National Health Service - improved efficiency in national healthcare

Challenge

According to recent research by the Doctor Patient Partnership charity, on average 14% of UK patients do not keep their clinic appointments. Nearly one third of non-attendees simply forget to turn up. Every time a patient misses an appointment time resources are wasted.

Solution

iPLATO has developed a mobile messaging solution that sends automated text messages to patients' mobile phones, reminding them of their healthcare appointments, with the aim of reducing patient absenteeism and improving the quality of care. The system can be integrated to the patient administration or clinical systems of the healthcare sites, leading to minimum/no additional workload for the administrative and medical staff.

Case Study

iPLATO’s Patient Care Messaging (PCM) has been running at City Road Medical Centre in Islington PCT since August 2004. This project is being monitored by researchers at the University College of London with a report due in the summer of 2005.

PCM reduces DNA’s, increases the quality of service to patients and represents an excellent means of communicating with patients, especially those from socially excluded or other disadvantaged backgrounds. It has also proven to be a cost effective method to carry out personalised communication with large audiences about public health issues such as smoking.

Soon the service will be used as a ‘patient support mechanism’ for patients with severe chronic conditions such as multiple sclerosis and cystic fibrosis. The service is provided in close collaboration with Orange.

Early findings:

• Key for successful service is the availability of mobile phone numbers in the Patient Administration System (PAS). The percentage of patients with mobile phone number on record in the PAS at the launch of PCM was 20%. Today, this number has increased to about a third of all patients on the list – and growing.
• DNA at City Road Medical Centre was close to the national average and around 20% at the time of PCM launch.
• According to City Road’s own ‘in-official’ estimates PCM reduces DNA by about 15%. We are extremely happy with this number considering that only one fifth of the patients had registered their mobile phone number prior to service launch. As a reference, the service as designed to break even in cost/benefit terms if we reduced DNA by more than 0.5%...
• At City Road, the system has been used cross-demographically to alert all patients with a PAS recorded mobile phone number about appointments. No specific data has, so far, been analysed on the impact on specific demographics such as young asthma patients although we expect the results to be better – because the target group is younger.
• Patients should be given the option of opting out of the service. The process for opting out is to complete a tear-off on a text messaging leaflet which is displayed at the registration counter at the Practice. Of the more than 5,000 patients at City Road Medical Centre in Islington, only 15 patients have opted out of the service to date.
• Patients seem to appreciate this service beyond not unsubscribing. Over the last few weeks, we have seen a 92 year old lady insisting being a part of the service and return messages claiming “I am away in Las Vegas this week. See you on my return” and “I am sorry totally forgot my hallway is flooded burst pipe got workmen here. Can u give me another appointment?”.
• A somewhat unexpected side benefit that we have discovered at City Road has been an element of social inclusion. It is clear that patients with unstable living conditions (frequent change of addressed / unreliable access to postal services) also use mobile phones. Text messaging appears to be the most attractive way of addressing this audience.

For more information on Patient Care Messaging, please click here.