Optimizing Patient Access & Experience to Drive Value

Every provider wants patients to feel satisfied with their experience and eager to continue their relationship with that provider. It is a critical component to enduring success. Whether it’s a physician visit, a discussion with front-office staff, or an appointment change, the hope is that the outcome will be consistent—and positive.

Achieving that outcome, though, does not just happen organically. As much as we’d like an accurate diagnosis or smiling front-office staff to be sufficient in determining the patient experience, there are far more touchpoints that impact the outcome: billing, scheduling, follow-up, care coordination, referrals, medical questions, prescriptions, and more. Meanwhile, clinicians and staff are juggling day-to-day care delivery and constantly evolving technology. 

Often, fragmented systems and inefficient workflows create barriers and drain resources, making the transition to seamless patient access challenging. Static operating models can fall out of alignment with the needs of patients and providers while antiquated technology platforms hinder an organization’s ability to realize desired efficiencies. Conversely, new technologies are often implemented without an understanding of workflows, rendering them ineffective. 

Now is the time to evaluate patient access and experience through a new lens. By strategically investing time and resources, you can align operations, optimize patient journeys, manage provider capacity, expand virtual care, and leverage AI to achieve your operational, patient experience, and engagement objectives—all of which drive value for your organization. 

Start With Key Insights 

Providers concerned with enhancing patient access and experience must first evaluate the current state. As the old saying goes, you can’t really know where you’re going until you know where you’ve been. A thorough assessment of current data and analytics can identify strengths and opportunities across key stakeholder groups. 

One way to do this is through journey mapping, which involves conducting patient journey interviews and sentiment analysis to gain insight into what is being requested (not what is being offered) and the emotional interactions between patients and front-line staff. Providers can also audit EHR usage and data to better understand the front-line team’s propensity for change and opportunities for improvement or map current agent, consumer, and patient intents to the strategic use of AI. Opportunities identified from these tactics might include reframing, restructuring or eliminating phone trees; reducing hold and transfers; and balancing operational metrics with experience (emotional) realities. 

For one of our clients, for example, mapping phone call intents to AI found that over 30% of those calls could be addressed with some level of AI automation. This created an opportunity to improve the caller experience by eliminating hold time while freeing staff to focus on more critical tasks. 

The Need for Investment

Once opportunities have been identified, you can make investments in technology and tools to support your vision while increasing efficiencies and improving experience. Patient access requires a holistic, organization-wide approach. It might include a coordinated patient engagement strategy, contact center development, capacity management, integrated scheduling, care model modernization, or clinical efficiency. Patient engagement platforms and virtual care solutions put care at patients’ fingertips, while scheduling and capacity management tools ensure timely care without overwhelming clinical teams. For example, healthcare organizations may not have visibility into how many provider hours or appointment slots go unused each day. Without accurate data or coordinated scheduling practices, these gaps often persist unnoticed. By identifying patterns of underuse and matching them with patient demand, organizations can increase appointment availability without hiring more staff. Addressing capacity management challenges can improve operational efficiency, reduce waste and allow for more timely, equitable care.

It’s important to remember that processes and systems must be scalable in order to support consumer-initiated service and automation. 

It is also critical that you establish a way to capture and monitor feedback to support proactive outreach and training. Doing so also enables continuous improvement to meet patient and clinician needs as they evolve. No matter what investments you decide to make, ensure that they are tailored to your specific operational, patient experience, and engagement objectives.

Governance is Key

While it would be wonderful to flip a switch and successfully change process and procedure, implementing these new tools and tactics requires more care and consideration. Simply co-locating existing, often siloed, operations and personnel without foresight and intentional design will fail to achieve the desired efficiencies or experiences. Instead, you must assess, standardize, and optimize workflows. Establishing rules that govern scheduling and system access, for example, is critical to enhancing and guaranteeing call center and experience outcomes.

Leaders should be mindful of how these changes impact existing teams and plan accordingly. Your change management plan should address anticipated pain points like loss of control, shifting from independent to team-based care, adjusting to new visit types, visit type definitions, and scheduling algorithms. The plan should also offer outlets for discussion and provide an escalation pathway to a multidisciplinary decision-making body that can and will protect provider scope of practice requirements while also upholding the guiding principles.

Delivering Value

When approached strategically, the outcome of these efforts should lead to success in the form of added functionality, enhanced operational efficiency, and enhanced agent productivity, which in turn, boosts patient access and experience while delivering cost savings. Clinicians and staff can work more productively with a centralized, well-managed front office, while the organization, in turn, saves time and resources. In today’s challenging, dynamic healthcare climate, making the right investments in patient access and experience is quickly becoming a make-or-break proposition. Providers who invest wisely can drive value while expanding access to care and improving experiences for their stakeholders, from local families in need of care to front-line providers and critical staff. These investments can’t wait—the time is now.