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. 2014 Sep;104 Suppl 4(Suppl 4):S588-94.
doi: 10.2105/AJPH.2014.302061.

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

D Keith McInnes  1 , Beth Ann Petrakis, Allen L Gifford, Sowmya R Rao, Thomas K Houston, Steven M Asch, Thomas P O'Toole
Affiliations

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

D Keith McInnes et al. Am J Public Health. 2014 Sep.

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.

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Figures

FIGURE 1—
FIGURE 1—
Utilization changes pre- versus postintervention: Providence, RI, 2013. Note. Appt. = appointment; ER = emergency room.
See this image and copyright information in PMC

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