Heaven help us: Airline-style schedule updates come to the doctor's office

Before I harsh on MedWaitTime, which I will do shortly, I do want to say that the company’s heart is in the right place –to make life easier for patients whose doctors and hospitals are keeping them waiting. The company’s smartphone app and text messages let doctors notify patients that they are running late and lets emergency rooms provide information on waiting time. The idea is to avoid having patients arrive at the waiting room too soon –just like airlines do with their flight status notifications.

I read about the company in today’s Wall Street Journal (Internet Tool to Curb Waiting-Room Time).

There are a number of problems with the approach:

  • As an experienced user of the airline flight status systems, I can tell you they are of little practical benefit. Flights are usually listed as on-time until it’s time to get to the airport. Once there it’s not that helpful when a delay pops up. The eventual departure time is almost never what the first or second update says it will be. You’ll also notice that there’s usually a disclaimer that says to show up on time anyway, since schedules can change. All these issues are likely to be present in the doctor’s office as well
  • Doctors offices have to be careful using these systems, since they could exacerbate their scheduling problems. If a doctor is running one hour late, what is he going to tell his patients? To come one hour late? 45 minutes? 30 minutes? If the office is completely honest patients might show up late for the revised appointment and push the doctor’s schedule back farther. If the patient is told it’s a 30 minute delay but then has to wait another 30 minutes upon arrival anyway, satisfaction will suffer and the patient will game the system on the next appointment, making everything will go haywire
  • Information on wait times has to be entered and updated manually. Can we really trust office staff to keep on top of this throughout the day, day after day? I highly doubt it
  • Emergency room patients are not seen on a first-come/first-serve basis, so having information on wait times is not too helpful without corresponding triage information on the specific patient relative to others in the waiting room. It could be modestly helpful, though, in deciding which hospital to go to

Waiting room times are a fairly small part of the overall access and customer service problem in health care. In my opinion there’s no need for a new system and dedicated company for waiting room notifications. Maybe MedWaitTime will prove me wrong but I don’t think they have a business here. Doctors offices would do better to collect cell phone info from patients and text or call the day of the appointment if there’s a problem. They can also make the waiting room more pleasant and educational.

I also recommend open access scheduling for physicians offices. This addresses the much more troublesome issue of long lead times for appointments. I don’t really mind waiting 30 minutes in the waiting room for a same day appointment. I do mind getting an appointment date weeks or months out.

May 25, 2010

4 thoughts on “Heaven help us: Airline-style schedule updates come to the doctor's office”

  1. David,

    While I agree completely with your assessment of Med Wait Time’s response to the visit scheduling conundrum, and the prospects for their business, I do disagree with your assertion that “waiting room times are a fairly small part of the … access and customer service problem in health care”, and to do the subject justice would have to go on at some length. Let me instead refer you to work by primary physician Dr. L. Gordon Moore, who can supply both examples & data to demonstrate the ‘heft’ of the problem.

    I feel your post’s more valuable theme is your bulleted identification of the glaring “component problems” that MWT’s application overlooks. For my money, your third item is the “application killer” – and one that should have stopped MWT’s development dead in its tracks. I can’t even imagine how its developers could conclude that their product would not founder on the rocks of staff-provided wait-time input.

    This kind of dumbfounding oversight happens with startling frequency in the world of health care applications.

    I urge all your readers to remember your sage observations about MWT the next time they are about to exclaim “gee whiz!” at a glowing press release for a new health care application of this sort.

  2. Excellent points all, and it’s not just true in airlines. From my experience working at a major amusement park, I can tell you that trying to keep up with wait times there was problematic: and we were experts on wait times!

    In fact, there was a position at each ride specifically geared toward keeping the line in order; even so, keeping up with a constantly fluctuating number of people and how long that meant the wait time might be was difficult. With workers rotating through duties, you might walk out to a line that had little to no people but listed a wait time of an hour because just a few minutes ago that same line was full.

    If you were watching the line you were also supposed to call in wait times so they could be listed at the front of the park. Remembering to do that on top of your other duties was difficult, and so the information you saw at the park might be inaccurate.

  3. I agree that such a system is unlikely to be helpful.

    Your idea of open access schedules is a good one. In this type of system people get seen when they want to be seen, and in most cases everybody is still able to get the care they need. The only problem with it is that you start to have a restaurant style schedule, where there is a rush at certain times of day when patients are more likely to find it convenient to be seen. This can lead to open spots in the schedule followed by several slots that are triple overbooked. Still a good idea though.

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