Self-scheduling in a Large Multispecialty and Multisite Clinic: A Retrospective, Longitudinal Examination of Multiple Self-Scheduled Visit Types

Abstract

Background: Self-scheduling of medical visits is becoming available at many medical institutions. We aimed to examine the self-scheduled visit counts and rate of growth of self-scheduled visits in a multispecialty practice.

Methods: For 85 weeks extending from January 1, 2022 through August 24, 2023, we examined self-scheduled visit counts for over 1500 self-scheduled visit types. We compared completed self-scheduled visit counts to all scheduled completed visit counts for the same visit types. We collected counts of the most frequently self-scheduled visit types for each week and examined the change over time. We also determined the proportion that each visit type was self-scheduled.

Results: There were 20,769 699 completed visits during the course of the study that met the criteria for inclusion. Self-scheduled visits accounted for 4.0% of all completed visits (838 592/20,769 699). Over the 85-week span, self-scheduled visits rose from 3.0% to 5.3% of the total. There were 1887 unique visit types that were associated with completed visits. There were just 6 appointment visit types of the total 1887 self-scheduled visit types that accounted for 50.7% of the total 838 592 self-scheduled visits. Those 6 visit types were a lab blood test visit (19.5%, 163 K visits), two Family Medicine office visit types (13.0%, 109 K visits), a screening mammogram visit type (6.6%, 55 K visits), a scheduled express care visit type (6%, 50 K visits) and a COVID immunization visit type (5.7%, 48 K visits). Twenty-one visit types that were self-scheduled accounted for 75% of the total self-scheduled visits. Four seasonal visits, accounting for 10.6% of the total self-scheduled visits, were responsible for almost all the non-linear change in self-scheduling.

Conclusion: Self-scheduling accounted for a small but growing percent of all outpatient scheduled visits in a multispecialty, multisite practice. A wide range of visit types can be successfully self-scheduled.

Keywords: access to care; efficiency; family medicine; health economics; medical informatics; outpatient visits; practice management; self-schedule; specialty visits; visit scheduling.

Figure 1.

Scatterplots of weekly self-scheduled completed visit counts for 85 consecutive weeks. The two different markers represent the total self-scheduled weekly completed visit counts (blue, round) and the sum of self-scheduled visit counts from 4 seasonal visit types (3 self-schedulable immunization types and 1 self-schedulable respiratory testing), marked by red diamonds.

Figure 2.

(a) Scatter plot of total self-scheduled weekly completed visit counts minus the sum of the weekly counts of 4 seasonal visit types (3 self-schedulable immunization visit types and 1 self-schedulable respiratory testing visit type). The blue round markers on this graph are the graphic representation of Figure 1 blue round marker counts minus Figure 1 red diamond counts. Outlier 10 holiday weeks are omitted from the scatterplot figure. Red spikes on this graph are the 95% confidence intervals for the linear regression best fit. (b). Scatterplots show percent self-scheduled by week. Blue round markers represent the percentage of visits that were self-scheduled (100*count of all self-scheduled visits/ count of all scheduled visits). Red hollow squares are the percentage of all visits that were self-scheduled minus the 4 self-scheduled seasonal visit types (100*(count of all self-scheduled visits minus sum of counts of 4 seasonal self-scheduled visits)/ count of all scheduled visits). Green spikes are the 95% confidence intervals for the linear regression fit of the red hollow squares. Outlier 10 holiday weeks are omitted from the scatterplots.

Figure 3.

Scatterplots of weekly self-scheduled completed visit counts for 85 consecutive weeks. Six self-schedulable appointment visit types are shown. Each visit type reached a highest weekly completed self-scheduled visit count of 1000 or greater during the 85 weeks.

Figure 4.

Scatterplots of weekly self-scheduled completed visit counts for 85 consecutive weeks. Six self-schedulable appointment visit types are shown. Each visit type reached a highest weekly completed self-scheduled visit count of 250 or more but less than 1000.

Figure 5.

Scatterplots of weekly self-scheduled completed visit counts for 85 consecutive weeks. Six self-schedulable appointment visit types are shown. Each visit type reached a highest weekly completed self-scheduled visit count greater than 95 but less than 250.

Figure 6.

Scatterplots of weekly self-scheduled as percent of total scheduled. Subgraphs selected to show variability of percent over time.