PAC's All Access Pass Podcast

How many patients is too many? In this episode, Dr. Kevin Shah, Vice President and Chief Medical Officer of Primary Care at Duke University Health joins us to unpack the complex science—and art—of managing patient panels.

Joy of Practice is the beating heart of healthcare.It represents the very reason our clinicians practice medicine in the first place, underscoring the fundamental purpose behind their care delivery. Despite their passion for patients, clinician burnout is threatening to destabilize the entire supply of the already-burdened healthcare industry. In this month's inspiring episode, we explore why clinicians' well-being is essential to patient access, and how access leaders can uplifttheir efforts through compassionate leadership. Elizabeth Woodcock, Founder and Executive Director of PAC,is joined by Lisa Griffin, MBA, CCCM, Chief Consumer Officer atUniversity Hospitals, and Dr. Christine Sinsky, Vice President ofProfessional Satisfaction at the American Medical Association.  Together, they unpack the recent surge in clinician burnout,and the responsibility of access leaders to build meaningful relationships with the clinicians who make up the ambulatory enterprise. Tune in on Spotify and Apple podcasts for more!

Our leaders know that patient access is a fundamental pillar of healthcare, but until now, there has been no standardized definition or framework to guide access leaders. This begs the question - what could our community of experts create if they came together to define the key elements of patient access management?This month, Founder and Executive Director Elizabeth Woodcock, DrPH, MBA; Senior Director of Research, Chris Profeta, MPH; and Children's National's VP of Ambulatory Services and a member of our Professional Development Committee, Marc DiFazio, MD, sit down to celebrate the upcoming publication of the Patient Access Collaborative's groundbreaking research study.Together, they break down the Patient Access Management Framework—the first comprehensive, evidence-based model that defines patient access -- and the key determinants that shape it. They discuss the Delphi survey methodology used to reach expert consensus, the determinants identified in the study, and how this research provides a roadmap for health systems to reliablyimprove simple, timely, and connected ambulatory care.Tune in to explore how this landmark study is transforming patient access management and what it means for the future of healthcare.

Wildfires have ravaged South California in recent months, forcing health system leaders to navigate patient access disruptions while ensuring continuity of care. Beyond the immediate crisis, these disasters create lasting "access debt"—a backlog of delayed appointments and unmet patient needs that can overwhelm health systems long after the flames have died down. How can access leaders prepare for and recover from such disruptions?This month, Founder and Executive Director Elizabeth Woodcock sits down with Aimee Corke, Director of Emergency Management and Business Continuity at Northwell Health; Connie Lee, MPH, FACHE, Senior Director of Patient Access at UCLA Health; and Leigh Bouskila Turk, MHA, Director of Practice Development and Support Services at Nicklaus Children's.The leaders share firsthand experiences managing patient access during wildfires, hurricanes, and other emergencies—discussing business continuity strategies, recovery planning, and how to maintain access in the face of disruption.

In this episode of All-Access Pass, we explore the intersection of health equity and patient access with Dr. Ryzell McKinney and Joel Hudnall from Vanderbilt University Medical Center, alongside Stephanie Schmidt from Oregon Health & Science University. The discussion centers on the role of preferred-language appointment reminders in improving care access for patients with limited English proficiency. Despite high hopes, research revealed that these reminders did not significantly increase attendance rates, highlighting the complexity of addressing access disparities.   The guests share insights into broader social determinants of health, such as income, education, and language, and discuss innovative strategies like clinician recruitment from marginalized communities and addressing dismissals from care. Together, they underscore that achieving equity in patient access is a multifaceted challenge requiring systemic solutions rather than isolated interventions. This episode serves as a thought-provoking exploration of the ongoing journey toward equitable access to care for all.   Focus: The complexities of health equity in patient access, highlighting research on preferred-language appointment reminders and the need for multifaceted strategies to address disparities.   Podcast Guests   Stephanie Schmidt, MS Senior Director, Ambulatory Care and Access Services Oregon Health & Science University   Joel Hudnall Epic Configuration Analyst Change Management, Strategic Access Support Vanderbilt University Medical Center   Ryzell McKinney, EdD Director, Access Technology Vanderbilt University Medical Center

In this episode, Patrick Kokoruda, MHA, CCSL, Vice President of Clinical Access Management, and George Ruiz, MD, a board-certified cardiologist and chair of Cardiology, both from Geisinger, discuss the transformative power of collaboration in improving patient access. They delve into the art and science of structuring clinicians' time, leveraging technology, and standardizing processes to connect patients with the right care at the right time. Hear their innovative approaches to optimizing capacity, addressing clinician shortages, and creating scalable, patient-centered solutions that redefine  access to care. 

