Retooling Patient Access at UH
March 26, 2023
UH Clinical Update | March 2023
Patients easily making appointments is the life blood of any health system. Although the COVID-19 pandemic has disrupted this process a bit and shaken patient confidence, being able to quickly and simply schedule the healthcare you need remains a priority for virtually every patient.
It’s also a priority for University Hospitals. To that end, the health system has invested in people and technology to update and enhance our systems, processes and procedures to create more access to UH healthcare professionals for our patients.
The revitalized effort even has a new name – Care Connection Access – a moniker that communicates the importance of meeting our patients’ needs to connect with our caregivers in a compassionate way.
“Our mission is to serve our community by seamlessly matching each unique patient need with all available care and services offered across the UH health system, with undivided attention, empathy, compassion and expertise,” says Lisa E. Griffin, MBA, PhD, CCCM, Vice President of Consumer Experience and Clinical Access.
Because Ms. Griffin and her contact center colleagues heard from patients that they had lost some confidence in healthcare during the pandemic and were sometimes frustrated in trying to schedule their appointments, the team decided to first focus on a credo of values. Mirroring the Zero Harm initiative going on across UH that encourages caregivers to adopt “I will” statements to show what they can personally do to reduce harm and suffering, they, too, adopted “I will” statements, such as, “I will make those I serve my highest priority.”
“This kind of work allowed us to personalize our frontline intake schedulers into understanding their importance,” Ms. Griffin says. “These ‘I will’ statements are their commitment to themselves, our patients and also to their team members.”
A New Approach
With that important foundation, Ms. Griffin and her team have embarked on a new way of doing business when it comes to appointment scheduling at UH. The driving vision is to provide a patient-centered access model that connects patients with the right care, at the right location, with a consistently exceptional experience.
One important new feature is 10 specialized scheduling pods, such as a pod for neurology or one for cardiology. Although invisible to the patient, these pods allow schedulers to gain expertise with the specialty. Patients are routed to the appropriate pod with a question from an interactive voice assistant when they call. They simply speak normally about the appointment they’d like to schedule – or they can opt easily to talk to a person instead.
Another change is the approach to scheduling patients’ referral appointments. These can often fall through the cracks for a variety of reasons, with patients not getting the healthcare their provider recommends and resulting in harm to their health. Under Ms. Griffin’s new system, the Referral Management Center will send patients who did not schedule their follow-ups when they checked out a series of three messages, by either text or email. Patients can schedule their follow-up appointments through MyChart or through Schedule Me Now, or they can call the UH Referral Management Center with the number provided. If after five attempts the patient has still not responded, the scheduler will make an outbound call to the patient to close the loop.
This change has only recently gone into effect. But already, Ms. Griffin says, the results are good. The initial run of days with the new technology had about 80 percent of cases resolved in fewer than three days.
Ms. Griffin says the move to Epic and MyChart will also allow her team to send outbound communication to UH patients similar to what dentists do when it’s time for a cleaning.
“The system will detect your last appointment, such as when you had your last physical and when you’re due for a new one,” she says. “Those are called health maintenance triggers, so they automatically trigger an outbound communication, whether text or email, based on age, like mammograms, colonoscopies and things of that nature.”
On the back end, the Practice Optimization team of Care Connection Access is also hard at work to make scheduling seamless for our patients and fruitful for our providers. They analyze data and create reports, indicating possible barriers in scheduling and reasons for no-shows.
“The goal is to ensure the success of every ‘systems of care’ department across our organization,” Ms. Griffin says.
Training and management of the UH contact center workforce are also key functions of Care Connection Access, and there, too, technology is easing the process. Computer systems at work at UH indicate when call volumes are likely to be high, as well as when caregivers have some down time during their day to undergo additional training. Through predictive modeling Care Connections Access can ensure ease of access for our patients and robust support for our schedulers.
“It goes and looks at our call volume historical patterns, and it tells you the best day for these employees to be trained, and it'll actually send that out to the employees,” Ms. Griffin says.
A Team Effort
Ms. Griffin says she’s grateful to the provider community at UH for all the work they’ve done along the way to make these changes possible. For example, she says, many rules governing scheduling have been removed, and there are significantly fewer restricted provider slots. This avoids the problem of a patient being told by the UH contact center that a provider is unavailable for several weeks, but getting a different answer from the provider’s office.
“We now have the same access and view that the practice level would have, and we’re grateful for that,” she says.
And, Ms. Griffin says, she’s pleased about the difference her team is already making. During her two-year tenure, UH’s net promoter score has increased from 4.8 to 5.0., while separately the number of patients indicating on Press-Ganey surveys that they could “get the appointment at the time they wanted” has also risen.
These improvements have impact.
“We know that one dissatisfied patient can tell nine others about it, and then that just balloons and could be a $1 million loss for an organization in one year,” Ms. Griffin says. “So we really focus on being customer-obsessed, every single one of us.”