Scheduling for Healthcare
Patient scheduling is an integral part of daily work for
healthcare professionals, from family practices to large clinics, from
physician offices to hospitals. Medical office staff has to schedule
patients for dentist, optometrist, ophthalmologist, surgeon,
psychiatrist and other general care and specialist appointments.
Scheduling quickly becomes complicated if the doctor is practicing in
several clinics and travels between medical offices. Appointments need
to be coordinated, medical support staff has to be constantly aware of
all new patients and doctorís schedule.
Patient scheduling can be greatly simplified with capable online
scheduling tools and appointment management software. With the help of
online scheduling, medical office staff can easily manage doctorís
appointment schedules, patient records and individual appointments.
Small medical practices can even allow patients to self-schedule their
Scheduling systems should take patient, doctor and staff privacy and
information security very seriously by enforcing high standards of
electronic and physical security on the application premises and data
center space. The application should not collect, sell, share, disclose
or provide customer, appointment and service provider information to any
third parties unless required by law.
HIPAA regulations will only apply to Appointment
Software Scheduling services if and only if this scheduling software is
used to perform insurance, payment or related transactions (HIPAA
transactions), and to collect any medical history from patients.
Standard features such as timed auto-logouts, protected passwords,
strong 128-bit secure SSL encryption, patient registration and login
options, just to name a few will also help compliance with the HIPAA
Patient contact and appointment information should be kept private and
shared only with account administrator and authorized personnel.
HIPAA Compliance with the Electronic Transactions and Code Sets
The Administrative Simplification Requirements of HIPAA
consist of four parts:
HIPAA does not require health care providers to conduct
all transactions listed electronically. Rather, if they are going to
conduct any one of these business transactions electronically they will
need to be done in the standard format outlined under HIPAA. It is
important for health care providers to see that their transactions are
being conducting in compliance with HIPAA.
Organization can determine if they are required to
comply with the HIPAA act if they are conducting or if a third party is
conducting billing activities on their behalf, any one of the following
business transactions electronically:
Claims or equivalent encounter information
Payment and Remittance Advice
Claim Status Inquiry/Response
Referral Authorization Inquiry/Response
Appointments are currently scheduled by professionals
who will negotiate the appropriate times and dates with patients. These
appointments can be made for any specialist at any location and can be
arranged by phone, fax or email. These schedulers are able to coordinate
examinations for claimants who may require more than one type of exam or
testing on the same visit, thus reducing transportation issues, costs
and processing time.
Detailed narrative reports are specifically tailored to the type of
coverage and address such issues as causal relationship, disability,
permanency, schedule loss, and apportionment. Board Certified physicians
dictate detailed clinical findings. All reports undergo an extensive
quality assurance review and are completed within seven business days.
American CITís Methodology and Approach
The Scheduling Software should allow Healthcare companies to:
Schedule patients for exams, visits, treatments or
Securely access appointment calendars from multiple
Easily navigate daily, weekly and monthly schedules
Search, browse and update patient contact
Create hardcopy and backup of appointments and
Schedule recurring appointments for multiple patient
Cross-schedule between multiple medical offices and
Optionally allow patients to self-schedule
The Application should be Customizable
Schedule application should give users the ability to
create custom schedules. These permit different schedules on different
days, allow for different durations depending on the visit reason, and
are easily changed on the fly. Correlating visit types and unique
patient requirements help the schedule dynamically adjust to the
changing environment of a busy physician's day.
Visit reasons can be specialty-specific to cater for different styles.
Users can also customize their screen to show multiple resources for a
day, week or even a month.
The Application should offer Simplified Daily Scheduling Tasks
Staff has rapid, simultaneous access to constantly
changing schedules. Scheduling for providers, equipment and services at
multiple locations is as easy as point-and-click. Automated warnings
messages ensure attention is paid to billing issues and other special
situations. Rescheduling and follow up visit copy functions are fast and
Customizable searches find available slots, and show patient appointment
histories. No-shows and cancellations are tracked, with automated
prompts to fill cancelled slots from wait lists. An on-screen
confirmation tool also will help staff rapidly deal with this necessary
but time-consuming process and automate the results instantly in the
The Application should offer better Practice Flow
Mini notes which will prompt the scheduler to ask
important questions or give patients instructions, educating the
scheduler to steer selected patients to other remedies before tying up
valuable slots. For example, a patient may initially be directed to a
laboratory to have labs drawn prior to the visit so that the results are
available to the physician.
Known as IDCOP (Idealized Design of Clinical Office Practice), this is
an enormous productivity tool that eliminates the time and cost of
tracking ordered labs, reviewing the results, making a disposition on
the results, tracking down the patient to inform them of the results,
and changing the treatment or follow-up. At check-in, demographics can
be verified and updated on-screen. The system also should notify staff
if co-payments are due.
