1. Professionalism/Customer Service in the Health Environment
Key Elements of Effective Communication
Welcome to Professionalism and Customer Service in the Health Environment, Key Elements of Effective Communication. This is lecture c, Using Media for Communication.
Lecture c – Using Media for Communication
This material Comp16_Unit4 was developed by The University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000023

2. Using Media for Communication Learning Objectives
Discuss communication in paper-based and electronic formats
Discuss personal communication in the work setting
Understand the importance of listening skills
Understand the role of diversity
The objectives for this lecture, Using Media for Communication, are to discuss communication in both paper-based and electronic formats, to discuss personal communication in the work setting, to understand the importance of listening skills, and finally, to understand the role of diversity in communication.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

3. Paper-based Media Know your audience
One of the more common paper-based communications you will be expected to generate is the business letter. When writing a business letter, first you need to identify and know your audience. This will greatly influence the content of the message. For instance, if you were writing to inform someone that the order entry system needed to be down for installation of a database patch, you might be very specific if writing to a database administrator. Conversely, if you were writing to a clinician, you would focus on how the change will effect that clinician and not go into detail on the technical steps.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

4. Paper-based Media Know your audience Be concise and clear
Use bullets to help provide detail
BE CONSISE, to the point, informative, and brief. In today’s healthcare environment, declining reimbursement rates coupled with more patients create a scarcity of time for clinicians. You want your communication to be concise and “content rich” so that information can be imparted as efficiently as possible. Use of bullet points greatly helps in this, by making your points obvious to the reader.
There are various conventions that surround the writing of a business letter. For example, DO NOT write a letter or as if you were texting. While use of texting conventions like “lol” are wholly appropriate for teens tweeting their friends, it will not endear anyone to you in a professional setting, and you will likely be ignored and discounted.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

5. Paper-based Media Know your audience Be concise and clear
Use bullets to help provide detail
Address only one topic per paragraph
Spell, format, and punctuate correctly
Remember that letters can become documental evidence
Each paragraph should discuss only one topic. The writing needs to be easy to refer to later, and if you keep the paragraphs topical you will make this much easier for the reader.
Ensure that your spelling and punctuation are correct. Remember that your letter can become documental evidence so do not write anything inappropriate. Letters can and do get copied, and forwarded so write it so you will not regret it being forwarded beyond original recipients. If you have time, and you feel uncertain about your letter, ask a coworker to review it for you.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

6. Email Communication DO: Use correct grammar and punctuation
Clearly state the purpose of your message
Clearly state by when you need a response
Write a meaningful subject line
Source: (Patterson, 2010)
Now let’s look at the do’s and don’ts of communications. This slide lists the “do” items.
Do use correct grammar and punctuation. Provide context as needed to frame your message and specify why you are sending the . In other words, say what the purpose is of the . Be clear in the when you need a response. Write a meaningful subject line to increase the chance of the receiver opening the . If a new topic is being discussed, even if you use an old to find the sender’s address, it is good to make the subject line match the new topic rather leaving the old subject in there.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

7. Email Communication DO: Use correct grammar and punctuation
Clearly state the purpose of your message
Clearly state by when you need a response
Write a meaningful subject line
Use screenshots and process flow diagrams to illustrate complex points
Prioritize replying to received s
Source: (Patterson, 2010)
It is often helpful to include a screenshot or flow diagram when imparting complex information about systems. When doing so be careful to use a commonly accepted format such a PDF (pronounced P-D-F) or a .Doc (pronounced dot doc) file. Always write the as if the recipient may not be able to open the attachment. That is, put much of the relevant information in the body of the .
A very common use of a screen shot might be to take a picture of an error code to send to the developer, or take a picture of the particular orders screen and annotate which fields are going to change with a new version of an order entry system.
Finally, when you receive s, always try to provide a prompt response. As an HIT professional it is likely you will receive many, many s per day. You will need to prioritize your correspondence based on the author and subject. This is yet another reason your subject lines need to be concise and clear!
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

8. Email Communication DON’T: Use company email for personal use
Include needless graphics
Source: (Patterson, 2010)
This slide presents a list of don’ts.
Don’t use company s for personal use; company s are saved by employers. It can also be easy to accidentally address personal s to the wrong recipient, and, depending on the content, can create quite an embarrassing situation.
Do not include needless graphics in an message. The recipients client may not be able to display the message. When you do use graphics, use common formats that can be read without any special software. PDFs and DOC files as attachments are usually safe. But don’t assume, for instance, that your recipient has Visio (pronounced VIZ—ee-o) installed on their machine for display of process flows.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

