Launching a New Dynamic Scheduling Flow for a Healthcare Membership System

A brand new scheduling flow that successfully reduced customer support issues by 88.83%.

A brand new scheduling flow that successfully reduced customer support issues by 88.83%.

A brand new scheduling flow that successfully reduced customer support issues by 88.83%.

Client

ĒSEN Clinic

Services

Product Design User Research

Team

Chih-ping Weng (Full-stack Engineer)

Date

July 2022

App Screen with open sidebar
App Screen with open sidebar
App Screen with open sidebar

With the expansion of ĒSEN Clinic’s services and operation, the original scheduling flow started to show its limitation and failed to keep up with the business requirements. Around the same time, ĒSEN had also decided to launch an entirely new membership programme - ĒSEN One, which also had new requirements that involved booking and scheduling. We made it our top project in our new product roadmap, aiming to develop a new scheduling system that can further support the growth of the healthcare business. This case study shows how we identified the problems in the current scheduling process and launched a new scheduling flow, combining with the new requirements from the membership programme.

Introduction

In the end of 2021, I developed and implemented a live-data Electronic Medical Record system (EMR) prototype at ĒSEN Clinic. As the prototype was built with several no-code tools, including Airtable, Zapier, and Calendly, that could integrate seamlessly to form a paperless workflow, it had since then served as the de facto medical record management tool in the clinic while the software development team continued to learn from the prototype and develop actual EMR product.

However, with the expansion of ĒSEN Clinic’s services and operation, Calendly started to show its limitation and failed to keep up with the business requirements. Around the same time, ĒSEN had also decided to launch an entirely new membership programme - ĒSEN One, which also had new requirements that involved booking and scheduling. We made it our top project in our new product roadmap, aiming to develop a new scheduling system that can further support the growth of the healthcare business.

Context

The success of Taiwan’s National Health Insurance (NHI) system is characterised by its accessibility, wide coverage, affordability, and short waiting time. In Taiwan, 83% of patients wait less than 30 minutes to see a doctor. The average waiting time in Taiwan is shorter than those of their counterparts in developed countries while having a higher-average number of doctor visits per person per year. That being said, due to the large number of patients, doctors in Taiwan are expected to deliver assessment and planning within a very short amount of time (3-5 minutes) to keep the queue moving and waiting time short, resulting in significantly shorter consultation time than those in the developed countries (15-20 minutes). 

To address this issue, ĒSEN Clinic had made their primary care service 20-30 minutes long, providing doctors and patients with enough time to consult. In order to avoid long waiting time and ensure the service quality, the clinic heavily depended on Calendly as their appointment tool for measuring their operation capacity and allocating resources. Therefore, having an efficient scheduling tool was essential to the clinic.

But why now?

The software development team was well aware of the scheduling issues for some time, as we had routinely collected feedback from the clinic since the implementation of the EMR prototype in December 2021. Due to constraints in engineering resources, this feature had been repeatedly postponed and wasn't an immediate investment priority for the management team until the pivotal moment where the management team discovered the new opportunity for the business and decided to launch a brand new membership programme, ĒSEN One.

The membership programme required the software development team to find solutions that could support the membership services. Essentially, the management team wanted to expand the product line into the customer-facing market, allowing the patients who joined the membership programme to access, manage, and interact with their data and records stored in the EMR system. After conducting several rounds of interviews and exploration, scheduling was identified as one of the pillar features. As a result, the roadmap finally aligned with the need to address scheduling issues.

Project Objective

Design and develop a scheduling flow that

  • allows patients to register as members, specify their needs, and manage their scheduling records;

  • meanwhile enables the clinic to maximise their operational capacity and allocate resources more efficiently.

Research

Since we had already implemented a live-data prototype in the clinic, the research process had greatly benefited from it. We conducted user interviews and feedback collection to understand the pain points of the current flow, as well as their thoughts and needs on the healthcare membership system.

Through the interviews and feedback collection from both patients and operation specialists, we had uncovered a handful of business and behavioural insights. In this case study, I'll primarily show the findings and problems related to the project objectives. The problems listed below were grouped into patient, operation, and system.

[Patient] Problem #1 Unable to know which time slots belong to which doctors

When the clinic started its business in November 2021, Calendly worked perfectly fine as there was only 1 doctor offering 1 type of service. The business hours were directly related to the doctor's availability, aka the shift schedule, on Calendly where patients could simply schedule an appointment by selecting a time slot.

