One Size Doesn’t Fit All

July 9, 2026

Mike McKay, AIA, ACHE, EDAC, LEED AP, NCARB

Healthcare Market Sector Leader

Designing Patient Arrival Models for the Communities You Serve

Healthcare leaders should stop asking, “What’s the newest arrival model?” and start asking, “What’s the right arrival model for our patients?”

Every healthcare organization is asking a version of the same question.

Should we implement self-rooming? Should we eliminate the waiting room? Should patients check in from their phones? Should registration become fully digital? These questions dominate planning conversations today, but they are not the most important questions. The better question is: What arrival experience best serves the patients and communities we care for? As health systems invest in new electronic medical record (EMR) platforms, digital front doors, artificial intelligence, and ambulatory expansion, patient arrival has evolved from a front-desk workflow into a strategic planning decision that influences operations, staffing, patient satisfaction, capital investment, and facility design. Despite the rapid pace of innovation, one lesson continues to emerge—there is no universal arrival model.

Patient Arrival has Become a Strategic Planning Conversation

Five years ago, most conversations about patient arrival centered on registration desks and waiting room capacity. Today, they encompass consumer expectations, workforce shortages, digital engagement, infection prevention, operational efficiency, and the future of ambulatory care.

The pandemic accelerated many of these changes, but it did not create them. Patients increasingly expect healthcare interactions to mirror other digital experiences in their lives. At the same time, organizations continue to face staffing shortages while implementing sophisticated EMR platforms capable of supporting
mobile registration, automated workflows, and self-rooming.

Technology Creates Options – It Shouldn’t Dictate Strategy

Healthcare organizations have more tools than ever before. Mobile registration, patient portals, AI-assisted scheduling, self-service kiosks, RTLS, digital wayfinding, and patient-led rooming all offer opportunities to improve efficiency and enhance the patient experience.

Yet technology alone does not define success.

The organizations achieving the best outcomes first establish the experience they want patients and staff to have. Technology is then selected to support that vision—not the other way around.

One Size Doesn’t Fit All

The most important planning variable is not technology—it is the patient population.

An outpatient orthopedic clinic serving digitally engaged adults may successfully implement self-rooming. A rural health system may choose to maintain personal concierge-style registration because of community expectations. Pediatric environments often require additional reassurance for caregivers, while organizations serving older adults may intentionally preserve more face-to-face interaction.

In some rural settings, the patient population generally places a higher value on personal interaction, familiarity, and relationship-based care than an automated or technology-driven check-in process. While digital tools such as self-service kiosks, mobile registration, and contactless check-in can improve efficiency,
they may not align with the preferences or comfort level of many patients in this market.

A welcoming reception area staffed by friendly team members who can personally greet, guide, and assist patients creates an experience that reinforces trust, reduces anxiety, and establishes a positive tone for the visit. This human-centered approach often reflects the culture of the community and supports organizational commitment to compassionate, patient-focused care.

The goal is not to eliminate technology, but to integrate it in a way that complements the personal connections that patients value.

Providing staff-assisted registration with opportunities for optional digital support creates flexibility while preserving meaningful face-to-face interaction. By customizing the arrival experience to the specific needs and expectations of this patient population, the facility will promote greater patient comfort, improve
satisfaction, and create a healthcare environment that feels approachable, familiar, and authentically connected to the community it serves.

Case Study: Planning Technology & Design Together

One health system planning a new multispecialty ambulatory campus used the implementation of a new EMR platform as an opportunity to rethink patient arrival from the ground up. Rather than designing around traditional registration functions, planning teams evaluated how mobile check-in, self-rooming,
and digital workflows could reduce registration space while improving patient flow.

The result was not simply a smaller waiting room—it was an entirely different operational model that aligned technology, staffing, and facility design from the earliest planning stages.

The Waiting Room is Becoming a Strategic Asset

Perhaps nowhere is the evolution of patient arrival more visible than the waiting room.

Historically designed as the primary holding space between registration and care, waiting rooms are increasingly being replaced by distributed seating, concierge arrival experiences, or direct-to-room workflows.

For planners, this represents an opportunity to reduce non-clinical space, improve circulation, enhance wayfinding, and redirect square footage toward patient care.

The ERDMAN Patient Arrival Decision Framework

Successful organizations evaluate patient arrival through four interconnected lenses. At the center of each decision is the patient and the community being served.

Looking Ahead

Artificial intelligence will continue to evolve. Mobile engagement will become more seamless. Waiting rooms may continue to shrink, and arrival processes will become increasingly automated.

Yet the defining characteristic of successful healthcare organizations will not be how quickly they adopt new technology. It will be how effectively they align technology with the needs, expectations, and realities of the people they serve.

Healthcare leaders should stop asking, ‘What is the newest arrival model?’ and begin asking, ‘What arrival experience best reflects our community?’

Because in healthcare, one size has never fit all.

Mike McKay, AIA, ACHE, EDAC, LEED AP, NCARB

Healthcare Market Sector Leader

608.410.8026

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July 25, 2022

One Size Doesn’t Fit All

Designing Patient Arrival Models for the Communities You Serve

Healthcare leaders should stop asking, “What’s the newest arrival model?” and start asking, “What’s the right arrival model for our patients?”

Patient Arrival has Become a Strategic Planning Conversation