In the episode, Access Unlocked: Mastering Change Management, we are joined by two influential leaders in patient access and change management: Dominic King, DO, FAOASM, FAMIA, Enterprise Medical Director of Access Transformation and High Reliability Coach at Cleveland Clinic, and Jalana McCasland, FACHE, DSL, Vice-President of Ambulatory Operations at VCU Health. Dominic has led transformative initiatives within Cleveland Clinic's Office of Clinical and Operational Improvement, while Jalana drives impactful changes across VCU Health's outpatient operations. Our discussion dives into the complexities of change management in patient access. Dominic and Jalana share their strategies for fostering staff buy-in, implementing sustainable improvements, and adapting systems to meet patient needs more effectively. We'll cover how they tackle challenges from system inefficiencies to maintaining team engagement, emphasizing that change management is essential to advancing patient access. This episode offers you, our listener, practical insights to navigate change in your own organization, ultimately enhancing patient and staff experiences alike.

In today's podcast, we delve into the critical issue of appointment attendance, a key factor affecting ambulatory access. This topic is vital because it represents both a significant opportunity to provide essential care and a major financial benefit for our organization. As we've discussed in earlier episodes, the imbalance between provider supply and patient demand has created a shortage of available appointment slots. Time is our most precious resource in ambulatory care, and when a patient misses an appointment, it not only results in missed opportunity to deliver high-quality and safe care to that patient -- but it means a substantial loss of precious time for our community. This challenge is even more pronounced in pediatrics, where the responsibility for attendance often lies with families or caregivers, not the patient. To explore this issue further, we're joined by two esteemed guests. Dr. Allison Gornik, a licensed clinical psychologist at Kennedy Krieger Institute and assistant professor of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine, recently served as the lead author on an article on appointment attendance. Lorna Kernizan, the Chief Ambulatory Officer at Children's Mississippi and a seasoned executive with nearly 30 years of experience, offers her insights from the perspective of leading initiatives related to appointment attendance at one of the leading US children's hospitals. Together, they will help us understand the nuances of appointment non-attendance and discuss potential solutions. https://www.tandfonline.com/doi/full/10.1080/13854046.2023.2219421

The "All-Access Pass to Access" podcast, hosted by Elizabeth Woodcock and brought to you by the Patient Access Collaborative, explores the application of behavioral science in patient access. In this episode, Senior Director of Patient Access at UMass Memorial Healthcare, Clara Doan, shares insights from her work on referral processes – and reflects on the application of behavioral science to access. Joined by the Patient Access Collaborative's Senior Director of Research, Chris Profeta, the discussion highlights key behavioral science concepts, such as the recency bias, active commitment, deterrence hypothesis, framing effect, and pique technique, offering valuable strategies for improving patient access. Tune in to learn how these theories can improve our ability, as healthcare leaders, to improve access.

A Novel Approach to Test Access Workflows Mayo Clinic recognized the necessity of moving beyond traditional telephone-based appointment intake processes to embrace a more digital-centric approach to patient access. The health system's Enterprise Office of Access Management opened the Innovation Contact Center in 2022. The goal is to test software, refine workflows, and optimize system integration and automation in order to mitigate risks and minimize disruptions of new access initiatives. Serving as a testing ground, the Innovation Contact Center reduces the impact on more than 4,000 agents – and millions of patients - by confining initial trials to a single unit. Join us for Episode XX of the Patient Access Collaborative's All-Access Pass podcast to learn about the new tools and technologies that Mayo Clinic is testing within this small, dedicated team, thereby laying the groundwork to effectively translate insights and improve access across the health system. Hear from Mayo Clinic's Elissa Nelson, Senior Director, Systems Transformation and Courtnie Garteski Bergler, Director of the Scheduling Innovation Contact Center.

