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Independents' Day

How automated check-in saves us two hours a day

A computerised appointment check-in system for patients is saving receptionists at Dr Stephen Gardiner's practice two hours a day ­ he explains how it works

Most practices are on the lookout for ways to manage their ever-increasing workload. In my practice we are offering more appointments for more services than ever before, and GMS2 will almost certainly increase appointments still further. Our reception desks always had queues of patients waiting to be seen and the frustration of patients and receptionists was at times plain to see.

To solve the problem we installed a simple self check-in system in our reception area, allowing patients to book themselves in when they arrive for appointments. The system is provided by Savience ( and consists of a computer with a touch-screen linked to our EMIS server.

Installation was straightforward and took only 30 minutes. Savience offers a range of options from complete installation with all hardware supplied and three years' maintenance costing £3,795 to self-installation using existing equipment which costs £2,400. The system currently works with EMIS, Exeter and IPS Vision. There is no routine maintenance needed and in the year we have had our system there have been no problems at all.

Patient feedback

We have found that patients enjoy using the system and I have been especially impressed by the technical know-how of the elderly contingent. On arrival in reception patients touch the screen buttons to indicate the month and day of their birthday and their gender. The system then checks for a booked appointment, marks the patient as having arrived and shows a message confirming this. The whole process takes about 10 seconds. We have found it extremely rare to have two people with the same sex and birthday to have appointments booked at similar times. In fact the only time I have known it happen was when I was showing a colleague how unlikely it was.

We allow patients to book in up to an hour before their appointment and five minutes after it. Otherwise they are asked to go to reception. These variables can all be changed to suit individual practices. For example, if appointments are booked with both the doctor and the nurse, then both are recognised.

As well as reducing stress in the reception area there have been other benefits from installing the system. In our practice we offer about 2,000 appointments each week and we have found about 75 per cent of patients use the new system. The potential time savings are huge. We estimated patients going to reception take 20-30 seconds to check in. The 300 patients using the Savience system each day therefore save about 150 minutes of reception time.

Time savings

Each practice will have its own way of using this saved time. In my practice we have already successfully trained the administrative staff as health care assistants, and they now do almost all our routine blood pressure measurements, blood testing and ECG recording, along with new patient checks, audiograms and urinalysis. Other receptionists are keen to develop their roles and with the recording requirements of the new contract we will be using the time saved to ensure we attain maximum quality target payments.

We search our electronic records to identify patients in whom there is a need for updated information on, for example, smoking, weight and blood pressure and we add this need to their patient diary on EMIS. Such patients are then identified when they arrive and are offered the chance to have their blood pressure and weight recorded while they wait. Their smoking status is also recorded and they are given appropriate advice leaflets and the information is recorded in their notes.

Higher quality payment targets are probably possible for most practices, but to expect this work to be done by GPs is unrealistic. Our staff enjoy their enhanced roles and at the same time enable us to work towards maximum income.

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