Methods and legal considerations

Methods of scheduling appointments

The two most common methods of appointment scheduling are computerized scheduling and appointment book or paper-based scheduling. Each has advantages and disadvantages, and the healthcare facility should weigh the benefits and choose the method that best suits the provider and the staff.

Computerized scheduling

The computer has replaced the appointment book in many practices. Software for appointment scheduling, often referred to as practice management software, ranges from relatively simple programs that merely display available and scheduled times to more sophisticated systems that perform several other functions. Many programs can display such information as the length and type of appointment required and the patient’s day or time preferences. The computer can select the best appointment time based on the information entered into the computer.

Another advantage of a computerized scheduling system is the ability to search for future appointments. For example, when a patient calls and inquires about an appointment, the system can search by his or her name to find the time and date. With computerized scheduling, multiple users can access the appointment schedule at the same time, minimizing the wait time for patients. Another advantage of computerized schedules is the reports that can be generated. A hard copy of the provider’s daily schedule can be created, showing the patients’ names, telephone numbers, and the reason for the visit. Some healthcare facilities print these out, and others use them on screen. Healthcare facilities must have scheduling procedures to follow when the technology is down; some keep an appointment book as a backup to computer scheduling.

Appointment book scheduling

Office suppliers carry a variety of appointment book styles. Some appointment books show an entire week at a glance; many are color-coded, with a special color used for each day of the week. This is very helpful when the provider asks the patient to return, for instance, in 2 weeks. If Wednesdays are colored yellow, the medical assistant can flip quickly to the correct day 2 weeks later and schedule the appointment. Multiple columns may be available to correspond with the number of doctors in a group practice, and the time can be divided according to their preferences.

Self-scheduling

Allowing patients to schedule their own appointments using the Internet and the healthcare facility’s website is becoming much more common. The patient is given limited access to the schedule, seeing only the available appointment times, not the other patients who are scheduled, thus protecting patient confidentiality. Other patients’ names should never be visible on an online system.

Software is available that allows the patient to self-schedule through secure links to the provider’s appointment book. The software or Internet site for the healthcare facility should give the patient guidelines as to the amount of time needed for certain appointments or should allow only a certain length of time to be self-scheduled, such as 15 minutes. These systems will reduce the number of calls and are available to the patient 24 hours a day. Some of these systems also send an automatic email reminder to the patient the day before the appointment, requesting a reply to confirm. These systems are less frustrating to patients, who do not have to wait on hold to speak to the person who does scheduling for the healthcare facility. However, lengthy or complicated appointments should be scheduled through the staff.

Although this type of system for making appointments appeals to most technologically savvy people, some patients may not be comfortable using it. It does require minimal skills and Internet access. Others may object to online scheduling because they do not want their names anywhere on the Internet. This is a valid concern, and the facility should allow these patients to schedule over the telephone. If this system is used, some allowance must be made for patients who choose not to use it.

Legality of the appointment scheduling system

Because the paper-based appointment book can be used as a legal record, it must be accurate and maintained so that it provides correct information about the patients at the healthcare facility. Patients are expected to follow the provider’s orders; this includes keeping appointments. If a patient does not show up for an appointment or cancels it and does not reschedule, a notation of this fact should be placed in the patient’s health record. If a patient reschedules an appointment and subsequently keeps it, there is no need to document that it was rescheduled.

Pens are permanent, but the appointment book can become illegible if several patients change or cancel their appointments. A pencil is used in the appointment book so that making changes is easier. The information in the book includes the patient’s name and a phone number where the patient can be reached. Some healthcare facilities list the reason for the appointment, but most note only the name and phone number. Listing the reason for the visit is not necessary if the medical assistant references the time needed for the appointment and blocks off that amount of time. Because the appointment book could be produced in litigation as a legal record, it should be kept for the number of years that constitute the statute of limitations in that individual state. If the appointment book is discarded, its contents should be shredded to protect patient privacy. Although the appointment book can be used as a legal record, actual medical records are more likely to be used in matters of litigation. Because progress notes are dated, a copy of the medical record shows all pertinent information about the patient’s adherence to the provider’s orders, including the appointments with the provider.

Computerized scheduling systems can also be used to track patient appointments. Most computerized scheduling systems will allow the user to indicate if the patient has checked in, canceled, or missed the scheduled appointment. When a patient misses or cancels an appointment, it should be documented in the electronic patient record for legal purposes.