Computers and EMRs are very good at performing repetitive tasks, particularly in areas such as appointment reminders for patients with chronic disease. Individuals with complex co-morbid conditions require a great deal of management, and generally this is more about consistently applying rules and reminders rather than dealing with acute complicating problems.
Here are some important points to think about when using an EMR for automated reminders:
- There are a number of mechanisms that an EMR may utilize to send reminder messages. Reminders can be generated internally by the EMR and directed to a specific individual. This could simply trigger a reminder to call a patient about an upcoming test or appointment. Reminders can also be auto-generated and sent directly to patients as text messages to their mobile phones or as email. Because mobile numbers and email addresses change from time-to-time, you must have an internal quality control mechanism to ensure that this information is kept as up-to-date as possible. Because physician to patient communication by phone has not been a standard process so far, the doctor’s office may not be on the list of individuals to notify if a mobile number changes.
- Spend some time with your EMR vendor or potential vendor (if you are looking for a solution) and learn how to set up or develop reminder patient messages. Ideally this should be a capability for anyone in the practice with the correct authority. Remember to establish rules for both template creation and reminder messages in order to adhere to best practices. For example, what time of day is best to send out reminders? How many times should reminders be sent?
- Test all reminder messages at least once, particularly if they are being transmitted via email or text message. Once the reminders are in place, users of the system will assume that they are working properly. Technical glitches do occur from time-to-time, particularly when software is being updated. Undelivered reminders have a significant impact of quality of care if regularly-seen patients do not attend appointments because they have not received a notification reminder.
- Reminders and recall messages improve quality of care by enforcing a disciplined approach to chronic disease management. When used properly, they are an effective proxy measurement that you are providing comprehensive care to appropriate patients.
Ensure that your reminders and recall messages do not include any protected health information that would contravene national or provincial healthcare privacy legislation. It may be tempting to provide more detailed results and information directly within the reminder message; however, if sent to an incorrect mobile phone or email catch-all, these messages should not contain personally identifiable information that could result in negative consequences for that individual.
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