How to personalize the access experience in ambulatory care for increased patient volume and consumer retention

Increasingly, consumers are seeking digital channels to gather information and access care. To meet consumer expectations, a cohesive, digital experience for self-service and pre-service is essential. This digital “front door” defines the approach to digital access and ongoing engagement through three key domains that must be streamlined and integrated: web search, owned websites and portals, and payor/employer portals. In doing so, you ensure that your other important front door (phone access) isn’t overwhelmed — thus providing you with a cost-efficient means of expanding access and improving the consumer experience for all. Avoid piecemealing your approach to a digital front door; create a comprehensive strategy and roadmap that focuses your efforts.

Access is no longer about waiting for consumers to find you. And providers today face an added challenge of increased patient non-consumption, for both routine care and more pressing care needs. By proactively reaching out to consumers on relevant healthcare items, you can further engage and activate them beyond episodic care, ultimately building more sustainable relationships. Using the consumer’s preferred communication method, health systems can target each individual consumer with relevant content. This can be a powerful tool in connecting consumers with information on post-visit services, health maintenance, transition support, general nurture campaigns, and navigation to the optimal care site. Turn access on its head by creating a proactive, personalized outreach capability through which your consumers feel seen and can engage with relevant healthcare services.

Even as more self-service options come online, phone access will remain an important means of consumer interaction with your health system. However, the historic way of managing calls simply cannot continue. Consumers will no longer tolerate poor customer service, long hold times, and inconvenient hours. And you should not tolerate the high cost of providing poor service. Today’s service centers are built to enhance the consumer experience and lend support across more services — from scheduling and registration to health maintenance and medication management — all while reducing associated costs. Deploy the three key levers of standardization, centralization, and tech-enablement to create an unparalleled consumer call experience.

The referring provider (both within and outside of your health system) and the patient being referred are important consumers. Referring providers value a streamlined referral experience to connect their patients to the care needed. Doing this well can be a differentiator in the market. This requires some level of centralization of referral and prior authorization processing to make it easy for referring providers to know where to turn to secure access for a patient in your system. A centralized service can significantly improve the efficiency and turnaround time for obtaining payor approvals, and quickly and accurately update providers when a referral has been received and authorized. A well-run program improves the patient and referring provider experience, improves time to care, and generates a positive financial impact for the health system. Create a frictionless referral process for your consumers with a single point of entry — via web, fax, or phone — and redesigned workflows to ensure timely turnaround on every referral.

Few organizations have a reliable way to predict demand or even understand the number of appointments being requested. With expanded care options, this capability will become more complex — and more importantly, consumer demand should inform how you deploy capacity. To begin understanding actual and potential demand, you need to measure the number of appointments requested in each care option, the number of in-network referrals captured and lost, and the number of proactive outreach activities identified to push campaigns underway.

Advanced capacity management requires being able to quantify your “supply” as well as your demand. This means moving beyond productivity to set specific expectations for “contact hours” at the provider level and establishing real-time measurement systems to monitor actual patient-contact time. You must then deploy contact hours across care options, including in-person visits, currently the most common type of interaction; capital light delivery models, such as e-consults, which are critical for supporting primary care while reserving specialist time for patients with the greatest needs; and virtual visits, which expanded exponentially during the pandemic and have leveled off at a significant percentage of total visits.³ Ongoing monitoring is required to adjust deployment based on consumer demand. Don’t leave this to chance — employ a thoughtful and repeatable methodology to reconfigure capacity to meet consumer needs and preferences, thus ensuring that each service line or specialty can offer the right complement of care options.

After years of hiring and expanding their APP workforce, many healthcare organizations have not yet determined how to appropriately deploy these roles to maximum impact. Strategic deployment of APPs allows you to match skill sets more effectively with clinical requirements and experiential demands of patients. Commit to maximizing the power of APP roles by creating a highly specialized care model that improves access, enhances patient experience, reduces cost, and improves quality, while differentiating you from your competitors.

Provider time expectations and deployment across care options are realized through an effective scheduling template. To do so consistently, you need a reliable approach to scheduling template design and execution. Complying with template design standards (e.g., reserving time for new patients, setting new-to-return patient ratios, and restricting use of blocks) can help you manage provider capacity to higher levels of utilization. Centralize template management to ensure that you are applying expertise to enhance every template and that you have insight into your true capacity at all times.

An often talked about but rarely pursued access lever for specialty services is returning management of patients with chronic conditions to their primary care providers, when appropriate. Studies suggest that one in six specialty patients could potentially be repatriated, which could mean an additional 16 percent capacity available for new and other established patients.[4] Requirements include sufficient primary care capacity with a care team trained to manage chronic conditions, co-development of clinical protocols, greater clarity around the purpose and duration of the initial referral, and active review of less intense follow-up patients to determine whether they can be safely returned to their primary care provider. Engage physician leaders to develop a standard process to return the management of patients with chronic conditions to their primary care providers, where appropriate, to untap critical specialty capacity.