Articoli di riviste sul tema "Telephone answering services automation"

Focusing on openings of telephone service encounters, this study utilizes two sets of comparable discourse data in Chinese collected in the same linguistic community more than a decade apart to explore discoursal style changes over time. The comparative analysis examines forms, tasks and discursive interaction of the opening phase oftelephone service encounters in Shanghai, China.Differences in opening routines over time are observed, which include the adoption of institutionalized, more elaborative expressions as well as increased range of interactional tasks performed (including greeting and business self-identification) in more recent data. The findings indicate that a shift may have taken place in business discursive practices in China; it is also suggested that the style of answering telephone calls by businesses or services, or first turn of Chinese telephone service encounters, may have been in the process of being reshaped, gaining certain distinctive institutional markers, thus making such interactions somewhat distinguishable from the pick-up style for non-institutional telephone interactions at home.

Telephone products such as answering machines, caller-ID services, and cell phones simplify modern-day life yet present an increasing challenge for survey researchers. In particular, contact and response rates have suffered due to changes in telephone usage patterns. To understand the effect that these technologies have on our research center, we examine cell phones, whose growing presence stands to greatly impact survey research. Through an RDD telephone survey, we examined cell phone usage, screening behavior of unknown numbers, reactions to survey research, and incentives, as well as potential cell phone behavior. Our study revealed a high prevalence of cell phone usage even among those who also own a landline telephone. We found that overall data quality is not impacted, as simple weighting techniques ensure that our collected data are representative. However, this dual telephone usage and the increasing future use of cell phones are still potential challenges to our research institution.

BackgroundAt Bristol Dental Hospital, we received almost 5000 calls per week, and we were not answering over 60% of these. This led to numerous informal complaints from frustrated patients and families to clinicians and administrative staff, reducing patient experience and affecting staff morale.MethodWe set up a Task and Finish group with clinical and managerial leadership using staff engagement and a clear message to improve our performance. We agreed metrics and feedback to administrative teams about weekly performance.ResultsCalls received fell from nearly 5000 calls per week to under 3000. Calls answered when available; we term ‘when available’ to indicate during standard operating hours when the line is not already occupied. During core hours call answering improved significantly from around 35% to over 75%. Complaints have dropped significantly in the same time period.ReflectionsEffective leadership with staff engagement has improved telephony at a dental hospital in the UK significantly. This initiative has been adopted by other areas in the Trust and helped inform good practice around the Trust.

The paper considers, proposes and describes possibilities and methods to solve problems in providing services in smart cities, where citizens have to appear in person in the city or municipality premises or at the teller/counter of the institution. In this way, by using information and telecommunication technologies, Web based solutions and Internet, citizens obtain services online, from their homes or working places, using all types of their PC equipment or smart mobile telephone, and do not waste their time in the city or municipality premises. Their contacts are also reduced, which is very important in the context of actual Corona virus pandemic. The services are provided and charged automatically and online. No cash is used, which is also a potential carrier of the Corona virus. The proposed method and proposed solution are based on application of the specially developed algorithm for service automation, developed and implemented adequate software application and designed hardware solution that fully supports the software solution and the process of service delivery automation. The proposed system decreases costs and increases availability, quality and speed of services realization in smart cities and municipalities. Also, the proposed solution uses reliable methods for identification and authentication of a person using a service. For identification are used pictures, taken by a Web camera or a smart mobile telephone, of an identity document and of the face of the user and appropriate software for text and face recognition.

Electronic banking has been around for some time in the form of automatic teller machines and telephone transactions. More recently, it has been metamorphosed by the Internet with a new look and delivery channel for banking services that benefits both customers and banks. The objective of this paper is to find out the correlation between the anticipated benefits/challenges and encountered benefits/challenges. This paper empirically adopted the use of survey research to explore in quantitative terms the various challenges and benefits e-business poses to Nigerian businesses, with particular reference to Banking and Finance Industry. It was found out that there is a statistically significant difference between the anticipated and encountered benefits and major challenges in the potential security breaches faced by the customers. Constant training of employees both local and international on new development in online trading should be encouraged.

The sales process is the most important part of the product manufacturer or the company being ditributor. Conventional sales system by the way telephone or consumer come directly to know the available or not the product needed to make consumers should take the time to do that. Such conditions can also lead to consumer dissatisfaction especially if the desired item is unavailable. Dissatisfaction with customer service can affect the indication of declining sales turnover. For that, the company needs a website-based sales information system that can be accessed by consumers anytime and anywhere so that it can expand its marketing area, and can facilitate salespeople to conduct promotions to Community. This research produces the sales information system by implementing a sales Force Automation (SFA) method which is expected to maximize the sales and focus of services to customers.

Automated telephone messaging systems have dramatically expanded communication about health services. However, few studies have investigated the design of these messages. Our earlier research examined the impact of organization and length on age differences in memory for appointment messages delivered by an automated telephone messaging system. The present study investigated if message repetition (0, 1, 2 repetitions) improved older (mean age=71) and younger (mean age=19) adult memory for appointment messages that varied in length. One message repetition reduced age differences for answering questions about the messages, but did not reduce age differences for a free recall measure, suggesting that older adults only took differential advantage of increased presentation time when they were also provided additional retrieval support. Younger but not older participants also benefitted from a second repetition of the messages. Younger adults may better monitor ongoing comprehension and gauge what additional processing is needed to take advantage of repeated presentations. The present findings show that older as well as younger adults benefit from at least one repetition of appointment messages delivered by an automated message system, suggesting that repetition can be an important feature of automated telephone messaging systems for both older and younger clients.

