Elon Musk is a highly controversial figure in our economy and society today. Nonetheless, he has demonstrated strengths in manufacturing design processes, which have been most evident in his work with companies such as Tesla and SpaceX.
In 2021, Musk provided Everyday Astronaut with a tour of the SpaceX Starbase in Boca Chica, Texas. Starbase is where SpaceX runs production and development of the Starship spacecraft and Super Heavy rocket. The transport system will initially be used to launch crew and cargo material into Earth’s orbit, with the eventual goal of reaching the Moon and Mars.
The Everyday Astronaut article outlines the five-step design process used by the SpaceX engineering team on a daily basis. The key components of this design process are:
- Make the requirements less dumb/challenge the requirements
- Delete the part or process
- Simplify or optimize the design
- Accelerate cycle time
- Automate
While health systems are obviously not in the rocket-making business, this design process provides a helpful framework for healthcare leaders to transform how patients access their systems.
1) Make the requirements less dumb/challenge the requirements
Takeaway: Examine the current state of patient access
While this may be the most direct (and satirical) criticism of existing processes, it highlights the importance of leaders continuously examining all current state access procedures. Leaders should be asking a key question: Have we designed a process for patients that we wouldn’t want to navigate ourselves? We regularly hear from organizations that certain patient access processes are in place because “this is how it’s always been done.” With rising competition in local markets by large retailers, it is time to reengineer your patient access strategy to stay ahead of the curve. All access components need to be on the table for review, from initial inquiry all the way through to the clinical appointment and subsequent coordination of diagnostics and referrals. The key here is to question every component of the patient access “assembly line” for optimal efficiency.
2) Delete the part or process
Takeaway: Patient access processes should be minimal
When assembly lines at SpaceX are developed, they begin as minimal as possible and additional steps are added to the process only when needed. If part of the process is removed, it can be added back only if it improves cycle time. The SpaceX process is based on the belief that if you are not adding back 10% to 20% of what you originally cut, then you aren’t cutting enough. Once leaders have examined the current state of patient access, the next step is to be agile and eliminate any redundancies and inefficiencies. In this part of the process, it is important to pay close attention to those components that are added “just in case.” These “just in case” components need accountability and constant reevaluation of their effectiveness.
3) Simplify or optimize the design
Takeaway: Don’t try to fix something that should not be there
As noted in the Everday Astronaut article, it is a common error for engineers to “optimize something that should not exist.” Leaders need to start designing processes that work for patients, and not try to bring efficiency to workflows that are broken and unnecessary. The key here is taking a holistic view of patient access, not just focusing on one element. For example, we frequently see organizations that have complex scheduling algorithms at the point of initial inquiry. These complexities are usually added to account for as many chief complaints as possible, with the attempt to get precise routing to an exact physician. Creating the perfect scheduling algorithm is nearly impossible, and more questions make it even more complicated and time-consuming for patients. The proper algorithm for subspecialties may instead require initial intake and triage by a provider, allowing the patient to advance another step in the access journey.
4) Accelerate cycle time
Takeaway: The process needs to be seamless and fast
The goal at SpaceX is 144 launches in the 2024 calendar year. For perspective, SpaceX launched 67 times in 2022, meaning that in just two years, SpaceX will have more than doubled their launch capability. The key point with accelerating cycle time is to move faster, but also make sure you are moving fast in the right direction. Shoppable and strategic specialties (i.e. cancer and neurosciences) require a very short scheduling lag of less than a few days to get the patient seen. A newly diagnosed cancer patient will likely call multiple cancer centers in the market—the one with the fastest access has the immediate advantage. Leaders need to ensure time is reserved to see new patients for same/next day availability. Patients are demanding it, and market disrupters are providing it.
5) Automate
Takeaway: Optimize self-scheduling capabilities
While automation is a key to accelerating cycle time, a process should only be automated after going through design process components 1 through 4 multiple times. In the case of building a rocket engine, an autonomous robot might be able to assemble the components faster than a human; however, if the engine design is suboptimal, money and time will have been wasted in automating inefficiency. Ensuring the patient access processes are as trim as possible prior to introducing any automation ensures the automation will achieve true gain and not just cover up existing inefficiencies. A practical example would be self-scheduling; this capability alone will not solve your patient access problems if you have not addressed all the bottlenecks in the process. However, a fully optimized patient access process with self-scheduling will standardize the workflow.
Zocdoc, an online patient scheduling platform, released their 2023 year-end report, featuring an eye-opening insight regarding after-hours bookings. According to Zocdoc, “roughly half of all appointments were booked after hours, when doctors’ offices are typically closed.” Automating the way patients access care through self-scheduling allows organizations to meet patients at the time and place of their choosing. The telephone line that only gets answered between 9 a.m. and 5 p.m. is quickly becoming obsolete. Health systems need to meet younger generations especially through the online platforms that they prefer and use regularly. The Zocdoc report affirms this by revealing that in 2023 “nearly half of all bookers were Millennials.” Leveraging automation is integral to executing a transformed patient access strategy.
Change management lays at the foundation of any patient access transformation. Your goal should be to shift your patient access improvements from incrementalism to transformation. The healthcare market disrupters today are iterating on components 1 through 4 and many are well into the automation phase with their patient access processes.
Nothing is more important in healthcare today than improving patient access. It matters from a revenue perspective, it matters from a quality perspective, and it is a huge driver of patient satisfaction—or dissatisfaction. Is your patient access process ready to meet these challenges?
