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Sep 3 2015   10:58AM GMT

Unlock the chronic disease management potential in your appointment reminder system

Posted by: adelvecchio
appointment reminders, preventive care, texting

scott zimmermanGuest post by Scott Zimmerman, president, TeleVox

Healthcare providers know the statistics: Seven out of every ten deaths in the U.S. are linked to chronic illness, and approximately 45% of Americans have at least one chronic condition. The numbers are real and patients are the proof. There are a lot of challenges that come along with managing care for patients with chronic illnesses. Luckily, most providers already possess a tool that can make chronic disease management a little easier: an appointment reminder system.

Most healthcare providers have access to appointment reminder systems, but few have figured out how to effectively use them to drive improved health outcomes for patients with chronic conditions. The six-point checklist below provides suggestions for immediate actions to take to expand your use of appointment reminder technology and improve patient care.

1. Notify patients when they are due for preventive services.
The first step a practice can adopt to do more for patients with chronic conditions and stretch the value of appointment reminder systems is to send patients notices about preventive services. Prevention plays a major role in managing chronic disease. Whether you are working to prevent patients with chronic diseases from lapsing into acute conditions or trying to keep at-risk patients (and even healthy patients) from developing chronic conditions in the first place, regular visits, tests and screenings are essential. Unfortunately, most patients are not good about seeking preventive care and need a certain amount of coercion. An appointment reminder system can be used to notify people when they are due for preventive services, engaging them in managing their chronic conditions.

A healthcare provider that is getting preventive notifications right is Ochsner Health System, one of Louisiana’s largest healthcare delivery systems. Ochsner recognized many patients were not scheduling preventive screenings and tests and took action to change that. Its initial focus was on educating patients about their eligibility for colorectal cancer screenings. Using an appointment reminder system, Ochsner delivered automated phone notifications to a group of 3,137 people with recent orders for a colonoscopy or upper endoscopy. The conversion rate was an impressive 18.4% — meaning Ochsner scheduled 578 colorectal test screenings for its patients simply by explaining eligibility and asking people to set up appointments.

An organization can easily leverage the technology it already has in place to involve more of its chronic disease patient population in preventive care. That will have a big effect on the health of patients struggling with chronic diseases. Simply identify patient groups that are eligible for services and reach out to them with preventive care information and invitations.

2. Remind patients to keep their appointments.
Missed appointments pose a significant challenge when it comes to monitoring and managing the health of patients with chronic conditions. So this step — reminding patients to keep their appointments — is a no-brainer and something many healthcare providers are already doing well. If a healthcare organization is not successfully using automated notifications like text messages, voicemails, and emails to remind patients of upcoming appointments, it should make changes and implement reliable technology immediately.

Setting up reminders is as easy as running a report of upcoming appointments. You can choose any timeframe for reaching out to patients, but keep in mind that patients with multiple chronic conditions may need to arrange for transportation to get to their appointments. It’s helpful to schedule reminders early enough to allow patients that may have forgotten about their appointment to find transportation.

3. Make appointment cancellations available to patients with high needs.
Because chronic diseases require constant monitoring and sometimes sudden attention, patients with chronic conditions require easy access to appointments. To minimize the length of time patients with chronic conditions must wait for appointments, offer them appointment slots that other patients have vacated.

According to a study by The Commonwealth Fund, 71% of U.S. adults reported problems gaining access to needed healthcare. This included an inability to get timely appointments. Appointment accessibility can be improved by including an easy cancellation option on all appointment reminders and maintaining a short-notice call list of patients willing to take last-minute appointments. As a provider receives cancellation notices, they should contact high priority patients that are waiting to be seen and offer them the resulting openings.

It might go against instinct to give people a way out of appointments when your intention is to get them to show up, but don’t worry. Cancellations are only a lost opportunity when they are discovered at the very last minute. If a patient has decided not to keep an appointment, their caregiver is going to find out about it one way or another. Either they will find out when the patient does not arrive at the scheduled time or they can be warned ahead of time. With the first option — the no-show — the appointment time is lost. But if patients are allowed to offer advanced warning, would-be holes in a schedule can turn into appointments for patients with high needs.

United Regional Health Care System in Wichita Falls, Texas uses automated notifications to fill scheduling holes caused by cancellations. After using appointment confirmation calls for eight months, a total of 273 patients opted to cancel an appointment. However, because of the advanced notice, United Regional was able to refill 177 of those openings — which is a 65% appointment retention rate. By implementing similar processes, other providers can be more accessible to patients.

4. Follow up with educational information and support resources.
Caring for patients with chronic diseases is an ongoing process — care cannot end when a patient leaves a physician’s office. To help support patients and guide them through self-care between visits, use an appointment reminder system to deliver focused outreach campaigns to subsets of a patient population. For example, diet and weight management materials can be delivered to patients with diabetes.

The U.S. Centers for Disease Control and Prevention reported that the National Assessment of Adult Literacy — which measures the health literacy of adults living in the U.S. — rated only 12% of the population as having a “proficient” health literacy level. That means a lot of adults in the U.S. have difficulty understanding and using health information that is given to them. More good can be done for patients by repeatedly sending them text messages or emails containing information related to their disease, follow-up instructions, medication reminders and alerts, and other additional resources.

Design patient outreach around the questions commonly asked about chronic conditions like: What is the cause of this chronic illness? What is the prescribed treatment and why is it necessary? What role does medication play? What assistance can a patient get between visits and how can they get help when needed? Who should a patient contact if they have additional questions?

5. Reach out between visits to offer support and motivation.
The final step is to use technology to deliver motivation and support for patients as they work to self-manage their conditions. Most patients with chronic conditions — and those at risk for developing them — need to adopt some lifestyle changes, such as exercising more or quitting smoking. These types of behavioral changes aren’t always easy. Healthcare providers can help by inspiring patients to change unhealthy or risky behaviors. This could mean sending resources that encourage patients to incorporate healthier foods into their diets, or congratulating patients when they hit weight loss goals.

TeleVox found that patients really want to feel supported and encouraged by their physicians. According to our research, nearly 40% of patients say they would follow doctors’ orders if they got some kind of reminder or nudge from those doctors between their visits. This is significant because we also found evidence that about 83% of people do not do what their doctors tell them. So, an email or text reminder to take care of themselves could make a big difference.

If you are currently using an appointment reminder system for basic communication, you have the necessary technology to make improvements to your chronic disease management processes. Now it is up to you to implement changes — like the ones explained above — that will allow you to automatically reach out to patients and collaborate with them on how to prevent and manage illnesses.

About the Author:
Scott Zimmerman is a regularly-published authority on utilizing technology to engage and activate patients. He also spearheads TeleVox’s Healthy World initiative, a program that leverages ethnographic research to uncover, understand and interpret both patient and provider points of view with the end goal of creating a healthy world — one person at a time. Healthy World promotes the idea that touching the hearts and minds of patients by engaging with them between healthcare appointments will encourage and inspire them to follow and embrace treatment plans — and that activating these positive behaviors leads to healthier lives. Zimmerman possesses 20 years of proven performance in the healthcare industry, with domain knowledge in the surgical, interventional and pharmaceutical arenas. He currently serves as the President of TeleVox (, a part of West Corporation (, where the healthcare mission is to help organizations harness communications to expand the boundaries of where, when, and how healthcare is delivered.

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