Put This on Your Schedule

Health Management Technology, Sept, 2001

Texas healthcare facility uses automated scheduling to efficiently plan the medical staffs time, reduce patient cancellations and cut administrative costs.

Finding the right scheduling system means a lot more than merely making sure patients can be seen in a timely manner. For The Clinic@Brackenridge, it also means making sure the medical staff is scheduled in a way that maximizes their time and makes the scheduling process more proactive and less reactive.

PROBLEM

The Clinic@Brackenridge, located at Brackenridge Hospital in Austin, TX, is part of the SETON Healthcare Network, one of the largest healthcare systems in Central Texas. The Clinic@Brackenridge conducts 26 different specialty clinics that rotate on a daily basis at the hospital. Referrals come from 15 primary facilities and also from the emergency department. We have 150 doctors, including interns, residents and specialists, who serve for different periods of time throughout the year.

Scheduling at our clinic was a challenge on a variety of levels. We handle 20,000 patients visits a year, comprised of primarily low income and uninsured patients who are difficult to track, contact and follow up with.

Using a diverse staff of doctors, including numerous specialists, we also had to schedule their time. Often we have five clinics a day, and combined with a backlog of patients and overlap between clinics, we discovered our staff of doctors spent a lot of time waiting and standing idle as the traffic was herded in and out of the waiting room.

Scheduling for patients was also difficult. A paper and pencil-based system was initially used and patients were asked to come to a specific clinic on a first-come-first-serve basis during a block of time while that clinic was in session. The primary care facilities that serve as our main referral source would tell patients when to show up and where to go. As a result, we had no way of knowing what our traffic flow would be like on a given day or what medical staff we needed to have available, if any. Wait times averaged 162 minutes and cancellations soared.

Given the characteristics of our patient base, we had no ability within our system to follow up or track patients before, during or after their visits.

Integration with the legacy system used by SETON was impossible, and patient demographics changed without our knowing it.

SOLUTION

Over time, we had evolved from a strictly paper-based operation to one that utilized a homegrown database system. This worked suitably for a while, but we still wanted to identify a system that would better meet our automation needs and fulfill enterprise requirements. In short, we wanted even greater efficiency for doctors and patients.

Toward the end of 1999, we started looking for a scheduling solution that would be easy for our staff to use and would require as little training and down time to implement as possible. We also wanted to find a system that would provide us the capability to schedule our patients in real-time with the primary care centers and give us the ability to integrate patient demographics with SETON's legacy system.

After conducting an RFP, we selected Vitalz and their Web-based scheduling solution in April 2000. Within eight weeks, the Vitalz scheduling system was fully operational. Staff needed just 10 to 15 minutes of training to learn the system and our ability to get it up and running was extremely smooth.

RESULTS

With the new system in place, we were able to take control of our scheduling situation on all levels.

The system provided us with the ability to analyze and schedule our doctors based on their specialties in conjunction with the most cost-effective use of their time. Doctors no longer sit idle. Now their time is maximized with a system that helps us plan the most appropriate services to provide, what kind of patients we need to see and what staff will be necessary to see them--all within a given period of time.

Patients are now scheduled into specific time slots both through The Clinic@Brackenridge and directly from the primary care centers. Three of the 15 primary care centers have real-time access to our scheduling system and can make and schedule appointments while the patient is physically at the primary care facility. As more primary care centers get the appropriate systems to integrate with our system, this service will be added at those locations.

The Vitalz system has been operational for more than a year now. During the four-year period in which we progressed from paper to our own homegrown system to the Vitalz system, patient wait times have been reduced by 50 percents, from 162 minutes to 81 minutes. Since implementing the Vitalz system, we have reduced the cancellation rate by 12 percent and we have had a 30 percent increase in patient throughput. The system has also helped us reduce the staff necessary to manage the clinics, and we have been able to reduce our costs-per-scheduling each transaction by 32 percent.

Another feature of the system gives us the ability to track our patients more efficiently. The new system integrates with the SETON legacy system and we can update patient demographics at each visit, increasing our ability to track patient care and follow up with patients after their visit or even to confirm appointments.