Unreliable patients most likely to ask for SMS reminders

Tags: A DNAs iS Mental Health mobile SMS UK Wireless

07 Apr 2005

Patients most likely to be 'Did Not Attends' (DNAs) at outpatient clinics are also the most likely to sign up for text reminders, according to new research.

SMS patient appointment reminders can reduce DNAs by up to 30% even if only 20% of patients sign up to receive the service, says a study published by Wireless Healthcare.

"The patients most likely to forget, or not bother, to turn up for appointments fall within the 16 to 35 age group," said Peter Kruger, senior analyst at Wireless Healthcare. "By a lucky coincidence people in this age group are heavy users of mobile phones and text messaging. This is one reason why text message based reminder systems have been successful from day one."

Although patient reminders are having a positive effect on hospital performance data, these benefits tend to tail off if more than the 20% of patients least likely to attend sign up for the service. Additionally, healthcare organisations are finding it difficult to sign anybody else up for the service.

Researchers looked at a number of UK healthcare organisations and also SMS software supplied by companies such as McKesson.

The research appears to explain the early gains made by using SMS reminders, but also implies that there will be diminishing returns if organisations try to roll out the service more widely.

Wireless Healthcare says SMS appointment reminders have particularly positive roles to play for mental healthcare trusts; not just because they have clinical benefits but because, according to the researchers, many mental health trusts are under "political pressure" to make sure their patients keep appointments and take medication.

The SMS appointment messaging market could be worth around £20m a year to service providers, according to figures released by the researchers.

The report also suggests that in the future, some trusts may start using text messaging within clinics to inform waiting patients that they are ready to be seen. Since the Medicines and Healthcare products Regulatory Authority recommended that mobile phones in hospitals were less dangerous than originally thought, text messaging could overtake some systems such as "patient paging".

Readers Comments

A late April fool...?

08 Apr 05 16:23

This is nonsense, isn't it? But a couple of points:

Everyone entering a hospital/GP surgery is - quite rightly - reminded to turn their mobile phone off. I've never known whether mobiles genuinely interfere with medical equipment, but I'm all for mobile-free zones.

At the risk of sounding grouchy - isn't sending SMS reminders simply training 16-35 year olds to be more feckless and demanding of services, and take less responsibility? How hard is it to remember an appointment? And might we not spend a fraction of £20m reminding the public of the cost in ponds of missing appopintments? Ah, but then we might have to explain that taxes pay for the NHS...

'The market could be worth £20m a year'. I bet it could. Worth 20m to telecom companies. I imagine they're all in favour. Since when was that a reason for the NHS to line their pockets?

Is it me, or is this a rather grubby and depressing initiative?

SMS chasers more useful than Choose and Book

11 Apr 05 14:05

I don't think it is nonsense at all. Chaser letters and phoning patients have long been used to try and minimise DNAs to outpatient clinics.

The advantage of SMS is that it can be completely automated for those patients opting in. And if it can be targetted to the most frequent DNAs, surely this is a good way to limit the waste of having NHS resources idle because the patient forgot to come.

Most of us use an alarm clock to get up, I am now firmly attached to my e-diary to tell me what I am supposed to be doing. I am outside the target group, but would not object to an SMS reminder.

Private dentists tend to provide a courtesy call to remind patients of impending appointments to limit their DNAs. It is said that Choose and Book will limit DNAs as the patients negotiate their own timings, and I am sure this will have an effect. But SMS messaging can help forgetfullness whether part of the patient's condition, or amongst the populace at large. If this can be done cheaply, great.

£20M does sound alot, but that is what NPfIT has done to the costs of automation in the NHS. It wouldn't buy a whole lot of advertising either.

But I don't like the idea of mass SMS of patients in the waiting room. Perhaps just calling the odd patient who can't be found by voice ?

Why grubby?

11 Apr 05 14:05

Anything which improves the use of available resources and reduces the DNA rates has got to be tried.

Why because a company makes a profit should something be seen as grubby and depressing. If the profit they make is less than the reduction in wasted resources it can only be a good thing in my humble opinion.

Case study

s.tocker@softechglobal.com

11 Apr 05 16:47

Eighteen months ago I was diagnosed with cancer. After three operations and six weeks of radiotherapy (performed brilliantly by the staff at the Royal Marsden, incidentally) I had then to visit the hospital on a monthly basis. Initially, because of the novelty and psychological necessity, it was very easy to remember on what date the check up was to occur. However, now I am fortunate enough to require a consultation only once every two months (and am hoping to end up on yearly checks), it is becoming more problematic to remember precisely for when the next appointment has been made. A simple SMS message a couple of days prior to the appointed date would not only be useful but relieve the scramble for the diary when the thought strikes that an appointment may have been missed.

A simple solution to a problem at little expense. My company market a SMS Appointment Reminder application and, according to all of the cost benefits analyses that we have performed, the payback can be huge - unless you go with a provider charging 10p+ per message, of course! Only gullible teenagers will fall for that one, won't they?!

Wireless Healthcare SMS Reminder Report

PETER.KRUGER@WIRELESSHEALTHCARE.CO.UK

12 Apr 05 12:17

Just to clarify a couple of points. Although our report states that the market could, potentially, be worth £20 million per year it also points out that this figure would only be achieved if every patient was reminded of their appointment via SMS rather than a letter or other means. This will not happen in the medium term and our estimate for revenues from SMS Reminders, based on current take up of the facility by patients and system deployment by Trusts, is under £1.5 million pa by 2010.

Sixteen to thirty four year olds, who are heavy users of mobile phones, tend to organise their lives in different ways to other age groups and rely heavily on electronic devices such as PDAs. At some point in the future the idea of having appointment details forwarded to a personal wireless device will become the norm. Then SMS reminders will become redundant as appointment reminders will be handled in the same way as any other electronic diary alert - a factor we identified as placing a limit on the growth of the SMS Reminder market in the long term.

It is also worth noting that SMS patient reminders are not being sent out as part of one 'initiative' but as part of a number of individual experiments by a handful of Trusts. Some of these experiments appear to have reduced DNAs and to demonstrate that, sometimes, small IT projects built by niche vendors can have as much impact as large IT projects put in place by the bigger players.

[Peter Kruger was involved in writing the report -- EHI]

The bigger picture

13 Apr 05 08:36

SMS text messaging is one of a number of ways in which patients can be contacted. However, there are a few advantages over more traditional methods, its quicker and its cheaper for certain types of communication. There are many projects underway today (some of which are selected for awards) that are using SMS to great effect.

This is a much wider picture than just appointment reminders! I for one am encouraged to see the debate this article has created, as SMS is a simple low cost method of communication and no-one needs to have any new equipment to join in, that must be a good reason!