ObjectiveTo investigate if the option to bypass the telephone queue can increase satisfaction and feeling of safety in callers.DesignRandomised controlled parallel superiority trial. Data from questionnaire survey.SettingTwo out-of-hours (OOH) services in Denmark.Participants217 510 citizens who called the OOH services between 4 September 2017 and 30 November 2017.RandomisationTwo-faze study period: First half with randomisation of participants based on their date of birth; even date randomised to intervention, uneven date randomised to control group. Second half with all participants included in intervention group.InterventionProviding randomised callers (intervention group n=146 355) with the option to bypass the telephone waiting line through an emergency access button (EAB), while the rest got the normal service (control group n=71 155). All EAB users were invited to a questionnaire survey as well as random participants who did not use the EAB (of whom approximately 50% did not have the EAB option).Main outcome measuresSatisfaction and feeling of safety in callers.Results2208 of 6704 (32.9%) invited callers answered the questionnaire (intervention group n=1415 (users n=621, non-users n=794); control group n=793). The OR for answering in the two categories with highest satisfaction when provided with the EAB option was 1.34 (95% CI 1.07 to 1.68) for satisfaction with the waiting time, 1.21 (95% CI 0.91 to 1.60) for overall satisfaction and 1.46 (95% CI 1.12 to 1.89) for feeling of safety. Approximately 72% (441/621) of EAB users reported that the EAB option increased their feeling of safety with the OOH services ‘to a high degree’ compared with 25% (197/794) of callers who had the EAB option without using it.ConclusionsThe EAB can provide fast access to OOH telephone advice in case of severe illness. It favours citizens perceived in most need of urgent healthcare and significantly increases both feeling of safety and patient satisfaction.Trial registration detailsNCT02572115 (5 October 2015).

AimsThis audit was carried out in response to the Coronavirus pandemic. The COVID-19 pandemic has forced many teams to review how they provide care to their patients. Due to attempting to reduce the spead of COVID-19, the Child and Adolescent Mental Health Service within the Northern Health and Social Care Trust largely switched to telephone reviews instead of face-to-face reviews for non-urgent outpatient appointments from March 2020 onwards. The aim of this audit was to establish whether or not service users found telephone reviews to be as useful and therapeutic as the previous standard face-to-face reviews.MethodA questionnaire was used to assess opinions on telephone reviews. Those who were answering the questions were asked to rate their answers on the following scale: “not at all”, “a little”, “somewhat” or “a great deal”. There was an “any other comments” section at the end where service users could give detailed opinions on how successful they thought telephone reviews were. A sample of twenty patients was involved. This cohort of twenty patients was a mixture of ten ADHD reviews and ten medication reviews. The audit was conducted by one person and this was done via the telephone.ResultFor questions one to four (which will be fully outlined in the poster), the most popular category chosen was “somewhat” and this indicates that the majority of patients found telephone reviews somewhat better than face-to-face appointments. For question five (which was- “Overall, was the help you received good?”), 80% of service users stated that the help that they received was “a great deal” better than the help that they had received at previous face-to-face appointments. Lastly, for question six (which was- “If a friend or family member needed similar help, would you recommend that they are phoned by our service?”), 80% of service users said that they would recommend our service “a great deal” to family members or friends.ConclusionGenerally the feedback was positive for the telephone reviews. However, some still outlined a preference for face-to-face reviews. There may have been bias in this audit as it was the same doctor who did the telephone reviews as conducted the audit. To conclude, telemedicine is likely to become more popular in the future especially as the Coronavirus pandemic is still currently a worldwide problem therefore it is important to explore how service users feel about this as a way of communicating with the clinicians who are treating them.

The SAO offers a wide range of public-relations services. For example, research results may be transmitted, via reporters, to newspapers or television stations. More direct approaches include “Observatory Nights”, special events for children, series of popular lectures, and publication of lecture series as popular books. Television, radio and film are used whenever possible to provide information about general and specific events. Standard information packages answer many of the 5000 written requests received annually. Day-to-day queries are handled (in part) by an automatic telephone answering service. At the SAO’s Whipple Observatory in Arizona (site of the MMT), visits are by guided bus tours from the foot of the mountain 18 miles (32.5 km) away. Concrete pads have been installed at the base-camp for the use of amateur astronomers – perhaps the only amateur observing site connected with a major U.S. observatory.

<em>Information Services in agriculture are entering the era of industrial revolution 4.0, always associated with the use of automation machines integrated with the internet network. The technological sophistication of this era makes many conditions change. The chatbot application is one of the right solutions to solve farmer problems, this farmer chatbot application is about the information on handling rice plants, and this application uses the Artificial Intelligence Markup (AIML) method. The purpose of this study was to test the accuracy of the answers to the chatbot. This research method uses question data with words under 5 words and above 5 words, and uses question data according to keywords and outside keywords in this chatbot, with 50 question data, with each question data tested four times than taken the average. average. The results of this study are to get an accuracy of 90.9%, while the response time for answering questions of less than 5 words is 0.01 seconds, and for more than 5 words is 0.02 seconds with a data set of 1000 lines.</em>

