May 27, 2022

Getting it Right — Connecting Patients to the Right Appointment

Leveraging discrete data elements helped standardize the triage, imaging and scheduling process for orthopaedic consults

Doctor's appointment reminder

Providing easy, efficient access to care is more than scheduling an appointment. It’s about scheduling the right appointment. And finding the right appointment can be driven by multiple factors.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“When an orthopaedic consult is needed, providers are looking to connect their patient with the right provider, at the right location, on the right day, at the right time and to have the right images ordered before the appointment,” says Dominic King, DO, Director of Clinical Transformation for Cleveland Clinic’s Orthopaedic and Rheumatologic Institute.

Pathway to ease and efficiency

Every month, there are more than 9,000 orthopaedic consults placed at Cleveland Clinic. This heavy patient volume, coupled with operational complexity, can complicate access.

“Think of using OpenTable to make an online restaurant reservation,” describes Dr. King. “It’s such an easy, efficient experience — that’s the same experience we want for our patients. However, we lacked the technology needed to support that experience, especially given the complicated triage that is involved with providing access to patients with Orthopaedic injuries and musculoskeletal conditions.”

Focusing on this challenge meant exploring existing processes, gathering team input and using the Cleveland Clinic Improvement Model (CCIM) to develop solutions that could quickly connect patients to the right care.

To understand the patient’s journey, several teams evaluated each component of the process to determine its functionality and necessity. The tipping point came when the team realized that there were potentially 500 decision tree pathways involved in scheduling a consult.


Dr. King explains, “We partnered with stakeholders from across the enterprise to break down each element so we could figure out how to transform our current state and create the ideal patient access journey. Using the CCIM, we learned to look beyond a quick fix. It’s the small, iterative steps that yield sustainable outcomes.”

Just a few clicks

The team leaned on technology to streamline quick access to the right appointment. The solution: a standardized triage logic algorithm based on condition-specific discrete data elements to automate a consistent, efficient and highly reliable scheduling platform.

Dr. King adds, “We made significant progress by reducing the decision support triage elements to two core areas: primary joint of concern and primary condition. From there, Brendan M. Patterson, MD, our chair of the Department of Orthopaedic Surgery, along with department center and section directors, validated the patient workflows and developed the standardized triage logic. With the full participation of our ORI-Access Governance Team, there was unified agreement to move forward.”

Now, with order-based scheduling (OBS) enabled, a few clicks can generate a consult to Orthopaedics which results in 1) an appointment scheduling by the ordering provider during the office visit, 2) self-scheduling by the patient through the electronic health portal or 3) a patient-initiated phone call to the Access Center for expedited scheduling according to the standardize triage logic.

Bringing the same experience to the phone encounter

Even with online tools, some patients still prefer one-on-one scheduling over the phone.


Incorporating the standardized triage logic into the Access Center intake process involved several conversations with clinical and scheduling teams. As a first step, schedulers can check for OBS status. When OBS is completed, the scheduler bypasses the decision tree questions to select the right appointment for the patient.

Within a few months of launching OBS, the scheduling time on the phone has decreased by nearly 40%. With less time on these types of calls, caregivers can focus their attention on patients requiring more assistance.

For Dawn Colwell, Access Transformation Senior Director, the early results are encouraging.

“There’s a lot of promise and potential to further OBS integration,” says Colwell. “But equally exciting to the tool’s effectiveness and efficiency is the shared participation, collaboration and governance that lead to this early success. We will continue working together to look for expansion opportunities.”

Related Articles

Cloud technology
January 31, 2024
Recovery Readiness Maintains Patient Care, Safety

Cleveland Clinic’s roadmap to recovering critical digital assets stems from strategic planning and preparedness

January 9, 2024
Partnership Program Strives for Innovative, Secure Tech Solutions

The Friends of Cybersecurity program bridges innovative technology solutions with mitigating security risks

cyber security
November 24, 2023
Holistic, Multidisciplinary Approach Protects Patient Data and Privacy

Protecting patient data and privacy while preventing unnecessary risks

Infant fever
August 9, 2023
Infant Fever: Standardizing Care Connects Clinical Guidance with Digital Tools

The infant fever care path is an interactive, step-by-step tool within the electronic health record that reduces high variability among standard practices to ensure safe, quality care at all Cleveland Clinic locations

July 6, 2023
One-click Ordering Promotes Preventive Care, Eases Provider Workflow

Cleveland Clinic providers shifted to one-click ordering to simplify the workflow while increasing visibility of patient-specific recommended wellness screenings

June 6, 2023
Clinical Informatics Elective Provides Immersive Learning Experience

A physician-developed experiential learning elective illustrates the value and necessity for strong collaboration among clinicians and IT professionals

SAVES screenshot
February 14, 2023
Color Status Signals When to Intervene

Cleveland Clinic Children’s implemented an automated color-coded system to escalate timely care to prevent patient deterioration

Data transfer
January 10, 2023
Making Modern Healthcare Data Meaningful

Advancing Cleveland Clinic’s clinical systems integration by creating a secure, single database designed and built to modern healthcare standards