Access to Care Begins Before the Patient Arrives
Patient access doesn’t begin when a clinician enters the room. It begins the moment a patient tries to engage with the healthcare system.
In emergency medicine, I often see patients at the end of a long and frustrating journey. Some couldn’t get an appointment with their primary care physician soon enough. Others didn’t know what specialist they needed. Many have already spent days navigating patient portals, referral requirements, phone trees and insurance questions before finally deciding that the emergency department is the simplest option available.
I’ve cared for many patients whose medical condition wasn’t the primary reason they ended up in the emergency department. The real reason was that they couldn’t navigate the healthcare system effectively. That’s why I’ve long believed that patient access begins when patients try to schedule an appointment, log in to a portal, verify their insurance information or ask a question about their care.
Patients start forming opinions about the healthcare system long before they ever meet a clinician. Every scheduling delay, referral requirement, login problem or unanswered question shapes that experience. By the time some patients arrive in the emergency department, they are frustrated not because of their illness but because of everything they had to navigate to get help.
As healthcare becomes increasingly digital, organizations are looking for ways to reduce that friction. But before we talk about AI, it's worth discussing one of the least visible but most important elements of patient access: patient identity.
READ MORE: Move toward a more seamless patient experience with AI.
The Critical Foundation of Patient Access
Healthcare leaders often discuss patient experience, interoperability and digital transformation as separate initiatives. In reality, they all depend on the ability to accurately identify patients across systems, workflows and points of care.
Unfortunately, mistakes happen all too often. I am aware of a case of mistaken identity where a patient was brought to the operating room for a renal tumor that they did not have. It was not until they were sedated and the surgeon directly inspected the kidney that they realized the mistake. They came very close to removing a healthy kidney. And the patient who actually had the tumor experienced a delay in care while they sorted through the radiology studies and found out who that scan belonged to. Patient identity is not merely an administrative challenge. It's a patient safety issue.
When patient identities aren't accurately verified and matched, the consequences can be significant. Clinicians make decisions based on the information available in the chart. If records are duplicated, fragmented or attached to the wrong patient, trust in that information erodes. Care becomes slower, coordination becomes harder, and the potential for mistakes increases. Wrong diagnoses can be made. Unnecessary diagnostics might be performed, leading to unneeded risks and cost, often without reimbursement. Wrong or even harmful treatments can result; for example, a patient with a drug allergy being mistakenly given that medication, leading to a severe allergic reaction.
What's often overlooked is that many of these problems begin during patient access workflows. Registration, scheduling, insurance verification, patient portals and digital intake processes all create opportunities for information to be entered incorrectly, duplicated or disconnected from the right record.
Patient access teams are being asked to move faster while managing growing complexity across an expanding digital ecosystem. Getting patient identity right has become both more difficult and more important.
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