Health Systems Prevent Millions of No-Shows with Automated Patient Outreach

By automatically sending text messages and voice calls to patients ahead of their appointments, Hello World helped prevent more than 3.4 million no-shows at health systems across the United States in the past 12 months. The automated outreach helps patients confirm visits, sends reminders, and lets patients reschedule if needed—all without requiring health system staff to pick up the phone.  

When a patient misses a visit, the impacts are both clinical and financial. For the patient, continuity of care breaks: medications go unmonitored, preventive screenings are delayed, and acute problems are more likely to turn into chronic conditions. For the health system, each missed appointment means a slot that could have gone to another patient waiting to be seen—and clinician time, staff, and space reserved but not spent on patient care. One study of a single medical center found that no-shows across its ten clinics cost more than $10 million a year.^[1] 

Automating outreach benefits both patients and health systems—including by giving staff time back. For example, at Ochsner Health, SMS rescheduling resulted in more than 1,000 hours saved by call center staff across 10 months.  

Hello World draws patients’ preferred communication channels from their medical record to reach them the way they’re most likely to respond.  

The Next Step: Showing Patients Who’s Calling

For patients who depend on voice calls, Hello World’s new Branded Calling feature shows the health system’s name, logo, and the reason for the call on the patient’s phone before they answer. “When patients can clearly see the call is coming from us, there’s a level of trust that makes them more likely to answer and keep their appointment,” said Brian Gresh, vice president and chief marketing and communications officer at Community Health Network. “We’ve seen a 54% improvement in voice reminder answer rates and a 6% improvement in our overall no-show rate.” 

Branded Calling works for all major US mobile carriers as the result of a collaborative integration effort between Epic and Vonage, a leader in global cloud communications and part of Ericsson.  

“Telemarketers and scam artists have made it increasingly challenging for providers to communicate with patients by phone,” said Charles Peele, CIO at CarolinaEast Health System. “This tool helps patients get to their appointments, which improves their health while helping to reduce lost time associated with missed appointments.” 

Borno Akhter, who leads Hello World development at Epic, sees Branded Calling as a way to further drive reductions in no-shows through stronger patient engagement. He points to a Pew Research Center report stating that only one in five Americans answer the phone from an unknown number. In contrast, he says, “adopters of Branded Calling are seeing answer rates nearly double, with more patients following through to confirm or reschedule their appointments.” 

Branded Calling also helps after appointments have been missed. CarolinaEast has used Hello World to automatically reach out to patients who missed appointments and recovered more than 240 appointments over three months, with patients more likely to reschedule when they recognized the caller. 

Epic is working closely with its customers to enable this capability across the U.S. as quickly as possible, and is actively exploring similar efforts in Canada and the United Kingdom. 

_{[1] Kheirkhah, P., Feng, Q., Travis, L.M. et al. Prevalence, predictors and economic consequences of no-shows. BMC Health Serv Res 16, 13 (2015). https://doi.org/10.1186/s12913-015-1243-z}