Editor’s Note: Erin Jospe, MD is the Chief Medical Officer at Kyruus, a leader in provider search and scheduling solutions, helping health systems optimize patient access enterprise-wide.
Health systems today have access to a tremendous amount of data with which to understand their patient populations better. The population health movement represents a paradigm shift away from merely generating data, to now harnessing it as a means through which to understand the factors and determinants impacting the health outcomes of patient communities. Armed with that knowledge, health systems can respond with insightful action plans to improve the health and well being of their patient populations. Patient access and provider data management have fundamental roles to play in these action plans.
Traditionally, much of the population health discussion has focused on monitoring patient data. By understanding the issues confronting patient populations through this data analysis, health systems can make decisions to create targeted access and outreach for those populations that will be both efficient and effective. However, for true efficiency and effectiveness, health systems must also understand their provider data at a detailed level. At its heart, every discussion about patient access, patient empowerment in decision making, and the overall patient experience requires a foundational understanding of the providers themselves – those who will be delivering the care.
When we discuss the importance of engaging patients in order to help them better self-manage their care and participate more fully in their healthcare decisions, we need to acknowledge the types of information necessary for that degree of participation. We need to respect the different values and needs patients may have when choosing how and from whom to obtain care – from clinical factors (e.g., focus areas, years of experience) to logistical needs (e.g., location, insurance) and personal preferences (e.g., gender, hobbies). In order to fulfill that need, we require ways of gathering and surfacing comprehensive, current provider data to consumers who are increasingly going online to find or vet potential new providers: in a 2017 survey, 37% of healthcare consumers reported preferring to find a provider through independent research versus a recommendation or referral. What’s more, even when they receive a referral, 90% of consumers still perform research on the provider.
The provider information consumers demand goes beyond a provider’s board certification, office hours, and insurance accepted; it should also include a granular reflection of providers’ clinical areas of focus, so patients can factor in a detailed understanding of expertise in their searches for the right providers. It also means that detailed information should be available to others who may be helping guide patients – be it call center agents, referring providers, or other staff members.
Having that data available as part of the decision making process reduces misdirected referrals and ineffective appointments, helping make better use of provider time across a given network, while improving patient access. This creates an experience that is not only respectful of both the patient’s and provider’s time, but also aligns the appropriate clinical need to the appropriate type of care and level of expertise to optimize clinical outcomes.
Health systems should also take advantage of scheduling data as an additional key facet of provider data. Despite the importance of timely access to care in consumer decision making – over 80% of consumers in the aforementioned survey said appointment availability was extremely or very important in their provider decisions – appointment wait times in the US are only increasing. In fact, wait times have grown 30% since 2014 according to a recent Merritt Hawkins study. Empowering consumers, call center agents, and clinical staff with visibility into provider availability, alongside provider areas of expertise, is a critical step in optimizing network capacity and reducing unnecessary barriers to patient access.
Furthermore, surfacing availability in conjunction with the ability to schedule smooths the appointment booking process for both patients and providers. This decreases otherwise unavoidable delays in care due to lack of visibility into appointment options, improves care coordination, and helps health systems convert demand to booked appointments while reducing operational costs. Booking follow-up appointments or referrals at the point of care can also transform the outcomes of a patient’s care journey.
This supports care coordination by helping retain the patient within the health system and providing clinical teams with awareness of both the next provider who will care for the patient and the cadence of future appointments. It also creates the pathway for important communications between providers. Clinical communication between providers is a constant struggle, and yet a basic requirement to create high-functioning integrated care teams. With better provider data management, including appointment data, we can create a foundation for truly successful patient access initiatives that connect patients with the care they need, when they need it.
Lastly, when discussing the importance of communication with regard to patient access, we must also address the need for proactive patient communication. As with providers facilitating referrals, it is similarly important to develop communication strategies for patients who book online themselves or speak with call center agents in order to create inroads to a better patient experience. It is reasonable to presume that incorporating patient preferences and engaging patients in healthcare decisions will make them more likely to attend subsequent appointments.
However, it would be shortsighted to neglect additional strategies to promote appointment adherence, regardless of how the patient entered the health system or booked the visit. Appointment reminders and no-show management play a pivotal role in empowering consumers and driving compliance, since accessing appointments is only the first step in accessing care. Improving outcomes for the entirety of the patient population requires not only scheduling appointments, but also ensuring that they happen.
As we continue to embrace the possibilities of better care through population health strategies and use data analytics to identify opportunities to improve care for our patient communities, we should also embrace the chance to better understand our provider communities. By surfacing a nuanced understanding of the capabilities of our clinical communities, we gain opportunities to provide more deeply informed guidance to patients across the care landscape in a way that is respectful of their individual needs and preferences and permits more effective utilization of providers’ capabilities and time.
Analyzing provider data can also expose potential gaps in services and inform a strategic approach at the health system level to ensure ongoing alignment between provider supply and clinical demand. Though not typically at the forefront of population health strategies, provider data management is the keystone to truly successful initiatives – and has a major role to play not only in patient access, but also in care coordination and clinical outcomes.
