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Hi guys, it's been almost two years since I switched my mom's practice to AC and the other IMP standbys (AppointmentQuest, some other things). AppointmentQuest wasn't really cutting it, though, so I decided to write a web application called AppointmentPlease , which she's been using instead.

I decided to package it for use by other practices as well, so I was wondering if anyone would be willing to give it a try and provide feedback as to what would make it a better fit for your practice, or if anything is confusing/unnecessarily complicated.

I talked a bit with Jon about building an interface with AmazingCharts as well, so that the two could stay synchronized, so that when someone scheduled online, it would appear in your AC schedule. Hopefully we'll be able to get this done before too long.

Anyway, feedback would be great, and for AC users, I'll give an extra two months free (for a total of three months) so you can see if you like it. Just email me and I'll extend the free trial period.

Any thoughts, anyone?

Also, I'm considering adding automated phone call reminders, though this would rely on another service that charges ~5-10 cents per call, which if you do the math, could add up to quite a bit if it called everyone. Would this be an interesting addition to anyone?

I like your program, but I don't like that it has a subscription based pricing model. If AC's appointment scheduler was not working for us we might have tried it, but AC's works fine for us and it is nice to have everything in one place.

Hi Paul, thanks for the feedback! What type of pricing model would you prefer? Would it be better if it were annual, like Amazing Charts?

True, if you're happy with AC's scheduling, there's not a huge impetus to subscribe to another service :-)

The big thing this gets you over AC's scheduler is that customers can browse available times at their leisure and schedule/reschedule their own appointments without having to call - we've found that the patients like that a lot.

I know our patients would appreciate something like that, but to be able to host/edit the schedule ourselves at a one time fee for purchase would be the option I would prefer, with updates and support costing more (perhaps in addition to your current pricing). I think that when I buy software, it should be a one-time deal, unless support or updates are needed. When I play a video game or use Windows I would never expect to continue paying over and over every month or year.

Yep, I definitely understand the desire to own the software, but this way comes with too many advantages, and I think it's structured in a way that makes the total cost of ownership pretty close ($300 one time and $100/year for an update vs. $12/month). Also, since the price isn't upfront, it's lower risk for people who want to try it.

One of the biggest advantages is that performance can be monitored centrally, updates can be rolled out bit by bit across everyone, all at once, and bugs can be fixed same-day if they crop up.

Also, it simplifies adoption significantly because there's no installation, and hosting and backups can be managed, which most doctors aren't too well equipped to handle (though I imagine that AC users are well above average in this regard).

Perhaps it could be higher and then drop to a lower price after the first year? That way you would pay a normal "purchase price" over the first year, and then following years it would be cheaper.

Also, I would like to make it very easy to export all data (and print out all schedules, if you wanted to go to a paper-based schedule).

Would these alleviate your concerns a bit?

I agree that this way seems to work well for many. What happens when small towns with 1 ISP lose internet connectivity? What happens when your servers are down temporarily because something happened that you did not foresee? Like when Google Docs had downtime that ended up costing cities using their documents quite a bit of money. I trust my network, not other networks, for mission-critical applications. Over the course of 2 years our costs at your current rate would be $1,416.00 for our 5 doctors to use your scheduler. I could pay someone around $1,000.00 to make a program that is very similar and sell it online as well, make my investment back and have the software for free. I could probably even do the work myself if I had the time. Your program is great, but I would say that over the course of time the pricing arrangement benefits you much more than it benefits the end-user, which is something that your eventual competitors will live on. Think Walmart.

Good point with the potential reliability issue, especially if your town has an unreliable ISP and there isn't a secondary ISP available to sign up for for redundancy. This is one of the reasons I'm looking into making it so that the internet service synchs with a local one like AC, so that if your internet goes down, you still have a copy of your schedule. AppointmentPlease also emails you a copy of the next day's schedule every night at midnight, and makes it easy to make nice printed schedules. Any other ideas in this regard would be welcome.

Do you have any suggestions for the pricing that would make it more palatable? What about my prior suggestion of having significant discounts in the second year and onward?

