Do Today's Work Today: Why Advanced Access (Same-Day/Next-Day) Matters

The core idea of advanced access scheduling is disarmingly simple: do today's work today. Instead of booking patients weeks out and triaging the queue, a practice holds most of its capacity open and offers appointments when patients actually need them — the same day or the next. The model, developed by Dr. Mark Murray and colleagues and studied for two decades, consistently shows the same results: shorter waits, fewer no-shows, better continuity, and less demand spilling into emergency departments.

Why it works

Long booking horizons create their own pathology. Patients booked three weeks out forget, get better, or get worse — so no-show rates climb and urgent problems route to walk-ins and EDs. Ontario's own Primary Care Action Plan makes the economics explicit: a primary care visit costs roughly a third of an emergency department visit, and people connected to primary care use EDs dramatically less. Same-day and next-day access is how that connection becomes real rather than nominal.

Ontario is building for it

Look at what health teams are actually launching. The Barrie and Area OHT's Primary Care Network stood up a weekend cold-and-flu clinic at Royal Victoria Regional Health Centre — Saturdays and Sundays through respiratory season, with online registration — explicitly to give the community timely access when few other options exist, and to take pressure off the emergency department. The same OHT partnered with Huronia Urgent Care Centre and RVH on a nurse practitioner-led clinic for unattached patients discharged from hospital. In York Region, the NYSS OHT points residents to community urgent care for same-day needs. The pattern is provincial: advanced access is no longer a scheduling philosophy for keen practices — it's infrastructure OHTs are funding.

What it takes at volume

Here's the operational catch: same-day access at meaningful volume cannot run on phone lines. If your same-day slots release at 8 a.m. and your patients have to call to claim them, you've built a queue in front of your no-queue model — and staffed it. Advanced access at scale needs booking infrastructure that can: release same-day capacity automatically at the time you choose; fill it online, 24/7, from any device and in any language; write directly into the EMR schedule so there's no double-entry lag; and send automated confirmations and reminders so the slots you release actually get used.

That's how Huronia Urgent Care Clinic runs a fully same-day model at thousands of appointments per week on Empower's platform — 100% online, EMR-integrated, with rules that keep the schedule honest. Advanced access is a promise about time; online booking is how you keep it.

Sources & further reading

• Ontario's Primary Care Action Plan — ED cost & access figures
• Barrie and Area OHT — weekend cold & flu clinic; HUCC/RVH clinic for unattached patients
• NYSS OHT — community urgent care for same-day needs
• IHI — advanced access & office practice redesign resources