Creating Confidence and Trust in the Access Experience
Access to care is a foundational element of quality medical care. Yet, hospitals and health systems today are experiencing challenges as demand overwhelms supply. With surging volume, the access experience requires particular attention to avoid overwhelming providers and patients.
On the PAC’s All-Access Podcast, Patient Access Collaborative Founder and Executive Director, Elizabeth Woodcock, welcomed three experience experts from health systems across the Unites States: Alan Dubovsky, Vice President and Chief Patient Experience Officer, Cedars-Sinai, Rick Evans, Senior Vice President, Patient Services and Chief Experience Officer, NewYork Presbyterian Hospital, and Alpa Vyas, Vice President, Chief Patient Experience & Operational Performance Officer, Stanford Health Care.
Together, the leaders examined increasingly relevant topics around access and patient experience in the healthcare system. The group identified how access is multifactorial, impacts patient satisfaction and improves business opportunities for growth. In addition, they examined avenues to effectively navigate the composite of elements critical for improving access and patient satisfaction. These include cultivating patient confidence and trust in the healthcare system; reimagining access as it relates to the “whole journey;” recognizing how access fits into the patient experience; using metrics to drive the patient experience forward; and assessing innovative technology to propel experience to new heights in the future.
Access leaders play a paramount role in supporting the patient’s experience. Dubovsky identified how poor access impacts the rest of the experience. He stated, “if the ease of your access experience is positive, then typically, the overall experience is 95% positive and, if negative, then…the experience as a whole takes a huge hit.”
Helping patients develop a sense of confidence with the health system and their care team creates ease over the all-too-common friction and anxiety patients often endure as they enter the system. Unfortunately, “confidence appears to be absent from the moment our patients even begin their access journey,” Woodcock relayed. Acknowledging that the patient’s multifaceted journey may naturally create friction, Evans suggests that we avoid striving for happiness. Within the access journey, encourages Evans, “…the patient experience should be understood as less about happiness and more about [whether] I am in good hands -- and do I have the confidence in the team around me?”
Reimagining access through the lens of the patient enables us to build confidence and provides a buffer against the friction. Patients want to feel the assurance to “take a deep breath in the unknown,” and to trust their care teams, describes Evans. This notion presents a more viable access model; a model that everyone will want to buy in to. Vyas described the need for “shifting our mental model from access being defined as a clinic or telemedicine visit, to beyond traditional measures, given technology and the advancements, to rethinking how we define access.”
Vyas discussed how Stanford Health Care links access and experience, relaying, “the notion of building trust is critical to improving access and experience.” She acknowledged the need for administrative arms of various teams in health systems to streamline the often-overlooked small acts, or tasks, to address experience challenges. These tasks pose barriers to a smoother patient experience and ultimately impact confidence and trust. They include following up on the back-and-forth messaging with contact centers and clinics, and closing the loop on the status of a referral. If left unfulfilled, these tasks can feed feelings of frustration, anxiety, and uncertainty, in an already challenging time for many patients. Vyas identified, “often times, we are adding burden to the experience of an already stressful time that the patients have to navigate.”
Dubrovsky discussed how the work at Cedars-Sinai is tied to access and experience: “conversations…are centered around the notion of ease and eliminating the burden for our patients as much as we can. It is not just about getting patients seen quicker; what we really must do is make life a lot easier for our patients and for our providers, with new technologies and platforms.”
Woodcock led the group to consider how access leaders and their teams measure success in attaining confidence, trust and ease, relevant for moving the access journey forward. Evans described how evaluating the metric for success around access and experience, “involves an ordinance of measures that include confidence and convenience, but also understanding the metric of the experience as a whole.” Evans suggested, “we want patients to feel they are getting what they want while they are interfacing with our front door, virtual or real.” The process includes measuring patient feedback around what they want and need, from faster call backs to fewer wait times and less appointment delays.
Looking at effective ways to improve access and further support the health of our communities, the experts concurred that turning up the treadmill and expecting more from patients and providers creates increasing apprehension about the system and adds burden. Stanford Health Care’s Vyas encouraged health care leaders to contemplate: how hard or how easy are we making access? Further, she highlighted the importance of acknowledging the level of effort we are expecting patients to exert to receive access. Vyas stated, “experience is tied to good outcomes, and if you cannot get access to care and the right care teams to receive the ultimate ROI [return on investment], which is the health and quality of our patients, then we are not meeting our overall mission.”
Exciting innovations are underway to expedite ease of access and steer the trajectory forward. Dubovsky highlighted a new mobile platform at Cedars-Sinai. The platform leverages artificial intelligence to “help to ease the burden on providers [with] a 24/7 sick, chronic, and routine care platform.” Dubovsky is “excited to see what it does for access.” Vyas discussed innovations at Stanford Health Care and how they are “traversing the system by using large language models, which hold vast amounts of hidden feedback, from patient portal messages and clinical advice that can be used to move work upstream, ensuring the right resources are addressing the gaps and coming up with predictive interventions to eliminate the noise in the access journey.”
Evans likened the approach to access to being in the “care delivery” or “care model business.” He stated, “you must deal with the whole journey of access from front to back.” He explained that NewYork Presbyterian Hospital recently developed a capacity index, which considers how capacity is measured and examined throughout the patient’s whole journey. Evans described how the access teams are using the capacity index: “It is foundational, but critical to obtaining a common platform to access, for addressing what capacity is and how it should be viewed and measured. By providing…a common definition around capacity, the team found they were able to create a foundation from which high-quality discussions arise about how to expand access for patients.”
In closing, Woodcock enthusiastically embraced the collective knowledge shared by Alan Dubovsky, Rick Evans, and Alpa Vyas, all extraordinary experience leaders, during the podcast, as well as the remarkable work they are leading to propel access forward at Cedars-Sinai, NewYork Presbyterian Hospital, and Stanford Health Care, respectively.
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