The Application should provide Data Analysis and Time Management
Reporting capabilities include no show and cancellation tracking,
appointment histories, user productivity, reminders, wait lists and
more. The application should track the time it takes for patients to
move through the clinic. Reports allow management to analyze these
statistics to identify areas needing improvement so that you can
maximize the use of reimbursable resources and improve patient
The Application should offer Industry Compliance and Security
User defined, role-based security groups control access
to different functions. Different view options ensure protected
information is more secure while audit trails track all accesses to
patient information and appointments.
Initial Tasks and Features that will be evaluated and addressed:
User Defined Views. Ability to see services,
equipment, or providers with day, week, and month views, and ability
to see any number of resources side by side. Check also if Users
have many options that control how they see data.
Multi-Location, Multi-Resource, Enterprise Capable.
The ability to Schedule for different facilities, providers,
equipment and services to ensure maximum utilization of resources.
HIPAA Privacy and Security. View options and
automated logoffs prevent unauthorized views of patient information.
Check In Module. Automate the check in process, save
time and improve work flow by doing everything on one window
including demographics verification, super bill printing (if used),
patient photos, taking co-payments and printing a receipt, checking
referrals and printing forms.
Wait Lists. "First available" or "specific doctor"
request automatically fills cancelled slots to ensure a full
schedule and happier patients. Empty slots still incur overhead.
Appointment Instructions. Print, e-mail or read
instructions pertinent to a specific visit reason to ensure improved
patient expectations and improve workflow (for example, the patient
does not have to be rescheduled because they were never told to fast
First Available Appointment Searches. The ability to
Search by resource, date, specialty, appointment type.
Appointment History Searches. The ability to Locate
patient appointments easily including the ability to see no shows
User Defined Blocking and Unblocking. The ability to
Create time for appointments, time off, or build pressure valves
into time grids for catching up.
User Defined Color Coded Appointment Types. The
ability to Guide the scheduler to make appointments that work
correctly for the provider, equipment or resource.
Color Coded Patient Types. The ability to Alert
staff to VIPs, family of staff, disabled, delinquent accounts.
Rapid Navigation Tools and Summary Screens. The
ability to enable rapid completion of often repeated tasks while
guiding users to schedule optimally while saving time.
Customizable Time Grid Management. The ability to
Allow resources to have different schedules for different days and
gives the ability to change schedules at a moment's notice. Users
can build in empty slots as pressure valves. Same day/open access
slots can be created. Users can define specific appointment types
and durations at particular times of the day or week. Time tracking
helps staff design grids that match your real world situations and
helps drive optimal workflow.
Wave and Group Scheduling. The ability to Graphic
appointment time views gives users the ability to optimize patient
density by visit type.
Simple Rescheduling and Rapid Copying. The ability
to Schedule follow up visits or move them with just a few clicks.
Patient Photos. If the application offers patient
photos (where applicable) to Reduce mistakes at check-in.
Balance Lookup. The ability to access account
balances to help schedulers and other staff notify patients if they
have balances due.
Appointment Density Analysis Tools. Check if Graphic
views is used to show times when the practice is busy and times when
traffic is lighter, enabling better analysis and design of time
Overbooking. The ability to allow easy entry of
No Show and Cancellation Tracking. Simplifies follow
up for legal and clinical reasons.
Conflict Checking. Ensures staff does not schedule
the same slots.
Appointment Work Flow Time Tracking. Based on check
in, treatment, and check out time, reflects activity-based costing,
this is a powerful feature necessary to help manage bottlenecks and
inefficiencies due to staffing issues or visit types and measure
efficiency by specific procedure.
User-defined Role-based Security Access. Includes
audit trails and productivity analysis.
On Screen Appointment Confirmation. Make the
necessary but time consuming task of confirming appointments much
faster. Check also if Appointment confirmations can be automated
with IMA telephone system (CTI-Computer Telephony Integration).
Specialty Specific Visit Reasons. The ability to
Allow schedulers to rapidly select the reason for the visit from a
list of common diagnoses or procedures linked to a specialty.
Customizable Triage Hints. Prompt schedulers with
appropriate questions to ask patients to improve scheduling,
workflow, and patient access.
Integration with Other Modules. Common demographics
shared among modules, referral warnings, and integration with the
User-Defined Role-Based Security Access. Check if
the application offers a complete flexibility down to the granular
level giving the Administrators the ability to control access to
different parts of the system. This helps with HIPAA compliance as
well as ensures that functional groups in a practice have targeted
Audit Trails. Audit trails track access to
appointments, who has been blocking and unblocking slots and more.
Fully Scalable. Check if the application is Scale to
enterprise-wide, multi-specialty, and multi-site locations with
master person index.
Master Person Index. Reduces the chances of
duplicate records and saves staff time.
32. Integrated Database. Improves workflow by making more than just
demographic information available in all modules. Reduces cost of
managing inherent problems with bridged systems.
User-friendly Windows Interface. Check if the system
offers an Intuitive navigation, natural workflow pattern, and
multiple options for quick data entry.
