A recent study published in American Journal of Ophthalmology evaluated the efficacy of electronic health record (EHR) messaging for re-engaging patients following missed appointments.
Give me some background first.
Missed appointments are a large issue in healthcare, as they can lead to higher costs, inefficient resource use, and missed intervention opportunities.
In this study, researchers set out to assess the ability of EHR reminders to combat poor patient follow-up.
Now, talk about the study.
In this prospective, randomized clinical trial, 362 participants were chosen after two rounds of recruitment from the UPMC Vision Institute ophthalmology department.
All participants were aged 18+, had an active patient portal within the EHR, and also had a missed return appointment or a “no show.”
What about the methods?
Each participant was randomly assigned to either the control or intervention group. In the control, patients would receive a reminder to reschedule through only direct standard mail.
Participants in the intervention group also received the standard mailed letter, but in addition, an electronic EHR message was also sent within one business day of the missed appointment.
Go on…
Re-engagement was defined as patients attending a rescheduled appointment within 30 days following their no-shows.
What were the participant demographics?
Demographic and clinical data was also collected, displaying that participants had an average age of 59.9 years and were 42.5% male.
White patients made up 56.9% percent of the participants and Black patients made up 36.2%. The retina service led the recruitment with 39.2% of recruitments, followed by the glaucoma service at 29.3%
Findings?
Many of the patients included in this study had previous missed appointments. Across the health system utilized here, the study population had an average no show rate of 18.8% out of all scheduled visits.
In the control group, 11.6% of patients attended a follow-up appointment within 30 days (20/173). In comparison, 22.2% of the intervention group attended a follow-up during this same time frame (42/189).
Tell me more.
When only including those in the intervention group who read the EHR message, 28.4% of the group attended a follow-up (21/74), compared to 11.6% from the control.
Expert opinion?
Per the study authors, “EHR-based reminder messages sent within a business day of a missed appointment may promote re-engagement in ophthalmology care after appointment no-show.”
Take home.
Ultimately, while further research with larger sample sizes will be necessary to further confirm the results and to explore additional variables, the findings in this study offer new insights into EHR re-engagement and the issue of follow-up in ophthalmology.