Kairoi Health
Understanding, Predicting, and Reducing Appointment No-Shows

Patients failing to keep their scheduled appointments is a persistent and growing problem throughout the healthcare industry. Estimates indicate that the cost of “no-shows” exceeds $150 billion a year. “However, a missed appointment is more than just a missed business opportunity,” says Dr. John Golenski, CEO and co-founder of Kairoi Healthcare Strategies (Kairoi Health). When a patient doesn’t show up for an appointment, it negatively impacts the organization’s productivity and access to care for all patients. Medical practitioners have used myriad strategies to influence patients’ behavior—e-mailing appointment reminders, making personal and automated phone calls, even penalizing them for missed appointments—but such tactics, though occasionally effective, have rarely improved clinical productivity in the long run.

Kairoi Health, a Boston-based healthcare IT company, takes a different route to mitigating appointment no-shows. “Our endeavors are focused on increasing the availability of clinicians and clinic resources, and making the best use of provider time,” Golenski says. “While working with a large public clinic, we found that if appointments had shorter lead times, patients were more likely to show up. This and other findings pointed us toward fine-tuning scheduling architecture for optimum utilization—to increase the supply instead of trying to manage the demand.”

In another case, Kairoi Health was engaged by a clinic that had an especially high percentage of no-shows on Monday mornings. Clinic managers speculated that the low patient attendance was related to the early morning after a weekend. But Kairoi Health’s findings showed otherwise, notes Golenski. “We analyzed two years of the client’s scheduling data, which demonstrated that they consistently experienced high rates of no-shows right around 9:30 a.m. every Monday. Yet the 8:00 a.m. slots showed better patient turn-up,” he says. To rectify the situation, Kairoi Health advised the clinic to maximize productivity by double booking at 9:30. This approach reduced the impact of no-shows considerably. “Many organizations are reluctant to even talk about double booking,” says Golenski.

Our endeavors are focused on increasing the availability of clinicians and maximizing provider time

“Used wrongly, it can be a blunt tool, but our methods enable strategic double booking with a laser focus.”

Kairoi Health’s unique approach is delivered via its breakthrough cloud-based analytics and schedule optimization solution, KairoiSuite. The SaaS software offers a robust clinical appointment analytics system—KairoiLogic—linked to a workflow optimization application, KairoiScheduler. Insights gained from KairoiLogic are integrated into the scheduling tool to optimize clinical performance. KairoiSuite helps healthcare organizations streamline operations, reduce stress on providers, and enhance patient access and satisfaction.

A crucial step in Kairoi Health’s solution is assimilating and cleansing the client’s historical appointment data. Golenski explains: “More often than not, the data stored in electronic health records and other practice management systems is flawed due to human error.”KairoiLogic’s patent-pending data-cleansing engine filters out erroneous appointment records, preventing data inaccuracies from skewing the analysis. Using the cleansed data, KairoiLogic then performs its analysis and presents results in user-friendly dashboards, which display key indicators of operational efficiency at the health system, clinic, and individual provider levels. Guided by these results, Kairoi Scheduler easily creates scheduling templates based on historical data and organizational goals. To inform the clinic’s ongoing performance monitoring, Kairoi Suite incorporates staff and patient feedback, enabling clinic managers to assess—within seconds—the impact on productivity of the actions taken.

“The ultimate aim of all these innovations, our core objective, is to improve patients’ access to care,” says Golenski. The company now intends to bring real-time scheduling analytics to the patient level. This will enable Kairoi Health to conduct analytics on a patient’s clinical status and prioritize appointment schedules depending on the criticality of the patient. “I’m inspired by a mantra from the quality-of-care movement: ‘The right care for the right patient at the right time,’” Golenski concludes. “This will be a huge leap toward achieving our shared goal of improving access to patient care.”