Use of Messaging App in Reducing Outpatient Visits and Waiting Time for Re-prescription in a Tertiary Hospital Cardiology Clinic in Oman: An Audit

Introduction: Stable cardiac patients after their visit at cardiology outpatient department (OPD) clinic are given a referral letter to follow-up in local health centers for their monthly medications. However, majority come as walk-in for medications which causes overcrowding. Objective: The aim of this quality-improvement project was to evaluate use of a messaging App in reducing outpatient visits for patient’s re-prescription. Methods: We used a messaging App to communicate between patients and pharmacy. We employed Lean and Six Sigma quality improvement methodologies such as value-stream mapping (VSM), a lean manufacturing technique to compare project efficiency before and after implementation of a messaging App to dispense monthly refill medications. Results: Patients spent about 109 min (total lead time), when they come to the clinic without an appointment. The ratio of value added time (VAD) to lead time was 17% (VAD %). After initiation of the project, patients spent about 9 min (total lead time). The ratio of VAD to lead time was 80% (VAD %). Two hundred and four patients attended the OPD for prescriptions in the 1 st month which reduced every month and finally to 0 in the following month’s, i.e., 100% reduction. Simultaneously, the messaging App pharmacy request messages/dispensation increased from 32 to 150 numbers by the end of the 8 th month, i.e. from 18% to 87%. Conclusions: The use of a messaging App for monthly medication refill eliminated walk-in OPD visits and significantly reduced total waiting time by 90%.