Elizabeth Woodcock, speaker, author, and trainer, presented the SR Health webinar “Seven Strategies to Improve Patient Access” June 2. Click the link to watch a recording of the webinar in its entirety.
In discussing the current state of healthcare, she said as ambulatory enterprises have become more important to delivering value-based care, the topic of patient access has become a critical topic. Healthcare providers must make patient access a priority in order to shore up network containment for the health system.
However, there are many challenges to accomplishing this goal, Woodcock said. Among them are the many expenses a provider incurs just to manage scheduling activities. For example:
- $4.26 is the cost (personnel only) to handle a call.
- Only 40 percent of patients call to make an appointment.
- 25 percent of appointment calls are from new patients.
- 80 percent of new patients book an appointment (Why didn’t the other 20 percent?)
- Only 63.3 percent of new patients actually arrive for their scheduled appointments.
“Each one of these data points offers an opportunity,” Woodcock said. “Each one of these is really a treasure chest of information once you begin to access your own patient journey.”
Other challenges include the fact that scheduling templates are often so complex that schedulers don’t know how to use them and slots simply go unfilled. Not only do we have a crisis in access but we also have crisis in supply, she said. Add to that the increasingly more competitive market with non-traditional, large, and well-financed companies throwing their hat into the provider ring, and as Woodcock says, “the odds are really not in our favor.”
“While we scratch our heads and tell our patients, ‘Just call this number’ these companies are eating our lunch,” Woodcock said. “These companies are creating a landscape (due to regulatory relaxations) where, if we wait much longer to address patient access, we may not have the luxury to be able to do so.”
Thus, the call to action is urgent and real. From an internal perspective, we must realize that our greatest asset is our providers’ time. It is a quantity that we can’t get back once it’s expired. Providers can gain a positive return on investment by taking at least three of this webinar’s strategies and tactics and applying them to their organization, Woodcock said.
Determine What Access Is (And What It Is Not)
Patient access involves developing a culture of access. If we consider our call center to be patient access, we’re not going to be successful, Woodcock said. Just as data exchange technology revolutionized patient data 10 years ago, we need to apply the same lens to where we’re making sure we optimize every minute of our providers’ time. This is divided up into strategic priorities—culture, physician/APP (supply) workforce planning, and our compensation model, and tactical priorities—communication management, experience, scheduling optimization, referral management, and practice operations.
“What are we doing in terms of texting patients? …,” Woodcock said. “Thinking about not only of the patient experience as a face-to-face but our patients’ digital experience. We have to get better at the patient experience by truly understanding what access is in our patients’ eyes.”
Access is about meeting our patients’ needs, she said. It should be about getting real-time feedback such as, “Were you satisfied with the appointment we gave you?” Real-time surveys and things like net promoter scores (NPS) typically used in industries outside of healthcare help us know if we’re meeting our patients’ expectations and creating a loyal patient.
“Net promoter scores help us understand not what we think access is, but what our patients do,” Woodcock said.
Manage the Balance of Supply and Demand
This entails not only managing and balancing our own time but also thinking about time from our patients’ perspective. Woodcock relates it to the ultimate game of Tetris, where instead of worrying only about a provider’s time, we know also have to include patients’ time in what is a very complex formula.
“It’s only been in about the last 10 years that we’ve thought about those Tetris blocks from the patient’s perspective,” Woodcock said. “It’s complex, it can’t be easily solved, and it’s even going to depend on the day of the week.”
For example, during Monday appointments, instead during checkout of automatically scheduling follow-up care for a month later on a Monday (typically the busiest day of the week), consider scheduling follow-up visits on Thursdays or Fridays, she said.
Work the Runway
Much like airline seats, even though we think out schedules are full, empty seats/slots often appear in the days leading up to an appointment. One of our greatest assets is also our physicians’ time, our advance practice providers’ time, etc. We have to create a system to fill those last-minute vacancies whether they’re caused by late cancellations, no-shows, etc.
“We’ve got to work the runway,” Woodcock said. “If I’m a primary care practice, my runway may be the day of. If I’m a pediatric neurotology specialist, my runway may be 14 days out.”
Determine what your runway is and then begin diving deeper. Identify what the root causes of the empty slots are. Find out if your team that’s performing the scheduling can even see the empty slots. Create a way to automate a flip to pull a patient into an empty slot from a waiting list, for example.
Delve Deep into Realized Utilization
From either a slot basis or a time basis, providers can analyze how many slots were actually filled (numerator) with appointments based on the total number of available slots (denominator). Begin by figuring out how many slot availabilities or total minutes per day your provider has. Variables of utilization include:
- Patient communication (speed)
- Scheduling abilities (visibility)
- Scheduling practices (construction)
Determine what those variables of utilization are, how to control them, and consider ways to get your realized utilization up to the ultimate goal of 100 percent for every available time slot or every available minute, Woodcock said.
Focus on Patient Communication
Expand your patient communication offerings from just phone calls to include texting, patient portal messaging, etc. And instead of asking how do we engage more people or why aren’t people engaging more with us, flip it on its head and put the culpability right back on yourself, Woodcock said.
“How can we build a better system that meets your needs—one in which you want to engage,” she said. “This, in my opinion, is really the heart of patient access.”
Instead of erecting call centers, we need to step back and ask ourselves—and our patients—this question.
Create a “Smart” Schedule
We often talk about productivity but do we consider the adage, “You can only be as productive as your schedule allows.” Providers need to ask themselves what their scheduling goals are. For example, if you’re scheduling 15-minute visits for existing patients and 40-minute visits for new patients, you’re actually wasting 5 minutes of every hour, of every day, which is incredibly meaningful, Woodcock says.
Also consider it in terms of using advanced practice providers in new and unique ways, freezing and thawing slots, making waitlists an important part of your arsenal, and becoming more attuned to what your schedule distribution is to make it as productive as possible.
(Get) Obsessive Culture Disorder
This includes things like:
- Hire—Hire for fit, retain for contribution. “Hire the best team who are truly obsessed about patient access, patient accommodation, and patient experience. They’re the front door of your practice,” Woodcock said.
- Compare—Compare constantly. Compare yourself and think about benchmarks. Ask patients if you are accommodating them. Use net promoter scores; instead of waiting on patient satisfaction survey results to come in in months or quarter, you want to compare yourself now.
- Fail—Fail because you’re taking risks. It’s OK to fail. Identify three tactics that you’re going to try. One won’t work and that’s OK.
- Engage—Engage through trust and transparency.
- Relish—Relish change. Instead of thinking of change in a negative light, actual view in very positively.
“One strategy or tactic won’t work. One might work but won’t be sustainable. But one will be really revolutionary and that’s going to get you started on that journey to not only think, analyze, and plan, but to try and do, and then do again,” Woodcock said.
For more on about how to create better patient access and to improve engagement through a text-first approach that supports a more refined appointment workflow, check out the guide, “The Perfect Appointment Workflow: A Path to Improved Patient Outcomes and Increased Revenue.”