healthcare information technology

How to Reduce Waste in Your Health System by Tackling No-shows

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You’ve seen it time and time again—the patient schedules an appointment, your provider waits for them a few minutes past the appointment start time, the patient doesn’t show up at all. No text, no call. It isn’t just a poor experience for the doctor involved — it’s hurting the health system’s bottom line.

It’s no secret that hospitals and health systems across the nation are having issues with profitability. A large part of this equation has to do with keeping costs down. While you can’t just choose not to invest in your infrastructure, technology, or your people — something you can control is the money lost by no-show appointments. These no-show appointments are a colossal waste that lurks in your scheduling process and is estimated to cause the healthcare industry an estimated $150billion in losses each year.

What is a no-show appointment?

A no-show appointment is an appointment that a patient 1) makes with a provider; 2) fails to arrive at; 3) does not cancel before the time of the appointment. These are different than cancellations. In a cancellation, the patient reaches out to the provider before the appointment, giving the provider sufficient time to fill the slot with another patient.

Why are no-shows so wasteful?

With cancellations, there is an opportunity to schedule another patient in the canceled time slot. Usually, the window that you have to fill these canceled appointments will be as short as 24 hours but can be as long as three weeks. We call this the replacement window because this is the amount of time that you have to replace the canceled appointment with a new patient. In a no-show, the replacement window is zero, which is why you cannot get your money back. These no-shows translate to lost revenues which hurt your health system’s bottom line. By allowing your health system to continue this wasteful process systematically, you are undermining its profitability.

What tools exist for reducing these wasteful no-show appointments?

Fortunately, there are a few different approaches and tools at your disposal for tackling no-show appointments. The first approach is the old-fashioned punish and reward system. It goes like this: financially punishing no-shows while rewarding (either through a small discount on their bill or another incentive like a sweepstakes drawing) patients who show up on time. However, this carrot-and-stick method isn’t enough to move the needle by itself. While you may limit the return of no-show patients, you aren’t increasing the replacement window or maximizing patient volume.

Thankfully there are technologies already on the market that are designed to reduce no-show appointments and maximize your replacement window. The most effective of these are digital, multi-channel appointment notifications. To appeal to a broader range of patient demographics, we recommend offering reminders via several media, including text message, email, and phone calls. To maximize the effectiveness of reminder notifications, they should include appointment confirmations with options to cancel or reschedule. Additionally, these notifications should have appointment reminders within 24 hours of the appointment start time, and any other information pertinent to the appointment. Examples include directions to the appointment location and appointment preparation procedures.

For additional engagement, some solutions like DocASAP’s Consumer Connect include a calendar appointment that can be saved to the patient’s schedule. Consumer Connect provides a mobile-first, patient-centric solution that helps not only with patient engagement, but also reduces no-show appointments. On average, DocASAP’s Consumer Connect solution, which includes DocASAP Reminders, cuts down the no-show rate by over 35% in the first year after deployment.

How online appointment scheduling maximizes the replacement window

If appointment reminders are a powerful way of reducing no-show appointments, then online appointment scheduling is its significant other, maximizing access which optimizes the replacement window. Think of it this way: you are now reducing your no-show appointments, but still have some patients who elect to cancel or reschedule. Online appointment scheduling, proven to expand patient access, increases the chance that another patient will be able to fill your empty timeslot. By expanding patient access, you can increase the likelihood that you fill empty slots in your provider’s schedule. This maximizes patient volume, which translates to money in the bank. Appointment reminders can truly work in tandem with online appointment scheduling to improve your health system’s bottom line.

To summarize, if you want an impactful reduction in no-show appointments, you need to use an appointment notification service that includes multiple notification types and mediums. To make further improvements, you need to maximize your replacement window by implementing intelligent online scheduling. Marrying reminders with online scheduling is one of the most impactful ways to start reducing waste in your health system — ASAP.

Is your IT department a strategic hero?


