When we talk about new innovations in healthcare, we often mention new ground-breaking treatments, sci-fi inspired diagnostic tools or maybe even new fancy digital channels for patients and doctors to connect. We seldom talk about innovations in other parts of the care journey. What other parts you say?
There is more to care than care services
There are so many more things a hospital is doing on top of the actual care bit. Think about it: How much of your hospital experience is actually made up by interactions with your clinical team?
You usually have multiple touchpoints with your hospital before you’re even at the grounds. The hospital handles your referral, they manage your appointment booking and help you prepare for your visit. All of the stuff happening in between appointments is important to make sure that hospital operations run efficiently and that you, and your fellow patients, get the care you need.
Booking teams are really, really, important.
Hospital booking teams are at the core of the patient care journey. Alongside driving the activities mentioned above, it’s part of their job to make sure that the right patient is seen at the right time, that care resources are used efficiently and that the wait list doesn’t get out of hand. They are also the first point of contact for any patient starting their care journey at a hospital.
We should pay more attention to the key challenges faced by booking teams and we should celebrate the innovation that is happening in their space.
Patient no-shows are a huge problem for booking teams, hospitals and patients
One of the biggest challenges facing booking teams are patient no-shows. A patient not showing up has a huge effect on hospital performance:
1. It costs a lot of money.
From the booking clerk scheduling the appointment, through to the cost of sending out appointment letters and onwards to the clinical team using their time to prepare for a patient that will not show up. Considering that patients who do not attend their appointments can make up 10% or more of all appointment instances, we’re actually looking at a severe haemorrhage of taxpayer money.
2. It makes waitlists really, really long
Wasting appointment times on patients who don’t show up means a major blow to the hospital’s treatment capacity. We all know that the waiting time to see a specialist is out of control. If more patients were seen each day, you wouldn’t have to wait as long to see your doctor.
Patient’s aren’t mean, lazy or stupid people. You can’t blame them for having a life that doesn’t revolve around their next hospital appointment. There is actually a seemingly obvious fix to this problem. You see, patients are more likely to show up to their appointment if they’ve been involved in the scheduling decision. It’s quite clear when you think about it: if they can express when they’re able to attend they’re more likely to do so.
Booking teams struggle to solve this problem
When you’ve understood that involving patients = fewer patient no-shows, it can feel quite strange to learn that most booking teams in the NHS schedule their patients without involving them when deciding when and where the appointment will take place. In the UK, this is still the most common way for booking teams to operate.
Booking clerks aren’t mean, lazy or stupid people. They know that booking a patient without involving them will lead to massive no-shows and rescheduling requests. So why are they doing it?
It’s quite simple. The reason booking teams are not involving patients comes down to one thing: Capacity. If you’re part of a booking team consisting of 2 clerks, responsible for scheduling 200 patients per day, there is no way you’d be able to call each patient to check when they would prefer to come in for their next appointment.
From personal experience I can say, booking teams are often so stretched they barely have time to go to the bathroom.
Solving patient no-shows is a key to the future
If we could decouple the capacity the team has from their ability to involve patients in the scheduling decision, we would be entering a major paradigm shift for booking teams.
Solving this problem doesn’t only mean that we’d save money and cut wait lists. It would also mean that the teams would be free from the constant battle of patient no-shows, able to focus on higher value challenges like patient experience, clinic utilisation and advanced patient prioritisation.
We created a great solution that didn’t fully solve the problem
A few years ago, we launched patient-led booking, a solution that automatically allowed patients to select an appointment, removing the need for the clerk to call the patient. This tool has done a great job of involving patients in the booking decision. Problem solved, right? ..Well, not quite.
Considering the extent of the problem, it was somewhat of a surprise to us that we didn’t see the roaring appetite we expected for the solution.
After investigating with booking teams, it became clear that the workload associated with running the tool meant that teams that already are working on full capacity simply don’t have enough space to adopt it. Remember, these teams make up the vast majority of all teams in the UK.
After learning this, we’ve asked ourselves how we might involve patients in the scheduling decision without demanding an increase in capacity from the booking team.
We set out to eliminate the workload associated with running the solution. The main workload was connected to actioning requests coming in from patients. A booking clerk had to take the patient appointment request, see if the appointment was still available in their internal system, book the patient in and then capture the action in our system.
This mind-numbing activity took hours away from the booking team each day.
This is why the 2-way integration is exciting
With a two-way integration the booking clerk doesn’t have to bother updating their own system with patient requests. The integration does it for them. When a patient selects an appointment time, that request gets sent through to the booking teams’ system. The appointment is automatically booked, and the patient is informed.
Picturing this activity flow might be a bit underwhelming. Other industries have done this for ages. Think about booking a flight or cinema tickets for example. But it’s not underwhelming, it’s actually really, really exciting for two reasons:
1. Innovation and digital transformation in healthcare is really hard. A combination of legacy, clinical risk, funding and regulations are examples of what makes healthcare a vastly different beast from other industries. Factors like this is what makes innovation in this space really difficult.
2. The problem is huge, and so is the benefit of solving it. The impact on you as a patient, your booking team and your hospital will be massive if the problem is solved. Money saved can be used to improve care, care capacity will go up, waiting lists will be shorter and booking teams can focus their time on the patients who really need it.
DrDoctor is ready for an integrated future
At DrDoctor, we have worked to get a two-way integration in place for several years. This autumn we’ve made some really exciting progress with our innovation partners at Chelsea and Westminster Hospital.
Patients can now self-refer to an ambulatory care service and schedule themselves in at a time that works for them, all without involvement from the booking team. This will mean unlocking these benefits.
This is just the beginning. The coming year we will see new integration services that will further unlock the future for booking teams. Watch this space.