Development of a New Web Appointment tool in Osakidetza for Demand Management in Primary Care: Piloting, implementation, and satisfaction of the population
Authors: Nuñez Soraya , Antolin Lali , Tutor Josune , Portuondo Janire , Sanchez Alvaro , Gonzalez Maite , Santano Dabi , De Blas Antonio , Cuadrado Maite , Gonzalez Nuria , Moro Inmaculada , Martin Susana 
Published: January 2024

Introduction: The use of information and communication technologies (ICTs) in the process of citizens’ accessibility and citation to health services can contribute to both alleviating and properly organizing demand and increasing user satisfaction.
Objective: To describe the process through which the web appointment app was designed and implemented based on the demand management model and the evaluation of the perceived satisfaction and/or usefulness by the users of the app.
Material And Methods: A formative study was carried out by a multidisciplinary working group, made up of professionals from the sub-directorate for the Coordination of Primary Care, sub-directorate of ICTs department and the sub-directorate of Quality and Information Systems for the design and development of the new web tool. It was pretended to design this new tool in line with the existing face-to-face and telephone appointment system, which organizes the appointment system according to the reason for consultation and the most appropriate professional to resolve it. A multiphase implementation was proposed, which would allow piloting the solution within the expected deadlines and facilitate the resolution of possible incidents that may arise: Phase 1: Functional analysis of new needs, IT development and integration. Phase 2: Initial 10-day pilot in a highly controlled environment, limited to one Primary Care Unit per Historical Territory, including the evaluation of perceived satisfaction and usefulness in a selected sample of users (n=196) and recording of incidents. Phase 3. Carrying out the necessary readjustments, solving all the detected incidences. Phase 4. Staggered deployment in all Osakidetza Service Organizations of the updated version of the tool, including a second evaluation of satisfaction and usefulness in a new random sample of users (n=254).
Results: In the first of the piloted deployments, a total of 5966 appointments were taken through the web, of which 1523 and 4443 solicited face-to-face and telephone appointments, respectively. More than 85% of the people surveyed considered the new web appointment application to be simple and easy to use, enabling them to get the appointment they needed. The main incidents that occurred were related to the adaptation of the appointment model (referral flows) to the new administrative agendas, errors in the configuration of agendas, and other minor technical incidents. In the second staggered deployment, 325762 appointments were made through the web, of which 113,496 solicited face-to-face and 212266 telephone appointments. Seventy-seven percent of respondents reported that they found the tool useful and easy to use, and 75% confirmed that they got the appointment they needed.
Conclusions: The new web appointment has been developed and implemented adapting to the corporate care flowchart to care requests trying to provide a comprehensive response to the health needs of the population. In general, the degree of acceptance of the new tool is high, although there is still room for improvement, trying to respond to most of the users' needs.