Charlie Norwood VA Medical Center
OMG! VA in Augusta 1 of 3 to use text messaging for patients
September 14, 2016
by Jason Tudor
Charlie Norwood VA Medical Center
Public Affairs Officer
AUGUSTA, Ga. (Sept. 14, 2016) – Charlie Norwood VA Medical Center’s effort to improve the Veteran experience has entered the world of OMG, LOL and emojis.
Text messaging as a means of reminding, keeping and canceling appointments is running as a pilot program at VA Augusta. Initial capability started Aug. 8. Charlie Norwood VA Medical Center is one of three VA health care organizations across the country using a text messaging system for appointments; Loma Linda, Calif. -- which developed the local software -- and Fayetteville, Ark. are the others.
The system is confidential and relies on one of three responses from a Veteran: “yes,” which means the Veteran will make the appointment time; “no,” which means the Veteran will not; and ‘stop,” which means the Veteran no longer wants to receive texts. The only information passed through the messaging system to the Veteran is the phone number (needed for the text) and the date of the appointment.
The goal of the text messaging pilot is to improve the Veteran experience and make the appointment process more efficient, said Dr. Oladipo Kukoyi, VA Augusta chief of staff.
“At Charlie Norwood, we aim to make each Veteran’s experience with us an exceptional one. This experience carries through with them each step of the way through their medical appointment, to their ancillary services, to medical tests, to dispensing pharmaceuticals or prosthetic items, and in their discharge process until we see them again,” Kukoyi said. “This text messaging program is part of that effort and so far, it’s going very well.”
Numbers tell the story
For Fiscal Year 2015, there were about 48,000 no-shows, about 136 per day, at Charlie Norwood. In the same time period, the “missed opportunity rate” (no shows by Veterans) for all clinics was about 14 percent. The hospital’s goal is to have a no-show rate of less than 12 percent. Through August – which had the lowest monthly overall rate of the year at 13.26 percent – the rate was 13.72 percent.
“Though we realize it will be difficult to impact a year’s average with eight weeks [of the text messaging pilot program], the results can give us momentum moving into FY 2017,” according to Cary West, a program analyst for the chief of staff who oversees the text messaging pilot.
The program started with five focus areas, but expanded to 10. They include clinical pharmacy, ear, nose & throat, gastroenterology, mental health (individual and group), optometry, physical therapy, PTSD, substance abuse, and women’s health. All told, West said the 10 focus areas represent about one-third of all “no shows” at Charlie Norwood. In FY 2015, there were 14,500 no shows for the 10 focus areas amounting to a loss of about $3.6 million.
Improvements ranged from 1 percent in women’s health to an 18 percent improvement in mental health individual clinic. Three others had 7 to 10 percent improvements. Overall, average improvement for five focus-area pilot group was 9.5 percent. West said optometry has a significant improvement going from a 15 to 10 percent no show rate. Other factors affecting current rates include Tropical Storm Hermine, which passed over Augusta Sept. 2, triggering many no shows across the board and skewed data.
The rise of texting as a business tool
According to West, Veterans want text messages, adding that “consistent feedback has shown that Veterans want this as part of the overall experience.” According to the Centers for Disease Control and Prevention’s “National Health Interview Survey,” 91 percent of adults own cellphones. When last measured by Pew Research Center in 2013, 81 percent of cellphone owners used text messaging.
Veterans say they want the text messages, too. Army Veteran Nicole Cartwright gets care at Charlie Norwood and said the digital reminders would help her in receiving care.
“It would help a lot. I have a tough time remembering things, so this would be helpful,” Cartwright, who served from 2008 to 2015, said. “Other businesses have already integrated that technology into the way they do business. If the VA would use [text messaging], that would be pretty awesome.”
While West said the pilot is successful so far, he said there are still challenges to integrate the more forward-leaning texting capability and the more traditional ways Charlie Norwood schedules and cancels Veteran appointments. For instance, while the texting capability exists, when eventually accepted, it still has to be integrated into policy, standard operating procedures and staffed with the right people. Much of the accounting and reconciling is done ad hoc.
“We still have a ways to go, but what we see is promising,” West said.