My previous post explores how requesting a medical appointment online begins a patient's digital journey. A hospital's appointment request form might be a new patient's first interaction with a healthcare institution. As such, it is one of the most public-facing forms for a healthcare institution, establishing the baseline for the quality of other external and even internal facing forms. The user experience of the appointment request form sets the tone for the entire patient experience.
A patient's successful user experience when finding, filling out, and submitting an appointment request form is determined by the visual, information, and interactive design of the website and form itself.
Visual design matters
Visual design identifies a healthcare institution’s brand and aesthetic. The quality of care at a healthcare institution is reflected on their website. The website's visual design should be clean, efficient, and caring. Since an appointment request form results in a call back from a live person, including a photograph of a nurse or clinician on the form or landing page can visually reinforce this expectation and experience.
Information design matters
Information design ensures that the patient understands how to navigate the form and makes it clear what information is required and what information is optional. Appointment request forms act as an ambassador of sorts, beginning an interaction between a patient and healthcare clinicians. The form's information design and corresponding editorial sets the tone of a patient's interaction with a healthcare institution.
Interactive design matters
Interactive design improves the flow and process for filling out a form. As someone fills out an appointment request form, conditional logic may hide or show different individual or groups of inputs. When a user clicks submit, how a form validates submitted data can increase or decrease a user's frustration.
Keeping the visual, information, and interactive design in mind, let's look at how the top US hospitals approach their request an appointment.
The U.S. News' Best Hospitals rankings is primarily based on the overall quality of a hospital's care, treatments, and outcomes. The U.S. News' patient experience ratings never directly ask questions about a patient's digital experience. However, the fact that the number 1 ranked hospital, the Mayo Clinical, has a 'Request Appointment' link on the U.S. News' Best Hospitals landing page reinforces the importance of this form.
We are going to look at how the top four hospitals allow patients to request an appointment on their individual websites. We will examine the positives and negatives to each hospital's appointment request form. The goal is to extrapolate some recommendations and best practices which can be used to build an appointment request form template for the Webform module for Drupal 8.
It’s essential for us to see how users navigate to the appointment form from a hospital's homepage. We will examine how many inputs, questions, steps, and conditions are included on a form, and then determining the level of effort needed to complete a form. Finally, we want to assess the overall user experience, which encompasses the visual, information, and interactive design of the form.
On the Mayo Clinic's home page, the appointments link is the first and largest element on the page. It takes three clicks from the home page to navigate to their appointment request form. The appointment request form contains 20-30 inputs depending on who is completing the form. Inputs are grouped by contact, insurance, and medical information. Most inputs are required.
On top of the U.S. News' direct link to the Mayo Clinic's appointment form as well as the prominent appointment link on the Mayo Clinic's homepage, Mayo Clinic's appointment landing page does a great job of providing all the relevant contact information needed to make an appointment by phone. This ensures even if a patient can't complete the form, they can call the hospital. This contact information, with links to dedicated international and referring physician form, are then included as a sidebar on Mayo's appointment request form.
The goal of this blog post's exploration is to identify best practices and recommendations, which helps to establish a baseline for a good appointment request form. Once there is a baseline, it also helps to experiment to improve a form's user experience
Typically, required inputs are marked with red asterisks. Since most inputs are required and there are only a very few optional inputs on the form, Mayo's team inverts the normal, more common, approach of noting required inputs. Instead, they include the message, "All fields are required unless marked optional" with a right aligned "(optional)" label next to optional inputs. This approach appears to be successful. The more important lesson is to be cognizant of a form's required and optional inputs.
The form groups related inputs into visually defined and well-labeled sections. The form also uses a vertical layout with left-aligned labels. Left-aligned labels are more difficult for users to comprehend the relationship between inputs and labels. Alternatively, the form's mobile layout uses the recommend top-aligned labels approach, and it is easier to fill-out. Mayo Clinic should experiment with using top-aligned labels for the desktop form and see if it increases the forms completion rates.
Mayo Clinic values and promotes their appointment request form. The Mayo's Clinic digital team has put a considerable amount of thought, care, and consideration into their appointment request form's user experience. They should continue to experiment, test, and improve this form.
The Cleveland Clinic's homepage also includes a prominent link to appointments. It takes three clicks from the home page to navigate to the appointment request form. Their appointment request form is a multistep form with five pages and contains between 50-90 inputs. Most inputs are required. The form collects information about patients, caregivers, referring physicians, and comprehensive medical history. Entering this much information takes a considerable amount of time to complete.
Cleveland Clinic's forms is a beautifully designed and logically arranged multi-step form. Multi-step forms makes it easier to collect a lot of information. It is important to ask, "Does an appointment request form need to collect a lot of information?"
When it comes to digital experiences, people have less patience. How long it takes to complete a task matters. Does a new patient need to supply their marital status or subscribe to a mailing list to book their first appointment? Wouldn’t it be more appropriate to collect a patient's medical history after the appointment is booked?
