SMS Patient Reminders in WA Public Health Services Policy

SMS Patient Reminders in WA Public Health Services Policy health.wa.gov.au

Effective: 2 November 2015 Title: SMS PATIENT REMINDERS IN WA PUBLIC HEALTH SERVICES POLICY 1. Background WA Health supports the use of Short Messaging Services (SMS) as a means of communication with employees, consumers and patients. Many WA health services currently use SMS technology to remind patients of their upcoming outpatient appointments or booked admissions. The purpose of this policy is to outline the business requirements for health service staff using SMS technology to remind patients of their upcoming appointments or booked admissions. This policy should be read in conjunction with the Electronic Messaging Policy and Acceptable Use Policy Information and Communications Technology. 2. Scope SMS for the purpose of this policy includes SMS reminders and confirmations for outpatient appointments (and associated ImagingWest appointments) and booked admissions where the appointment is entered into TOPAS, webpas, Radiology Information System (RIS) or other patient administration systems (PAS). This policy applies to all officers (employees, contractors, students, volunteers and agency personnel) within WA Health. 3. Policy statement 3.1. SMS providers Health services must purchase SMS services from the WA Government Common Use Arrangement (CUA) for Telecommunication Services (CUA56808) in accordance with the Buyer s Guide. WA Health has secured price discounts with a single provider, based on volume. Please contact sss@health.wa.gov.au for more information. 3.2. Consent Receipt of an appointment reminder via SMS is now an acceptable community standard, and a patient providing a mobile telephone number is deemed to have agreed to that mode of contact. The automated SMS applications utilise numbers stored in the relevant field of the PAS (TOPAS: Contact No field and webpas: Mobile Phone field). Should a patient request not to be contacted via automated SMS then this field should be made blank by the health service and the mobile number either removed completely or moved to another field (e.g. TOPAS: Home Phone and webpas: Work Phone). 1

3.3. Privacy and confidentiality WA Health s preferred SMS provider does not collect or hold mobile numbers or message information, it merely transmits them. WA Health does not hold or collect any information. All identified information remains with the health services. The SMS message should not include information that relates to the patient s health or medical condition, including the proposed treatment however the name of the specialty is acceptable. Specific clinic instructions should not be contained within the SMS reminder. This information should be included in the original appointment letter. The SMS message may include the following information without breaching patient privacy and confidentiality: the patient s first name OR the patient UMRN/UR; and the specialty name. See Section 4.3 for examples of standard messages. 4. Business Rules 4.1. Application and approval process SMS reminders for outpatient appointments and booked admissions can either be sent via the WA Health centralised and automated systems for example SMS-OR or the Booked Admission system, or via local health-service-built automated or manual systems. The WA Health centralised systems are operated on a user pays basis where health services are responsible for the cost of the SMS reminders they send and WA Health (HIN and System Policy and Planning s SSS unit) manage and fund the statewide system development. Given the decentralised funding model it is a requirement that approval for funding the SMSs is granted from the relevant personnel at Health Service level (e.g. Executive or Head of Department) via the SMS Patient Reminders Approval Form. The completed form must then be forwarded to the local Site Administrator so that appropriate billing can be arranged. The SMS Patient Reminders Approval Form and a list of Site Administrators can be found on the System Policy and Planning, Strategic System Support (SSS) unit s intranet page. The Site Administrator can assist clinics/specialties with completing the relevant forms for outpatient reminders and/or booked admissions. Where local data extraction systems have been deployed, the SMS Patient Reminders Approval Form must still be forwarded to the appropriate Site Administrator to ensure the SMSs are appropriately billed and to ensure that the number of SMS sent are added to the whole of health volume to maximise the opportunity for whole-of-health volume/price savings from the provider. For assistance with the application and approval process, please contact System Policy and Planning, Strategic System Support (sss@health.wa.gov.au). 2

