Patients, providers still see many pain points with 'digital front door' and care access, survey finds

Despite the increased adoption of digital health tools and telehealth in the past three years, patients and providers see the "digital front door" as still being a less-than-ideal entry point into healthcare, according to a new Experian Health report.

The report is based on a survey (PDF), conducted in December 2022, that reached 202 providers and 1,001 U.S. adult patients who sought care for themselves or a dependent in the prior 12 months.

The top-line story from the survey is a bottom-line warning: Patient and provider perceptions of access are getting worse, not better, the report authors wrote.

Patient access was defined as scheduling an appointment, registration, coverage verification, pre-care payments and patient communication.

Most respondents believe the access experience is the same or worse than it was in the last two years. “Calling the patient access experience ‘the same’ following unprecedented pandemic chaos is a sign that more work is needed,” the report said. “‘Worse' is troubling since much effort and budget have been spent to make improvements.” 

Nearly half of providers believe access is worse today than it has been in the past two years, a much higher rate than patients. But providers also see things as better at a higher rate than patients. This could be because of their daily work tied to improvements in this area, like accurate data collection at intake.

“Providers leaned more into ‘worse’ or ‘better,’ underscoring that not much has stayed the same for healthcare workers over the past few years,” the report said. More than half of patients (62%) feel access is the same as before.

For most patients, seeing a practitioner quickly has stayed a top concern for three years, trending up each year. For providers, the top challenge is getting patients to use the digital services designed to help them see a doctor quickly. Other provider concerns include staffing shortages, patient confusion caused by the pandemic and cost estimates.

Other challenges for patients include trying to schedule appointments, scheduling appointments with a specialist and knowing where to go for needed care. More than half of patients who considered the access experience to be worse this year said they would switch providers because of that. 

More than a quarter of patients believe the payment experience has gotten worse. Four in 10 patients said they’re likely to cancel or postpone care without an accurate cost estimate. And nearly three-quarters of patients find an online option for payments to be important. 

Three-quarters of providers agreed that accurate, upfront estimates led to better collections, and nearly 9 in 10 believe it’s important to their organizations to improve the access and financial experiences of patients. Yet more than half (65%) of patients said they didn’t receive an estimate before care, though most of those that did said it was accurate.

Most patients say they’d like to schedule appointments online. More than half also say they want more digital options to manage healthcare. These priorities were recognized by provider respondents, most of whom agree that digital access is very important to patients. 

Other things patients expect from the digital front door include accurate pre-care estimates, prepayment plans, digital payment options, a multipurpose portal and mobile scheduling, registration, communications and telehealth care. 

Providers are hopeful things will improve in 2023. Nearly 6 in 10 say digital solutions have improved the patient experience and that digital communications have been implemented. More than a third believe cost estimates are provided and are accurate.

About 40% of providers currently offer self-scheduling. Those that do are also heavy users of digital channels for communications including appointment reminders, schedule changes, lab results, collections, preventive care and the social determinants of health. 

Experian’s surveys reflect a “slowly shrinking gap between patient satisfaction and healthcare’s efforts to better address consumerism and earn patient loyalty,” the report concluded. Patients should benefit from convenience, transparency, communication and possibly reduced costs. Providers will also benefit as collections and reimbursements increase and become more predictable, and patients reward them with loyalty.