Could allowing patients to choose their own appointment times help reduce missed visits and shorten NHS waiting lists?
In this episode of Tech Talks Daily, I speak with Alison MacDonald, European Lead and Senior Vice President at Nordic Global. Alison brings an unusual combination of clinical and technology experience as a registered nurse who moved into digital health over 15 years ago.
Her career began in community nursing, where she was asked to lead an electronic health record project because colleagues thought she was good with computers. What initially appeared to be a simple exercise in converting paper forms into digital records encouraged her to question whether healthcare could redesign the process rather than copy it onto a screen.
We discuss Nordic's work with Cambridge University Hospitals NHS Foundation Trust on patient self-scheduling and automated earlier appointment offers. Before the program, missed outpatient appointments were removing valuable clinical capacity while administrative teams spent time calling patients and rearranging bookings.
Cambridge introduced self-scheduling through Epic MyChart, allowing patients to select appointment times through the patient portal. Alison says the DNA rate fell from 5% to 2.2% during the program.
According to the supplied results, over 20,000 patients successfully scheduled their own appointments and over 3,000 accepted offers to attend earlier when cancellations created availability. Patients moved appointments forward by an average of 16 days.
Forty percent of accepted earlier appointments occurred within seven days of the offer, while 7% took place on the same or following day. Administrative teams also saved an estimated ten minutes for every self-booked appointment.
Alison explains why patient control can improve attendance. People can choose times that work around employment, caring responsibilities, travel, and family life instead of receiving a fixed appointment through a letter or telephone call. Patients can also cancel or reschedule without waiting for somebody to answer the phone.
The operational lesson goes beyond appointment booking. Healthcare systems may be able to recover existing capacity by examining missed appointments, theater scheduling, waiting list processes, pre-visit questionnaires, and patient communications before concluding that every problem requires additional staff or facilities.
We also discuss where AI is producing practical results in healthcare. Alison points to medical imaging, emergency department triage, waiting list management, clinical documentation, and workforce deployment. She warns against discussing AI as one generic solution because each application requires a defined use case, suitable data, workable processes, governance, and staff adoption.
Ambient clinical documentation offers one example. An AI scribe can record a consultation, prepare a structured note, and pass it to the clinician for review and correction. Alison cites an NHS evaluation reporting a 23.5% increase in direct patient interaction time and an 8.2% reduction in appointment length.
Interoperability remains another major challenge. Healthcare journeys cross hospitals, primary care, community services, and specialist providers that may use different systems or a mixture of electronic and paper records. Even basic differences, such as one organization measuring pain on a five-point scale and another using ten points, can prevent reliable comparison.
Alison recommends agreeing on common data standards, defining the minimum patient information required during care transitions, including interoperability requirements in procurement, and avoiding bespoke integrations that make future information sharing harder.
Digital access also requires balance. Online services can improve convenience, but healthcare providers must retain appropriate alternatives for patients who lack digital skills, connectivity, confidence, or access.
Could your healthcare organization improve patient access and staff capacity by redesigning one familiar process before purchasing another large technology platform? Listen to the episode and share your thoughts with me.