Retaining homeless veterans in outpatient care: a pilot study of mobile phone text message appointment reminders.

McInnes DK, Petrakis BA, Gifford AL, Rao SR, Houston TK, Asch SM, O'Toole TP. Retaining homeless veterans in outpatient care: a pilot study of mobile phone text message appointment reminders. American journal of public health. 2014 Sep 1; 104 Suppl 4:S588-94.

Related HSR&D Project(s)

• CDA 09-016 – Understanding Health Information and Informatics Needs of Veterans

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Abstract:

OBJECTIVES: We examined the feasibility of using mobile phone text messaging with homeless veterans to increase their engagement in care and reduce appointment no-shows. METHODS: We sent 2 text message reminders to participants (n = 20) before each of their outpatient appointments at an urban Veterans Affairs medical center. Evaluation included pre- and postsurvey questionnaires, open-ended questions, and review of medical records. We estimated costs and savings of large-scale implementation. RESULTS: Participants were satisfied with the text-messaging intervention, had very few technical difficulties, and were interested in continuing. Patient-cancelled visits and no-shows trended downward from 53 to 37 and from 31 to 25, respectively. Participants also experienced a statistically significant reduction in emergency department visits, from 15 to 5 (difference of 10; 95% confidence interval [CI] = 2.2, 17.8; P = .01), and a borderline significant reduction in hospitalizations, from 3 to 0 (difference of 3; 95% CI = -0.4, 6.4; P = .08). CONCLUSIONS: Text message reminders are a feasible means of reaching homeless veterans, and users consider it acceptable and useful. Implementation may reduce missed visits and emergency department use, and thus produce substantial cost savings.