Purpose Telephone triage or hear and treat (H&T) describes the process of UK ambulance services nurses and paramedics undertaking enhanced telephone assessments of patients to determine the most appropriate response, which can sometimes result in no ambulance being sent. Given, however, that 999 is not considered an advice service, it may be reasonable to assert that the expectation of those calling 999 is always an immediate ambulance response. This may not always be realised and may affect patient experience. The purpose of this paper is to ascertain the following: to what extent are the views of UK ambulance telephone triage service users being gathered? In answering this research question, this review also aims to explore the findings to determine service users’ expectations of ambulance telephone triage and the possibility that these expectations are influenced by the UK media. The findings of which could be used to inform the need and nature of future research. Design/methodology/approach Phase one consisted of a computerised literature search of online databases CINAHL, Pubmed, Science Direct, Cochrane library, Web of Science and UK government-funded databases. Phase two consisted of searches of all UK ambulance services websites and the submission of freedom of information requests. Phase three consisted of a computerised literature search of the ProQuest international news-stream database. Findings A total of 78 results were identified and after further screening 34 results were excluded, leaving 44 for final review. The extent to which users experience of ambulance service telephone triage are being gathered is low; and often limited to one off pieces of non-peer reviewed work. Patients felt overall that they were treated with respect, dignity and care. However, being listened to, reducing anxiety and a need for prompt assurances remain important to those whose overriding expectation is that an ambulance should attend every time a 999 call is made. There appears to be a balanced media portrayal of H&T with the UK media. However, unrealistic public expectations represent a significant barrier to providing sustainable care that users consider to be of high quality. Research limitations/implications Some user experiences may have been gathered in more broad research exercises which explored various aspects of 999 ambulance service experience. This was not included if it could not be clearly differentiated as being related to H&T and thus may have resulted in data being omitted. It was not possible to systematically search social media platforms (such as facebook or twitter) for any media results related to this search strategy; only traditional print and online media platforms. This also may have resulted in data being omitted. The inclusion of non-peer reviewed research results and grey literature represents a possible limitation to the conclusions drawn within this review. The concept of Insider Research Bias cannot be ignored within this review. The author himself practices in telephone triage within a UK ambulance service; however, this insider bias is mitigated by the clearly articulated systematic methodology and use of the Critical Appraisal Skills framework. In a similar vein, reviews of this nature are also often conducted as part of a team, to reduce bias, increase objectivity and ensure the validity of findings. This review was a sole effort, and while this is not uncommon, there were no cross checks by peers of the search terms, strategy, paper selection, exclusion criteria or data extraction. This lack of peer critique is considered a possible limitation in mitigating selection and reviewer bias. Practical implications The results of this review would suggest a need to increase the amount of research and patient feedback gathered from those being assessed and managed by ambulance service telephone triage within the UK. Ambulance services could hold regular monthly small-scale qualitative interviews with patients and families to ascertain their views, perceptions and anxieties which can then provide an up-to-date understanding of user expectations and the health educational needs of local communities. Patient feedback received directly to ambulance services or via the Patient Advice and Liaison Service could be retrospectively analysed by researchers to determine key themes of positive practice or negative patient experience. Such feedback can be tracked through time and be used as a pre and post community intervention measure, to determine any changes. Moving forward, nationally standardised research frameworks should be adopted to provide more easily collated local and national data, which can monitor improvement strategies and provide a comparison between services to aid the sharing of best practice principles. Originality/value There is no other piece of work published which has reviewed the data in this area of clinical practice within the UK.

Abstract Objective – The University Libraries at the University of North Carolina at Greensboro (UNCG) sought to gain feedback on the customer service experience beyond satisfaction surveys. After reviewing a variety of methods, it was determined to conduct a mystery or secret shopper exercise, a standard practice in the retail and hospitality world. Methods – Two mystery shopper assessments were conducted in 2010 and 2012. Students were recruited from a Hospitality Management class to serve as the secret shoppers. “Shoppers” completed a rating sheet for each encounter based on customer service values established by the Libraries. Data was analyzed and presented to staff. Results - Initial findings were generally quite positive but indicated that we could improve “going the extra mile” and “confirming satisfaction.” As a result, we developed training sessions for public services staff which were delivered during summer 2011. A LibGuide that included training videos was created for public services student employees who were required to view the videos and provide comments. In addition, we developed more specific public service standards for procedures such as answering the telephone, confirming satisfaction, and referring patrons to other offices. The Secret Shopper assessment was administered again in spring 2012 to see if scores improved. The results in the second study indicated improvement. Conclusions - The mystery shopper exercises provided the UNCG University Libraries with the opportunity to examine our services and customer service goals more closely. Conducting the mystery shopper study identified several areas to address. We realized we needed more clearly defined standards for staff to follow. We saw that we needed to discuss what “going the extra mile” means to us as an organization. We also needed to develop a scalable training method for student employees.

28 Background: Increased levels of anxiety and distress in both patients and physicians have been reported in response to the significant impact COVID-19 has on cancer service delivery globally. We aimed to investigate how these changes have been perceived by patients diagnosed with colorectal cancer and identify determinants of increased anxiety. Methods: Survey (32-item) of consecutive patients diagnosed with colorectal cancer attending a large tertiary comprehensive cancer centre in the United Kingdom (18 May to 1 July 2020). Self-reported GAD-7 (both paper/electronic forms) was used as a screening tool for anxiety. Statistical analyses of associations:Chi-square, Fisher’s exact, and uni- and multi-variable analyses were performed using SPSS v19 and R. Results: A total of 143 patients (response rate 67%), 82% male, and median age of 61-70 years were included. Majority of patients had telephone consultation (78%), including 40% who had scan results discussed over the phone; with favourable feedback received with both respectively. Twenty-three patients (18%) were considered to have anxiety, with 7 (6%) scoring for moderate or severe anxiety. Three items asked patients if they had concerns about getting COVID-19, were worried that COVID-19 would have effect on mental health, and affect their experience of cancer care. Patients answering positively to any of these items were most likely to have anxiety; multivariate analysis – OR 2.361 (95% CI 1.187-4.694, p=0.014), 3.219 (95% CI 1.401-7.395, p=0.006) and 3.206 (95% CI 1.036-9.920, p=0.043), respectively. Majority of the patients did not feel that they needed support during the pandemic period and hence the available well-being services were not used. Patients felt that friends and family had been very supportive but less so the primary care services (p<0.05). However, they felt they were supported by the clinical team. Conclusions: At our centre, during the first-peak of COVID-19 pandemic in the UK, patients with colorectal cancer did not display increased rates of significant anxiety. The findings of this survey suggests that some service changes implemented, including increased telephone follow-up, may have already improved the overall experience of cancer care. Importantly, patients were much more concerned about their cancer treatment than COVID-19, emphasising the need to continue to provide comprehensive cancer care even if we get a “2nd wave” of COVID-19.