Major Activities that will be conducted and performed during this
Current State Evaluation- Business Processes and
Enterprise Business Process Reengineering, Mapping
Business Enterprise Architecture
Enterprise Business Process Reengineering, Mapping and Redesign
activities and Tasks
The objective of business process re-engineering is to
achieve a fresh perspective on organizational tasks. In a "redesigned"
business process, activities that are managed as a single, coordinated
operation by individuals or teams. Interfaces between activities are
improved and the IT emphasis will be on supporting value-adding
activities and making them more tightly coupled.
Our experts will perform business process reengineering using the latest
modeling tools, methods and techniques under the UML (Unified Modeling
Language) methodology. Our strategic business process reengineering
approach is an enterprise-wide and will include concurrently a review of
enterprise data requirements and data modeling.
Tasks to be performed:
Evaluation and Determination of Companyís
Objectives, Wish list and Critical Success Factors
Analysis of the Core and Related Processes and
Connect Organizational Units and Roles to Process
Evaluation and selection of the appropriate Business
Process Modeling Techniques
Process Triggers Modeling
Existing Data Integrity Evaluation
Data Flow Modeling
Process Flow Modeling
Documentation of the Data Stores and Their
Relationship to Entities
Identification of all External Triggers and Events;
Documentation of Business Rules and Logic Conditions
Critical Path Analysis and Process Improvements
Function Hierarchy Diagrams
Functional Decomposition Diagrams
Quality Assurance Techniques
Business Enterprise Architecture Activities and Methodology
Strategic Business Enterprise Architecture analysis will
result in an enterprise- wide information systems strategy. This
strategy provides an overview of the organization and its information
systems requirements and serves as a structured framework for the
development of the integrated applications thereafter.
Major deliverables of Business Enterprise Architecture:
The Business Direction Model
The Information Model
The Functional Hierarchy Model
The Application Architecture Diagrams
A) The Business Direction Model
The Business Direction Model outlines the goals and
objectives of the organization, and then further defines critical
success factors (CSF's) and key performance indicators (KPI's). Goals
are broadly expressed statements that support the mission of the
organization. Objectives quantify the goal. Critical success factors are
those things that must be in place to achieve the objective and, in
turn, to realize the goal. Key performance indicators are the specific
measurements of success.
B) The Information Model
The Information Model is a diagram composed of
high-level entities and the relationships between them, along with
descriptions and examples. It is a model of the information within an
organization, and illustrates how that information is linked.
The things of importance (entities) within the business, the properties
of those things (attributes), and how they are related (relationships)
are depicted on a diagram. In the strategy study, entities are defined
at a high level and do not go into specific detail (e.g., address is
defined, not street number, street name, city, zip code, etc.). Later,
as more information is gathered during the analysis phase, this model
will be amended and further detail added to produce the Business Data
Model, which will provide the definition of the structure of all the
data that is used or generated.
Data Model and Entity Relationship Model are synonyms for Information
Model, and are often used interchangeably. When the scope of the
modeling is across the entire business, the model is called an
Enterprise Data Model.
Enterprise data modeling is a technique that aids in:
Identifying related and overlapping information
across multiple systems elements
Reducing data overlaps and inconsistencies and data
integrity problems arising as a result
Creating architecture solutions for data interfaces
and potential integration of data elements that can be mapped to
database designs for future in-house Information Technology projects
and third-party software products
Developing a direct route to an integrated, flexible
information resource based on a clear understanding of information
requirements expressed as data structures, interdependencies, and
Planning for high-quality systems that better meet
the requirements of business enterprise information processing,
derived from business models agreed between managers, users and
Initiating working practices in the organization to
support the implementation of structured techniques for information
systems development and the use of supporting CASE tools
Improving productivity within Information Technology
by clarifying basic concepts at the senior management level and
often simplifying requirements or converging redundant development
C) The Functional Hierarchy
Function modeling and Function Decomposition Diagrams
provide a model of what an organization does (its functions) and how
those functions can be grouped. The functions within a business are
grouped into a hierarchy.
The initial Functional Hierarchy, created during the strategy study, is
a list of the major functions of a business. It is created by analyzing
the business, using the top-down approach. The starting point and
highest function of the hierarchy is the mission statement or goal of
the organization. The finishing point is an elementary business function
in which a specific unit of work is defined.
The purpose of function modeling is to show how the mission statement is
fulfilled by the functions performed within the organization. This is a
powerful technique that can lead to fundamental questions about how an
D) The Application Architecture
Once the Information Model and the Functional Hierarchy
of the business Enterprise Architecture have been completed, the
relationships and dependencies between entities and functions are
established through high-level strategic analysis.
This interrelationship of entities and functions forms the basis for the
application architecture. These are the key to insuring seamless
integration of applications. When such a building block is completed, it
is available to more than one application, and It will allow for
intelligent sequencing of development efforts and eliminates redundant