BACKGROUND Our orthopedic practice recently implemented a system that enables patients to schedule outpatient visits through an online portal without the need for traditional communication with office staff. Previous studies have found that the use of web-based scheduling correlates with reduced no show rates, staff labor, waiting time, and improved patient satisfaction. The appropriateness of the web-based scheduling and the rate of progression to surgery is unclear, as patients may not be appropriate candidates for surgical consultation. The purpose of this study was to compare the no show and surgical progression rates between online-scheduled and traditionally scheduled outpatient visits in our practice. OBJECTIVE Our primary hypothesis was that there is no significant difference in the rate of progression to surgery within three months after the initial ‘new visit’ between online-scheduling and traditionally scheduling services. The secondary hypothesis was that there was no significant difference in the no-show rate between the two scheduling services. METHODS All outpatient visits at a single large multispecialty orthopedic practice from 2/1/2022 through 2/28/2022 were collected. Scheduled visits were identified as either “online -scheduled” indicating patients scheduled their own visit through the new web-based patient portal system, or “traditionally scheduled,” indicating that the visit was scheduled with office staff. All visits were further categorized as either a “new visit” or a “follow-up visit.” Surgical records were reviewed to identify patients that underwent surgery within three months of their scheduled office visits. RESULTS Within the one-month timeframe, there were 71,673 traditionally scheduled visits and 3,058 patient scheduled visits. The rate of progression to surgery within three months after the new visit showed a significant difference (18% of online-scheduled vs. 21% of traditionally scheduled new visits; P=0.036). There was no difference in no-show rates between the two scheduling groups (4.5% of online-scheduled vs. 4.4% of traditionally scheduled visits; P=0.79). Subgroup analysis showed no significant difference in no-show rate when comparing new patients and follow-up visits separately. CONCLUSIONS Online-scheduling systems allow for greater patient autonomy and access to care, while reducing the administrative burden of office staff. A small but significant difference in the surgery rate with the traditional scheduling might be explained by the fact that the older generation still has more confidence in phone call scheduling than in using electronic applications. Moreover, the new office visits following urgent care referrals can be squeezed more rapidly into the schedule via the traditional scheduling because it is impossible to haggle with the system.
Background: This study aimed to compare the rate of scheduled surgery and no-show rates between online-scheduled appointments and traditionally scheduled appointments. Materials and Methods: All scheduled outpatient visits at a single large multi-subspecialty orthopedic practice in three U.S. states (PA, NJ, and NY) were collected from February 1, 2022, to February 28, 2022. Visits were categorized as “online-scheduled” or “traditionally scheduled” and then further grouped as “no-show,” “canceled,” or “visited.” Finally, visits were categorized as either “new patient” or “follow-up.” Results: There was no significant difference between scheduling systems for patient progression to any procedure within 3 months of the initial visit ( P = 0.97) and patient progression for surgery only within 3 months of the initial visit ( P = 0.88). However, we found a significant difference with a higher rate of progression to surgery in traditionally scheduled than online-scheduled visits when accounting for only new patient visits that progressed to surgery within 3 months of the initial encounter ( P = 0.036). No-show rates between scheduling systems were not significant ( P = 0.79), but no-show rates were significant when comparing the practice's subspecialties ( P < 0.001). Finally, no-show rates for online-scheduled compared to traditionally scheduled patients for both new and follow-up appointments were not significantly different ( P = 0.28 and P = 0.94, respectively). Conclusion: Orthopedic practices should utilize online-scheduling systems as there was a higher progression to surgery of traditionally scheduled appointments compared to online. Depending on the subspecialty, no-show rates differed. Furthermore, online-scheduling allows for more patient autonomy and less burden on office staff.
While pickleball and paddleball are rapidly growing as popular sports in the United States, research on the incidence of hand and upper extremity injuries and treatments in outpatient clinics are lacking. This study evaluates the incidence rates and treatment options, both surgically and nonsurgically, for patients presenting with pickleball/paddleball-related injuries. MethodsA retrospective database search of our multispecialty, multilocation electronic medical record (EMR) system from 2015 to 2022 identified 204 patients with outpatient pickleball-and paddleball-related injuries. The data from these patients' charts were reviewed for injury incidences, treatment trends, and demographics. ResultsThe majority of patients suffered wrist fractures due to a fall/dive and were treated nonsurgically. The most common surgical treatment, when required, was open reduction and internal fixation of the distal radius. We found that pickleball and paddleball players who sustained wrist fractures required surgery at a higher rate than the general population if above the age of 65. ConclusionAs pickleball and paddleball continue to gain popularity, hand surgeons should be aware of the types of injuries that can occur and, when possible, counsel patients accordingly to try to prevent them. Additionally, hand surgeons should recognize the common treatments and outcomes that arise from pickleball/paddleball-related injuries.
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