Background The high demand for health care services and the growing capability of artificial intelligence have led to the development of conversational agents designed to support a variety of health-related activities, including behavior change, treatment support, health monitoring, training, triage, and screening support. Automation of these tasks could free clinicians to focus on more complex work and increase the accessibility to health care services for the public. An overarching assessment of the acceptability, usability, and effectiveness of these agents in health care is needed to collate the evidence so that future development can target areas for improvement and potential for sustainable adoption. Objective This systematic review aims to assess the effectiveness and usability of conversational agents in health care and identify the elements that users like and dislike to inform future research and development of these agents. Methods PubMed, Medline (Ovid), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and the Association for Computing Machinery Digital Library were systematically searched for articles published since 2008 that evaluated unconstrained natural language processing conversational agents used in health care. EndNote (version X9, Clarivate Analytics) reference management software was used for initial screening, and full-text screening was conducted by 1 reviewer. Data were extracted, and the risk of bias was assessed by one reviewer and validated by another. Results A total of 31 studies were selected and included a variety of conversational agents, including 14 chatbots (2 of which were voice chatbots), 6 embodied conversational agents (3 of which were interactive voice response calls, virtual patients, and speech recognition screening systems), 1 contextual question-answering agent, and 1 voice recognition triage system. Overall, the evidence reported was mostly positive or mixed. Usability and satisfaction performed well (27/30 and 26/31), and positive or mixed effectiveness was found in three-quarters of the studies (23/30). However, there were several limitations of the agents highlighted in specific qualitative feedback. Conclusions The studies generally reported positive or mixed evidence for the effectiveness, usability, and satisfactoriness of the conversational agents investigated, but qualitative user perceptions were more mixed. The quality of many of the studies was limited, and improved study design and reporting are necessary to more accurately evaluate the usefulness of the agents in health care and identify key areas for improvement. Further research should also analyze the cost-effectiveness, privacy, and security of the agents. International Registered Report Identifier (IRRID) RR2-10.2196/16934

IntroductionStudies and research have shown that providing patient education through knowledge and counselling of the disease process and subsequent treatment empower patients and carers to improve patient’s health. Through understanding rationale for treatment, implications of non- compliance, non-adherence, disease progression and adverse effects of therapy, pharmacy staff are perfectly placed to empower patients and carers with evidence based knowledge and information to make their own educated decisions regarding therapy. The ‘Let’s Talk Medicines’ telephone service was set up in 2015 for exactly this purpose. It is a dedicated medicines information (MI) service aimed at patients, parents and carers, giving the opportunity to ask questions and obtain advice from specialist paediatric pharmacists about their child’s medicines once leaving the hospital. The services have vastly expanded over the last 2 and half years with the addition of an email address as an alternative means for contact. The helpline number and email address are heavily publicised to parents and carers through posters throughout the hospital, details published on all paediatric discharge summaries and printed information cards given to all outpatients during counselling.AimTo evaluate the service progression by analysing the sheer volume and types of queries over the last 3 years to identify how beneficial the novel service has proven to be.MethodsTo retrospectively analyse data from 3 monthly reports over the last 2.5 years of the service to identify number of calls, emails, types of queries received and users of the service.ResultsThe current service relies on all members of the pharmacy team answering calls on a dedicated patient line on an ad-hoc basis with several specialist pharmacists reviewing queries on a daily basis. Average call durations were between 5 to 8 minutes with more complex queries requiring in depth data search taking up to 30 minutes. All queries are logged on paper and then reviewed on a monthly basis as they are entered onto a database. Since the introduction of the service, the volume of calls received has increased by more than 50% with average of 35 per month in 2015 and 54 in 2017. Originally, the service was designed primarily for patients, parents and carers. Due to the increased recognition, the service has now been expanded to a variety of internal and external healthcare professionals, community practitioners and pharmacies, drug companies, commissioning staff, researchers and students. The types of queries range from supply issues, procurement of unlicensed medicines, to adverse effects, administration advice and complex pharmaceutical queries.ConclusionThe service has grown and developed with focus based around improving patient care, medication adherence and minimising medicines related risks. Through providing accurate, up-to-date and evidence based information its appeal has reached a wider audience including healthcare professionals. Combined with an increase in the number of calls and technological advances, a new email service has been rolled out in 2017, as an alternate means to contact the service. Direct comments from users of the service has shown positive feedback and trust.

