BARRIERS AND FACILITATORS TO AUTOMATED PATIENT SELF-SCHEDULING FOR HEALTH CARE ORGANIZATIONS: SCOPING REVIEW, CONSENSUS FROM A DELPHI PANEL OF KEY STAKEHOLDERS, AND EXPLORATORY CASE STUDY

Abstract

Appointment management in the outpatient setting is important for provider organizations as waits and delays lead to poor outcomes and inefficiencies. Automated patient self-scheduling of outpatient appointments has demonstrable advantages for organizations in the form of patients’ arrival rates, labor savings, patient satisfaction, and more. Despite evidence of the potential benefits of self-scheduling, organizational uptake of self-scheduling in health care has been limited. The goal of this dissertation is to identify the barriers and facilitators to self-scheduling for provider organizations through a scoping review of the literature, a consensus from a Delphi panel of stakeholders from US academic health systems, and an exploratory case study of a large medical practice in the US that implemented automated self-scheduling. Results demonstrated that self-scheduling initiatives have increased over time, indicating the broadening appeal of self-scheduling. Offering convenience for patients is the leading enabler for organizations to implement the technology, signaling that provider organizations may now recognize the need for innovation. For provider organizations, the relative advantage of self-scheduling over the traditional method of scheduling is a facilitator; barriers include complexity and providers’ resistance. There is evidence of digital inequities based on identifying users, with relatively less use by Medicaid beneficiaries. Provider organizations may benefit from thoughtful, intentional strategies to identify, diagnose, and address barriers and facilitators. Additional research is warranted to understand actionable steps to address the impediments and promoters of the technology.