Hospitals and health systems continue to face considerable ambulatory access challenges despite perennial focus and previous improvement efforts. Solving this challenge is critical for clinical quality, consumer experience, and providers’ financial sustainability—especially as outpatient volumes are projected to drastically outgrow inpatient care across the coming decade. But at current course, hospitals and health systems will not have the capacity to capture this lucrative business, and competitors are ready to capitalize on health systems’ access shortcomings.

To improve ambulatory access, hospital and health system leaders must confront both the apparent delays (traditional time to appointment) and hidden delays—all the additional points in the patient journey that unnecessarily extend wait times. These hidden delays include the time spent deciding which provider to choose, searching for price information, scheduling during business hours, waiting for preauthorization, and traveling to sites of care.

This research report explains how leaders can reduce wait times by unlocking additional provider capacity, expediting the referral process, making the transactional elements of care frictionless, and deploying telehealth tools to improve convenience.

Maximize practice capacity

Wait times for physician appointments have increased across major specialties since 2014. Fully booked schedules, no-shows and last-minute cancellations, and inappropriate referrals drive mounting wait times. Leaders should use a combination of tactics to alleviate these pressures and expand provider capacity to reduce traditional time to appointment.
1. Physician-oriented template standardization (p.13)
2. Waste-free schedule management (p.17)
3. Appointment-protecting specialist referral redirection (p.20)

Expedite physician referrals

Even when referrals are made in-network, health systems fail to capture business when referrals are not converted to scheduled appointments. Health systems must create a mechanism to find the right specialist quickly and implement a standardized process to complete referral transactions rapidly.
4. Data-driven referral ranking (p.27)
5. Rapid referral coordination system (p.29)

Enable frictionless transactions

The transactional elements of care are often time-consuming and frustrating for patients and staff alike. Major points of friction include finding price estimates, obtaining payer preauthorization, and scheduling appointments. Health systems should strive to make these points in the patient journey quick and efficient by using automation and enabling self-service whenever possible.
6. Instantaneous and customized price quotes (p.37)
7. Proactive and structured preauthorization process (p.39)
8. 24/7 patient self-scheduling platform (p.40)

Minimize distance to care

Despite their best efforts, hospitals and health systems are being outcompeted by a range of disruptors that offer unprecedented convenience and on-demand access with virtual options. Leaders must dramatically increase convenience by expanding the use of synchronous virtual visits and evaluating when they can substitute live visits with asynchronous care.
9. Travel-reducing synchronous virtual visits (p.46)
10. Visit-eliminating care pathway redesign (p.48)