Magandang Gabi po sa inyong lahat lalo na sa mga bagong specialista (o Diplomate) ng ating samahang PBO-HNS na pinararangalan natin ngayon; Ganuon din sa kanilang mga kabiyak, at mga magulang, mga marangal nating panauhin at syempre sa mga dati kong kasama sa PSO at PBO-HNS. Itong samahang ito ang hindi tumitigil na paunlarin ang mga patakaran ng Society at para ang ENT Diplomate ay maging tunay na specialist at hindi “ispecialista daw.” For the single ones among you, let’s give your parents special citation for having sacrificed not only once during your medical student days but twice-during your residency days. Their encouragement and material aid are phenomenal. Likewise to those married, your spouses either had a more challenging housewife’s role or became “house bands” during your busy training days. So in this talk of mine which you may consider “unsolicited advice,” I will mention some idealistic-- even bordering on the philosophical -- reminders of some of our pillars in the specialty and my own experience as a budding practitioner. Also my personal pitfalls and how to possibly solve them. After all, when we reach our sunset years, we can discuss such topics ad infinitum. Success in your practice is more or less guaranteed. After all, our specialty is still relatively young and in demand and our membership is still wanting in proportion to the needs of a 100-million population. I still have to see an ENT practitioner unhappy in his chosen field. The only factor that may be unfavourable is your questionable attitude towards your patient, your colleagues in the profession and the hospital administrators in the institution where you belong. In an article by the multi-awarded neurotologist Dr. Michael Glasscock entitled “The Lost Art of Medicine,”1 he enumerated the basic principles of the time-honored physician-patient relationship which are: “The Science of Medicine” which you have just endured by passing the board so I will not elaborate on it. “The Art of Medicine” which is multifaceted approach to patient care that takes into consideration the patient’s emotional as well as his physical well-being. I remember a patient, my own cousin, who fainted in front of me when he learned from the histopath that he had cancer. I miscalculated his intelligence against his anxiety, which brings me to the next topic; “The Art of Full Disclosure” a most important aspect of good patient care is keeping the patient fully informed. A well-informed patient is an understanding patient who may think twice or more before suing you after a surgical complication, because you have explained that possibility to him. A DVD or disc on the surgical procedure, showing its advantages, indications, and possible complications can be a good source of informed consent. An anatomic picture in your laptop can explain the pathophysiology and help prevent problems in the lifestyle of -- let’s say-- a chronically allergic patient. “The Art of Listening” studies have shown that during the initial interview an average doctor interrupts the patient’s story within 17-20 seconds. This frustrates the patient. True, the patient can be a poor historian so you can prompt him-- but not to the point of leading the story. Remember 40 to even 60% of his story can be the source of the diagnosis. “The Art of Compassion” Postoperatively make rounds twice a day and even more if the case is a difficult one. This lets the patient and family know that you are on top of the situation and are concerned about their well-being. A secure physician will suggest a second opinion before the patient and/or family ask for one.1 And again will not even consider a malpractice suit if a complication happens. Those are the emotionally-charged problems you may encounter. So it’s not only the 3A’s of malpractice, namely Ability, Availability, Acceptability that can ensure success. Maybe add 2 more – Accessibility and Affordability for obvious reasons, when inefficiency is very palpable, such as in this unfortunate place known as Metro Manila with its horrendous traffic and other problems. There is a clamour for the next president to create a “department of common sense.” As to affordability, you may be the best ENT doctor but if your PF is preposterous, that will be a definite turn-off for the patient. Here are few reminders for a starter: Recruit a “smiling staff” from the secretary in the reception room, your clinic nurse and/or clinic assistant. Nothing can be a better welcome scene for a sick, depressed patient than a smiling, assuring face. Be always on time as posted. Working patients have to rush back to work and get disappointed with errant doctors, and seek one who is available. A few red flags in practice: Beware of a secretary who may be a cheat, charging your pro bono patients without your knowledge and pocketing the money. A colleague who captures “walk-in” patients by socializing with personnel from the admitting section, OPD-ER nurses and residents. No wonder inspite of “on call” scheduling you never received any patient from these departments. These events really happen. One of the fastest ways for a quick fix to accumulate patients is to join HMO’s. Financial returns may not be as great as private patients but in the long run an HMO-satisfied patient is eventually your recruiter of his relatives and friends. Some downsides on joining HMO’s: Controlling your work-ups such as by refusing necessary, thorough, but expensive requests. Delayed payments. Defining what is pre-existing illness. In this day and age of social media, here are some do’s and don’ts: Never refuse an invitation to TV forums. During my time the two popular ones were: “Kapwa Ko, Mahal Ko” and “Damayan.” I was invited a few times to guest in these fora. As a result, my telephone lines became busy answering calls about my schedule. I felt like a superstar. The availability of information about your practice at a click of a mouse will allow you to reduce your marketing budgets. You can even create your own website or thru the services of facebook, twitter, etc. As long as your statements in your ads are not false, misleading and deceptive you can’t go wrong. Some examples of false statements: Statements of ability to do subspecialty procedures where in fact he did it with a “ghost surgeon.” Has had fellowship in a well-known medical center abroad but actually spent just a few days of observation. Example of deceptive claims: - paid testimonials by prominent patients about his greatness. Still some other tricks of the trade: Practice in the provinces where you grew up. People there are very familiar with you, a returning professional, who will appreciate your humanitarian services. You will be the pride of your family. A very rewarding feeling indeed. Accept speaking engagements from other medical groups, and socio-civic clubs. Again, they become your sources of referral. The PhilHealth is a noble undertaking by the government for those who have less in life should have more in law. It is a law and we are all bound to abide by it. Let us not abuse it as is happening with one of the other specialties. I understand there is also an ongoing controversy between LGU’s and provincial hospitals about PhilHealth Returns. Thinking of academic medicine and research? You don’t have to be in a classroom or in the laboratory. Remember even the ancient Oath of Hippocrates mentioned this art of sharing knowledge and experience with others, when it states: “I will impart this knowledge of the art to my own sons and those of my teachers and to other disciples…”2 Teaching can also be self-serving since it forces one to study more and updated. Masama naman na mas marunong pa sayo ang estudyante mo. In closing, let me remind you about the past. While you are in a solitary moment savouring the thought of your enormous professional success, please remember the toils, the sacrifices, the idealism of the “heroic nine” who founded our specialty society, and the Board and the subsequent leaders who nourished it. Don’t forget your Department Chairmen, Training Officers and Consultant staff who shared their time and expertise with you. They are part and parcel of your success. So there goes the remark of a French philosopher, Bernard De Charter: “We are like dwarfs seated on giants shoulders. If we can see far, it’s not because we are tall but because we are seated on giant’s shoulders.”3 And most of these giants are with us tonight and they are all very proud of you. Good evening and thank you for the pleasure of sharing these ideas with you today.

Abstract Background In Italy on the 20th of February, the first Italian patient was tested positive for Coronavirus Disease 2019 (COVID-19) in the Lombardy region. The Regional Emergency Medical Services (EMS) Trust (Azienda Regionale Emergenza Urgenza, AREU) of the Lombardy region decided to apply a Business Intelligence (BI) System to take timely decisions on the management of EMS and to monitor the spread of the disease in the region in order to better respond to the outbreak. Methods Since the beginning of the COVID-19 outbreak, AREU developed a BI System to track the daily number of first aid requests received from 1.1.2. (Public Safety Answering Point 1). BI evaluates the number of requests that have been classified as respiratory and/or infectious episodes during the telephone dispatch interview. Moreover, BI analyses the pattern of the epidemic, identifying the numerical trend of episodes in each municipality (increasing, stable, decreasing). Currently, AREU is still implementing the BI as the epidemic is still ongoing. Results In the Lombardy region on the 20th of February the number of the first aid requests for respiratory and/or infectious episodes were 314. This figure increased sharply during the month of February and March reaching its peak on the 16th of March with 1537 episodes. In the area around Bergamo, this number experienced a greater rise compared to the rest of the Lombardy territory, going from 74 episodes on the 20th of February to 694 on the 13th of March. Therefore, AREU decided to reallocate in the territory the resources (ambulances and human resources) based on the real-time data elaborated by the BI system. Conclusions The BI System has been of paramount importance in taking timely decisions on the management of EMS during the COVID-19 outbreak in the Lombardy region. Indeed, BI can be usefully applied to promptly identify the trend of the COVID-19 epidemic and, consequently, make informed decisions to improve the response to the outbreak. Key messages The Emergency Medical Services Trust of the Lombardy region applied a Business Intelligence System to promptly respond to the outbreak of COVID-19 and reallocate the resources based on real-time data. AREU used a Business Intelligence System to track the daily number of first aid requests that have been classified as respiratory and/or infectious episodes during the telephone dispatch interview.