Heh, I think you may be underestimating the amount of effort it would take to make an equivalent system, if you think it would cost you $1000 :-) I probably gave the impression that this was a project that I made just for my mom in two weeks, tweaked it a bit to allow others to use it also, and then opened it up, but in reality, quite a bit more has gone into this than 2 weeks (I'm also a professional software engineer, my mom's practice's need was just a great excuse to make a competitor to AppointmentQuest that wasn't so awful to use).

Also, are you accounting for the value of the time it takes to manage the web server, mail server, etc? I'm sure one would spend much more than 40 hours over the course of those two years managing a custom solution, especially if you outsourced the development and were unfamiliar with the code.

Anyway, thanks for the interesting things to think about :-)

I was not accounting for anything other than initial programming for the application. I have not yet tried your system, but I am in the early stages of learning C# and Python and think that building something similar would be a fun task for me when I get some time. I really hope you do well, and don't wish you to be offended by my posts, in case you were. I have never agreed with Cloud computing, Software as a Service, and many other things.

As far as more palatable pricing, I don't think that I would want to give suggestions as they would low-ball you and seem unfair I am sure. Think of this, though. How much do you think Call of Duty: Modern Warfare 2 costs to produce? How much do they charge for the game? Do you have to pay every month if you want to continue playing it? I currently pay ~$50 a year for my Xbox Live Gold membership. That comes out to a pretty cheap price considering the immense effort that goes into regulating cheaters, banning modders, adding new features all the time (which are free with the subscription), the quality of service, the customer support, etc.

I am not saying that you are overcharging for your work. I am saying that unless your program were a sub-$xxx.xx (edited out) one time purchase (after a 30 day free trial) our office would never consider it even though I think it trumps AC's scheduler and the features like giving the patients the ability to self-schedule are amazing.

No offense taken, I enjoy debating :-) (and this is great for figuring out what potential users concerns are)

My thinking was that it comes down to... do you think it would save your practice more money than it would cost, and is it cost effective compared to the competitors? I don't think it can be easily compared to a mass-market consumer product, especially not one that works on the movie blockbuster model.

It would be a good project to chew on, though proper Time handling can be very annoying (DST, time zones, etc). Some languages handle it pretty well, others (Java) don't handle it nicely at all natively (though there's an excellent library called Joda time that you can use instead). Not sure how Python and C# deal.

My two cents, Python is a pleasure to work in, though if you're going to be making desktop business software, C# and the .NET environment might be more useful. If you want to try your hand at web apps, Django (a python framework) is great.

Anyway, if you'd like to focus on something else which you REALLY need done and there's no good alternative for, AP can take care of the scheduling for you :-)

Thanks for the good discussion.

Thank you for the discussion as well

It is nice to be able to discuss things directly with software developers at times so that they can see what direction other people might prefer. Of course, the decision is up to you.

As for us, I think that our staff is doing great with AC's scheduler. Other practices may be able to use your product and greatly increase productivity or allow for people such as SoloMio to benefit from patient self-scheduling.

Good luck in the endeavor!

I like the scheduler in AC. It might be COOL to use an online scheduler, but I think it is of limited value for my practice. Only a small percentage of my parents have frequent internet access.

I can see where an online scheduling option would be great for some practices but it would need to sync with AC, or they would need to use it exclusively, definately less optimal.

The cost factor will be crucial. Most AC users are very price concious.

Thanks for weighing in!

Well, it is cool ... but the main point is it saves you phone calls, reminds your patients to reduce noshows, and lets them browse availabilities at their leisure to find the best time for them. Its usefulness depends on your patient population, though - if one's patients hate using the computer, it's unlikely that this will be very useful compared to ACs scheduler in its current state. However, text message and potentially phone call reminders are on the way, so it might still be useful, even without self-scheduling.

My mom's practice actually uses it to the exclusion of AC's scheduler without ill effects. Otherwise, yeah, synching is a necessity so that double booking doesn't occur. It's designed to be very responsive, though (especially the patient search, which happens in real-time as you type), so it's usable as a substitute.