9. Email Communication DON’T: Use company email for personal use
Include needless graphics
Send emotionally-charged
Use backgrounds that obscure your text
Use abbreviations or symbols like smiley-faces 
Don’t copy others unnecessarily
Source: (Patterson, 2010)
Do not send off emotionally charged response s. can be a difficult medium to discern tone and emotion, and as a result your recipient can easily take a strongly worded statement personally and send a retaliatory response. When you receive charged s, and you will, if possible try to hold off for twenty four hours before you respond. Waiting will allow you to cool down and respond with objectivity. Also, consider setting up a face-to-face meeting with the sender. Clinicians will sometimes project an adversarial tone in an , when they are really only “venting” over frustration with change. Talking with them (after sufficient cooling off time) will more times than not result in a less emotionally charged discussion and a path forward.
Do not use background colors or borders. Do not use emoticons (pronounced ee-mote-ih-cons) such as smiley faces or characters made with the colon and parentheses. Many view this as being childlike or unprofessional.
Use of CC (pronounced C-C) can be very helpful when wanting another party to know the status of a project and or situation, but be careful. If you consistently CC someone on minor and unrelated content, you may quickly find that those recipients prioritize your lower than you want.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

10. Email Communication Critique
Now let’s see if you can critique this message. What did Barry do right?
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

11. Email Communication: Do
Good subject line
Polite greeting
Clear professional language
Helpful attitude
Full contact information
We can see that Barry was professional and polite in his tone and language, that he used a descriptive subject line and that he provided his full contact information in case Dr. Winston needed to talk with him. It is also helpful to add a “click here” link in addition to the URL (pronounced U-R-L). This makes it easier for the recipient to find the information and you will likely get higher responses when you do so.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

12. Email Communication Critique
Now let’s critique this message. What did Barry do wrong?
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

13. Email Communication: Don’t
Hard to read because of background
Greeting does not recognize education credentials
Negative in language and tone
Use of emoticons
No contact information
The closing is juvenile
The textured background makes it difficult to read the message. Also, Barry’s tone and language are more suited to personal communication with friends rather than a professional situation. Barry’s opinion of the online learning modules was negative and not helpful. The negativity was added to by the emoticons. He neglected to provide Dr. Winston with any contact information other than his address. Additionally he neglected to refer to Dr Winston as “doctor”. Dropping titles should only be done after being informed to do so.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

14. Maintaining Records of Electronic Communications
Separate your inbox into distinct folders
By project, by functional area, by dates, by type of work, business name, etc.
Use “flag” function
Do not delete s until absolutely necessary
Archive periodically to improve performance of your client
It will be necessary for you to maintain a record of electronic communications like . One approach to this is to separate your inbox into distinct folders. For example, s could be sorted by project, by functional area, or by dates. The advantage of this system is that you can more quickly find existing s.
Also consider using your clients “flag” function to indicate which s require a quick response. That way you can sort through your inbox and note which messages have priority.
Do not delete s until absolutely necessary. Often you will be the keeper of contracts and project communication. It is not unheard of to be requested to produce timelines on communication several years after the fact. If you have not archived and kept these messages this will be difficult if not impossible. In addition, you should archive your s periodically to improve performance of your system.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

15. Business Phone and Other Real-Time Communications
Use the caller’s name
Repeat important points
Do not mumble; ask if you can be heard
When calling others ask if this is a good time to talk
Use good judgment when paging clinicians
Source: (Melanson, 2003)
For phone and other real-time communications make sure you use the caller’s name in the conversation. Restate or rephrase key points made by the caller, as this can validate the caller and confirm that you understand the message. Don’t mumble. You need to speak clearly because you want to be understood.
Whenever you call someone else, it is a good practice to ask “is now a good time to discuss this?” This sends the message that you value the caller’s time and are not assuming that your time is more valuable than theirs.
In many clinical settings a corporate paging system is the most effective way to reach clinicians. Use (pronounce yoose) may depend on your institutional policies, but be judicious when paging clinical staff. For text paging, it is helpful to include a phrase like “when you get a chance please call ” and the like. You want the page to acknowledge that the recipient may be taking care of patients and have more pressing clinical responsibilities at that moment.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

16. Business Phone and Other Real-Time Communications
Do not use negative language
Do not chew gum or eat while on a phone conversation
Do not argue
Listen
If you have anything in your mouth such as food, gum, or a tongue piercing, you may be difficult to understand. Avoid harsh negative language in the conversation, even if you are receiving it from the caller. You can be firm and assertive without resorting to harsh language. Avoid direct arguments with the caller, instead offer to schedule a time to meet and discuss the issue later, in person.
Finally, listen intently to what the caller is saying and note the tone. Unless the call uses a live video of the caller you are unable to ascertain body language cues, so do your best to listen intently.
Oftentimes working in HIT you may find yourself taking calls in support of some type of implementation. These events are “all hands on deck” type of situations and regardless of your normal role, you may be taking calls during a go-live (pronounced live to rhyme with jive). The callers will be stressed and probably not in the best of moods. Being cheerful and attentive will help move the conversation in a positive direction and assist in getting the clinicians comfortable with the changes they are experiencing.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

