New Research on Automated Waitlists: From Cancellations to Connections

Patient access leaders are making operational and strategic decisions every day that affect millions of patients. Yet, ambulatory access remains one of the least studied areas of healthcare operations. As a field, we're often left relying on anecdotes and vendor claims rather than evidence.

One of our commitments at the Patient Access Collaborative is to help change that. In addition to bringing the latest research to our members, we're committed to conducting and publishing our own peer-reviewed research that advances the science of patient access.

Our latest publication, Automated Waitlists for Ambulatory Appointment Scheduling: A Multi-site Mixed Methods Evaluation, was recently published in the Journal of Medical Internet Research. The study is the first multi-site evaluation of automated waitlists in ambulatory care and explores both the outcomes health systems are achieving and the implementation strategies behind their success.

Read the full article here.

Automated waitlists have become increasingly common across health systems, particularly as self-scheduling continues to grow. But until now, there has been very little evidence to help access leaders answer some basic questions: Do automated waitlists actually improve access? What makes an implementation successful? And how can health systems ensure these digital tools improve access for all patients?

Those questions drove this research.

What We Learned

The results were compelling.

Across the health systems studied, automated waitlists moved patients into appointments an average of 38 days sooner. Even more impressive, appointments filled through an automated waitlist had a missed appointment rate of just 3.1%, compared to an overall missed appointment rate of 6.6%. In other words, the missed appointment rate was cut by more than half.

Perhaps most interesting, the biggest benefit of automated waitlists wasn't necessarily filling same-day cancellations. Instead, health systems are using them successfully to improve appointment availability and connect patients with care sooner.

Giving patients more flexibility turns out to be good for both patients and operations.

Technology Is Only Part of the Story

One of the clearest findings from the qualitative portion of the study was that successful implementations don't happen simply because a health system turns on a new technology.

The highest-performing health systems treated automated waitlists as an ongoing operational strategy. They continuously monitored performance, adjusted workflows, and tailored their waitlist settings based on specialty needs, insurance requirements, patient populations, and organizational goals.

Automated waitlists are not a "set it and forget it" solution. Like most access initiatives, success comes from thoughtful implementation and continuous improvement.

Keeping Equity at the Center

As access leaders adopt more digital tools, it's important to remember that technology can both improve and unintentionally limit access.

Patients differ in their access to technology, digital literacy, language preferences, and scheduling needs. Throughout this research, we intentionally considered how health systems can implement automated waitlists in ways that promote equitable access to care.

Our recommendations include engaging patients in implementation planning, considering the digital divide when designing workflows, and ensuring that automated waitlists are part of a broader access strategy rather than a standalone technology project.

The goal isn't simply to implement new tools. It's to improve access for all patients.

A Different Way to Think About Cancellations

One of the more surprising findings from this work is that cancellations aren't necessarily the enemy.

Healthcare has traditionally viewed cancellations as a scheduling problem. But cancellations can actually create opportunities to improve access if health systems have the right processes in place to fill those appointments efficiently.

Automated waitlists help turn cancellations into opportunities by connecting patients who want care sooner with newly available appointments. When implemented thoughtfully, they improve appointment utilization while giving patients greater flexibility and choice.

Why This Research Matters

Patient access is a complex problem, and there isn't a single technology or workflow redesign that will solve it. But meaningful progress happens when health systems are willing to test new approaches, measure outcomes, and share what works.

We're proud to contribute to the growing body of research in ambulatory patient access and remain committed to producing practical, evidence-based research that health systems can use to improve care delivery.

Ultimately, that's what this work is about: advancing access to care and ensuring that innovation helps us build a more accessible and equitable healthcare system.