Online Scheduling System Can Help Improve Efficiency in Orthopedic Practices

Written by Renée Tomcanin | July 10, 2009 | Print  |

Orthopedic practices are often very busy places, and keeping schedules orderly can present a challenge. Further complicating issues is the fact that many orthopedic surgeons receive patient referrals from local emergency rooms who must be added into their schedules, often at short notice.


The Center for Orthopedics in Sheffield Village, Ohio, ran into this challenge. The multi-specialty orthopedic practice manages the schedules of five physicians at three locations and needed to find a way to manage follow-up visits from the ER.

As a result, the center developed an online scheduling system called "Fast Track" for just these kinds of patients, which has allowed the physicians to maintain the referrals from ER as well as see their regular patients in a timely manner.

Too many patients at once
According to Daniel Zanotti, MD, a physician at The Center for Orthopedics, the physicians at the center are consultants at six different ERs in their area. As a result, they receive many referrals from the ER of patients who have broken bones.

The center also has an "open cast room" policy, which means that any one of these referral patients can come to the clinic the next day for a consultation by an orthopedist, rather than a physician assistant or other staff member, without an appointment.

"It gives us great access to patients," Dr. Zanotti says. "Plus, we enjoy the patient interaction."

However, oftentimes on a Monday, dozens of patients who had been seen in the ERs over the weekend would be at the clinic waiting to be seen. This would require staff to get the charts and additional paperwork of each patient and often required patients to wait a significant amount of time before they could be seen by an orthopedist.

As many physicians in the area don't offer the same open cast room policy as The Center for Orthopedics, the facility wanted to find a way to make this service more efficient and accessible for patients and staff to ensure that the service was viewed positively.

Dr. Zanotti says that the center had worked with ERs in the past to develop a solution for this problem; however, none were effective. Then, the center decided to look to the Internet and an online scheduling option.

"Because patients were so familiar with it, the Internet was the most effective, much more than programs with the hospital," he says.

Developing an online system
In order to expedite the waiting room process for open cast patients, the center wanted to create a system that would let patients select a time for their appointment that was convenient and would allow enough time for the patients to complete their paperwork before arriving at the facility.

The current system enables patients to do just that. After their visit to the ER, they can log on to The Center for Orthopedics Web site, click on Fast Track scheduling and select a 15-minute interval that works best for them. The site allows patients to see what times are already taken and choose a time up to five days in the future.

After patients select a time, they can then enter their medical histories into the system, which is received by the facility's staff. The history is then waiting for the orthopedist when the patient comes in for a consultation.

Dr. Zanotti says that the center hired a Web site consultant and designer to help create the system. It took multiple trials to get the system working the way the facility wanted it to, and the process took the center more than a year to complete.

"It takes a lot longer than one would think because there are a lot of nuances in the system," Dr. Zanotti says. "However, if you have a good developer, it can make the process easier."

Seeing progress
After The Center for Orthopedics started using its Fast Track scheduling, it began to receive positive feedback from the patients.

One area that patients especially liked was the ability to do their paperwork online before arriving at the center rather than completing multiple forms at the time of the appointment, according to Dr. Zanotti. "Paperwork is tedious, and the patient doesn't want to deal with it when he's injured," he says. "Our system allows patients to complete it in the comfort of their own home, and once the information is in the database, we can access it at both ends."

Providing electronic medical records was one area that had been tested prior to the final launch of the Fast Track system. According to Dr. Zanotti, the option had been given for patients to download paper files or to input the information directly into a secure Web site. Patients preferred the electronic version.

As an added bonus, the new patient data is integrated into the center's existing EMR system and the information is on-hand for follow-up appointments or future visits.

Patients have experienced increased convenience because they have been able to choose the 15-minute block and avoid the lengthy wait they had seen in the past, according to Dr. Zanotti.

Time and investment worth the benefits

Dr. Zanotti says that The Center for Orthopedics has seen many positives since implementing the Fast Track online scheduling system.

Aside from increasing the number of patients the center can continue to see after they receive treatment in the ER, the physicians have seen other benefits. "It eliminates the need for follow-up phone calls or delays in treatment," he says.

Most of all, by enabling patients to determine what times work best for them, online scheduling has increased patient access to physicians and overall patient satisfaction.

For any practice considering developing an online scheduling system, Dr. Zanotti says that it is important to remember that it will take some time because it is necessary to test the system multiple times.

He also notes that it takes the support of the staff and the physician partners in a practice to take this kind of initiative and be successful. "Everyone has to be on board," he says.

Currently, the Fast Track scheduling is only available for the Sheffield Village open cast room, but The Center for Orthopedics has considered expanding the service beyond the open cast room for use in day-to-day scheduling at its two other centers. One consideration in this process that Dr. Zanotti notes is that it may be difficult to integrate the schedules of multiple physicians into a single online program.

To learn more about The Center for Orthopedics and to see the Fast Track open cast room scheduling system, click here.

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