17. Personal Phone and other Real-time Communications
Minimize or eliminate personal cell phone calls or personal text messages
Turn off the ring function – use vibrate or a silent option
Occasionally, you may be tempted to make personal phone calls while at work. However, it is very important that you minimize or eliminate personal cell phone calls while you are working. In addition, responding to personal text messages should be kept to a minimum. It’s a good idea to turn off your cell phone’s ring function and use vibrate or a silent option for your personal devices while at work.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

18. Personal Phone and other Real-time Communications
Minimize or eliminate personal cell phone calls or personal text messages
Turn off the ring function – use vibrate or a silent option
Do not have an offensive ringtone
Save personal interactions for a defined break period or lunch
Do not have an offensive ringtone. Imagine the embarrassment if you were having a meeting with executives and a coworker were to call your phone with the ringtone of Beck’s “Loser.” Not only would it interrupt the conversation, but the people there would wonder what ringtones you had for them!
It is best to have your interactions with personal friends and loved ones during a defined break period or lunch.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

19. Tone of Voice
The tone of our voice contributes to how a message sender is perceived
Most healthcare information technology professional positions require significant communication. Communication occurs between and within departments, as well as with outside suppliers and/or users of the services provided.
For many people, daily communication involves live in-person or face-to-face communications, live phone communications and/or receiving or leaving recorded messages. So you can see that we all have plenty of opportunities to use our voices each day.
The tone of our voice, or how we say the message, affects how we are perceived by others, positively or negatively. Take for example the phrase, “Wow, you are really getting good with that order entry screen!” Depending on which tone is used, this phrase can either be supportive and encouraging, or sarcastic and condescending. Be cognizant of the tone you use. Condescension is not going to work well at all when you are working with other professionals in a healthcare setting.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

20. Tone of Voice
The tone of our voice contributes to how a message sender is perceived
Also important:
Choice of words
Non-verbal behavior
Source: (Northouse & Northouse, 1998)
Northouse and Northouse describe a study by Mehrabian (pronounced Mer-abe-ee-uhn) who identified that, for face-to-face communication, the tone of voice accounted for a significant part of how a person is perceived. Other measures included the words used and nonverbal behavior.
If you are making a professional presentation, there are some things you can to improve your voice. These include breathing from your diaphragm, smiling as appropriate, drinking water and avoiding caffeine and dairy products before making the presentation.
In short, remember when your mother told you, “Don’t talk to me in that tone of voice!” Well, she was right. Instead talk softly, calmly and confidently and you will be more effective.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

21. Listening Skills
Listening intently is a crucial piece of the communication process
Effective listening skills will improve your skills as a communicator
There are a number of components associated with being an effective listener
In order for you to become a good communicator, you must develop strong listening skills. Listening provides the message receiver an opportunity to more fully understand the message.
An added benefit is that focusing on the message provides an implicit signal to the speaker that you care about what is being communicated. By practicing it, you are adding validation to the conversation and helping to obtain understanding of the speaker.
There are a number of components associated with being an effective listener. These areas are often discussed in professional and lay publications and even on blogs on the Internet.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

22. Listening Components Focus Take notes Keep your speech at a minimum
Remove distractions
Take notes
Keep your speech at a minimum
Source: (Barber, 2010)
Focusing on the message sender entails removing distractions as much as possible. This can include turning off your cell phone, muting your office phone and not using your computer. Monitoring your computer or laptop or smart phone during a face-to-face conversation is considered rude or disrespectful at best. Another way to improve your focus is to physically remove yourself from your distractions and have the conversation in a quiet neutral space.
To further enhance your understanding of the conversation, note taking is appropriate. Note taking serves a number of purposes. Besides the obvious purpose, to understand the message, note taking serves as a signal that you are interested in what the message sender is saying and confirms that the sender is important to you. In the practice of healthcare it is very useful to document next steps and “take aways” that come from the many conversations you will have in your career.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