4.2. Message timing Research has shown that an SMS reminder sent two days before the appointment is most effective. The default setting for outpatient reminders using the WA Health centralised system is 2 days prior to the appointment. This can be changed by contacting the Site Administrator. Outpatient reminders are sent at 1pm, 7 days a week. The default settings for SMS messages for ImagingWest are 5 days for a confirmation and 2 days for a reminder. Automated confirmations and/or reminders for ImagingWest are sent 7 days a week. The default settings for SMS messages sent using the WA Health centralised system for booked admissions are 5, 7 or 14 days for a confirmation and 2, 5 or 7 days for a reminder. Again, variation to these default settings is possible through the Site Administrator. Automated confirmations and/or reminders for booked admissions are sent at 9am, 7 days a week. 4.3. Standard message template 4.3.1. Message size Messages should be no longer than 160 characters, including spaces. Messages over 160 characters long are split into two or more SMSs, incurring extra charges. The message should be simple and clear. 4.3.2. Outpatient appointments The following message templates can be used for an outpatient appointment reminder. Clinics connected to the Outpatient Direct (OPD) program can use the OPD phone number (1300 855 275) in the message. Clinics that are not connected to the OPD program should use their own clinic telephone number or a generic number (such as the switchboard) as required by their health service. Staff should notify the Site Administrator of any required changes to the appointment reminder (content or phone number) or delivery schedule so they can make the relevant change(s). The two standard SMSs are provided below. The first reminder is particularly useful for parents with more than one child. [first name] has an appointment at [HOSP] [appt_time], [appt_date]. DO NOT SMS REPLY. Please call [clinic phone number or OPD number] business hours if you cannot attend. appointment at [HOSP] [appt_time], [appt_date]. DO NOT SMS REPLY. Please call [clinic phone number or OPD number] business hours if you cannot attend. Ref:[UMRN] 4.3.3. Booked admissions The following message templates can be used for booked admission reminders. Staff should notify the Site Administrator of any required changes to the appointment reminder (content or phone number) or delivery schedule who will raise an IT request for the change to occur. 3

Reminder for your admission to [HOSP] booked on [appt_date] at [appt_time]. If you cannot attend please call [clinic phone number]. Ref: [UMRN]. [first name] you have an admission to [HOSP] booked on [appt_date] at [appt_time]. If you cannot attend please call [clinic phone number]. The following message templates can be used for booked admission confirmations: Your admission date at [HOSP] is booked on [appt_date] at [appt_time]. Please confirm your attendance on [clinic phone number]. Ref: [UMRN]. [first name] your admission date at [HOSP] is booked on [appt_date] at [appt_time]. If you cannot attend please call [clinic phone number]. 4.3.4. ImagingWest SMS reminder and confirmation messages sent from ImagingWest may include the exam or appointment type. Please contact your Site Administrator for information on the standard templates. Any required changes to the SMS reminder or confirmation (content or phone number) or delivery schedule should be submitted via an ImagingWest IT request. 4.3.5. Other Other appointment reminders should use a text as close to the templates as possible. 4.4. Exclusions Certain groups should not be sent SMS appointment reminders. The description for the following exclusion groups is current procedure in most health services. 4.4.1. Prisoners The health service is responsible for ensuring prisoners mobiles are not used and that prisoners mobiles, if they have them, are not inserted into the relevant PAS field (TOPAS: Contact No and WebPAS: Mobile Phone). 4.4.2. Illegal Immigrant Detainees The health service is responsible for ensuring detainees mobiles are not used and that detainees mobiles, if they have them, are not inserted into the relevant PAS field (TOPAS: Contact No and WebPAS: Mobile Phone). 4.4.3. Estranged, non-custodial parents The health service is responsible for ensuring the appropriate next of kin s mobile number is inserted into the relevant PAS field (TOPAS: Contact No and WebPAS: Mobile Phone). 4

4.4.4. Deceased individuals Data on death is manually provided to WA Health by the Registry of Births, Deaths and Marriages monthly and is then inserted into the relevant PAS. Before an automated SMS is sent the application is to check to make sure the person is not noted as deceased. Unfortunately, there may be a small number of errors for people who have recently died as the PASs are updated monthly. The Site Administrator is to report any complaints to the SMS Group for consideration and possible remedial action. 4.4.5. Children The health service is responsible for ensuring appropriate mobile numbers are inserted into the relevant PAS field (TOPAS: Contact No and WebPAS: Mobile Phone). Where a health service deems a child of any age to be responsible (Gillick competence principle in Secretary, Department of Health and Community Services (NT) v JWB and SMB (Marion s Case) (1992) 175 CLR 218), that child s mobile number may be used. 4.4.6. Patients already seen by the doctor The health service is responsible for keeping the relevant PAS data updated. There may be a small window of error if system information is updated at the same time as an automated SMS run is active. 4.5. Non exclusions: patients already admitted to hospital It is not possible or advisable to stop automated messages while people are in hospital as the message may refer to an appropriate appointment. 4.6. Outpatient Direct Clinics that are connected to the OPD program must ensure messages from OPD have been actioned to avoid sending an automated SMS to a patient who has cancelled their appointment via OPD. For TOPAS users, messages from OPD can be found and actioned on the OPD Report Database and for webpas users messages are located and actioned on the OPD Action List in the Outpatient Views menu within webpas. Again there may be a small window of error if clinics have not completed their action requests from the OPD provider. 4.7. Complaints Minor complaints resulting from SMS reminders sent via the WA Health centralised systems are to be recorded and handled by the Site Administrators. If the complaint requires technical assistance for resolution, please raise an IT request detailing the nature of the complaint. If the complaint is deemed by the Site Administrator to be of a serious nature and in need of formal investigation, the complaint should be directed to the Hospital Complaints Department for action and a copy sent to SSS for consideration by the SMS Group. It is requested that a record of all complaints (irrespective of seriousness) is forwarded to SSS for review and possible remedial action from a systemwide perspective by the SMS Group. 5

