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Study finds ultrasound and mammo have highest no-show rates

by Thomas Dworetzky , Contributing Reporter
No-show visits continue to pose challenges for imaging facilities.

A new study of the facilities at the University of Washington covering 2.9 million patient visits during a time period from 2000 to 2015 shows the no-show rate ran from 3.36 percent in 2000 to 2.26 percent in 2015, researchers at the institution reported in the Journal of the American College of Radiology (JACR).

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The rates for the total length of the study period averaged 3.25 percent, and varied by type of exam with mammography and ultrasound missed visits running at nearly twice that, at 6.99 percent and 4.45 percent, respectively.

One possible reason for the higher rates for the pair are their frequent use for screening, thus making patients see getting the studies done as less urgent.

MR, nuclear medicine, and CT had 3.70 percent, 3.54 percent, and 3.35 percent rates of no-show visits, and computed radiography had the lowest rate at 1.24 percent.

Mondays and Saturdays were the highest no-show days of the week.

“In general, screening examinations have a low rate of disease, and patients often feel that there is little harm in postponement of the examination,” the study advised.

Overall, the authors looked at no-show rates for exams broken down by radiography, CT, mammography, MR, ultrasound and nuclear medicine.

These visits are “missed healthcare opportunities,” according to lead author Dr. Joshua I. Rosenbaum and his team.

“No-show visits also confer a negative impact on other patients, because a different patient could have been imaged during the unutilized time slot,” the authors wrote, adding that “besides the more obvious lack of revenue generation that is associated with an unused appointment, there is also sunk cost from the utilization of human resources for scheduling, determining examination protocol and financial pre-authorization.”

The type of exam and the lead time were the two biggest factors in skipped appointments, the research found. Lead times over six months fared worse than when scheduling was within a week of performing the examination.

The researchers expressed their hope that this study, as well as ongoing efforts looking for other factors in missed visits, “may be used to guide new interventions, such as targeted reminders and flexible scheduling.”

Dr. Joshua Rosenbaum, one of the researchers who worked on the study, said personal experience has taught him a few tricks to help reduce the rate of no-shows. He shared them with HCB News:

  • Employ data analytics tools to easily analyze your own practice's data to understand practice-specific trends. Our group's data demonstrated that modality and scheduling lead time were most important.

  • Direct practice interventions, such as patient reminder systems and flexible or short-term scheduling options, toward the patients and modalities most at risk of no-show.

  • Work closely with practice administration to identify gaps in the scheduling, billing and patient education process to increase department's efficiency.

The challenge of maximizing facility optimization comes as the global medical imaging market continues to expand – rising from 2016's $29.8 billion to an expected $45.1 billion by 2022, according to a recent report by Stratistics MRC.

The report attributes the growth to a number of global forces including technology advances, expanding medical knowledge, the increasing use of molecular imaging in clinical settings, and the turn to cloud-based computing.

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