We are excited to announce that DocAsap has officially launched today, and that you can now use our service to find and book online dental appointments in Philadelphia!

On DocAsap, patients can instantly find and book available appointments 24 / 7 from local doctors and dentists who take their insurance, and can research providers based on their backgrounds.  Our rationale for starting in Philadelphia is not only because we commenced the venture while Wharton students, but also because Philadelphia, which has the second longest doctor appointment wait time of any U.S. city, could use a service that helps its residents get more timely care in a quick and convenient manner.

Right now, DocAsap only provides online appointment booking for Philadelphia dentists.  But in coming months, we will launch more specialties, add more content on our doctors and dentists, and roll out other features to improve the efficiency of finding and visiting a doctor.  In addition to providing us with any feedback, we would love for you to tell your friends in Philadelphia to book their next dentist appointment through DocAsap, join our Facebook group to get future updates, and spread the word to those you think might be interested in our service.

Anyways, thanks again for your help along the way, and we look forward to hearing from you.

The DocAsap Team

I recently met with directors of the Camden Coalition, which is seeking to radically change the way residents of Camden, New Jersey seek and receive care.  To provide context, Camden, New Jersey was America’s poorest city as of 2006 (pdf article) and one of its most violent.  Furthermore, over 50% of Camden residents visit the ER room in a year, which is over double the national average in the U.S.

This over-usage of ER rooms led a group of New Jersey physicians and public health officials to undertake the ambitious effort of tracking ER “super user” characteristics over time in order to make Camden residents healthier while lowering overall medical costs.  According to Dr. Anthony Mazzarelli of Cooper Health, who directs Cooper’s ER room and has been named one of ten Outstanding Young Americans and hosts a radio show, the ER over-usage results not only from many Camden residents lacking insurance, but also many insured residents lacking physician relationships.

In a program led by Dr. Jeffrey Brenner, the Camden Coalition is now hyper-targeting those ER super-users with an all-encompassing care management program by having physicians and public health workers promote preventative care and healthier lifestyles among these patients.  Furthermore, the Coalition has a broader goal to reach out to all Camden residents to increase access to preventative care through open access scheduling (see our previous post about open access scheduling).

A key lynchpin of their effort is effectively utilizing electronic medical record information, as a patient health record helps physicians better track and serve patients.  DocAsap also believes that online technology can help patients find appointments or interact with doctors remotely.  While internet usage in poorer areas typically trails that of wealthier communities, Camden’s young population, many of whom have cell phones and use the internet regularly, could benefit from having online tools such as DocAsap to more easily get doctor appointments.  DocAsap believes that providing intuitive doctor appointment search tools to all Americans that it can decrease over-usage of ER rooms, reduce overall healthcare cost, and create a healthier U.S. population.

DocAsap’s primary goal is to help patients get appointments as quickly as possible.  Given delays after scheduled doctor appointment times average 20 minutes, and that Americans in total spend 847 million hours per year waiting in doctor office lobbies for care, DocAsap has some tips to help you get out of the waiting room ASAP:

• Schedule your appointments first thing in the morning or immediately after lunch since the doctor won’t have a backlog.  Also, schedule appointments midweek to avoid typical Monday and Friday rushes. (via eHow)
• Visit open-access urgent care centers for non-emergency same day care, as this BusinessWeek article states that they are more likely to provide care without a wait.
• Encourage your doctor or dentist to message you if they are experiencing long delays, either via email or text message, so you can show up later.

Since office waits will never completely disappear, DocAsap obviously recommends bringing good reading material, or homework if you’re a student like us, to fill your time.  We’re eager to hear more time-saving advice, so please share your own tips below.

Ever feel rushed by your doctor and forget to ask something?  DocAsap has compiled some online tips to help you maximize your next doctor visit:

• An AHA article recommends you bring a notebook to list out your questions and to take notes.  Also, slow down doctors to double-check instructions, and be bluntly honest with doctors.
• A Kaiser flyer also stresses honesty as well as repeating instructions and voicing disagreements.
• An amusing Men’s Health article recommends you “don’t rub your eyes or scratch your schnozz until you’ve treated your mitts with hand sanitizer” since waiting rooms are rife with germs.  The article also suggests you talk to nurses to get more information and see female physicians since they tend to spend longer amounts of time with patients.

Please add any other tips you have to share!

This sure is an extreme statement. However, I firmly believe that open access to doctor booking systems would provide significant value for both doctors and patients.

Years ago, people who needed to see a doctor simply walked in, “took a number” and waited for their turn. At that time appointment scheduling was a welcome change as it brought order to the chaos. However, the results did not meet expectations. Appointment systems became complex and frustrating. Despite proper scheduling, the appointments were rarely honored. Double and triple booking by doctors to mitigate no-shows resulted in the same old wait-your-turn system.

