Text Message Reminders Reduce Outpatient Radiology No-Shows But Do Not Improve Arrival Punctuality

Abstract Purpose To assess whether text-based appointment reminders are a cost-effective strategy to decrease patient no-shows and improve arrival punctuality in the setting of outpatient radiology imaging. Methods and Materials From July 2016 through October 2016, all patients scheduled for MRI imaging at two outpatient locations were randomly assigned to a texting or nontexting arm based on the day. On texting days, patients scheduled for MRI received both the traditional phone call reminder as well as a text-based reminder of their MRI examination. On nontexting days, patients scheduled for MRI received only the traditional phone call reminder. All patients were evaluated based on whether they attended the MRI appointment and, if attended, whether they arrived 30 minutes before the MRI appointment as requested in the text message. Potential associations between the text reminder and examination attendance and punctuality were assessed by χ2 test with associations considered significant at P ≤ .05. Results A total of 6,989 patients were eligible for analysis, 3,086 in the texting group and 3,903 in the nontexting group. In the texting group, 67.5% (2,083/3,086) of patients were successfully texted with an appointment reminder, with the other 32.5% not having text accessibility. The percent of no-shows was significantly decreased for the texting group compared with the nontexting group (3.8% versus 5.1%, P = .02, odds ratio 0.75, 95% confidence interval 0.59 to 0.94). There was no significant difference between the percent of patients arriving the requested 30 minutes before the MRI appointment between the texting and nontexting groups (60.0% versus 58.5%, P = .25). Conclusion Text message appointment reminders are an effective strategy for decreasing radiology no-shows, even in the presence of traditional phone reminders, but do not improve patient arrival punctuality.