Impact of Web-Based Self-Scheduling on Finalization of Well-Child Appointments in a Primary Care Setting: Retrospective Comparison Study

Abstract

Background 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. Objective 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. Methods 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. Results 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. Conclusions 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.

Self-Scheduling Process Efficiency and Utilization of Online Self-Scheduling of Lab Tests: A Retrospective Analysis of Self-Scheduled Appointments for COVID Testing

“…Previous work also showed that patients were increasingly getting familiar with self-scheduling though use of self-scheduling for well-child visits and screening mammograms. 5 , 6 Online symptom self-triage linked with self-scheduling was also being implemented in 2020 and throughout 2021.…”

“… 11 Mayo Clinic experience with self-scheduling appointments showed that 5% of well-child appointments and 21% of screening mammograms were self-scheduled. 5 , 6 …”

“…Prior to COVID, Mayo Clinic had other self-scheduling opportunities such as for well-child visits and screening mammograms. 5,6 However, prior to COVID test self-scheduling, patients were not able to request and schedule a lab test in a seamless single online encounter as they could with the COVID testing we describe in this study. We examined measures of efficiency and utilization of the COVID test self-schedule process over 17 months of use.…”

The Effect of Automated Mammogram Orders Paired With Electronic Invitations to Self-schedule on Mammogram Scheduling Outcomes: Observational Cohort Comparison

“…The outcomes for self-scheduled mammograms show some interesting contrasts and similarities to outcomes for Mayo Clinic’s self-scheduled well-child visits [ 15 ]. Despite differences in patient populations (adult vs pediatric) and appointments scheduled (radiology procedure vs provider visits), there were similar scheduling efficiencies with 93.1% (712/765) of exclusively self-scheduled well-child visits being finalized with 1 appointment step compared to 1 appointment step needed for 93.5% (7553/8079) of the exclusively self-scheduled mammograms.…”

“…The periodic well-child examination is another example of a self-scheduling appointment type that requires a completely different set of rules. Scheduling of the well-child examination is based on the age of the child, the date of the last well-child examination, and matching with the child’s primary care provider [ 15 ].…”