A recent survey finds that health systems see patient self-scheduling tools as vital, but they aren't using them because clinicians aren't buying into the strategy.
The transition to consumer-centered healthcare can sometimes create conflicts between patients and their doctors, especially as patients seek more of a say in matters that doctors have traditionally—and stubbornly—managed. An ideal example is scheduling.
Patients want the ability to schedule their own appointments with doctors, and healthcare organizations recognize that this is a vital tool in fostering patient engagement and improving care management and adherence. But while a recent survey from the Center for Connected Medicine (CCM) finds that 88% of health systems see patient self-scheduling as their top target for investment, only about 3% currently have that capability, and few are actually acting on those plans.
That's because doctors don't want to give up control of their schedules.
"Many physicians believe that by allowing patients to self-schedule appointments they are giving up control of their own calendar," Joon S. Lee, MD, executive vice president of UPMC, which supports CCM, said in a press release accompanying the study. "Self-scheduling is a big part of improving patients' access to care. It is up to organizational leaders to work with physicians to find solutions that address their concerns while still meeting the demands and expectations of our patients."
According to the CCM report, 78% of the health systems surveyed do have some self-scheduling technology in place, but four out of five health systems are seeing less than 20% of their appointments booked through those tools. Not only are those patients not making use of the technology, but the health system isn't making them aware of that capability.
When asked for reasons for those delays, only 8% said patient adoption is an issue, while 22% cited physician buy-in, and another 16% cited staff concerns.
Lee, who's also president of UPMC Physician Services and vice dean for clinical affairs at the University of Pittsburgh School of Medicine, told HealthLeaders that it's up to healthcare leadership to change that dynamic by convincing physicians that patient self-scheduling is a good thing.
"We often think this is a technological problem, but it's not," he says. "It's a cultural problem and an organizational problem, and that needs to be changed. Organizations have to be committed to making this happen."
The Benefits of Patient Self-Scheduling Technology
Self-scheduling tools have the potential to improve not only the patient experience, but clinician workloads as well. While giving patients the ability to schedule appointments that fit into their lifestyles, the platform also makes sure the patient is seeing the appropriate care provider. This reduces no-shows and other delays, and ensures that the visit is valuable to both patient and care provider, thus enriching care management and offering a better chance of improving clinical outcomes.
Lee notes the technology makes the scheduling process much more efficient, reducing phone calls and cutting down on time spent by staff and clinicians fiddling around with schedules and calendars. It also ensures that clinicians are seeing the right patient, someone who needs to be seen by that particular care provider, rather than one who should have been seen by someone else or someone who could have been treated via telehealth or some other pathway.
"Patients want to be seen by the doctor who can help them the most," he says. "This should be a much better experience."
And it's what the consumer wants. Encouraged by the use of digital tools in everything from banking to travel to retail shopping, consumers want that ability in their healthcare experience as well, and they'll change providers if those desires aren't met. Add to that the influx of competition in the healthcare market from telehealth companies, retail giants like Amazon and Walmart, and nearby health systems who are adopting new technology, and the traditional hospital or health system has to embrace these new services or risk losing business.
"We do have to tell physicians to adapt or lose out," Lee says. "They have to realize that."
Lee says a health system should lay out the groundwork for adopting patient-self-scheduling by first targeting provider concerns. Management should sit down with clinicians and explain the benefits of the technology for both sides, tackling the worries that clinicians will be losing control of their schedules or workflows. As with most new technology, the platform is designed to assist healthcare providers in mapping out and improving their workflows, not replacing providers or staff or interfering with them.
Getting the Technology Right
Preparing for a patient self-scheduling platform also means understanding the technology, Lee says, and it's important that a health system research the various types of platforms available on the market and choose the best option. This isn't a one-size-fits-all technology, nor is it plug-and-play or something that just falls into place and works on the first try.
According to the CCM survey, roughly a quarter of those surveyed say they're still looking for the right platform, while 22% are working to standardize templates and schedules. Some 17% were focused on installing the technology and 14% were looking to expand the platform to outlying sites. Just 6% were focused on patient education and support.
Clinicians and other staff should be part of this process, Lee says, so they know what the technology can and can't do. In addition, leadership should design the platform "with a human touch," so that a patient can opt out and speak with a live person at any time, or switch from a virtual visit to the scheduled in-person visit if that's more comfortable for them.
Lee says the technology should be seen as another tool in the care provider's toolbox, much like the virtual visit. Many health systems set telehealth and digital health aside, separating those services from other healthcare services so that they're seen as add-ons or supplementary services rather than a part of the healthcare process. Instead, health systems should be integrating those services, making them a part of the process.
The healthcare industry "has always focused on care inside the hospital," Lee says. "But that is changing. Consumers want a connected healthcare experience." This means connecting with consumers at home and giving them a portal into the hospital that enables them to accomplish any tasks before they meet with a care provider.
Lee says UPMC has been actively integrating patient self-scheduling alongside other services, such as direct-to-consumer telehealth and remote patient monitoring. And they've been careful to include staff and clinicians in every step of the process. A health system, he says, shouldn't give its employees a new tool or platform and tell them to go try it out. They should include them in the planning and installation so that they already know all about it before anything goes live.
With patient self-scheduling, he says, "they have to learn to give up some control … but if you choose the right technology they will see why that has to happen."
“We often think this is a technological problem, but it's not. It's a cultural problem and an organizational problem, and that needs to be changed. Organizations have to be committed to making this happen.”
— Joon S. Lee, MD, executive vice president of UPMC
Eric Wicklund is the Innovation and Technology Editor for HealthLeaders.
A recent survey by the Pittsburgh-based Center for Connected Medicine finds that 88% of health systems see patient-self-scheduling tools as a key investment, but only 3% have systems in place.
Many are having problems convincing clinicians and staff that the new technology will make things better for them, and clinicians are wary that the tools will take away their ability to manage their own schedules.
Joon S Lee, MD, executive vice president at UPMC, says it's important that health systems carefully plan out integration of patient self-scheduling tools, so that clinicians and staff understand the value of the technology and are on board when those services go live.