Improving Follow‐up Attendance for Discharged Emergency Care Patients Using Automated Phone System to Self‐schedule: A Randomized Controlled Trial

• Published in: Academic emergency medicine 2021-02, Vol.28 (2), p.197-205
• Main Authors: Bauer, Kyla L., Sogade, Omolade O., Gage, Brian F., Ruoff, Brent, Lewis, Lawrence, Meisel, Zachary F.
• Format: Article
• Language: English
• Subjects: Adult; Aftercare; Appointments and Schedules; Automation; Clinical trials; Continuity of care; Discharge; Emergency medical care; Emergency Service, Hospital; Follow-Up Studies; Humans; Medical appointments; Patient compliance; Patient Discharge; Patient education; Prospective Studies; Reminder Systems; Telemedicine; Telephones
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1111/acem.14080

Background Automated phone appointment reminders have improved adherence with follow‐up appointments in a variety of hospital settings, but have mixed results in patients discharged from the emergency department (ED). Increasing adherence to follow‐up care has been a priority in the ED to improve patient outcomes and reduce unnecessary future visits. Methods We conducted a prospective randomized open, blinded end‐point (PROBE) trial of 278 adult patients discharged from the ED and referred to a provider for follow‐up care. Participants in the intervention arm received a self‐scheduling text or phone message that automatically connected them to their referral provider to schedule a follow‐up appointment and sent them appointment reminders. Those in the control arm received standard‐of‐care written instructions to contact listed referral providers. The primary outcome was time to appointment. The secondary outcome was time to return visit to the ED. Results The automated reminders increased the cumulative incidence of keeping the referral appointment after ED discharge (p