Apps Being Studied for Ease in Getting Patients to Medical Appointments

FEBRUARY 28, 2018
My kid's doctors appointment is coming up, and I a can't figure out if I should leave now, in 10 minutes, or I should have left 15 minutes ago. I mean, do I want to sit in an office with coughing kids around him when he's just there for a checkup? So, how can this be better?

ER's and some offices have begun to broadcast on apps, and their websites wait times for potential patients. It reminds me of the restaurant queue lines that tell you they will call you when your seat is ready. But that means I have to meander meaninglessly while I wait. 
 
So, it seems a team of medical researchers at Sloan Kettering Cancer Center in New York also have been considering this question and looked to create a solution with an already familiar app on mobile phones: Google Maps.1 Now before you get too excited, this is an exploratory study using hypothetical patients in digital modeling scenarios, just before the proof of concept phase.

The study published in the Journal of Digital Imaging looked into whether a custom Google Maps app could help patients get to an interventional radiology appointment on time within a multi-site hospital system. Encompassing a range of 33 cities within its network, the custom app using hypothetical patients looked to see if by inputting users' homes it would be possible to identify the best clinic to visit. This was based on the estimated travel time, not distance. The key was speed and time saved. This includes multiple factors, including traffic, because rush-hour can vary. I'm inclined to think that you could also factor volume of patients at a clinic as well in the future for another variable of visit completion. In any event, their model showed that users could cut their time for travel down more than 7mins on average.  So that's cool, and I could see that being a valuable service for networks to offer to their patients in the future.
 
But what if a person can't make the drive? Or what if they don't want to, and instead just have someone take them? The Uber mentality is rife, and some researchers have investigated if we could use ride-sharing apps to help boost visits to clinics.

A recent study published this February in JAMA looked into whether rideshare services could help avoid missed appointments.2 The study was conducted in the Philadelphia region at an academic internal medical practice. Essentially, patients were either offered the ride-share service or allowed to do as they wished (based on the weekend of visit). Overall, 786 patients were included in the study, and only 85 of 288 participants offered the ride-share service said they would use it. Nonetheless, that didn't mean necessarily they used it, and results demonstrated that the missed appointment rate was 36.5% (intervention) vs 36.7% (control). So, not that promising of a result. Again, this was a small regional study, so not all-encompassing depending on whether a more extensive study would show similar or different results is up to argument.
 
What all this boils down to is the fact that hospitals and clinics run a tight schedule. Money boils down to the number of patients seen, and they want to cram as many patients in as possible while maintaining a level of quality. But patients are humans, subject to the whims of the day and if they are late or miss their appointment, it throws the whole schedule out of whack.

It's no surprise that from a business perspective many companies are looking to see if technology can help with the process. While the Google Maps is hypothetical at this point, it could be an excellent tool to offer patients who are traveling.

The issue with extending rides at this time doesn't seem positive, but some more research I feel is on the way that may change its tune. I don't see it being a dead topic at this time.

References
  1. Mandel, J.E., Morel-Ovalle, L., Boas, F.E. et al. J Digit Imaging (2018). https://doi.org/10.1007/s10278-018-0054-2
  2. Chaiyachati KH, Hubbard RA, Yeager A, et al. Association of Rideshare-Based Transportation Services and Missed Primary Care Appointments: A Clinical Trial. JAMA Intern Med. . Published February 5, 2018. Accessed February 28, 2018.


Timothy Aungst, PharmD
Timothy Dy Aungst, PharmD, is an assistant professor of pharmacy practice at MCPHS University. He graduated from Wilkes University Nesbitt School of Pharmacy and completed a PGY-1 Pharmacy Practice Residency at St. Luke's University Hospital, and then a Clinical Geriatric Fellowship at MCPHS University. He is passionate about the rise of technology in health care and its application to pharmacy. He has published primarily on the role of mobile technology and mHealth, and made multiple national and international presentations on those topics. He blogs at TheDigitalApothecary.com, and you can find him on Twitter @TDAungst.
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