By Matthew Shore, CHFP, Project Manager I, Organizational Excellence

I’m sure it’s no secret to Patient Access Collaborative members that employee engagement and morale are very important in our industry. Engaged employees are happier, more loyal, more productive, and more devoted to the organization’s mission. It is for these reasons that I launched a team newsletter for the access center at Montefiore Health System.

How long have you been a member of the Patient Access Collaborative?:  4 Years           

What do you like about being a member?: Innovative approaches to similar problems.

Join us for a webinar on November 29 titled Improving Access for Priority Populations.

Co-authors Emily Godsey, MSHA, Operations Manager, Cancer Services and Dr. Bruce Gamble, Senior Data Scientist, Mayo Clinic, join us to present insights from their recent article in the Journal of Ambulatory Care Management, "Improving Access for Priority Patient Populations." In an outpatient practice, it can be challenging to convert patient demand into completed appointments, even for high-priority patients. One of the barriers to higher conversion rates is excessive appointment lag time, which can lead to nonattendance or cancellation for other reasons. Emily and Bruce will report on a pilot program with 12 outpatient practices at Mayo, representing multiple specialties. The results of the pilot show that improvements to completed appointments can be achieved.

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Weill Cornell Medicine, amidst staffing shortages and a push for digital acceleration, searched for a patient engagement solution that would improve website navigation while boosting patient access and acquisition. In just two weeks, Hyro deployed a customized conversational AI assistant capable of finding physicians based on multiple criteria and booking appointments end-to-end, with no training or coding required. So far, Weill Cornell Medicine has increased converted appointments online by 47% with Hyro's conversational AI, while lowering their bounce rate by 31%.

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Please welcome our newest organizational members: University of Mississippi Medical Center, Children's of Mississippi, and University of Colorado Medicine!

University of Mississippi Medical Center (UMMC) provides patient-centered treatment, clinical excellence, and an advanced level of care unavailable anywhere else in the state, offering primary care, specialty care, and subspecialty care throughout Mississippi. Visit their website.

Tina Tolomeo, DNP, MBA, APRN, FNP-BC, AE-C, Senior Director, Patient Access at Yale Medicine shares how her team measures success.

There are a number of ways to measure success in the field of Patient Access. One is to measure performance of the access center, the doorway to healthcare delivery. 

Patient Access Collaborative members wrestle with access opportunities in all specialties, but Neurology has long been a particular challenge. We invited two members to present on their initiatives to improve access to neurological care through novel approaches. The University of Florida College of Medicine used existing faculty to form a new-patient access clinic, while Penn State deployed clinics that featured walk-in appointments followed by a more successful integrated care team approach.

Taking advantage of the complexity of the inpatient environment, the Department leadership at the University of Florida College of Medicine offered faculty the choice of working in a newly created outpatient clinic in exchange for hospital call. Physicians who opted in could fulfill their responsibilities via an access clinic week(s); residents were also staffed to the clinic. The clinic -- which shares space with the main existing outpatient clinic for the Department - operates five days per week, 10 hours per day. Forty new patients are scheduled per week; if patients require longitudinal care, they are subsequently scheduled for the subspecialty clinic. According to Vice Chair of Operations, Dr. Katharina Busl and Executive Director AJ Yarbrough, the access clinic has not only improved the lag time for new patients (142 days, on average, to 18 post-intervention), but also reduced ED readmissions. Relying on higher-value new patient visits, furthermore, the clinic is profitable. Read more about their work at Neurology Access Clinic: A Model to Improve Access to Neurologic Care in an Academic Medical Center - PubMed (nih.gov)

November 10, 2022 | 1:00PM EST

Join patient access leaders Michelle Winfield-Hanrahan, Chief Access Officer of UAMS and Nicholas Mah, Senior Consultant, Enterprise Access & Innovation at UW Medicine, as they discuss their deployment of PAC industry partner's Luma Health solutions. Michelle will discuss the opportunities and challenges of implementing an innovative patient confirmation strategy; Nick will highlight the novel referral management communication recently deployed at UW Medicine. Join us for a rich discussion of the deployment of new technology to improve access.

This month the Member Spotlight is on Shelby Smith, Director of Care Access, University of South Alabama Health. Learn more about Shelby below. Want to be a part of our PAC Member Spotlight? Fill out the form here.

How long have you been a member of the Patient Access Collaborative?: 7 years

Please join us for a webinar featuring experts in Access in Neurology at 1pm ET on Thursday, November 3. You can hear about their efforts -- and engage in a discussion with your peers about this important topic.

Speakers:

• Katharina M. Busl, MD, MS, Associate Professor and Division Chief of Neurocritical care in the Department of Neurology, UF Health Shands
• James E. Rooks, Jr., Professor, and medical director of the NeuroICU at UF Health Shands
• AJ Yarbrough, MBA, CPC, Director- Department of Neurology, University of Florida College of Medicine
• Stephen Ross, MD, Professor and Vice Chair for Clinical Affairs, Department of Neurology, Chief, Division of General Neurology, Penn State University

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By Elizabeth Woodcock, DrPH, MBA, FACMPE, CPC

As with any complex, multi-faceted process, there are opportunities to improve scheduling. Calls may be processed by a health care organization with ease, but if there is nowhere to put the patient – that is, no appointment slot available – then picking up the telephone matters none.

