Barriers to and Facilitators of Automated Patient Self-scheduling for Health Care Organizations: Scoping Review.

BACKGROUND: Appointment management in the outpatient setting is important for health care organizations, as waits and delays lead to poor outcomes. Automated patient self-scheduling of outpatient appointments has demonstrable advantages in the form of patients' arrival rates, labor savings, patient satisfaction, and more. Despite evidence of the potential benefits of self-scheduling, the organizational uptake of self-scheduling in health care has been limited. OBJECTIVE: The objective of this scoping review is to identify and to catalog existing evidence of the barriers to and facilitators of self-scheduling for health care organizations. METHODS: A scoping review was conducted by searching 4 databases (PubMed, CINAHL, Business Source Ultimate, and Scopus) and systematically reviewing peer-reviewed studies. The Consolidated Framework for Implementation Research was used to catalog the studies. RESULTS: In total, 30 full-text articles were included in this review. The results demonstrated that self-scheduling initiatives have increased over time, indicating the broadening appeal of self-scheduling. The body of literature regarding intervention characteristics is appreciable. Outer setting factors, including national policy, competition, and the response to patients' needs and technology access, have played an increasing role in influencing implementation over time. Self-scheduling, compared with using the telephone to schedule an appointment, was most often cited as a relative advantage. Scholarly pursuit lacked recommendations related to the framework's inner setting, characteristics of individuals, and processes as determinants of implementation. Future discoveries regarding these Consolidated Framework for Implementation Research domains may help detect, categorize, and appreciate organizational-level barriers to and facilitators of self-scheduling to advance knowledge regarding this solution. CONCLUSIONS: This scoping review cataloged evidence of the existence, advantages, and intervention characteristics of patient self-scheduling. Automated self-scheduling may offer a solution to health care organizations striving to positively affect access. Gaps in knowledge regarding the uptake of self-scheduling by health care organizations were identified to inform future research.

A physician's due: measuring physician billing performance, benchmarking results.

A 2008 study focused on four key performance indicators (KPIs) and staffing levels to benchmark the FYO7 performance of physician group billing operations. A comparison of the change in the KPIs from FYO3 to FYO7 for a number of these billing operations disclosed across-the-board improvements. Billing operations did not show significant changes in staffing levels during this time, pointing to the existence of obstacles that prevent staff reductions in this area.

Total account ownership. A new model for streamlining your business office staff.

A growing number of medical practices are transforming their payer-based, account follow-up staffing model to total account ownership (TAO). This approach recognizes the equally important tasks of coding, claims transmission, payment posting and refunds, which are usually divided among business office staff. TAO assigns work by payer rather than function. It ensures a fully cross-trained business office and vastly reduces the economic impact of employee absences. In addition, TAO gives every employee approximately the same workload in terms of both quantity and complexity.

Benchmarking the billing office.

Benchmarking data related to human and financial resources in the billing process allows an organization to allocate its resources more effectively. Analyzing human resources used in the billing process helps determine cost-effective staffing. The deployment of human resources in a billing office affects timeliness of payment and ability to maximize revenue potential. Analyzing financial resource helps an organization allocate those resources more effectively.