Launch Technology
- Justin Fansler
The technology immediately available for patients to self-schedule is called Epic Open Scheduler. It lets new and existing patients schedule appointments via a widget that is embedded on the Yale Medicine and YNHH websites.
Widget Use and Access
To implement these widgets, there are three parts:
Access to display widgets:
The widgets are restricted by website domain (meaning only traffic from a particular domain, like yalemedicine.org or dev.yalemedicine.org can display the widget).
There is a Test and a Production version of the widget. The test widget enables the YNHH team to add “dummy” data to the system for testing purposes. The production widget shows real appointment data from Epic. Access needs to be granted to both widgets.
Access is granted to the widgets by a specific Epic URL (unique to Yale Medicine) and a security key.
Appointment availability for providers:
By default, the Epic widgets will show the next available appointment for the provider, no matter how far the future date is for the appointment. YNHH data suggests that 50% of patients who self schedule appointments further than 30 days in the future will cancel or not show up for the appointment. Epic offers an API (data feed) that will return a provider’s next available appointment.
For Yale Medicine website implementation, we will first call the API to determine if the provider has appointment availability within the next 30 days. If they do, we will show the Epic widget with next available appointments. If they do not, we will show a message encouraging the user to call the Care Center for help scheduling the appointment OR click to view appointments available for other providers in the specialty. See designs.
Access to the API requires the YNHH team to add the YM web servers to an “allow list”, create a security key, and provide several other security parameters that need to be included in the API call.
Based on the API documentation from Epic, the API should only be used to call data for seven days in advance, but it has the ability to call for up to 30 days. Tests show that calling data for 30 days often takes up to three seconds to return information, which is at the limit of what users will tolerate. To accommodate this limitation, we are not planning to use the API, but will instead rely on the widget to provide the appropriate messaging for users. [Updated 9/27]
Access was fully granted by the YNHH team on September 16, 2022. API errors and false returns persisted until September 22, 2022. On September 26, 2022 the API was determined unhelpful for messaging – there are too many possibilities in the widget output that cannot be anticipated. API will not be used.
Website Implementation
The implementation approach for provider profiles changed on September 23, 2022 to accommodate newly discovered Epic limitations.
Currently there is display logic on the Yale Medicine website to provide five different ways for patients to see how to make an appointment. These five variants depend on the provider’s scheduling preferences as determined by operational constraints:
Provider is not in the Care Center or online appointments and has an independent scheduler (there are currently 206 unique appointment phone numbers on YaleMedicine.org): Edouard Aboian
Provider is in the Care Center but does not participate in online appointments: Sonya Abdel-Razeq
Provider accepts online appointments for new patients (through MyHealthDirect) and return patients: Arik Alper
Provider only accepts online appointments for returning patients. New patients must contact Care Center: https://www.yalemedicine.org/specialists/hardik_amin
Provider only accepts new patients via online appointments. Return patients must contact Care Center: Joachim Baehring
Open Scheduler Launch
When Epic Open Scheduler launches on YaleMedicine.org, we will adjust the display logic for those providers who accept online appointments for new and/or return patients to display a link to the new Epic Open Scheduler widget.
We are assuming that every provider in Epic Open Scheduling (new patients) is also in Epic Direct Scheduling (return patients) so that we can show one view into their appointment availability.
Using the API and the Widgets, we’ll update provider profile pages (Arik Alper) and the “Book an Appointment” link on department pages (Pediatric Gastroenterology & Hepatology > Yale Medicine)to show open scheduling. Designs are available here.