Abstract:
The present invention comprises a system and method for dynamically scheduling patient medical facility appointments. The present invention is capable of contacting patients to ensure that each patient will be present for the appointment and is capable of dynamically adjusting the schedule in the event the patient plans to be late or plans to cancel the appointment. The present invention is also capable of contacting patients to reschedule appointments in the event that their medical service provider unexpectedly becomes unavailable. The system&#39;s scheduling method has the effect of increasing medical facility efficiency and standardizing medical facility wait time for the patients and thereby increasing profitability and increasing patient convenience.

Description:
FIELD OF THE INVENTION 
       [0001]    The present invention relates generally to patient appointment scheduling software and specifically to patient appointment scheduling software that dynamically alters the patient schedule based on medical service provider availability, patient availability, and patient priority. 
       BACKGROUND OF THE INVENTION 
       [0002]    Most medical facilities currently use a variant of a scheduling system that has been available for many years. Before the prevalence of computer software, the medical facility would divide the day into a series of time slots. The number of these available time slots was limited based on the number of medical service providers working at the medical facility and the number of hours each medical service provider was willing to work. Under this system, every patient wishing to receive care is placed in a time slot. For reasons of profitability, the medical facility tends to schedule as many patients into each day as possible. Since the limiting factor in the profitability of a medical facility is the medical service provider&#39;s time, the assumption has always been that patients should wait on medical service providers, but a medical service provider should never wait on a patient. 
         [0003]    This mode of thinking encourages the medical facility to load the schedule as heavily as possible. One problem with this method is that patients occasionally need care quickly and can&#39;t wait for their turn in the schedule. These patients must be forced into the schedule into any open slots or more slots must be created for them. This forces medical facility personnel to work longer hours to see these patients. This problem is further exacerbated when a medical service provider is called away because of an emergency. When this happens, the medical facility gets behind schedule and continues falling behind until the medical service provider is available. All patients that were scheduled must then be taken in order, which causes long waits for both the patients that were scheduled during the emergency and patients who were scheduled later in the day. Additionally, each patient requires a variable amount of time with the medical service provider. Therefore, the allocated time slot is only an approximation and appointments that run long further force the medical facility off of schedule. 
         [0004]    Due to the advent of software, approximately 32% of medical facilities have gone from the old paper schedule to a computerized software schedule. However, the old method of placing patients into static time slots is still almost universally employed. Some companies have attempted to leverage the possibilities granted by software to increase productivity. They use various methods to allow patients to schedule appointments online to reduce the need for personnel to accept patient calls. Other software applications allow patients to submit their personal schedules and compare those schedules to medical facility schedules in an attempt to determine the optimal time slot for the patient. Other systems even contact the patients immediately prior to their time slots to allow them to check into the system remotely. However, all of these systems use the old time slot method. That means that they each place the medical facility off of schedule and require long patient wait times when medical service providers suddenly become unavailable, when unscheduled patients come in, and when appointments last longer than a normal appointment. In addition to these inefficiencies, these systems are not designed to adjust the schedule to compensate for patient cancellations. 
         [0005]    Therefore, what is needed is a system for dynamically scheduling medical facility appointments. The system for dynamically scheduling medical facility appointments should keep a queue of patients wanting appointments for a particular day and contact them only if a medical service provider is available to prevent long in-facility wait times. This system should also adjust based on canceled appointments and patients who fail to appear for appointments by contacting other patients in the queue. This system should also place non scheduled patients in the queue so that they can be worked into the schedule fairly and in a way that minimizes the need to burden the staff by extra long hours. This system should also be capable of altering patient appointment priority and be capable of referring and scheduling patient appointments for other networked providers. Furthermore, other desirable features and characteristics of the present invention will become apparent when this background of the invention is read in conjunction with the subsequent detailed description of the invention, appended claims, and the accompanying drawings. 
