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Leveraging patient engagement strategies to reduce appointment no-shows

Patient appointment no-shows are surprisingly costly for provider organizations but customer service strategies can save time and money.
By admin
May 9, 2022, 8:31 AM

A patient appointment no-show is a triple loss for a clinic. The patient who was supposed to get care doesn’t receive it. Another patient who could have seen their provider misses an opportunity to get on the schedule. And the clinic itself is thrown off balance, unable to generate revenue during that time.

Unfortunately, no-shows are extraordinarily common across all care settings and can range from 12 percent of scheduled appointments to a whopping 80 percent of time slots. Some estimates pin the cost of no-shows at $150 billion per year for the health system, with individual practices seeing millions of dollars in losses from patients who don’t give advanced warning of their intent to skip a visit.

It’s easy to feel angry or frustrated with the patients who don’t show up, but there are many reasons why an individual fails to make their appointment.

Related story: Piedmont’s evolving digital front door strives to engage patients and staff

Patient interviews reveal that some patients simply forget, don’t understand the scheduling system, or experience logistical issues. Others see no need to go out of their way to inform their clinic of a no-show because they feel disrespected by the health system themselves.  Still more are unable to overcome their anxiety about visiting a clinic or their fears of getting bad news and stay home at the last minute.

Whatever the reason, healthcare organizations have strong incentives to reduce their no-show rates as much as possible. A combination of patient engagement strategies and customer service technologies can help to control gaps in the schedule, ensure quality care delivery, and maintain productivity for clinicians.

Automated appointment reminders

Whether by text message or phone call, patients sometimes need a little nudge to remind them of their upcoming appointment. Automated appointment reminders are the first line of defense against forgetful patients.  

One study from a team of UK-based researchers found that text message reminders reduced non-attendance by 38 percent. Another study shows that automated reminders increase the rate of proactive cancellations, giving clinics time to call another patient from the wait list and make use of the appointment slot. 

Automated text messages and phone calls are now a commonly available technology, reducing outbound call burdens on administrative staff while measurably cutting the number of no-shows.

Online appointment scheduling and cancellation

Practices can enhance their reminder systems further with online scheduling and cancellation tools. Allowing patients to control the scheduling process enhanced convenience and reduces potential frustrations that occur when trying to manage busy schedules with a person at the other end of the line.

Adding a hyperlink to the online scheduling system when sending a text message reminder makes it easier for patients to remember to cancel or change their appointment right at that moment, potentially improving retention rates and reducing friction.

Telehealth, RPM, and online chat functions

Virtual care isn’t always a replacement for in-person services, but sometimes it can do the job equally well – or better. Telehealth, remote patient monitoring (RPM), and even online chat with a nurse or physician assistant can serve a patient’s needs without a visit to the clinic.

Consider offering a combination of telehealth visits and home-based monitoring devices for routine chronic disease management or adding extra hours to the live chat for patients who are on the fence about whether they really need to keep their scheduled appointment.

Taken together, these flexible, convenient patient engagement options could help avoid unused time slots while keeping valuable in-person appointments available for patients who need hands-on attention.


Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry. Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.

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