Implementing a Digital Patient Access Solution

Contra Costa Health Services (CCHS) is a county health system in California that serves the surrounding area’s most vulnerable populations.

At the time of the engagement, in 2020, patient scheduling was inconsistent across specialties, handled by multiple departments, and lacked a thorough or documented training program. Additionally, information systems were not being utilized to their fullest potential, leading to fragmentation, lack of accountability, and wide variation in access performance across the organization.

To understand the patient access challenges, ECG conducted a rapid assessment of contact center and practice operations and developed prioritized recommendations for improving access. ECG then developed and implemented a future-state model for centralized services and patient access operations that supported and balanced the needs of patients, physicians, clinics, and the county. Implementation of this model included:

• Optimizing templates, including expanding capacity, introducing guided scheduling, and removing barriers to access. 
• Offering online scheduling for new and established patients in primary care and all specialty departments. 
• Reconfiguring contact center staffing and introducing shrinkage reduction and productivity tracking management. 
• Streamlining and optimizing the referral management and new-patient specialty-scheduling processes. 
• Optimizing and digitizing clinic-based processes, including preregistration, check-in, and checkout. 
• Introducing strategies to reduce and streamline clinic cancellations, patient rescheduling, and no-shows. 
• Configuring the telephony platform, online scheduling, electronic registration, and other digital tools to expand self-service and consumer-centric options.

These optimization efforts led to increased revenue, decreased costs, and an improved patient experience.

Increased Revenue: Provider Productivity 

The contact center was able to keep provider schedules full by improving the scheduling process, including introducing online scheduling, revamping the referral management process, using additional mediums of communication, simplifying provider templates, and optimizing use of their EHR to better organize work. This led to a 2.7% increase in provider fill rate in the first six months, expanding provider capacity and volumes.

Improved Patient Experience: Digital Options

Patients can now schedule or register for an appointment online. Just six months after its launch, 18% of new patients are scheduled online at CCHS. This digitization of patient access services has begun CCHS’s efforts to empower the consumer and establish a digital front door. Additionally, improvements to the contact center have reduced phone wait times by more than 25%.

Decreased Costs: Labor Efficiencies

Three separate patient access teams were combined to reduce fragmentation and improve efficiency in completing tasks. To improve employee productivity, ECG implemented shrinkage monitoring and coaching protocols. ECG also updated the training program and created more efficient processes through workflow and template optimization sprints. 

CCHS saw a 4.1% decrease in inbound call volume primarily due to online appointment scheduling, 5.2% decrease in time employees spend on the phone, and 4.0% improvement in scheduling efficiency from cross-training staff, introducing automation, and standardizing workflows.