Jan 26, 2011

Missed appointments cost millions annually
Better reminders; patients rescheduling to cut no-shows

By Phil Tegtmeier
ERMC Public Affairs Office

HEIDELBERG, Germany – Nearly 5,000 missed medical appointments per month costs Army Medicine in Europe about $5 million per year.  Engaging beneficiaries and unit leaders can help reduce the number of missed appointments by half, health officials say. 

In addition to reducing the cost of health care, reducing missed appointments will help Europe Regional Medical Command clinics provide beneficiaries improved access to the health care they so richly deserve, according to Army Lt. Col. Andrew Lankowicz, ERMC Clinical Operations director. He noted that one missed appointment can impact three others: the unfilled missed appointment, the missed appointment someone could have used, and the one the person still needs for himself.

"We cannot expect patients to be able to make it to every single appointment they make with us, but we can work together to bring our no-show rate of 10 percent down to five," Lankowicz said.

To that end, Army community health care clinics are looking at better ways to remind people of upcoming appointments. At the same time, they are taking other, customer-oriented, steps to bring the rates down.

Lankowicz referred to a study of no-show rates in military hospitals. He said nearly half of the study’s respondents said they missed their appointment because they simply forgot they had one scheduled.

"If we provide better reminders and help patients make their appointments, we can make a great improvement," he added.

Reminding patients of upcoming appointments does two things, Lankowicz said.

If everyone who missed an appointment because they forgot about it came in, the Europe no-show rates would go down by half, he said. At the very least, a reminder a few days before the appointment is due gives patients a better chance of rescheduling at a time that’s more convenient to them if their plans have changed.

"We also want to give unit leaders more time to make certain Soldiers make appointments or change them if the unit mission dictates rescheduling," Lankowicz said. In order to do so, clinics across Europe are improving their reports of Soldier upcoming and missed appointments to unit commanders for Soldiers in their units.

Knowing which Soldiers in a unit have medical appointments can be a useful tool in a combat unit. One deployed combat medic took part in an online discussion at the NCO Net forum at Army Knowledge Online. He said that asking Soldiers to leave their NCO leadership’s telephone information when making appointments would also help.

"Letting the platoon or first sergeant know of the appointment is not a cure-all, but it is a cheap and effective way to ensure another is tracking the appointment," said Sgt. 1st Class Richard Stickels, a combat medic assigned to the 2nd Stryker Cavalry Regiment.

The goal of notifications to leaders and other initiatives are to make it easier for patients to go to appointments when they can and to call in to reschedule when they cannot.

"Each missed appointment is a missed opportunity to provide care to someone needing our services," said Col. William Novakoski, ERMC’s chief medical officer and deputy commander. "Please call your clinic as soon as you know if your plans change. By doing so, you give us an opportunity to provide services to more patients in need of our care."