Digital doctors appointments: where to now

Universal healthcare starts at the point of entry

Most people in the UK will tell you it’s difficult to get a doctors appointment. An ageing population, chronic diseases, staff burnout and a greater shift to urban living are all creating a growing strain on the limited resources of GP centres around the country.

In parallel, missed appointments are costing the NHS approximately £650,000 a month [Jbs.cam.ac.uk, Sept 2023], creating additional strain on limited financial resources.

To help prevent these unnecessary expenditures and reduce the workload on staff, digital booking systems should be part of the answer.

But getting them right is not as easy as it sounds.

The process of booking a doctors appointment has changed dramatically since 2020. Where you could once simply pop down to the surgery and book an appointment now most people are faced with only two options:

• Calling the surgery, or

• Going online to complete a form request.

Calling the surgery can be challenging for many as it involves making a phone call early in the morning at a very specific time. The caller is then placed in an invariably lengthy and time-consuming queue with no guarantee of getting an appointment at the end of it.

The expectation is that going online should be more efficient and convenient.

However, in a recent study, we found quite the opposite. The quality of the online booking process available across the country was so variable that depending on where you lived you could be asked anything between 5 to 25 questions, more for those with complex medical needs, just to get a time to see the doctor.

Friction in healthcare booking

At best, this can be off-putting to people who are used to engaging with the digital world and have a simple issue to deal with. For those who struggle with or have limited access to technology, have low health literacy or for whom English is a second language, the experience can be debilitating. Quite natural feelings of anxiety created by ill health are compounded by struggling through a process that is overly complex or confusing.

Good intentions, new approaches

Medical professionals want to give the best care possible to their patients but have limited time and resources. An efficient and effective process, that works well for both parties must be the end goal. So why has this proven so difficult to get right up to now?

Clearly, good intentions and the need for process in booking systems are necessary. However, these systems are often designed from the health care providers’ mental model rather than a patient or carers’ mental model - the intended users of the system.

Complicated medical terminology, confusing diagrams, seemingly unnecessary detail and on occasion, overly cautious and potentially alarming messages are commonly found in automated processes which can do more harm than good. Automated routing, inherent within these processes, means that one incorrectly answered question early on can lead to confusing questioning, frustration and early exit. None of which helps the doctor or the patient obtain the outcome they need.

The Health Service was founded on the principle of universal access for all and it’s essential that this principle is upheld from the first point of contact to the last. So, how can this situation be improved, ensuring that both the doctors and the patients’ best interests are better served?

Simple steps: the path to better digital bookings

System providers need to stop thinking about the process as one that gives the Doctor the best information, and instead start to better consider the varying needs and limitations of the patients who need access to the health service.

There are two points of engagement with this process, the first being the initiator, an individual who needs help or advice, at a point when they may not be at their best either physically or mentally, and the second being the receptionist who must action and direct the request to the best health professional available.

As a first step, correctly identifying yourself to the system should be both simple and intuitive, usernames and passwords are neither. They can be complicated to remember and input, instead its far easier to use biometrics or QR codes which are now widely accepted and easy to use.

Secondly, the system should only ask the patient what is absolutely necessary to assist in the identification of the care professional and the assistance required. These are not diagnostic systems, they are booking systems, so they should act as such.

Offering alternative services such as a specialist nurse or a pharmacist at the right time and in the right way would ensure that the most appropriate and beneficial services are offered to the patient.

Using clear, simple and commonly used terms throughout the process would be beneficial to all, reducing potential friction points and simplifying the route to completion.

Standardising and simplifying the online process will not only reduce anxiety for the patient but it will also improve the efficiency and effectiveness of receptionists and healthcare professionals when processing an appointment made online.

Understand your patient

What initially looks like a logical and sensible process to a system engineer can be anything but to a concerned and unwell member of the public. An incorrectly completed form or a frustrated exit from the process fails both the patient and the doctor, wasting time for both.

Engagement with and understanding both sets of people in this process is essential if we are to make platforms such as this fit for purpose.

Only by correctly meeting both the needs of the user (patient) and the service provider (doctor) can a health system truly be seen as offering universal access to all.