Executive Summary
Patient access/registration/scheduling areas are using automated reminder calls to reduce no-shows. No-shows in behavioral health were cut by 20% at Western Connecticut Health Network. Some practices at Orlando Health now have 0% no-show rates.
• Patients can speak directly with a scheduler to cancel or reschedule the appointment.
• Patients are likely to forget appointments made months in advance.
• Managers track no-show rates and how patients responded to the reminder calls.
An automated reminder system has reduced the no-show rate in behavioral health by 20% at Western Connecticut Health Network, reports Maureen Moreno, MBA, director of patient access and the Contact Center at Danbury (CT) Hospital.
“We make three attempts at different times over two days,” says Moreno. The first call is made at 6:30 p.m., the second call is made during the late morning the following day, and a third call is made during the afternoon. “If someone answers the phone or it hits voicemail, there are no more attempts,” Moreno says. If the patient answers, the recording states the patient’s first name, address, and appointment time. The patient can confirm the appointment, speak to a representative to reschedule, or cancel.
“That call then goes directly to a scheduler,” says Moreno.
Because preregistration is now centralized with the Patient Access Contact Center, all patients in the health system’s three hospitals receive the same automated reminder calls. “Before, it was all decentralized, so there was no rhyme or reason,” says Moreno. “Some departments were calling the patient to remind them of appointments, and some weren’t.”
Reducing no-shows increases productivity. “If the patient doesn’t show up, then that technician is idle, so there is a loss,” explains Moreno. Patients make some follow-up appointments six months in advance and simply forget about them. Using the new system, “we’ve found it a win-win. Either the patient can reschedule, or the patient will show up,” Moreno says.
The automated tool allows managers to track no-show rates and how patients responded to the reminder calls.
“Because processes were inconsistent before, we never had any way to track it,” says Moreno. “Since we’ve been doing this for some time, we’ve seen some trends.” When the weather is bad, patients typically call to reschedule appointments; when the weather is nice, though, many patients just don’t show up.
Patient access staff members need permission to call a patient’s cell phone, notes Moreno. “We get them to grant permission by asking the patients if we can use their cell phones and noting the account. We are close to 50% of cell phone numbers as a main contact,” she says.
Some patients comment, “My doctor sends me text messages. Why can’t you?” “We don’t do text currently, but it’s definitely something that patients want,” says Moreno.
Patients sometimes indicate that they don’t want or need the reminder calls. While some behavioral health patients need reminders because they repeatedly fail to show up for monthly appointments, others want to be removed from the call list. “Some patients have come in multiple times a month for years, and they don’t need a reminder,” says Moreno. “We work with departments, and we tweak things.” (Western Connecticut Health Network uses TeleVox House Calls, manufactured by Mobile, AL-based TeleVox Software.)
0% no-show rate
At Orlando (FL) Health, front office assistants use an automated tool to ensure all available slots are used.
“Previously, practices would have to make these calls manually, often reaching a lot of answering machines because calls were made during regular business hours,” reports Tawnya Adkisson, corporate director of population health and care coordination.
Automated calls now are made in the evening, when patients are more likely to be available to respond. “This means a greater response rate, which leads to more appointments confirmed,” says Adkisson. Staff members are alerted of cancellations far enough in advance to book another patient in the now-available timeslot.
“Because we are able to act so timely, our current no-show rate across all practices is 5%,” says Adkisson. “Some practices actually have a 0% no-show rate.”
Automated calls have been made to nearly 750,000 patients to date. “Depending on the department, as many as 25% request to cancel or reschedule their appointments,” reports Adkisson.
If the system reaches a person instead of an answering machine or voicemail, the patient is prompted to select what he or she intends to do with that appointment: confirm, reschedule, or cancel.
“The system then collects information regarding the patient’s intention and displays it back for us in real time,” says Adkisson. “We act on any cancel or reschedule requests.” (Orlando Health uses Phytel Remind, manufactured by Dallas-based Phytel.)
SOURCES
- Tawnya Adkisson, Corporate Director, Population Health and Care Coordination, Orlando (FL) Health. Phone: (321) 841-8160. Fax: (321) 843-1504. Email: [email protected].
- Maureen Moreno, MBA, Director, Patient Access/Contact Center, Danbury (CT) Hospital. Phone: (203) 794-5440. Fax: (203) 739-8851. Email: [email protected].
