3 Signs Your Health System Has A Patient Access Problem — And How To Fix It

By Scott Andrews, senior vice president of delivery, Kyruus

We are fast approaching spring break, which in the Northeast is a huge milestone as it is an early sign that warmer weather is on its way. To get a reprieve from winter many of us flock to the beaches of Florida or the Caribbean, but imagine if you went to Kayak or Expedia (or worse yet, had to call a travel agent) only to find the next available flight is 24 days away. Luckily, we know this is not the experience we will encounter when looking for fun in the sun. Unfortunately, the same cannot be said in healthcare.

Patient Access: We Have A Problem

Health systems nationwide struggle to align patient demand with network supply, resulting in patient access challenges that hinder clinical, operational, and financial performance. Three key signs of an access problem include:

Long appointment wait times: According to a 2017 study, wait times for new patient appointments have increased 30 percent since 2014 to 24 days on average. If you hale from Boston, that number jumps to 52 days. Closing this gap is not only important for clinical outcomes but also for capturing demand. In fact, a 2017 survey of 1,000 consumers found that 40 percent have booked an appointment with a different provider to be seen sooner.

Low conversion rates: While most people wouldn’t dream of booking an airline ticket via an agent nowadays, in healthcare, this remains the primary method, in part because online experiences don’t meet expectations. However, this is slowly changing; Accenture predicts that 64 percent of patients will use digital self-scheduling by next year. As health systems expand access options, they must pay close attention to conversion rates by channel to detect where the patient experience may be falling short.

High referral leakage: A contributing factor to the above is that in 2017 there were over two mergers of healthcare organizations per week on average and it’s difficult for these entities and their providers to have “systemness” when they’re constantly changing. Oftentimes, referrals go out of network - frequently to classmates from years earlier with little regard for current clinical focus – because it’s too difficult to figure out who is in-network. A high leakage rate could indicate poor visibility into the network or gaps in the network itself – both of which hinder access.

It’s All About The Data

To solve this problem, health systems first need to understand the data locked away inside their revenue cycle, EHR, and credentialing systems. Who are their providers? What are their clinical focus areas? Where are they located? When are they available? These questions will decipher the solution, but the answers aren’t always readily available. To build a unified provider directory, health systems must not only consolidate existing sources, but also engage providers effectively. Ultimately, capturing and analyzing provider data will show if providers are over or underutilized – or misutilized (e.g., if they’re seeing appointments more appropriate for a physician extender).

Armed with this insight, health systems can configure provider profiles and scheduling processes to optimize their networks and the appointment inventory within it. Once curated, they must disseminate this information to all points of access (e.g., Web, Call Center, Provider Referrals).

After analyzing their providers (supply), health systems must turn their attention to analyzing patients (demand). Where are wait times longest? Who’s visiting the website? Is the find-a-provider modern? Are profiles optimized for SEO? Is online scheduling available? Are agents empowered to book appointments? Can providers understand their colleagues’ clinical expertise?

Paving The Way For A Better Patient Experience

Long waits, low conversion, and high leakage are key indicators of a patient access problem. By unleashing the data in their operating systems, health systems can better understand supply and demand and, armed with this information, develop strategies to lower the amount of time it takes to access care and deliver an experience in line with 21st century expectations.