Improving Patient Access: Are You Smarter Then A 5th Grader?

Next February it will have been forty years since two of my friends and I ran the Kennedy 50-mile hike-run across an ice-covered and boulder-strewn Appalachian Trail, and along the C&O Canal into Harper’s Ferry, Maryland. The Appalachian Trail is on the Appalachian Mountains. Mountain trails go up mountains.

I was reminded of the race because of a conversation I had Saturday with an elderly gentleman who was in the process of running in a twenty-four hour relay on a high-school track, an event I also ran forty years ago.

The AARP runner mentioned having completed the Kennedy run this February.  Then and there I decided to locate my two friends, whom I have not seen since high school, and have the three of us run the race.

On October 14, 1947 Chuck Yeager became the first person to break the sound barrier flying the Bell X-1.  Many people thought it could not be done. On February 6, 2016 I will attempt to break the stupidity barrier although I will not be wearing leather wingtips like Robert Kennedy did when he walked the course during the first running of the race.

I mention all of this because knowing I had less than nine months to train for the event, I ran a few sprints Saturday after I had finished my eight-mile run. It was during my third sprint that my right Achilles communicated that it was done sprinting—I looked the stupidity barrier straight in the eye and continued to run.  Bad idea.

Let’s play patient access together.  The question I wanted to be able to answer is:

When do health systems think patient access and patient experience begins?  What I learned is that for them it begins way too late.

With my foot resting on a bag of frozen peas and after taking two Tylenol, I thought it would be interesting to call a few hospitals to see what I needed to do.  I called three hospitals, at which I or I member of my family had been patients.  None of the people I called were able to identify me from my phone number—Comcast can do that.

Remember, it was Saturday.  As far as patients and consumers are concerned, hospitals are closed on weekends to anyone unless they need the services of the Emergency Department. Using the main number on the hospital’s homepage I made four calls to each hospital and asked four different questions:

  • I hurt myself running, what should I do?
  • May I speak with a nurse?
  • My Achilles hurts, do I need to see a doctor.
  • My Achilles hurts; I want to schedule an MRI.

Each call was either transferred or I was told to call another number or to call my doctor.  The two closest answers I received that may have helped me was an offer to transfer me to the outpatient lab, and one gave me the phone number for a podiatrist.

Next, I went to their websites.  None of them offered online chat. One offered a Contact Us box; somebody would respond to my request within forty-eight hours of the next business day (Wednesday).

I then went to everyone’s favorite and tested solution—Google, and I searched “Triage Achilles Pain.”  Lots of good information.  Feel for a bump.  Assess the severity of the pain.  Ice and Tylenol—I could’a been a doctor.  I read about treatments—whatever you do, don’t do any more sprints.

I found the website for a local orthopedist. It is still Saturday.  Something pops on my screen—My name is Cindy, how may I help you?

Access. Access with a good experience.  An Easy Button.  And I didn’t even need to be in the hospital.  Note to health systems—It is possible to for people to need access healthcare prior to having a hospital bed.

I chatted online with Cindy. She triaged me and recommended how to treat it over the weekend.  She told me if the pain got worse let her know Monday.  If it wasn’t better by Wednesday, let her know.

She called me on Monday.

So, let’s quickly return to the 50-mile race and attempt to draw a comparison to the patient access experience.

Health systems treat people as though the only access attempts that matter to their patients are those that happen at mile markers 25-30.  Attempts to access the health system before you are a patient does not matter, and those that happen once you have left the hospital do not matter.

Noticeably absent from a health system’s view of access are consumers.  Since consumers are not yet patients, health systems to not have a plan in place for consumers to access the health system.

People—patients and consumers—need access when they want it.  Not 8 to 5 Monday through Friday.  They want it how they want it; on the phone and online.  And if online, they want to choose what device they want to use for access.

Until they have that, whatever access they may have will not give them an experience that makes them want to be your patient or to remain your patient.

Maybe that is a little steep for a 5th grader, but I am confident you understand it.

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