Self-Scheduling: Barriers and Facilitators

The Patient Access Collaborative added digital access metrics to its 2023 benchmarking survey to include the proportion of self-scheduled appointments. Our members report median self-scheduling rates for primary care at 9%, specialty care at 3%, and ancillary services at 1%. These results are not surprising, given the promise of self-scheduling. Self-scheduling may benefit patients by expanding the opportunity to book appointments and reduce the rate of non-arrivals, among other advantages. The offering makes intuitive sense; however, the literature about the topic is limited at best. I was fortunate enough to research the barriers and facilitators to self-scheduling for my doctoral dissertation. The highlights of the findings include:

• Offering convenience for patients is the leading enabler for healthcare organizations to implement the technology, followed by the prioritization of organizational culture to promote access to care. 
• The most significant implementation barrier is the acknowledgment and analysis of the underlying complexity to avoid inadvertent consequences.
• Younger, commercially-insured patients were more likely to be self-scheduling users.
• Self-scheduling tethered to platforms with burdensome administrative requirements may perpetuate the digital divide; access to care may be encumbered for patients facing challenges related to social determinants of health.
• Missed appointments were lower; however, cancelations were higher for self-scheduled patients and must be proactively managed.
• The relative advantage of self-scheduling was most often cited in comparison to the telephone as an access point.

The research findings were published in JMIR, JAMIA, and AHIMA, and summarized in this video.

PAC’s Executive Director, Elizabeth Woodcock, graduated from Johns Hopkins University’s Bloomberg School of Public Health, with her doctorate in December 2021. She currently serves as an adjunct professor at Emory University’s Rollins School of Public Health.