Most health systems think accessibility means phone hours. Maybe a portal. Maybe a chatbot.

That’s availability. Accessibility is different. You can be available 24/7 and still be impossible to reach if every channel dead-ends in a phone tree or a password reset loop.

Accessibility has three dimensions:

1. Channel Availability. Can patients reach you by phone, chat, portal, SMS, and app? Not just during business hours. At 2am when a new mother is scared. At 6am when a patient remembers a question they forgot to ask at discharge. On a Sunday when a billing statement doesn’t make sense.

2. Escalation Paths. When AI can’t solve it, can patients get to a human? Quickly? Without navigating a seven-layer IVR maze or telling their story three times? The most dangerous accessibility failure isn’t a missing channel. It’s a missing escape hatch.

3. Language and Cultural Accommodation. Can patients communicate in their language? “Accessible” looks different for a Spanish-speaking grandmother in South Texas than it does for a tech-savvy millennial in Seattle. Health inequities cost $320 billion annually, according to Deloitte, and accessibility gaps are a big part of that number.

Accessibility isn’t a service metric. It’s a revenue metric. Every abandoned call represents potential revenue walking to a competitor. For a high-volume contact center, that adds up to $45,000 per day in lost opportunity (we broke this down in Issue #33). And every patient who can’t reach you and drives to the ER instead? That’s $2,500+ in system costs for a visit that might have been a phone call and an appointment confirmation. Now multiply that across the 60% of ER visits that are non-urgent.

Two health systems stopped treating accessibility as a phone schedule and started treating it as infrastructure.

Intermountain Health deployed Hyro’s AI-powered platform across their websites, mobile apps, and call centers. The results:

•             85% reduction in call abandonment rates

•             79% improvement in speed to answer

•             27% of patient interactions now handled outside traditional hours

•             79% of online chats resolved without agent involvement

•             44% of repetitive calls automated, freeing agents for complex cases

As Craig Richardville, then Chief Digital and Information Officer at Intermountain Health, put it: “We’ve experienced an 85% reduction in call abandonment and a 79% increase in speed to answer. This partnership is a game-changer for our patients and support teams.”

They didn’t just extend hours. They made the system smart enough to resolve common issues (scheduling, password resets, prescription questions) around the clock. And when AI couldn’t handle it, patients were routed to the right human with full context. No starting over. No explaining it twice.

Steinberg Diagnostic Medical Imaging implemented the Genesys Cloud platform with virtual agents integrated into their electronic medical records. The headline number is call abandonment dropping from 10% to 2.9%. But what matters more is what happened behind that number.

SDMI now supports an additional 4,000 calls per month, ensuring more people receive compassionate guidance to their questions and care without sacrificing quality. Patients gained 24/7 access to services, providing peace of mind and ensuring support is available outside traditional business hours. When you’re waiting on diagnostic imaging results, anxiety doesn’t clock out at 5pm. Having someone available at 9pm to walk you through next steps changes the entire experience.

As Rachel Papka, Chief Innovation Officer at SDMI, put it: “Today’s phone systems are no longer just about connecting calls – they’re about connecting people.”

That’s accessibility in one sentence. Not faster technology. Not more automation. Connection.

Most hospitals hear “AI for accessibility” and jump straight to: “Let’s automate everything.” They deploy a chatbot that handles 80% of interactions. Except it’s the wrong 80%.

They automate the easy stuff (balance inquiries, appointment confirmations) while the complex, trust-building interactions (billing disputes, care coordination, post-discharge questions) still sit in a queue. Patients end up waiting longer for the calls that actually matter.

I call this the Agentic AI Paradox: most hospitals automate the wrong 80% of calls. Smart accessibility means AI handles routine inquiries while getting complex cases to humans faster, not slower.

The best implementations use agentic routing. The system identifies what the patient needs and sends them through the fastest path: end-to-end AI resolution for tasks like scheduling, the option to switch from a call to a text for self-service scenarios, and live agent handoff with full context for everything else.

Hyro’s platform reports that agentic routing averages 85% less call abandonment across their health system clients. Not because AI replaced humans. Because it got patients to the right resource without the runaround.

Think about my San Francisco traffic experience. I didn’t need a faster car. I needed someone to tell me which roads were open. Patients don’t need more channels. They need channels that actually get them somewhere.

If you have accountability for patient experience and revenue, accessibility is where those two things converge. Every abandoned call is revenue walking to a competitor. Every after-hours inquiry that goes unanswered is a patient forming their opinion about your system without your input. And every patient who can’t get through and drives to the ER instead is costing your system $2,500+ for a visit that might have been a phone call and an appointment confirmation.

Accessibility is Trust Signal #1 for a reason. Resolution, Continuity, Proactivity, Recovery – they all require the patient to reach you first. If they can’t get through the front door, nothing downstream matters.

Start here: audit your after-hours capabilities this week. What happens when a patient calls at 2am? If the answer is “voicemail,” that’s a measurable revenue leak. Track abandonment rates by time of day. The pattern will show you exactly where trust is breaking down. And evaluate every technology investment through one lens: does this help patients reach us, or does it put up another wall between them and care?

Virtual agents that deflect calls aren’t making you more accessible. They’re building a barrier. The standard should be simple: patients can reach you on any channel, at any hour, in their language, with a clear path to a human when they need one.

Before you commission a consulting engagement or deploy new technology, do two things:

1. Call your own contact center at 2am tonight.

What happens? Voicemail? IVR maze? AI assistant? Human? Nothing?

Then try your patient portal. Reset your password. Schedule an appointment. Check a lab result.

Time it. Document the friction. Note where you get stuck.

2. Pull your ER data for non-urgent visits.

How many of those patients had an existing relationship with your system? How many called your contact center or logged into the portal in the 24 hours before their ER visit? The overlap could tell you exactly how many ER visits your accessibility gaps are creating.

That combination reveals your Accessibility signal. And it costs nothing.

Take the Trust Assessment: patientexperiencestrategist.com/#/assessment

Score your organization across all five Trust Signals in about five minutes.

You already know trust drives margins. The 4.7% vs. 1.8% operating margin differential between high-performing and low-performing patient experience organizations is well documented.

Where does that trust start? With accessibility.

When a patient reaches out and you’re not there, that’s not a missed call. It’s a trust withdrawal. And unlike a bank account, trust doesn’t send you a statement showing your balance.

Next week: Trust Signal #2, RESOLUTION. Why your 85% First Contact Resolution rate might be a lie, and what happens when you start measuring patient-confirmed resolution instead of system-defined resolution.

What’s your 2am experience like? Have you called your own system after hours? Hit reply and tell me what you found. I read every response.

Let’s get to work.

— Ebony

Ready to Go Deeper?

Get Your Trust Algorithm Score

Take the 5-minute assessment and see exactly where your organization stands across all five Trust Signals.

TAKE THE TRUST ASSESSMENT

Book a Discovery Call

Ready to run a full Accessibility Audit? Let’s find out what your patients experience at 2am.

BOOK YOUR ACCESSIBILITY AUDIT