Appointment+Status+App

Team Information

 * **Name** || **Email** || **Phone** ||
 * Stephanie Aanstoos || sa11g@my.fsu.edu || 919-906-0327 ||
 * Daniel Adler || daa08d@my.fsu.edu || 240-298-7270 ||
 * Thomas Helstowski || tph10c@my.fsu.edu || 810-623-1588 ||
 * Harrison Lindblad || hl10r@my.fsu.edu || 240-538-8747 ||
 * John Patsias || jgp10c@my.fsu.edu || 561-628-4652 ||

4:50-7 ||  || 2-3:30 4:50-7 || 2-6 || varies || varies || 2-5 || 10-12 5-8 || 2-10 || 10-12 5-10 || 4-10 || All Day || All Day || 7-10 || 5-10 || 10-3 7-10 || All Day || All Day || All Day || https://docs.google.com/document/d/1RDkQoFs_gcDmiskUZVr-2rYlQO00kv7k6NuLOYO1x9c/edit
 * **Name** || **Monday** || **Tuesday** || **Wednesday** || **Thursday** || **Friday** || **Saturday** || **Sunday** ||
 * Stephanie || 2-6 || 2-3:30
 * John ||  ||   ||   ||   ||   ||   ||   ||
 * Thomas || 10-12
 * Dan || None || 11-3 || None || 11-3 || Varies || All Day || All Day ||
 * Harrison || None || 10-3

Problem statement

 * Doctor’s appointment are a hassle
 * Always a long waiting period for medical appointments
 * Lots of paperwork required for new patients
 * Emergencies happen that can affect appointment times
 * No easy way to communicate with patients

It is common knowledge that a doctor appointment means a long wait. This is in-part due to unforeseen issues with patients that ruins the original schedule and forces the office to work through the backlog until they are ready to see more patients. Currently, there is no easy way to communicate this backlog to the patients. Patients often show up late, expecting a delay; however, this just perpetuates the problem.

Evidence to support the problem

 * The Huffington Post article: Doctor Office Wait Times: Where Do Patients Wait The Longest?
 * This article reveals the average wait times across the country according to Vitals.com, a doctor review website. The nationwide average wait to be seen by a doctor is 21 minutes. The Southwest has the longest average wait time of 22 minutes, while the Midwest has the shortest wait time of 19 minutes.
 * CNN article: Long wait at the doctor's office? Blame the patients
 * This is an interesting article written by a doctor discussing the problems patients cause in scheduling by running late or raising complications that were never discussed when setting the appointment. This highlights the fact that it is extremely easy for patients to completely wreck a doctor's schedule and that these type of problems are frequent occurrences for most doctors. The article acknowledges other cases when it is the physician's fault, but that is not typically the case. Either way, scheduling is an major problem in all doctor's offices, and rarely are they running on schedule (or ahead of time).
 * Forbes article: How To Win The Waiting Game At Your Doctor's Office
 * This article discusses the negative effects of waiting in the doctor's office for prolong periods of time. The average wait time is nearly 23 minutes for all US hospitals and clinics, causing patients to lose valuable time and wages. This is a major opportunity cost, especially for busy working professions. The article provides possible ways to alleviate the wait problem, something we hope our app will accomplish!

Potential Solutions

 * Smartphone app that updates patients about their appointment time
 * Automated text messages that update patients
 * Use of a patient-driven scheduling system.
 * Allow patients to register and update any personal information, insurance information, current medications and allergies.

Research on existing/alternate solutions tried by others

 * **ZocDoc:** @http://www.zocdoc.com/
 * Find a doctor and book appointments online instantly. Read doctor reviews and ratings by real patients.
 * This is a web scheduling service available in 14 metropolitan areas in the US allowing patients to find open doctors appointment by location, type of doctor and insurance accepted.
 * The service is free to patients, but doctors offices pay a monthly subscription fee to participate.
 * Based on the comments on an article about ZocDoc, it is very clear that many doctors and patients are extremely unsatisfied with this service. Doctors feel the benefits do not out weigh the costs or solve the problem, and patients have had bad experience with the doctors they end up seeing. (Lohr, 2012)
 * **MedWaitTime:** @http://www.medwaittime.com/
 * "MedWaitTime provides you with free, real-time information about the wait time at your doctors’ offices and healthcare facilities including urgent care centers and emergency rooms. The service also allows you to locate doctors who are currently accepting walk-in appointments and view medical services provided by healthcare professionals."
 * This is another app that is free to patients and the doctor's office pays a monthly subscription fee. The app allows the patient to check-in and see a green, yellow or red signal corresponding to the wait time. It does not show an exact time of delay, but it allows patients to get a feel for how late their appointment may it.
 * Doctors may also send the patients direct messages telling them to arrive a certain amount of time later than the scheduled time.
 * The app has poor reviews and there has not been any activity in the past year from the company. It has not taken off as well as planned because the doctors' offices paying for the service do not see the benefit to them.
 * **Register Patient:** @http://www.registerpatient.com/
 * RegisterPatient is a complete scheduling system with appointment requests, reminders, insurance verification, and Facebook connectivity. It allows prescription refill requests, custom EMR integration, online patient registration forms and more.
 * There is not much information available about how the software is working in doctors offices so far, but they are currently expanding their staff and recently secured over 4 million from two venture capitalists and a $320,000 grant from the Department of Labor. (Clark, 2012)
 * While this software has not yet proven itself, it seems like a very promising venture that may help solve many of the scheduling problems in the medical field. However, there is no mention of a mobile app or mobile integration with the software, which may prove detrimental in our increasingly mobile society.
 * **DocMeIn:** @http://docmein.com/corp/
 * "DocMeIn is the first medical scheduling system to recognize the value of calendar integration as the most efficient appointment reminder mechanism. Coupled with email invitations and the calendar's built-in notification capabilities, DocMeIn makes doctor appointments as reliable to the practice and as visible to the patients as their office meetings and social functions."
 * Unlike the alternatives, DocMeIn is free for both patients and doctors. They claim it will remain free, but they will offer additional services in the future at an additional cost.
 * DocMeIn is not yet mobile-friendly, but they claim they are working on it.
 * They have a suggestion forum on their website, so you can see what improvement customers would like to see: http://docmein.uservoice.com/forums/27191-general