       SUMMARY OF THE INVENTION 
       [0006]    The present invention advantageously fills the aforementioned deficiencies by providing a system for dynamically scheduling medical facility appointments. The system keeps a queue of patients, contacts them to come into the facility immediately prior to their appointment and only if the medical facility is prepared to receive them, contacts other patients if a patient does not respond to a contact attempt, places nonscheduled patients in queue with scheduled patients, and fairly distributes patients throughout the day to prevent long wait times for either the medical service provider or the patient. 
         [0007]    The present invention now will be described more fully hereinafter with reference to the accompanying drawings, which are intended to be read in conjunction with both this summary, the detailed description, and any preferred and/or particular embodiments specifically discussed. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided by way of illustration only and so that this disclosure will be thorough, complete and will fully convey the full scope of the invention to those skilled in the art. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0008]    The drawings contained herein exemplify one of the embodiments of the claimed invention. The invention is not limited to the embodiment shown. The embodiment shown is purely an example, and the invention is capable of many variations of said embodiment. In the drawings, 
           [0009]      FIG. 1  is a block diagram of hardware components and a software process used in an embodiment of the present invention; 
           [0010]      FIG. 2  is a block diagram of hardware components used in an embodiment of the present invention; 
           [0011]      FIG. 3  is a block diagram showing a data transfer used in an embodiment of the present invention; 
           [0012]      FIG. 4  is a block diagram showing the information stored in the data structures used in an embodiment of the present invention; 
           [0013]      FIG. 5  is a flow chart showing a method of initiating an appointment request in an embodiment of the present invention; 
           [0014]      FIG. 6  is a flow chart showing a method of scheduling patient appointments in an embodiment of the present invention; 
           [0015]      FIG. 7  is a flow chart showing a method of scheduling patient appointments when patients are unresponsive to contact attempts in an embodiment of the present invention; 
           [0016]      FIG. 8  is a flow chart showing a method of tracking patient movement during the course of an appointment and collecting data related to appointment duration for later use in an embodiment of the present invention; 
           [0017]      FIG. 9  is a flow chart showing a method of scheduling dependant appointments in an embodiment of the present invention; 
           [0018]      FIG. 10  is a flow chart showing a method of dynamically rescheduling patient appointments when a medical service provider becomes unavailable in an embodiment of the present invention; and 
           [0019]      FIG. 11  is a flow chart showing a method of referring patients between medical service providers in an embodiment of the present invention. 
       
    
    
       [0020]    The first digit of each reference numeral in the above figures indicates the figure in which an element or feature is most prominently shown. The second digit indicates related elements or features, and a final letter (when used) indicates a sub-portion of an element or feature. 
       DETAILED DESCRIPTION OF THE INVENTION 
       [0021]      FIG. 1  is a block diagram of hardware components and a software process used in an embodiment of the present invention. The present invention comprises a scheduling unit  100  further comprising a microprocessor based computer system. In the preferred embodiment of the present invention, the scheduling unit comprises a computer server or a cloud of computer servers, as discussed in reference to  FIG. 2 . 
         [0022]    The scheduling unit  100  further comprises a database component  101 . The database component  101  may be any software, firmware, or hardware device that is capable of saving and retrieving data. The database component should be configured to store schedule data  401  and patient data  402  as discussed more fully in relation to  FIG. 4 . 
         [0023]    The scheduling unit  100  further comprises a connection component  103  configured to transmit and receive data. The connection component  103  may be any of a wide range of hardware, firmware, or software devices capable of transmitting data over a network or over the internet. The connection component  103  may be permanently installed into the scheduling unit  100 . The connection component  103  may also comprise an external device that may be attached and removed from the scheduling unit  100 . The connection component  103  may also comprise more than one device or a series of devices. The only requirement is that the connection component  103  must be capable of transmitting and receiving data from the scheduling unit  100  to other devices in the system and receiving data from those other devices. 
         [0024]    The scheduling unit  100  further comprises a scheduling component  102 . The scheduling component  102  may comprise one or a plurality of microprocessors or similar devices configured to control the general operations of the scheduling unit  100 . The scheduling component  102  should be electrically connected to the connection component  103  and the database component  101  using industry standard technology. The scheduling component  102  should be configured to retrieve data from the database component  101  and send data to the connection component  103  to be forwarded to other devices outside of the scheduling unit  100 . The scheduling component  102  should also be configured to receive data from the patient contact system  105 , through the connection component  103  as discussed below, and alter data stored in the database component  101  based on the data received. In the preferred embodiment, the scheduling component  102  should also be configured to implement the appropriate embodiments of the methods discussed herein. 
