January 7, 2021

The Compelling Case for ‘Healthcare Access and Orchestration’ and Why It Matters

The language of healthcare evolves over time, for good reason: It reflects what’s actually happening on the ground. Advances in technology and treatments continually spawn new terms, such as “hybrid imaging” in radiology departments “CAR T-cell therapy” in cancer treatment centers and “triage platforms” for telehealth users.


Similarly, new terminology has infiltrated our conversations about moving patients into, through, and out of a health system. Sometimes these new words and phrases replace existing language because they simply do a better job of communicating fundamental concepts.


For example, the terms “transfer center” and “command center” don’t fully convey efforts to ensure efficient patient navigation across health systems and through a continuum of care, whatever it entails and wherever it occurs. Moreover, neither term speaks to strategic initiatives, such as uncovering new opportunities to boost margins or to optimize staff and other resources.


Clearly, we’ve moved into an era of “healthcare access and orchestration,” in which access centers play a vitally important role.


Before diving into a high-level discussion of how healthcare access and orchestration translates to real-world outcomes, let’s take a quick look at how we define the words in the context of how health system operate.


Traditionally, “transfer” refers to the linear movement of patients with acute needs from one hospital to another or from department to department within a hospital. “Access,” on the other hand, speaks to patients engaging with providers in various ways at multiple levels, both in person and virtually. Access may involve one health system, multiple health systems or even a large geographic area. It spans the entire spectrum of care, from the moment an individual presents with a healthcare need through discharge to a post-acute care setting or a return to home.


Orchestration” takes the concept of access a step further. It describes a coordinated deployment of resources — facilities, physicians, staff, beds, and equipment — in a way that yields optimal clinical outcomes for the patient, as well as operational and financial benefits for the organization.


Clinical Outcomes

High-quality, timely patient care


Every patient deserves the highest quality care without delay, even at a time when resources are stretched to the limit. The healthcare access and orchestration model supports this objective by enabling real-time visibility and management of every juncture in the patient journey, whether it’s provider scheduling, bed placement, transportation, or discharge.


To better understand the clinical benefits of access and orchestration, consider the example of an individual who has arrived at the emergency department of a community hospital with symptoms of stroke. Following an assessment, the on-duty hospitalist calls a nearby health system about transferring the patient to a tertiary hospital with a comprehensive stroke center for further evaluation and intervention. Of course, time is of the essence for this and other patients who may be experiencing a life-threatening health condition.


With comprehensive access and orchestration capabilities, the health system’s access center quickly pinpoints the real-time availability of a neurologist and an acute-care bed. But the health system can do much more than respond with a prompt “yes” to the transfer request. For example, the access center team may also coordinate transportation for the patient — essentially arranging point-to-point care for an overburdened hospitalist and ED team.


In the case of a potential stroke patient, the access center’s experienced clinicians may coordinate a telestroke consultation with a health system neurologist. Using a tablet linked to a device in the community hospital’s ED, the specialist performs an assessment and may start an intervention, such as ordering thrombolytics, prior to the transfer. This significantly reduces time to care, potentially leading to an improved outcome. And it’s just one of many examples of how a health system can leverage access and orchestration to elevate patient care.


Operational Outcomes

Improved processes and use of resources


Health system operations also benefit from a solid foundation of access and orchestration. By “operating as one” — everyone acting in a highly unified manner, based on a single view of real-time capacity and other critical data — processes flow smoothly, and resources are deployed with maximum efficiency. At every step, redundant activities and manual data entry are eliminated.


For a deeper insight, let’s continue the story of our stroke patient. Following treatment and inpatient rehab, the specialist determines that the patient is ready for discharge to a post-acute care (PAC) facility. In the past, a case manager or nurse used the phone or fax machine to contact prospective PAC facilities with the goal of locating an available bed. Today, thanks to robust access and orchestration capabilities, the health system finds a PAC bed, as well as transportation, for the patient in a matter of minutes with just a few clicks, freeing hospital staff from a time-consuming manual process.


Expediting transfers to a PAC facility not only makes for happier patients, family members and clinicians, but it benefits the health system by reducing length of stay and freeing up acute-care beds, which are often in short supply.


In an alternate twist to this story, let’s say the neurologist determines, via the telestroke assessment, that the patient does not meet stroke criteria. It’s likely that the patient may not need to be transferred after all and can receive treatment from his or her local physician. Besides saving the health system’s limited resources for other more critically ill patients, this determination spares the busy neurologist from seeing a patient who doesn’t require advanced stroke care.


Financial Outcomes

Increased referrals and revenue 


All too often, referring providers don’t have the same smooth and seamless experiences as the hospitalist in the story about our stroke patient. The financial implications can be profound.


Central Logic Chief Medical Officer Dr. Darin Vercillo has shared stories about patients under his care who urgently needed to be transferred to a larger hospital for advanced intervention. In one article, he wrote: “We get bounced around between providers and are forced to repeat information multiple times. Transports or records are delayed. When the patient arrives, nothing is arranged and further delays occur. There was one such case that kept me from calling a particular hospital’s transfer center back for years.”


Now think about the ramifications of Dr. Vercillo’s last statement. While he was naturally most concerned about the health of his patients, his decision to bypass a certain hospital for future referrals translates to a substantial loss of revenue for that organization — one recent study pegs it at an average of $10,836 per inpatient admission nationally. In all likelihood, other referring physicians had the same negative experience and made the same decision, compounding the impact of flawed transfer processes.


On the other hand, when patients and their providers have a positive healthcare access and orchestration experience, something very different happens: their loyalty to the health system grows. Even better, they convey their satisfaction to friends and peers. At a time when cost-cutting seems inevitable, health systems with a unwavering commitment to healthcare access and orchestration are increasing their referrals and boosting revenues. Consequently, these organizations are empowered to make new investments that further benefit their patients, providers, and staff.


In summary, “healthcare access and orchestration” isn’t merely a new catchphrase. Rather, it defines profound changes in the healthcare delivery landscape and how we at Central Logic will support our clients in confronting new challenges and seizing new opportunities.