Relating to how long it takes to fill out an appointment request form, it is important to ask the value and purpose of each question. Cleveland Clinic's form asks, "Has the patient been seen at Cleveland Clinical in the past?" if answered "Yes", the form then proceeds to ask for a Medical Record Number (MRN). It makes complete sense to collect an existing patient's MRN, which can be used to look up a patient's medical history. However, once the patient provides an MRN, does the form still need to obtain a comprehensive medical history?
Asking for too much information increases the likelihood that a patient or caregiver might not be able to complete a form or result in them being frustrated with the process of completing the form. Let’s not forget the appointment request form facilitates a phone call that ultimately results in an appointment. Cleveland Clinic's form should also include the phone number on every page to ensure if someone is frustrated they can pick up the phone and still book an appointment.
Cleveland Clinic's form is an overwhelming user experience. At the very least, users should be given the option to complete a more straightforward appointment request form, but also provided a secondary option to provide a full medical history
Before even building any form, it helps to summarize the goal of the form with the scope of the information being collected. This summary can also become the form's introduction text. For public-facing forms, each input should be scrutinized to determine if the information is required to complete the immediate task at hand.
Johns Hopkins Hospital
The Johns Hopkins Hospital homepage includes a small icon with a label linking to their appointments landing page. It takes four clicks from the home page to navigate to the appointment request form. Their form contains 20-25 inputs with five optional inputs. The form has one conditional question asking, "Who are you seeking care for?"
By and large, the Johns Hopkins Hospital's appointment request form is the simplest form that we are going to review. There is no input grouping and it has a straightforward two column layout. This, despite the fact that grouping related inputs using top-alignment and a one column layout, is generally recommended. The simplicity of this form makes it easy for users to understand how much information is required to fill out the form. Having all the required inputs displayed before any optional inputs also makes it easier for a user to fill in the form quickly. The two column layout does make the form more difficult to fill out. When the browser is resized to a mobile layout, the form is easier and faster to fill out. Making a form easy for everyone to fill out, including users with disabilities, is essential.
The Johns Hopkins Hospital's appointment request form is not accessible to users who depend on screen readers. The form's inputs are missing the necessary code, which allows screen readers to accurately describe to an end-user the labels for each input. Instead of a screen reader saying something like, "Input first name required" the screen reader just states, "Input required" for all the form's inputs.
The inaccessibility of the Johns Hopkins Hospital's appointment request form is a significant problem. An inaccessible appointment request form is the equivalent to not having a wheelchair ramp to enter a building. Fortunately, this issue is not hard to fix. The John Hopkins Hospital digital team needs to become more aware of and monitor the accessibility of their forms.
Nowhere on the Johns Hopkins Hospital's appointment request form does it indicate the patient or caregiver will receive a callback within a defined period of time. The Johns Hopkins Hospital's appointments landing does include this information. This information should be repeated at the top of the form just in case the user has not been to the appointments landing page. Users need to know what to expect when the click submit on a form. In the specific case of an appointment request form, users need to know when (i.e. how many days) and how they will be contacted (i.e., phone or email).
The Massachusetts General's homepage also includes two links to appointments. It takes three clicks from the home page to navigate to the appointment request form. The appointment request form contains 20-25 inputs in three groupings with only two optional inputs. Yes/no conditional logic is used to ask for more information about the patient and referring physician
Massachusetts General's appointment request form asks questions using a tone that guides the user through the process of completing the form. For example, every hospital wants to know if a patient has insurance. Instead of displaying a large dropdown menu labeled "Insurance", Massachusetts General's form states, "To facilitate processing, please provide insurance plan name if known." Using this type of phrasing explains to a user why this information is needed, while also stating it is optional. This is an excellent example of the relationship of asking the right question with collecting the best answer.
Many patients decide which hospital to be treated based on physician referrals. When intaking new patients, hospitals may need to contact a referring physician to get a patient's medical history. Most appointment request forms ask for the referring physician's contact information as individual inputs. Massachusetts General's appointment request form just asks for the "Name of referring provider, facility name, address and phone if known." This approach is a brilliant and deliberate decision. First off, it makes it very easy for a patient to enter what information they have about their physician ensuring that at least some information is collected. Appointment requests are always reviewed by an actual person who can take the plain text physician information, fix a misspelling, look up the referring physician's NPI (National Provider Identifier), and get all the needed information into a new patient's medical record.
Massachusetts General appointment request form is asking some very well thought out questions, which are being supported by the right process.
Massachusetts General has an exemplary appointment request form. There are no immediate issues that need to be addressed by their form. Ironically, Massachusetts General's international appointment request form does have some design and user experience issues. Without getting into specifics, most of the problems on international appointment request form would be resolved if this form followed the best practices and care established by the domestic appointment request form. Providing a consistent user experience across an institution's webforms can ensure a better patient experience.
An appointment request form is a small but key piece to the complex puzzle of a patient’s experience and journey. Soon, someone is going to disrupt, change, and simplify this puzzle. For example, people will be able to schedule an appointment using voice-controlled systems. When we look at the user experience of these relatively simple appointment request forms, there is still some work to be done now and moving forward.
We have extensively explored four hospitals appointment request forms. In my next blog post, I am going to make some concrete recommendations and strategies for building an exemplary appointment request form.
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