Every practice that offers telehealth eventually faces the same question: should patients book a time, or should they request care and be seen as soon as someone is free? Framed that way, it sounds like a one-or-the-other decision. In practice, the strongest telehealth programs use both, and they are deliberate about which visit types go where.
This guide explains what each model means, where each one works best, what each one asks of your staff, and how to run them side by side without confusing patients or overwhelming your team.
What Each Model Means
On-demand care is synchronous and unscheduled. A patient requests a session and connects with the next available provider, much like walking into an urgent care waiting room. Scheduled care means the patient books a specific date and time in advance, and the provider blocks that time on their calendar, as described in How Urgent Care Clinics Use On-Demand Telehealth.
SecureVideo’s Virtual Clinic supports the on-demand side. A practice opens “virtual doors,” and patients request sessions on their own time. The feature is built for settings such as urgent care and crisis intervention, where waiting for a booked slot would defeat the purpose. Patients are typically connected within minutes, or as quickly as someone is able to assist, and they can see how many requests are ahead of theirs.
Behind the scenes, the workflow is simple. A patient clicks Request Session Now under a provider’s name. If the provider accepts, the session appears on the patient’s Dashboard and they click Enter Waiting Room. If the provider declines, the patient sees a notification with any note the provider left and can try again. On the provider side, a toggle at the top of the Dashboard controls availability, and new requests appear at the top of the Dashboard with Accept or Accept and Enter buttons, according to the Virtual Clinic help article.
A Virtual Clinic can also be driven by appointment slots rather than an on-demand toggle. When staff assign a request, the popup shows whether the provider is available based on either the on-demand toggle or the clinic’s appointment slots, per the accepting and declining requests help article. That flexibility lets a practice mix both models inside the same workflow.
Where On-Demand Works Best
On-demand shines when the need is time-sensitive and does not require a physical exam. SecureVideo’s own guidance on urgent care lists examples such as cold and flu symptoms, ear pain, rashes, pink eye, prescription refills, and some mental health concerns. It also notes that anything requiring hands-on care, testing, or imaging belongs in person.
Beyond urgent care, on-demand fits several other situations:
- Crisis and first-contact support. When a person reaches out in a hard moment, a fast response matters more than a perfect time slot.
- Triage. A quick conversation can decide whether a patient needs a booked visit, an in-person exam, or just reassurance.
- Short, low-prep questions. A refill check or a quick symptom update rarely needs weeks of planning.
- Patients who struggle to plan. Shift workers and caregivers often cannot commit to a time a week from now, but can talk right now.
The benefits for patients are clear: no waiting for an opening, no extra scheduling steps, and care while the concern is fresh. For practices, on-demand can capture patients who would otherwise go to a competitor or skip care.
Where Scheduled Care Works Best
Scheduled visits suit anything built on continuity and preparation: therapy sessions, medication management, chronic condition follow-ups, post-procedure check-ins, and visits that need the same provider each time. They also give you time to prepare. Paperwork can go out ahead through E-Documents, and reminders carry the join link and support contact so patients arrive ready, as covered in scheduling and notifications.
Scheduled care has a weakness, though, and it is the gap between booking and visit. One practice-management source reports a 30% no-show rate for patients given an appointment more than 150 days after their last visit, compared with under 5% for patients seen within 10 days of their previous visit. That figure comes from a general office setting, not telehealth specifically, but the lesson carries over: the longer a patient has to wait for a booked slot, the more likely life gets in the way. Keeping lead times short, and leaving room for same-week openings, reduces that risk.
What Each Model Asks of Your Team
On-demand and scheduled care create different operational demands, and it helps to be honest about them before you launch.
On-demand requires responsiveness. Someone has to watch the incoming requests, and providers need to be free when requests arrive. If a request sits for twenty minutes, the whole promise of “seen within minutes” falls apart. Staff can monitor incoming requests and assign them to providers based on availability, which spreads the work, but it still needs coverage.
Scheduled care requires planning. Providers need protected blocks, front-desk staff need to confirm and remind, and the practice has to manage cancellations and no-shows. The workload is more predictable, but it is not smaller.
Because Virtual Clinic is an add-on workflow, practices that do not have it yet need to contact SecureVideo’s sales team to add it.
A Decision Framework You Can Use
For each visit type you offer, ask five questions:
- How urgent is it? If waiting days would matter to the patient, lean on-demand.
- Does it need a specific provider? Visits that depend on an ongoing relationship lean scheduled.
- Does it need preparation? Forms, labs, or documents point toward scheduled.
- Can you staff unpredictable demand? If not, limit on-demand to set hours.
- Is a physical exam likely? If so, route to in-person, not either telehealth model.
Write the answers into a one-page guide for staff so everyone sends patients to the right door.
Running Both Without Chaos
Start small. Open on-demand during defined hours when providers and staff are free to respond, and reserve the rest of the day for booked appointments. When a provider enters a scheduled session, they set their status to unavailable so new requests are not routed to them. If a provider needs to decline everything for a stretch, the I Am Unavailable for Sessions status handles that in one step.
Tell patients what to expect, in plain words. For example: “On-demand visits are available weekdays from 9 a.m. to noon. For anything outside those hours, you can book a time online.” Clear hours prevent the frustration of a patient requesting a visit at 8 p.m. and wondering why nobody answered.
When you decline a request, use the message box. Patients who are declined see your response on their Dashboard, so a short, kind explanation and a next step, such as booking a scheduled visit, turns a dead end into a path forward.
Measure What Matters
Track a few numbers for each model: time from request to acceptance, share of requests accepted, no-show rate for scheduled visits, and patient feedback. If on-demand requests are going unanswered, narrow the hours or add coverage. If scheduled visits are being missed, shorten lead times or tighten reminders.
Common Mistakes
- Offering on-demand with no one assigned to watch it.
- Using on-demand for visits that obviously need an exam.
- Leaving hours vague, so patients guess.
- Treating a decline as the end of the conversation.
- Never reviewing which visit types belong where.
Frequently Asked Questions
Can a practice offer both models?
Yes. A Virtual Clinic can use an on-demand toggle, appointment slots, or both, and your visit-type rules decide which door patients use.
Is on-demand only for urgent care?
No. It also fits crisis support, triage, and quick follow-ups, as long as the visit does not need hands-on care.
What should happen when no provider is free?
Set expectations in advance with posted hours, and use a decline message that points patients to a booked appointment.
Bring Both Models Together
The best telehealth programs are not on-demand or scheduled. They are both, with a clear rule about which visits belong where. Explore the Virtual Clinic or request a demo to see how it could fit your practice.