December 17, 2020

Access Centers and Patient Orchestration: What Health Systems Need to Know

Many hospitals and health systems are familiar with the concept of the command center.


This is where data related to ED capacity, OR visibility, environmental services and other information pertaining to what occurs within the walls of the hospital ultimately resides. The command center provides analysts, IT personnel, hospital leaders and others with the insights they need to become more clinically effective and ensure resources are being utilized to their greatest extent. This “hub” of information is essential to helping hospitals scale and maintain efficient patient throughput.


But there’s another concept that isn’t as heralded, or as well-known, despite the immense gains it can bring to health systems: the access center.


The Access Center

There is indeed some overlap between the access center and the command center, chiefly in the area of patient transfers.


With its array of available data, the command center does play a role in the patient transfer process. After all, in order to have a successful patient intake, you need to know basic information about capacity, resource availability and other data points. Some hospitals have even set up “transfer centers” to deal with information related to transfers into the acute space.


By and large, there are essentially three ways that an individual will find themselves admitted to the hospital:


  1. Emergency care
  2. Elective, non-emergency procedure
  3. Transfer from a different medical facility


These are the purview of the transfer center and, in turn, the command center. But here’s the problem: by focusing only on acute transfers into or within the facility, the command center fails to account for the vast degree of planning necessary for the various other steps in the patient journey. How do you account for the movement of the patient to and from various acute and non-acute settings? Where does post-acute discharge and follow-up monitoring fall?


Helping to facilitate patient transfer and getting the patient to a setting where they can be treated efficiently and effectively is the problem Central Logic was founded to solve more than 10 years ago. Since that time, we have expanded our orchestration capabilities to cover the entire continuum of care – from patient transfers into the health system to patient transitions out of the system, to post-acute and step-down facilities or rehab, or even transfer to the home where a patient is going to continue to receive services in their home environment.


The access center goes beyond the transfer center and even the command center. It looks at the totality of the patient care journey and helps hospital leaders better manage every step within that process.


It’s only when you take a step back and look at the full picture of patient movements that you really begin to see just how far-reaching the access center is, and how transformational this pillar of patient movement can be for revenue, clinical outcomes and throughput. The access center centralizes processes and procedures related to:


  • Acute patient transfers into the system
  • Patient transitions to post-acute care
  • Non-acute referrals
  • Transportation to, from, and within the health system
  • Load balancing across all settings of care
  • Real-time provider scheduling and bed visibility
  • Provider engagement
  • Behavioral health transfers
  • Centralized nurse triage
  • Telemedicine access


By addressing these functions, all of which are central to the patient care journey, the access center doesn’t just play a strategic role within the health system, although it certainly does that. It acts as a revenue engine for the health system, turning patient transfers from a drain on resources to an area that contributes to overall revenue.


That’s because the access center can ensure all movements to and from care settings are optimized to the benefit of patients and health systems alike. This careful analysis of the full scope of patient movements allows for a more efficient deployment of hospital resources. It reduces the hours clinical professionals must focus on non-clinical administrative tasks, enabling them to work top of license for longer, and it frees up bed space more quickly – allowing the health system to treat more patients with acute conditions and keeping capacity optimized.


Most importantly, it provides health systems the necessary controls to orchestrate patients to the appropriate level of care, navigate patients to the right setting for care, and elevate revenue capture, clinician effectiveness, and patient outcomes.


Which brings us to the next concept that’s critical to touch upon: patient orchestration.


Patient Orchestration

At its most fundamental level, the concept of patient orchestration can be boiled down to the optimization of the patient movement across the entirety of their care journey.


The access center is fundamental to ensuring orchestration can be achieved. This isn’t simply about checking off a box as the patient reaches the next step in the process. The term “orchestration” denotes a level of planning and coordination that simply isn’t possible without the full breadth of centralized analysis and expertise available from the access center.


This can be somewhat difficult to grasp, so let’s take a look at an example of what we mean. Let’s imagine a patient coming in for a fairly standard elective knee replacement operation.


For much of health systems’ history, the disparate parts of that patient’s journey would be taken piecemeal as they happened. The physician’s diagnosis would highlight the need for the knee to be replaced, at which point the procedure would be scheduled. The patient would arrive for their procedure. Upon completion, they would recover in a designated space. Once deemed ready for discharge, he or she would be sent home or to an available post-acute facility. On their way out, they would likely be given a packet of instructions on how to continue their recovery. The case manager might reach out in a couple days to check on progress and schedule a follow-up appointment.


In an ideal scenario, where everything goes as planned, this is fine. But what happens if things start to go wrong? What if the patient lacks transportation to or from the acute setting? What if recovery takes longer than expected and they’re taking up a bed for a couple days longer than anticipated? What if post-acute facilities are unexpectedly full? What if the patient ignores the recovery instructions?


The traditional patient movement process isn’t orchestration; it’s a checklist. But when even one item on that checklist doesn’t go as planned, revenue dwindles, the patient experience is compromised, and the likelihood of adverse events increases.


Orchestration is what happens when the access center takes the data available and uses that information to plan the patient’s movements from diagnosis all the way through to follow-up care. It enables its clinical staff to assess the patient’s needs, the resources available, and the likelihood of events to develop a plan with numerous contingencies in place and maximum potential for successful throughput.


The patient undergoing a knee replacement thus gets assigned an ideal date, staff, and, if necessary, transportation prior to their arrival. Their recovery is monitored, and resources are utilized according to how they’re recuperating. Their eventual discharge is planned well in advance and, upon discharge, the patient has already been assessed for their likelihood of sticking to the recovery plan.


Over time, this journey gets iterated upon and improved. All the data generated by each patient’s experience ends up informing the next patient experience, helping clinical staff truly orchestrate all movements.


Access and Orchestration

We hope this has helped you to understand these two concepts and their importance in the modern healthcare space. As health systems grow, the need to anticipate movements and outcomes grows too, and the access center is key to success in this regard.


Orchestration via the access center can help ensure hospitals succeed, patients recover and clinical outcomes improve over time.