Five things to know: How one health system offers same-day specialty appointments


Allegheny Health Network (AHN) in Pittsburgh, Pennsylvania, has achieved what few health systems have been able to do-offer same-day specialty appointments across its hospital network.

Allegheny Health Network (AHN) in Pittsburgh, Pennsylvania, has achieved what few health systems have done-offer same-day specialty appointments across its hospital network.

AHN, a mid-sized health network with eight hospitals, approximately 90,000 discharges annually, and 2,300 beds, spent much of 2016 overhauling its call center and redesigning its clinical scheduling system to achieve this. In October 2016, it went live with same-day appointments for primary care physicians and as of January 23, it did the same for almost all specialists.

Here’s a look at some key takeaways from the initiative:

1. Multiple specialties require multiple approaches.

Kenyokee Crowell, MBA, FACHE, CPC, senior vice president, Clinical Access, Allegheny Health System, says the endeavor took months of planning and analysis. “We worked closely with physicians and office managers at different sites to try and predict what patient needs would be for each specialty,” she says. “You can’t take a cookie cutter approach to all specialties; there isn’t a perfect recipe.”

Ultimately, they determined that the key was to reserve inventory ahead of time. “A lot of physicians’ schedules are completely full; the only way to ensure same-day access was to reserve time slots in advance,” Crowell says. “By doing this, a certain amount of inventory become available each day.” An additional approach includes filling slots created by late cancellations.

2. One hub manages appointment requests.

The program works by allowing patients to schedule a same-day appointment by calling the Care Connect Access Center between 7 a.m. and 11 a.m., weekdays. Based on the patient’s need and availability of services, the health system will find the most appropriate provider and location.

Same-day appointments are scheduled on a first-come, first-serve basis. “When patients call after 11 a.m., they are offered either a same-day appointment pending availability or the next available appointment,” Crowell says. “Certain clinical needs could result in an exception to the same-day commitment.” In this instance, a member of the AHN Care Connect team triages the call.

3. Initiative with a big payoff.

Enabling patients to get same-day appointments should result in better patient care and ultimately lower costs. “Expediting access to healthcare services positively impacts the entire patient experience,” says Elie Aoun, MD, AHN, medical director for Clinical Access. “By eliminating long wait times for appointments and addressing a patient’s health concerns in a more timely and well-coordinated fashion, better clinical outcomes can be achieved.”

Crowell points out that by offering same-day appointments with specialists, patients may be able to have their issue addressed in an office setting rather than the emergency room.

Next: The final two takeaways



4. Prior-authorization requirements can raise problems.

Despite the benefits, challenges exist for some patients in getting same-day appointments, such as their health insurer requiring pre-authorization for a specialist visit. “We always encourage patients to be familiar with their health insurance coverage and any limitations,” Crowell says. Crowell points out that although AHN is offering same-day appointments, this does not include same-day procedures or ancillary testing because oftentimes they require pre-authorization.

5. Patient satisfaction is skyrocketing.

Crowell feels strongly that offering same-day appointments is a key cornerstone in creating a patient-centered access model. “It’s a positive step toward keeping us moving in that direction,” she says. “Many industries have on-demand access to meet people’s needs. Healthcare is lagging behind a bit. Nationwide, norms for wait times to see a specialist can be three weeks or longer.”

Preliminary patient satisfaction research shows a 96% satisfaction rate with same-day appointments for primary care at AHN. The system plans to do a similar study on specialty care in the coming months.

Karen Appold is a medical writer in Lehigh Valley, Pennsylvania.

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