Look Who is Calling: Analysis of Call Patterns Can Facilitate Discovery of Core Clinical Workflows


Stuttgart, May 2016 – Hospitals and health systems face significant challenges as they attempt to reduce rapidly escalating costs. Analysis and visualization of phone calls among staff offers insight into core clinical workflows. Efficient communication not only serves patients but may also be an automation or re-design target to improve bottom line. It is an unparalleled opportunity for hospitals to monitor and improve a variety of service metrics such as call times, staffing efficiencies and department performance.

Using telephony data to facilitate discovery of clinical workflows, published in the May 2017 issue of Applied Clinical Informatics (ACI), provides invaluable methodologies hospital administrators can utilize to analyze, streamline, and improve efficiencies of institutional telecommunications activities. “The article describes a framework for mapping telephone calls to clinical areas identified by cost centers using call detail record (CDR) logs and then graphically displaying the high-volume call patterns,” said author Donald W. Rucker, MD.

Current methods for identifying workflows to redesign typically rely on employee recollection as the key identifier, which presents significant limitations. The transition to voice over IP (VoIP) servers which route internal calls over institutions’ Internet protocol (IP) networks, offers a more effective method for analyzing clinical communications at an enterprise scale.

Analysis of phone numbers by cost center at a single academic medical center and its affiliated clinics, yielded data on phone numbers associated with individual nursing units, operating room areas, and numerous other specific departments and areas. Big picture data was also revealed including overall call volume and hours expended during the one-week period analyzed.

Key Findings

• There were 912,386 calls, which equates to an average call volume of 130,341 calls per day
• The total duration of call time was 23,186 hours
• The average duration of successful calls was 101.54 seconds
• There were 533,311 unique call pairs of number x calling number y
• Short unique call pairs under 60 seconds numbered 267,158, with an average duration of 27 seconds

Aggregating individual call information into enterprise-wide data structures indexed by calling number, called number and calling-called number pairs generated cumulative statistics on clinical workflow. The large volume of phone calls in this study suggests medical care at large clinical enterprises involves extensive telephony equivalent to hundreds of full-time equivalent employees (FTE’s), a major labor investment. The limited information transfers within short calls may enable automating or redesigning simple tasks, thereby increasing efficiency and reducing labor costs. “The visual displays generated from this type of analysis may provide key information not otherwise available to teams responsible for identifying clinical workflows requiring redesign, for example, as part of a ‘Six Sigma’ or ‘Lean’ process,” concluded Dr. Rucker.



Donald W. Rucker: Using telephony data to facilitate discovery of clinical workflows in Appl Clin Inform 2017 8 2: 381-395


About the Author

Donald W. Rucker, MD, performed this research as Adjunct Professor, College of Medicine, Departments of Biomedical Informatics and Emergency Medicine, Ohio State University, Columbus, Ohio, USA.  He currently serves as the National Coordinator for Health Information Technology for the US Department of Health and Human Services, a cabinet agency of the United States Government.


About ACI

The official eJournal of AMIA and IMIA, the online journal ACI aims to establish a platform that allows sharing knowledge between clinical medicine and health IT specialists, as well as bridging gaps between visionary design and successful and pragmatic deployment. ACI is one of more than 20 journals under the Schattauer Publishers imprint.

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