         [0025]    The scheduling component  102  further comprises a patient queuing system  102 A. It should be noted that in the present disclosure patient queuing system  102 A is sometimes referred by its acronym PQS. The patient queuing system  102 A is a software process capable of initiating contact with patients through other components, adding patients to and removing patients from a medical schedule based on the patient&#39;s response, and dynamically adjusting a medical schedule based on patient behavior. The patient queuing system&#39;s  102 A method of operation is discussed in more detail in relation to  FIG. 6  and  FIG. 7 . 
         [0026]    The present invention further comprises a patient contact system  105  capable of eliciting responses from patients. The patient contact system  105  may comprise automated computer systems employing communication lines, human operators, or medical facility employees. For the purposes of the present disclosure, patient contact system  105  is sometimes referred to by its acronym PCS. In the preferred embodiment, a medical facility has the option of employing a combination of human and automated systems to contact patients. The patient contact system  105  may contact patients by telephone, cellular phone, text message, email, or any similar technology. In the preferred embodiment, the patient contact system  105  employs a computer system that is configured to connect to the connection component  103  of the scheduling unit  100  through the internet. When human operators are employed, the human operators must have access to a system capable of connecting to the scheduling unit  100 . The patient contact system  105  receives patient data from the scheduling unit  100 , elicits responses to scheduling related questions, and forwards the patient responses to the scheduling unit  100 . The scheduling component  100  may then alter the data in the database component  101  based on the patient responses. Any scheduling data  401  alteration should be made on a first response first scheduled basis as discussed in reference to  FIG. 7  hereinbelow. 
         [0027]    In the preferred embodiment, the present invention further comprises one or more local units  104 . A local unit  104  may be any personal or office computer system typically used in a medical facility or similar setting. The local unit  104  is configured to receive input from medical service providers or their staff. The local unit  104  is also configured to transmit and receive data to and from the database component  101  of the scheduling unit  100  over the internet and through the connection component  103 . 
         [0028]      FIG. 2  is a block diagram of hardware components used in an embodiment of the present invention.  FIG. 2  is intended to show that the scheduling unit  100  may comprise several servers or a cloud of servers. In this case, the database component  101  spans several different server systems. The database component  103  stores schedule data  401  and patient data  402  as discussed more fully in reference to  FIG. 4 . In the preferred embodiment, each local unit  104  is capable of accessing both patient data  402  and schedule data  401  relevant to the medical facility related to the particular local unit  104 . These data may then be displayed for the medical facility staff. The medical facility staff may modify data stored on the local units  104  for transmission to the database component  101 . 
         [0029]    In the preferred embodiment, the local unit is capable of receiving schedule data  401  and patient data  402  as discussed more fully in relation to  FIG. 4 . The local units  104  are configured to receive input from medical facility personnel related to patient check in as patient data  402 . The local units  104  may also be configured to track a patient&#39;s status in the medical facility during the course of their appointment and save the data as patient data  402 . A patient&#39;s status may include a patient&#39;s current physical location, a patient&#39;s location in the medical facilities workflow model, or any similar status descriptor. The local units  104  may also be configured to save data related to patient appointment durations, durations between status changes, and data related to the patient&#39;s check in timeliness as patient data  402 . The local units  104  may also be configured to transmit patient data related to the database component  101  of the scheduling unit  100  through the connection component  103 . In the preferred embodiment, the scheduling component  102  is configured to alter schedule data  401  stored in the database component  101  on an analysis of patient data  402  and trends in patient data  402  related to a particular medical facility, particular medical service provider, particular patient, or other criteria. 