As more and more doctors joined the clinic, the business hours no longer directly related to any doctor’s shift schedule. When clicking into Calendly, patients were prompted with the usual scheduling interface where the shift schedule wasn't shown. Patients couldn’t figure out which doctor was in which time slots unless they memorised the shift schedules somewhere else. This issue had made some patients extremely discontent as they didn’t realise they booked a different doctor until they stepped into the clinic, jeopardising the trust and confidence between patients and doctors.

[Patient] Problem #2 Re-entering same information every time

Although Calendly allowed patients to make appointments directly upon landing without any sign-up or log-in, the system also required them to re-enter contact information manually every time they revisit. Even with the help of cache, this issue still created nuisances for the patients when they switched browsers, and increased the possibility of entering wrong information. 

[Patient] Problem #3 Couldn’t find the cancellation or reschedule action

For some reason, many patients at the clinic were not familiar with email and mentioned that they were unaware of how to cancel or reschedule appointments since these actions were sent along with email confirmations and reminders. Despite making the email field required in the scheduling process, some patients didn’t bother offering their real email addresses, resulting in not receiving the confirmation or reminders of the appointments whatsoever. The lack of verification also contributed to this issue.

[Operation] Problem #4 Rigid time slot setting

When ĒSEN Clinic first started, they tried to offer 30-min consultation sessions for each patient. They soon realised these in-depth consultations weren’t the most cost-effective approach for the clinic, and not every patient in primary care required one. 

To diversify the services and find a balance between goals and reality, the clinic decided to include a new service with a shorter duration of 15 minutes. However, the clinic immediately realised that it was impossible to create time slots with different duration in the same Calendly event. In other words, if the duration of each time slot was set to be 30 minutes, the availability time would only be divided by 30 minutes, creating the 30-minute time slots accordingly.

If the clinic wanted to offer a new appointment option with 15-minute duration each, they’d have to create a whole new Calendly event that would be connected to another new link. The rigid setting startled the clinic as they knew if every doctor offers 2-3 types of appointments, there would be a handful of Calendly events to handle and their patients would be confused by all these appointment links as well.

[Operation] Problem #5 Constantly cancelling or rescheduling appointment on customers’ behalf

As mentioned in Problem #3, due to the lack of familiarity with email, many patients had never learnt how to cancel or reschedule an appointment themselves. In the end, many patients just contacted the customer support through the official Line account of ĒSEN Clinic and asked the clinic personnel to cancel, reschedule, or even book an appointment for them. And sometimes, people would simply pull a no-show if they found contacting the clinic was simply too cumbersome.

[System] Problem #6 Unable to verify email address nor phone number

Calendly didn't offer any verification process for data entry, only determining whether the email address or mobile number inputs were correctly formatted, but didn’t continue the process to check if the data actually belonged to that person. This had posed several challenges to the EMR prototype on Airtable, as some patients might accidentally enter incorrect information or share the same mobile numbers with family members, making it difficult for the system to properly register a patient profile.

[System] Problem #7 Unclear information

As Calendly prioritised its scheduling features, important information regarding services, treatments, or clinic operations could only be found in the “Read more” section, making it lengthy and unreadable on mobile devices. Hence, patients barely read through, or expand, the section, and ended up missing some important details.

Proposed Solutions

The clinic had been managing their medical records and patient profiles using the EMR prototype since December 2021. The current scheduling and registration process consisted of both Calendly and Airtable integrated together via Zapier. To replace Calendly and initiate the development of the new scheduling and registration process, we had to first assess the legacy and define the scope of the project.

Original flow

In the original flow, there was no clear step for registration, as the process started with Calendly and its scheduling page. This led to the "registration" of patient profiles being split between the booking and the medical onboarding process (Medical Intake Form), resulting in occasional data inconsistency and duplication in the system (mentioned in Problem #7). Defining a clear registration step became imperative for the new flow.

At the time of replacing Calendly with our own membership system, Airtable continued to play a vital role in clinic operations since the EMR system was still under development (and paused due to the new membership project). Although the fundamental infrastructure of the EMR system had been developed, it was not yet ready to handle the entire workflow. Thus, to replace Calendly, we also needed to plan the integration between our new system and the EMR prototype on Airtable.

Regarding the onboarding process, we did consider moving it from Airtable to the membership system alongside the scheduling process. However, the development effort required would be overwhelming and could jeopardise the original plan. Plus, the current medical questionnaire used in the onboarding process still required reviews and changes before entering the product planning stage. Therefore, we decided to also keep the onboarding process on Airtable for now.

