By Sarath Degala, BIP Capital
Unfortunately, healthcare technology is at least a decade behind the rest of the professional world. For the most part, healthcare systems rely on a combination of manual, paper-based processes and disparate systems that do not communicate in real-time. Nowhere is this more evident than in scheduling techniques. While businesses have made an art of productivity and schedule optimization, many clinical settings are plagued with scrambled schedules and inefficient calendar models. In my career, I have studied both the healthcare and business worlds. Here are four methods that practice administrators and physicians can adapt from businesses to build a saner, more sustainable approach to scheduling.
Think Outside The Block
In block scheduling, every patient gets a specific set amount of time for an appointment (e.g., 30 minutes). While clinicians adopted this method to simplify scheduling, it actually has the opposite effect. Inevitably, a physician ends up running behind due to a patient who is either more complex or is running late or the physician gets called away to the operating room. Then the next appointment gets squeezed short along with the following appointment and the one after that gets squeezed, too. Suddenly, it's three hours into the workday and the schedule is an hour behind. To combat this, consider assigning certain patient types different, specific time windows. For example, an existing patient in good health might need 20 minutes, while a new patient or more complex patient with a history of chronic diseases will likely need longer—40 minutes. This may not be the same for every specialty, but it's important to keep in mind that not all appointment types are equal in their time requirements and to plan accordingly.
Send Appointment Reminders
The American Journal of Medicine estimates an average no-show rate of 23 to 34 percent across practices. From hair salons to dog kennels, many businesses use appointment reminders to reduce their no-show rate. These reminders can be automated phone calls, emails or text messages. Beyond reminding you of your appointment, these systems often allow you to reschedule online if you need to cancel/change. So why aren't more physician offices employing this tactic? It's a small, easy change that can dramatically improve the efficiency of any practice.
Scheduling becomes especially tricky when incorporating specialist referrals. In today's world, when a patient needs to see a specialist, his/her primary care doctor writes a referral on a piece of paper. But extended wait times often mean the patient will need to call multiple doctors before finding the earliest opening. In fact, according to a study of commonly used specialty physicians conducted by Merritt Hawkins, patients are waiting an average of 24 days to schedule an appointment with a doctor. Instead, imagine that all physicians under the same health system (like Epic) chose to share even 10 percent of their schedules with one another. The primary care doctor could say to a patient: "Hey, you need a cardiovascular visit. You also need to see a neurologist. Let me go ahead and coordinate both those visits for you." While doctors may initially be resistant to sharing their schedules, over time the opportunity to positively impact quality of care should outweigh their hesitation.
Plan For The Unplanned
There's a second complication with referrals: add-ons. "Hey, I'd really like for you to make time to see this patient today," says one colleague to another. "They really need to come in and see you." So rather than upsetting a colleague or losing out on potential future business, the specialist says, "Sure. I'll fit them in the schedule." Inherently, when you do that, you're moving other patients around and making their experience less than optimal. So, instead of responding to requests as they come in, try a more proactive approach. Companies like Radix Health use smart learning algorithms to study your scheduling history and optimize appointments for patients. These systems offer a window into enterprise scheduling that shows real-time appointment availability based on patient needs and allows them to schedule/cancel and reschedule all via mobile and/or web. They also use historical data to estimate the peak demand times for add-ons—maybe for your practice it's Tuesdays and Wednesdays from 11 a.m. to 3 p.m. Based on recent historical visit data, you can start incorporating additional timeslots to plan ahead for add-ons while making sure that your other appointments are for existing patients who won't require extended visits. As crazy as it may sound, leaving space open in your schedule can help you become more productive and efficient.
In addition to Radix, there are numerous other software solutions for helping physicians to automate and improve patient scheduling, as well as optimize other aspects of practice management. Ones to look at include MyHealthDirect, DocASAP, Kyruus and PatientPop.
On some days, the challenge and complexity of schedule optimization may seem to be an untamable beast. But better is possible. Look no further than the business world to adopt a few simple tactics that can make a lot of difference in your practice's management.
About The Author
Sarath Degala is VP at venture capital firm BIP Capital, where he leads its healthcare investment activities. He offers 16 years of healthcare administration experience and has achieved noteworthy operational and financial results within a variety of healthcare settings. Connect with Sarath at firstname.lastname@example.org or on Twitter at @BIPCapital.