         [0030]      FIG. 3  is a block diagram showing the data transfer used in an embodiment of the present invention. As discussed more fully in reference to  FIG. 5 ,  FIG. 6 , and  FIG. 7 , when the scheduling unit  100  attempts to schedule an appointment; the scheduling unit  100  forwards data  301  relating to the patient to the patient contact system  105 . Any patient responses  302  received, and any failures to respond, are returned to the scheduling unit  100  for further processing. 
         [0031]      FIG. 4  is a block diagram showing the information stored in the data structures used in an embodiment of the present invention. The database component  101  stores schedule data  401 . In the preferred embodiment, the local units  104  each store schedule data  401  relevant to a particular medical facility, medical service provider, or both. The local units  104  can access relevant schedule data  401  from the database component  101 , display the schedule data  401 , and make changes to the schedule data  401 . Depending on the embodiment, the local units  104  may have varying levels of access to schedule data  401  depending on the needs of the end users. In the preferred embodiment, the schedule data  401  comprises information related to medical service provider availability  401 A. The medical service provider availability  401 A data may indicate when a given medical service provider is projected to be available to see patients, whether the medical service provider is currently available, or similar data. Medical service provider availability  401 A data is used for scheduling purposes. The schedule data  401  may further comprise facility preferences  401 B which include information relating to particular medical facility hours and other scheduling data. This information may be used to allow medical facility staff to group similar appointment types together, require certain appointment types only occur at certain times or on certain days, or may be used for other scheduling purposes. The schedule data  401  may further comprise an appointment table  401 C. As discussed below, the appointment table  401 C contains data regarding pending appointments, and is created by the scheduling unit  100 . The schedule data  401  may further comprise a contact list  401 D. The contact list is created by the scheduling unit  100  from data in the appointment table  401 C and comprises the patients to be contacted regarding a pending appointment. The schedule data  401  may further comprise a patient schedule  401 E, created by the scheduling unit  100  as discussed more fully in reference to  FIG. 5 ,  FIG. 6 , and  FIG. 7 . The schedule data  401  may further comprise logging and archiving data  401 F comprising expired schedule data  401  that may be retained for future efficiency analysis or other purposes. 
         [0032]    In the preferred embodiment, the database component  101  stores patient data  402 . Depending on the embodiment, the local units  104  may store, some, all, or none of the patient data  402  relevant to a particular medical facility. The local units  104  may access, display, and change patient data  402  as needed. Depending on the embodiment, the local units  104  may have varying levels of access to patient data  402  depending on the needs of the end users. In the preferred embodiment, patient data  402  further comprises patient appointment time preferences  402 A. Patient appointment time preference data may indicate the times that a patient wishes to come to the medical facility for an appointment or the times that a patient will be unavailable for an appointment, depending on the embodiment. The patient data  402  may further comprise patient information  402 B, including contact information, medical history, and any other information that may be useful to a medical facility. The patient data  402  may further comprise data containing an appointment request date  402 C. Patient appointment request date  402 C data indicate the date or dates that a patient wishes to come to the medical facility for an appointment. The patient data  402  may further comprise an appointment type  402 D. Appointment type data  402 D may be used by the scheduling unit  100  in conjunction with provider preferences data  401 B for scheduling purposes. The appointment type data  402 D may comprise data related to the status of the patient including whether the appointment is for a routine checkup, checkup related to a specific illness, a sick patient, or an injured patient. The patient data  402  may further comprise appointment priority data  402 E. The appointment priority  402 E may contain data related to the urgency of the appointment including, but not limited to, whether the patient&#39;s needs are normal, heightened, urgent, or critical. In an alternate embodiment, the appointment priority  402 E may contain data which includes standard patient codes. The appointment priority  402 E may be used to increase or decrease the patient&#39;s position on the appointment table  401 C for earlier or later scheduling based on that patient&#39;s needs. The patient data  402  may further comprise previous appointment data  402 F. Previous appointment data  402 F may be used for estimating the time a patient will need for an appointment for scheduling purposes. The system may track a patient&#39;s check in time, check out time, and patient&#39;s status and location in the medical facility as previous appointment data  402 F. Previous appointment data  402 F can be used to track the historical length of specific procedures and wait times to better predict appointment length. Previous appointment data  402 F may also be retained to determine if a particular patient has a history of missing appointment or appearing late for appointment. Previous appointment data  402 F may also be used by the scheduling unit  100  to predict patient behavior based on past behavior and adjust relevant schedules to minimize that patient&#39;s impact on the schedule. The patient data  402  may further comprise logging and archiving data  402 G which can be used to store any other patient data that the system designer deems useful for further efficiency analysis or other purposes. 
