Transforming Patient Access: Lessons and Innovations

By Elizabeth W. Woodcock, DrPH, MBA, FACMPE, CPC

Founder & Executive Director, Patient Access Collaborative

Patient access is a cornerstone of healthcare delivery, and addressing it effectively is critical to ensuring equitable and timely care. At the Patient Access Collaborative, a peer-learning community of leaders from 125 of the largest U.S. health systems, we’ve led remarkable efforts to tackle access challenges head-on. These innovations range from the most advanced infrastructure development to simple, yet impactful interventions for the benefit of patients nationwide.

Exemplars in Patient Access Innovation

PAC-member health systems are pioneering solutions to enhance patient access. Here are a few standout examples:

• Texas Children’s Hospital established a virtual care support center, enabling clinicians to deliver seamless telemedicine care to families.
• Duke Health launched "Duke Today," which guarantees patients same-day or next-day appointments, even in hard-to-access specialties like neurology.
• Geisinger is proactively closing care gaps by scheduling preventive services for patients who call about unrelated appointments.
• Memorial Sloan Kettering Cancer Center developed a cutting-edge lymphoma clinic led by advanced practice providers to expedite care.

These intricate interventions – spearheaded by the skilled leaders of these health systems - have already had far-reaching effects on patient access. However, that’s not the only form of innovation going on at the Collaborative. Our member organizations are also creating extensive impact with deceptively simple interventions; for instance:

• UCSF Health sends text-based appointment reminders during the first two weeks of the month, accounting for vulnerable patients who may lack cell phone minutes later in their billing cycle.
• Children’s of Mississippi has synchronized appointment reminders with transportation scheduling for Medicaid patients, resolving a mismatch which historically contributed to high appointment non-attendance rates.

Whether through major infrastructure investments or thoughtful, small-scale changes, these innovative health systems demonstrate that scalable, sustainable solutions are achievable when patient needs are prioritized.

Key Drivers of Change in U.S. Healthcare

The COVID-19 pandemic was an inflection point for access. Scheduling contact centers – now referred to as “access centers” -- became indispensable for COVID testing and vaccinations, propelling patient access into the heart of the health system. As the effects of the pandemic have stabilized, however, two major challenges have emerged:

1. Evolved Patient Expectations: Patients need frictionless and convenient ways to engage with healthcare systems. They now view these interactions as a fundamental expectation - rather than a luxury.
2. Systemic Imbalances: Financial instability, clinician burnout, and mismatched supply and demand have exacerbated access issues. For instance, as clinician time becomes more constrained, barriers to access continue to grow—disproportionately affecting vulnerable patients who face hurdles like faxing medical records or navigating fragmented scheduling processes.

We find ourselves caught in a vicious cycle: delayed appointments drive up non-attendance, which, in turn, worsens the access bottlenecks. Breaking this positive feedback loop requires a concerted effort to streamline our systems, reduce friction, and put the patient at the center of every decision.

Streamlining Clinical Pathways Without Compromising Quality

Improving access requires rethinking clinical workflows with a focus on psychological safety and high-quality data. One key metric is new patient appointment lag, which should be reported from the patient’s perspective—from the moment they are informed they need a specialist, diagnostic study, etc., to the day that appointment is scheduled.

By honoring the patient’s journey and embracing data transparency, health systems can firstly identify these friction points, then address them with meaningful changes. Conscious change management is fundamental to this process, because successfully embedding access improvements into operations requires leadership, collaboration, and ongoing education.

Leveraging Digital Tools for Flexible Patient Access

Digital transformation is vital in the changing world of patient access. Successful systems begin by defining the specific problem they aim to solve, then leverage the appropriate technology to address it. Among the tools gaining the most traction are:

• Conversational AI for triaging patient calls and streamlining access centers.
• Callback assist, chat, and dialers to improve communication efficiency.
• Bidirectional texting, self-scheduling platforms, and automated waitlists to simplify the scheduling process.
• AI-powered tools to support clinicians with documentation, prescription refill management, and patient messaging.

By integrating cutting-edge technologies into their workflows, health systems can create a more responsive, patient-centric experience. Embracing innovation not only improves efficiency but also ensures that every patient has access to a seamless journey to the care they need.

What’s Possible for Patient Access?

Health systems can redefine patient access, but it requires us to reframe our challenges from the perspective of the patient. Whether by borrowing from evidence-based approaches in patient safety and quality, creating a shared language around access across disciplines, or fostering a culture of humility and patient-centered problem-solving, our leaders can transform our health systems into beacons of patient access going forward.