Patients like digital health options but do they change behaviour?

The impact of SMS messages to remind patients about upcoming appointments was not expected.

First year results show that introducing SMS has not increased the number of no shows for medical appointments. However, there has only been a 1-2%. decrease in no shows, and in some areas, the impact was even less than that.

In her role as Assistant Undersecretary for Primary Care at the Ministry of Health, Kingdom of Bahrain, Dr Al Alawi has overseen the work in the primary care health centers that are connected and integrated with the governmental hospitals in Bahrain. 

The introduction of the SMS appointment reminder is something that patient feedback said was wanted and has been welcomed by patients. But it is not understood why the introduction of reminder messages has not made a more significant impact on reducing missed appointments.

Further research into behaviours

In her presentation to the GCC eHealth Workforce Development Conference Dr Al Alawi will set out the findings from the first year of the project and also discuss what she and her team think are possible causes for the outcome.

“We think that reasons for no shows include some attitudinal aspects which we want to understand more, as well as better communicating the benefits. We also think that not all the telephone numbers are updated” she says.

“When we look at the no show level, we were expecting to have a bigger effect. People told us they were happy and grateful to have the option, but in practice we are not seeing the anticipated impact.” These various aspects are now being explored. 

Health within the digitisation agenda

Healthcare digitalisation is being accepted by the public – indeed, in patient surveys “the patients are requesting to have more reminders, even for their lab tests,” says Dr Al Alawi.

The nation has a digital transformation strategy: “We have various online government services for citizens, and the government strategy is to move towards digital ways of working.”

The Ministry of Health has been working towards implementing electronic health record system since 2012 and there is now almost universal electronic health record integration between family health/primary care centres and the main hospital. 

In July 2019, the Ministry of Health announced it has received the Canadian accreditation for the third year after achieving the Diamond level with 99.1% of the required quality standards. This reflects the commitment of health centres to ensure professionalism in 770 required quality standards, digitalizing health services played major role in achieving those standards. 

Digitise patient services

Using the eHealth Service, patients can book, reschedule or cancel medical appointments, choose the doctor and follow up the status of their radiology and laboratory tests. The new SMS reminder links into the system. 

“We are integrated – we can see the type of management received by the patients when we refer them to the main hospital” says Dr Al Alawi. Work is ongoing to improve reports and the data intelligence. Part of this is involving training for admin staff and clinicians. 

At the Conference

Dr Al Alawi will be taking part in two sessions at the GCC eHealth Workforce Development Conference on November 3. 

In addition to her presentation on the SMS appointment reminder, Dr Al Alawi will also participate in a discussion looking at governmental strategies to promote eHealth engagement in the Gulf region.