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Reducing missed hospital appointments with better text messages

28 February 2019


Each year thousands of patients miss their outpatient appointments at hospitals. St Vincent’s Hospital wanted to reduce the number of missed hospitals appointments even further and reached out to us to see if behavioural insights could be used to achieve this. 

While St Vincent’s Hospital send reminder text messages to patients to remind them of their outpatient appointments, nearly 15 per cent of people still miss their appointments. Each missed appointment reduces patient care and costs the hospital money.

Our research that found it wasn’t enough to send a reminder text message - the content of the message also matters.

We worked with St Vincent’s Hospital to test different types of text message reminders to see which one was the most effective at getting people to attend their appointment.

Two randomised controlled trials were conducted. Each trial ran for six-months over a 13-month period and included nearly two-thirds of all outpatient appointments at the hospital. During the two trials around 20,000 text messages were sent to nearly 7,500 people.

First trial

In the first trial, seven new messages were developed. The new messages built on the original text message reminder sent by St Vincent’s Hospitals.

 

Version Text message
Original You have an appointment with Dr [XXXX] in [clinic XXXX] on [date] at [time]. For enquiries, call 8382–3150. Do not reply.
Version 1 Original Message + Last year the hospital lost $500,000 due to lost appointments.
Version 2 Original Message + If you do not attend the hospital loses $125.
Version 3 Original Message + If you do not attend the hospital loses $125 that can be used to treat other patients.
Version 4 Original Message + If you attend the hospital will not lose the $125 we lose when a patient does not show up.
Version 5 Original Message + By attending the hospital will not lose the $125 that we lose when a patient does not turn up. This money will be used to treat other patients.
Version 6 Original Message + You are free not to attend but please call us on 8382–3150 if you need to cancel or rearrange.
Version 7 Original Message + Please attend or call 8382–3150 to cancel/rearrange, or we will record as a missed appt.

 

The two most effective messages were Versions 4 and 5.

Second trial

The second trial tested four messages: the two most effective messages from the first trial and two new messages which focused on non-financial impacts that missed appointments have on clinics and staff.

 

Version Text message
Version 8 We are expecting you at [clinic XXXXXX] on [day] [date] at [time]. If you do not attend, St Vincent’s loses the ability to treat others in need of our services. Please call 8382–3150 if you need to cancel or rearrange.
Version 9 We are expecting you at [clinic XXXXXX] on [day] [date] at [time]. Your clinic is depending on you to attend. Please call 8382–3150 if you need to cancel or rearrange.

 

While all of the messages in the second trial led to a reduction in people missing their appointments, the most effective message was Version 5: 

You have an appointment with Dr [XXXX] in [clinic XXXX] on [date] at [time]. By attending the hospital will not lose the $125 that we lose when a patient does not turn up. This money will be used to treat other patients.

During the first trial there was a 19 per cent reduction in the number of the people missing their appointments, which saved St Vincent’s Hospital over $68,000.  

The information from the second trial was used by St Vincent’s Hospital to better target their messaging strategies for patients in the future.  

 

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