This series explores the uncomfortable reality that this adaptation will likely span a longer period than the authors believe has been widely expected. Three leading organizations — Salesforce, Perficient, and The Chartis Group — have come together to share bright spots within the healthcare community that can point the way to building the necessary capacity to adapt.
Today, we turn our attention to:
The FIFTH COMMITMENT
Proactively engage target patients to match care needs with appropriate and available sites of care.
Healthcare delivery has always been principally-focused on being reactive. We look to patients to articulate their needs, and health systems respond by being ready to supply access to the necessary caregivers to tend to those collective patient healthcare needs. The problem created by only focusing on the supply-side (caregiver capacity) of the supply/demand equation is that, even for the best-run health systems, natural variation in patient demand, combined with the high cost of unutilized caregiver time, often results in a model that structurally constrains access out of financial necessity. Given our country’s aging population and dramatic physician shortages projected across many specialties, this industry-wide challenge can only be expected to get worse.
Health systems need to redefine the word “access.”
To fundamentally redefine the problem, health systems need to change their definition of the word “access.” It can no longer be solely focused on getting patients to access to care when they choose to seek it, but rather, focusing on getting patients access to the care they NEED, WHEN they need it. Achieving this foundational reorientation will require health systems to proactively engage their patients and expand access to more convenient and accessible care modalities/channels, the lower common patient activation, and utilization thresholds.
Solving for this new definition of access necessitates a masterful balance of both supply and demand of the populations a health system serves. The health systems that succeed in the future will be those that can best maximize their effectiveness across both dimensions while ensuring they remain aligned such that the patient experience and outcomes do not suffer.
This reorientation to supply and demand activated access will require health systems to change how they operate, and success will require four discrete steps of transformation.
Step 1 – Expand patient access modalities.
Let’s be honest, accessing healthcare historically is just a pain. Planning weeks or months in advance for a specific time, when you need to get yourself to a particular location for an indeterminate amount of time. The first step for health systems to begin to proactively engage patients is to dramatically expand the care modality options available for patients to choose from, which are more convenient and timely. While this change will necessitate significant new technical capabilities for many providers, it will also require the advancement of the operating model as well as the care team model. Merely offering more ways to contact the same constrained resource will do nothing but exacerbate the legacy caregiver supply (capacity) issues.
Step 2 – Systematically Understand your Care Supply
To be able to effectively match up supply and demand, it’s imperative for a health care provider to first be able to size and manage their available caregiving supply. To do this requires migrating all providers into a centralized, digital, scheduling solution, and establishing an array of management reports that enables the system to assess, at any time, available and unutilized capacity. This isn’t to suggest that all caregivers should be accessible directly to patients for online scheduling, but the consolidated oversight and capacity management competency necessitates as a consistent, enterprise-wide viewpoint. With the supply clearly understood, health systems can begin to quantify the cost of unutilized capacity and also better understand the underlying drivers of unutilized size (e.g., no shows, insufficient demand, physician preferences, etc.).
Step 3 – Define EVERY Patients’ Next Step(s)
As articulated in Paul Griffiths’ Fourth Commitment, to be able to proactively engage patients in their care needs, providers need to be able to systematically understand the required “next step(s)” for every patient. While this information invariably resides within the mass of the unstructured EMR data, consistently capturing and documenting that clinically-defined next planned interaction serves as a critical component to activating the proactive dimensions of the health system’s patient engagement. Patients don’t want generic, theoretical content, they want targeted and personalized engagement that aligns with the plan defined in their last care interaction. For a health system, the next step may be a scheduled follow-up with the same care team/member, a referral to a specialist, or recording a diagnostic test. Still, value is created and perceived when the interaction advances the patient’s defined care plan.
Step 4 – Match Supply to Reactive AND Proactive Demand
The final step requires evaluating the expanded, multi-modal caregiver supply relative to the “reactive” (inbound, patient-initiated) demand and filling the supply gap with the “proactive” (outbound, health system-initiated) demand, offering available, unutilized capacity to patients based on their previously defined and documented care needs, with immediate and convenient access. With this dual focus, health systems will be able to more confidently invest in innovative care models that dramatically expand and lower the unit cost of caregiver capacity (care supply), knowing they can more effectively manage and align that capacity with patient demand, both reactive and proactive.
Advancing these four steps will enable health systems to begin to proactively engage and better care for their patients. Still, it will also place them on the path of developing a new and essential care delivery competency for the future healthcare context. While health system capabilities across these four steps may be less sophisticated and automated, establishing the foundation and developing processes for iterative improvement will be essential. Those who internalize these steps and create a new organizational competency will establish compelling strategic advantages in fee for service healthcare, while also uniquely positioning themselves for population health management.
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In next week’s post, we’ll discuss the sixth commitment: