Although patients had to be educated about the self-scheduling option at first, they warmed to it quickly.
After successfully introducing self-scheduling in its retail clinics, Providence St. Joseph Health plans to extend the consumer-friendly service to all primary care offices and some specialty clinics.
Based in Renton, Wash., Providence St. Joseph Health, one of the nation’s largest not-for-profit systems, includes 51 hospitals and more than 800 clinics in seven states. The system introduced self-scheduling in its Express Care retail clinics when they were launched in 2015.
Although patients had to be educated about the self-scheduling option at first, they warmed to it quickly. About 55 percent of Express Care patients are scheduling their appointments online, says Sunita Mishra, vice president of Express Care and Consumer Innovation.
By the end of this year, self-scheduling will be available for approximately 1,200 primary care providers. While self-scheduling won’t work well for specialties that require a referral, specialties such as dermatology and sports medicine lend themselves to online scheduling. “We are going to be offering it throughout primary care and then our goal is to start turning it on for the specialties where it makes sense,” she says.
Self-scheduling comes with a learning curve for patients and providers alike. But after they get used to it, consumers are telling their primary care clinics how much they like it.
“People are coming in and saying, ‘Why can’t I schedule online? I was able to do it easily in the Express Care clinic. I wish this office had that functionality,’” Mishra says. “That is a reflection of how the Express Care product line has really helped to push that as a patient expectation into our primary care delivery model.”
Reducing the Burden in Primary Care Offices
Providence St. Joseph’s markets include Portland, Seattle, and Los Angeles, three of the fastest-growing cities in the country. The system started rolling out its Express Care products, as they are called in 2015, to take pressure off its overburdened primary care clinics.
“There’s more demand out there than we have capacity for, so it’s really important that we create these alternative access strategies,” Mishra says. “We want to make sure that we’re there for our patients when they need us.”
The product line currently includes:
Express Care retail clinics. By the end of this year, about 50 clinics—some embedded in Walgreens stores, others freestanding—will be operating in Portland and Seattle. Retail clinics will open in the system’s other markets in the next few years.
Express Care Virtual. These video visits allow patients to access care from a phone, laptop, or kiosk at the airport or their workplace. The service, staffed by nurse practitioners, is available from 8 a.m. to midnight seven days a week in Washington, Oregon, and Montana and from 8 a.m. to 8 p.m. in California.
Express Care at Home. This app-enabled house-call service provides a nurse practitioner who will deliver care at patients’ homes or offices.
In addition, Providence St. Joseph is testing asynchronous e-visits in Oregon, giving patients the opportunity to seek non-urgent care via secure email messages; providers typically respond within several hours. If patients gravitate to e-visits, they will be introduced to some or all of the system’s other markets.
The Express Care modalities—each of which capture information for patients’ electronic health records, offer flat-rate pricing, and accept insurance—are increasing access to care. Last year, Express Care clinics handled nearly 140,000 patient visits, and patients had 10,000 video and home visits.
Beyond that, the Express Care team is helping the Providence St. Joseph system see healthcare delivery through the eyes of a consumer, Mishra says.
“We are trying to learn when patients want to see us, what they are looking for and what kind of friction do they encounter when they interact with us in the traditional way?” she says. “And we’re trying to chip away at all of those areas of friction to make accessing healthcare just as easy as ordering groceries online.”
Patients who want to schedule an appointment at an Express Care clinic go online or use the Providence Health Connect or Walgreens Find Care Now smartphone app to identify the Express Care sites that are most convenient to their location. On the same screen, they can see the 20-minute appointment blocks available for each location.
In one click, patients who have insurance can get to a cost-calculator and self-pay consumers can see the flat-rate prices for various services. The screen or app also informs consumers that virtual visits and home visits (in some markets) are other options to consider.
Self-scheduling replaces the first-come, first-served policy that is common for retail clinics. Walk-in patients see a screen that lists appointments that are currently open, and consumers use a kiosk to schedule one of the time slots.
“We have found that patients are really looking for predictability,” Mishra says. “They want to know that if they are there for an appointment at 3:20 p.m., they are going to be seen at 3:20.”
All consumers know the traditional way to connect with and use a primary care clinic; many do not know what to expect at a retail clinic in a strip mall or a drugstore or how to interact with one. To build awareness of its Express Care clinics, Providence St. Joseph used a mix of marketing tactics, including social media, digital marketing, and traditional media.
“The average patient wouldn’t even look to schedule online because they are so used to picking up the phone and calling the clinic,” Mishra says. “So that was something we needed to educate patients about.”
Offering a Consumer-Friendly Option
Online scheduling is popular with patients. They recognize the convenience and take advantage of cost-calculators and flat-rate prices for various services. Although acclimating patients to the new option required some awareness building, patients now view it as a benefit.
Lola Butcher is a freelance writer and editor based in Missouri and is a member of HFMA’s Show Me State of Missouri Chapter.
Interviewed for this article:
Sunita Mishra, MD, MBA, is chief executive of Express Care and Consumer Innovation, Providence St. Joseph Health, Seattle.