Abstract Digitalising patient-centric services to address society’s challenges with an ageing population and healthcare provision is by many seen as important. Studying the effects of the digitalisation on the work engagement of the users of the new systems is vital in this context, especially since previous research has established that the work engagement at work in healthcare is problematic. Work engagement is defined as a positive, fulfilling, affective-motivational state of work related well being, as is closely connected to the experience of resources and demands in the work context. These resources can be for example digital support, experienced demands or empowerment whereas exhaustion is connected to work demand in a workplace. This study contributes to knowledge about the effects of digitalisation on work engagement and exhaustion in the context of patient-centred services and eHealth. Contextual interviews were conducted on site for 5 h with nurses using a new chat function and using telephone for medical advice to patients. Additionally, semi-structured interviews were conducted with all the nurses participating in this digitalisation project to gather more insights into their work engagement in the two work situations. Results were analysed in different themes of areas affected by the digitalisation in the two overarching themes: job demands and job resources. The results show that the change to a chat function when communicating with advice seekers had connection to work engagement in several ways. The nurses experienced less time pressure and emotional pressure, but also a loss of job control and feedback from colleagues working from home.

Abstract Background Since 2015, pharmacists have been integrating into English general practices and more recently into primary care networks. General practice-based pharmacists provide a range of patient-facing services, such as medication reviews, management of long-term conditions and minor ailments, prescribing duties and answering queries over the telephone. Literature reports patients’ satisfaction with general practice-based pharmacists’ services, however, previous research captured only limited experiences. The aim of the current study was to pursue an extensive exploration of patients’ experiences of pharmacists in general practice. Methods General practice-based pharmacists, working in practices in West London, Surrey and Berkshire, handed invitation packs to patients seen during consultations. Patients that wanted to take part in the study were invited to undertake a qualitative, in-depth, face-to-face, semi-structured interview within the practice with which each patient was registered. Interviews lasted from 15 min to more than 1 h and were audio-recorded. Recruitment continued until data saturation. Audio-recordings were transcribed verbatim and transcripts analysed thematically. Results Twenty participants were interviewed. Four themes were discerned: awareness (“I had been coming to this practice for 24 years and I didn’t know that there was a pharmacist”); accessibility (“People ring for a GP [general practitioner] appointment … it’s Monday and they [receptionist] tells you ‘We can slot you in on Friday’ … with a pharmacist on board, they can [instantly] look at you”); interactions (“I’ve always had a really good interaction with them [pharmacists] and they listen and they take on board what I’m trying to say”); and feedback (“It’s easier [to collect feedback instantly] because I could have forgotten half of what they [pharmacists] have told me in an hour or so’s time”). Conclusions Findings indicate that pharmacists’ integration into general practices could improve accessibility to, and the quality of, care received. The findings will assist policy development to provide general practice-based pharmacists’ services as per patients’ needs.