Feasibility of each solution

 * **Mobile app:** Not all patients are going to have access to a smartphone, but as research has shown, the majority will. Therefore, access will not be universal, but it will likely be more beneficial to the same type of people who do have smartphones. While possibly complex to develop, the mobile app can give the most flexibility to a patient. The ability to GPS the address or to call the office directly can be integrated into the application and allow for the most usability to the patient.
 * **Text messaging:**<span style="font-family: Arial,sans-serif; font-size: 10pt;"> While possibly simpler to implement, this option lacks the functionality of the mobile application. Frankly, it is a clunky and somewhat outdated solution.
 * **Patient driven scheduling:**<span style="font-family: Arial,sans-serif; font-size: 10pt;"> Patient-driven scheduling would give the most flexibility and usefulness to the patients, but would not bridge the gap between the schedule and the backlog in the office. Additionally, it would be much harder for offices to create effective schedules without some sort of oversight.
 * **Patient Registration:** Patients will have the ability to fill out any registration documentation from their home. This will reduce the amount of time wasted sitting in the doctors office, especially if the patient is running late. If the patient takes the time to fill out the documents prior to the scheduled appointment, they won't feel as rushed and leave out vital information. This may make the check-in process smoother, but does not solve all the backlog issues.

** Your chosen approach (and reasons) **
<span style="font-family: Arial,sans-serif; font-size: 10pt;">We will create a mobile application for doctors appointments with updates on the actual appointment time, so patients know if there is a delay (just like a flight status). It will still be the patient's responsibility to get there on time, and they will only be allowed to use the app and come in later if the appropriate paper work is filled out. Paperwork and insurance verification can also be done through the app.

<span style="font-family: Arial,sans-serif; font-size: 10pt;">This solution will benefit both the doctor and the patient, making the appointment process less opaque to the patient without having loss of control from the office side. Patients will feel more informed and willing to arrive on-time if they know when their appointment will actually be and appreciate not having to arrive 30 min early to accommodate time for filling out paperwork when it is already complete. The appointment reminders and updates will greatly reduce the number of no-shows and later appointment, drastically increasing efficiency for the office.

Your timeline for completion
<span style="font-family: Arial,sans-serif; font-size: 10pt;">09/13 Select project topic/problem you are solving <span style="font-family: Arial,sans-serif; font-size: 10pt;">09/28 2 page project outline (problem statement, evidence, potential solutions) <span style="font-family: Arial,sans-serif; font-size: 10pt;">11/09 Solution prototype/Demo <span style="font-family: Arial,sans-serif; font-size: 10pt;">11/26 Project Due (wiki access turned off) <span style="font-family: Arial,sans-serif; font-size: 10pt;">11/27 Presentation

Team workload and roles
Stephanie Aanstoos- Wiki editor; Researcher of the problem and existing/alternate solutions; Team organizer. Daniel Adler- Prototype Builder, Final Solution and Next Steps Writer Thomas Helstowski- Information Researcher and Editor; Presentation Coordinator Harrison Lindblad- Team Leader, Assignment Coordinator <span style="font-family: Arial,sans-serif; font-size: 10pt;">John Patsias-

Meeting minutes
9/6- Putting together the list of alternatives for the project. 9/11- Selecting the problem we are solving and putting together the problem statement. 9/25- Working on the outline, researching existing app and software. 11/6- Meeting about the prototype and what should be included. 11/19- Discussing what is left to finish and splitting up the work over the break. 11/26- Final meeting. Wrap-up for the wiki, reviewing the final solution and preparing for presentation.

Solution prototypes
Our Prototype was edited and updated using the Lucidchart Cloud Software. Because Lucidchart is in the cloud the prototype is saved in real time thus no previous versions of the prototype exist. Our final version of the prototype will be shared on November 27, 2012 in the Health Informatics class. Students who wish to access the prototype for their own research can request to do so by sending an email to daa08d@my.fsu.edu after November 28, 2012.

Final solution
The final solution our group completed was an interactive wireframe that represents an Apple IOS Application. The wireframe is designed to work on users' computers and give them an understanding of how the application would work upon development. Users are able to click on the buttons and navigate through the wireframe, which simulates the feeling of using the app on an IOS device. We improved upon our original prototype design by adding in a way for the Doctor's to notify patients that they are running late, or need to reschedule. We also updated payment options, adding an option for the patient to pay out of pocket. We also modified the wireframe to include the ability to select specialty and insurance, so that the patient can make sure the Doctor would be able to see them based on their insurance.

Next steps
The next step will involve further tweaking the interface design of our final wireframe. We could hold a user test with members of the class to get their suggestions on how to improve the interface of the application. Upon acceptance of the final wireframe, we could use the Apple App Developer IDE to create the application using our in-house resources, or hire a programmer to build the application for us to be released onto the Apple App Store. We could also talk to physicians and patients and see if they had any ideas, or what they would like to see from this application. This would give us a broader view of what people would want and we would get the answers from the people that this application is intended for. After that, we could hold trial versions for certain physicians that have a lot of patients. This way we would get a real test to see how well this could do, and what we could improve on before releasing a full version of the application.