The face of health care is rapidly changing with a new emphasis that has been placed on patient-centeredness. The course of this transformation is based on the increasing recognition of the patients’ role in healthcare design and delivery. Traditionally, patients medical appoints have been made in person or verbally over the phone. Traditional methods lack the ability for a patient to get timely appointments for its not only limited by the availability of slots, but also the phone lines and the schedulers. Patients’ satisfaction with booking appointments is largely influenced by their capability to book at the right time and with the right health care service providers. Patient scheduling is one of the most common tasks performed by health care institutions and even though it seems like a simple process, it has a huge impact on the success of a practice. Health care practices ensuring that patients are scheduled efficiently and effectively is vital to maximizing and maintaining a health care institutions revenue. One needs to do what they can in order to keep missed patient schedules to a minimum and also make sure that patients have been seen by the doctor as close to their booked appointment time as possible.
Appointment Schedule Workflow
Hospital appointments can be made through a phone call or a visit at the practice. When the patient is in need of an appoint, s/he checks in at the practice physically or makes a phone call to his practice of choice. In the case of a new patient, the clerk creates a new record in the system by entering the patient’s information. Once this is done, the clerk or provider checks in the system whether it is a returning patient or a new. Searching the system is done by using the patient’s social security number (SSN), date of birth (DOB) or their medical record number (MRN). Once the patient has been found in the system, the clerk then selects the name of the preferred physician by the patient (Hess, 2018) . The system being intelligent, it ensures that there are no conflicts in the dates and time with the patient’s appointment. A slot is then given to the patient and the reason for the appointment is selected. A summary of the details of the appointment is then made and thereafter the patient is given an appointment card. In the case of a phone call, the appointment details and card are emailed to the patient in addition to them being summarized verbally by the clerk (Hess, 2018) .
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The clerk is at the reception or the provider is responsible for creating the patient’s appointment. The technologies used in creating the patient appoint management system are: C#, JavaScript, HTML5, CSS 3 and SQL. Integrations include: Google calendar bookings, website integration, mobile application, automated reminders, SMS text customization, Payment processing through PayPal, stripe and Authorize.NET and live chat support. The policies and integrity checks in the system are meant to maintain and achieve information governance objectives such as: Availability, Confidentiality, Accountability and Integrity the sensitive information and data that is accessible to authorized individuals only (Zhao, Yoo, Lavoie, Lavoie & Simoes, 2017) . These are four main polices that govern how, where, when and where each step is executed in the patient appoint flowchart. To access the system, the clerk or provider or nurse needs to registered in the system which constitutes their tax information, employee identification number, full names, date of birth, address, passwords, biometric information, employee related information and sexual orientation (Zhao, Yoo, Lavoie, Lavoie & Simoes, 2017) . For the patient, the following information is required:
Medical records covered by HIPAA rules and regulations.
Biometric information
Passwords
Mobile phone numbers
Passport information
Social Security number, employee identification numbers and tax information.
Address
Electronic and digital account information
Sexual orientation
Ethnicity
Performance in the main metric that is used to measure the soundness and effectiveness of the patient appointment schedule workflow diagram. Deliverability is one of the main objectives of the workflow diagram (Singh, Singh, Singh & Raj, 2013) . A single call at the clerk’s desk takes 8 minutes before a single reservation is made. If the clerk is unable to make reservations for both physical and on call patient’s in under 3 minutes then the success and effectiveness of the workflow will be zero (Singh, Singh, Singh & Raj, 2013) . To ensure the deliverability of the scheduling appointments, the workflow eliminates the need of phone calls at the clerk’s desk as it has an integration of a patient self-service portal. This means that patients do not have to be physically at the practice to make an appointment. Once an appointment is booked, an email is sent to the patient with the appointment details (Cofiel, Bassi, Ray, Pietrobon & Brentani, 2013) . It is therefore vital to ensure that emails are delivered to patients without fail and in order to ensure that this is a success, one may need to filter out all the inactive users and emails from the system. It is important to also measure the engagement and open rate of the emails that have been sent. This metric has proved to be effective as the portal will be able to handle more than 100 requests at time thereby reducing the time that is wasted on calls. One does not have to be physically present at the provider in order to make an appointment (Cofiel, Bassi, Ray, Pietrobon & Brentani, 2013) . Leveraging the power of the internet and the cloud, patients can make appointments anywhere, on any device, at any time and at their own convenience (Cofiel, Bassi, Ray, Pietrobon & Brentani, 2013) .
Many at times, patient visits vary depending on the level of care needed and the time required to attend to the patient. Once, an appointment has been made, it will be the role of the system to prioritize the appointments based on their urgency (Solutionreach, 2017) . Patient issues that do not require the patient to be physically present can be solved through an email or a phone call by a doctor or a nurse. This will ensure that patients who are needed or the highest level of care can have better access to same-day appoints when necessary (Solutionreach, 2017) . The workflow should also include an appointment reminder that will improve on the number of on-time arrivals as no-shows are inconvenient and costly as both the patients the provider misses out when a no-show occurs (Solutionreach, 2017) . It is important to be aware bout the flow of an activity in order to increase the efficiency of a process and to keep the required processes running smoothly and effectively (Ayaz, 2017) . Each activity is highly dependent on another activity and when it fails or slows down, the entire processes at a provider are affected and leads to a decline in efficiently and productivity of a given practice. It is therefore vital for the hospital staff, nurses, physicians and vendors to make sure that they understand and are aware of every activity that happens (Ayaz, 2017) .
References
Ayaz, S. (2017, November 30). How Can Healthcare Workflow Analysis Help Hospitals in Deploying their EHR System Successfully? Electronic Health Reporter . Retrieved from https://electronichealthreporter.com/can-healthcare-workflow-analysis-help-hospitals-deploying-ehr-system-successfully/
Cofiel, L., Bassi, D., Ray, R., Pietrobon, R., & Brentani, H. (2013). Detecting Dissonance in Clinical and Research Workflow for Translational Psychiatric Registries. Plos ONE , 8 (9), e75167. doi: 10.1371/journal.pone.0075167 .
Hess, C. (2018). Workflow Analysis. Advances In Skin & Wound Care , 31 (9), 431-432. doi: 10.1097/01.asw.0000544498.91342.78 .
Solutonreach. (2017, August 18). 6 Ways to Schedule Patients Effectively and Efficiently. Solution Reach . Retrieved from https://www.solutionreach.com/blog/how-to-schedule-patients-effectively
Singh, G., Singh, R., Singh, A., & Raj, D. (2013). Improvement of workflow and processes to ease and enrich meaningful use of health information technology. Advances In Medical Education And Practice , 231. doi: 10.2147/amep.s53307 .
Zhao, P., Yoo, I., Lavoie, J., Lavoie, B., & Simoes, E. (2017). Web-Based Medical Appointment Systems: A Systematic Review. Journal Of Medical Internet Research , 19 (4), e134. doi: 10.2196/jmir.6747 .