How do you feel about the pricing? (12/mo for a solo, 29/mo for 3, 59/mo for 8). Do you think it's fair?

You do have to make money but 144 a year is about 1/4 the cost of AC guardian assistance.

Interesting way of putting it. Do you feel that's too much compared to guardian assistance?

I should note that AppointmentPlease gets small upgrades for all users about once per week - that is included in the price. Support, hosting, etc are also rolled into that, so I suppose it's comparable to the guardian service, in a way. The difference is that there's no up-front cost for the software, so that's included as part of the monthly price as well.

A lot would depend on the need for the service. If you have a micropractice with no secretary, it may be more useful.

Before signing up for ongoing costs, one needs to look at the usability.

Although scheduling is an essential function, it is small compared to the overall AC program, so as an isolated item, I would say the cost is too much. But then again, I also do not have much need for it in my practice as well.

Eh, I think it's probably at least 1/4 as useful for us, but your mileage may vary depending on your practice. Just the decreased call volume has been enough to make online scheduling worth it for us (and we were paying AppointmentQuest $21/month for one doc).

I think the price is okay for an office who wants online scheduling - I think that for most offices you need to be able to synchronize with the AC database. The AC scheduler is useful in the office as well as for reconciling pts seen vs superbills, etc. I think the auto e-mails would be great for those pt. who want them - work on getting Jon to let you interface it and that should make it even more marketable.

I think you're right, Steven. I've been hearing from a few people that they are interested in trying it, but that would want it to interface with Amazing Charts. I'll try to get something worked out with AC. Thanks for the feedback!

I have to agree with Paul & Wendall. The monthly costs of online scheduling, ePrescribing, appt reminders, etc. all add up. If the scheduler of AC is working well, I don't see any reason to add your service.

I haven't seen it myself, but I imagine it has a great look and feel. Probably very simple to use. The issue for most of us, however, is differentiating needs vs. wants.

Yeah, the costs can add up. I think the question is whether the amount you make adds up faster because of it. I don't always ask myself that when evaluating a service, though, as I tend to be pretty price conscious. But rationally, I think that's the thought process one should follow, it's like the old saying "penny-wise and pound-foolish".

Basically, if the reminders part makes it so that there is 1 fewer no-show per month, it much more than pays for itself. It's not intended to be just a convenience for you, but to help you make more money while providing better service for your patients.

Does that seem valid?

(Edit: heh, it's also not the prettiest app - I'm a much better programmer than I am a visual designer. I do like to think it's pretty easy to use, though.)

Also, if one's patients are decently computer savvy, it replaces one of the big functions of the front desk. Combined with AmazingCharts, electronic billing, and so forth, you don't necessarily need a front desk or a person at the front desk.

Needless to say, not needing a support staff can save a huge amount of money.

There is no way on this green earth I would ever leave scheduling an appointment to a patient. They don't know the guidelines and restrictions that an office puts in place on how appointments are scheduled, what can be back to back, what can be done same day and what needs to be put out a few weeks. I'll pay the overhead to make sure things are done the way they should be. To do that changes your clinic from having customer service to self service.

Hi Carolie,

Yeah, you're right, that is one of the big challenges of scheduling.

AppointmentPlease can enforce simple scheduling rules for you automatically - it doesn't give patients free reign on your scheduling book unless you want it to. By default, until you set up "public schedules" for the doctors dictating when patients can schedule for specific types of service, patients can't schedule anything. You basically set up the program by white-listing the times that patients are allowed to schedule in for each service. Also, for each public schedule, you can dictate how far out from today they must schedule, how far out they're allowed to schedule, how much notice they have to give to cancel, and so on.

As an example, we have it set up to schedule shots in the morning, checkups in the morning, and sick patients in the afternoon to keep them segregated. We then have some catch-all times at a couple times for those that can't fit in at those times, and we have some slots that open up just the night before and same day for emergencies.

