4 Clinical Trials for Various Conditions
Penn Medicine is continually trying to optimize operations and decrease number of patients who do not show up for their appointments. This has included new changes to text message reminders, implemented as usual care. At a baseline, less than 75% of scheduled outpatient appointments are actually completed. This results in longer wait times and decreased access for patients and operational inefficiencies. The goal of the project is to test whether supplementing standard text message appointment reminders with targeted outreach using an automated phone call to patients with increased risk of not showing up for their appointment (\>15% per Epic's Risk of Patient No-Show Model) reduces no show rate (the study's primary outcome) and increases patient appointment completion rate (% of appointments that were completed during scheduled appointment time, a secondary outcome). Participants will be randomized in a 1:1 ratio to receive either the standard text message or standard text message plus the automated caller. Eligible patients have already consented to receiving text message reminders from Penn Medicine and must have an in-person appointment scheduled during the study period. The Access Optimization Group at Penn will be monitoring the randomization and outcomes reporting of whether a patient confirmed, cancelled, or no showed at the scheduled appointment. All eligible outpatient appointments over a two week period will be included in this operational evaluation. The Access Optimization Group will then make a decision on which approach to implement as usual care based on the results of this operational evaluation.
"No-shows," or missed visits are a persistent problem in all health care systems. They contribute to worsened patient access, longer wait times, and inefficient use limited health care resources. The VA's no-show rate has shown no improvement in years, resulting in a staggering 9 million ambulatory no-shows in Fiscal Year (FY) 2015. Appointment reminders are an essential and proven element to addressing no-shows but major research gaps exist. Behavioral economics (BE) and allied fields offer key insights that are relevant to developing innovation in the field of appointment reminders. Adding "nudges" informed by concepts such as social norms, behavioral intentions, clear instructions, and potential negative consequences to the Veteran and others is a novel but evidence-based way to create enhanced appointment reminders. Seemingly small changes to appointment letters can create measurable shifts in appointment attendance and no-shows. Even more, these behavioral nudges can produce large benefits when taken to scale and compounded across a population. This project will address several aims, including: developing BE-informed messages to incorporate into enhanced appointment reminders; evaluating the effect of several versions of enhanced appointment reminders; and identifying potential barriers and facilitators to widespread implementation of enhanced appointment reminder messages.
This project proposes administer and evaluate via a randomized controlled trail a text message-based appointment reminder system to promote attendance at clinic appointments after ED discharge.
The purpose of this study is to assess, prospectively, the effect of email reminders for well-child check (WCC) visits on adherence to these visits among those who have not yet scheduled the visit. The investigators hypothesize that sending reminders will increase scheduling WCC visits, attending WCC visits, and being up to date for the child's required immunizations beyond what occurs in the absence of these reminders.