To most, it probably seemed like a normal flight. It may have been if not for the other three passengers. My wife and I were seated behind, Dr. Phil, Hillary Clinton, and Carrot Top.

After eavesdropping for more than an hour, I whispered to my wife, “You know, I might even see circumstances that would aloud me to vote for her.”

She began screaming, “You are not going to waste your vote!” And, it took more than a minute for the air marshals to pry her fingers from my left and right carotid arteries—I used Google to make sure I had more than one carotid artery. I learned Tasers work pretty well, especially when used at close range. The charge was not only sufficient to reduce my wife to a quivering mass, but also turned my bottle of water into seltzer.

Then I woke. My national nightmare was over.

One of my favorite sporting events is the Boston Marathon. If you search for pictures of the marathon, most of them look like one of these two; the start and the finish.

When I was in high school my girlfriend was the editor of the yearbook. She took a lot of pictures of me like the first picture above, pictures of me leading the race. There were very few pictures of me coming in first. That is because what you do not see are many images that look like the one below, the things that happen between the start and the finish of the race.

That is where all of the action takes place. Like when someone calls your health system and when the call ends. Most of the notable access experience happens between the two dial tones.

For everything the people in charge of your health system think they know about how people want to interact with your institution on the phone, I bet nobody in your health system knows the following information.

Most health system executives could not state their system’s access strategy in a concise sentence. If they could, it would be something like this: “We want them to access us. We advertise on NPR, we put up billboards, and we call people.”

The following four facts should change your entire patient access and experience strategy.

• 80% of people access their cell phone within fifteen minutes of waking
• 79% of people have their cell phone with them at least 22 hours each day
• On average, people access their cell phones 150 times a day
• 98% of text messages are read versus 22% of emails

When you add tablets and laptops to those figures the asymptote—I hardly ever get to use this word, so I tossed it in here—for access approaches 100% for each of the above.

Let’s look for a minute to look at how behavior modification could impact patient and consumer access, patient and consumer experience. And which group of stakeholders needs to modify their behavior? (One of the benefits of blogging is the freedom it gives to redefine the rubrics of grammar. Also, people who believe that there is only one way to spell each word are limiting themselves.)

The patients and consumers, or the health system executives? The way I see the situation is as follows. The entire planet determines which way is up; 22 of every 24 hours based on what they learn from their cell phone. Aliens invade. Cubs win the pennant. People place much more credence on information they receive online. And on average they check for information online, using their phones, 150 times a day.

Here are some other facts health system executives should staple to their foreheads.

• The people passing a kidney stone are not the same people who happen to be driving past the health system’s billboard depicting a twenty-foot tall Instagram photo of the health system’s urology coven—double, double, toil and trouble; fire burn and caldron bubble.
• The people who are driving to work, who just passed the urology billboard, and who are now listening to an NPR blurb about the fact that your health system just hired a tarot card water-walker PhD from Our Lady of Clairvoyance, are not going to pull over and change their healthcare provider.
• People rely on information gleaned from NPR to learn about when ichthyopods (fish; I may have invented the word) first walked from the sea, and why republicans are the anti-Christ.) They do not rely on NPR as the determinant for where they should buy their healthcare.

I have always been the outlier. When I want to share an idea or make a point that I want to be very visible, I never erect a billboard; I do not advertise on NPR, and I never hire a telemarketing firm to get the word out. As my children would tell me, “That is so 80’s dad.”

The entirety of mankind, or at least the entirety of the U.S., uses online devices as a tool to gather information about how they will determine what they will do with their day. They separate the wheat from the chaff of what is important to them. Health systems use billboards and NPR to attract consumers and to retain patients. The people they are trying to reach do not use those channels.

The disconnect seems obvious, but then again there are people who think the earth is flat and who believe we never landed on the moon.

If the majority of people in your health system’s radius of service check their phones within fifteen minutes of waking, why aren’t they hearing about something meaningful from your health system? If the majority of people have their phones with them 22 of every 24 hours, why aren’t they hearing about something meaningful from your health system? If the majority of people check their phones a 150 times a day, why do they never get a message from your health system?

Mobile access seems like a much more effective way to communicate with the people the health system serves.

Mobile, online, and interactive healthcare opportunities continue to be missed by a huge percentage of the electorate. The opportunity to make population health and patient and consumer access more effective is being missed.

I may be wrong, but I doubt it.