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Effect of an Online Appointment Scheduling System on Evaluation Metrics of Outpatient Scheduling System: a before-after MulticenterStudy

  • Patient Facing Systems
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Abstract

Online appointment scheduling systems have been designed in response to the problems of the traditional ones. In Iran, most outpatient clinics and our study population suffer from high patient’ no-show rate and long waiting times because of not using online appointment scheduling system. In this study, the effect of an online appointment scheduling system was investigated by comparing the evaluation metrics of appointment scheduling before and after the intervention. This before-after pilot study was conducted on ten outpatient clinics with different specializations. Five clinics were selected as the intervention group and five clinics as the control group. A checklist was designed to evaluate appointment scheduling metrics. These checklists were completed from April to July 2017 in the pre-implementation phase and from September to December 2017 in the post-implementation phase. The evaluation metrics were evaluated before and after the implementation of the online appointment scheduling system. A total of 470 checklists containing 9034 patients’ information and 460 checklists containing 9130 patients’ information were completed at the pre- and post-implementation phases, respectively. There were significant positive effect on the improvement of the three metrics means, including Patient waiting time (38.2 min before vs. 23.8 min after the intervention), No-show rate (25% before vs. 11% after the intervention), and Physician punctuality (−30 min before vs. -14.2 min after the intervention). The use of an online appointment scheduling system was successful in improving several evaluation metrics in our target population and resulted in continued usage in intervention group clinics.

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References

  1. Zhao, P., Yoo, I., Lavoie, J., Lavoie, B. J., and Simoes, E., Web-based medical appointment systems: A systematic review. J Med Internet Res. 19(4), 2017.

    Article  Google Scholar 

  2. Jones, R., Menon-Johansson, A., Waters, A. M., and Sullivan, A. K., eTriage - a novel, web-based triage and booking service: Enabling timely access to sexual health clinics. Int J STD AIDS. 21(1):30–33, 2010.

    Article  CAS  Google Scholar 

  3. Walters, B. A., Danis K, editors. Patient Online at Dartmouth-Hitchcock–Interactive Patient Care Web Site. AMIA Annu Symp Proc. 2003:1044, 2003.

  4. Grain H, editor. Patients’ adoption of the e-appointment scheduling service: A case study in primary healthcare. Investing in E-Health: People, Knowledge and Technology for a Healthy Future: Selected Papers from the 22nd Australian National Health Informatics Conference (HIC 2014); 2014: IOS Press.

  5. Wang, W., and Gupta, D., Adaptive appointment systems with patient preferences. Manuf Serv Oper Manag. 13(3):373–389, 2011.

    Article  Google Scholar 

  6. Cao, W., Wan, Y., Tu, H., Shang, F., Liu, D., Tan, Z., Sun, C. et al., A web-based appointment system to reduce waiting for outpatients: A retrospective study. BMC Health Serv Res. 11:318, 2011.

    Article  Google Scholar 

  7. Maeder A, Martin-Sanchez F, editors. Patients’ perceptions of web self-service applications in primary healthcare. Health Informatics: Building a Healthcare Future through Trusted Information: Selected Papers from the 20th Australian National Health Informatics Conference (HIC 2012); 2012: IOS Press.

  8. Gupta, D., and Denton, B., Appointment scheduling in health care: Challenges and opportunities. IIE Trans. 40(9):800–819, 2008.

    Article  Google Scholar 

  9. Paré, G., Trudel, M.-C., and Forget, P., Adoption, use, and impact of e-booking in private medical practices: Mixed-methods evaluation of a two-year showcase project in Canada. JMIR Med Inform. 2(2), 2014.

    Article  Google Scholar 

  10. Weiner, M., El Hoyek, G., Wang, L., Dexter, P. R., Zerr, A. D., Perkins, A. J. et al., A web-based generalist–specialist system to improve scheduling of outpatient specialty consultations in an academic center. J Gen Intern Med. 24(6):710–715, 2009.

    Article  Google Scholar 

  11. Chan, T. C., Killeen, J. P., Castillo, E. M., Vilke, G. M., Guss, D. A., Feinberg, R. et al., Impact of an internet-based emergency department appointment system to access primary care at safety net community clinics. Ann Emerg Med. 54(2):279–284, 2009.

    Article  Google Scholar 

  12. Mohebbifar, R., Hasanpoor, E., Mohseni, M., Sokhanvar, M., Khosravizadeh, O., and Isfahani, H. M., Outpatient waiting time in health services and teaching hospitals: A case study in Iran. Glob J Health Sci. 6(1):172, 2014.

    Google Scholar 

  13. Aeenparast, A., Farzadi, F., and Maftoon, F., Waiting time for specialist consultation in Tehran. Arch Iran Med. 15(12), 2012.

  14. Bastani, P., Garavand, A., and Abhari, S., Evaluation of internet booking system in websites of health centers affiliated with medical universities in Iran. Journal of Health and Biomedical Informatics. 2(4):219–228, 2016.

