folks (or hire us for this), you can connect your Amazon Chime to any PBX server in the cloud and send/receive faxes via the internet using the same PSTN phone lines you are using for phone calls.

Typically when we use fax servers in the cloud, we get charged per page. However, Amazon Chime doesn’t charge per page – it’s just like dialing phone numbers. You can transmit faxes at speeds of up to three seconds per page when using Super G3 — which results in reduced calling charges versus slower transmission speeds.

How do I reduce costs for phone calls with Amazon Chime?

Look at the pricing page of Amazon Chime for how much you really spend on making and receiving calls. How much you really spend on making and receiving text messages.

You will be amazed at how much money you really save.

How does this work with my contact center software?

Amazon Connect Contact Center software is what your contact center probably uses – right? If not, you should check it out (another stellar service from Amazon). It will support web chat, inbound and outbound calls, whatsapp, imessage, wechat or whatever else you connect to it. You can even use NisosHealthCRM on top of it, to make it run on steroids 🙂

You can also have video calling enabled on Amazon Connect using Amazon Chime SDK (something that Amazon Connect does not do out of the box).

So, basically the same video calling that you do with Amazon Chime, that you can use for telemedicine, now can be extended via your Amazon Connect over to your contact center as well.

Increase patient access without disclosing personal contact information

Most of us in healthcare do want to do the right thing. We want to be available for our patients. But we also don’t want to lose our personal space.

Each patient considers their health as an emergency and (quite understandably so) does not know how to differentiate between emergent vs urgent vs normal categorization of an episode.

We would like to share our contact information with patients so we can answer their questions, but we also don’t want them reaching us at all hours of the day, expecting us to be a “24 hour service”. We also do not want the liability that this comes along with.

As we all know, text messaging is not HIPAA compliant and most patients do not quite understand that. Sure, there are simple solutions to that and our healthcare CRM does follow those guidelines as well (i.e. the first message itself being a consent to communicate PHI information over SMS with the patient).

However, our personal cell phone numbers are tied to our personal email accounts, our personal social media accounts and our personal lives online (digital) these days. We do not want our work and personal lives so intertwined that our patients would also be able to follow us into our personal lives.

This challenge goes beyond healthcare as well. In most industries, we all share our office contact information (phone and email contact information). That was fine for the old times when people used to leave voicemails and we used to leave voicemails, listen to voicemails, respond to voicemails etc.

These days (let’s be honest about it), we have all moved on to sending and receiving text messages and email messages. Emails have come to our personal mobile devices. But.. our office phones have not. If we receive a voicemail on our office phone and want to respond to a patient after hours, we would have to call the patient back from our personal cell phones. If it is a simple response we want to send back, we would have to talk to the patient – that takes more than the 10 seconds it would take to send a text message.

2 Way Texting with patients

The issue concerning giving your cell phone number to patients has been around for ages – there’s a great article published on NCBI as well. It works wonders in the ER department and does a great job for the doctor’s patient satisfaction rating.

But how about other providers that see patients on a regular basis? Does it do well for them? 

In this fee for service world, and more so, in the value based payment system that we are headed towards, will patient care outside of office hours be rewarded?

While you can actually get paid for texting with patients using the Virtual check-in (HCPCS code G2012) codes, we are not discussing that here.

Let’s look at how to send text messages from our business phone number.

Amazon Chime to the rescue

This is so simple – you don’t even need to hire any IT folks to do this.

Open up an Amazon Chime account

Open up an Amazon Chime account
Open up an Amazon Chime account

From the Amazon Chime Users Screen, Invite as many colleagues as you want

Amazon Chime Users Screen
Amazon Chime Users Screen

These doctors, frontdesk, billers and technicians or anyone else in your healthcare business get an email invitation like this below

Amazon Chime Invite users email
Amazon Chime Invite users email

All they have to do is to click Accept and that’s it.

Once they accept it, they can login and finish the registration process. To finish the registration process, they will need to create an Amazon.com account. 

REMIND THEM NOT TO REGISTER OR LOGIN WITH THEIR PERSONAL AMAZON.COM ACCOUNT 🙂 IF THEY DO SO, THEN THEY WILL SHOW UP AS “UNREGISTERED” IN YOUR AMAZON CHIME ACCOUNT BECAUSE THE TWO EMAIL ADDRESSES WILL NOT MATCH (THEIR PERSONAL EMAIL VS THE EMAIL YOU INVITED).

Once your staff and doctors join, you will see something like this in your User Management page

Amazon Chime User Management page
Amazon Chime User Management page

Now you are all set and can assign phone numbers to your doctors and staff.

Assigning phone numbers to your doctors and staff to text patients

Next, go to Home->Calling->Phone Number management and Provision new phone numbers that you will then assign to your doctors, technicians, front desk etc.

Amazon Chime phone number management
Amazon Chime phone number management

Simple, pimple.

Once you get phone numbers, click on each phone number and assign to your doctors and staff. Then, make sure that you allow telephony options for each person like this

Amazon Chime phone number telephony management
Amazon Chime phone number telephony management

Once you do this, your doctor or staff can make and receive calls at this number you assigned to them. They can also send and receive text messages on this number. We will get to video calls later on.

Tell your doctors and staff to download Amazon Chime mobile app from the app store or Google play store or on their desktops or wherever you want them to use it. The full list is here https://aws.amazon.com/chime/download-chime/

Amazon Chime Voicemail setup

When you are unable to answer an incoming call, Chime voicemail will answer it for you. Voicemails are captured and can be accessed directly in the Chime application. In your Amazon Chime app, it looks like this – btw, you can even respond to that with a text message or call that person back.

Amazon Chime respond to patient voicemail with text
Amazon Chime respond to patient voicemail with text

Text your patient from Amazon Chime app

Seriously, this is how simple it is.

If you are using the desktop version, you can simply type your patient’s phone number and send a text message like this

Amazon Chime send patient a text
Amazon Chime send patient a text

And hit save to add that to your contacts, type a message, send a file, hit send. 

Done.

If you are using the mobile app (like most doctors and technicians would be doing it) you can do it like below. In the screenshot below, you can see that this patient had called the number below a couple of times and left a voicemail as well.

Amazon Chime send patient a text
Amazon Chime send patient a text

Amazon Chime Incoming Text Message

What happens if a patient texts me? Sure! You get those messages just like you would get any other message. If you are on the web, you will see it like this.. And something similar happens on the mobile app as well

Amazon Chime Incoming Text Message
Amazon Chime Incoming Text Message

The mobile app will show the same unread messages as well.

Amazon Chime Incoming Text Message
Amazon Chime Incoming Text Message

That’s about all it takes to get started with Amazon Chime.

You can change your status while seeing patients to whatever you need it to be

Amazon Chime Change Your availability

This way your current patient does not complain about you not paying attention to them.