The Use of Mobile Messaging for Telecommunications with Patients in Ophthalmology: A Systematic Review

Effect of a Patient Portal Reminder Message After No-Show on Appointment Reattendance in Ophthalmology: A Randomized Clinical Trial

PURPOSE

To assess the efficacy of electronic health record (EHR) messaging for re-engaging patients with ophthalmology care after a missed appointment.

DESIGN

Prospective, randomized clinical trial.

METHODS

The study setting was an academic ophthalmology department. The patient population comprised of return patients age 18 years or older with an appointment "no show," or missed appointment. Over 2 phases of recruitment, 362 patients with an active patient portal in the EHR were selected consecutively each business day. Patients were randomized using a web-based tool to receive a reminder to reschedule via a standard mailed letter only (control) or the mailed letter plus an electronic message through the EHR within 1 business day of the missed appointment (intervention). Reengagement with eye care was defined as attendance of a rescheduled appointment within 30 days of the no-show visit. Patient charts were reviewed for demographic and clinical data.

RESULTS

The average age of recruited patients was 59.9 years, just under half of the sample was male (42.5%, 154/362), and most patients were White (56.9%, 206/362) or Black (36.2%, 131/362). Patients were most commonly recruited from the retina service (39.2%, 142/362) followed by the glaucoma service (29.3%, 106/362). Many patients in this study had previous no-show appointments, with an average no-show rate of 18.8% out of all scheduled visits across our health system. In total, 22.2% (42/189) of patients in the intervention group attended a follow-up appointment within 30 days of their no-show visit compared to 11.6% (20/173) of the control group (OR, 2.186; 95% CI, 1.225-3.898; P = .008). When including only the 74 patients in the intervention group who read the intervention message in the patient portal, 28.4% (21/74) attended a follow-up compared to 11.6% (20/173) of the control group (P = .001).

CONCLUSIONS

EHR-based reminder messages sent within a business day of a missed appointment may promote re-engagement in ophthalmology care after appointment no-show.

The use of mobile devices in oculoplastic and oral and maxillofacial surgery: A systematic review

BACKGROUND

The use of smartphones in the United States has more than doubled since 2011. Mobile phone applications have versatile functions in ophthalmology, otolaryngology, and plastic surgery, such as increasing patient engagement in treatment, decreasing no-shows to appointments, and providing patient education. They also provide practical advantages to the clinician, including supplementing an otoscope, laryngoscope, or ophthalmoscope. Their use in oral and maxillofacial surgery (OMFS) and oculoplastic surgery has shown effectiveness for a variety of applications, such as for photography and medical reference. Research suggests that smartphones may improve clinical outcomes and efficiency.

OBJECTIVE

The goal of this study is to provide a comprehensive and up-to-date systematic review of the available literature investigating mobile phone use in oculoplastic surgery and OMFS.

METHODS

A query of terms relevant to oculoplastic surgery and OMFS was conducted using the databases PubMed, CINAHL, Web of Science, and PsychINFO to identify studies meeting inclusion criteria that investigated the implementation, efficacy, and outcomes of mobile device use in oculoplastic surgery and OMFS. A qualitative summary and discussion of the literature was subsequently synthesized.

RESULTS

Out of a total of 289 articles reviewed, 171 were removed due to duplication across the four databases. Of the 118 studies remaining, 19 of them were included within the final qualitative review after screening the abstracts and full text for relevance. The articles were published between 2005 and 2020 from 7 different countries. Review of the relevant articles showed three settings in which mobile devices were used: communication between providers, communication between providers and patients, and as surgical supplementation. The literature review included use of mobile device photography for quality improvement, visual representation of procedures for patient education, and improved communication amongst providers and patients in the setting of oculoplastics and OMFS.

CONCLUSION

Mobile device use has become ubiquitous across cultures worldwide. The literature suggests that mobile phone use in oculoplastic surgery and OMFS may improve clinical practice in multiple settings. However, further investigation is necessary to quantify the clinical benefits of mobile device use in oculoplastic and oral and maxillofacial surgery.