Offer Online Scheduling
New Option Saves Staff Time And Pleases Patients

By Susanna Donato
Susanna Donato is a writer for Physicians Practice

While massive numbers of calls to physicians' offices may not impact doctors directly, staff efficiency and patient satisfaction could be increased, by simply offering another option — online patient scheduling. The latest numbers show that 164 million Americans surf the Internet, so many practices are taking steps to incorporate online appointments into their offices, and many are already reaping the benefits.

Knock out the telephone monopoly
A Houston neurosurgeon, Bruce Ehni, M.D., definitely recommends the service. "Online scheduling dramatically reduces the amount of time employees have their ear to the phone, allowing more time to communicate with patients who are in your waiting room or standing at the front desk," Ehni says. "It makes the office so much more efficient."

Ehni, whose scheduling system comes via Methodist Healthcare System in Houston, has found that up to 80 percent of his patients will request appointments online, although telephone registrations still have a role. He notes that online scheduling allows him to employ just one patient care coordinator. Some of his colleagues who only offer appointments by phone require two employees for a similar workload.

The perfect service mix
In the past, security and privacy were the top concerns for potential users of electronic appointment scheduling. Now that security measures can protect patient data online, the biggest concern for most practices is integrating an online scheduling element with existing or new office management systems.

Practices can leap the integration hurdle with a complete electronic practice management system or simply by designating certain time slots for online appointments and manually inserting those patients into the main schedule system.
However, to win the online efficiency game, practices have to overcome patients' reluctance. A 2001 Harris Interactive poll of Internet users found that 26 percent of patients say making doctors' appointments is frustrating. Yet 86 percent of those prefer to schedule appointments by phone, with a live person.

Optimal patient service and cost-saving efficiencies for practices require combining traditional and electronic scheduling.

Leslie Jebson, director of business operations at the Kansas University Medical Center, says technology isn't the only key to online scheduling success. What should be a concern, he says, is ensuring a reasonable response time. "Making scheduling work requires the ability to give patients their first or second preference for an appointment — along with a good verification system."

Easing the burden
A typical "entry-level" approach to online scheduling is that taken by the Central Texas Spine Institute (CTSI) in Austin, Texas. CTSI began allowing patients to request appointments via the institute's Web site about four years ago. The specialty practice now nets a handful of appointment requests via the Web each week.

"In the big scheme of things, it's not high volume, but many [requestors] are new patients who found us on the Internet," says Jim Gdula, CTSI's business manager. "And a number of them are follow-up or established patients who find it convenient."

CTSI also offers a follow-up Internet efficiency: patients can download registration materials from the Web site to complete on their own time, before they come into the office.

Assess your needs
Indeed, the prudent practice will do its homework before adopting an e-scheduling program. Be sure that your practice — both staff and patients — is ready for the change and will take advantage of the benefits. And, make sure that the telephone remains an option for scheduling appointments.

"Patients might schedule different things different ways," says Jane Metzger, research director for First Consulting Group in Lexington, Mass. "If they want to talk to a nurse, they are probably not going to come in online to schedule an appointment; but if it's clear that they want to be seen, they might. I'm not sure every patient is going to do online scheduling consistently."

Additionally, access to the Internet is still not universal. Another 2001 Harris Interactive poll shows that 93 percent of physicians now use the Internet at work or at home, and 62 percent of administrative staff are online in the office. However, just 59 percent of all American adults are online, according to Nua Internet Surveys. Find out if your patients are currently or are likely to become Web users by surveying patients at checkout, when they phone in for appointments or on new patient information forms.

If a significant base of patients can make the transition to online scheduling, make sure that your office can too. Is the technology in place to use online scheduling? If not, are you ready to invest in new programs and upgrades? Compare vendors' products with your existing and future needs. If your administrative system is aging, a complete, integrated system could be worth the investment. Or, a separate scheduling element might make more sense. Today, systems available to practices can handle everything from scheduling and prescription refill requests to patient-physician communication and lab results; other systems let patients go online to update insurance data and complete registration forms. It's up to you to determine how much you need.

Be sure to work with your staff so that the transition goes smoothly, designating specific responsibilities, assignments and backups. Develop guidelines for how soon inquiries will be answered, and design a message flow for patients to reach specific staff members.

Finally, realize that e-scheduling only works if patients use it. Decide if you want to alert only existing patients or use the service to attract new patients. Activities as simple as sending out a patient mailing and posting a flier at the front desk to encourage e-scheduling can put existing patients in touch with your practice in just a click. Notify patients at the Web point of contact about which requests are appropriate for online scheduling, let them know the hours that online requests will be handled and what to do if they have an emergency.

Whatever route you choose, take your time finding the right vendor and the program that will work for you. Invest in staff training and integrate the system into the practice's daily workflow. Then be sure you involve your patients by letting them know the practice offers e-scheduling — and responds as promptly and as courteously to online inquiries as to phone calls.

Susanna Donato can be reached at sdonato@physicianspractice.com.

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