Facilitating Access to UH

Individual clinicians and UH as a whole both have an important role to play

UH Clinical Update | September 2019

By Cliff Megerian, MD, FACS
President, UH Physician Network and System Institutes

Every health care organization - including ours - is more successful when it has increased volumes, and we have certainly been successful in increasing our market share over the past five years. It can become more difficult to continue this trend, but we’re constantly working to keep our organization as healthy as possible.

Some of the reasons the upward trend can be a challenge:

• The population in the region has remained fairly flat, with no major influx of new residents.
• Birth rates continue to decline.
• More people have high-deductible health plans, which leads some patients to defer care. 

On the plus side, we know from surveys that we have a tremendous reputation among patients as the most trusted partner in health care in the region, and that the desire of patients to use UH for their health care needs is high.

We have many patients who need our care, but sometimes have difficulty accessing it. We also have other patients who need screenings, such as colonoscopies or mammograms, who may not know or remember that now is the time to have them. Both of those groups represent opportunities for us.

If you’re a UH provider, take a look at which of your patients are overdue for a colonoscopy, mammogram or another type of screening. It’s human nature for patients to postpone these, but a call from their physician’s office to remind them and suggest they make the appointment is a powerful motivator.

As an organization, we’re also embarking on a series of interventions to make seeing a doctor at UH the most frictionless event possible. We are aware that there was, and continues to be, work we have to do on this end.

That’s why we have launched the platform Schedule Me Now (SMN), so that physicians and their office staff can make referral or follow-up appointments to UH physicians before the patient leaves the office. This practice of Point-of-Service scheduling dramatically increases the number of patients who keep those appointments.

We also have added concierges at many of our practice locations, who streamline the process for patients being scheduled to see specialists. We also are opening more UH Urgent Care and UH Convenient Care locations, both of which increase patients’ access for non-emergency issues that occur outside of physician office hours. And we now have three orthopedic-injury clinics that offer same day, open access to patients with any orthopedic need, as well as a psychiatric access clinic that provides most patients a collaborative psychiatric consult within five days.

Perhaps even more important is opening what I call the “front door” of UH to make it as easy as possible for patients to make appointments with UH physicians.

That means a renewed emphasis on the administrative component, so that patients are able to reach someone when they call for an appointment, not just to our call center but to a physician’s office, or if they leave a voice mail, that their call is returned promptly. It also means committing the resources necessary so that patients don’t have to wait for weeks or months to get the appointment they need, and again making sure a consult appointment is made before they leave their referring physician’s office.

Our new Service Level Agreements outline what to do when a primary care or specialty office is having trouble with patient access or scheduling a patient for a referral appointment at the point of service. Each includes contact information for the specialty administrator, the primary access contact and a clinical contact – typically the department chair.We have made strides in these areas, but now we are laser-focused on removing barriers to increased volumes.

Dr. Randy Jernejcic, UH Vice President of Clinical Integration, has been overseeing the improvements to help increase volume. This includes emphasizing that specialists refer their patients to a UH primary care provider when they don’t have one, as well as making an appointment if a patient needs to see a sub-specialist. It also means working with central scheduling and concierges to ensure that patients are contacted and scheduled for appointments without delay. He and his team are also leading efforts to ensure that all patients get their appointments scheduled promptly when a physician order is placed.

The latter is part of a 100-day hyper-focused volume program in four critical areas: oncology, digestive health, orthopedics and neurology. We know that volume increases the quality of care – the higher volumes we have, the better the outcomes for our patients. We also get more people participating in clinical trials and obtain even greater expertise in treating surgical and non-surgical conditions.

The bottom line: We want as many patients as possible to receive the superlative health care our UH physicians and other clinicians provide every day. Please do all that you can to facilitate patients’ access to UH.