Appropriate use of provider scheduling tools yields dramatic results across a practice, including improved provider utilization, better patient access, reduction in administrative burden, and faster training and onboarding for new administrative staff, according to analysis of the healthcare organization client data of provider scheduling IT vendor Relatient.

"The only thing that doesn't lie is your calendar," said Jeff Gartland, CEO of Relatient. And providers will be the first to tell you they have many problems with their calendars that need addressing.

Healthcare IT News interviewed Gartland to talk about the state of access challenges organizations face today, the unbalanced physician capacity across different specialties, and how intelligent scheduling potentially can drive improvements in both operational efficiency and patient satisfaction.

Q. Let's talk about that analysis of your client data and the findings. Please explain how those positive outcomes are achieved and what exactly your data shows in some of these instances.

A. Intelligent scheduling tools save providers time and money by optimizing physician capacity, accelerating patient access and cutting unnecessary staff training and administration.

Let’s start with physician capacity. Many clinics tell us they regularly lose large amounts of their physicians’ productivity due to unfilled time, because they either haven’t managed to identify and fill all available appointment slots aligned to the physician’s preferences, or because they lose appointments due to patient cancellations and no-shows.

The scope of the no-show problem alone is striking: No-shows cost the industry $150B annually. The average no-show rate is 27%, and it’s even as high as 50% in some places. Some providers just accept this as a cost of doing business.

Intelligent scheduling systems that consistently manage a healthcare institution’s entire set of available physician schedules make a dramatic difference. By analyzing rules and preferences for each provider in context to the specific individual patient, the technology helps identify open appointment slots to expand new capacity, as well as backfilling canceled appointments through automated wait-list management.

Second, finding ways to give patients modern, more convenient access is an area ripe for improvement in healthcare. A recent survey found 84% of provider organizations limit patients to only scheduling appointments through the front desk or call center.

Meanwhile, 61% of patients reported they’ve skipped doctor appointments altogether due to challenges associated with scheduling, including being directed to schedule appointments via a traditional phone call. It’s a massive disconnect – and opportunity.

Organizations that facilitate online access, where patients can book their own appointments based on their unique needs, have seen up to 20% of appointments being scheduled online, with strong annualized growth in both new and established patient adoption.

Technology allows patients to not only take better control over their own care, it allows them to do it at their own convenience, whether that’s in the middle of the night, in a meeting, in a busy social setting, or any other time that a phone call would be inconvenient.

Lastly, the dependencies on staff knowledge and training are proving to be a greater burden to scheduling operations and accuracy. This may be most evident in examining the costs associated with training scheduling personnel on how to accurately schedule patient appointments that accommodate physician rules and preferences.

It can take weeks or months to bring schedulers up to speed on learning and applying the intricacies of a moderately sized medical group. Intelligent scheduling systems, on the other hand, are proven to reduce staff training time by an average of 50% by delivering an automated, guided user experience for schedulers.

Q. Your remark, “The only thing that doesn't lie is your calendar.” You added that for providers, this is especially true, with calendars showing utilization gaps, as well as disordered or mismanaged patient appointments. What is the “truth” that provider calendars are telling the industry, and what does that mean for healthcare organizations?

A. The big truth provider calendars reveal is there is a tremendous problem of unbalanced capacity at many, if not most, healthcare organizations today. Some physicians are under-booked, some physicians are overbooked, and not enough canceled appointments are quickly refilled.

This unbalancing happens, as evidenced in some of the statistics I’ve just cited, because as healthcare organizations become bigger, more complex, and offer more diverse services, the act of managing the calendar has simply moved beyond traditional methods and processes.

It may be reasonable for an administrator in an office of four or five doctors to remember the preferences of each doctor and stay aware of available openings. On the other hand, it’s nearly impossible for schedulers dispersed across multiple locations, or in a regional contact center, to actively keep up with very complicated lists of existing (and changing) preferences across dozens or hundreds of physicians.

Organizations grow and change and merge. Physicians and staff turnover. Patients get new insurance. Evidence-based protocols evolve. It can get quite complicated quickly – which is why these organizations are embracing intelligent, automated scheduling.

Q. Specifically, when it comes to specialty care organizations, why are their practices the hardest to get into, yet also, per your observations, see some of the largest opportunities to improve utilization?

A. Patients can struggle to find timely appointments with different specialties because those physicians tend to have very particular barriers to access, whether it’s requiring a referral, validating a particular insurance requirement, or because there are unique scheduling rules in place to ensure the right specialist is booked based on the patient’s needs.

From a consumer perspective it all creates longer wait times. For instance, getting a new knee from an orthopedic surgeon has different levels of complexity than a more routine appointment, like an annual preventive care screening appointment with a dermatologist.

While intelligent scheduling can uncover benefits and improvements for all types of providers and organizations, the data on specialists alone is impressive.

We’ve found specialty organizations using an intelligent scheduling system have seen an average increase of 5-10% in physician utilization, with gastroenterology, orthopedic and musculoskeletal, urology, and multispecialty practices each maintaining between 87-98% physician utilization rates:

• 98% gastro (GI and GE).

• 93% orthopedic.

• 88% urology.

• 87% multispecialty.

These findings are even more exciting when you consider the potential revenue associated with specialty medical groups in a larger health system.

Q. Patients want more autonomy and access to their care and, in many cases, they're not getting it. You say online scheduling is tricky, but implemented the right way, it's a win-win for patients and administrators. You add that transferring the “power of scheduling” to patients actually puts much more control in the hands of the administrators. Please elaborate on these points.

A. Online scheduling, implemented the right way, is a win for patients, because offering them ways to self-schedule via online access not only reduces administrative burden, but it also makes patients happier. They can now take control and schedule healthcare appointments when, where and in whatever manner they prefer.

This is a big deal for patients, who’ve been quite vocal about their dissatisfaction with call wait times, phone trees, and other clunky operations at their providers’ offices. Not only does intelligent technology increase scheduling (and rescheduling) flexibility for both new and existing patients, it also allows for a streamlined process that collects only the key data points required to schedule an appointment, such as contact information, visit reason, insurance information, etc.

From the administrative perspective, medical groups can struggle with online scheduling when it is designed without context to the complexities of a provider’s needs. Booking the patient in the wrong appointment slot, or with the wrong provider, can have a ripple effect to other appointments or revenue cycle processes, and it also leaves the consumer highly dissatisfied.

In contrast, a well-architected, intelligent scheduling system for online booking by the patient allows for management of the physician rules, preferences and availability at scale and in context to the individual patient’s needs.

Whether it is data-backed visibility into provider utilization, understanding patient access blockers by provider or accurately rotating new patient volume across providers, there can be good wins for medical groups with a strong online scheduling system in place.

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