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Taking the 'wait' out of waiting rooms
From: Medicine on the Net by: Cynthia Johnson

When you schedule a doctor's appointment, you know that you are probably destined to spend the majority of your time in a waiting room. If you're lucky, the office will have a good selection of maga- zines from this decade to peruse while you wonder what the holdup is. Waiting without understanding why can be frustrating; however, a new company has developed technology that takes the "wait" out of the waiting room and lets you get back to your hectic schedule.

In May, Chicago-based MedWaitTime (www. launched a service enabling patients to check the current wait time of a phy- sician office or healthcare facility. Patients can access the information via computer or from a mobile device, such as an iPhone®. Users can also enter an e-mail address or phone number to receive real-time status updates one or two hours prior to a scheduled appointment.

A physician's schedule can get backed up for a variety of reasons, says Vishal Mehta, MD, a practicing orthopedic surgeon and founder of MedWaitTime. Phone calls from the emergency department, from previous patients, and from referring physicians constantly interrupt a physi- cian's workday, causing delays in care. Many of these phone calls also result in new and follow-up appointments that need to be scheduled quickly.

For a physician who books 30 patients per day, the earliest time he or she would be able to see many of these patients would be in one month, says Mehta. Since most people find this unac- ceptable—and rightly so—the office staff add the patients who need to see a doctor immediately to the schedule, which often results in the practice running an hour to an hour and a half late.

"In my personal life, I would be mortified if I didn't call and tell you that I was going to be late," says Mehta. "So why should I not do that in my own professional practice?"

Giving patients the green light
Before MedWaitTime, Mehta says his patients would routinely ask him whether the office could send notification when he ran behind. He says that although they understood the nature of emergen- cies, they also wanted the option of coming in later rather than sitting in the waiting room.

"The answer to that question has been no," he says. "If my secretary takes the time to make phone calls to tell everybody that we're running behind, then she's even further behind checking patients out—it's a vicious cycle."

Mehta realized that he needed to automate the process, so he developed MedWaitTime. Offices can use the online ser- vice to enter updates that indicate whether they are running on time (shown by a green clock image), running behind (shown by a yellow clock image), or experiencing significant delays (shown by a red clock image). The system relies on the color-coded system, since entering an exact time could result in downtime for physicians between patients.

If users want to employ an automated process rather than manually entering wait times, they can import any system file that computes the time between when a patient arrives and when that patient checks out.

In addition to posting their wait time, offices can also enter a reason for the delay. "If I'm running 45 minutes behind, I'll put in yellow and I'll put the reason for the delay—complex surgical discussion, emergency surgery, or whatever it might be," says Mehta. "Then what we've done is we've turned an uninformed wait into an informed wait and we've given people back half an hour of their day."

In the future, the product will interface with scheduling sys- tems to further automate the alert process. For example, if the scheduling system has the patient's e-mail address or mobile phone number on record, it can send updates automatically. This feature is currently in development.

Patient approved
"We're all about customer service, so we try to do what- ever we can to increase the customer's satisfaction and experience with us," says Rose Liggett, manager of market- ing for Rose Medical Center, an imaging center in Denver ( "With imaging, the equipment is pretty much the same. As a way to stand out, we try to strive for the best customer experience that we can have. We find that MedWaitTime offers and adds to that experience."

In August, the center implemented the MedWaitTime service at two of its facilities. The Lowry, CO, outpatient imaging facility, which offers MRIs, CT scans, x-rays, and ultrasounds, accepts walk-in patients. The service allows refer- ring physicians to log in and determine whether their patients will experience delays at the office upon arrival. If so, they can tell the patients to wait until the delay has passed.

"The patient knows that they're not going to go from waiting in the referring physician's office to going over to radiology and having to wait 45 minutes there," Liggett says.

The Rose Breast Center in Denver, which accepts walk-in mammography appointments, also uses the tool. The service is beneficial to these patients because it is likely that they could experience significant delays due to high patient vol- ume, says Liggett.

The organization is in the process of educating patients about the service when they schedule their appointment. Although the service has only recently been implemented, Liggett says that patients who have appointments for longer examinations, such as MRIs and CT scans, are the ones who are logging on the most to check wait times.

