By Robbie Hughes, CEO, Lumeon
One of the things that I regularly get asked is why so many other ‘service’ industries are consumer-friendly, whereas healthcare isn’t. The example given is always scheduling an appointment “Why can’t I schedule a healthcare appointment online like I can for my haircut/massage/movie/name your event?”
The short answer is that you can, but it’s not quite that simple. The challenge we have in healthcare is that so much of it is what I describe as an ‘it depends’ problem – in other words, scheduling can be more complex than you might think:
- Who should I book in with?
- What should I book?
- When do I need to book in?
- How long for?
- How do I prepare?
A problem like this is one where the answer to the question is always ‘it depends,’ and what’s worse, these aren’t even driven by the same factors!
Who the patient should book in with is not only a function of their symptoms but also whether they’re an existing patient, what their insurance will cover, who is available to see them, the provider’s schedule, and other factors. A scheduler would automatically look for these when on the phone with a patient trying to book them in. They would also address the fact that it may not be ‘one visit’ the patient needs, but a series of visits to be scheduled together, coordinating different care team members to solve ‘one problem’ for the patient.
In healthcare today, we don’t have a single ‘product’ that a consumer can book as they would in another industry – so we need to reframe the problem to simplify the experience for the consumer.
The way most systems manage this today in our industry, is to offer up a limited range of visit types that are always the same and leave the complex stuff for later. That’s why online scheduling in healthcare is often focused on general-purpose PCP visits, as 20mins with your family doctor is easy to solve. This is not where schedulers spend most of their time. Things that can be automated easily tend not to be hard to do; they’re just repetitive.
So, what does good look like in this space, and how can we use it to create the most value for health systems and patients? Let’s consider four key aspects of patient scheduling:
For an online scheduling tool to be effective, it needs to triage the patient. This means understanding the nature of the patient’s problems then recommending the appropriate visit type, practitioner type, and urgency of the booking. This capability is important so the patient doesn’t book the wrong thing, or the scheduling team will need to contact every patient to ensure what they’ve booked is right for them. It’s an issue we see time and time again – patients book slots online, then the scheduling team contacts them to ask questions and check if what they’ve secured is correct. This doesn’t help the providers or the patient, but it is a surprisingly common practice.
Once we’ve determined the visit type, we then need to go on to the next step; to match the practitioner and appointment type to the patient. Each practitioner is likely to be skilled in multiple problems, so we need to have an optimization step to ensure that we’re presenting the ‘right’ practitioner to this patient. This optimization often needs to take place across multiple dimensions – such as insurance, calendar loading, and cost optimization. If the visit type is not fully reimbursed, it’s unlikely that we’ll want to use an expensive resource. In some cases, we may prefer that a follow-up is scheduled with the same person who saw them previously. These are all subtleties that need to be considered.
Once we’ve understood who we want to schedule with, we need to understand who is available and whether it is the only practitioner required. A substantial number of visit types require several practitioners, all of whom need to be balanced and scheduled together. For example, in a screening visit, the patient will likely involve a nurse, some tests, and a physician to complete the review. We need to schedule these together in the correct sequence to achieve the best experience for the patient.
With all the resources lined up, we need to do the final piece, handing off the scheduling messages to the appropriate external systems, such as the EMR. This is rarely as easy as it should be, but necessary to avoid having scheduling in two places.
And that’s it, we confirm with the patient by SMS, email or however else they want to engage, and we’re set until the patient wants to move their visit, at which point we can reschedule using the already existing patient context.
As you can see, this is the problem of online scheduling in healthcare. To make it work for today’s consumer needs is not as simple as putting a ‘Book me’ button on a health system’s website. It requires detailed knowledge of context, intent, availability, and capability, all of which should be seamless to the consumer.
By integrating self-scheduling in our pathways, Lumeon automatically interprets the consumer needs. The system can manage demand, loading, and case routing and do all of this algorithmically in seconds. When the patient needs to be scheduled for a follow-up or a new visit, it can determine their need, recommend slots, gather multiple resources together as one, and offer these out to patients in a single, easy-to-use tool that makes the hard things easy, just as it should be.