North Frederick, Nelson Elissa M, Majerus Rebecca J, Buss Rebecca J, Thompson Matthew C, Crum Brian A
Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Enterprise Office of Access Management, Mayo Clinic, Rochester, MN, United States.
JMIR Med Inform. 2021 Mar 18;9(3):e23450. doi: 10.2196/23450.
Web-booking of flights, hotels, and sports events has become commonplace in the travel and entertainment industry, but self-scheduling of health care appointments on the web is not yet widely used. An electronic health record that integrates appointment scheduling and patient web-based access to medical records creates an opportunity for patient self-scheduling. The Mayo Clinic developed and implemented a feature in its Patient Online Services (POS) web and mobile platform that allows software-managed self-scheduling of well-child visits.
This study aims to examine the use of a new self-scheduling appointment feature within POS in both web and mobile formats and determine the use characteristics, outcomes, and efficiency of self-scheduling compared with staff scheduling.
Within a primary care setting, we collected 13 months of all appointment activity for the well-child visit for children aged 2-12 years. As these specific appointment types are for minors, self-scheduling is performed by parents or other proxies. We compared the appointment actions of scheduling and cancelling for both self-scheduled and staff-scheduled appointments. The frequency in which patients were using self-scheduling outside of normal business hours was quantified, and we compared no-show outcomes of finalized appointments.
Of the 1099 patients who performed any self-scheduling actions, 73.1% (803/1099) exclusively used self-scheduling and self-cancelling software. For those with access to self-scheduling (patients registered with the Mayo Clinic POS), 4.92% (1201/24,417) of all well-child appointment-scheduling actions were self-scheduled. Staff scheduling required more than a single appointment step (eg, schedule, cancel, reschedule) in 28.32% (3729/13,168) compared with only 6.93% (53/765) of self-scheduled appointments (P<.001). Self-scheduling appointment actions took place outside of regular business hours 29.5% (354/1201) of the time. No-shows accounted for 3.07% (28/912) of the self-scheduled finalized appointments compared with 4.12% (693/16,828) of staff-scheduled appointments, which is a nonsignificant difference (P=.12). Staff-scheduled finalized appointments (that allowed for scheduling appointments for more than 12 weeks in the future) revealed a potential demand of 11.15% (1876/16,828) for appointments with longer lead times.
Self-scheduling can generate a significant number of finalized appointments, decreasing the need for staff scheduler time. We found that 29.5% (354/1201) of the self-scheduling activity took place outside of the usual staff scheduler hours, adding convenience value to the scheduling process. For exclusive self-schedulers, 93.1% (712/765) finalized the appointment in a single step. The no-show rates were not adversely affected by the self-scheduling.
在旅游和娱乐行业，通过网络预订机票、酒店和体育赛事已变得司空见惯，但通过网络进行医疗预约的自我安排尚未得到广泛应用。集成了预约安排和患者基于网络访问病历功能的电子健康记录为患者自我安排预约创造了机会。梅奥诊所（Mayo Clinic）在其患者在线服务（POS）网络和移动平台上开发并实施了一项功能，允许软件管理的儿童健康检查自我安排预约。
本研究旨在检查POS中一种新的自我安排预约功能在网络和移动格式中的使用情况，并确定与工作人员安排预约相比，自我安排预约的使用特征、结果和效率。
在初级保健环境中，我们收集了2至12岁儿童的儿童健康检查13个月内的所有预约活动。由于这些特定预约类型是针对未成年人的，自我安排预约由父母或其他代理人进行。我们比较了自我安排预约和工作人员安排预约的预约安排和取消操作。对患者在正常工作时间以外使用自我安排预约的频率进行了量化，并比较了已确定预约的爽约结果。
在进行任何自我安排预约操作的1099名患者中，73.1%（803/1099）仅使用自我安排预约和自我取消软件。对于有权使用自我安排预约的患者（在梅奥诊所POS注册的患者），所有儿童健康检查预约安排操作中有4.92%（1201/24417）是自我安排的。工作人员安排预约在28.32%（3729/13168）的情况下需要不止一个预约步骤（例如，安排、取消、重新安排），而自我安排预约仅为6.93%（53/765）（P<.001）。自我安排预约操作有29.5%（354/1201）是在正常工作时间以外进行的。自我安排的已确定预约的爽约率为3.07%（28/912），而工作人员安排的预约为4.12%（693/16828），差异不显著（P=0.12）。工作人员安排的已确定预约（允许提前12周以上安排预约）显示对提前时间更长的预约有11.15%（1876/16828）的潜在需求。
自我安排预约可以产生大量已确定的预约，减少工作人员安排预约的时间需求。我们发现29.5%（354/1201）的自我安排预约活动是在工作人员通常的工作时间以外进行的，为预约过程增加了便利价值。对于仅使用自我安排预约的患者，93.1%（712/765）在一步之内完成了预约。自我安排预约对爽约率没有不利影响。
