Reimagining Patient Access for Comprehensive Care

The patient experience is a cornerstone of healthcare, impacting individual outcomes and the effectiveness of healthcare providers. Positive experiences encourage confidence, improve treatment adherence, and ultimately, better health outcomes. Organizations that prioritize the patient experience drive elevated satisfaction levels. These outcomes translate into improved reputation, trust, patient loyalty and ultimately organizational effectiveness.

Healthcare providers deploying a patient-centered approach focus on personalization of care, empathetic communication and streamlined processes. These methods lead to patients that feel valued, understood and supported through their health journey. The lasting impact leads to trust, loyalty and long-term relationships between patients and healthcare institutions

At the heart of a patient-centered approach lies the patient access organization. This group is often the first point of contact for individuals seeking care. Patient access plays an important role in enhancing the patient experience, covering all initial interactions from scheduling appointments to intake processes. 

The initial impression sets the tone for the entire healthcare journey. A smooth, compassionate and efficient intake process can alleviate apprehensions and pave the way for a more trusting relationship. 

Creating a patient-centered strategy that succeeds requires integrating key elements from the People, Process and Technology (PPT) framework. Forward-thinking healthcare institutions understand that their employees and patients form the core of this framework. When these components interact effectively, organizations benefit from improved performance. However, any imbalance and these pillars can result in a fragmented patient experience, that both employees and patients readily notice.

The patient access organization provides the critical linkage connecting healthcare providers and patients. It coordinates essential processes such as appointment scheduling, addressing inquiries and providing patient education. Various communication methods are employed to streamline these interactions. While the traditional voice channel remains prevalent, Chat has gained popularity among patients in recent years. The Mobile or Web channel is rapidly becoming the preferred channel, allowing patients to schedule appointments and communicate with their care team.

In recent years, one key challenge in patient access has revolved around the debate on the ideal location for a clinic's patient access functions. The conventional practice involves having all patient access resources housed within the individual clinic, under the clinic's leadership. However, some organizations are opting for a decentralized model, where certain aspects of patient access are managed within the clinic while others are handled centrally. 

The highs and lows of in-clinic patient access

In the clinic-specific model, the majority of the patient access staff is directly managed and led by the specific clinic leadership. Most of the members of this team are responsible for handling a variety of activities including patient check-ins, reminder calls, administrative tasks and possibly even performing some sort of clinical support. 

In this model, when patients need to book or discuss appointments, calls are directed straight to the relevant location. If you've ever felt frustrated while standing in line at a clinic waiting to be checked in or ask a question and you see a front desk agent actively engaged in a conversation. When this occurs, there is a high probability the check-in agent is on the phone it's likely because of this operational approach.

The approach's benefits lie in personalized service and local expertise. Patients receive support from agents well-versed in the clinic's operations and staff. These agents can build relationships with patients, leading to more personal interactions. Agents will be able to utilize their personal knowledge of the patient's history and needs to help beyond basic questions. Additionally, as representatives take on diverse roles, they can provide extensive support.

One of the main limitations of this method is that agents have many responsibilities, and even in the best-run clinics addressing patient inquiries can become a lower priority. This can lead to poor response times and an inability to meet expected service levels. The quality of patient communication may suffer if representatives become overwhelmed or distracted by their various duties. Scaling this model can present challenges as each clinic requires its own team of skilled agents. This can result in increased training costs and inconsistent levels of service. 

This method can be successful if call volume aligns with forecasts and staffing levels are well-known and predictable. Even if you are able to accurately predict your estimated call volume, clinics will assume more risk with this approach. For instance, if one of the four staff members responsible for this function is absent due to an unforeseen event, it will have a significant impact. Few contact center organizations are equipped to handle a 25% reduction in staff.

Go central, stay personal

Many organizations are transitioning to a centralized model to boost communication, service quality, efficiency and scalability. A vital aspect of successful execution lies in preserving the patient experience by prioritizing personalization and localization. In this strategy, agents are designated as 'Primary' for specific clinics or groups, fostering an understanding of each clinic's unique needs, protocols and procedures. In cases where clinic-specific agents are unavailable, interactions will follow a predefined overflow process until the call is answered.

Successfully implementing the centralized model depends on a few crucial success factors. First, ensure your agents receive comprehensive training, equipping them with in-depth knowledge of each clinic's operations and services. It is essential to have quick access to information about clinics, providers and procedures through a centrally managed knowledge management application. Next, organizations that effectively adopt this approach rely on their EHR application to drive standardization of common scheduling attributes, such as visit types and durations. Unwritten scheduling rules for specific providers or clinics complicate matters, leading to decreased overall efficiency and a subpar patient experience.

Crucial to effective call management is the use of advanced call routing technology, which intelligently distributes calls based on agent availability and expertise. This feature is known by various names like advanced skills routing, precision queuing or bullseye routing. They all share the common goal of directing interactions to the most suitable agent for addressing specific requests, rather than solely focusing on agent availability. 

When setting up a centralized clinic, the main goal is to assign a qualified representative to handle calls at the Main Street Clinic. With multiple agents available the decision-making process might involve routing the call to the most proficient agent. If no agents are available, calls will be added to the queue. If a call remains in the queue for more than 60 seconds, the pool of agents will be expanded. In our example, we will expand to any agent that has the capability to handle primary care interactions.  This cycle repeats, expanding the agent pool until all overflow options are exhausted. 

Navigating the future of healthcare 

WWT is uniquely positioned to support your organization in developing and implementing a patient access solution that meets your patient's expectations. Leveraging our vast experience in collaborating with leading healthcare providers and our technological proficiency, we can design and deploy a personalized patient access process tailored to your specific needs.

Our team of specialists will collaborate closely with you to grasp your organization's individual challenges and objectives, crafting a solution that enhances patient access and streamlines operations. With expertise in contact center advisory services, our team can support your patient access organization across all essential functions. Our consultants bring extensive experience in optimizing your staff, processes and technology with solutions that elevate performance.