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Matching a Patient with the Most Appropriate Provider: Why is This Still Such a Challenge?

Matching a Patient with the Most Appropriate Provider

I’ve been in healthcare for over 16 years and have always heard that “healthcare is about 10 years behind other industries.”  While I’d argue it’s not quite 10 years anymore (it’s still close), the time I’ve spent in call centers has revealed that there is still a long way to go when it comes to delivering an optimal front door experience to patients.  The scenario below occurs all too often, even at leading health systems.

Common Patient Access Scenario

Access Center Agent: “Thank you for calling The Best Healthcare System’s appointment line, how may I help you today?”

Patient: “Yes, my Primary Care Physician told me to call this number to book an appointment with a doctor that can see me for a possible herniated disc in my back.  I have never seen any other doctor at your system except my PCP, so didn’t know if I had the right number or not and I saw three different numbers on your website.  I also tried searching for a specialist on your website, but had a hard time finding one who could treat a herniated disc.  I was hoping if I did find one I could book an appointment online (patient thinking: like I did for my flights yesterday to NYC), but you don’t have appear to have that option on your site.

Agent: “Yes, sorry, we don’t offer the ability to book online (thinking: she’s right, I can’t believe we don’t offer that, but the health system down the street does) at this time, but I can help you find the right doctor and appointment time. You said you had a possible herniated disc, right?  Did your PCP tell you what type of specialist you need to see?”

Patient: “Yes, but I forgot the type she said.”

Agent: “Okay, no problem, I can figure that out.  Hold on a minute please while I look this up…” Patient is now on hold. Agent scrambles to look up diagnosis in EHR and assumes, based on her experience, that the patient will need to see an orthopedic surgeon. However, maybe it’s a sports medicine doctor because another patient was booked with one of those for back pain...Agent decides to Google it (”doctors treating herniated discs in [City]…”).  Okay, looks like she found a few. Now she goes back over to EHR to see if any of them are in the EHR. Yep, great, she found one.

Agent: “Okay, sorry about the wait, I’m back now and found a doctor for you.”

Patient: “Great.  When can I get in? My back is really hurting and I can barely walk.”

Agent: “Well, it looks like the first available appointment is in six weeks with Dr. Backfixer. Does that work?

Patient: “Six weeks?  Oh my, I can’t wait six weeks.  Can I get in sooner?”

Agent: “I will have to look here again, one minute please….”

Patient: “Nevermind, I will have to call back later. I don’t have time to wait on hold again.”  The patient never called back and instead, found a provider at the health system down the street!

It Doesn't Need to be This Hard

The above scenario is about as real as it gets, and unfortunately, it happens more often that it has to!  It’s mind-blowing that this still happens in 2016.  Pile on a fax or two, and it’s even worse, but still very much a reality in healthcare.  Healthcare doesn’t have to be so far behind other industries though!  I have been on both sides of the fence with the introduction of Meaningful Use many years ago.  On one side, it has catapulted us to a place many of us thought we would never be – digitized in healthcare.  On the other, the rollout of EHRs has also created some avoidable inefficiencies that could have been, and still can be, avoided.

If EHRs solved all of the patient access issues out there, it wouldn’t be necessary for agents to run internet searches like in the scenario above.  EHRs have solved many issues in healthcare, and I commend them for all they have done, but they cannot possibly solve them all. There are complementary solutions that help “fill in” some of the gaps to improve the efficiency and effectiveness of aligning patients with the right providers and vice versa (remember, providers want to be aligned with the right patients, not just the other way around).  We have to  employ new approaches to align patients and providers more appropriately, leading to a decrease in patient leakage (or the glass half full version known as “keepage”), improved outcomes (because the patient saw the best provider for them), and increased satisfaction (for both the patient and provider).

While the various challenges we face in healthcare sometimes seem near impossible to fix, improving patient-provider matching and delivering better patient access experiences, while challenging, are very achievable objectives. In fact, healthcare systems across the country are achieving success on both fronts with technology-driven approaches. There’s no overnight fix to bring healthcare on par with other industries, but improving patient access is a key step in delivering a more modern patient experience.  

To learn how Kyruus has helped health systems across the country navigate through similar (and worse) scenarios to the one above and improve patient access across points of service, sign up for a demo at Also, join the patient access conversation directly at the Annual Thought Leadership on Access Symposium (ATLAS) in November: “Reinventing the Patient Experience Through Better Patient Access.” Register at today.  

Topics: Patient Access Access Center Patient-Provider Matching