Enhancing Patients’ Connection to UH Providers

Major access initiatives planned for 2021

UH Clinical Update | October 2020

By Cliff Megerian, MD, FACS
President, University Hospitals

Over the past several years, University Hospitals has created the largest primary care network in the region, one with about 2,000 employed physicians and specialists and another 3,000 independent affiliated practitioners.

Today, we are a fully mature health system that has achieved success by providing value for our patients. An integral part of that is making sure that we retain patients within the UH system for all their care. We ensure they are getting exactly the care they need, with no gaps or redundancies, and we will know precisely what care that is, because the patient’s information is current in our UH electronic medical record.

We excel in the quality and cost of care we deliver – with our cost being the lowest among healthcare systems in the region. When patients leave UH, we can’t ensure the quality of the care they receive, and we know their cost will be higher. And yes, in the value-based world in which all healthcare systems exist, there are tremendous benefits to practitioners and hospitals for retaining patients.

So we need to work harder than ever to guide our patients to our trusted UH colleagues.

Yet we also are aware that sometimes it takes too long for a new patient to get the initial appointment they seek, or the referral appointments for more specialized care or procedures they need.

This is a matter of access, and improving it is a key priority for 2021. Changes are already underway. We are looking at how we can better accommodate our patients’ needs with our employed caregivers. While we recruit every year where needed, we also can further maximize the capacity we already have.

Here are some of our strategies:

Continuing enhancement of Schedule Me Now (SMN): Physician offices use SMN to schedule referral and follow-ups for patients, and our SMN consumer app allows patients to make their own appointments. Since May 18, patients have made more than 24,000 appointments through SMN, including virtual visits. That means those thousands of phone calls for appointments did not have to go through our call center; patients could efficiently make them on their own and at their convenience.

Now we are adding the ability for parents to book their children’s appointments for primary care pediatric visits – this has gone live in some practices already and is continuing to be rolled out to more; the ability to make appointments this way for pediatric specialists will be available soon. So will the ability of caregivers at home to make appointments for adult patients who are unable to do so on their own.

Just this past week, we activated the ability for patients to make their own SMN physical therapy or occupational therapy appointments, if they have a physician order. Also, while in the past patients could only schedule only one order at a time, they now can schedule multiple orders at the same time, with a corresponding physician order.

SMN also allows for hospitalized patients to have appointments made from their bedsides, for subsequent care, diagnostics and radiology.

All of these improvements are expected to result in more appointments being made, and patients getting in more quickly.

Addressing no-show appointments: Since the pandemic began, more and more patients have made appointments for virtual visits. Currently, about 10 percent of our visits are for virtual appointments, and that number will likely grow over time. Not surprisingly, our no-show rate for virtual visits is 3 percentage points lower than it is for in-office appointments.

In addition to standard appointment reminders, we now also send patients a text 90 minutes before their appointment, both as a reminder and to detail the process for how they should check in from their car by clicking a link when they arrive in the health center parking lot (this is our PatientTrak system that debuted this month.) The text from PatientTrak will also help reduce the number of no-shows and a patient’s time in the waiting area.

We also are looking at strategically maximizing our provider schedules and where we see consistent patterns of high no-show rates, adjusting schedules to accommodate additional patients. In addition, we will be embarking on a schedule optimization initiative that will – from a holistic standpoint - evaluate our capacity management and provider utilization, specialty by specialty. We’ll review workflow and scheduling templates, and use MDfit to ensure that patients are guided to the appropriate provider for their condition.

Call center enhancements: We are investing in additional technology and personnel to ensure that callers with a specific need are connected to the right person who can answer their inquiry, and to ensure the patient’s appointment is made with the specialist most appropriate for their condition or illness. This will decrease the wait time for a patient’s appointment with the appropriate clinician, while also improving their overall experience with UH through personalization. Analytics will track our progress, and identify any opportunities for improvement.

All of these changes are just the beginning of what I’m sure will be a fruitful process in improving patient access. Many patients have told us that they had a wonderful experience as a UH patient, but that the hardest part was getting in.

This is something we can fix. We can make the process better for our patients, and better for UH. Improving accessibility is the key component of achieving our strategic vision - to be the most trusted healthcare partner for our patients.