Moving the Needle on Patient Cancellations Through Mobile Integration: A Hospital-Based Quality Improvement Project

The Annie application (Annie app) prompts patients to track and guide their adherence to colonoscopy bowel prep protocol referred to as nothing by mouth (NPO) instructions. The app is a series of timed educational text messages geared toward colonoscopy preparation. This quality improvement project aimed to establish whether implementing a short message service (SMS) application (Annie app) would decrease the same-day cancellation rate among individuals receiving a nonemergent colonoscopy in a large Houston hospital clinic. Most same-day cancellations are related to failure to follow NPO instructions provided by the clinic nursing staff. All patients received the standard 14-day call, as well as the 3-day nurse reminder calls. The Annie app SMS was in addition to the standard nurse reminder calls. There were significant associations between using the Annie app and cancellations. Cancellation rates decreased by 21% when patients elected to receive the Annie app messages versus receiving voice-mail-only messages. African American individuals benefitted the most from the Annie app decreasing from 28.4% to 17.9%.