5. Roles and responsibilities 5.1. SMS Policy Oversight Group The policy for using SMS patient reminders is to be governed by the SMS Policy Oversight Group (SMS Group) which consists of representatives of the health services, System Policy and Planning s SSS and the HIN. The SMS Group is to meet as necessary, and is to ensure the policy is consistent with the current standards of health care, safety and privacy, and that the use of the technology aligns with current IT and telecommunication standards and costs. The SMS Group is to be responsive to both positive and negative consumer feedback, and the implications of any consistent feedback or serious complaints are to be considered and appropriate policy changes made. 5.2. Health Services Health services are responsible for the costs of the SMSs they send, the day to day administration of their local SMS usage, and for ensuring information recorded in their PAS abides by the business rules set out in this policy. Each health service is to appoint an SMS Site Administrator (the Site Administrator). A list of the current Site Administrators can be found on the System Policy and Planning, Strategic System Support intranet page. It is the role of the Site Administrator to ensure all SMS users are aware of and accept the business rules in this policy. This includes the requirement to ensure relevant officers from Management/Executive agree to the use of the system and take responsibility for the cost of messages. The Site Administrator is to also handle patient complaints, respond to consumer feedback and undertake evaluation from a site perspective if required. They are to provide appropriate feedback, including, for example, complaints and any identified costs/benefits of the system, to the SMS Group if this data is collected. 5.3. Health Information Network The HIN is responsible for management and upkeep of the IT and telecommunications components of SMS usage. HIN ensures that information automatically drawn from the PASs is accurate, safe, appropriate and in line with the business rules set out in this policy. HIN, with assistance from SSS, is to also ensure that negotiations with telecommunications providers, regarding service costs and IT advancements occur regularly so that WA Health is ensured of the best system at the most competitive price. 5.4. WA Health System Policy and Planning s SSS unit is responsible for Executive Support to the SMS Group, oversight of the currency and accuracy of this policy, oversight of the governing administration of the whole system, ensuring the protocols governing patient privacy are up to date, support to HIN with SMS volume data for negotiating volume credits with the provider and reporting to the WA Health Executive on the outcomes of the service where information is available. 6

6. Compliance It is a requirement of the WA Health Code of Conduct that employees comply with all state government policies, standards and Australian laws and understand and comply with all WA Health business, administration and operational directives and policies. 7. Evaluation The SMS Group will review this policy annually or as required. WA Health no longer tracks the benefits of the use of SMSs on Did Not Attends as the evidence was undisputable and sustained. Sites should perform their own costbenefit analysis if required. 8. Related documents Associated WA Health ICT policies are available on the HIN intranet site: Electronic Messaging Policy Acceptable Use Policy Information and Communications Technology The CUA can be found on the Department of Finance website. Telecommunication Services Common Use Arrangement (CUA56808) 9. Definitions Outpatient Direct RIS SSS TOPAS UMRN/UR webpas Outpatient telephony service for patients wishing to reschedule, cancel or ask general enquiries about their outpatient appointment. Radiology Information System is used to make appointments, record examinations performed and reports for Medical Imaging across the metropolitan area. System Policy and Planning s Strategic System Support unit. The Open Patient Administration System. TOPAS is a database containing patient demographic details and appointment dates and times. Unique patient identifier consisting of seven numeric characters prefixed by an alpha character. This one number is used by all of the hospitals who utilise TOPAS and webpas (TOPAS: Unit Medical Record Number and webpas: Unit Record). The Web based Patient Administration System. The successor to TOPAS, currently being rolled out across WA Health. 7

10. Authority Title: Contact: Directorate: SMS Patient Reminders in WA Public Health Services Policy Sarah Zilko Strategic System Support Version: 1.0 Date Published: 04/02/2016 Date of Last Review: 29/10/2015 Date Next Review: 02/11/2016 8

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