The Patient Access Collaborative (PAC) had the pleasure of featuring speakers from Montefiore Health System, Cedars Sinai Medical Center, and University of South Alabama Health to discuss Diversity, Equity, & Inclusion (DEI) in Access. Each institution highlighted one aspect of the amazing work they are doing related to DEI. From interpreters to digital navigation, the speakers imparted their wisdom and experience to an eager audience.

Greg Lewin, Senior Director, Patient Access Center and Marjulie Munoz, Assistant Director of Digital, Transformation Office showcased their digital strategy, which was built to best serve the "mosiac" of patients served by Montefiore Health System. Aimed to get patients what they need in a language that works best for them in a format that they prefer (text, voice, email), the Montefiore digital front door smartphone app features 23 languages. Their telemedicine strategy extends the language offer to a total of 65 languages, with interpreters fully integrated within the encounter with a seamless three-way video and audio interface. Perhaps surprisingly, seniors are taking advantage of the virtual encounter:  Montefiore found that 50% of their virtual visits were Medicare beneficiaries.

By Chris Profeta, MPH

The Bump Rate

The bump rate is an access metric used to measure internally-driven appointment cancellations and, by proxy, disruptions to care caused by the health system. A bump is defined as a patient appointment that was cancelled by an internal stakeholder – the physician or provider for example. The reasons for the bump may vary but the key factor is the appointment change is instigated by the system, not the patient. The rate is derived by dividing the volume of bumps into all scheduled appointments across a designated period of time. 

Please join us for a webinar featuring experts in Best Practices in Diversity, Equity & Inclusion in Care Access on October 20 at 1pm ET. You can hear about their efforts and engage in a discussion with your peers about this important topic.

Speakers include:

• Shelby L. Smith, MS, Director - Care Access, University of South Alabama Health
• Michael Barlow, Referral Center Team Leader, University of South Alabama Health
• Laiza Ramos-Pamias, Spanish Navigator, University of South Alabama Health
• Pravina Mason, Director, ACET Team (Access Care Experience Team), Cedars-Sinai Medical Center
• Greg Lewin, Senior Director, Patient Access Center, Montefiore Health System
• Marjulie Munoz, Assistant Director of Digital Transformation Office, Montefiore Health System

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Why do the best teams make the most mistakes? The answer may not be so apparent. In a ground-breaking study by Google, five factors were identified as characteristics of effective, high-performing teams: dependability, structure/clarity, meaning, impact, and (most importantly) psychological safety. The best teams, it turns out, don’t make the most mistakes – they are simply the ones who reveal them.

Many Patient Access Collaborative members are surprised when they listen to one of our educational sessions. The speakers, you see, are all required to include their challenges, reflect on their mistakes -- or whatever positive spin they want to put on the language of fallacy. In doing so, we are creating psychological safety. The term, according to Amy Edmonson, PhD, a Harvard Professor who recognized the relationship between performance and candor in teams, is a “shared belief that the environment is safe for interpersonal risk taking.”

This month the Member Spotlight is on Karla Esqueche, a Epic Analyst-Team Lead at Montefiore Medical Center. Learn more about Karla below. Want to be a part of our PAC Member Spotlight? Fill out the form here.

How long have you been a member of the Patient Access Collaborative?: 4 years

By Nkechi Okwu-Lawrence, MPH

Enriching the patient access experience in ambulatory settings is crucial from the moment a patient enters the facility, but what about the patient access experience prior to arrival? Justin Ko, MD, Alpa Vyas, and Rebecca Carey of Stanford Medicine Healthcare share their efforts in mitigating fragmentation in referral & pre-visit experiences for patients by transforming the referral structure, referral processing & scheduling, and pre-encounter experience. All three of these leaders sit in the Pre-Visit Experience Governance & Work teams, aiming to “improve likelihood to recommend an easy, timely access to appropriate care”. A novel aspect of their efforts is the 50/50 Prep process within the Pre-Encounter Experience used to inform and prepare for a patient’s upcoming visit. Phillip N Quick, VP of Access Operations at Rush University System for Health, highlights “schegistration” challenges in their Access Center, where pre-registration and scheduling processes are completed simultaneously. Some solutions to this challenge that have been implemented include:

Have you checked out the PAC Job Board? Reaching over 2,000 access leaders, our job board is a great way to advertise your open position to the highest quality and most relevant candidates in the industry - or to find a new role you'll love! 

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We're thrilled to announce the host for the 2023 Patient Access Collaborative Symposium is Michigan State University Health Care! The symposium will be May 9-11, 2023. Keep your eyes out for more details coming soon.

Well into year three of COVID-19, our members are experiencing staffing shortages and challenges with retention. To help those institutions facing these problems, we surveyed our members who reported the lowest turnover rates for their access teams via our benchmarking survey -- and asked them key questions about their retention tactics. Sharing these strategies and tactics with all our members is at the core of what we offer as an association – an opportunity to learn from each other.

Internal Transfer Hold Period – most of these organizations reported that the period the employee must wait until a transfer can be made is six months. Some exceptions are made if they apply for a promotion or if the current and new departments agree to the transfer. There were a few organizations that reported no waiting period.