         [0033]      FIG. 5  is a flow chart showing a method of initiating an appointment request in an embodiment of the present invention.  FIG. 5  describes both the operation of the system and the methods for scheduling appointments which are both a subject of the present invention. The flow chart begins when a patient contacts the patient contact system  501  requesting an appointment. As stated above, the patient contact system  105  may be medical facility personnel, third party operators, an automated system, or a combination of both automated and human operated systems. The patient contact system  105  receives the patient call requesting the appointment and queries the scheduling unit  502  to determine if additional patient data  402  is needed for the patient requesting the appointment. If the patient contact system is an automated system, the query and response are automatic. If the patient contact system requires human interaction, a computer system must be used to execute the query and update the information. The query is then executed to determine if the patient is found  503 . If the patient&#39;s data  505  is already present in the scheduling unit  100 , the system updates the patient&#39;s data based on the appointment request  505  with an appointment request date  402 C, an appointment type  402 D, and any changes to the patient&#39;s appointment time preferences  402 A. If the patient is not found, the patient contact system  105  obtains the appropriate patient data  503 , including patient information  402 B, patient appointment time preferences  402 A, appointment request date  402 C, and appointment type  402 D and then updates the patient&#39;s data based on the appointment request  505 . The update may occur on the scheduling unit  100  the local unit  104  or both depending on the embodiment. In the event a patient is scheduling a new visit while at the medical facility and immediately following an appointment, known as a post visit reschedule  506 , the office personal act as the patient contact system  105  and the patient&#39;s data is updated  505 . It should be noted that alternate embodiments of the present invention may not require all of the preceding data to be collected or may require additional or different data. The recitation of data to be collected from the patient should not be construed as limiting. 
         [0034]    If the patient requests that the appointment be made for a later time  507 , no immediate action is required  508 . If an appointment is scheduled for the same day, the scheduling unit  100  must determine if the patient called in or is present at the medical facility  509  from information obtained from the patient contact system  105 . If the patient is present at the facility, the patient may be immediately added to the patient schedule  511 . In an alternate embodiment, the patient may instead be added to the appointment table  401 C for later addition to the patient schedule  401 E. Adding the patient to the appointment table  401 C increases in-facility wait time for the walk in patients, but ensures greater fairness in scheduling with the call in patients. If the patient is a call in patient, the updated patient data  505  is used by the patient queuing system  102 A when it initiates  510 . 
         [0035]      FIG. 6  is a flow chart showing a method of scheduling patient appointments in an embodiment of the present invention. More specifically,  FIG. 6  discloses both the system and the method for creating the patient schedule  401 E based on the patients that have already requested appointments. The patient queuing system  102 A initiates at intervals  510  that are set by scheduling unit  100  operators. In the preferred embodiment, the patient queuing system  102 A initiates for each medical facility immediately after the end of the medical facilities office hours to prepare for the next day and periodically throughout the day to keep the patient schedule  401 E filled. In the preferred embodiment, when the patient queuing system  102 A initiates at the end of the medical facilities office hours, said patient queuing system  102 A sends an automated appointment reminder to all patients scheduled for the next day, depending on the preferences set by the medical facility. 
