The following is a guest article by David Higginson, Chief Innovation Officer at Phoenix Children’s.
“If I can book a restaurant or car repair online, why can’t I book a doctor’s appointment?”
Frustrated patients across the country ask this question every day. At Phoenix Children’s, we set out to change the inefficient dynamic that has always required patients to make multiple phone calls simply to schedule a doctor’s visit.
Twelve months ago, a team of us began a deep-dive into the issues. We uncovered multiple challenges, identified solutions, found the sweet spot for physician buy-in, and ultimately, phased in our solution earlier this year. Called On-Demand Booking, this tool offers to significant differentiators:
- It includes not just general pediatricians but all 75 specialty clinics in the online booking process.
- It flips the traditional scheduling paradigm. Instead of focusing on documentation and the physician’s scheduling preferences first, On-Demand Booking prioritizes the appointment and the patient’s needs.
Our focus is getting patients into the system quickly at their convenience; we take care of documentation later. We aren’t aware of any other system that has been able to open online scheduling of appointments with all of their generalists and specialists.
For sure, this approach broke the traditional scheduling mold. We were accustomed to requiring two things before an appointment could be made:
- We needed to validate the patient’s need before scheduling a visit with a specialist.
- We prioritized the practices and preferences that optimized physicians’ workflow rather than prioritizing the patients’ needs.
We even found in our research that several of our physicians were spending large amounts of time collecting and reviewing detailed documentation to validate every referral.
We worked to shift the thinking. The patient clearly needs specialized medical help and the best way to determine the most appropriate next steps is to meet with them and review their situation one-on-one. While that may mean some patients will occasionally be referred to a different specialty – or maybe they ultimately don’t need treatment at all – this is never a wasted visit for the patient.
On the scheduling protocols issue, we worked with physician practices to help them streamline their appointment parameters and still function effectively. Telemedicine – a tool of growing importance – also helped facilitate shorter patient visits, which were still productive. We are still able to develop the best treatment plan for each patient, even though the visits are virtual.
Despite the need to change these two long-standing traditions around validation and scheduling, the clinical team quickly embraced the new approach. After all, they are avid users of online tools in their own lives, so booking appointments online began to make sense to them.
External Factors that Accelerated Adoption
As with many innovations, timing is everything. In this case, the COVID crisis accelerated trends that were already taking shape.
The market was driving us to transition away from phone calls because of consumer preference. No one wants to spend 30 minutes booking an appointment with a person and have to do it between 8 am and 5 pm. During COVID, patients and physicians became more accustomed to doing things online out of necessity. Then, with the current labor shortage, we needed an alternative to booking every appointment with a person, making online booking a critical part of our scheduling strategy.
Securing Physician Buy-In: Key to Success
To ensure that physicians saw the value of On-Demand Booking, I made sure to emphasize – first and foremost – that this was not an IT initiative. Rather, this is an important shift in doing business more efficiently and effectively. It is also a matter of better patient care.
Second, two of our physician leaders, Jared T. Muenzer, MD, physician in chief, and Daniel J. Ostlie, MD, surgeon in chief, became the face of On-Demand Booking. They took the message to every physician in the system, addressing big concerns head on.
The first slide in their presentation stated:
“Electronic booking has swung the trust/control pendulum to the customer. When you book the service for your car online, they trust that it needs a service. If you were wrong, they fix it after its booked.”
Drs. Muenzer and Ostlie importantly encouraged physicians to see appointment scheduling using this same mindset. They also shared that under the current system, Phoenix Children’s was missing some patient appointments due to scheduling inefficiencies, and some patient follow-up appointments were being booked later than requested because of rigid scheduling protocols. On-Demand Booking is helping solve both of these issues for everyone involved.
Finally, the physician leaders described the patient and family satisfaction component. Within 60 seconds of being referred for an appointment at Phoenix Children’s – either for a new or follow-up visit – patients receive a text message allowing them to select the date and time of their appointment. Or, alternatively, the referring physician can book the appointment then and there with the patient.
This simplified system works for the patient and family while also reassuring the physician that the appointment has actually been made.
Phasing In the Launch
Knowing that we would be most successful with a phased-in launch, we took this step-by-step.
- Step 1: We opened On-Demand Booking to internal physicians who were requesting follow-up appointments for their own patients.
- Step 2: We allowed internal physicians to use the scheduling app for all internal referrals.
- Step 3: We opened On-Demand Booking to all physicians who refer to Phoenix Children’s.
- Step 4: We allow patients to self-refer and directly book appointments themselves for a more restricted set of specialties (such as general pediatrics). Phoenix Children’s sent a permanent link to On-Demand Booking to patients and families currently in the general pediatrics database.
Encouraging Results
With an overall goal of booking 75% of appointments online, the system is well on its way. We’re already at 50%, so we are making great progress. We know we’ll never be at 100%, but if we reserve our schedulers for the more complex appointments, On-Demand Booking can handle the rest.
I’m really proud of how our clinicians took this leap of faith. Our physicians are world renowned experts in their fields and many patients seek out their expertise. It’s very important for them to see the right patients.
At the same time, if we spend a month validating that need, we may miss seeing a patient who would really benefit from our help. Physicians have embraced the need for flexibility and recognized its value from both a business and patient care perspective. Their initial buy-in was critical, and I think that having our physician leaders be the face of this initiative was very effective. They were able to not only get the message across, they made sure it had an impact. That has been key to our success.
