How voice exchange eliminated after-hours chaos and achieved full adoption in one week
"Keona gave us what we've been looking for: a system that actually understands how triage nurses work. Our team was fully trained and confident in one week."
- Voice ExchangeVoice Exchange Contact Center
Founded to provide 24/7 clinical support for healthcare organizations, Voice Exchange has built its reputation on delivering consistent, high-quality nurse triage around the clock.
Voice Exchange faced a challenge familiar to many 24/7 triage operations: managing the chaos of after-hours coverage while maintaining clinical consistency across all shifts. Night and weekend nurses were drowning in fragmented workflows, physician protocols scattered across multiple systems, and decision trees that varied by practice and specialty.
The after-hours burden was real. Nurses spent precious minutes hunting for the right protocol, second-guessing triage decisions without clear guidance, and manually documenting every step. Patient care suffered from inconsistency. Staff satisfaction plummeted during off-hours shifts. And the risk of clinical variability kept leadership up at night: ironically, the same hours their nurses needed the most support.
Requirements for a new platform centered on operational relief: standardized clinical workflows that operate the same at 3 PM and 3 AM, guided triage protocols that reduce cognitive load during high-stress calls, seamless integration with existing systems to eliminate double documentation, and rapid implementation that wouldn't disrupt 24/7 operations.
Voice Exchange needed a partner who understood that nurse triage isn't just about answering phones, it's about empowering clinical decision-making under pressure, especially when physician backup isn't immediately available.
The implementation was remarkably swift. Within one week, Voice Exchange achieved full adoption across all shifts. The key was Keona CareDesk's intuitive design that mirrors how triage nurses actually think and work, not how software vendors think they should work.
Fast forward to today, and the transformation is measurable. After-hours nurses report significantly reduced stress thanks to guided workflows that provide clinical confidence on every call. Triage consistency has improved across all time periods. Quality of life for night and weekend staff has tangibly improved; they're no longer fighting the system while trying to care for patients.
Most importantly, Voice Exchange now delivers the same high-quality clinical care at 2 AM that they deliver at 2 PM, with documentation and protocols standardized across every shift.
Key Outcomes
Rapid adoption with minimal training
Staff became fully comfortable with the platform in less than a week after only a couple hours of training, with support response times under 12 hours (typically within hours).
Extended specialty coverage without additional hiring
After ~1 year of implementation, nurses from different specialties (oncology, NICU, pediatrics) can confidently triage patients across all age groups (newborns to geriatrics) using built-in protocols.
Provider work-life balance restored
Physicians regained family time by eliminating after-hours interruptions for non-urgent cases, with Voice Exchange's 23 years of healthcare operations experience now enhanced by structured 24/7 triage workflows
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Critical patient interventions identified
System enabled early detection of patients needing social services intervention (e.g., elderly patient with suspected dementia identified through call pattern analysis and repeat call tracking)
Operational visibility for clients
Clients gained real-time insights into service gaps and process breakdowns at their practice level that were previously invisible, with call acuity scoring helping prioritize urgent vs. non-urgent cases for better resource allocation.
Posted By
Stephen Dean is COO of Keona Health, where he’s spent 13 years building AI systems that transform patient access. Before “agentic AI” was a term, his team was deploying autonomous systems that now handle millions of patient conversations annually.
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