23. Listening Components Focus Take notes Keep your speech at a minimum
Remove distractions
Take notes
Keep your speech at a minimum
Ask questions
Confirmation
Clarification
Restate decisions and understandings
Source: (Barber, 2010)
Also, your listening skills will improve when you summarize the conversation as it is happening. Finally, note taking reduces your talking which leads to increased understanding. If you don’t feel you understand what has been said, you can ask for clarification or confirm your understanding.
It is very appropriate to rephrase or restate what the person has said. This serves to solidify your understanding and reduce ambiguity. In HIT, ambiguity can be costly, resulting in development of incongruent solutions, or acquisition of systems that will not work as intended. Something as simple as restatements of understandings can greatly reduce this problem.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

24. Listening Components Pay attention to nonverbal cues
Facial expression, body language, etc.
Note changes in nonverbal cues
Sources: (Northouse & Northouse, 1998)
(Evenson, 2007)
If you are able to observe the person you can observe the message sender’s body language for congruence with the words used. You may note that the sender’s facial expression, tone of voice, gaze, or type and intensity of gestures (pronounced jestures) used are not aligned with the spoken words. These can serve as flags for multiple messages.
Additionally, watch for changes in nonverbal cues during a conversation. These can point to items that are emotionally charged or conversational points that are or are not associated with negative emotion. For example, imagine you were at a vendor demonstration with one of your cardiologists, and every time the vendor discussed a new measurement tool in the software, the physician rolled his eyes. You may want to make note and ask the cardiologist later what their thoughts are on that aspect, and how important it is for care delivery.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

25. Listening Components Pay attention to nonverbal cues
Facial expression, body language, etc.
Note changes in nonverbal cues
Remove personal bias
Consider assistive technology
Sources: (Northouse & Northouse, 1998)
(Evenson, 2007)
Try to remove personal bias based on prior contact with the message sender or other’s opinion of him or her. Additionally, avoid preconceived opinions that may be based on sexual preference, religion, age, gender, favorite sports teams or culture.
In terms of the use of assistive technology, if you have permission, in some circumstances, it can help to record the conversation through the use of special pens that function as digital recorders. An added benefit of some of these pens is that you can touch your handwritten notes with the tip of the pen and the conversation from when you made the notes will replay. This is a real time saver and an aid to communication.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

26. Diversity Issues Acknowledge individual distinctions
Culture can influence communication
Don’t assume that what you meant is what was understood
Source: (Gressang)
Do not expect cultural similarity in communication. Diversity or culture-influenced communication can be challenging. One approach is to learn the cultural communication norms of individuals that you communicate with and perhaps to modify your communication style or approach to address differences.
Additionally, make note of the tone, formality, and language used in their messages to you. Aim to use a similar formality. Similarly, you may find that certain responses to questions may be related to cultural norms associated with the messenger’s position or place in the organizational hierarchy.
Be alert to cues that the receiver may not have understood your message and rephrase it if necessary. Also, though remember that while it is true that verbal and nonverbal communication can appear to be culturally driven, there are variations among persons in all cultures.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

27. Humor Use humor with caution Can be useful to diffuse tense situations
Use humor about situations, not people
Self deprecating humor can be effective in some situations
Humor can be an effective way to diffuse a situation and can be extremely useful. One must take care in its use, however. You want to avoid offending anyone. Use humor about situations, not about people or groups of people. Also mild self-deprecating (pronounced DEPP-rih-kate-ing) expressions can be a useful tool in diffusing tense situations. For example, if you were trying to explain a process to some clinicians at a meeting and were getting blank stares indicating they were totally lost, a good response might be to say something like, “I’m sorry I think I am coming across as a total propeller-head, let me try a different approach.” Again, things can be taken out of context, so be careful. If in doubt, do not use humor.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

28. Key Elements of Effective Communication Summary
Verbal Communication
Non-verbal Communication
Communication Media
This concludes Key Elements of Effective Communication.
In summary, we reviewed the common elements of communication, the importance of verbal and non-verbal communication, and the use of personal communication devices in the work setting. We examined listening skills, we looked at how diversity affects communications, and we recommended that humor be used with caution in the workplace.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c

29. Key Elements of Effective Communication References – Lecture c
Barber G. Improving your listening skills. Man With No Blog [Internet] Jan 14. Available from:
Evenson R. Award-winning customer service: 101 ways to guarantee great performance. New York: Amacom; 2007.
Gressang J. Cultural diversity issues in healthcare [Internet]. Available from:
Melanson MS. Effective telephone communication skills. Help Desk Institute [Internet] Available from:
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford (CT): Appleton and Lange; 1998, p. 127.
Patterson RF. Basics.[Internet]. [updated 2010 Aug 11]. Available from:
“No Audio”
Health IT Workforce Curriculum Version 3.0/Spring 2012
Professionalism and Customer Service in Health Key Elements of Effective Communication Lecture c