Reducing dropouts in outpatient care through an SMS-based system.

The objective of this work is to reduce the number of outpatients dropouts, i.e. appointments that, unexpectedly, are not attended by the scheduled patients, thus causing disturbances to the regular ambulatory workflow, waste of resources, and, eventually, longer waiting lists for ambulatory care. A collateral, but not less important result is the improvement of the relationship between citizens and the public Hospital Company. The method proposed consists in sending short instant messages to remind the appointment. After the promising estimates obtained by a preliminary cost-benefit analysis, a commercial product was purchased for the communication infrastructure, while a software module has been developed for interacting with the legacy system, in order to retrieve the information necessary to compose the text of every sms and send it to the citizen. The system has been implemented since seven months, and its benefits have been measured. Dropouts trend, stable at 7-8% during last years, is clearly decreasing, while the number of citizens providing their mobile number to the healthcare booking facilities is constantly increasing. Our conclusion is that the cost of the system will be amortised in a very short time, leading to a significant cost saving and, hopefully, to shorter waiting lists.