    Google Scholar 

  15. Murray, M., Reducing waits and delays in the referral process. Family practice management. 9(3):39, 2002.

  16. Golalizadeh E, Moosazadeh M, Amiresmaili M, Ahangar N. Challenges in second level of referral system in family physician plan: A qualitative research. 2012.

    Google Scholar 

  17. Rohleder, T. R., Lewkonia, P., Bischak, D. P., Duffy, P., and Hendijani, R., Using simulation modeling to improve patient flow at an outpatient orthopedic clinic. Health Care Manag Sci. 14(2):135–145, 2011.

    Article  Google Scholar 

  18. Zhu, Z., Heng, B. H., and Teow, K. L., Analysis of factors causing long patient waiting time and clinic overtime in outpatient clinics. J Med Syst. 36(2):707–713, 2012.

    Article  Google Scholar 

  19. Huang, Y.-L., Hancock, W. M., and Herrin, G. D., An alternative outpatient scheduling system: Improving the outpatient experience. IIE Trans Healthc Syst Eng. 2(2):97–111, 2012.

    Article  Google Scholar 

  20. Bennett, K. J., and Baxley, E. G., The effect of a carve-out advanced access scheduling system on no-show rates. Fam Med. 41(1):51, 2009.

    PubMed  Google Scholar 

  21. Price, R. S., Balcer, L. J., and Galetta, S. L., Education research: A new system for reducing patient nonattendance in residents' clinic. Neurology. 74(10):e34–ee6, 2010.

    Article  Google Scholar 

  22. Williams, M. E., Latta, J., and Conversano, P., Eliminating the wait for mental health services. J Behav Health Serv Res. 35(1):107–114, 2008.

    Article  Google Scholar 

  23. Klassen, K. J., and Yoogalingam, R., Appointment system design with interruptions and physician lateness. Int J Oper Prod Manag. 33(4):394–414, 2013.

    Article  Google Scholar 

  24. Cayirli, T., and Veral, E., Outpatient scheduling in health care: A review of literature. Prod Oper Manag. 12(4):519–549, 2003.

    Article  Google Scholar 

  25. Chen, P.-S., Robielos, R. A. C., Palaña, P. K. V. C., Valencia, P. L. L., and GY-H, C., Scheduling patients’ appointments: Allocation of healthcare service using simulation optimization. J Healthc Eng 6(2):259–280, 2015.

    Article  Google Scholar 

  26. Siddiqui, Z., and Rashid, R., Cancellations and patient access to physicians: ZocDoc and the evolution of e-medicine. Dermatol Online J. 19(4), 2013.

  27. Samadbeik, M., Saremian, M., Garavand, A., Hasanvandi, N., Sanaeinasab, S., and Tahmasebi, H., Assessing the online outpatient booking system. Shiraz E-Medical Journal. 19(4), 2018.

  28. Cayirli, T., Veral, E., and Rosen, H., Designing appointment scheduling systems for ambulatory care services. Health Care Manag Sci. 9(1):47–58, 2006.

    Article  Google Scholar 

  29. McMullen, M. J., and Netland, P. A., Lead time for appointment and the no-show rate in an ophthalmology clinic. Clin Ophthalmol (Auckland, NZ). 9:513, 2015.

    Google Scholar 

  30. White, D. L., Froehle, C. M., and Klassen, K. J., The effect of integrated scheduling and capacity policies on clinical efficiency. Prod Oper Manag. 20(3):442–455, 2011.

    Article  Google Scholar 

  31. Robinson, L. W., and Chen, R. R., A comparison of traditional and open-access policies for appointment scheduling. Manuf Serv Oper Manag. 12(2):330–346, 2010.

    Article  Google Scholar 

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Acknowledgements

This study was supported by Mashhad University of Medical Sciences. The authors would like to acknowledge “Research Deputy” Mashhad University of Medical Sciences for financial supports. We thank physicians and staff of 10 outpatient clinics.

Funding

This study was funded by Mashhad University of Medical Sciences.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Saeid Eslami.

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Conflict of interest

Authors declare that they have no conflict of interest.

Ethical approval

This study was approved by Mashhad University of Medical Sciences. The permission was obtained from the Ethics Committee with No. IR.MUMS.fm.REC1395.312. All procedures performed in the study were in accordance with the 1964 Helsinki declaration and its later amendments.

Informed consent

All physicians and staff of clinics participated voluntarily and were verbally informed about their privacy.

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This article is part of the Topical Collection on Patient Facing Systems

Appendix A

Appendix A

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Habibi, M.R.M., Mohammadabadi, F., Tabesh, H. et al. Effect of an Online Appointment Scheduling System on Evaluation Metrics of Outpatient Scheduling System: a before-after MulticenterStudy. J Med Syst 43, 281 (2019). https://doi.org/10.1007/s10916-019-1383-5

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  • DOI: https://doi.org/10.1007/s10916-019-1383-5

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