Expanding reach and improving margins with the help of digital tools
In a search for better margins, staffing solutions and more expedited and efficient care, ambulatory services have become a popular focus for hospital systems. Ambulatory care is emerging as one of the most effective levers for health systems to improve margins, alleviate inpatient capacity constraints and expand access — without the capital burden of traditional hospital growth.
According to McKinsey & Company, while some areas of healthcare have a murky financial future, ambulatory care is primed for growth due to site-of-care and at-home care trends. This reflects an aging population that is less able to travel far for exams, scheduled follow-ups and other treatments.
But as more systems look to supplement their operations with ambulatory care offerings, there are practical ways to make these investments as effective as possible. Let’s explore some of the factors that organizations should consider in this structural and industry shift.
An extension of the hub
One of the best ways to look at the organization is through a hub-and-spoke model. This means that while the main hospital campus is the system’s epicenter, all care centers are connected to it, linking data and protocols to provide the best possible care.
If protocols and data are all connected across the system using digital tools like integrated scheduling, imaging interoperability and real-time specialist collaboration, it ultimately supports the accomplishment of the two key goals of most ambulatory centers. First, you can expand your footprint far beyond where most people might typically travel to get care, bringing in more patients and revenue.
Next, it can help bring return on investment with the help of technology and remote care capabilities. Shifting appropriate procedures to lower-cost ambulatory settings can help systems reduce cost per case while potentially increasing procedural throughput and freeing inpatient capacity for higher-acuity care.
Getting creative with scheduling
Because ambulatory care centers are more nimble, the possibilities could be endless when it comes to how you leverage them to support the entire system. The equipment is typically more mobile and can be swapped out to account for different patient needs within the same system.
In light of that, to take pressure off the larger system, one helpful tactic is to group similar procedures and funnel them to different ambulatory care centers. For example, at a care center, you could organize imaging such that one day you’re doing all knee scans; the next day is shoulders, the next is cataracts and so on.
Offloading those procedures to a secondary care center can help healthcare providers optimize care while still gathering valuable information from patients that then dictates where they go next.
Digital tools can help make this possible. Specialists can remotely view some scans either in real time or immediately following, enabling them to ask technologists for a different image or angle or provide specific feedback on next steps. This can help decrease rescans or unnecessary visits by the patient.
Mammograms are another excellent example of the opportunities for connected ambulatory care centers. Ambulatory care centers can offer an ideal environment for these scheduled, routine scans. By investing in mobile units, a hospital can potentially have a full 12-month schedule for patients that meets a common, scalable care need and essentially delegates it to the hospital’s ambulatory care centers.
The flexibility of at-home care
Beyond the reconfiguring of procedures, check-ups and routine visits like mammograms and prostate exams, the rise of at-home care and telehealth is something that hospitals may want to factor into their growth strategies. If you’re serving a wide geographic area, at-home care can work as a patient access strategy in tandem with local ambulatory care centers.
Post-operation follow-ups can potentially be more flexible now as patients don’t have to travel so far, and they can either have an initial post-op check-up at the ambulatory care center or engage in a telehealth appointment, when appropriate, to determine the need for an in-person evaluation at the main hospital campus.
Leveraging the digital tools available while using ambulatory care centers as a bridge can help provide a great deal of flexibility that can ease the burden on different care areas within your hospital system.
Putting it into action
To bring this vision to life, there are certainly “big picture” considerations like digital connectivity and enterprise-wide workflows, but there are also more specific things to address. For example, you will likely need either additional training to move some of these procedures to ambulatory centers or have traveling technologists to staff the different procedures at those facilities.
Compliance and organized governance are also key considerations, as your connected care centers must manage data and imaging appropriately. Without strong governance, health systems may risk creating fragmented patient experiences, inconsistent clinical protocols and data silos across sites. Centralized oversight and interoperable systems are key to avoiding these pitfalls.
Sustainable growth
Expansion of care or geographic footprint can always carry the risk of diminished patient experience or a lack of organization. However, telehealth and digital tools that assist with scheduling, imaging and more can help create a path where ambulatory care centers can thrive in a hub-and-spoke model. When appropriate, they can be the first touchpoint for routine check-ups or exams, or they can be the “path home” for patients who need frequent post-op appointments.
Health systems that deliberately design and operationalize a hub-and-spoke ambulatory strategy — supported by interoperable technology and disciplined workflows — can be better positioned to scale access, protect margins and compete in an increasingly decentralized care landscape.
Nancy Wright is vice president of Commercial Services Digital Platforms at GE HealthCare. She is a trusted advisor to health system administrators and C-suite officers across the country, known for her expertise in complex systems architectures for hospital redevelopments, new construction, IT infrastructure, cybersecurity and whole health system solutions.
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