Business Consult: Offering Advanced Access to Cardiology Care | Miranda Mooneyham, Senior Manager with ECG Management Consultants

CardioSource WorldNews | Traditional ways of delivering care simply aren’t meeting the health needs and expectations of the population. How appointments are scheduled plays a big part, but that’s changing. In the traditional paradigm, the physician booked 6 months out is assumed to be a top clinician. In the new paradigm, the inaccessible physician is increasingly losing patients to available partners and/or external competitors.

Ultimately, patients want more readily available care options, and provider groups are responding. Initiatives for expanding access range from extended hours of clinic operation to the development of telehealth programs to the increased use of advanced care practitioners. That said, receiving care starts with getting an appointment. Changing how clinic visits are scheduled goes a long way toward providing greater access to care. In this column, I highlight one particularly effective scheduling solution—the advanced access model.

Advanced Access vs. Traditional Scheduling

Finding slots or double-booking providers for urgent appointments, dealing with no-shows, and rescheduling requires heavy lifting on the part of front office staff. Advanced access (or open access) scheduling offers greater freedom and efficiency by creating schedules based on providers’ historic appointment patterns while making room for new patients and same-day appointments. Though commonly used in primary care, this approach works for specialty care practices as well. So, how specifically does advanced access compare to traditional scheduling? (TABLE 1)

An Advanced Access Example

I recently worked with a cardiology practice transitioning from traditional to advanced access scheduling. This practice included invasive and noninvasive specialists, as well as electrophysiologists and vascular surgeons. There were two primary goals of this effort:

  1. Ensure 48 hour access for new patients
  2. Decrease provider-specific restrictions to enable appointing across multiple providers/practices (to provide the first available visit)

We accomplished the migration from traditional scheduling to an advanced access through five major steps, each with its own set of actions. (TABLE 2)


The results attained 6 months after the implementation of the advanced access model show demonstrable improvements. Specifically, the following have been realized:

  1. Decreased average patient wait time by 50% or more within three of six provider groupings;
  2. Decreased no-show rate within three of six provider groupings;
  3. Increased percentage of patients seen within 48 hours to approximately 40% within the largest provider grouping; and
  4. Average WRVU productivity per provider per site remained stable.

This practice continues to improve access, patient satisfaction, and retention as part of implementing this strategy. Staff also report increased satisfaction and efficiency, largely stemming from decreases in how often they have to disturb providers during clinic days to request approval for work-ins.

A Step Toward Greater Patient Access

Even established patients are willing to leave their providers when care is not readily available, studies suggest. It stands to reason, then, that new patients, who are vitally important to cardiologists, are going to be less likely to wait for weeks or months to see a new provider— especially when others physicians are available. Though it won’t solve the entirety of the patient access problem by itself, advanced access does allow patients to get in the door more effectively and efficiently, benefiting patients and providers alike.

Read the full August issue of CardioSource WorldNews at

Keywords: CardioSource WorldNews, Ambulatory Care, Appointments and Schedules, Pharmaceutical Solutions, Telemedicine

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