May 17, 2024: The Need to Change the Patient Scheduling Format
Moving from Fee for Service to Prospective Payment in Primary Care: Advanced Primary Care: The Future of Primary Care – Part 11
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One of the things we’ve seen with our work is that the “Tyranny of the Urgent” often ruins the schedule because of the response to patients of all various risk levels calling in for appointments. If you don’t have a process for managing those high-risk patients, they start to overwhelm your schedule and they don’t get the care they need when they need it. The low-risk patients oftentimes don’t need to have a face-to-face visit. Perhaps a telehealth visit or a phone interaction with a clinician would suffice as they only need to have a connection with the practice to get some advice on how to evaluate a particular complaint, they may have that doesn’t require a face-to-face visit.
What we’re encouraging centers to do is to move to an advanced access scheduling model where almost 30 or 40 percent of the appointments are same day or appointments that occur within 24 hours of the call. That allows patients to be placed in those appointments who really need to be seen that day. We would use the Whole Risk Score as a primary guide for that process flow with a triage nurse evaluating patients who are high risk or really looking to be seen right away and getting them in on the schedule because there are open appointments available.
This decompresses your schedule over time and you’ll see that you’ll have fewer bookings out of patients because you’ll eliminate those patients who typically might no-show if their appointments are scheduled three to four months now. Instead, you get those patients who need to be seen on the same day and then their follow-up needs become less if you’re addressing their acute problems more rapidly.
That’s the whole idea about having this advanced access scheduling with more same-day, less long-term booked appointments. You want to get the people the care they need the day that they call in. This is the way that we found to move into a service model that works instead of one that continually frustrates the staff.
Scott Conard, MD Michael Tuggy, MD Susan Lindstrom Laurence Bauer, MSW, MEd
scott@scottconard.com MTuggy@converginghealth.com slindstrom@mypha.com Laurence.bauer@gmail.com
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