In this episode of the All-Access Pass podcast, host Elizabeth Woodcock delves into the evolving landscape of leadership, focusing on the burgeoning role of the access medical director. Drawing from recent research findings by the Patient Access Collaborative published in the Physician Leadership Journal, Elizabeth explores the increasing prevalence of this position in U.S. health systems and its pivotal significance in enhancing organizational performance. Joined by esteemed guests Dr. Brian Crum (Mayo Clinic), Dr. Bryan Tsao (Loma Linda University Health), and Alice Cooper (Duke Health), who each serve as access medical directors in their respective institutions, the conversation navigates through key insights unearthed by the study. From the imperative of collaboration and systems-thinking to the critical need for more comprehensive training in data analysis and qualitative skills, the discussion sheds light on the multifaceted responsibilities inherent in the role. Moreover, the podcast delves into the patient-centric ethos underpinning the role and the challenges posed by the complexity of ambulatory patient access. As leaders operating within a sphere of influence rather than direct authority, the guests offer invaluable advice for navigating the dynamic landscape of the ambulatory enterprise -- and driving impactful change within health systems. By providing a platform for these trailblazing professionals to share their expertise, the podcast not only informs but also inspires listeners to explore further and engage with the evolving discourse surrounding the access medical director role. Tune in! Woodcock E, Profeta C. A Mixed-Methods Evaluation of the Emerging Role of Access Medical Director in U.S. Health Systems. Physician Leadership Journal. (2024);11(2)13/20.  https://doi.org/10.55834/plj.7643819928 https://www.physicianleaders.org/articles/doi/10.55834/plj.7643819928 

In the latest podcast episode, Sarah Kier, Senior Vice President of Enterprise Patient Access at Emory Healthcare, shares insights from the 2024 PAC Symposium. Despite facing market challenges, Emory Healthcare showcased impressive, if not awe-inspiring, progress in improving patient access to the ambulatory enterprise. Sarah discusses the perfect storm -- and the ideal "EmoryNow" initiative -- that served as the fertile ground for the now-sustained gains in growing volumes by 10% - or more - with existing capacity. Sarah's contributions to the field were recognized with the prestigious Gable Award, named after access pioneer Bill Gable of Duke Health. Reflecting on Bill's legacy, Sarah imagines he would be proud of the community's progress in our shared experiences in improving access for our patients.  

VP of Access Services at New York-based Memorial Sloan Kettering, Kelly Turner, MHA, discusses the pivotal role that she and her team are playing in the post-pandemic recovery of one of the nation's most prestigious cancer centers. Kelly and Elizabeth discuss the opportunities for ambulatory access to improve volume by elevating the role, reducing barriers – and focusing on the patient.

Guests: Chris Profeta, MPH, Senior Director of Research and Instruction, Patient Access Collaborative  Rebecca Carey, PMP, MBA, Senior Director, Patient Journey Optimization, Stanford Health Care For patient access leaders, collecting, monitoring and reporting data is essential to identify challenges and opportunities. Since the founding of the Patient Access Collaborative, we have issued annual benchmarking data to support our leaders' need for data. Join Elizabeth as she sits down with Rebecca Carey, PMP, MBA, Senior Director, Patient Journey Optimization for Stanford Health Care and the Collaborative's Senior Director of Research and Instruction, Chris Profeta, MPH, to discuss patient access data. We'll discuss the importance of data as evidence as we work with physician scientists to manage change; identify how we're using academic research to support management decision-making; and recognize that caution is necessary so that using data doesn't facilitate unintended consequences.  https://pubmed.ncbi.nlm.nih.gov/32970013/

The evidence demonstrates that access to primary care is associated with positive health outcomes, yet challenges abound. Elizabeth sits down with three primary care physicians who serve as leaders in their health systems, tackling the issue of access limitations head-on. Guests include Dr. Melissa Blakeman, the Medical Director for Patient Access at Johns Hopkins Community Physicians; Dr. J Nordstrom, the Access Medical Director for Baylor Scott & White Medical Group; and Dr. Gina Engel, the Associate Chief Medical Officer of Ambulatory for UVA Health. Learn their strategies for addressing primary care access - and their hope to solve this pressing challenge in the future. 

