How can appointments be organized under conditions of high demand in outpatient and publicly funded healthcare settings in a way that gives patients greater flexibility while also easing administrative processes? This question was examined by the Center for Social & Health Innovation (CSHI) at MCI within the research project “Online Waiting Time Management”, which is part of the wider CSHI project EVIGT – Efficient Healthcare Systems and Innovative Healthcare Tyrol and thereby contributes directly to efficient, high-quality care.
Using an exploratory case comparison, the research team investigated the introduction and use of digital appointment scheduling in different healthcare settings. The main case involved an ophthalmology practice within Austria’s public health insurance system that had introduced an online appointment booking system. In addition, a hospital in the Netherlands was included as a contrasting case, allowing experiences from an outpatient practice to be compared with those from a more digitally integrated healthcare environment.
The online appointment system used in the Austrian practice is synchronized with the internal appointment management system and also includes automated SMS reminders and a cancellation option.
For the case study in the Austrian outpatient practice, 26 semi-structured interviews with patients and staff members were analysed. As one staff interview was conducted with two participants, a total of 27 individuals took part. The patients were between 13 and 82 years old, and both users and non-users of the online system were deliberately included. In addition, the research team descriptively analysed 131 standardized questionnaires.
A qualitative contrasting case study at Laurentius Hospital in Roermond, the Netherlands, broadened the analysis by adding a more digitally integrated healthcare context. The exploratory comparison made it possible to identify similarities and differences in how digital appointment scheduling is embedded within organizational processes.
The results from the Austrian outpatient practice indicate a high level of acceptance of online appointment scheduling. Of the 120 respondents who provided a valid answer, 70.8 percent had already used the online service. Participants with previous experience using the system rated both their most recent appointment booking experience and appointment scheduling in general at an average of 9.8 out of 10. Ease of use and perceived usefulness were also rated very highly, with mean scores for the surveyed items ranging from 6.68 to 6.78 on a scale from 0 to 7.
In the interviews, patients particularly emphasized the greater flexibility in terms of timing. Appointments can be searched for and booked in the evening, at weekends or during short periods of free time, and can be coordinated directly with their own calendars. For standardized requests, patients also no longer need to make repeated calls during office hours.
From the staff perspective, online booking can reduce routine telephone contacts and help structure appointment management, as bookings are automatically transferred to the shared calendar. Digital appointment scheduling can therefore provide particular relief in cases where appointment types are clearly defined and can be booked without additional clarification.
At the same time, the study shows that online booking is not suitable for every situation. Urgent, complex or unclear concerns continue to require clarification by telephone or in person. Patients with limited digital experience, insufficient technical equipment or a clear preference for personal contact also need reliable alternative access channels.
Maintaining several booking options is therefore important for ensuring accessible healthcare services. Digital solutions can complement existing channels but should not replace them entirely.
Another finding from the Austrian case study is that age alone does not adequately explain the use of digital appointment services. More important factors include previous digital experience, everyday use of smartphones or computers, confidence in one’s own abilities and the availability of support. Family members can play an important role, particularly when patients use the system for the first time.
The research team therefore recommends easily accessible support and clear communication about the online service rather than relying on general assumptions about particular age groups.
The benefits of digital appointment scheduling do not arise from the technology alone. Reliable synchronization with the internal calendar, clearly defined appointment types that can be booked online and an understandable presentation of appointment availability are equally important. The project also recommends regularly reviewing how appointment capacity is distributed across online, telephone and in-person booking channels.
Reminder and cancellation functions may additionally help improve the use of available appointments. Their actual effects on missed appointments and the reallocation of cancelled slots should, however, be systematically assessed in future research.
The comparison with Laurentius Hospital in Roermond illustrates how strongly digital appointment scheduling depends on the organizational and clinical processes of the respective healthcare setting. In the hospital context, digital scheduling is more closely linked to the patient portal, referral processes, triage and department-specific workflows than in an outpatient practice.
The Dutch case should not be understood as a model that can be transferred directly to other settings. Rather, the exploratory comparison highlights that the requirements for digital appointment management increase with the complexity of the healthcare environment. The more closely different stages of care, professional groups and information systems are interconnected, the more important the organizational coordination between digital booking systems and the underlying care processes becomes.
The results of the exploratory case comparison indicate that digital appointment scheduling can be a useful addition to existing booking channels. In the Austrian outpatient practice examined, it made available appointments easier to access, increased flexibility for patients and helped reduce administrative routine tasks.
At the same time, the findings show that digital appointment management must always be embedded in the specific healthcare context. It does not create additional medical capacity. Sustainable implementation therefore depends on effective organizational integration, clear information, well-defined booking processes and the continued availability of alternative access channels.
The project received financial support from the Austrian Health Insurance Fund (ÖGK) and the Austrian Research Promotion Agency (FFG).
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Research for the Public Interest
Center for Social & Health Innovation
Managing the Public Interest
Social, Health & Public Management | Bachelor
International Health & Social Management | Master
European Health Economics & Management | Master
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