One-on-one service delivery is often considered ideal, with individualized attention assumed to improve client outcomes. In shared service delivery, clients are served in batches, and it is feared that loss of privacy and personal one-on-one connection might undermine patient engagement. However, this research shows that might not necessarily be the case in the setting of an eye care delivery.



Nazlı Sönmez from ESMT Berlin; Kavitha Srinivasan and Rengaraj Venkatesh from Aravind Eye Hospital in India; Ryan W. Buell from Harvard Business School; and Kamalini Ramdas from London Business School conducted research to understand the impact of shared medical appointments (SMAs) on patient engagement. In SMAs, patients meet with the physician in a group, each receiving attention in turn. The physician shares information specific to individual patient needs while also sharing information relevant to others with the same condition.



The researchers conducted a randomized controlled trial at the Aravind Eye Hospital with 1,000 patients undergoing glaucoma treatment over a three-year period. Groups of five patients were assigned to attend one-on-one appointments or SMAs, with each attending a total of four appointments scheduled four months apart. Using verbatim and behavioural transcripts from video recorded during the trial, researchers examined how SMAs impact patient engagement.



On average, per minute, a patient who experienced SMAs asked 33.3% more questions and made 8.6% more non-question comments. With multiple patients in an SMA, an increase in engagement resulted in patients hearing far more comments in the group setting.



Patients in SMAs also exhibited higher levels of nonverbal engagement on a wide array of measures including attentiveness, positivity, head wobbling (a South Indian gesture to signal agreement or understanding), eye contact, and end-of-appointment happiness.



“Our analysis sheds light on the benefits of designing service models that enable customers to be more helpful in serving one another, leading to more efficacious service encounters in healthcare and beyond,” says Nazlı Sönmez, Assistant Professor of Management Science at ESMT. “During our trial, our physician partners observed patients in SMAs who became motivated to ask particular questions by hearing the questions and comments of other patients.”



These results exhibit the potential for shared service delivery to increase client engagement and enhance service performance, particularly within healthcare. The design of SMAs enables patients to spend more time with the physician, albeit alongside other patients. Providers also spend more time with each patient, over 600% more time in this study, a driver of quality and value.



This research was published in the journal Manufacturing and Services Operations Management and can be viewed here.