Blog Post September 2, 2020 Beyond the Clicks: 10 Steps to Prepare for Online Scheduling Authors Stephen McMillen Jyoti Mishra Digital tools, like online appointment scheduling, have been differentiators for healthcare systems, but as people of all ages have become more accustomed to using computers or cell phones for everyday tasks, patient portals and online scheduling have become expected options rather than nice-to-have features. A study by Healthgrades found that about 80% of patients prefer a physician who offers online scheduling. Digital technology is ubiquitous in almost every other sector, yet its use in healthcare has lagged. Many organizations have not implemented online scheduling; others offer it in a limited way. Patient-centric health systems are now playing catch-up. In the rush to modernize, many health systems try to implement online scheduling tools without adequate preparation. Poorly implemented EHRs, limited patient access, and internal cultural barriers prevent scheduling tools from being properly implemented and optimized. If these challenges are not resolved first, the problems they cause are likely to be magnified and compounded. Here are 10 steps to prepare for successful online scheduling. 1. Assemble a teamA multidisciplinary operations team should include IT, administrative and physician leadership, and marketing. Health systems often believe this is an IT-driven exercise, but successful online scheduling designs are built by operations leaders who know how to keep the patient in mind and set the appropriate direction, tone, and guiding principles from the start. 2. Review patient access and provider capacityHealth systems should make sure they have enough scheduling options prior to going live. If appointment options are limited, or wait times are lengthy, new patients may turn away without asking for additional options. Prior to go-live, a capacity analysis should be performed that includes visit durations, a provider time-in template, fill rate, and provider utilization. This exercise will yield the greatest number of scheduling options. 3. Identify the appropriate route for each patientIn order to build the technical components of online scheduling, a framework must be developed that maps providers to the appropriate patients. This framework can be based on visit type, diagnosis or condition, or insurance type. As the grid is being prepared, these questions should be answered. Which providers see which primary concern? In subspecialized areas, patients can navigate to the appropriate provider by using their primary concern. Create a provider selection algorithm that routes patients to the right provider.Should advanced practice providers (APPs) treat new patients? Online scheduling gives patients options. One option may be to allow them to choose between physicians and APPs, especially if APPs have better availability.Should any visit types be excluded from online scheduling? Some visit types, such as procedures or nurse visits, may not be suitable for online scheduling because clinical clearance or a physician’s order prior to scheduling is required.4. Optimize physician templatesProvider templates should be open, automated, and reflect physicians’ actual schedules. Templates should include these attributes. Individual provider preferences should be removed whenever possible (e.g., dictating which type of patient should be scheduled in each slot). When providers over-manage their template, they limit access to care and it is harder for patients to make appointments online. Standard scheduling protocols allow more efficient appointing and also create an easier online scheduling build.Templates should allow follow-up appointments to be booked at checkout. Typically, clinics should release templates for 13 months into the future to accommodate one-year follow-up appointments.An open-access approach should be embraced to avoid restricting scheduling options based on patient or appointment type.Concurrent booking—when multiple patients are scheduled with the same provider at the same time—should be accommodated. If providers allow concurrent booking, this practice should be built into the template so each available appointment can be selected online.5. Optimize and automate preappointment workWhen patients schedule an appointment online, little additional work should be needed prior to the appointment. This may include: Removing the preappointment clinical review or triage.Encouraging, but not requiring, medical records, labs, and imaging prior to the appointment.Making preappointment paperwork available online. Collecting preregistration information as part of the online scheduling process6. Capture incoming referralsAs new patients begin to schedule online, each patient’s referral should continue to be tied into each department’s operation. Incoming referrals should be monitored and checked daily so the referrals that were received for appointments scheduled online can be linked. Also, financial clearance teams should continue to ensure that referrals are present when one is required by the patient’s insurance. A centralized or standardized referral model will help with this task. 7. Understand if ancillary services are needed for an appointmentWorkflows should be developed for patient visits that require labs and/or imaging to be done in conjunction with a new patient appointment. Often, the EHR can link these appointments in the background, making it seamless for the patient and reducing work for staff. 8. Develop a process to review scheduled appointmentsProviders and staff often are worried that appointments scheduled online will not be accurate. Most practices find this is not true. However, it can be helpful for the first few weeks to have a system to monitor appointments as they are scheduled and verify their accuracy (e.g., appropriate specialty, appropriate provider, updated demographics). 9. Create a marketing planPrior to launching online scheduling, inform patients that the option will soon be available. The best way is to use appropriate marketing strategies to get the word out. A sound marketing strategy could include: Featured articles on the health system’s website.Patient portal messages.Emails from the practice.Advertisements through commercials, websites, billboards, or magazines.The multi-disciplinary team gathered in step one should provide input for the marketing plan. These plans often require a long lead time, so it is recommended to begin this process early. 10. Prepare to track your successDevelop a dashboard to track the success of your online scheduling using agreed-upon metrics. Operations leadership will want to answer questions like these. How many appointments have been scheduled?How many of these appointments needed to be rescheduled or canceled?Did we gain any new patients to the system?Where did patients find out about the tool?The New Normal Online scheduling is one of the most common patient-facing tools in the digitization of healthcare. Given this new normal, and the growing consumerism of patients, online scheduling across all specialties and providers is becoming less of a market differentiator and more of a consumer expectation. When done well, the ability to schedule new and return appointments online gives patients a better consumer experience and provides the organization with a new front door and marketing tool. Online scheduling initiatives also push organizations to address their patient access performance, which is a key factor in attracting and retaining patients and providing high-quality care. Not only will patients reap the benefits, but the entire health system will see how online scheduling can improve productivity, efficiency, and revenue generation.