No one likes a “no-show.” We all know the frustration when we expect someone to arrive and they don’t. The waiting. The time lost. The wondering. In healthcare, patient no-shows, or missed medical appointments with no prior notice, are prevalent—and costly.
The size of the problem in radiology is particularly burdensome with rates ranging from 4-40%, and an estimated $300 to $400K of uncaptured revenue per year in certain modalities. While these statistics may not be surprising, they are problematic.
Recognizing the impact of patient no-shows
The three main impacts of patient no-shows in radiology are uncaptured revenue, underutilized staff and resources, and delayed patient care. The high rate of patient no-shows is a big concern in imaging due to cost and efficiency—imaging exams are expensive compared to other medical appointments and require highly-skilled staff to perform them.
Related article: Decreasing No-Show Rates in Radiology
The lost revenue opportunity and workflow, and equipment utilization for radiology departments is also significant. Beyond the more obvious financial impacts, patient no-shows have clinical ramifications as well. Imaging exams are usually ordered when a patient’s condition has reached a more serious stage or doctors need to identify more clearly the root cause of concern. When patients don’t show up, it delays a definitive diagnosis and possible treatment, which affects patient care.
Understanding why patients no-show
Unfortunately, most hospitals or imaging centers don’t usually have a good answer as to why patients don’t show up for appointments. Possible explanations range from patient anxiety about the exam or diagnosis; to employment, marital, or insurance status; to the number of past visits and familiarity with the hospital.
Other uncontrollable variables that attribute to patient non-compliance include things as simple as busy schedules, forgetfulness, driving distance, or the weather on the day of the exam. There are so many variables, many of which can be unique to a particular hospital’s demographic area or particular situation, that it’s difficult to pinpoint.
There are some ways to better understand patient no-shows. Using healthcare informatics and radiology information systems, providers can track which patients didn’t show up for appointments and determine if patients were double booked at another site in a multi-site organization. They can also identify what types of imaging exams have a higher rate of no-shows, or track how many patient no-shows they had each month or year. However, these tactics only provide insight on a small part of the problem.
Learning from patient no-show research
To better understand the patient-no show issue, Philips worked with the University of Washington Medical Center (UWMC) looking at data from nearly 2.9 million outpatient imaging examinations during a 16-year period to produce original research that was published in JACR in 2018. Overall, the results of the research revealed that predictors of patient no-show rates are multi-dimensional but generally fall into three main categories each with their own set of unique variables: