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Several strategies facilitated by technology are helping provide access to hidden capacity in our current health system.
Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The opinions expressed here are that of the authors and not UBM / Medical Economics.
The threat of a physician shortage is nothing new but seems to have picked up steam in the last few years. In fact, new figures from the Association of Medical Colleges (AAMC) anticipate a shortage of up to 120,000 physicians by the year 2030. This is a particular challenge in rural areas, where the ratio of patients to physicians is around 769 to 1.
As discouraging as these statistics may seem, there is still hope. The fact is that, despite a widening ratio of patients to doctors, there remains a severe lack of optimization in healthcare organizations across the country. Far too many appointments currently go unfilled or are missed by patients on a daily basis.
When physicians operate at full capacity, with fewer no-shows and cancellations, there’s a much better balance between healthcare demand and physician supply. Addressing this imbalance would be the equivalent of adding thousands of physicians into the healthcare system overnight.
To begin, we must build a system that benefits all involved in healthcare delivery-from physicians to patients to staff. The good news is this solution is already available. Several strategies facilitated by technology are helping provide access to hidden capacity in our current health system:
Digital care coordination
Digital care coordination, or technology with the ability to intuitively guide patients to and immediately schedule them with the right care, is key to filling any open or unused appointment slots and reducing no-show rates, both of which increase physician capacity. With direct access to physicians’ calendars, call center agents, patients, and referring agencies can see all available appointment slots in real time for any given day. This increases the chances that those open slots will be filled on an ongoing basis, ensuring that physicians’ daily schedules are full.
Physician practices note that no-shows are one of their biggest challenges. Across specialties, no-show rates hover between 5 percent and 10 percent on average although we have seen them as high as 30 percent or more. Implementing online self-scheduling with automated reminders can help physicians regain these lost appointment times and reduce no-show rates.
Lead time, or the time between scheduling and a care visit, is also one of the strongest determinants of patient no-shows. Reducing this time can reap positive results that not only improve care outcomes, but better utilize existing capacity. Our data show that 20 percent of patients can get same- or next-day appointments when self-scheduling is available, and more than 50 percent can see their physician within a week.
But digital care coordination isn’t just about self-scheduling. When used by call centers, referring agencies, or discharge staff, it can enable real-time referrals that close gaps in care. For example, with one of our clients we’ve seen lead times for referrals from primary care physicians to specialists decrease by nine days on average when referrals were booked digitally.
Actionable analytics are a vital factor in optimizing physician capacity. With analytics, physicians can track patient behavior, better understand patient needs, and optimize their calendars accordingly. This ensures a more orderly day and a better anticipated schedule with appointment availability that aligns with demand. Viewing patient show rates in aggregate and over time helps physicians guard against no-shows, while real-time capacity metrics can identify opportunities to increase utilization.
Digital health and long-distance medicine
In light of the physician shortage, virtual care tools can be particularly helpful for providing care to patients in remote rural areas. Such tools further close gaps in care by connecting rural primary care physicians and their patients with specialists that may normally only be accessible by visiting a larger, urban hospital.
By balancing the demand for specialty care with those who are capable of providing it, but may not be geographically accessible, virtual care technology is helping patients in need receive expert care while filling existing capacity in the calendars of available specialists.
Technology is helping to transform access to care for millions of Americans and can be an effective tool in addressing the physician shortage. With digital care coordination, analytics, and innovations such as telemedicine, we can bring a more proactive approach to healthcare and solve some of our industry’s greatest challenges.
Tom Cox, MBA, is the chief executive officer of MyHealthDirect.