7 Best Practices for Patient Access: Lessons from High-Performing Health Systems

Twenty-five percent of the ambulatory encounters in the United States walk through the doors of one of our member health systems.  The Patient Access Collaborative has determined seven leading best practices for successful outcomes for patient access in the ambulatory enterprise:

1. Unleash stellar leadership. The majority of our health system members manage the access infrastructure within operations. However, the best practice is not the line of management control, but rather the person(s) at the helm. The leaders of our high-performing health systems have a remarkable blend of qualitative and quantitative talents. They are creative, hard-working relationship builders with top-notch analytical skills. Change management is a must: access leaders inspire; they innovate.

2. Add a clinical leader. Success depends on engaging with a clinician leader who is focused on supporting ambulatory access. Indeed, our preliminary research demonstrates that staffing the role of access medical director has nearly doubled in the past year for PAC member health systems. Many of our health systems have an administrator/clinician dyad. This partnership allows crucial conversations to be held – and productive.

3. Shift the focus. Patient access in the ambulatory enterprise began with a sole focus on the call center. Fast forward a decade – access leaders from high-performing health systems recognize that answering the phone is actually the easiest task in access. Finding the appointment slot, now that’s the real challenge. The post-pandemic imbalance of supply and demand has placed even more pressure on the sophisticated approach that access requires. Capacity and demand management are key priorities for our high-performing health system.

4. Value transparency. Access in the ambulatory enterprise has always been a problem, but it has remained largely unrecognized for many years. Our patient satisfaction surveys suffer from a significant bias: we only ask for feedback from persons who obtain access. A key strategy is to illuminate the access problem to internal stakeholders:  days to obtain an appointment; queues of patients waiting for appointments; template fill rates; and conversions of referrals. These metrics are just a handful of the dozens that our high-performing health systems measure – and report.   

5. Acknowledge the negative loop. Access challenges can lead to massive opportunities, and our high performing health systems recognize the components of the vicious cycle. As the length of time to gain an appointment grows, more barriers are erected to “save” the current supply of appointments; new business entrants take advantage, spurred by the bolus of private equity available to entrepreneurs; non-arrivals increase; and churn is fostered. This negative chain of events disproportionately affects those patients who most need our assistance, resulting in an unprecedented level of inequity. Further, our high-performing systems have identified access as a core patient safety liability.  Recognizing the negative loop – and working to overcome each element of it – is a key strategy for high performers.

6. Eliminate the friction. Health systems throughout the US have leaned into their digital front door; high performers recognize the underlying opportunity of these efforts. It’s not about automation, but rather propelling the experience of the user. If one can offer a referring provider an easy method to send a patient for a specialty consult – or a patient a simple tool to schedule an appointment – that’s the goal of the digital revolution, to reduce the friction inherent in access.

7. Resource the infrastructure. The current financial state of health systems has put pressure on patient access, which is often seen as a cost center. However, high performing health systems continue to resource their access infrastructure as an investment in the future. Why? The ambulatory enterprise is the entry point to the patient’s journey to care. Value-based care requires access to preventive, outpatient care. Health systems simply cannot manage risk without leveraging the network of ambulatory practices.

Creating a scalable, sustainable access solution is challenging, but necessary. The high-performing health systems of the Patient Access Collaborative are trailblazers, and we are grateful to learn these seven best practices for access success from them.