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Two-Way Texting: The Simple, Effective Way to Reduce Radiology Revenue Loss


Contacting patients via cell phone can save time, money, and resources.

Radiology departments tend to have some of the most advanced and effective technology in a hospital. Yet, when it comes to communication with patients, most radiology departments lack a crucial, yet inexpensive technology: two-way texting.

Before we discuss this technology, it's helpful to gain a better understanding about why patient communication is so important for radiology departments. Consider that according to research published in Current Problems in Diagnostic Radiology, radiology loses more uncaptured revenue per patient visit than primary care or other practices due to patients failing to keep appointments. This research estimated that uncaptured radiology revenue due to no-shows likely reaches $1 million annually at a typical U.S. academic medical center.

To communicate with patients about appointments, radiology departments have historically relied upon staff phone calls or mailed letters, such as mammogram reminders. While these communication methods may have once served radiology departments well, they are likely no longer effective for achieving their objectives.

A Harris Poll survey found that 29 percent of consumers do not listen to their voicemails. A Consumer Reports national survey found that 70 percent of Americans will not answer their phones when they don't recognize the incoming number. This will likely include calls made by healthcare organizations and radiology departments. Voicemails can linger unheard for days or may be deleted without ever being listened to if the message is believed to be spam.

Letters sent via the Postal Service take at least a few days and there is no means of determining whether a letter reached its intended location and recipient. Furthermore, there is no way of knowing whether the recipient will read, let alone, act on the contents of the letter.

Finally, both of these more traditional communication methods are expensive. The cost of sending a stuffed envelope, factoring in staff time and materials, typically runs around $1.20 to $2.00. Phone calls - with most outreach efforts requiring multiple calls - occupy expensive staff time.

The (Radiology) Case for Two-Way Texting

Now let's assess why texting - specifically two-way texting - is a communication platform that radiology departments should strongly consider. Two-way texting, when used in healthcare, enables information to be pushed to and pulled from patients, caregivers and facility staff.

What makes texting such an effective method of communication? The American adult, irrespective of age, has made texting a fundamental part of the communication in their lives. Texting is how Americans choose to communicate with their family, their friends, their colleagues and select businesses.

Nearly all U.S. adults now own cell phones, with smartphone ownership exceeding 80 percent, notes the Pew Research Center. This extends to older individuals, with 91 percent of adults 65 and over owning cell phones and a majority owning smartphones. Many adults now prefer to receive and send a text instead of receiving/making a phone call, according to a Chicago Tribunearticle. This preference is apparent when considering that 95 percent of text messages are read within just three minutes of being sent, according to a Forbesarticle, and 98 percent of all text messages are read, Mobile Marketing Watch reports.

Cost is also a factor that makes texting an appealing means of communication for healthcare providers. Whereas the cost of making phone calls and sending letters is measured in dollars, the cost of sending texts is measured in pennies.

Value of Two-Way Texting for Radiology

Radiology departments that leverage two-way texting can achieve improvements in several areas of their operations. These include the following:

Topline revenue: Texting can have a significant, positive impact on appointment cancellations and no-shows. Texted reminders can help keep patients compliant with pre-appointment requirements and better ensure they arrive at their appointment at the right place and on time.

If patients need to cancel an appointment, one cannot assume they will pick up the phone and call to do so. They may choose to simply not show rather than wait on hold and eventually discuss their situation. However, they may not hesitate to text the need to cancel, especially if prompted by a message asking patients to confirm their appointment or asking if they have any concerns. A follow-up text from hospitals can help with rescheduling the appointment.

An additional revenue-generating opportunity is to send mammogram recall texts. Since patients' mobile numbers rarely change, those numbers already in your system or captured going forward are likely to remain the same for years. You can schedule text messages to go out to patients in advance, whether that be days, weeks or months before upcoming appointments. When texting is automated, there's no risk of falling behind and developing a backlog of outreach efforts.

Expenses and waste: Two-way texting will eliminate some of the expensive mail usually sent for appointment reminder or results communication. Two-way texting can also eliminate wasted doses that need to be discarded because patients failed to show up for their appointment.

Staff workflow: Staff in the radiology department tasked with communicating to patients can significantly reduce the time they spend on the phone calling and leaving voicemails for patients or assembling letters.

Portal utilization: Two-way texting is an easy way to notify patients that results are available. If a link to the patient portal is included in the text, patients can click on the link to activate the browser on their phone and go to the sign-in page of the portal.

Radiology Department Case Study

Data backs up the value of two-way texting for radiology departments. A radiology department that used a two-way texting platform ran a study in 2019, according to Dialog Health data, to see what impact two-way texting could have on its top-line revenue. From January through April, half of its patients were enrolled to receive texts while the other half did not receive text reminders about their appointment. The study included nearly 5,000 scheduled appointments.

The results: Patients receiving only text reminders had 180 no-shows, while patients receiving phone calls had 254 no-shows. That's a 29 percent reduction in no-shows. Another way of looking at it: 75 additional appointments in the first third of the year, which would translate to more than 220 additional appointments for the entire year.

Implementing Two-Way Texting for Radiology

Hospitals and their radiology departments must ensure the channels used to communicate with patients are chosen based upon individual patient preferences. Some patients will prefer letters, some may prefer phone calls or emails. But, for a majority of patients, texting will be a - if not the - communication method of choice. This should be welcomed news for the reasons highlighted earlier and many others. Texts can eliminate many outgoing phone calls and letters, generate inbound calls and increase touch frequency with patients. Two-way texting is a channel that should be considered as a key part of any radiology department's communication strategy.

A good rule of thumb: If you can include a message in a voicemail, email or letter, consider sending it as a text message. You'll find that's often a winning proposition.

Brandon Daniell is president and co-founder of Dialog Health. He has nearly 20 years of business and program development experience in healthcare, having worked with leading employers, physicians, payors and hospital systems. With three physicians in his family, Brandon understands the challenges many providers face concerning patient engagement.

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