Enhanced Access

Overview

Access to primary care services is a critical element of the Patient's Medical Home (PMH).

Access issues can be divided into two components:

1. Access to care (Deprivation) - patients are unable to access care because they don't have an established ongoing relationship with a primary care physician. They are not "paneled" to a physician due to inability to find a physician who has room on their panel.
2. Timely Access for care - a patient has a primary care physician and is a part of their panel, but they must wait to receive an appointment beyond an acceptable timeframe

Both issues are critically important and by beginning our focus on timely access for care we can also begin to address deprivation or access to care. Delays represent the relationship between demand and supply. If demand for care exceeds capacity (supply) to provide care, delays will occur and worsen. Delays can only be improved by seeking to achieve demand – supply balance. Those deprived of care can be brought into the fold (paneled with a physician) when better balance is achieved, and as clinical capacity becomes greater than demand for care. In this situation a physician would now have openings on their panel.

Delays for care have a direct relationship to continuity. As patients seek care outside their PMH due to inability to see their own provider or practice team in a timely fashion, continuity suffers due to the lack of relationship and information available to the provider seen. Delays for care can also lead to rework and triage, provider/patient dissatisfaction, no shows, phone chaos, which can all have negative impacts on the clinical capacity to provide care. In some cases, adverse clinical outcomes can result from excessive delays for care.

The Link Between Access & Continuity

The concepts of access and continuity are inextricably linked. For a patient and provider to have high continuity (informational, relational and management), patients must have timely access to their primary care provider whenever healthcare needs arise. The goal of providing timely access to your panel of patients is to allow patients the ability to see their own primary care provider to maintain continuity of care and optimize health outcomes. 

Tools and Resources

Watch this space for more to come. We anticipate opportunities for input and early testing of innovations in design and delivery with Primary Care Network partners. If this is something that is of interest or if you have questions for our team, please contact actt@albertadoctors.org.