Cancellations and missed appointments on the calander


(venkat) #1

We want to get the communities feedback on - in our practice we add cancellations and missed appointments as another provider so that they show up as another column on the calendar and we can move canceled and missed appointments to these columns. This presented a problem in sending patient appointment reminders by email and text messaging. I want to see if any one have any ideas as to how to handle missed and canceled appointments? May be a configurable feature of oemr.


(Brady Miller) #2

Hi @vambati ,

This would be a very useful feature to support. Rather than make a new column, would be nice to support it for each provider on their column, sort of like how double booking would look (but visually obvious that it was a cancelled visit).

-brady


(Teresa) #3

This would take some coding but how about add a “Hide” option to the Appointment Status list. Then, on the calendar, have a toggle of some sort to switch between active view (active appointments, checked in, etc) and inactive (Hide) view (cancelled, rescheduled, missed, etc.). This is how our current EMR we are switching from works.


(venkat) #4

I like this idea. I can code this and submit it for review. @brady do you and community think this is the way to go?

Regards

Venkat


(Brady Miller) #5

@vambati ,
Sounds like a good place to start.
thanks,
-brady


(Satyajit Deshmukh) #6

@vambati

you can set status of appointment as no show so that it will not show on calendar


(Teresa) #7

Changing to “No Show” is not the answer. I can’t track how many patients were No Shows vs. Cancellations vs. Reschedules etc if they all say No Show. Also, I need to be able to see the Cancellations, No Shows etc on the calendar at times; just not all the time.


(D Amy Martin) #8

This would really be a fantastic feature. In our clinic, if a person cancels an appointment greater than 48 hours in advance and reschedules to a different time or date, we delete the appointment. However, our clinic has a 48-hour cancellation policy. We need to be able to track late cancellations under 48 hours and no shows and want them displayed on the calendar because we also include how many missed appointments they’ve had in the comment section. It would also be a good idea to allow the provider to have the ability to customize available appointment times. We see 4, 5, or 6 patients per hour depending on the type of visit. When the office staff tries to find an available appointment, the calendar find available status shows no available appointments because regular cancelled or late cancelled appointments still take up the calendar time slot. The way it is set now, we can only schedule 4 appointments per hour using the find available. We might have one new patient, one moderate complexity follow up, and 2 low complexity medication refill follow ups. But, we also could have 5-6 low complexity medication refill follow ups in an hour. It is very time-consuming to switch day today to manually add an appointment to fit our needs. I feel like an easy way around this would be to allow a single provider to have the ability to have 2 in office event columns for the calendar. It will basically be customizable for a follow-up column and a new patient column.

Another note: We really have to keep track of cancelled / no show appointments for our psychiatry clinic, as some of our patients might miss an appointment because they have been hospitalized inpatient psychiatryand we need to be able to keep track of their missed appointments for continuity of care to help stabilize them post-discharge.

Thanks,
Amy


(Ralf Lukner MD PhD) #9

Is there a way to see what appointments a patient has canceled from the patient’s chart? It’s on the flowboard, and I suppose I could search for canceled appointments there. This is an important factor in patient compliance (if they are constantly cancelling appointments it creates issues in terms of scheduling and adequacy of patient preventative care).


(Stephen Waite) #10

hi @Ralf_Lukner, have you tried enabling past appointments in admin->globals->calendar-> Past Appointment Display Widget? Set the # to 5 or 7 or however many you decide as reasonable. From the patient summary screen you’d be able to see the status of those appts.


(Ralf Lukner MD PhD) #11

Awesome!! I love the past appointments widget! Thank you.


(Brady Miller) #12

hi,
Another thing to look into is the flow board report, which report some cool things:
Reports->Visits->Patient Flow Board
-brady


(Ralf Lukner MD PhD) #13

Very cool indeed! Thank you.


(MD Support) #14

It is important to track appointment changes to tag patients who have a history of frequent changes/cancellations or no-show. As a rule we ask staff to delete only when appointment is set up in error or as a placeholder. At the same time, standard logic of showing cancelled appointments in calendar view makes it harder for front office to visually look for open slots.

For those inclined to maintain non-standard changes, here are couple of blocks that hide cancelled appointments in daily view (ajax_template.html) around line 450(selection) and line 540(display) :

        $events_in_timeslot = array();
        foreach ($events as $eKey => $e1) {
            // ignore IN or Cancelled (x or %) events
            if (($e1['catid'] == 2) || (($e1['apptstatus'] == 'x') || ($e1['apptstatus'] == '%'))) {
                continue;
            }
			// skip events without an ID (why they are in the loop, I have no idea)
            if ($e1['eid'] == "") { continue; }


    // now loop over the events for the day and output their DIVs
    foreach ($events as $event) {
        // ignore IN or Cancelled (x or %) events
        if (($event['catid'] == 2) || (($event['apptstatus'] == 'x') || ($event['apptstatus'] == '%'))) {
            continue;
        }
        // skip events for other providers
        // yeah, we've got that sort of overhead here... it ain't perfect
        if ($providerid != $event['aid'] && $event['aid']!=0) { continue; }