Improving Access: What Is Your Best First Step?

One of the problems with getting across a new idea is presenting it in a manner that allows others to visualize something they have not seen before.

I think people have that problem when it comes to understanding how to recast patient experience and patient access. We have patients, they think to themselves, therefore those people must have access or they would not be our patients. It is this kind of thinking that allows them to check the box—problem solved, now let’s move on.

So let’s ask the question; exactly what kind of access do people have? Do they have good access? Do they have a good experience when they try to access our health system? Can they accomplish what they set out to accomplish in one attempt? Did they have to talk to more than one person to have their needs met? Was there an easier way for them to do what they needed to do?

Perhaps we can define a few things.

Access: Everyone can interact with the entire organization in a manner that was designed by the organization to provide a good user experience for every type of interaction–not just scheduling.

Ease of Access: People are not willing to work hard to access the health system. Access should be intuitive.

Effective Access: People are able to accomplish what they set out to accomplish 100% of the time.

To learn if your health system has access, or merely has a group of phone numbers for people to call to try to accomplish tasks requires work. You have to look around, and you have to ask questions.

It also helps to have an example of what good access and experience look like. UBER is an example of a company that designed access, designed access to be easy and intuitive, and designed it in a way to be effective. If you have not used UBER, you can see how user-centered-design reinvented the task of getting a taxi by watching this YouTube video: https://www.youtube.com/watch?v=U9A86Nh75xQ

For non-UBER users, the idea of hailing a taxi evokes memories of standing in the rain on a crowded street and competing with others for the attention of the cab headed your way.

For UBER users it works like this:

  • Activate the UBER app on your phone
  • A map comes up on your screen that shows where you are
  • On the map are images of moving vehicles—UBER cars—in your area
  • You enter where you want to go
  • The screen shows you a photo of your UBER driver, a description of the driver’s car and the car’s license plate, and an estimate of how many minutes it will take for the drive to arrive at your location.

Your work is done. When you arrive at your location you exit the car. You do not need to ask for a receipt, it is already being emailed to you. You will then be asked to rate the driver by clicking on how many stars you award. Every driver gets rated on every trip, and the driver rates every rider. If a driver’s average rating gets below 4.2 stars out of a total of 5, the driver will be removed from UBER.

That is the brilliance of UBER. They took a highly dysfunctional industry and turned it on its ear, and the only thing they require of their customers is to enter the address of their destination.

Very slick, and very effective and efficient. A great user experience. In fact, it provides a remarkable experience every time, and the reason the user experience is great each time is that it was designed to be great. Great design, user-centered design, is difficult work.

Design is a verb. In health systems, access and experience were never designed; they simply evolved. Having phone numbers for people to call did not involve design. Having a place where lots of people sit and answer calls did not involve design. Having a website that only allows people to read about the hospital never involved designing the user experience.

Access to most health systems by phone involves a poor user experience. Having said all of that, what is the first thing that a health system should do to dramatically improve the access experience? Since access, using the definition from above, involves everyone, not just surgical patients, not just acute patients, and not just scheduling done by phone, it is important to determine just how poor of an access experience your health system offers by phone.

That said, the first step for improving the access experience is for health systems to determine is to determine how broken the phone experience is, and then design an experience that provides a remarkable experience every time for every caller.

Simply having happy and smiling people answering the phones does not mean the access experience is good. They can smile all day long, but if people have to call multiple times, and/or have to speak to several people, and are still not getting their needs met, their experience is poor.

Sooner or later poor user access will result in people buying their healthcare from another provider.

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