Blog Post

Measuring New Patient Access with the Right Metric at the Right Time

Measuring New Patient Access Web

While the importance of patient access is generally recognized, healthcare leaders face a problem that may be surprising: no single, nationally accepted metric or benchmark exists to measure it. When discussing access, the conversations surrounding which metric to pursue are largely dependent on what data has been historically available to a health system. Even more, systems may disagree about what access should measure, balancing when patients want to be seen with what is achievable by the organization and what is medically reasonable.

Typically, three metrics are most commonly used to measure new patient access:

  • Third next available new patient appointment
  • Percentage of new patients scheduled within threshold
  • Average time to new patient appointment (“lag days”)
Third Next Available New Patient Appointment
Percentage of New Patients Scheduled within Threshold
Average Time to New Patient Appointment
(“lag days”)
DefinitionThe number of days until the third next available new patient appointment slot exists in the provider’s schedule The percentage of new patients who were scheduled within the threshold days The number of days between the scheduling date and appointment date, on average, across all appointments
TypeProspective Retrospective Retrospective
Best Practice

  • Primary Care: Same day or next day (within 24 hours)
  • Specialty Care (urgent): 2 days (within 48 hours)
  • Specialty Care (nonurgent): within 10 business days (14 calendar days)

  • 80% of patients scheduled within the threshold. The threshold may vary, but is typically as follows:
    • Primary Care (establish care): Within 5 business days (7 calendar days)
    • Specialty Care (to establish care): within 10 business days (14 calendar days)
    • Some specialties, namely oncology, will require quicker access to be competitive

  • Primary Care (establish care): Within 5 business days (7 calendar days)
  • Specialty Care (to establish care): within 10 business days (14 calendar days)
  • Some specialties, namely oncology, will require quicker access to be competitive.
Highlights of the Metric
  • Provides real-time, prospective information
  • Is immediately actionable; if this metric increases, managers and providers can work to immediately add more slots
  • Provides insight into the proportion of new patient demand that could and could not be accommodated within the time frame measured
  • Accommodates for outliers and patient preference within the 20% who fall outside of the goal
  • Can be normalized across all providers and specialties; even with different thresholds by specialty, a single target of 80% can be meaningful across the organization
  • Provides a precise number that allows for performance tracking over time
  • Provides actual, actionable data that can help tell a story (e.g., on average, patients wait 3 weeks for an appointment with a cardiologist)
  • Minimizes impact of exceptionally good or poor access by looking at the average of all appointments
  • Not always accurate; depending on when the report is run, it may be counting recently canceled appointment slots that make access look better than it is
  • Is dependent upon a sound EHR build; if slots appear available but are not schedulable, it can be inaccurate
  • Only provides a point-in-time look, limiting the reflection on the provider’s or practice’s long-term availability

  • Cannot provide real-time information, limiting usability in daily access management
  • May not always be an available built-in metric within the EHR, in which case a manual back-end calculation would be needed; becomes less meaningful if access is poor and the metric is always around 0%
  • Cannot provide real-time information, limiting usability in daily access management
  • Depending on the data set, can be impacted by outliers (e.g., a patient who chooses to schedule an appointment in 3 months)
  • Is not normalized across specialties and does not take into account national trends (e.g., behavioral health specialties will usually have a longer wait time than surgical specialties)
Recommended UseIdentifying real-time availability for a single provider or practice; should be used in a limited capacity System-wide/multispecialty dashboards to be used at the executive level as a single benchmark for patient access Refined and trackable reporting on a specific provider or specialty

Measuring access to care in the ambulatory enterprise is essential to the successful delivery of cost-effective and patient-centered care, and metrics provide insight for healthcare organizations to optimize performance. Operational leaders should be looking at all available access metrics regularly.

When health system executives are seeking to choose a single metric to gauge the system’s access performance, percentage of new patients scheduled within threshold should be chosen. This metric provides a cross-specialty view that accounts for each specialty’s need and ability to schedule new patients in a timely manner. This metric should be the metric of choice for executive dashboards.

When monitoring access at a practice or department level, average time to new patient appointment can be a helpful metric. It provides more precise and actionable data that can be tracked over time. Ambulatory leaders will understand the impact of this metric and how it compares across specialties.

We do not recommend using third next available new patient appointment. However, it can be helpful when looking at real-time schedules, allowing providers and practice managers to add access when needed.

Establishing a dashboard with the appropriate KPI and goal is the first step to improving patient access. Alongside this effort, organizations should:

  • Obtain buy-in from their employees and providers to improve access.
  • Measure appointment supply and demand across specialty departments and find a balance between the two.
  • Ensure there is an adequate staffing and provider workforce.
  • Ensure processes and technology are optimized to support intended outcomes.
  • Continue to monitor patient access measures, and continuously improve on the key success factors listed above.

In some cases, improving patient access is a multifaceted approach that can require organizational transformation. However, failing to make improvements and investments can result in inability to meet consumer demands and loss of market share in a competitive landscape.

Now is the time for ambulatory care transformation.

Driven by ubiquitous technology and increased purchasing power, patients are seeking care that is convenient and cost-effective. Read ECG’s latest whitepaper to learn more.

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