The state of Oregon established an Influenza hotline to serve as a one-stop information call line for both seasonal and H1N1 for the general public, health care providers and labs. The hotline began taking calls Sept 15th. 1-800-978-3040, Monday—Friday 8 am—6 pm with some extended hours during peak of crisis.Information provided included: vaccination locations and answers to general questions about the vaccine and H1N1 and seasonal flu. Call takers did not give medical advice for make appointments. Call center services contracted thru 211info, a nonprofit. Call center gathered demographic data including where they were calling from, age range, gender and general info on call type. Information was reported to the Health Action Network and updated every day.Calls from clinicians routed to Oregon Poison Control Center (staffed by health care professionals and supported by medical consultants)Set up nurse triage
1) State 800 # dedicated to public health emergencies Contract for up at $180K, about $150K spentGoal from state side: one number to give public but have that number act as triage. State selected 211info because we could ramp up on their timeline and absorb the projected call volume. State had internal challenges all summer making a decision about how to handle the hotline. In the spring, the poison control hotline had the contract but it wasn’t a good fit. State needed more responsiveness and learned they needed responsiveness more than medical expertise. It was challenging to not receive timely feedback from the state re: our proposal knowing we’d have to deploy quickly. Ultimately our patience and persistence paid off but it was a good lesson learned re: the bureaucratic decision making behind the scenes.
Oregon had one of the highest rates even though the state didn’t promote the line as well as Minnesota did. Internal to Oregon government, there were lots of debates about how to promote the line. There were daily phone calls for a time with the lead PIO’s from the most populated counties and the state and debates about best way to message and how aggressive to message. One of the benefits of the hotline was providing anecdotal information about what callers were calling with….anxious, how interpreting news, etc. That they shaped the public messaging.
1) We peaked at 642 calls in one day, 400 per day for about 3 weeksWe answered 15,327 of 20,260 calls receivedWe added 14 staff members, 7 preparing for the build up and 7 more as the state began to realize the extent of the situation. Staffing was based on a formula we developed for how many staff would be needed based on state’s projected call volume. We quickly responded to each of the ever-changing state directives during the situation remaining the ready to update our practices and messaging to suit the information on the ground. Call center was in conference room and updates would be given by directing team to a large white board or quickly putting all calls on mute for updates.5) Internally, we created an org chart with clear roles. In the beginning we had daily huddles to trouble shoot messaging, coordination, staffing and technology. We excluded staff who didn’t need to be involved and maintained the call center and resource dept on daily operations. The 211 call center was not involved and that was ultimately a smart decision. Lots of new staff in short order did create interesting challenges (crowded fridge, bathrooms, etc!)
Original costs included: telephony charges, language line (we charged actual costs but gave a range of projected costs)Database licensing but we ended up not needing to charge for thisCall Center Supervisor I&R Specialists We did receive prepayment of $7,000 for computers and wiring Database management was assumed as part of the supervisor’s roleWe initially hired 3 FTE (7 people) temporarily for 3 monthsDaily reports (part of admin costs, started at 8% increased to 10%)Final agreements were made by Sept. 28th and we began operations 2 weeks later. We had to wire a conference room, order phones, set up the database and hire temp workers in two weeks. Prior to 211info answering the calls they were handled by misc public health staff at the state office building. They were quickly overwhelmed and did not have sophisticated phone reporting capacities so did not have a grasp on what volume of calls they were missing and the staff needed to be reassigned to their regular jobs.
Created our own database within File Maker Pro
Information call center used was on DHS website
Caller data collected in IRis
Call center manager produced daily reports out of phone system, reports staff created daily reports out of Iris late at night and then were combined with phone reports and sent to DHS in the am.
Our personnel costs increased 37% which presented cash flow challenges. We responded two ways—requested a new, short term line of credit from our bank with copies of the contract to demonstrate the issue wasn’t cash but cash flow. Once Governor elevated import of H1N1, we were able to work with the public health team to turn our invoices around quicker. In retrospect, we would ask for one month of personnel costs up front.We had a staff person who wanted to experiment with VOIP and wanted to try a new phone company. The phone company we chose, Betterworld was able to comply with our timeline and stepped up. However, it was a learning curve we didn’t necessarily need. Our other phone system needed a new T1, VOIP capacity and it would have taken a month to be prepared. Betterworld offered a quicker solution. We deployed with DSL to be the bridge while the T1 was ordered and installed 4 weeks later. In retrospect, our phone vendor would have negotiated payment with us differently and the main sticking point would have been timing not cost. We now had additional phone expertise in house but it was a tough set of knowledge to be skinny on at an opportune time. In planning for crisis, understand phone trunk capacity, VOIP capacity. You don’t necessarily need the capacity up front but do need to know how you’re going to practically make it happen and how long it will take to deploy. Ideally, states will invest in infrastructure during non-crisis times which should be goal but not always realistic. Sometimes the crisis can be the way to build the capacity and pay for it but be prepared with what your needs are.Contract: we operate the state’s maternal/child health hotline and the contract is managed by maternal child health team. Everyone thought it would be easiest to amend that contract. In retrospect, probably easier to have had public health emergencies hold the contract in order to be more dynamic and process invoices faster. Good news: conversation is now with that dept to talk about keeping an open contract that can be added to in times of crisis. Temp staff—we were able to hire high quality people, several who came from for-profit call centers. Benefits: calls went to specifically trained staff. Currently participating in a pilot project reaching out to seniors and people with disabilities. Flyers are given out in meals/wheels program, seniors call and are connected to AMR to have someone be dispatched to the home to provide vaccination.
One-stop Information Call Line: Seasonal and H1N1<br />General Public <br />Vaccination location and general information<br />Health Care Providers<br />Labs<br />Oregon Poison Control center staffed by health care professionals and answered by medical consultants<br />Nurse Triage Hotline <br />People with or exposed to H1N1<br />
Keys to the First Few Weeks<br />Equipped to handle high call volume<br />Quickly changed messaging to callers<br />Build staff knowledge rapidly<br />First rate customer service<br />Internal Organization<br />
Make changes in Iris as needed </li></ul>Call Center Manager <br /><ul><li>Coordinate new hires and training
Supervises H1N1 Supervisor</li></ul>Contract Coordinator<br /><ul><li>Trouble shoot with state
Liaison with seasonal flu team</li></li></ul><li>Flu Expansion Options <br />
Main Resource Database: State Resources<br />H1N1 Influenza Information Request<br />Send Question to Hotline Coordinator<br />Call Center Schedule<br />Flu Symptoms transfer Check<br />Request Schedule Change<br />