EHR Usability

Patient Reminders and Recall Messaging

Computers are extremely good at performing repetitive tasks, particularly for mundane things such as appointment reminders. By extension, EHRs excel at the same type of functionality, particularly when applied to patients with chronic disease. Individuals with complex co-morbid conditions require a great deal of management and generally this is more about consistently applying rules and reminders than dealing with acute complicating problems.

The following are important points to consider:

  • Reminders are an integral component of Meaningful Use: The ability to “Send reminders to patients for preventive and follow-up care” can be selected by eligible professionals as one of the 10 menu-set Meaningful Use measures. The patient population that you serve will influence your choice of this  particular measure. If you have a large 65+ patient population with a high prevalence of chronic diseases, your practice may be a good candidate for this measure.
  • There are a number of mechanisms that an EHR may utilize to send reminder messages. Reminders can be generated internally by the EHR and directed to a specific individual. This could simply trigger a reminder to call a patient about an upcoming test or appointment. Reminders can also be auto-generated and sent directly to patients as text messages to their mobile phones or as email. Because mobile numbers and email addresses change from time-to-time, you must have an internal quality control mechanism to ensure that this information is kept as up-to-date as possible. Because physician to patient communication by phone has not been a standard process to date, the doctor’s office may not be on the list of individuals to notify if a mobile number changes.
  • Spend some time with your EHR vendor or potential vendor (if you are looking for a solution) and learn how to set up or develop reminder patient messages. Ideally this should be a capability for anyone in the practice with the correct authority. Remember to establish rules for both template creation and reminder messages in order to adhere to best practices. For example, what time of day is best to send out reminders? How many times should reminders be sent?
  • Test all reminder messages at least once, particularly if they are being transmitted via email or text message. Once the reminders are in place, users of the system will assume that they are working properly. Technical glitches do occur from time-to-time, particularly when software is being updated. Not only can undelivered reminders have a significant impact of quality of care, but they will also hurt your bottom line if regularly-seen patients do not attend appointments because they have not received a notification reminder.
  • Reminders and recall messages improve quality of care by enforcing a disciplined approach to chronic disease management. When used properly, they are an effective proxy measurement that you are providing comprehensive care to appropriate patients.

Finally, ensure that your reminders and recall messages do not include any protected health information in contravention of HIPAA (Health Insurance Portability and Accountability Act). It may be tempting to provide more detailed results and information directly within the reminder message; however, if sent to an incorrect mobile phone or email catch-all, these messages should not contain personally identifiable information that could result in negative consequences for that individual.

Do you use patient reminders and recall in your EHR? Have you optimized the reminder and recall capability in your EHR? Share your experiences and best practices by adding feedback or comments.

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