As health systems struggle with capacity constraints, workforce shortages and rising patient demand, access has become one of healthcare’s most urgent challenges. At Jefferson Health, leaders increasingly view access not as a scheduling or staffing issue alone, but as a technology-enabled enterprise problem that requires coordinated digital, operational and clinical strategies.
Judd Hollander, MD, senior vice president of healthcare delivery innovation and chief virtual care officer at Philadelphia-based Jefferson, said access pressures are shaping nearly every major initiative across the organization.
“The pressure point, I think, at health systems all across the country is access, access and more access,” Dr. Hollander said during an episode of the “Becker’s Healthcare Podcast.” “How do you get in?”
Jefferson’s access strategy is closely tied to its broader digital and AI roadmap, including a systemwide effort to reclaim 10 million patient care hours over three years. While some of those initiatives sit outside Dr. Hollander’s direct portfolio, he said technology is central to creating capacity without adding physical space or delaying care.
“We’ve grown out ambient listening to thousands of our clinicians, physicians and advanced care providers, across the enterprise,” he said. “Colleen Malazzi, RN, senior vice president and chief nursing informatics officer, led a team that launched ambient AI for our nurses on our first unit, which will free up nurses to be at the bedside more, rather than doing documentation.”
The goal is not simply efficiency, but expanding access by freeing clinicians to spend more time with patients. The demand for care is increasing in many communities across the U.S., while health systems are experiencing clinician shortages and tighter margins. The time and energy clinicians devote to patient care is a valuable resource within the healthcare ecosystem.
“[AI for nurses] may help create capacity,” Dr. Hollander said. “It may also help us recruit more people to take care of patients, because the job may be better, burnout may be less, retention may be better.”
Matching patients to available capacity
Jefferson is also using technology to better match patients with available appointment slots — a challenge that increasingly falls to IT and data teams. Dr. Hollander described two parallel access problems: identifying where capacity already exists and creating capacity where it does not.
“There’s practices that have capacity. That’s easy,” he said. “How do we identify the patients that need to see those specialists so they could take the open slots and we could provide better care to people in the community?”
But just installing technology isn’t enough. Patients need extra space for timely care now. Jefferson is redesigning workflows and care models to create new capacity without huge capital investments and years-long projects.
“The challenge is, how do we create more capacity without actually having to go build a multi-office or multispecialty office building,” Dr. Hollander said. “We’re transitioning some people that work in the office to work at home, backfilling the office space with a new clinician creates more capacity without us having to wait 10 years to build a building and find real estate.”
One of Jefferson’s most visible access initiatives — its same-day, next-day cancer care program — underscores how tightly technology, workflow and access are intertwined. The program was built on a simple premise: patients with a new cancer diagnosis should not wait weeks for an appointment. But delivering on that promise required redesigning scheduling systems, escalation pathways and clinical workflows.
Jefferson’s enterprise strategy for centralized scheduling empowers physicians to bypass traditional bottlenecks and resolve patient issues in real time. They’re able to provide more efficient care and a better experience, personalized to each patient’s journey.
“What happens if the first clinician seeing somebody is a nurse practitioner who’s not entirely sure of the answer on somebody with a super specialized cancer?” he said. “Rather than send them to the cancer specialist, they have permission to call and disturb that specialist in the middle of the day to get the answer, so the patient gets off the phone with the answer.”
Why access is becoming an IT leadership issue
As access challenges intensify, Dr. Hollander said the hardest work ahead is not deploying new tools, but helping clinicians adapt to new ways of delivering care. Clinicians who do not adapt to virtual care, AI-enabled workflows and new access models risk falling behind patient expectations.
“If we have clinicians that haven’t figured out how to use AI where AI can be used, if we have clinicians that haven’t figured out how to engage their patients in virtual care, then patients are going to go somewhere else,” Dr. Hollander said.
For CIOs and IT leaders, that reality continues to push access higher on the digital agenda as a core outcome shaped by technology strategy, data, governance and workflow design across the enterprise. It’s not just a downstream operational issue.
“We need to have programs with our leadership about how we can get the people we work with, the people we work under, and the people we supervise, how to embrace change and to move forward into the next decade,” Dr. Hollander said.
Over the next year, health systems will experience additional pressure to diversify as margins tighten and the demand for care increases. The potential for more uncompensated care amid ACA subsidy and Medicaid cuts is looming large for health system executives. Academic systems in particular are looking for ways to stabilize funding; Jefferson has a venture fund, health plan, academic research and patient care arms.
“If we’re going to take great care of patients, we can’t be on the receiving end of everybody else’s policies and not influence it. It’s so much easier for us to give really good, cost-effective care if we’re in control,” Dr. Hollander said. “People talk about controlling the whole premium dollar, but really I prefer to think of it as controlling the whole patient journey, and working with the patient to create the optimal journey.”
