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By: Sailu Challapalli on February 16th, 2018

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Decentralized vs. Centralized Access at Health Systems: The Patient's Perspective

Patient Experience | Access Center | Provider Networks | Provider Data Management

Last year in our centralized patient access webinar series with Culbert Healthcare Solutions, we discussed top things health system leaders need to know about access centers, focusing primarily on processes, technology, and staffing. In this blog, we will highlight the benefits of centralized access from the patient’s perspective by contrasting two different patient access scenarios.

In Scenario A, John is searching for a primary care provider (PCP) at a health system with decentralized access. In Scenario B, Amy is looking for a specialist at a health system that has invested in a centralized access center. The two scenarios highlight some of the key ways the patient experience can differ and what this means to patients on the other end of the calls.

Scenario A - John Seeks a PCP

John has recently moved into the area, and he would like to find a new PCP for himself. Like 53% of consumers seeking a healthcare provider, John decided to search online for a doctor near his house. He landed on his local health system’s website and found three PCPs nearby who appeared to accept his insurance. Although John is a tech-savvy consumer, he felt more comfortable scheduling his appointment by phone.

Each doctor had a different number listed, so John dialed the first doctor’s number. After a few minutes, the office receptionist picked up the phone and John explained that he was a new patient looking to schedule the first available appointment with the doctor. The receptionist placed him on hold to pull up the doctor’s schedule, and, after a brief hold, replied that the first available appointment was in six weeks. John didn’t want to wait that long, so he asked if she would schedule him with the second doctor he had found online instead, but she couldn’t, as that doctor was at a different practice, so John would need to call that office directly (she did not know that number and could not transfer the call). Total call time was 10 minutes.

The second call didn’t go much better for John, as he learned that the second doctor was not taking on any new patients. Total call time was five minutes. Slightly frustrated, he persisted as he dialed the number for the third (and last) provider on his list. This time, the receptionist  answered the call quickly, but then needed to transfer John after he asked to schedule a new patient appointment. After waiting on hold for the scheduler, John was forced to abandon the call so he could finish some work for an upcoming meeting. He diligently jotted down the names and numbers he had called so he could pick back up where he left off next time. John had spent a total of 25 minutes and still didn’t have an appointment.

Scenario B - Amy Searches for a Specialist

Similar to John, Amy began her doctor search online. She needed an appointment with a specialist and found several online, but wanted to speak with someone at the health system to ensure she found the right doctor for her specific clinical need. Hoping to obtain an appointment within the next week, Amy dialed the phone number listed on the website. After selecting the option for new patients from the phone tree, she was pleased when an agent picked up.

Amy conveyed the urgency of her appointment and also mentioned that she needed a location within walking distance of public transportation. Within less than a minute, the agent had filtered Amy’s request down to six doctors who worked in five different affiliated practices. Unprompted, the agent asked for her insurance plan and said she could verify acceptance by the doctor—something Amy had forgotten to consider. Four of the six doctors accepted Amy’s insurance and, of those four, two had open appointments within the next week. The agent scheduled Amy with her preferred doctor for the following Monday and also told her what test results/information she would need to bring with her to the appointment. Amy thanked the agent and noted to herself how quickly and smoothly the call had gone. After hanging up, she saved the number in her phone for the next time she needs to make an appointment. Total call time was seven minutes.

First Impressions Leave a Lasting Impact

From the patient perspective, neither John nor Amy are certain what’s taking place “behind the scenes” of their calls to schedule an appointment with a new doctor. All John knows is that his experience was inconsistent and fraught with long holds and transfers. In the end, despite multiple calls, he was unable to schedule his appointment and was left scratching his head to try to make sense of why it is so difficult to find a doctor with reasonable availability.

Contrast that with Amy’s experience. Since all agents in the centralized access center she called have full visibility into doctor schedules across specialties and practices, Amy only needed to make one call and was never transferred. Best of all, she found the right doctor based on criteria important to her (clinical needs, location, availability, and insurance) and hung up the phone with a confirmed appointment and prep instructions. Amy may never understand all of the work that goes into creating a smooth scheduling experience, but she will certainly remember the positive experience and mention it to her friends and family when they ask her for a recommendation.

1 Kyruus, Patient Access Journey Research, 2017