Electronic Health Record-Embedded Automated Patient Outreach to Increase Completion of Outstanding Health Care...

Automated patient outreach (APO) approaches offer promising solutions to patient engagement for outstanding health care services. Little is known about APO effectiveness.

This study evaluates the effect of an electronic health record (EHR)-embedded APO. We assessed how outreach modality, number of outreach attempts, patient sex, and patient age affected outreach success across various recommended health care services.

We conducted a retrospective evaluation of an EHR-embedded APO at a large, academic safety-net health system located in Northeast Ohio. The APOs involved up to three outreaches via patient portal (PP), phone call (PC), or SMS message, based on patient preference. APO evaluation included outreach for specific outstanding recommended health care services: lead screening, laboratories, colorectal cancer screening, immunizations, CT scans, and ultrasounds.

Among 46,261 outreaches to 19,537 patients, success occurred in 23.4% of outreaches and 55.4% of patients. Success varied widely by campaign (3.2-35.2%). SMS (24.6%) outreach was associated with greater success than PP (21.6%, p < 0.001) and PC (20.4%, p < 0.001), though results differed between campaigns. Outreach conducted in the third phase (50.5%) was overall more likely to be successful than the first (13.4%, p < 0.001) or second (13.8%, p < 0.001). However, some campaigns showed the greatest successes at phase 2. Male and female patients showed small but significant differences in success (54.2 vs. 56.0%, p = 0.016). Patient age was strongly associated with campaign success (p < 0.001).

EHR-embedded APOs are a viable method of patient outreach for outstanding health care services. SMS messaging and three outreach attempts were found to be associated with the greatest success overall. Notably, analysis of individual health care services campaigns shows patients responded differently to different campaigns with different message modes, message frequencies, and length between messages, indicating further need for research in this space. Patient characteristics, especially age, appear to be associated with campaign success, but additional study is needed.