Not just this, the need for timely access pushed more and more patients to emergency room care. Studies show that more that 50% of HMO patients would have preferred a day or two wait for their primary care instead of going to an ER. It’s just that the receptionist telling them “come next week” led them to an ER.

Open access eliminates most of these issues.

Wouldn’t it be great if you could be sure that when you call your doctor, he/she would see you either today or tomorrow instead of making you wait for weeks?

In the book, Strategic Management of Health Care Organizations, the authors talk about one such open access scheduling system – developed as part of idealized design of clinical office practice IDCOP – in Jefferson County, Alabama. The system required the doctors to provide for same day appointments. When implemented the results were startling:

• Contrary to popular belief, physicians were fine with the guarantee of same day appointments
• Revenue increased by almost 10%
• After 6 months average appointment wait time was reduced from average 46 days to 5 days
• No show rates reduced from 56% to 19%
• New patients per month increased from 78 to 95

Needless to say, the results were so amazing that Jefferson County adopted the same-day scheduling system.

Clearly, medical practices can create considerable value by enabling patients to see the doctor promptly by improving existing appointment scheduling systems. I believe DocAsap would prove to be a prominent open access mechanism that would create value for both doctors and patients.

We tell just about anyone we come into contact about DocAsap. When we first tell people about the idea of “doctor appointments at your fingertips”, the reaction of the listener most often starts, “Wow! that’s a great idea! I would definitely use a service like that!”  Then, as we get deeper into the conversation, the “yeah, but….” comments start to come out  (e.g. “yeah, that’s a great idea, but patients won’t actually book appointments online!”).  We love the objections, and want to respond below with data supporting the need for DocAsap.com.

Objection 1. Patients aren’t going to want to go and see just any doctor. They won’t switch doctors because they only want to see their own doctor!
In fact, a recent McKinsey study involving more that 2000 patients found that 2/3 of patients are willing to switch providers for improved scheduling and 77% would switch for more timely appointments.

Objection 2. Most patients already have strong relationships with their doctors and aren’t often looking for new doctors.
56 million Americans across all demographics of income, race, geography and insurance coverage do not even have a regular primary care physician relationship. Specialists relationship is even lower.

Objection 3. Patients here in the U.S. can’t just book an appointment to see a specialist, they need referrals.
First of all, patients with referrals will certainly be able to use DocAsap to book appointments.  In addition, from a macro-perspective, HMO enrollment continues to decline , falling 5.8% to approximately 44 million from July 2007 to January 2008. At the same time, PPO enrollment grew 4.4% to 110 million, increasing the number of patients who can book directly with specialists, without a stringent referral requirement.

Objection 4.  All doctors are overbooked and there aren’t going to be open slots available!
New and emerging practices and doctors are constantly looking for new patients. Even well-established doctors know that they need a certain fraction of total patients to be new patients in order to keep their practices thriving. In addition, surprisingly high cancellation rates reduce doctor utilization significantly. Anecdotally, in practices and clinics in the West Philadelphia area where we go to school, the cancellation/no-show rate is regularly up to 50% of appointments!

Objection 5. I can’t imagine patients booking doctor appointments on line, this is something that people only do over the phone.
Even without the benefit of statistics, we know that online appointment booking in general for major service sectors continues to grow rapidly. People manage a large percentage of their “offline” lives online, and we don’t see that trend reversing.

Let us know what you think! We appreciate more of your feedback on your service and we’d love to hear what you think of our responses.  Also, let us know if you have any additional data supporting the need for online doctor appointment booking.

While seeing a doctor has never been fun, it is about to get a lot easier.  DocAsap.com helps you instantly choose and book the best doctors in your area.  No more long waits.  No more flipping through the yellow pages to pick a doctor.   Just convenient doctor appointments.

We started DocAsap.com because of the frustration we felt in making doctor appointments, and we know we’re not alone.  A 2007 McKinsey Quarterly study found that 66% of patients would switch doctors for better ease of scheduling and 77% would switch for timely appointments.  By making it easier to schedule convenient appointments, we hope to make America (and ourselves) healthier by getting patients in to see doctors more frequently.

Over the next few months, we at DocAsap.com will continue to progress on our mission to bring convenience to U.S. healthcare, and we will start implementing our solutions in a doctor’s office near you.  We hope that you’ll continue reading this blog to hear about product updates and our thoughts on healthcare in America, and we encourage you to share your opinions, ideas and advice in this space as well.

Vince and Puneet
Co-Founders
DocAsap.com