Abstract
BackgroundThe COVID-19 pandemic has prompted the adoption of digital health technologies to maximize the accessibility of medical care in primary care settings. Medical appointment scheduling (MAS) systems are among the most essential technologies. Prior studies on MAS systems have taken either a user-oriented perspective, focusing on perceived outcomes such as patient satisfaction, or a technical perspective, focusing on optimizing medical scheduling algorithms. Less attention has been given to the extent to which family medicine practices have assimilated these systems into their daily operations and achieved impacts.ObjectiveThis study aimed to fill this gap and provide answers to the following questions: (1) to what extent have primary care practices assimilated MAS systems into their daily operations? (2) what are the impacts of assimilating MAS systems on the accessibility and availability of primary care? and (3) what are the organizational and managerial factors associated with greater assimilation of MAS systems in family medicine clinics?MethodsA survey study targeting all family medicine clinics in Quebec, Canada, was conducted. The questionnaire was addressed to the individual responsible for managing medical schedules and appointments at these clinics. Following basic descriptive statistics, component-based structural equation modeling was used to empirically explore the causal paths implied in the conceptual framework. A cluster analysis was also performed to complement the causal analysis. As a final step, 6 experts in MAS systems were interviewed. Qualitative data were then coded and extracted using standard content analysis methods.ResultsA total of 70 valid questionnaires were collected and analyzed. A large majority of the surveyed clinics had implemented MAS systems, with an average use of 1 or 2 functionalities, mainly “automated appointment confirmation and reminders” and “online appointment confirmation, modification, or cancellation by the patient.” More extensive use of MAS systems appears to contribute to improved availability of medical care in these clinics, notwithstanding the effect of their application of advanced access principles. Also, greater integration of MAS systems into the clinic’s electronic medical record system led to more extensive use. Our study further indicated that smaller clinics were less likely to undertake such integration and therefore showed less availability of medical care for their patients. Finally, our findings indicated that those clinics that showed a greater adoption rate and that used the provincial MAS system tended to be the highest-performing ones in terms of accessibility and availability of care.ConclusionsThe main contribution of this study lies in the empirical demonstration that greater integration and assimilation of MAS systems in family medicine clinics lead to greater accessibility and availability of care for their patients and the general population. Valuable insight has also been provided on how to identify the clinics that would benefit most from such digital health solutions.
Highlights
IntroductionThe main idea is to manage supply and demand efficiently by applying 5 key principles: balance supply and demand, reduce the backlog, review the appointment system, create contingency plans, and integrate interprofessional practices [6-9]
The accessibility of primary care services remains a global concern, and to address the underlying issues, considerable improvements must be made to health systems around the world [1,2]
More extensive use of Medical appointment scheduling (MAS) systems appears to contribute to improved availability of medical care in these clinics, notwithstanding the effect of their application of advanced access principles
Summary
The main idea is to manage supply and demand efficiently by applying 5 key principles: balance supply and demand, reduce the backlog, review the appointment system, create contingency plans, and integrate interprofessional practices [6-9] For their part, digital health technologies supporting medical appointment scheduling (MAS) represent innovations whose integration is critical for primary care clinics looking to improve accessibility [10-12]. MAS systems, called electronic booking systems, are digital solutions that enable practices to streamline their management of medical scheduling through functionalities that optimize physician schedules according to preset parameters [13]. These systems propose a convenient and accessible means for patients to manage their appointments with their care provider while facilitating online communication [14]. Less attention has been given to the extent to which family medicine practices have assimilated these systems into their daily operations and achieved impacts
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