The Growth Channel

Tired of "no-show" patients? Use predictive overbooking.

by Gunjan Desai

Patient absenteeism for scheduled visits and procedures occurs frequently in clinics, resulting in treatment delays, unnecessarily long wait times, and inefficient use of clinic resources.

Predictive overbooking helps clinics improve access for current and potential patients, while also ensuring clinic resources are used efficiently. Predictive overbooking uses electronic health record data to identify scheduled "no-shows," or patients who are at a high risk for missing procedures. Then, the program double-books these appointments with the no-show patient and a patient more likely to show up.

A recent study conducted at the Veterans Administration (VA) outpatient endoscopy clinic indicated several benefits to using predictive overbooking over traditional booking. While this study focused on gastroenterology (GI), other resource-intensive clinics with high no-show rates can also benefit from these positive results.

Improve access for current and potential patients

Predictive overbooking can improve patient access by adding additional appointment slots to the clinic schedule, allowing patients to schedule more appointments with little lag time. Using this model for just 17 weeks, the VA clinic was able to accommodate 111 more patients than if they had used traditional booking. The program identified common characteristics of no-show patients by filtering through categories such as previous attendance and cancellation records, demographics, and medical comorbidities. For further guidance on the factors and data sources used to predict a patient's no-show rate, see this 2014 Applied Clinical Informatics study.

Increase staff productivity

Predictive overbooking can also maximize staff productivity. The VA study showed service utilization (the ratio of completed appointments to capacity on a given day) increased from 86.4% to 99.5% with the help of predictive overbooking. While physicians and staff worked slightly longer hours under this model (8.31 hours vs. 7.84 hours), the clinic was able to maximize appointment efficiency and minimize downtime under similar working hours without overworking employees.

Reduce unnecessary spending

Predictive overbooking can allow clinics to allocate funds more efficiently by reducing the number of unused appointments. In the VA study, the clinic decreased their weekly average of 2.5 no-show appointments to just 0.35 through the use of the program. And, while staff did work slightly longer hours on average, overtime costs weren’t statistically higher for the predictive overbooking group.

Patient absenteeism is a challenge for most clinics. However, strategic planners can use predictive overbooking as an effective solution to handle no-shows and, in turn, improve patient access, staff productivity, and clinic finances.

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