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Related Experiment Video

Updated: Jul 16, 2026

Radiation Planning Assistant - A Web-based Tool to Support High-quality Radiotherapy in Clinics with Limited Resources
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Radiation Planning Assistant - A Web-based Tool to Support High-quality Radiotherapy in Clinics with Limited Resources

Published on: October 6, 2023

Reducing New Patient Wait Times in Dermatology Using an Algorithmic Scheduling Strategy.

Nikhita J Perry1, Iain Noel Encarnacion1,2, Noelle Desir1,3

  • 1Medical Student, Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, PA, USA.

NEJM Catalyst Innovations in Care Delivery
|July 15, 2026
PubMed
Summary

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Implementing an acuity-based scheduling model significantly reduced dermatology new patient visit wait times by 76.8%. This system-level intervention also improved appointment attendance and preserved diagnostic yield for skin conditions.

Area of Science:

  • Dermatology
  • Healthcare Management
  • Health Services Research

Background:

  • Long wait times for new patient dermatology visits (NPVs) delay diagnosis and treatment, impacting conditions like skin cancer.
  • Extended lead times are linked to increased no-show rates and disproportionately affect underserved populations.
  • Scalable, system-level interventions are needed to improve access to dermatologic care.

Purpose of the Study:

  • To evaluate the impact of a decision tree-based, acuity-driven scheduling model on appointment lead times, attendance, and clinical outcomes in a large academic dermatology department.
  • To assess the model's effectiveness in reducing wait times for new patient visits and improving overall clinic efficiency.

Main Methods:

  • Implementation of a decision tree for structured triage based on patient concerns.

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  • Assignment of patients to acuity-based appointment blocks with defined target time frames.
  • Redesign of scheduling blocks to preserve urgent capacity and optimize slot utilization without increasing resources.

    • Main Results:

    • Median new patient visit lead time decreased by 76.8%.
    • Lead times for biopsies and biopsy-proven malignancies reduced by 63.9% and 70.8%, respectively.
    • No-show rates declined significantly from 18.6% to 8.1%.

    Conclusions:

    • A structured, acuity-based scheduling model can sustainably decrease dermatology appointment wait times.
    • This approach improves patient attendance and maintains diagnostic yield.
    • System-level scheduling interventions are effective in enhancing access to dermatologic care.