         [0036]    When the patient queuing system  102 A initiates, said system saves an appointment table  401 C, further comprising a list of patients requesting appointments, as schedule data  401 . The patient queuing system  102 A queries the patient data  402  relative to a given medical facility, returns all patients with an appointment request date  402  within a predefined range, and saves the returned patients to the appointment table  401 C. In the preferred embodiment, the date range is the current date. In an alternate embodiment, the date range may be extended to the following date for reminder purposes. In the event that an appointment table already exists when the patient queuing system  102 A initiates, the patient queuing system  102 A saves any new patients returned by the query to the existing appointment table  401 C. When creating the appointment table  401 C, the patient queuing system  102 A marks certain appointment times as unavailable based on provider preferences  401 B, medical service provider availability  401 A, and the patient schedule  401 E. The patient queuing system  102 A saves patients into the available times in the appointment table  401 C based on each patient&#39;s appointment type  402 D, patient appointment time preferences  402 A, appointment priority  402 E, and previous appointment data  402 F. 
         [0037]    The patient queuing system  102 A saves a contact list  401 D, as schedule data  401 . The contact list  401 D comprises patients requesting appointments. The patient queuing system  102 A saves patients to the contact list  615  from the appointment table  401 C. In the preferred embodiment, the contact list  615  is created immediately before patient contact attempts are undertaken by the patient contact system  105 . In the preferred embodiment, the patients are contacted the day before the appointment with an approximate appointment time. The patients are then contacted again immediately prior to the appointment based on that patient&#39;s previous appointment data  402 F, appointment time preferences  402 A, and any imminent openings in the patient schedule  401 E. The patient queuing system  102 A contacts the patients on the contact list by sending a request to the patient contact system  602 . The purpose of the contact immediately prior to the appointment is to request that responsive patients confirm their availability for the next available appointment time in the patient schedule  401 E. The contact immediately prior to the appointment  602  is only undertaken if there is an imminent opening in the patient schedule and the appropriate medical service provider is available. In this manner, patients are not called in until the medical facility is ready to receive them. If the patient does not answer  603 , the patient queuing system  102 A updates the contact list and the appointment table as discussed in  FIG. 7 . If the patient answers  603 , the patient queuing system  102 A reacts to the patient&#39;s response as received from the patient contact system  105 . 
         [0038]    If the patient confirms  604  that he will be present for the appointment, the patient queuing system  102 A adds the patient to the patient schedule  605  and does not consider other patients for that patient&#39;s scheduled time period. If, as a result of a contact, the patient elects to postpone  607  the appointment or reschedule  609  the appointment, the patient queuing system  102 A removes the patient form the appointment table and updates the patient&#39;s appointment request date  402 C as necessary, thereby postponing any further contact attempts. The patients that elected to postpone the appointment are contacted during a later cycle of the patient queuing system  102 A, after a predetermined interval set by the system administrators. This process allows other patients to be called to fill the available time in the schedule left by patients that wish to postpone, reschedule, or cancel. If a patient responds by requesting an appointment be cancelled  611 , the patient queuing system  102 A removes the patient from the appointment table  612  and changes the patient&#39;s appointment request date  402 C so that the patient will not be added back to the appointment table  401 C. If the patient responds by requesting an operator  613 , the patient contact system  105  sends an alert requesting that a human operator respond  614  to discuss the patient&#39;s concerns and make any appropriate schedule changes in the scheduling unit  100 . 
         [0039]      FIG. 7  is a flow chart showing a method of scheduling patient appointments when patients are unresponsive to contact attempts in an embodiment of the present invention. More specifically,  FIG. 7  discloses both the system and the method for updating an appointment table and contact list  616  when a patient is unresponsive to a contact attempt. The process begins when that patient queuing system  102 A contacts a patient from the contact list via the patient contact system  602 . This contact occurs prior to the next available appointment time in the patient schedule. The patient queuing system  102 A requests that the patient contact system contact the patient using the contact information stored in that patient&#39;s information  402 B. For explanation purposes, the first patient on the contact list is considered to be the primary patient. In this case, when the patient contact system makes a contact attempt, the primary patient is unresponsive  701 . The patient queuing system  102 A responds by adding a secondary patient to the contact list  702  from the appointment table  401 C. In alternate embodiment, additional patients may be added to the contact list as well. The patient queuing system  102 A then attempts to contact both the primary and secondary patients  703 , thereby attempting to contact a plurality of patients from the contact list. The patient queuing system  102 A attempts to contact all patients that have been unresponsive to previous contact attempts using an alternate contact method, if available. 
