Where next for advanced access: will it be embraced by specialties?

dvanced Access, sometimes referred to as Open Access (see page 199), is a set of principles designed to help practices reduce waiting times for appointments and reduce office-waiting times, two common access barriers in healthcare today. The Advanced Access approach to practice management and scheduling was originally developed by Mark Murray, MD, MPA, and Catherine Tantau, RN, at Kaiser Permanente in the early 1990s. Many if not all of the strategies were derived from the experience of other industries—though cleverly adapted to healthcare. In the mid-1990s, Murray and Tantau began a partnership with the Institute for Healthcare Improvement (IHI), a nonprofit organization devoted to the spread of improvements in healthcare. Together with the IHI, Murray and Tantau have been involved in spreading Advanced Access to thousands of practices, primarily in primary care settings. The improvements in care documented by Triangle Family Practices in this issue are important drivers of the increasing appeal of this approach in primary care. More recently, the IHI, the Veterans Health Administration, and the National Health Service in the United Kingdom have developed methods for widespread dissemination of Advanced Access to thousands of practices. These large scale efforts have included specialty settings. However, adoption of Advanced Access by specialty practices has been slow and generally limited to a small number of organizations and geographic areas. Access Problems in Specialties