Introduction Australia’s mobile communications industry has been slower to embrace the convergence of digital communication technology compared to other areas of the Asia-Pacific region, in particular Japan. However, the introduction of new mobile networks and spread of broadband (albeit still limited in some areas) has given Australians opportunities to experience the new technosocial communications. As a result mobile communication resources have become embedded within a sociocultural infrastructure that is at once mobile, personalised and consumerist. This paper examines how the iGeneration (or ‘Internet Generation’, those born in the first half of the 1980s and who were the first to grow up in a networked and communications media driven society) of young Australians have taken up and embraced the mobile technologies as part of their everyday sociability. This journal issue is concerned to understand the significance of the convergence of mobile media. In this paper ‘mobile’ is taken to refer to the range of digital media that are owned and used by the iGeneration. These can include mobile phones, laptops, computers alongside an array of other digital social software and Web 2.0 resources such as email, Social Networking Systems (SNS), e.g. Facebook, that enable individuals to situate themselves and communicate across their social networks. The discussion that follows will touch on all of these mobile communication resources. It is argued that these should be seen as more than technical tools, as they offer a constant ‘tether’ to personalised and intimate connections (Ito et al, 2005). This in itself is significant because the emphasis is on a digitally mobile and connected sociability rather than any single device or piece of software. It will be concluded that this connected sociability means that for the iGeneration there is a seamless movement across what has been previously depicted as an off/online and disembodied dichotomy. Researching the iGeneration The paper draws on the data from 40 in-depth and open-ended interviews with undergraduate students who were in the last term of their first year at University in Australia in 2006. The conventions of anonymity have been followed to ensure that no individual may be identified. All interviews were digitally recorded (with permission) and detailed analysis undertaken utilising AtlasTi. The analysis involved identifying themes and issues as they emerged from reading and re-reading of the data. This group was chosen as they had established non-university social networks and new connections amongst university peers. The focus on what constitutes one of the more privileged sections of young people in terms of education, if not material resources, is appropriate in a study that seeks to explore those who are likely to be able to take advantage of innovative communications technology. Extracts from the interview data for this paper, are not intended to be representative, but rather are used for illustrative purposes. Mobile Life The diffusion of communications media has become ubiquitous amongst the iGeneration who are socially, temporally and spatially mobile and likely to immerse themselves in their social connections. This is a generation that has been said to “inhabit a different world” (Muller), where seemingly unregulated flows of information and methods of staying in touch with others ‘situate’ social lives as part of mobile sociability. Part of this more mobile sociability is the crossover between global and localised connections. Indeed, globalisation theorists have emphasised how the world is characterised by the flows of such information. Urry has paid particular attention to the forms of mobility that take place in a society characterised by the exchange and sharing of information and communication practices. This paper has a narrower focus and is concerned with what might be thought of as ‘local’ communicative practices between people situated in the same city and at the same, but dispersed, institutions. Mobile communications technology takes on an increasingly ‘invisible’ sociotechnological power that underlies the structure and shapes the experience of everyday sociability and relationships (Graham). Identified as “Digital Natives” by Prensky these individuals ‘thrive’ on their constant connectivity to one another. The following quote reflects the sentiments of many of the students interviewed: I would never be without my phone, or at least having some way of being in touch with my friends. People tend to have ties everywhere now and I find that I am always in touch at the click of a button anytime. (Jon) Key to social interaction for the iGeneration is to be constantly ‘switched on’ and available to others. Significantly, the mediated aspects of mobile technology means that social connections are valued for their ‘liveness’, whereby interactions are expected to take place in ‘real time’. In this way the iGeneration have become both the producers and consumers of ‘live’ content where personal engagements are ‘active’. This ensures that individuals are (and are seen to be) socially and digitally engaged. The new social practices that form part of an ‘on-the-go’ and ‘ever-current’ lifestyle means that to be ‘in touch’ has taken on a new symbolic and social form. All 40 of the students interviewed mentioned that they could not ‘imagine’ being detached from their social networks, or without some form of communication device on their person. The relationship between previously defined on and offline lives, or ‘real’ and ‘virtual’ situations are not separate entities in this context. Instead they are inextricably linked together as the individual is continually socially connected. Individuals are part of a constant present-ness and engagement to what is experienced as a lived or ‘worldspace’, rather than static ‘real’/’virtual’ world duality (Steinberg cited by White). As a result members of the iGeneration have to maintain two active and dynamic social presences, one that is ‘real’ world and the other that is virtual. They are always ‘situated’ in both their embodied and disembodied digital lives, and yet this is a duality that many do not consciously recognise as they move ‘seamlessly’ across different venues for sociability. In order to remain ‘up-to-date’ communication strategies are employed, as one student explained: Things are changing so fast, like you go away for just one day and you are just so out of the loop, things change continually and it’s nice to be part of that. It’s hard if you miss a message because then you are behind and don’t know what’s going on… you have to continue to make the effort if you want to stay in touch. (Kim) In Goffman’s classic analysis of face-to-face interaction he revealed the complexity of social communication and the nuanced use of ‘props’ and ‘backstage work’. In a similar fashion the mediated and real time interaction amongst the iGeneration is full of symbolic meanings and rituals. Ironically in what is often thought of as a disembodied sociability, where time and place cease to matter, it is the immediacy or live presence that is valued. Thus social life rotates around the emergence of a set of continually updated communications between individuals. Social relationships are ‘reworked’ as mobile communications introduces a new layer of social connectiveness. The process of communicating with someone is not just about what is expressed, but includes a set of subjective meanings as to the ‘whom’ an individual is and value of a relationship. Successful communication and development of relations through technology require the engagement of the self with shared social conventions and representations. Mobile technology has enabled a whole generation to mobilise relationships and connections whilst ‘on the move’ in a way that strengthen social bonds and facilitates a sense of social connectedness (Wei and Lo). Getting to Know Each Other For members of the iGeneration traditional forms of social meetings, and indeed settings, have become modified to take into account constant social connectivity. Students employ technologies to provide new ways of ‘getting-to-know’ others and to develop relationships. In particular, SNS is used to find out about potential new friends by drawing on the profiles and connections that are displayed on resources such as Facebook. Profiles involve the creation of a virtual ‘identity’ that represents an individual and may include digital photographs, music, a detailed self-description, lists of interests and of other ‘friends’ etc. Sites such as Facebook are popular because (at the time the research was undertaken) they require an email address from an academic institution in order to join. Consequently, users trusted the information displayed on these sites and rarely questioned whether the descriptions that they read were accurate (Jones and Soltren). Not only would it be seen as breaking communicative norms to, for example fabricate an identity on Facebook, it would also be a fabrication that would be difficult to maintain across the various media that are in use. Indeed it would be ultimately pointless in terms of a sociability that moves across media and between the virtual and non-virtual domains. Such sites are geared to the student population and it is often taken-for-granted that amongst students that they will have a Facebook profile. Reflecting this university clubs and societies distribute notices of events and so forth through Facebook. Individual profiles may also display mobile