Improved access to care can help a healthcare organization remain competitive in a consumer-driven market.


Digital care coordination is essential to creating a patient experience that fosters patient loyalty. The goal for healthcare providers should be to leverage advances in technology and interoperability to make it easier for patients to find physicians, access schedules, book appointments, and ultimately maintain their health. 

Improving the Patient Experience

To be competitive in a consumer-driven market, healthcare organizations should focus on improving the patient experience in the following key areas to.

Scheduling. Knowing that the patient experience starts well before a visit, providers should first look to improve the process of accessing care. One easy step toward this goal is offering patients the option to schedule their own appointments on the organization’s website. Online self-scheduling is the most convenient way for patients to both find a physician or specialist and get in the door for care, all on their own terms. 

Consider this scenario: A mother is awakened in the middle of the night by her fussy infant, who has a fever and bad cough. Using a traditional scheduling model, she would have to wait until the next morning after the pediatrician’s office has opened to call and schedule an appointment. Once on the phone, she would likely spend a few minutes going back and forth with the provider representative on availability before finally securing an appointment. 

This process is not only frustrating for the mother of a sick infant, but even those few minutes on the phone can delay care for others in the same situation. The more individuals that call to schedule an appointment, the greater the operational strain on a practice, and the longer it takes for appointments to be scheduled and for patients to be seen. 

With online self-scheduling, that same mother can go to the pediatrician’s website at the very time she was awakened, view the pediatrician’s appointment availability for the next day, and click to book an appointment, all on her mobile device. 

A large, multispecialty, physician-owned clinic in the Midwest has seen success with this method of scheduling. Since implementing online self-scheduling, the clinic has observed higher rates of patient satisfaction and engagement and an increase in patient acquisition and retention. 

Today, at least 15 percent of the clinic’s appointment bookings occur online. Call center volume has dropped 30 percent, which means more patients are being connected to the right physician, and faster. Patients scheduling appointments online are also showing up for their appointments, with a show-rate specific to online scheduling at 97 percent. Patient acquisition also has improved, with providers averaging eight new patients per month from online scheduling alone.

To ensure online self-scheduling is effective, providers must ensure their calendar is visible via a number of channels: a patient portal, the organization’s website, the in-office schedule, at the call center, and even on third-party sites. This 360-degree view of appointment availability increases the chances that those vacant slots will be filled. 

Care referrals. Another pain point in the patient experience is the process of being referred to another physician or specialist. For such a commonality, this practice couldn’t be any less consumer-friendly. Only one-third of patients who seek referrals receive them, and of those who do, only 20 to 40 percent follow through with a visit to the referred specialist.a 

Upon discharge, providers often hand patients a packet of care instructions with detailed follow-up information, including whom to contact, which specialist to see, and when to be seen, for example.  Unfortunately, patients are rarely empowered to make these connections on their own, and even if they do, that referral provider or specialist’s schedule may not accommodate a patient’s need to be seen for several weeks. In such a scenario, the risk of an adverse care event or even readmission increases. 

This process can prompt patients to look elsewhere for their care, outside of the health system’s own network of providers and specialists. Many organizations don’t realize the amount of money that is lost from patients seeking care from a different provider—usually a competing organization. It’s an even bigger hit to an organization’s bottom line when patients go elsewhere for higher-value visits, not just routine follow-ups and exams. 

With more sophisticated referral coordination, hospitals and health systems can transform the discharge process and ensure that patients are scheduled for their follow-up appointments, with the right provider, before they even leave the four walls of an organization. A streamlined referral process not only lifts an incredible weight and responsibility off patients’ shoulders, but also greatly reduces the chance for network leakage. 

When a large for-profit health system in the southeast began scheduling follow-up appointments before patients left their facilities, case managers confirmed booked appointments upon discharge and reduced the loss of patient by 25 percent. 

For additional perspective, this organization has calculated that a single care visit is valued between $100 and $300, and a single patient per year is valued anywhere between $1,000 and $1,500. Over time, and with that value, the adverse effect of losing patients to out-of-network referrals or not acquiring new patients will add up. Keeping those patients in-network has helped providers to average nine new patients per month, allowing the organization to generate tens of millions of dollars each year. 

Decision support. Regardless of their size or specialty, providers already have scheduling rules that determine what patients they should see, and when. What they often don’t have is a way to automate the scheduler’s interview process before enabling patients to book online or be referred, while also maintaining full autonomy over their calendars. 

Take, for example, a 45-year-old male wanting to schedule an appointment with an orthopedic specialist for pain in his right knee. If he is scheduling the appointment on his own online, he needs a way to ensure that he is choosing the most appropriate specialist for his condition. If “orthopedic specialist” is the only search criteria, he could be matched with a physician that specializes in shoulder injuries, or even a physician that specializes in pediatric orthopedics.

Although referrals made over the phone may be better able avoid such physician mix-ups, they still aren’t without complications. Call center agents often are equipped with a book or spreadsheet of scheduling rules, but these documents often are not user-friendly and take several minutes to search. This cumbersome process erodes the patient experience and contributes to staff dissatisfaction as well. 

Call center agents also are relying on their own institutional knowledge for referrals. While there may be five or ten specialists available to see a patient, they may only be familiar with one or two and consequently only refer into those individuals. This creates a large bottleneck for scheduling, contributing to long wait times and poor capacity and utilization of specialists. 

When scheduling protocols are digitized, providers don’t have to worry that a patient may book the wrong appointment or that staff may forget a specific scheduling scenario. Automating decision-making criteria ensures best practices are maintained, regardless if the appointment is booked online or in person, and helps the patient connect with the right provider in the least amount of time.

The Role of Analytics

Digital care coordination can be made even more effective with analytics, which provide an organization with information it requires to understand what is and isn’t working for any given patient. With analytics, healthcare organizations can actively track patient conversions and see how many visits turn into booked appointments. They can see precisely when patients drop off during the process and tie together data sets with information such as lead times or wait times, and if and where bottlenecks exist.

Simple things like adjusting what questions are asked during the scheduling process or changing what appointment inventory providers make available can dramatically improve the conversion rate. 

Data from a digital care coordination platform also can show how well an organization’s physicians are being utilized while presenting booking patterns for further optimization. 

A Consumer-Centric Organization

When considering ways to make a hospital or health system more consumer-centric, leaders should focus first on the factors that influence access to care, because these factors are truly the crux of patient acquisition and retention. Simply put, ensuring that the patient experience is positive begins with reimagining patient access.


Jason Kressel is COO, MyHealthDirect, Nashville, Tenn.

Footnotes

a. Mehrotra, A., Forrest, C.B., and Lin, C.Y., “Dropping the Baton: Specialty Referrals in the United States,” The Milbank Quarterly, March 2011; Reinberg, S., “Many Patients Don’t Pursue Referrals,” abcnews.go.com, Aug. 3, 2018.

Publication Date: Thursday, February 21, 2019