Donna Imhoff is good at keeping appointments, but even the most organized person would still like to have a proper reminder system in place for medical appointments that are scheduled for weeks, months or years down the road.
Imhoff, 67, who suffers from rheumatoid arthritis, has her next appointment in the spring — an appointment scheduled three years in advance at the time it was set.
Imhoff has always had a beef with how the province’s regional health-care authorities issued patient reminders for specialist appointments — that is, sending out just a letter reminder through regular mail at a time when most people are using email and texting — including seniors.
She said she felt for a long time the appointment-reminder system was outdated and disjointed. She checked again recently and was happy to learn changes are being made to improve things.
“After my last appointment they rebooked me for three years later, not because of a waitlist, but because that is when I needed to be seen again,” Imhoff said. “I took the piece of paper at the time and, I’m OK, I can file it and bring it up three years later, but a lot of people wouldn’t to that.
“This morning I got that paper out and I called the department at the Health Sciences Centre and asked, ‘Do you send out a reminder?’ and the lady said they do, and that they are now on a system where they will text, or email, and they will try to contact the people. This is something new. I guess the hospital is finally getting onboard with technology.”
According to information on Eastern Health’s website, an automated notification system (ANS) was introduced in November 2016 in an effort to reduce the number of no shows to clinical appointments — a concern with all four regional health authorities in the province. It was first piloted in the 12 endoscopy services departments throughout the province, and in February 2018 ANS was expanded to include the diagnostic imaging department, beginning with the ultrasound service.
Eastern Health states that with automated notifications, patients will be notified by phone, text or email a week prior to an appointment, so they can either confirm the appointment and make required preparations, or cancel the appointment, allowing other patients to be booked.
Imhoff said she is relieved to know the health-care system is finally trying to get up to date.
“They are still a bit antiquated. I spoke to a couple of friends (recently) who have a series of doctors they go to and one lady said only one of them sends her a reminder and the others don’t,” Imhoff said. “The other friend said she gets all these reminders in the mail that she doesn’t need.
“I actually got a reminder today (about a different appointment). That’s almost a dollar every time they send out something like that. The health care is all over the place, and it’s crazy that they haven’t integrated a reminder system before this.”
Imhoff said there should also be communication with patients about what type of reminder would suit them best.
“For me, the best way to remind me is by email or texting because we travel a little bit, so what’s the good of a piece of paper sent to my house?” she said. “Then they don’t know if I’m coming or not. If they send out an email for me to confirm, and I haven’t confirmed, then they can call me. But if they send out a piece of paper, I may not see it.
“You are giving someone an appointment, a piece of paper for a year out and there is no reminder, and this is why there are so many no shows, because most people take that piece of paper and it gets lost. So there has to be reminders. Not everybody puts that appointment in their calendar.”
The Newfoundland and Labrador Medical Association (NLMA) has suggested regional health authorities in the province should invest in an ANS and other measures to improve adherence to appointments and to remove administrative burden from physicians’ offices.
According to Eastern Health, about one million appointments are scheduled annually at its adult ambulatory clinics, sometimes referred to as the outpatient specialty clinics. They include a variety of program areas, such as endoscopy, orthopedics, diabetes and physician appointments, among others.
Statistics for fiscal years 2016-17 indicate that 10.4 per cent of patients either did not show up for their appointments or did not cancel with sufficient notice. This equates to just over 97,000 missed appointments, which have a significant impact on the organization’s resources and waitlists. With new changes implemented, the rate of no-shows for the fiscal year 2017-18 has shown some improvement.
Imhoff said there appears to be much more work to be done. She said that two month ago she booked an appointment for a mammogram at the Health Sciences Centre in St. John’s and recently got a paper reminder in the mail.
“They should have asked me for my email and cellphone number for texting,” Imhoff said. “My dentist’s office, if they don’t hear back from me through email or text, they call me. So those reminder systems are already available and in place. The (regional health authoriites) don’t need to develop that internally, they can just go and buy one. Health care seems so backward, as they can’t seem to get together to put a system in place. Hopefully they are now on the way to having that.”
