Three Doctor’s Appointments, Three Cases of Technology Problems & Some Appointment Location Confusion

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Thankfully, I'm relatively healthy. I have occasional doctor visits for a few minor conditions. Some visits go smoothly, but some (or most?) highlight opportunities to better incorporate technology into clinic practices.

Back in December, I visited my primary care physician to be greeted by this sign on the front door:

To avoid any possible delays, if you used the E-Check In feature for your appointment today, please let the front desk know to ensure that you have been properly check in. Thank you.

I didn't get a chance to ask exactly what the issue was. Clearly, using “E-Check In” in the “MyChart” app wasn't helping the patient or the front desk staff. If patients HAD used the app, they were being asked to do double effort.

I wonder how many patients didn't see the sign and then ended up sitting there in the waiting room with the clinic thinking they hadn't shown up. I'd like to think a patient would eventually speak up after waiting a bit (and waiting rooms often have signs asking patients to talk to somebody if they've been waiting more than X minutes).

I don't know if this was a case of being “temporarily broken” or if this was a longer-standing implementation issue of “it's never worked.”

As a patient, I don't understand the benefit of checking in through an app. I do see great benefit in the MyChart app for seeing test results and communicating with the office. It's far better than a few years ago when a doctor wanted to FAX results to me, as I blogged about.

I'm home today and tomorrow and have two appointments at different specialists. I know you might be doubting my claims of health at this point.

Both practices sent text message reminders of the appointment (and one also emailed, which seemed like overkill).

Both texts created confusion about something as simple as WHERE the appointment is.

I have a problem with one of my fingers, so I got referred to an orthopedic group that has two offices in different suburbs near me.

I was pretty certain my appointment was set for the “Heritage Trace” location, about 30 minutes from my home.

So the first text says “Heritage Trace.” The second text includes the address for the Grapevine office, which is closer to my home.

Why would they send the main office address in this reminder?

I dug into the original appointment confirmation email and it says Heritage Trace… so I hope that really is the case.

I didn't notice the potential discrepancy until office hours last night, of course. I can try to call them when they open, but I have a work conference call to do… the timing isn't great to try to figure that out.

My appointment tomorrow is a follow up with another specialist I have seen a few times. At the end of my last appointment, the office front desk staffer gave me a heads up that the next appointment would be at a different location, since the office is moving. OK, thanks. I put that address into my calendar.

Yesterday, I get an automated “Smart Text” about my appointment:

The reminder gave the OLD address. Of course, this led to me having to call and leave a voicemail with questions. Did the move get delayed? Or, did they just not update their “smart” system? The system is not smart enough to accept a reply text, as I tried to do.

None of these are life-and-death issues, but it does show a lack of customer focus and a lack of attention to detail. If you're managing a clinic, are you taking steps to make sure you view operations through the eyes of your patients? Are you customer focused?

There are many other examples out there about how healthcare can do better.

See updates to the story, below, in the comments.

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Mark Graban is an internationally-recognized consultant, author, and professional speaker who has worked in healthcare, manufacturing, and startups. His latest book is Measures of Success: React Less, Lead Better, Improve More. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. He also published the anthology Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also a Senior Advisor to the technology company KaiNexus.

7 Comments
  1. Once the doctor’s office opened, I was able to confirm that the appoint is indeed “Heritage Trace” and not the address that was in the text message. I need to give them feedback that the text was confusing. Whether they actually turn that feedback into process/tech improvement… I wouldn’t count on it.

    1. At the front desk, I showed the confusing text. I was told, “It normally shows the right address.” She jotted down a note and said she would talk to somebody. So hopefully her frontline input turns into improvement.

    2. Once in the exam room, I saw this:

      So, while waiting for the MD, I sent a text to that number about the confusing confirmation text… and got a response about an hour later:

  2. The office with the Friday appointment returned my call and left a voicemail (I was on a call) and said yes, it’s the new location. She didn’t acknowledge the confusing text that I mentioned in the voicemail I left for them.

    I will mention it at the clinic tomorrow and, again, I hope my feedback turns into process improvement. Part of their move process should have included updating their text messages… but hopefully they will respond and fix it, otherwise I wonder how many patients will show up at the old address because the text message told them to…

    1. I nicely mentioned the incorrect text to the front desk.

      “We know… we’ve been trying to get them to fix that!”

      I apologized if I was the 80th person to mention this.

      “Oh that’s fine, you were nice about… some others were just mean about it.”

    2. I also learned they moved to this new location the week before Christmas. Six week of incorrect text messages. Sigh.

  3. Joseph Mee says

    Mark,
    Interesting set of events regarding doctor appointments. I have had a similar issue with “Smart texts” and not completely knowing where to go for an appointment. They are helpful and convenient most of the time but sometimes they can be tricky and is also hard to confirm information when life is so busy. Maybe an area of improvement would be for someone to monitor the Text service if anyone does try and send a reply or to have the office be more proactive and make sure that their text service is up to date before people get confused. The first example with “E-check in” is interesting. I feel as though checking in from the app that the office has is very convenient for the patient and the receptionist however if people need to let the receptionist know that they already checked in online then why do extra work. Might as well check in at the front desk when arriving since patients still need to talk to someone. As time goes on the processes will be revised and whether it’s “E-check in” or “Smart texts” they will work themselves out into more improved customer focused programs.

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