The Tech Doctor: Appointment Reminders

March 1, 2009

Autodialing machines can be a nuisance, but using them for appointment reminders is a cheap, easy way to reduce no-shows.


We’ve all received calls at home from any number of automated phone systems. These calls often start with the dreaded robotic voice saying, “Please hold for an important message,” or with that low electronic hiss we’ve come to recognize as a call from an auto-dialer calling system. Sometimes they leave unintelligible messages on our answering machines, since it seems that waiting for the beep is beyond the capabilities of these systems.

Whether it is a call from a fundraising organization or your credit card company, like a newly evolved seventh sense, most of us can detect an automated phone call within a few seconds, and if not, we cringe when we realize we’ve been duped by technology once again.

The good side

Still, these systems can have practical applications in healthcare environments by decreasing your no-show rate and providing a convenient service to your patients, while freeing up your staff to perform other tasks. You might think setting up such a system requires an advanced degree in computer science, but take heart. These days, virtually any practice can take advantage of telephone-based automated appointment reminder systems with minimal technical skills required.

Automated dialing systems generally come in two flavors: in-house hardware-based systems, or outsourced calling solutions where the actual calling is done by a third-party company using their hardware systems. Both of these methods are common in physician practices, and both options are worthy of exploring for your practice.

How it works

So how does an automaton from Metropolis know how to call patients and tell them when their next appointments are? Nearly all appointment reminder systems (in-house or outsourced) work by simply passing an electronic form of your appointment report from your scheduling application to the dialing system. Even in the simplest practice management system, this is usually an easy task. Most dialing systems can accept your appointment schedule from existing reports already contained in your PM system. There is usually a great deal of flexibility on the side of the appointment reminder system, and this can often save you from having to pay your vendor to develop a special appointment report in your PM system.

Once the electronic output is generated, it must be conveyed from the PM system to the appointment reminder system. If you purchased an appointment reminder system, and it is onsite, your vendor can assist you with methods for transferring these files. If you have secured the services of an external appointment reminder vendor, then that vendor will likely already have a method by which you can transmit your ‘dialing file’ (which is really just an electronic appointment report) to their system.

Work with your vendor to develop a method for encrypting the files before any Internet transmission. Never store these files on an employee’s personal data storage device.

In or out?

Once the dialer gets the information for dialing, there are two possible dialing options: outsourced or in-house.

There are many reputable companies providing automated dialing services to physician practices. These vendors realize an economy of scale by securing a large client base from across the country, and using one centralized infrastructure to make automated calls for all of their customers. Such organizations can easily be found through the Internet. Ask them for a list of references from their existing customers (and, of course, check them). Once you are satisfied with the service, begin negotiating a rate. Some companies will charge you a flat monthly fee for a range of calls. (Say 400 to 1,000 calls per month might equate to X dollars, while 1,000 to 2,500 calls per month might equate to Y dollars.) Other companies may charge you a flat per call rate. In either case, shop around. Some more advanced vendors can even offer appointment confirmation, allowing patients to confirm their appointment, or to notify you of cancellation by simply pressing a button.

Be cautious about entering into long-term contracts with such vendors. One year is usually adequate, and you should ensure that you leave yourself an ‘out’ in the contract, in case the quality of the service is poor (and this happens).

In-house solutions can prove more costly, but for mid- to large-size practices, this can sometimes be the best answer. While there are numerous systems on the market, it is probably best to approach your current PM system vendor, and ask if they have a partner they commonly work with to provide such automated dialing systems. That should provide a good start.

In addition to upfront capital costs, in-house systems also have other associated costs such as phone line connectivity, additional wiring, and software and hardware maintenance fees. (If your system dials at night, additional phone lines are often not needed.)

The details

Once you have chosen a system, and leveraged your vendor to handle the initial technical setup, pay heed to a few housekeeping items. One issue to consider is your chosen dialing times. Some practices feel that making calls during the day is useless, while other practices set their systems to dial between 8 a.m. and 7 p.m. Also consider general etiquette, as I’ve seen some elderly patients get upset after receiving an automated reminder call at 8:30 p.m.

Inevitably, you will also encounter patients who adamantly do not want to receive automated reminder calls. This may surround privacy issues with their family or other housemates. All of these issues will most certainly arise, and must be addressed. Expect some level of initial resistance. Many of your patients will complain about your use of impersonal dialers, but once accustomed to the product, they will value the reminder, and you will reap the rewards.

Jonathan McCallister is a client-site IT manager for a major healthcare consulting firm, and he is currently assigned to a 140-physician practice. He has worked in healthcare IT management for more than eight years and in general IT management for more than a decade. He can be reached via physicianspractice@cmpmedica.com.

This article originally appeared in the March 2009 issue of Physicians Practice.