Learn about ambulatory access from the nation's top physician leaders in access: Mount Sinai Medical Center's Dr. Angela Lamb and UCSF Health's Dr. Jennifer Perkins.  Elizabeth sits down with Angela and Jen to discuss the impact of the pandemic, responding to the changing needs of patients, addressing the novel ways that patients are accessing care, and focusing on the wellbeing of providers. Change management is at the forefront of these remarkable leaders' skill sets – and it's no wonder, as the very nature of how we deliver care in the ambulatory setting is changing.

As health systems improve access to care, it puts more pressure on the ambulatory practices to operate efficiently and effectively.  Join Elizabeth as she sits down with three seasoned ambulatory leaders -- Mike Condrin, Interim Chief Administrator, UC Davis Medical Center and Interim COO, UC Davis Health Hospital Division; Jennifer Hayden, Associate Vice President, Patient Access and Ambulatory Facilities, Atrium Health Wake Forest Baptist; and Alpa Prashar, Director of Operational Performance Improvement, Ambulatory Care Services, NewYork Presbyterian Hospital, as they discuss the changes to the ambulatory enterprise propelled by access improvements.

Getting a doctor's appointment is undoubtedly difficult. To unpack the challenges that got us to this point – and pivot to improvement, we sat down with the nation's leading expert on failure, Dr. Amy Edmondson.  Dr. Edmondson is the Harvard Business School professor and author of the recently released book, The Right Kind of Wrong, The Science of Failing Well.  Long-time Patient Access Collaborative member, Victor Hassid, MD, the Executive Medical Director of Access Strategic Operations and an Associate Professor of Plastic Surgery at MD Anderson Cancer Center, joins Elizabeth and Amy to discuss the importance of psychological safety in patient access. Join us to discover how to nurture a culture that favors learning over knowing.

When we started getting together to discuss access more than a decade ago, the notion of quality assurance didn't even exist. We were just happy if someone answered the phone. Over the years, however, our contact center leaders have developed processes to measure quality – understanding the experience of the caller, as well as elevating our callers' voices to improve performance throughout the health system. Let's hear these experienced leaders engage about the value of quality monitoring – and how artificial intelligence is changing the face of it.    Guests: Tracy Cocco, Senior Director, Patient Line Innovation, UCHealth  Suzanne Ronner, Vice President, Patient Access Center, Digital Engagement, Hackensack Meridian Health  Chris Munoz  , Senior Patient Access Center Manager, Patient Access Center, University of Florida Jacksonville Physicians  Special guest: Scott Kendrick, SVP, Strategy and Alliances, Callminer

Our focus at the Patient Access Collaborative is on the ambulatory enterprise - and the way most patients enter that setting is via an appointment with their physician.  This can be an annoying journey of locating a point of contact, calling during business hours, and explaining one's needs. Of course, it is often peppered with waits and delays, voicemails and transfers, and a lot of frustration. Elizabeth goes in depth with Alan Dubovsky, Vice President and Chief Patient Experience Officer, Cedars-Sinai, Rick Evans, Senior Vice President, Patient Services & Chief Experience Officer, NewYork-Presbyterian Hospital and Alpa Vyas, Vice President, Chief Patient Experience & Operational Performance Officer, Stanford Health Care to discuss the challenges, innovations and how to convey confidence in the access journey.

Adrin Mammen, VP & Chief of Ambulatory Patient Access at Mount Sinai Doctors Faculty Practice is on a mission to make Patient Access better and to stop no-shows!  Join Elizabeth as she sits down with Adrin to discuss what exactly is Ambulatory Access, its challenges and the impact of new and innovative ways to approach care.

