New College, Oxford, was founded in 1379, hundreds of years prior to the invention of the I-Beam. The roof of the college’s main dining hall is supported by big oak beams, two feet square and forty-five feet long.

Wood has a number of characteristics.  The characteristic most relevant to this discussion is that it rots.

About 100 years ago, entomologists were studying the beams in the roof and they noted that the beams were infested with beetles, thus eroding the integrity of the roof. Unfortunately for the college it was believed that all of the large trees from the old-growth forests had long since fallen.

As luck would have it, the college owned a great deal of land and actually employed its own forester. When the college asked their Forester about whether he knew of any large trees, the Forester replied, “I was wondering when you’d come asking.” It was discovered that when the college was founded, a grove of oaks had been planted to replace the beams in the dining hall when they became beetle-infested. This information had been passed down from forester to forester for more than 500 years.

Long term planning: Planning that involved the exact solution, not a series of ad-hoc fixes year-in and year-out.

When I built my home I did some long term planning as well.  I had telephone jacks and Ethernet wired to every room in the home.  That way, I would be able to make a call from any room in the home and have an internet connection in every room.  About a week after we moved in to the house I learned about something called a wireless router.  So much for my astute planning.

So, how does planning come in to play with healthcare providers?  Or does it?  Has anyone every used the terms planning and patient access in the same sentence?

Most health system call centers are nothing more than a big room with a lot of phones in them.  And that is exactly how they function.  There is no ability to support care coordination and back office functions. There is no single path to anywhere.  There is no first call resolution.  There is, however plenty of opportunity to call and call and call.

So, how would things differ if instead of the call center being just a big room with a lot of phones, someone had actually planned for what it needed to do?  What if the goal was to provide care coordination and back office support? It might look something like this.

But until someone actually creates a plan and a design for supporting the most complex business system in your organization it will continue to be just a big room with a lot of phones.

But until someone actually creates a plan and a design for supporting the most complex business system in your organization it will continue to be just a big room with a lot of phones.