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Use technology to slash your DNA rate

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Missed appointments, or Did Not Attends (DNAs) are frustrating, infuriating, and expensive. They use up time that could be allocated to other patients, and, according to an estimate made after Blackpool CCG surveyed DNAs across its GP surgeries earlier this year, cost GP practices a total of £1 billion every year.

There have been various measures proposed to reduce DNAs, which are estimated to cost every GP practice an average of 34 days of GP time. The most controversial and perhaps hardest to apply is charging for missed appointments – just how would you impose such a fine?

Instead of taking this difficult draconian action, GP practices could use technology to slash DNAs. Here we look at three technologies that reduce DNAs.

Appointment reminders by SMS

Marketing people know the power of text messages:

  • 99% of text messages are open and read
  • The majority of opened texts are read within 3 minutes of being received

Where CCGs have adopted text messaging to remind patients of appointments, the DNA rate has fallen dramatically. For example, Doncaster and Bassetlaw NHS saw their DNA rate crash from 23% to just 6% after implementing an SMS reminder policy.

The best strategy appears to be:

  • Confirm the appointment when it is made
  • Remind by SMS 24 hours before the appointment
  • Remind by SMS on the morning of the appointment

With modern technology, the SMS appointment reminders can be set up to run automatically, so there is little to no time impact on the GP practice.

Make it easy to cancel appointments

While many patients simply forget their GP appointment, many others claim that they tried to cancel but were unable to do so because they couldn't get through on the phone.

You could consider making it easier for appointments to be cancelled by providing the ability to do so on your website. The SMS message sent should include a prompt to cancel if needed, and direct the patient to doing so via a simple website application (such as the GP online service).

Make appointments virtually impossible to miss

Virtual consultations are increasing. Meeting with a patient over Skype or another video-based application has a number of advantages for the patient and the doctor. These include:

  • Less travel
  • No fuel or parking costs
  • Reduction of the spread of infection
  • Encourages the patient to take responsibility for their own care
  • Far quicker for patients who lead busy lives

What is your strategy to reduce DNAs?

The use of SMS reminders, website applications to book and cancel appointments, and video technologies to conduct consultations is a powerful trio of technologies that help to slash DNA rates. However, you may find resistance to using them. It's natural for concerns about security to be raised, and there are worries that consultation by video could lead to overprescription.

When implementing any new process, procedure, or practice, there will be a need for internal consultation, training and coaching. Perhaps the most difficult hurdle to overcome will be that of readjusting ingrained culture to embrace modern technologies and methods.

Do you have any tips on DNA reduction? What methods does your practice employ to remind patients about their appointments? Applying best practice across all GP practices could help to relieve the day-to-day pressure that affects all employees and healthcare professionals in general practice.

eSupplies Medical is a trading name of Williams Medical Supplies Ltd, a DCC business