Improving Patient Scheduling with Decision Trees

Scheduling patients with the right provider at the right time at the right location has been the mantra for scheduling optimization projects for a long time now. In recent years, location has been complicated with the use of online / virtual options. Providers and patients can now be connected without needing a physical location. Now, more than ever before, we are seeing scheduling efficiency at the core of healthcare access operations.

Over complicated provider templates and scheduling processes can lead to access challenges and can drive patient dissatisfaction.  Empty appointment slots in schedules also have a commercial impact on an already fragile market.    

Leveraging tools within Electronic Health Records (EHR) to optimize the search of the next available appointment can help deliver to patients and providers the ideal solution.  Aligning workflows through scheduling logic can reduce ‘errors; and reduce callers being transfers back to offices for assistance in getting a patient scheduled.  Logic can also reduce the time it takes to schedule an appointment as all callers experience a very similar workflow.  Logic tools also reduce the training requirement on new hires, with the system helping navigate to the correct provider, time and location. 

We sat down with our in-house Scheduling Optimization expert Dana Cameron to walk through the merits of introducing Decision Trees to enhance scheduling operations. 

Why do you believe Scheduling Logic /Decision Trees are a good step for organizations to take? 

Throughout my career, I have worked with organizations who crave a solution that meets the needs of providers, administrators, and patients. This is often difficult to accomplish but I have experienced that the introduction of Decision Tree logic has had a material positive impact on many different stakeholders. We hear the phrase ‘standardization’ thrown around a lot which I know is sometimes off-putting. I have always been of the view that the introduction of Decision Trees, whereby individual provider preferences and approaches can be accommodated, can achieve a similar result if they are implemented in the right manner.  

What is your typical approach? 

For me, I believe that the whole approach needs to be collaborative and structured. We typically help an organization select service lines and/or specialties that are good places to start. We attempt to collate as much information available about current state by reviewing training materials, scheduling guidelines, knowledgebases, sticky notes etc. this gives us some familiarity with the organization. From there we begin to lead workshops and discussions to develop the target operating model as it pertains to agreed workflows for various visit types, block, pools, panels, subgroups, and resources, amongst other applicable items. 

At this point, we engage with management, super schedulers, and providers to discuss the variances of practices, visit requirements/preferences and approaches. We help guide the conversation and ensure we document what we hear, and we attempt to advise on best practice seen elsewhere.   The questions are asked – who, what, where, when and importantly why. 

Along with the development of scheduling logic, we also optimize the building blocks of scheduling – provider schedules, visit type functionality, instructions, etc. in order to maximize the impact of the addition of the logic for all. 

From there, we move to a build phase and soft go live. This stage, results in guidelines being built directly into the system. It is important at this stage other stakeholders are brought up to speed and trained on the new approach. We remain on standby to iron out any kinks or any process improvements opportunities.  

What is the impact? 

The advantages of the introduction of Decision Trees are widespread. First and foremost, it alleviates the need for Scheduling Representatives to remember a wide range of nuanced information while decreasing the need for documented guidelines.  In a time where there are challenges related to labor shortages, employee engagement and staff turnover, anything that can be done to simplify complex processes is significantly important.  By introducing decision logic, we have seen the speed a new hire can become proficient in scheduling appointments reduced from upwards of five weeks to two weeks depending on the service line.   We have also seen organizations introducing a cross-skilling approach whereby representatives can now schedule across multiple service lines rather than just being a master of one area. 

We have also seen a positive impact on provider schedules.  For example, under scheduled APCs are automatically being brought into the appointment offering, thereby reducing the lengthy ”next available appointment’ metric. This reduces leakage and which in turn increases patient access and satisfaction.  Carving out specialty clinic time and automating the scheduling path also increases provider satisfaction. 

Lastly, there is an impact on the bottom line. More efficient and effective scheduling process has led to increased template utilization of up to 20% in some areas. It has also resulted in a decrease in no-shows/missed slots because of errors and because of cross-skilling and economies of scale advantages additional savings have been felt.  

Why can’t healthcare organization do this work themselves, whats the advantage of bringing in a consultant?  

Some organizations choose to undertake this project themselves which can work out. My perspective of the advantages of bringing in third party consultants is that you can avail of the expertise and experience of a consultant who has worked on similar projects in multiple organizations. It also brings that outside review of existing practices that have been in place for years that no one remembers why.  I like to believe we can bring a holistic opinion to the table. Third party consultants can often work at pace suitable to the organization to reach milestones.