Reducing patient no-shows through health care technology

By Jane Hevezi, grants specialist

Many clinics that Methodist Healthcare Ministries of South Texas, Inc. supports through community grants share the common problem of patient missed appointments and no-shows and are searching for solutions. In alignment with Methodist Healthcare Ministries' strategy to increase access to care, an innovative solution was implemented in Bandera, Texas by one of our funded partners, the Arthur Nagel Community Clinic, addressing this very issue and empowering patients to engage in their health care.

The clinic's executive director, Bruce Hanks, was determined to find a solution to the chronic no-show problem since many patients face issues such as transportation limitations and are unable to keep an appointment or need to reschedule. He adapted a technological solution – a mobile patient engagement app called CareMessage that has the ability to send appointment reminders via text, send surveys, collect data from any patient population, manage prescriptions, engage patients in chronic disease management, and support patients outside of the clinic with automated health education programs that are bilingual.

"We needed a way to increase patient engagement while improving patient outcomes," said Hanks. "We used CareMessage to send text message reminders to patients, which came in handy not only for appointments but other notifications too – like reminding patients to bring in their medications, or to drink extra water if it was a hotter than normal that day."

Through CareMessage, the clinic significantly reduced the number of no-shows by using the mobile appointment reminder system, which positively impacted the health of patients and increased access to care. In 2014 before CareMessage, the clinic had an almost 30 percent no-show rate. With the use of CareMessage, the number of no-shows reduced by approximately 70 percent in 2015.

Another byproduct of the new technology was the reduction of medical costs. Hanks explained, "If we can see more patients and fewer appointments are missed, then our cost-per-patient visit goes down."

To further address the problem, the clinic has worked to update patient phone numbers at each appointment to ensure they can be reached.

"The most important thing I learned after implementing this software was that folks who were the ones showing up the least were the ones who are the most chronically ill," said Hanks. "I took those statistics to heart and am glad we made changes."

To learn more about the Arthur Nagel Community Clinic, visit For more on Methodist Healthcare Ministries' grant-making, click here.

The Arthur Nagel Community Clinic joined Methodist Healthcare Ministries' family of funded partners in 2009. The Clinic provides free primary, preventive, mental and dental health care services to the underserved residents of Bandera County. To date, Methodist Healthcare Ministries has provided more than $462,875 in funding to support the Arthur Nagel Community Clinic.