Kyruus Blog

Putting the "Patient" Back in "Patient Access"

Patient Access


We in Boston were proud to have our city included on Becker’s list of health IT hubs to know. After participating in the IX Health innovation summit at Cincinnati’s Union Hall recently, I would not be surprised to see Cincinnati on a future edition of the list. In the words of Wendy Lea, CEO of Cintrifuse (one of the sponsoring hosts of the event), Union Hall is the “front door to innovation in the greater Cincinnati region.”

While the initiatives and investments of the StartupCincy community span multiple industries, healthcare is a primary vertical of focus, given the high density of providers (Mercy Health, Cincinnati Children’s, TriHealth, and U Cincinnati Health were among those represented), large payors (Humana), and large self-insured employers (Kroger, Proctor & Gamble) in the area. All of these stakeholders had a presence at the summit, which created a robust forum for discussion on a number of key topics, one of which was Patient Access 2.0: Breaking Down Barriers With Patient Centric Design.

My fellow patient access panelists and I expounded on a number of issues that our customers are grappling with, including the very definition of patient access, the affordability of health insurance for Millennials, and what health systems are doing to improve the access experience for their patients. Some key takeaways from the discussion were as follows:

  • Today, “patient access” means affordability, availability, and convenience - we discussed the fact that while legacy definitions of “Patient Access” related to backend revenue cycle functions, access to pharmaceuticals, and payor network definitions, patient access today is increasingly focused on the front door experience for patients seeking care. Can they afford to pay their premiums and deductibles, such that finances are not a barrier to healthcare services? Can they get appointments with the right providers in a timely manner? Will their care delivery settings and providers be located close to their home or work, and timed conveniently for them? In general, our discussion on this topic connected directly back to the concept of “patient-centric design” - almost as if we were finally putting the “patient” back in “patient access.”

  • A patient’s ability to get access to a provider is only as good as his or her ability to find the right provider - there were a lot of nodding heads in the audience from health system executives and other ecosystem players when we discussed the fundamental challenge of managing a live and accurate “digital inventory” of providers to enable consumers to search for the right providers and book clinically-appropriate appointments. This challenge intensifies as health systems form networks, expand their networks, and engage in M&A activity.

  • Providers’ scopes of practices are changing - an optometrist in the audience insightfully pointed out that it’s not just knowing who the right providers are, it’s also keeping up with the dynamic landscape of what each provider actually does in practice. The “scope of practice” of optometrists has broadened quite a bit over the past few years, which is similar to what we’ve seen with nurses (consider that retail clinics are often solely staffed by nurses in states that allow it) and other healthcare professionals, while other practice areas, such as Orthopedics and Cardiology, have become much more granular and subspecialized over time. Thus, a health system must acknowledge that patient access can improve in some areas simply by taking advantage of a broadening scope of practice of a set of providers, which then allows more specialized providers to focus on practicing at the “tops of their license.”

One of the panelists from a consulting firm noted that, while healthcare organizations have historically struggled to prioritize and invest in high-leverage areas to improve access, more and more of them are starting to put structure around their solution evaluation processes to facilitate better and faster decision making. It was exciting to hear about some of the examples of that happening in Cincinnati, including Humana’s efforts to improve access through high-quality provider data via a Data Jam, which occurred right after the event.

A final particularly noteworthy point made at the event was that technology is typically only part of the answer - at the end of the day, any patient access initiative must account for the significant change management efforts and human capital investments required to make truly comprehensive and lasting improvements. Based on our experience with more than 20 health systems across the country (including in the great city of Cincinnati), we would heartily agree.

Topics: Patient Experience Patient Access Access Center Patient-Provider Matching