Generation 'text'

Technology is making it easier than ever to catch up with patients and remind them of appointments. But the very latest systems deliver reminders right to the digital mailbox in their pockets. Cell phone text messages tend to carry a unique urgency of their own, so the medium lends itself especially well to the task of appointment reminding. Messages can be silently communicated to people when they are on the go or even in a meeting in which they may not be able to take a call but can sneak in a glance at their cell phone. Text message appointment-reminder systems are offered by an increasing array of companies, including Mobile, Ala.-based Televox Software Inc., which offers a service called Housecalls, and Lehi, Utah-based Smile Reminder.

IMAGE IS EVERYTHING As its name implies, Smile Reminder initially provided appointment reminder services primarily to dental practices, and in recent years the company has extended its service to other specialties, including cosmetic surgery and dermatology. "The expansion into those areas makes particular sense because practices that are cosmetically focused really need to exceed patient expectations," Jim Higgins, the company's founder, tells Cosmetic Surgery Times. In addition to helping to track down patients and remind them of appointments, text-messaging systems offer the chance for practices to present themselves as sophisticated and in touch with the latest technology, Mr. Higgins notes.

"The high-tech image is clearly important," he says. "Patients come in and want to have the confidence that you are using the latest and greatest technology because they're putting their health in your hands." Like other systems, Smile Reminder is not limited to appointment reminding. It also allows doctors to personalize other communications with patients, including everything from birthday greetings to educational information, which can be sent directly to patients' cell phones.

LIMIT YOUR LOSSES Although prices for the systems vary, both companies contend that with missed appointments cutting heavily into practice revenues, their fees are worthwhile. (For the Smile Reminder system, physicians pay a one-time set-up fee and a monthly service charge. Televox charges on a per-call and call volume basis.)

No-show rates tend to vary by specialty, but figures are generally in the 20 percent range, representing substantial losses for medical practices. And traditional voice message reminder systems, while helpful, leave much to be desired, according to Neil Sadick, M.D. "[Voice message reminder systems] don't always work that well, so text messaging is something that can be very helpful as an appointment reminder," says Dr. Sadick, clinical professor of dermatology at Weill College of Medicine at Cornell University and president of the Cosmetic Surgery Foundation. "Any solutions are helpful because one of the major causes of lost income for physicians is patients failing to keep their return appointments."

But the very things that make text messaging so convenient — its visibility and mobility — are the things that concern some the most. For Joel Schlessinger, M.D., those concerns are big reasons why his practice won't be texting appointment reminders any time soon. "While we understand that this is a convenience thing, there is also the issue of privacy and that far outweighs any convenience in my mind," says Dr. Schlessinger, director of the Advanced Skin Research Center in Omaha, Neb., and president of the American Society of Cosmetic Dermatology and Aesthetic Surgery.

"One unhappy person can make things very problematic for the physician, and possibly cost them a HIPAA fine," he adds. "In addition, there are some things that may be okay with certain people, but may drive a majority of people crazy. This is one that has that potential."

HIPAA HELP While text-messaging might appear to have the potential to open a whole new can of worms when it comes to patient privacy, representatives with Televox and Smile Reminder say their systems are HIPAA-compliant and allow for communications that use only patients' first names and don't include sensitive information.