12/02/2021
Co-authored by Brennan Turner, President and Co-Founder of The Joiner Firm.
Scheduling patients can be a deceptively complex process. While the idea of a patient selecting a time slot seems simple enough, there are several questions to consider:
- Does the patient have general questions or specific symptoms that may require an appointment with a specialist?
- Does the patient have an existing relationship with a provider?
- Is the patient new to the healthcare system?
As you can see, a clinic’s scheduling process is important in ensuring that appointments are scheduled accurately.
Appointments scheduled incorrectly are not always identified right away. In many instances the patient has already arrived, or the appointment is canceled at the last minute. This makes it difficult to ensure schedules are full and the provider’s time is maximized. When appointments are scheduled correctly the first time, there will be fewer last-minute cancellations and visit volume will increase.
Improving patient scheduling is key. The implementation of decision tree functionality can ensure that the patient is seen by the right provider at the right time. An effective decision tree can remove barriers to patient access, increase patient satisfaction, decrease revenue loss, and ensure effective time management. Decision trees are an Epic functionality that utilize rules and logic to aid a scheduler in navigating complex scheduling scenarios. Much of the decision tree logic runs in the background, unbeknownst to the scheduler, and references specific patient data within Epic to guide the scheduler through the scheduling process.
Epic is a leading Electronic Medical Record (EMR) software that stores all patient data, ranging from patient demographics to medical history. Since it is an electronic database, healthcare organizations can leverage this patient data against their specific clinic workflows through the implementation of decision trees.
Sendero sat down with Brennan Turner, a senior Epic Cadence consultant with The Joiner Firm, who we recently partnered with at a large healthcare provider to improve their clinic-specific scheduling workflows. We discussed the functionalities and benefits of scheduling with Epic decision trees:
What are Epic decision trees, and how can they help improve the patient scheduling process?
Brennan Turner: Decision trees are scheduling tools in Epic that utilize a set of predetermined questions and logic to guide a scheduler to correctly make an appointment with a clinic, without having to know the specific scheduling rules of each department. This tool can improve scheduling accuracy by making sure the right visit type, provider, and location are selected the first time, with an overall benefit of lowering no-show and cancellation rates.
How does this improve patient satisfaction?
Brennan Turner: Typically, in large organizations, especially those with centralized scheduling, it is difficult for scheduling staff to navigate all the different workflows and scheduling rules a clinic may have. These differences can result in patients being scheduled incorrectly, which then may require appointment cancellations or additional visits for the patient. For example, a pediatric clinic may only see patients over a certain age (i.e. patients over 2 years old). Through the utilization of an age restriction within the decision tree, this age restriction can be hardwired into Epic for the pediatric clinic so that a scheduler does not have to memorize the clinic specific rule of patients over 2 years old. When scheduling rules are hardwired into Epic with decision trees, it takes the decision-making process off the scheduler and automates the correct scheduling outcomes.
What impact does this have on training of new staff?
Brennan Turner: Scheduling rules are often either stored in a repository, written on a sticky note, or live within the knowledge of seasoned schedulers. This can make it difficult for new staff to schedule appointments accurately, causing frustration for the patient, the clinics, and the providers. With the decision-making process being built within Epic and automated through decision trees, there is less clinic-specific information a scheduler needs to learn.
Decision tree design considerations for healthcare organizations
An effective decision tree is not a one-size-fits-all solution. Each organization needs to consider their unique requirements and operational needs:
Considerations for Clinics
Decision trees can provide a high degree of automated control to ensure that patients are being scheduled for the right visit at the right time with the right provider:
- Clinic level payor restrictions can be built to filter out certain insurance types. The decision tree uses logic in the background to determine if a patient’s primary insurance is accepted at a clinic.
- Age restrictions can also be built at the clinic level if there is a certain age group that the clinic does not see. As noted above, a pediatric clinic can set an age restriction to only accept new patients over 2 years of age.
- Clinics with subspecialists or unique programs can also utilize decision trees to aid in scheduling accuracy. For example, a clinic with a weight-management program can ensure qualifying patients are scheduled in the right time slots with the right subset of providers.
Considerations for Physicians
Every physician, regardless of their practice, serves a unique panel of patients. Decision trees can help maintain unique workflows through monitoring patients’ reasons for office visits.
To ensure that patients’ concerns are not only identified prior to the visit, but also scheduled properly, a decision tree can be built to “flip” an appointment type to the proper visit type. A series of questions can be asked by the scheduler to determine if the original visit type is correct. For example, a patient with multiple concerns may need a little extra time, so the decision tree can suggest offering an extended office visit vs. a standard office visit. Additionally, a patient could call in with a specific concern that warrants its own specific type of visit, such as ADD/ADHD care.
Considerations for Implementation
Implementing decision tree functionality is no light undertaking; it involves detailed conversations across the clinic to verify that no details are overlooked in the process. To ensure that decision trees are inclusive of the entire clinics’ workflows, meetings need to be held with clinic management, subject matter experts, front desk personnel, and anyone else that may be involved in the scheduling process. It is very important at this step to get everyone past a theoretical understanding of what Epic can do and get them to critically think about how this application will affect their scheduling if they were to solely rely on it to accurately reflect their clinic processes.
Epic decision tree design is a complex process involving detailed scrutiny prior to the build and implementation phase. Sendero’s partnership with Epic allows for technical analysts to obtain the necessary clinical considerations and focus on building an effective program. We can liaise with a clinic and focus on communication, process alignment, and project execution.
Interested in learning more about Sendero’s expertise in this area? Use the form below to reach out to one of our consultants.
