Opportunity

Access to primary care is critical to the health of our patients and the community. Unfortunately, long wait times for primary care appointments, particularly for new patients, lead to cancellations, no-shows, and the loss of patients to other health systems.   

Penn Medicine has an extensive network of primary care practices in and around Philadelphia. Some practices are at full capacity, resulting in increased wait times for new patients. However, others can easily accommodate new patients. At the start of this project, the primary care scheduling process required new patients to call the central appointment hotline to be redirected to separate call centers that do not communicate or share schedules.

Intervention

We experimented to see what impact load balancing might have. Practice managers and call center supervisors gave 19 call center representatives the ability to schedule appointments at both the Clinical Practices of the University of Pennsylvania (CPUP) and Rittenhouse Clinical Care Associates (CCA) starting in December 2012. The load balancing effort aimed to redirect new patients from the over-capacity CPUP practices to the underutilized CCA clinics.

Impact

The experiment yielded impressive results. Close to 150 new patient appointments were scheduled. The wait time for new patient appointments dropped from around four weeks to a few days. Most importantly, 80 percent of patients showed up to their appointments, and many continued to receive their primary care at the CCA practice. 

When we revisited the project several months later, a total of 905 new appointments had been scheduled over ten months using the load balancing process. Two physicians, new to the practice at CCA, had minimal patient volume before the intervention. After the redistribution, they had large, robust patient panels that brought additional revenue to Penn Medicine.