Barriers to and Facilitators of Automated Patient Self-scheduling for Health Care Organizations: Scoping Review

Abstract

Background Appointment management in the outpatient setting is important for health care organizations, as waits and delays lead to poor outcomes. Automated patient self-scheduling of outpatient appointments has demonstrable advantages in the form of patients’ arrival rates, labor savings, patient satisfaction, and more. Despite evidence of the potential benefits of self-scheduling, the organizational uptake of self-scheduling in health care has been limited. Objective The objective of this scoping review is to identify and to catalog existing evidence of the barriers to and facilitators of self-scheduling for health care organizations. Methods A scoping review was conducted by searching 4 databases (PubMed, CINAHL, Business Source Ultimate, and Scopus) and systematically reviewing peer-reviewed studies. The Consolidated Framework for Implementation Research was used to catalog the studies. Results In total, 30 full-text articles were included in this review. The results demonstrated that self-scheduling initiatives have increased over time, indicating the broadening appeal of self-scheduling. The body of literature regarding intervention characteristics is appreciable. Outer setting factors, including national policy, competition, and the response to patients’ needs and technology access, have played an increasing role in influencing implementation over time. Self-scheduling, compared with using the telephone to schedule an appointment, was most often cited as a relative advantage. Scholarly pursuit lacked recommendations related to the framework’s inner setting, characteristics of individuals, and processes as determinants of implementation. Future discoveries regarding these Consolidated Framework for Implementation Research domains may help detect, categorize, and appreciate organizational-level barriers to and facilitators of self-scheduling to advance knowledge regarding this solution. Conclusions This scoping review cataloged evidence of the existence, advantages, and intervention characteristics of patient self-scheduling. Automated self-scheduling may offer a solution to health care organizations striving to positively affect access. Gaps in knowledge regarding the uptake of self-scheduling by health care organizations were identified to inform future research.

Mapping Inequities in Digital Health Technology Within the World Health Organization’s European Region Using PROGRESS PLUS: Scoping Review

“…Among the included reviews, there was no evidence of the impact of gender and sex on access to digital health. Of the 22 reviews, 8 (36%) reviews reported on the impact of gender and sex on the use of digital technology, with 4 (18%) reviews indicating consistent evidence of a greater use of digital health technology among women [ 22 , 31 , 35 , 37 ]. Of the remaining 18% (4/22) of reviews, 2 observed no difference in use by gender and sex [ 4 , 21 ] and 2 reported mixed evidence [ 32 , 39 ].…”

“…The association between education and access to digital health was not reported in any of the reviews. However, 18% (4/22) of reviews reported a possible association between the use of digital health care and education showing that individuals with higher levels of education were more likely to use digital health services than individuals with a lower education level [ 18 , 21 , 29 , 35 ]. Only 5% (1/22) of reviews reported inconclusive evidence [ 32 ].…”

“…Lower income was reported to reduce access to digital health care in 1 included review [ 32 ]. However, the association between the use of digital health technology and socioeconomic status was reported in 23% (5/22) of reviews, 4 of which [ 4 , 18 , 35 , 37 ] reported higher adoption in higher income than lower income groups and 1 review [ 31 ] reported mixed results. Mixed results were also observed with engagement in digital technologies in the included reviews (2/22, 9%) [ 4 , 32 ].…”

Online access to spine care: do institutions advertise themselves as multidisciplinary?

“…Patients may benefit significantly from optimized scheduling of online care, as Luxenburg et al shows how older and more ill patients are less likely to schedule appointments when the process is difficult ( 17 ). Further research supports the importance of online self-scheduling in empowering patient-centered care and satisfaction while providing advantages to traditional phone scheduling ( 18 , 19 ).…”

Empowering patients to address diabetes care gaps: formative usability testing of a novel patient portal intervention

“…A recent review explored barriers and facilitators of patient self-scheduling in health care; however, none of the studies included in the review mentioned usability testing. 46 Considering low technology adoption and digital literacy among certain groups, 16 , 18 , 47 involving these users early in the design process is imperative. Similar to our study, the review of patient self-scheduling in health care did identify trust in the system as 1 factor which would impact use.…”