Below are the two proposed solutions for the new scheduling flow

Solution A - Booking first

By prioritising the booking process upfront, Solution A allows patients to navigate the process easily and receive immediate confirmation, minimising barriers and confusion. This solution also maintains similarities to the original flow, providing familiarity to existing patients.

Problem: 

  • Difficult to maintain as some individuals may forget to proceed with registration

  • Requires significant effort to convince patients to finish the registration process to become members

  • Prone to errors as Solution A may lead to fragmented verification process

Solution B - Registration first

In order to further establish the membership system, it was essential to ensure the proper verification of every patient's registration on the system. Solution B adopts a well-rounded approach that makes registration mandatory before allowing patients to book an appointment, limiting the potential systematic errors.

Problem:

  • Increases scheduling barriers and potentially leads to the decrease of the overall number of appointments

The final solution

We eventually decided to go with Solution B. While Solution A may appear tempting, the development effort required to address the potential issues didn’t seem justifiable. Moreover, Solution B allows the team to focus on optimising the registration experience rather than solely emphasising the number of appointments as a key performance indicator (KPI). Overall, Solution B aligns better with the project objectives.

Solution

Register and log-in with One-time Password

Based on the feedback we gathered from the clinic, we recognised that the lack of verification was the root of many system and operation issues. Through research and discussion, we came up with the following guiding principles to define a verification solution that could be applied to both registration and login processes:

  • Minimise barriers

  • Ensure the security

  • As accessible as possible

With these principles in mind, we introduced the One-time Password (OTP) approach to the membership system. Unlike social logins, which also offer speedy sign-ups, the use of mobile numbers makes OTP more accessible for patients of all ages and holds greater significance in the healthcare industry for doctor-patient communication. The OTP service also provides an additional layer of security and eliminates password-related concerns. The entire process can be completed in under 3 minutes and eliminates the need for re-entry in subsequent sessions, making the registration verification process simple and effective.

Dynamic scheduling

Patients can now directly select their preferred doctors and related services upfront when entering the scheduling process. This feature not only allows the system to calculate and propose suitable dates and time slots based on patient preferences, but also enables clinics to optimise their capacity utilisation by efficiently allocating time and resources. As a result, this solution effectively resolves usability and operational challenges for both patients and clinics.

Service details

In order to foster trust and communication between patients and the clinic, I had emphasised on the curation of service details. Rather than presenting all the details in one place, I organised the information based on context, enabling patients to receive, process, and review the details along the way. With clearer visual hierarchy, patients can now get a full grasp of the appointments more easily.

Scheduling management

After scheduling, patients are now encouraged to manage their own appointment records. They can easily access and review both past and future appointments in a single place. This newfound capability allows patients to take control of their scheduling needs, including the ability to cancel or reschedule appointments on their own without relying on assistance from the clinics.

Result

Significant Reduction in Customer Support Issues (88.83% Decrease)

In the past, 90% of customer support issues were related to scheduling. However, with the implementation of the new scheduling feature, the percentage of these issues dropped to 10%, marking an significant reduction of 88.83%. Patients no longer faced difficulties in identifying the assigned doctor or encountering scheduling inconsistencies, resulting in a more seamless and reliable booking experience.

Stable or Slightly Increased Total Number of Visits

Despite the implementation of the new scheduling system that requires patients to sign up first before booking, there was no sign of decrease in the total number of visits to ĒSEN Clinic. In fact, there was a slight increase in the number of visits, indicating that the new system did not deter patients from seeking healthcare services at ĒSEN Clinic. However, it is important to note that the slight increase cannot be solely attributed to the new scheduling system, as other factors may have influenced this particular result.

Successful Launch of the Membership System

The introduction of the customer-facing membership system was a success for the software development team and played a pivotal role in supporting the growth of the healthcare business. It provided patients with access to their data and records stored in the EMR system, enhancing their overall experience and engagement with the clinic. 

Conclusion

The implementation of the new scheduling system at ĒSEN Clinic has yielded positive outcomes and addressed the various issues present in the previous scheduling process. The results indicate that the new system has significantly improved the overall booking experience for both patients and the clinic. By addressing customer-related issues and streamlining the scheduling process, the new system has enhanced patient satisfaction and trust.

Moving forward, if there is a need to introduce further enhancements, one potential improvement could be to add an option for patients who do not have a specific doctor preference. By including an "Any doctor" option, patients without a preference can be accommodated more easily, allowing for better resource allocation and improved appointment availability.

Built with Framer from Taipei, Taiwan

Built with Framer from Taipei, Taiwan

Built with Framer from Taipei, Taiwan