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Scheduling patients via text messages is more effective than phone and saves GCA time

Poster presented at the 2021 National Society of Genetic Counselors Annual Conference

Authors: Hanah Cytron, Kaylene Ready, Kiley Johnson, Mark Sylvester, Jill Davies, Andi Hila, Colleen Caleshu

Background: While much focus has been put on efficient use of genetic counselor (GC) time, improving genetic counseling assistant (GCA) efficiency has received minimal attention. Efficiency at the GCA level can help extend the resources and reach of genetics teams. We piloted automated text message-based scheduling with a subset of patients in our GC telehealth practice to improve scheduling processes and increase GCA efficiency.

Purpose: To assess the effectiveness, acceptability, and GCA time saved associated with replacing scheduling via phone call from a GCA with automated text messages.

Methods: We compared the scheduling success rate when patients were contacted by phone during a three month window prior to the pilot period, to when they were contacted by text during the three month pilot period. The phone and text groups included patients from the same subset of referring organizations, to minimize confounding. Acceptability was evaluated using patient satisfaction survey data, collected as part of routine care. A time study was performed to determine how much time GCAs spend on phone-based scheduling compared to text-based scheduling.

Results: Prior to the text-based scheduling pilot period, 988/1376 (71.9%) of patients phoned by GCAs for scheduling were successfully scheduled. During the pilot period, 1157/1305 (89.7%) of patients texted for scheduling were successfully scheduled (p=0.008). Of the 1157 successfully scheduled patients who were contacted by text, the majority scheduled via text (908/1157 (78.5%)). 213/1157 (16.8%) who were contacted via text ultimately scheduled via GCA phone call, made after no response was received to texts. On the patient satisfaction survey, 103/104 (99.0%) of patients who scheduled via text reported scheduling this way was easy, which is comparable to the 95/98 (96.9%) of patients who reported scheduling via phone was easy (p=0.28). In the time study, a GCA took a mean of 4.1 minutes in total to schedule the patient via phone, including all phone calls. In contrast, scheduling via text took GCAs no time as it was automated. This translates to 91.6 GCA hours saved per month by scheduling this subset of patients via text instead of phone. Using a GCA salary of $33,946, this equates to a savings of $468.88/month.

Conclusions: Automated text-based scheduling is an effective and efficient alternative to GCAs calling patients to schedule. This represents one technological innovation that can improve efficiency and resource use in the GC(A) field.

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