Access to care is about more than wait times. That was the consensus among participants of the Strategic Access Management Initiative Roundtable.
VHA’s Office of Veterans Access to Care met with health care experts, corporations, other health care organizations and academic institutions to discuss the need for national ‘access to care’ definitions and standards to be used across the U.S. health care industry.
“Access to care is a very important and complex subject,” said Kenneth W. Kizer, M.D., chief health care transformation officer and senior executive vice president for Atlas Research, LLC, and former VHA under secretary for health. “At present, there is no standard approach to or framework for defining and assessing it, making it almost impossible to compare the quality of access across health systems.
“The outcome of this roundtable affirms that access to care should be defined by more than wait times, including especially how patients feel about the timeliness of their care.”
Roundtable participants agreed that wait times are one component of assessing access. It also discussed metrics that shift the focus to coordination and continuity of care, quality of care, patients’ feeling that they were treated with compassion, and whether their individual needs were met in a timely manner.
The roundtable discussion began with an historical overview of access, including a discussion of the many ways that access to care has been defined and measured. Participants identified patient experiences and how patients feel about the care they received as the emerging way forward in high performing health systems.
“This was a great first step to secure feedback about our approach while learning more about how the private sector tracks and measures access – and that access often means different things to different healthcare organizations,” said Susan Kirsh, M.D.,VA’s acting assistant deputy under secretary for health for access, VHA’s Office of Veterans Access to Care.
Veterans are choosing VA more than ever, with nearly 60 million appointments completed in fiscal year 2019, 1.7 million more than the prior year.
“It’s fair to say that VHA is a leader in assuring timely access to care through a coordinated combination of virtual and in-person care utilizing telehealth and face-to-face visits, including visits with providers from just about anywhere using a connected device,” said Kirsh.
“VA has advantages in healthcare delivery over other health care institutions,” said Dr. Thomas H. Lee, chief medical officer for Press Ganey, Inc. “VA is in a position to focus on those segments and change the discussion on what access to care truly means.”
VA calculates wait time averages from past Veteran appointments – the primary and often sole measure used to evaluate whether VA offers Veterans access to care. Unlike most health care organizations in the private sector, VA makes its wait times available online at https://accesstocare.va.gov, as well as information about quality and patient satisfaction. Veterans, their family members and caregivers can use this information when making decisions about their care.
“Wait times must be understood in a much broader context of services provided to Veterans,” said Dr. Patrick Romano, professor of internal medicine and pediatrics at the University of California, Davis. “There are opportunities for VA and other health care institutions to better align wait times by including virtual visits and other care options.”
Rick Fox is the director of communications at VHA’s Office of Veterans Access to Care