         [0040]    The patient queuing system  102 A reacts based on which patients respond  704  to the contact attempts. If neither patient responds, the appointment table is updated, thereby postponing contact attempts to the unresponsive primary patient. The primary patient is also removed from the contact list  705 . The secondary patient then becomes the primary patient  706 . The patient queuing system  102 A then treats the new primary patient as unresponsive  701 . If both patients respond, they are each added to the schedule on a first to respond, first to schedule basis  707 . In this manner, the patient queuing system  102 A adds responsive patients to the patient schedule  401 E based on the patients response, as shown in  FIG. 6 , and adds the responsive patients on a first to respond first to schedule basis. If only one patient responds, the patient queuing system  102 A reacts based on whether the response came from the primary or secondary patient  708 . If the response comes from the secondary patient, the secondary patient is added to the patient schedule and the primary patient is postponed in the appointment table, and removed from the contact list  709 . If the primary patient responds, the primary patient is added to the patient schedule and the secondary patient becomes the new primary patient  710 . The new primary patient is then treated as an unresponsive primary patient  701 . In the preferred embodiment, the patient queuing system  102 A discontinues contact attempts to patients with postponed appointments after a predetermined number of attempts. The number of attempts may be set by the system administrators. If a patient that previously failed to respond calls back at a later time, that patient is scheduled on a first to respond, first to schedule basis. In the preferred embodiment, all appointments for unresponsive patients that have not been confirmed by the end of the day are removed from the appointment table. 
         [0041]      FIG. 8  is a flow chart showing a method of tracking patient movement during the course of an appointment and collecting data related to appointment duration for later use. More specifically,  FIG. 8  discloses both the system and the method for tracking patient status in the medical facility during the course of the appointment and saving data related to patient appointment duration data as previous appointment data  402 F. The previous appointment data  402 F can be used for later scheduling purposes by the patient queuing system  102 A. The previous appointment data  402 F may also be retained for future use and analysis to support industry wide encounter benchmarks and to generate detailed statistical time based reports. 
         [0042]    Upon entering the medical facility for an appointment, the patient is checked in  801 . The patients check in time is saved as previous appointment data  402 F, and is used as a start time to determine the patients appointment duration. Upon checking in, the patient enters a waiting room or a series of waiting rooms. In the preferred embodiment, each time the patient enters a new waiting room, the previous appointment data is updated and archived  802 . The patient is then sent to a procedure room or series of procedure rooms so that relevant procedures may be performed on the patient. In the preferred embodiment, every time a patient enters a new procedure room, that patient&#39;s previous appointment data is updated and archived  803 . In the preferred embodiment, every time the patient&#39;s status changes, the patient&#39;s previous appointment data is updated and archived  803 . Depending on the particular medical facility and the patient&#39;s needs, a patient may move through several waiting and procedure rooms, and, in the preferred embodiment, the previous appointment data is continuously updated. Upon completing the appointment, the patient checks out and the previous appointment data is updated  804 . Using this tracking method, the system has data showing how long each encounter takes and how long wait times are in various statuses on an individual basis. The previous appointment data  402 F can then be used on an individual basis to estimate appointment times for scheduling purposes. The patient queuing system  102 A can then more accurately predict future appointment duration times for that patient based on previous appointment duration times and schedule more or less time accordingly. As a particular patient undergoes more appointments, the increased data allows the patient queuing system  102 A to more accurately predict a given patients appointment duration. The patient queuing system  102 A can also create average previous appointment data  402 F for patients associated with a given medical facility. This data can be made available to the facility for efficiency analysis and be used for staff or patient scheduling purposes. 
         [0043]      FIG. 9  is a flow chart showing a method of scheduling dependant appointments in an embodiment of the present invention. A patient may request an appointment that depends on another appointment  901 . This occurs when a patient needs two or more appointments that must be completed in sequence. The scheduling component  102  modifies the patient&#39;s patient data  402  to establish the new appointment or appointments and establish their dependency upon each other or upon any appointments that have already been established  902 . In an alternate embodiment, some or all of the dependant appointments may be immediately included in the patient schedule  401 E. 
