Impact of digital self-scheduling on operations management and patient experience in hospital outpatient settings: a systematic review and meta-analysis

Abstract

Digital self-scheduling (DSS) adopted for outpatient appointment system improves efficiency and quality of services, but how it contributes to improving outpatient care delivery in hospital settings remains unverified. To evaluate the impact of DSS on operations management and patient experience in hospital outpatient services. Studies published in PubMed, Embase, Web of Science, EBSCO, Science Direct, Scopus, and IEEE Xplore were searched up to June 2022. Studies describe DSS intervention for accessing outpatient services in hospital settings, analysing its effectiveness on operations management or patient experience compared with traditional scheduling methods/or not intervention, were included. PRISMA and SWiM guidelines were used to report the study. The ROBINS-I and GRADE criteria were used for rating risk of bias and quality of evidence. Meta-analysis was conducted for combinable results from at least two studies, performed by RevMan 5.4. A total of 18 observational studies were included. Compared with conventional methods, DSS resulted in lower no-show rates (OR = 0.70, 95% confidence interval (CI): 0.57–0.85, p < 0.001), increased scheduling efficiency (OR = 4.94, 95% CI: 4.54–5.38, p < 0.001), and improved patient satisfaction (OR = 2.83, 95% CI: 2.20–3.64, p < 0.001). Younger age (MD -9.07, 95%CI: -14.75 to -3.38, p = 0.002) and higher education (OR = 0.85, 95% CI: 0.80–0.91, p < 0.001) were observed in DSS population. Patient acceptance of DSS increased alongside the advancement of digital technologies and dominated by the ease of use. This study suggested the use of DSS for improving hospital outpatient services, but there is insufficient evidence for waiting time and other outcomes of outpatient operations, so future research is warranted.