Hospitals and health systems are moving from being a cost center to being a strategic differentiator. However, this pace of transforming IT from a Keeping The Lights On (KTLO) cost center to a strategic enabler is slow. 

We recently surveyed 100 CIOs from the nation’s top health systems to get a feel for what the typical CIO of a large health system looks like and to better understand how CIOs are equipped to deal with the new age of healthcare IT.

The majority of top health system CIOs have backgrounds in running large system integration organizations. The jury is still out on how these CIOs will retool themselves to deliver strategic differentiation in the age of real time decision enablement and information flow. 
 

Average Age:

We started with a simple proxy of CIO readiness: Age. While the typical age of leaders in core technology companies in silicon valley is trending lower - based on our study, the average age of CIOs was slightly unexpected: nearly three quarters (70%) are over the age of 50, and close to 20% over the age of 60. The shift in HIT of moving to a more strategic position could be the reason for this statistic. It is becoming increasingly obvious that executives at health systems are realizing that IT leaders need to be more involved in the boardroom and not just from a “review and approval of large IT projects” standpoint. Now more than ever, it’s important for CIOs to work with their peers in identifying and formulating strategy on forward-thinking technology that can improve and automate business processes.

Number of years at the current health system:

What we found interesting about the data in the graph above was the lack of longevity these top CIOs had at their current position: Five of 54 CIOs who have been at the health system for five years or less did not start off as a CIO, meaning that they worked their way up to the leader position. Since the IT department has the most constituents and bear the most burden of maintaining core functions of a hospital, it may be becoming more common to bring in new eyes and ideas to help move the IT functions of a health system forward. Another thought is that IT leaders need to have some experience in implementing change management because they have to bring departments together in order to be successful in running all the technology of a health system. By switching health systems after a series of years, more experience and exposure to best practices from other environments is helping to propel this change. Possibly, these new best practices are being learned and are more common that the new phase of IT is more than just a systems integration function. 
 

Non-IT Experience:

A small minority (18%) of the CIOs surveyed had non-IT experience throughout their professional careers. These non-IT positions were medical/clinical (41%), operations (29%), consulting (24%) and project management (6%). While having a tremendous amount of experience in information technology is important, not having other business knowledge and experience can be somewhat crippling. Clearly, it is imperative for CIOs to have knowledge about infrastructure, platforms and integrations, but having experience outside of the IT world is just as important. The fact that can make or break a solution is knowing not only how to run the solution and keep it running but also knowing if the solution actually solves the problem and is realistic for its use case. When IT leaders have had additional experience outside of the IT realm, it can be very useful when evaluating technology solutions utilized 24/7 in a health system such as clinical solutions.
 

Non-healthcare experience:

Close to 60% of the CIOs have not had experience outside of the healthcare industry. The majority of the CIOs who have non-healthcare experience held those positions early in their careers and made the transition to healthcare shortly after. The industry has seen a recent trend of hiring executives outside of healthcare to bring in different perspectives on improving operations and the patient experience. Having a different view from another industry that is more technologically advanced than healthcare could be very important in the near future. As health systems compete more and more, new perspectives will help differentiate them from the rest. The same is true with IT. Even though technology is technology, CIOs need to be at the forefront of new and innovative advances that could help their organization. Instead of being the gatekeeper, the IT department should be the gate enablers and lead the guidance and support of useful technology for their peers and constituents.

Employed at more than two organizations prior to the current role:

Of the 62% that have worked for two other organizations outside of their current health system, 50% have worked for companies outside of healthcare. This could be another testament as to how health systems are bringing in more talent from other industries and different types and sizes of organizations. While this statistic shows dedication and loyalty to an organization, it could also promote the “this is how we have always done it” mentality which is common for people to have when they have worked at an organization for a long period of time. Fortunately through the increased usage of analytics, IT leaders are getting past the preference for experience over data. The utilization of and reliance on analytics is ever present and will not be losing importance anytime soon, if ever.