Everyone should have a fair and just opportunity to receive healthcare, but unfortunately, there is institutional inequality in ambulatory access.  Elizabeth sits down with the co-leaders of the Patient Access Collaborative's Diversity, Equity and Inclusion Cohort to discuss the complex intersection of access and equity.  Our guests are Nick Mah, Interim Senior Director, Access & Innovation, UW Medicine, Dr. Ryzell McKinney, Director, Access Technology, Vanderbilt University Medical Center, and Pravina  Mason, Director of Patient Access Contact Center, Cedars-Sinai.

Matching provider resources to patient demand is a tricky equation to balance. How do you achieve equilibrium when the supply is fixed, the demand is hard to measure, and the price doesn't adjust? This is the challenge access leaders face when trying to manage clinic capacity - no easy task! Join Melanie Cassamas, Senior Director of Ambulatory Capacity Management, Massachusetts General Hospital,  Paul Roher, Director of Access, University of Colorado School of Medicine,  Rebecca Carey, Administrative Director of Patient Journey Optimization, Stanford Health as they discuss this topic.

Join PAC Founder and Executive Director, Elizabeth Woodcock as she talks about the nuances and subtleties of patient access and how she, together with the PAC best practices committee, created the Best Practices in Access document. Committee members featured include: Tina Tolomeo, Senior Director, Yale Medicine, Holly Koehler, VP of Patient Access, Northwell Health, Kevin Pawl, Senior Director of Access, Boston Children's Hospital and  Michelle Winfield-Hanrahan, Chief Clinical Access Officer, University of Arkansas Medical Sciences.

Elizabeth Woodcock welcomes Tia Rooney, Director, Ambulatory Operations and Strategic Initiatives at Seattle Children's Hospital, to discuss the health system's approach to access improvements. Analyzing access has revealed opportunities to better equity - and she and her team are doing just that!  Using their work on missed appointments, Tia reveals the stages of performance improvement -- starting with awareness while baking in sustainability from the outset. Acknowledging the complexity of ambulatory operations, Tia explains their formula to scale access opportunities for success. 

Elizabeth Woodcock sits down with Greg Addicott, Clinical Triage Nurse Manager at ColumbiaDoctors, Kendra Sutton, Director of Telehealth Nursing at Baylor, Scott & White Health and Laurie O'Bryan, Director of Outpatient Access Center at The University of North Carolina Health to discuss centralized nurse triage. Nurse triage and advice is not novel, as the service has been offered by doctors' offices for years. Centralizing nurse triage is, however, a new and innovative approach for health systems to ensure a consistent, optimal experience for patients – and most importantly, one that supports the delivery of quality care, particularly essential to access and care transitions. We'll address key questions such as advice for starting a centralized nurse triage team, keys to maintaining its success, and current challenges for today's leaders.  

Contact Center Management in patient access is a foundational issue for health systems throughout the country.  Elizabeth sits down with  Michael Hesseltine, Director of Ancillary Services, University of Iowa Patient Access Center and John Schultz, Director, Contact Center Operations, Ambulatory Services, Children's National Hospital to discuss their primary challenges including staffing & retention, managing provider templates and increased appointment channels.

Capacity management is a relatively new term in patient access, but the foundational work that it involves is most certainly not. Access leaders like our guests Hitan Kamdar and Gina Carilli are no strangers to optimizing the ambulatory enterprise's most precious asset - the providers' time. Join founder & executive director Elizabeth Woodcock as she talks capacity management with  Hitan Kamdar - Executive Director of Patient Access and Patient Experience, George Washington University Medical Faculty   Gina Carilli - Manager of Scheduling Optimization, Baystate Health. 

Geisinger's top priority is to ensure that their capacity is adequately utilized to serve their patients.  Patrick Kokoruda explains the various ways they do this including getting physician buy-in and using technology to enhance scheduling. Join founder & executive director Elizabeth Woodcock as she dives into this conversation with Patrick Kokoruda, VP of Clinical Access Management, Geisinger.

Creating and sustaining patient access is a challenge for all children's hospitals - and Texas Children's Hospital is no exception. Join founder & executive director Elizabeth Woodcock as she talks access with Grace Karon, Texas Children's  Director of Business Operations and Strategic Planning, Department of Pediatrics. They discuss how Texas Children's is navigating access opportunities in the post-pandemic era.