Evolving Healthcare Operations To Unlock Patient Access

By Tye Cook, Senior Executive Director, Revenue Cycle + Experience

Modern healthcare technology holds immense potential to enhance patient care and streamline operations. However, the key to realizing this potential lies not in the technology itself, but in how well prepared the organization’s operating model is to adopt and capitalize on the potential from technology.

For healthcare systems to succeed in improving patient access and operational efficiency, their operations must take the lead, ensuring that technology supports—and does not disrupt—core functions.  

This often surfaces in familiar challenges healthcare organizations face when adopting new technologies. Recently, we spoke with a customer who was facing problems with high volumes of patient messages overwhelming their physicians. They implemented a ChatGPT solution to automate responses and were able to reduce the volume by 85%. That’s a great win, right? After further analysis, they realized that almost none of those messages required a physician’s attention and could have been handled by a combination of medical assistants, nurses, and advanced practice providers. 

Healthcare Operating Models Must Evolve 

Examples like this one illustrate that technology alone cannot solve an operations problem. When healthcare organizations fail to understand existing workflows, technology implementations will fall short of expectations. This is worsened when static operating models fall out of alignment with the needs of patients and care providers.  

For example, many healthcare systems lack the infrastructure to effectively integrate data from new technologies, like Remote Patient Monitoring (RPM) tools, with core enterprise systems such as the EHR. When I attended a recent industry briefing on RPM, I asked my fellow attendees, “How many healthcare systems have a data infrastructure in place to co-mingle the data generated by the RPM tools for Cardiology or Neurology cohorts with their EHR data?” A handful, they responded. I then asked, “How many have an operating model in place to proactively engage a patient when the data shows potential risk?” There were crickets in the room.    

Patient Access Requires Future-Focused Leadership 

The industry is rightfully recognizing that expanding patient access requires more than new patient-facing tools, strong patient engagement, or centralized scheduling, but a more holistic, organization-wide approach. Many healthcare executives have led the charge in shifting their economic model from heavily inpatient-driven to a balanced revenue model, and in a growing number of instances, a more outpatient-heavy revenue model. To keep pace with this shift, operating models must evolve quickly to align clinical capacity with patient demand. 

This is not easy. It requires insightful leadership, clearly defined success metrics, and multidisciplinary buy-in to help decision-makers align technology implementations with today’s operational challenges and emerging operating models. But the payoff is clear. When organizations have a clear understanding of operational workflows and the needs of their end users, they are better prepared to recognize potential problems and pursue technology solutions that drive value. This is challenging work, yet the organizations that lead this charge will be the best positioned to realize value-based care at scale.