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論文Web-Based Medical Appointment Systems: A Systematic Review前沿與方法翻譯
Traditionally, medical appointments have been made with schedulers over the telephone or in person. These methods are based on verbal communications with real people and allow for maximum flexibility in complicated situations [1]. However, because these traditional methods require the intervention of schedulers, the ability to get a timely appointment is not only limited by the availability of appointment slots, but also by the schedulers and phone lines [2,3]. Patients’ satisfaction with appointment booking is influenced by their ability to book at the right time with the right health service providers [4].The Internet has recently emerged as another means to make appointments. Web-based appointment scheduling has been a popular research topic. Several studies conducted satisfaction surveys and found that Web-based appointment scheduling is an extremely important feature, and most patients would use the service again [2,5-7].There are two major types of Web-based medical appointment services, medical scheduling software as a service (SaaS) and proprietary Web-based scheduling systems. Medical scheduling SaaS has gained increasing prominence in recent years. These appointment systems are not built up by health care practices themselves, but are provided and maintained by health IT companies such as ZocDoc and InQuicker on a paid subscription basis [8]. The appointment services are cloud-based and can be integrated into health care providers’ own management systems. The other type of appointment service is proprietary appointment systems, which are integrated into patient portals on providers’ websites [9]. A patient portal is a secured Web-based service that allows patients to access their health information and communicate with their health care providers at any time [10]. In the United States, the growth of patient portals has largely been spurred by meaningful use (MU) requirements [11] because of the federal incentive program for adoption of electronic health records. To meet the requirements of MU and receive its incentives, the portal should be actively used by both the practice and patients [12].There are two modes of Web-based appointment systems, asynchronous and real-time. In the asynchronous mode, appointments are requested through emails or electronic forms on providers’ website, and then manually processed by schedulers. In the real-time mode, patients can directly interact with providers’ scheduling management systems [3,13]. Although the asynchronous Web-based appointment systems also use the Internet as a medium, they basically replicate the process of telephone-based appointment scheduling [13]. Under the asynchronous mode, if an appointment is requested outside of a provider’s business hours, it will not be processed until schedulers return to work. Normally, Web-based appointment requests are put in the same queue as phone-call appointments, and are thus limited by the backlog of phone calls in the queue [14].Aims of the StudyDespite the increasing adoption of Web-based appointment systems, their potential benefits are yet to be systematically studied. The purpose of this review was to examine the current body of literature about Web-based medical appointment systems, specifically in regard to their potential benefits to patients and providers. We also want to identify the most effective services or components of them and explore the benefits and barriers of implementation. It is not the intention of this work to review the literature regarding fundamental theories of medical scheduling or system design, which have been studied and reviewed by Cayirli et al [15] and Gupta et al [16]. To the best of our knowledge, this study is the first systematic literature review of the impacts of implementing Web-based medical scheduling systems.Go to:MethodsData SourceIn this study, we present a systematic literature review of Web-based medical appointment systems following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement for systematic reviews [17].A literature search was performed in MEDLINE using PubMed to identify pertinent articles relating to the impacts of Web-based appointment scheduling. The MeSH terms used in the search included “Internet,” “computers,” “cell phones,” “electronic mail,” and “appointments and schedules.” “Smartphone” used to be an entry term for “cell phones,” and it became a MeSH Descriptor in 2016. To include articles indexed by “smartphone” after 2016 and articles involving smartphones before 2016, “smartphone” was included in the search without any restrictions. Figure 1 shows the logical relationships among the search keywords and their restrictions in the search builder of PubMed.An external file that holds a picture, illustration, etc.Object name is jmir_v19i4e134_fig1.jpgFigure 1Logical relationships between the search keywords in the search builder of PubMed.The literature search was initially performed in April 2016. Since then, in order to make this literature review up-to-date (by including new articles), we regularly conducted literature searches with the same search keywords. Our last literature search was carried out in late February 2017.Inclusion and Exclusion CriteriaIn this study, articles published only after January 1, 1990, were included, because articles published earlier than this time were unlikely to be relevant to Web-based appointments. We only included articles mainly discussing general Web-based medical appointment services or a specific automated or Web-based tool that assisted patients in choosing a provider or making a medical appointment. The exclusion criteria were systems that solely discussed email- or phone-based appointment reminders and systems not designed for use by patients. Articles not written in English were excluded too.Study SelectionThe process of identifying eligible articles is shown in Figure 2. The initial query returned 587 articles, which were then filtered by publication date and language. 145 articles were excluded because they were published before January 1, 1990. Also, 16 non-English articles were filtered out. The remaining 426 articles were reviewed based on titles and abstracts and 336 of them were excluded due to low relevancy. The remaining 90 articles were then reviewed in full text, and 54 of them were excluded as they do not mainly discuss Web-based medical appointment services or a specific automatic or Web-based tool helping patients to choose a provider or make a medical appointment. The remaining 36 highly relevant articles discussing 21 Web-based medical scheduling systems were used in this literature review.
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