SMS text messaging improves outpatient attendance

Abstract

Objective: To evaluate the operational and financial efficacy of sending short message service (SMS) text message reminders to the mobile telephones of patients with scheduled outpatient clinic appointments.Design: Cohort study with historical control.Setting: Royal Children's Hospital, Melbourne, Victoria. Patients:Patients who gave a mobile telephone contact number and were scheduled to attend an outpatient clinic at the Royal Children's Hospital, Melbourne in October, November and December 2004 (trial group) or in October, November and December 2003 (historical control group). Main outcome measures:Failure-to-attend (FTA) rate compared between the trial group, whose members were sent a reminder, and the historical control group, whose members were not sent a reminder. Financial benefits versus cost of sending reminders.Results: 22 658 patients with a mobile telephone contact number scheduled to attend an outpatient clinic appointment in October, November and December 2004 were sent an SMS reminder; 20 448 (90.2%) of these patients attended their appointment. The control group included 22 452 patients with a mobile telephone contact number scheduled to attend an appointment, with 18 073 (80.5%) patients attending.The FTA rate was significantly lower in the trial group than in the historical control group (9.8% v 19.5%; P < 0.001). The cost of sending the SMS reminders was small compared with the increase in patient revenue and associated benefits generated as a result of improved attendance. Conclusions:The observed reduction in FTA rate was in line with that found using traditional reminder methods and a prior pilot study using SMS. The FTA reduction coupled with the increase in patient revenue suggests that reminding patients using SMS is a very cost effective approach for improving patient attend- FAILURE TO ATTEND outpatient appointments is a significant and widespread problem in public hospitals that severely reduces the ability to provide an efficient and effective outpatient service. Not only does a high failure to attend (FTA) rate waste clinical and administrative resources, it also reduces revenue opportunities, increases waiting times for outpatient appoint- What is known about the topic? Patients failing to attend their scheduled outpatient appointments is a significant problem, impacting on access to outpatient care and on the efficiency of the clinics. Reminder systems improve attendance but can be costly to operate. What does this study add?This study confirms that sending text messages to patients' mobile phone numbers three days before their scheduled appointments reduces failure to attend (FTA) rates at relatively low cost. What are the implications?Hospitals and other clinic operators could reduce waiting times for patients in need of specialist care, and the efficiency of clinics, by providing timely SMS reminders to patients.

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