title: The impact of a text messaging service on orthopaedic clinic Did Not Attend rates.
abstract: BACKGROUND
  Missed clinic appointments cause delays in treatment of other patients, under utilization of clinical manpower or facilities and impact upon hospital finances.
  
  
  OBJECTIVE
  The primary aim of this study is to evaluate whether a text messaging reminder service reduces the Did Not Attend rate. The secondary aim is to evaluate the cost-effectiveness of a mobile text message reminder service.
  
  
  METHODS
  The study focused on the outpatient department of a district general hospital. In January 2011 a patient text messaging reminder service was implemented across the outpatient departments in the trust. Data were collected prospectively 24 months prior and 24 months following the implementation of this service. A reminder was sent to patients one week prior to the scheduled appointment as a text message. All patients attending the orthopaedic department were included in the study. Patients who had an appointment and cancelled/rescheduled it prior to their original consultation date were excluded. Children were also excluded from the study.
  
  
  RESULTS
  The overall Did Not Attend rate was reduced by 12% following the intervention (p < 0.0001). The new appointment follow-up rate was reduced by 2% (p = 0.74) and the follow-up rate decreased by 13.7% (p < 0.0001). The economic analysis revealed a saving of £19,853 over a two-year period following the intervention.
  
  
  CONCLUSIONS
  Thus mobile technology is a feasible tool in improving attendance rates at outpatient clinics and is economically viable.
authors.affiliation: Trauma and Orthopaedics, Harrogate General Hospital, UK Leburrohman@doctors.org.uk.
authors.forename: Lebur
authors.initials: L
authors.lastname: Rohman
authors.affiliation: Hull Royal Infirmary, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Maruswezki
authors.affiliation: Harrogate General Hospital, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Boyce Cam
mesh_terms: D001071:Appointments and Schedules; D003362:Cost-Benefit Analysis; D017721:Hospital Costs; D006767:Hospitals, District / Q000706:statistics & numerical data; D006801:Humans; D000067455:No-Show Patients / Q000706:statistics & numerical data*; D009985:Orthopedics; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D017010:Reminder Systems / Q000191:economics / Q000706:statistics & numerical data*; D060145:Text Messaging; D006113:United Kingdom
keywords: Cost analysis; cost-effectiveness; ehealth