Adoption, Use, and Impact of E-Booking in Private Medical Practices: Mixed-Methods Evaluation of a Two-Year Showcase Project in Canada

Abstract

BackgroundManaging appointments in private medical practices and ambulatory care settings is a complex process. Various strategies to reduce missed appointments can be implemented. E-booking systems, which allow patients to schedule and manage medical appointments online, represents such a strategy. To better support clinicians seeking to offer an e-booking service to their patients, health authorities in Canada recently invested in a showcase project involving six private medical clinics.ObjectiveThe objectives pursued in this study were threefold: (1) to measure adoption and use of the e-booking system in each of the clinics over a 2-year period, (2) to assess patients’ perceptions regarding the characteristics and benefits of using the system, and (3) to measure the impact of the e-booking system on the number of missed appointments in each clinic.MethodsA mixed-methods approach was adopted in this study. We first extracted and analyzed raw data from the e-booking system deployed in each of the medical practices to monitor adoption and use of the system over time and to assess the impact of the system on the number of missed appointments. Second, we conducted a Web-based survey of patients’ perceptions in the spring of 2013.ResultsThe patients and physicians targeted by this showcase project showed a growing interest in the e-booking system as the number of users, time slots made available by physicians, and online appointments grew steadily over time. The great majority of patients said that they appreciated the system mainly because of the benefits they derived from it, namely, scheduling flexibility, time savings, and automated reminders that prevented forgotten appointments. Importantly, our findings suggest that the system’s automated reminders help significantly reduce the number of missed appointments.ConclusionsE-booking systems seem to represent a win-win solution for patients and physicians in private medical practices. We encourage researchers to replicate and extend our work in other primary care settings in order to test the generalizability of our findings.

Adaptation of TECCU App Based on Patients´ Perceptions for the Telemonitoring of Inflammatory Bowel Disease: A Qualitative Study Using Focus Groups

“…Different models have been implemented to identify the factors related to the patients´intention to use new eHealth tools. In other medical settings, patients prefer to employ useful and easy-to-use systems, which allow them to cooperate better with healthcare providers through flexible follow-ups [22][23][24]26]. These factors are largely represented in our findings, which supports the reproducibility of the results presented in this article.…”

“…In other clinical settings, the patientsṕ oint of view has been used to evaluate the acceptance of new eHealth systems. This consideration is essential because understanding the factors that influence user acceptance allows us to address their requirements and to promote the use of these programs [22][23][24][25][26].…”

“…These new tools support the integration of multidisciplinary care for patients with chronic diseases [28]. However, the design of new telemedicine programs should also consider that patients with different chronic diseases prefer to employ useful and high-quality systems, which allow them to cooperate with healthcare providers [22][23][24]26]. Accordingly, incorporating patients in the design, development, and implementation of eHealth will potentially improve patient engagement with a remote follow-up [29].…”

Assessing the Online Outpatient Booking System

“…Also in one study by Finkelstein et al, entitled "Priorities of appointment reminder systems and patient", the use of this facility was reported in 2.66% of all systems studied in Colombia (33), although in a study from Norway, 45.45% of hospital appointment systems were able to recall the appointment (34), which is not consistent with the current study. The reviewed studies revealed that post-appointment recall probability significantly contributed to the system flexibility, time management (15), reduction in the number of missed appointments (14,15,24,25,33,34) and costs (33,34).…”

“…This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited time and any place, allowing the user to see the physicians' appointments (9), selection of the desired option, editing the recorded information, more favorable relationship between physician and patient, improvement of the efficiency and effectiveness of care (5), cost reduction (11)(12)(13)(14), reduction of the number and volume of employees (7), saving patient information for use in subsequent appointments (11), and reduction of the number of missed appointments (9,11,(13)(14)(15)(16)(17)(18). However, despite the importance of this system, a few studies have been done on its evaluation and existing researches in this field have investigated topics, such as designing a web-based appointment system (19), patient satisfaction of online appointment booking systems (4,20), development of information technology acceptance model for an online appointment booking system in hospitals (21)(22)(23), implementation and use of the online appointment booking system in clinics (15,20), and improving the management of appointments (24,25). There are limited studies in Iran on the need for smart systems to prepare an optimized program for patients and investigating the appointment-making system of private physicians' offices (5,22).…”