| Description |
Missed appointments in primary care clinics have a negative impact on patient health, provider productivity, and clinic revenue. Typical ways of reducing missed appointments via email, texts, and phone calls are more difficult when serving homeless patients due to lack of access to telephones and mobile devices. Patients who frequently miss appointments have more emergency department visits and decreased preventative screening. Though deprivation ethnicity, substance use, and mental health problems are associated with missed appointments, there is little evidence regarding reminder systems tailored to meet their needs. The overarching purpose of this project was to design and create a wearable appointment reminder device for homeless patients to improve appointment attendance in primary care. More specifically, this project was a feasibility study to improve upon the design of the wearable appointment reminder prototype. The objectives of this study were to: 1) Develop an effective way to integrate wearable appointment reminders into clinic workflow. Then, distribute wearable appointment reminders to medical assistants to deliver to patients; 2) Gain information via surveys from medical assistants and homeless patients regarding the feasibility and usability of the device; 3) Present results to the university and homeless clinic's stakeholders so they can incorporate this information in their efforts of improving appointment attendance and health outcomes for homeless patients; and 4) Submit results for publication in appropriate peer-reviewed journals in order to disseminate information to a larger audience of stakeholders who serve the homeless population. Detailed notes regarding potential use of the prototype were taken throughout this project. After a full prototype was created, feedback about the device was solicited from clinic staff (n=4), and by a convenience sample of non-homeless volunteers (n=3). Semi-structured interviews were used to get feedback on the device itself and potential implementation barriers, and the information was disseminated to university stakeholders in order to improve upon the prototype. Delays in creating the device and program required that the initial project methods be altered. In lieu of patients themselves being able to test the device, feedback was solicited at the earliest possible phase of production and, doing so, allowed for identification of implementation barriers including patient comfort, and difficulty for staff to program during busy clinic workflow. Finally, the reliability of the device's program needs to be improved upon before a clinical trial can take place. In sum, the purpose of this project was to evaluate the feasibility of using a wearable appointment reminder in a homeless clinic. Results of this preliminary study will be used to improve upon the prototype in order to successfully develop a low-cost, effective, wearable appointment reminder. |
