“If you take that $60 billion dollars and divide it by the number of physicians in the United States, that is over $76,000 per physician, annually,” explains Tom Dewane Founder and CEO of Jaystreet Technologies. LLC.

Dewane is the developer of a new solution for the operational and financial drain caused by “empty” appointments: Avenue is a SaaS hosted cloud-based software that seamlessly integrates with existing office technology used for medical practice scheduling. It is available and already running in a variety of medical organizations, most notably in a clinic within the Jefferson University Hospitals system in Philadelphia.

The two biggest drivers for high rates of cancelled appointments are wait times and life itself. Providers have less control over the latter, which can include things like changes in a patient’s work schedule, family matters, and household emergencies that prevent a person from keeping a doctor’s appointment.

“Research shows that patients who expect that they will have long wait times at their practitioner’s office are more likely to cancel at the last minute, or simply not show-up,” Dewane says. “The research [I’ve reviewed] does not indicate what action those patients take; it is pretty safe to assume that they either were seen by another provider or chose not to receive treatment.”

There are many approaches to managing patient wait times as well as dealing with patients who repeatedly cancel or fail-to-show for appointments. Such methods must be customized to the needs of the practice (e.g., urban clinic or affluent suburbia family practice). More important to the workflow in the practice is the fact that these strategies can increase the work of busy medical assistants. Commonly used strategies often involve making additional phone calls to patients. Avenue changes all of this by making it simple and effective to fill the empty appointment without anyone having to pick up the phone.

How Avenue Works

Avenue addresses two problems simultaneously: first, it allows your practice to keep an automated wait-list of patients who want to be seen sooner than the next available appointment. Their name, appointment preferences, and mobile number are stored in Avenue. Now, those patients won’t have to keep calling the office to ask if something has opened up in the schedule. Second, when a cancellation does come in, staff won’t have to waste time calling (and leaving messages for) patients on the wait-list—Avenue will do it for them via text message to patients on the list.

This video illustrates the process that is outlined below.

1. Wait-list patient names and cell phone numbers as well as desired appointment details have already been entered into Avenue. Avenue rank-orders wait-list patients by the preferences entered.

2. Cancellation is phoned in by a patient.

3. Text messages are sent to one patient at a time, inviting them to accept the available appointment.

4. If the wait-list patient replies “yes,” an appointment confirmation message is sent.

5. Avenue generates a pop-up message and sends an email to your scheduler to indicate who has filled the cancelled appointment.

Mr. Dewane explains text messaging is used, rather than an automated phone call to patients, because “far more people are able to answer a text at any given moment…A recent survey indicated that 64% of Americans want their first point of contact for customer service issues (and this is a customer service issue) to be via text.”

Avenue’s Success in Medical Practices

Typically, there is a 90% reduction in the number of empty appointments in less than one month. Avenue is in-place in an array of practice settings ranging from small, independent clinics to large, integrated delivery networks and covers a range of medical specialties.

Each medical practice or organization can choose from two different payment options for the service: pay-per-filled appointment model or subscription model. The former emphasizes the immediate and direct value of the service to the practice. Doctors see the ROI in number of patients seen, average collection of visits, and the cost of the service. A subscription model works best for clinics that need a predictable expense each month—in this case, a fixed price per provider per month—and the ability to have unlimited filled appointments.

Is Avenue Right for Your Medical Practice?

To determine if Avenue is right for your practice, discuss the following types of questions with your staff:

1) How far out is my next available appointment?

2) How many appointment slots are available on my schedule?

3) How many patients did I see today?

4) How frequently are patients cancelling?

If the first available appointment is a week out yet the doctor is seeing less than the maximum number of patients in a day, appointments are being wasted. Avenue can fix that problem.

Resources

• Why We Don’t Come: Patient Perceptions on No-Shows. Lacy NL, Paulman A, Reuter MD, Lovejoy B., Annals of Family Medicine 2004;2(6):541-545. doi:10.1370/afm.123. Accessed 23 Feb 2015 
• Waiting Room Remedy: Doctor Pays for Delays (The Doctor’s Perspective). Pamela L. Wible Narratives 2012; (4); January 11, 2012