SMS text messaging improves outpatient attendance

OBJECTIVE: To evaluate the operational and financial efficacy of sending short message service (SMS) text message reminders to the mobile telephones of patients with scheduled outpatient clinic appointments. DESIGN: Cohort study with historical control. SETTING: Royal Children's Hospital, Melbourne, Victoria. PATIENTS: Patients who gave a mobile telephone contact number and were scheduled to attend an outpatient clinic at the Royal Children's Hospital, Melbourne in October, November and December 2004 (trial group) or in October, November and December 2003 (historical control group). MAIN OUTCOME MEASURES: Failure-to-attend (FTA) rate compared between the trial group, whose members were sent a reminder, and the historical control group, whose members were not sent a reminder. Financial benefits versus cost of sending reminders. RESULTS: 22,658 patients with a mobile telephone contact number scheduled to attend an outpatient clinic appointment in October, November and December 2004 were sent an SMS reminder; 20,448 (90.2%) of these patients attended their appointment. The control group included 22,452 patients with a mobile telephone contact number scheduled to attend an appointment, with 18,073 (80.5%) patients attending. The FTA rate was significantly lower in the trial group than in the historical control group (9.8% v 19.5%; P < 0.001). The cost of sending the SMS reminders was small compared with the increase in patient revenue and associated benefits generated as a result of improved attendance. CONCLUSIONS: The observed reduction in FTA rate was in line with that found using traditional reminder methods and a prior pilot study using SMS. The FTA reduction coupled with the increase in patient revenue suggests that reminding patients using SMS is a very cost effective approach for improving patient attendance.