Efficiency in Healthcare Delivery


The impact of online scheduling is explored

By Tom Cox, MyHealthDirect CEO


Providers want to spend their time providing great care to their patients. Unfortunately, operating inefficiencies can keep them from their mission. Some studies cite that administration takes up 30% of their work day. Fortunately, the healthcare industry is now starting to view operating efficiency in ways similar to other industries.

A key operating metric is capacity. In healthcare, this is appointment capacity per physician (their time). For an auto plant, it is how much of the time it runs. (Last year, U.S. plants operated at 96% capacity.) It can even be applied to sports. Most NFL teams operated at full capacity last year, with 100% of the seats sold for every game.

According to a recent Medical Group Management Association (MGMA) study, most U.S. practices operate at about 88% capacity. Some practices struggle more than this, with show rates as low as 50% – and where double-booking is the norm. No-shows and abrupt cancellations plague even the best physician practices.

A recent report commissioned by the Association of American Medical Colleges (AAMC) concluded that the U.S. will have a physician shortage of up to 90,000 doctors by 2025. Most groups say the solution is to train more providers. That might work in the long term, but what if we can boost the productivity of the physicians we already have with better technology tools? For example, if we reduce no-shows by 50% across the country (something that is being accomplished in many practices today via reminders and online scheduling solutions), we will add back the equivalent of 50,000 doctors to the healthcare system.

There are now online scheduling tools that are helping to solve this problem – and they’re rapidly becoming popular with patients. The research firm Accenture forecasts that two-thirds of U.S. health systems and their patients will use online scheduling tools within five years. The firm also predicts that by 2020, nearly 40% of all medical appointments will be self-scheduled, adding an estimated $3.2 billion in value to the healthcare system.1

Out With the Old?

For decades, most patients have made appointments by phoning their physician’s office. This leads to appointment times that are inconvenient for the patient and provider. For example, the patient might get stuck with an appointment several weeks away, which increases the likelihood of a no-show. And the provider might get too many appointments at peak times (like Monday mornings) rather than high-availability times like Friday afternoons.

Online scheduling tools make it much faster and easier to align patient demand with provider availability. The Accenture study found that it takes less than one minute to schedule a medical appointment online. In contrast, scheduling by phone takes an average of over eight minutes, where 63% of the time is wasted on call transfers from one staff member to another.

Patients who use cloud-based scheduling tools are seen much faster and have higher show rates:

  • 20% of them get same-day or next-day appointments – and more than half receive appointments within a one-week window.
  • Patients prefer choosing their own appointment time, rather than dealing with someone over the phone and being given a time.
  • By receiving confirmation and reminder messages the way they prefer (text, voice or email), some patient groups have improved show rates by 100% or more.

Online scheduling also helps improve provider productivity and patient satisfaction in a variety of ways, including:

  • Off-hour scheduling – More than half of all patients prefer to schedule outside of normal working hours: before work, during lunch or in the evening.
  • Improving provider workflow – Online scheduling tools can ensure that hospital discharge follow-ups fall on the same morning each week – and that two new patient appointments don’t get scheduled back-to-back.
  • Automated ways to boost show rates – Scheduling tools make it easy to identify times of day (typically late afternoon) when no-shows spike so that practices can double-book in a data-driven way.
  • Helping patients arrive informed – When patients schedule online, they can be prompted to fill out patient registration forms and can receive automated patient readiness information such as “Don’t eat 12 hours in advance of your appointment.”

Medicine’s Digital Frontier

Many industry observers feel that the growing acceptance of telemedicine will inevitably spur even greater demand for online scheduling. A new study from MD Live found that 82% of adults 18 to 34 actually prefer a same-day consultation via Skype or mobile device versus having to wait a week or more for an in-person appointment.2 Intel’s recent Healthcare Innovation Barometer showed that 72% of all patients, regardless of age, were willing to have teleconsultations for non-urgent care.

According to Truven Health Analytics, the current lack of online convenience is one reason why Millennials are 24% less likely to have a regular primary care physician than are Boomer Age patients.4 That will change as it becomes more commonplace to schedule – and be seen – online.

Digital tools are also solving the referral problem. Getting physician referrals for appointments with specialists has long been a sinkhole of time, where it may take 20 minutes to schedule an appointment using three-way calling. In addition, many “referred” patients are never confirmed for appointments. The journal Annals of Internal Medicine estimates that over 60% of referrals are never scheduled.

One major health insurer recently used online scheduling software as an alternative to three-way calling. Implementation of this convenience had impressive results:

  • Five times more calls were made using the same resources
  • Three times more member appointments were scheduled
  • Attendance rates nearly doubled, thanks to automated reminders

Convenience Drives Capacity Utilization

Consumers today have made it clear: They prefer going online to order a pizza, get a cab or reserve a movie ticket. Patients (the consumers of healthcare services) are also demanding online conveniences, which are sure to influence their loyalty to the providers with the easiest access.

What’s good for the consumer is also good for the provider, since the same digital solutions that improve the patient experience are boosting operating efficiency. While training the next generation of physicians is critical, let’s make it easier for them to increase productivity and do more of what they enjoy-providing care. A physician practice is no different from any other business. It’s more profitable and effective when running at full capacity. By helping eliminate costly no-shows and streamlining workflow, online scheduling tools help maximize the healthcare system’s most precious resource: our physicians’ time.


  • Accenture study. http://newsroom.accenture.com/news/two-in-three-patients-will-book-medical-appointments-online-in-five-years-accenture-predicts.htm
  • MD Live press release. https://www.mdlive.com/news/press_05142014b.html
  • Intel Healthcare Innovation Barometer. http://hitconsultant.net/2013/12/11/72-of-consumers-are-willing-to-see-a-doctor-via-telehealth-video-conferencing/
  • Truven Health PULSE Survey. http://truvenhealth.com/blog/generations-connect-differently-primary-care-providers-45

Tom Cox is CEO of MyHealthDirect in Nashville, Tennessee.

Source: Advance Healthcare Network | Executive Insight