         [0044]    At a predetermined interval, the patient queuing system  102 A checks all appointments with dependant appointments to determine if the patient attended or missed any previous appointment in the scheduled sequence  903 . If the patient attended the appointment, then no action is necessary and the PQS may follow standard procedure  904 . If the patient did not attend an appointment with a dependency, the patient queuing system  102 A contacts the patient using the patient contact system and either reschedules or cancels both appointments based on the users input  905 . The PQS then checks to determine if any of the rescheduled or canceled appointments were scheduled by another facility  906  using the referral system discussed in relation to  FIG. 11 . If the rescheduled or cancelled appointments were scheduled by another office, an alert is sent to the referring medical service provider  908 . If the appointments were not established by a referral, then no further action is necessary  907 . 
         [0045]      FIG. 10  is a flow chart showing a method of dynamically rescheduling patient appointments when a medical service provider becomes unavailable in an embodiment of the present invention. In the medical industry, it is common for medical service providers to become involved in emergency care that prevents them from being available for scheduled appointments. In the preferred embodiment, the patient queuing system  102 A is designed to react to these common situations and dynamically schedule appointments to minimize patient wait time until normal workflow can be restored. The medical service provider may initiate the feature by setting his or her status to unavailable using a local unit  1001 . The patient queuing system  102 A recognizes the unavailability of the medical service provider and ceases any attempts to contact further patients and dynamically schedule further appointments for that provider until his or her status changes  1002 . 
         [0046]    The patient queuing system  102 A then uses the patient contact system  105  to contact all patients that have already confirmed that they will be present for an appointment or have already checked into the facility  1003 . The patients contacted in this manner are then given the option of accepting a different medical service provider or waiting on their preferred medical service provider  1004 . If the patient decides to wait for the preferred medical service provider, the patient&#39;s data remains in the appointment table for the next available appointment time for the preferred provider  1005 . The next appointment may or may not be on the same service date. If the patient is willing to accept an alternate provider, the patient queuing system  102 A dynamically schedules the patient for an appointment with the alternate provider  1006  using the process discussed in  FIG. 6 . 
         [0047]      FIG. 11  is a flow chart showing a method of referring patients between medical service providers in an embodiment of the present invention. In an embodiment of the present invention, a medical service provider needs to refer a patient to another medical facility  1101 . The medical service provider interfaces with the present invention, performs a search for other facilities and providers available on the system that offer the required services, and selects an appropriate facility and provider  1102 . The system must then determine if the selected medical facility participates in the system by maintaining a local unit  104  on the network of the present invention. If the selected medical facility is not in network  1103 , the contact information of that facility is provided to the referring medical service provider. If the selected medical facility is in network  1103 , the system provides a copy of the selected facilities patient schedule  401 E for review  1105 . 
         [0048]    The preferred embodiment of the system then checks the facilities preferences  401 B to determine if the selected medical facility allows automatic referrals  1106 . If automatic referrals are permitted by the selected facility, the referring provider may add an appointment for the patient directly to the other facilities patient schedule  1107 . If automatic referrals are not permitted, the referring provider may request an appointment for the patient by sending an alert to the selected facility  1108 . The alert is then received and reviewed by the selected facility&#39;s staff  1109 . If the selected medical facility accepts the appointment  1110 , the system provides a confirmation to the referring provider and the appointment is added to that facility&#39;s patient schedule  1111 . If the selected medical facility does not accept the appointment  1110 , the system sends a notice to the referring provider that the appointment has been declined  1112 . The referring provider may then select another medical facility and try again. 
         [0049]    While the present invention has been described above in terms of specific embodiments, it is to be understood that the invention is not limited to these disclosed embodiments. Many modifications and other embodiments of the invention will come to mind of those skilled in the art to which this invention pertains, and which are intended to be and are covered by both this disclosure and the appended claims. It is indeed intended that the scope of the invention should be determined by proper interpretation and construction of the appended claims and their legal equivalents, as understood by those of skill in the art relying upon the disclosure in this specification and the attached drawings.