"We need to pay attention to what is valuable to our customers," she says. "And time is valuable to everyone. By offering this program, we are acknowledging that their time is important to us."

Mehta says MedWaitTime receives many calls from organi- zations that have a director of customer experience or patient satisfaction. He notes that these organizations—because they are already working to improve customer satisfaction—believe that part of their product is to offer a pleasant patient experi- ence, and MedWaitTime improves that experience.

Many patients will leave a practice if they repeatedly expe- rience excessive wait times prior to an appointment, Mehta says. Even if they don't leave the practice, having displeased patients leads to bad word of mouth.

"If you look at customer satisfaction surveys, the No. 1 complaint is not time spent with the doctor or quality with the doctor, it's time spent in the waiting room," he says. "Anything that we can do to impact that will improve the doctor-patient relationship. Once the patient has been wait- ing for an hour and you walk into the exam room, it's a totally different relationship."

"If the patient feels that they have more control over the situation, they're not as edgy and uptight," Liggett adds.

Mehta says the idea for MedWaitTime was created with the doctor-patient relationship in mind, since the tool allows physicians to communicate wait times to patients without making phone calls.

When a physician doesn't honor an appointment time, it leaves patients feeling as though the physician hasn't respected their time, says Mehta. "Changing that relation- ship by demonstrating that you're doing your best to be mindful and respectful of their time is huge for the doctor- patient relationship."

Mehta uses MedWaitTime in his own orthopedic prac- tice. Some of his patients include nuclear physicists who work for Fermilab in nearby Batavia, IL. "It doesn't make any sense to have them sitting in a waiting room reading Better Homes and Gardens," he says. "It's the same for the young mom who has four kids. It's crazy to have these people sit- ting around for an hour unnecessarily. It's time to put an end to that, especially when it's something as simple as a technol- ogy solution."

Medical specialties serving tech-savvy patients
Some hospitals are implementing the service by depart- ment, whereas others are implementing it throughout the facility in order to provide patients with several options for care. For example, someone with an ankle injury can go online and view wait times at a health center's emergency room, urgent care center, and specialist offices.

"Hospital systems like it because they can display all their options and patients can determine which choice fits best given their schedule," Mehta says.

According to Mehta, the tool would work well in any medical specialty where there's a chance of significant delays. For example, it is popular with many high-traffic specialties, especially those that have unpredictable schedule and volume changes, such as OB/GYN offices and walk-in mammogra- phy centers like The Rose Breast Center.

Rose Medical Center plans to roll out the service for exams performed at another outpatient facility and the main hospital. "It definitely fits into the outpatient arena—cardiac tests, pulmonary tests, physical therapy," says Liggett. "The physicians are very excited about it. A lot of them are inter- ested in getting it for their offices."

Mehta believes the tool also has the potential to control the spread of viruses, such as the flu. For example, even though a pediatric office may have a well child area and a sick child area, diseases can still spread during the time a child is waiting to be seen.

"The less time you spend in the waiting room is better for everybody," he says.

Mehta acknowledges that not all doctors will embrace the tool. "Tech-savvy doctors who are compassionate and caring realize that this is a service industry and not some sort of professorial relationship where a doctor is lecturing a patient," he says. Although some physicians believe that patients should wait to receive their medical attention and expertise, Mehta believes that these physicians will eventually feel the effects of poor customer service.

Growing demand for the service
According to Mehta, MedWaitTime is growing rapidly as demand for the service increases. He says that three new clients begin implementing the tool each week, which costs approximately $50 per month per physician (their patients can access the service for free).

Healthcare facilities that routinely run four hours behind have contacted the company to learn more about imple- menting the tool. "In places like New Mexico, where there's a scarcity of healthcare resources, people don't have another option," he says. "They have significant wait times and they're trying to improve patient satisfaction."

Conversely, facilities located in places with an abundance of healthcare providers use the service because they know that patients will switch providers if they are routinely run- ning behind.

"This is a natural technology solution to a big problem," says Mehta.