If someone schedules something they shouldn't, it's pretty easy to see why they scheduled, and you can reschedule them fairly quickly. This ends up being the rare exception rather than the rule, however, at least for us.

And really, most of our patients prefer self-service to customer service. I think it's because they don't have to call during business hours and that they can take more than a minute choosing a time. Maybe some other reasons I don't know. But it's worked very well for us.

hello
I;ve used AppointmentQuest (AQ) for 6 months - i had excessive call volumes when I started and - it was important to avoid placing anyone onhold. Rather than hiring 2-3 receptionists - i outsourced to a virtual office. I started with free yahoo calender (i was desperate) then changed to AQ. Call volume more reasonable now.

AQ is clunky and I dont like what I have to pay. The cloud option has speed and security drawbacks. More importantly, I feel I am underutilizing AC ( I am sure there are benefits to using its scheduling features). Can anyone name a few?

I think self scheduling will be the norm in a few yrs ... a large portion of my pts shop, bank and make travel arrangements online - the majority of front office transactions do not require human interface - remember the naysayers re ATMs and those who asked why on earth would anyone choose to check out their own groceries?. Whether we like it or not, a good portion of our encounter with pts is retail - customer service based. If done properly, self scheduling could increases access while decreasing expenses. I would like to ultimately offer 24/7 self scheduling - seamlessly via my website.

Perhaps AP has a role here. I would like my staff to do more scheduling, I would like to use the AC scheduler if there is value in doing so. I have not found a good solution yet. Lots to think about.

re price? - trying your product is a risk - this needs to be addressed. I'm not being cheap but realistic - your job is to sell - mine is to run a business. Scheduling is key ... you could not reimburse me what it costs in frustration and downtime if your program proved buggy and I had to retrain and recover. I am taking on risk - you might follow ACs lead and offer the product for demo for 3 months - pay if you like it. How much? I have to think about that.

Never underestimate the lack of knowledge (or just plain stupidity) of patients who claim "I'm really smart! I am computer savvy!" Their next statement: "You should walk me through step by step to schedule the appointment."

Eric, I'd like to try and find time to try out your program. Now, I currently use AppointmentQuest and have have alot of success with it, but no program is perfect. Also, Gino has a big point about reliability in the program. We wouldn't be able to afford bugs and downtime so you have to prove to me that I can depend on you. I dont mind the ASP model as long as the monthly cost isnt too much. I like the fact that, if I have a pc problem or internet problem, appointments can still be scheduled. but i do have a problem right now with time to try out a new program. I missed the pricing. I'll look again.

What is asp?

I believe he is referring to the monthly payment model, instead of the one time purchase model traditionally used by software companies.

application service provider (ASP) is a business that provides computer-based services to customers over a network.

Essentially a web-based program.. instead of a local program installed on pc.

I don't know if you are familiar but, Office Ally's Practice Mate/Reminder Mate are asp models.

Hi guys, sorry, I haven't checked back here for replies in a while.

Gino -
Yeah, a lot of patients like the ability to schedule any time of the day or night, and see availabilities all at once. If you need more time than the one month free trial to decide if you want to keep using it, just send me an email and I'll extend it (tophatmonkey@gmail.com). The clunkiness of AppointmentQuest is what inspired this.

Wayne -
Great! You can sign up on the website if you like. I live in NYC as well, and I'd potentially be interested in seeing customers learn to use it to see if there's anything really confusing. If you're located near a subway stop, I'd be happy to come in after hours one day and help you/your staff try it out.

My mother's practice depends on this for their scheduling, so I have skin in the game, and I intend to keep it working well. If there are any errors, I'm usually notified automatically, and if you email me with issues/questions, I'm very responsive.

Eric, let me get the latest V5 beta on my machines and I'll try and play w/ your scheduler. If nothing else, I can offer suggestions on features that might be attractive. If you like, I can provide you with the fake patient id so that you can see exactly how we use AQ.

Sure, send me an email at tophatmonkey@gmail.com.

Any news on an AC interface?

It has one. Import Schedule (AppoinmentQuest).