phone numbers and other points of contact so that the online descriptions of the self are linked to other forms of connection. As this Melbourne student explains, these resources provide new means of ‘getting to know’ others. The way in is different now if you are getting to know someone, before maybe you went out a few times and got to know their circle of friends, but now you can check out their MySpace profile, or send them a message on Facebook BEFORE you meet up. Just by messaging each other you know that there’s no awkwardness or danger of gaps in conversation before you get together. (Tom) In effect the individual is digitally represented in a range of digital spaces so that a stranger can imagine or construct a sense of the ‘real’ person without ‘knowing’ or engaging with them. Such imaginings represent an important means of being on familiar terms with others and the ‘social value’ or individuals ‘place’ within a social network (Gotved). In the early stages of becoming acquainted with someone the status of the individual was related to the how frequently they were contacted and the form of interaction that took place. As noted earlier Goffman’s (1978 [1959]) work is useful as social ceremonies and rules for interaction can be detected although these are often taken-for-granted unless people are prompted to talk about how they communicate with others. They are perhaps best exemplified by the following descriptions from students talking about how they ‘got-to-know’ one another at the beginning of the university term: When you are getting to know someone it’s interesting to see if they’ll message you or call, then your like ‘oh he’s a caller’ and can go from there. (Emma) If I don’t know the person well I like to text, I am not good on the phone and so it creates a way to say ‘hi’ without the danger of awkward gaps. Then you find yourself messaging back and forth and can meet up later… (Katie) You have to play to their agenda otherwise you never hook up. (Stu) Instant messaging like on MSN or texts or whatever totally helps with getting to know someone. Before you meet up you can find out whether you’ll get on or not and whether it’s worth you while meeting up. Kind of like a filtering process. (Dan) This mediated process may involve text messages, emails and mobile calls before individuals meet offline. Members of the iGeneration therefore use an integrated set of devices and software resources to initiate and maintain friendship networks. In effect the often-rich descriptions created in SNS reflect a visualisation of what Bourdieu has described as ‘habitus’. This notion of habitus, that can basically be seen as set of acquired dispositions is appropriate, as “when habitus encounters a social world of which it is the product, it is like a “fish in water” ... it takes the world about itself for granted” (Bourdieu and Wacquant 127). This neatly describes how the iGeneration incorporates mobile communications technology into their everyday lives. An Etiquette for Mobility The ‘rules’, attitudes and expectations, that come into play as part of these new mobile communication practices continue to remain tied to a recognised and preconceived social ordering. Indeed, one of the most important aspects of this kind of mobile communication is the adherence to a set of social rules through which individuals continually control the process of interaction itself. This includes for example, the pace of communication, when to text, to make a voice call, or to email, and so forth. Galloway has argued that there is a “decidedly playful” aspect to mobile interaction. However, a range of communicative strategies underwrites this ‘play’ as periods of non-contactability have to be ‘justified’ or explained. If such episodes are not explained these can become problematic, generate misunderstandings or cause anxieties within networks and emergent relationships. Indeed, the “simple fact of carrying a mobile phone generates in the carrier the expectation of being immediately available” (Licoppe and Heurtin 100). For this reason a sense of disappointment, or cause for concern, may be experienced if an individual receives for example no text messages for a period of time. Amongst those students who were in regular contact with one other a set of what can be thought of as ‘communicative regimes’ is negotiated. These arise out of social practices for connectivity that are part of virtual and face-to-face meetings. Such negotiations may be largely implicit but occur out of a shared sense of ‘knowing’ the other. Actions or non-actions such as not answering a voice call or responding to a message straight away can be seen as a social distancing. For example, a student talked about how he always immediately returned a text message to his housemate because “it was expected” and to delay a response without an explanation would not be seen as an appropriate response to a “close mate” (Riley). Consequently communication regimes are developed around relationships and may be layered in terms of status within a peer group. For the iGeneration such practices reflect what in pervious times would have been thought of as etiquette. It is interesting to note that at the time of writing this paper there were 11 global groups with some 2,870 members on Facebook dedicated to what is described as ‘Facebook etiquette’. Conclusion A purpose of this paper is to suggest that recent changes in the provision of information and communications services in Australia have created new opportunities for an iGeneration to incorporate the technologies within their everyday lives. There are similarities here with the practices found amongst young people in Japan, South Korea and other counties that have some of the most advanced publicly available communications infrastructures (Ito et al). It is worth noting that 3rd Generation mobile phones, and video technologies are less common in Australia, hence future convergence remains open to speculation and dependent upon improved network infrastructures and marketing. The emphasis in Australia is on the seamless use of different mobile communications technologies and the embedding of these within broader social practices. The convenience and ‘pocketability’ of communications devices has become one of the most important innovations for an iGeneration that desires communication, information and entertainment accessible in the palm of their hand, a first step “towards a digital paradise” (Standage). However, care has to be taken to differentiate between media and marketing hype and actual social practices. Commentaries and research in the early days of the Internet tended to focus on the possibilities it offered to escape the fleshy body through the screen into new identities, genders and bodily forms (Turkle; Haraway). While there are resources such as Second Life that provide a means to escape form the embodied self the main concern of the iGeneration is to promote sociability across the digital and real worlds. One reinforces and reflects the other so that the virtual self is always anchored in the embodied self. It is the convergence of the self through such representations that whilst not exactly embodied in a physical sense refer to a ‘real’ physicality and presence. This suggest that in terms of social practices for the iGeneration the virtual/place dichotomy is unhelpful and as Daniel Miller and Don Slater note “we need to treat Internet media as continuous with and embedded in other social spaces” (5). The convergence of mobile communicative resources highlighted in this paper and their embodiment into social practices suggests that users may have little more to gain in terms of sociability from, for example, streaming video on mobile phones. The emotive experience of being ‘in touch’ with one another remains a fundamental amongst the iGeneration who draw upon a range of mobile media and social software to form and sustain interactions. Such connections are conducted through a more or less nuanced set of communicative regimes that move across what for them is a seamless landscape of mediated and off line resources and relationships. References Bourdieu, Pierre, and L. Wacquant. An Invitation to Reflexive Sociology. Cambridge: Polity Press, 1992. Goffman, Erving. The Presentation of the Self in Everyday Life. Harmondsworth: Penguin, 1978 [1959]. Gotved, S. “Time and Space in Cyber Social Reality.” New Media and Society 8.3 (2006): 467-486. Graham, S. “Beyond the ‘Dazzling Light’: From Dreams of Transcendence to the ‘Remediation’.” New Media Society 6 (2004): 16-25. 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Standage, T. “Your Television Is Ringing.” The Economist: A Special Report on the Future of Telecoms. 14-20 Oct. 2006. Turkle, S. Life on the Screen: Identity in the Age of the Internet. New York: Simon & Schuster, 1995. Urry, John. “Mobile Sociology.” British Journal of Sociology 51.1 (2000): 185-203. White, M. “Television and Internet Differences by Design.” Convergence: The International Journal of Research into New Media Technologies 12.3 (2006): 341-355. Citation reference for this article MLA Style Hardey, Mariann. "Going Live: Converging Mobile Technology and the Sociability of the iGeneration." M/C Journal 10.1 (2007). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0703/09-hardey.php>. APA Style Hardey, M. (Mar. 2007) "Going Live: Converging Mobile Technology and the Sociability of the iGeneration," M/C Journal, 10(1). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0703/09-hardey.php>.