7 Deadly Sins of Recalls and Reminders

A robust recall and reminder process is key when providing safe, quality care to patients in general practice. However, many clinics overlook this important activity even though it is one of the most powerful ways to protect the practice from litigation, and protect patients from adverse outcomes due to poor or inconsistent follow up. Make sure your practice and patients are protected by checking if you’re making any of the following:

Mistake #1: Poorly communicate the reason and importance of the recall

Practices using a generic mail merge template with the recall reason automatically inserted from the reason list, run the risk of sending notifications that are not engaging or patient-friendly.

For example, practice staff may understand what ‘Hep B 2nd dose’ means, but this may make little to no sense to the patient. In some cases the lack of an explanation as to why the recall is important may lead patients to discard a letter without a second thought.

Mistake #2: Send recalls too early for Medicare items, triggering claim rejections

Practices that try to stay on top of upcoming recalls by sending out notifications which are due over the coming 4 weeks, often run the risk of patients booking appointments too far in advance for time-sensitive services such as immunisations or care plan reviews.

In the event of chronic disease items, providing the service sooner than the approved time interval may lead to costly Medicare claim rejections or patients being out of pocket for non-compliant and therefore non-rebatable services.

Mistake #3: Incorrectly assume patients will respond to a single contact attempt

There are several reasons why patients may not respond to a recall attempt:

  • The communication may not have reached them if their contact details have changed
  • They don’t perceive the recall as important or
  • They never get around making an appointment and eventually forget about the recall

This is why it is paramount to ensure your practice system is able to accommodate multiple contact attempts and ideally use a variety of communication methods.

Mistake #4: Incorrectly assume letters are the safest recall method

Letters and the use of snail mail are quickly falling out of favour when it comes to communicating medical information to patients or to other providers.

Not only are letters becoming increasingly expensive to print and post, they can also be easily intercepted by unauthorised parties such as nosey neighbours or relatives.

The only way to ensure a letter has been successfully delivered is by sending it via registered post, which further increases costs and should therefore only be used as a last resort.

Mistake #5: Send recalls via email or SMS without using a secure transmission or patient identity verification

This is a particularly concerning practice and in direct breach of Accreditation Standard 4.2.2F. There are considerable issues with breach of privacy and confidentiality if any clinical information is included and the message is sent without an adequate form of patient identity verification (such as with a 3-point identifier as included in HotDoc’s SMART Recall notifications).

Some practices will attempt to get around this privacy issue by sending only a generic SMS, which as mentioned in mistake #1, runs the risk of not conveying the relevance or importance of the recall and therefore resulting in a disappointing appointment uptake.

Mistake #6: Inadequate tracking or failing to check patients receive and act on recalls

A good recall and reminder system should include provisions for timely tracking to ensure notifications have successfully reached the patient as well as to check whether or not an appointment has been booked.

Clinics that rely solely on mass mail outs without a consistent follow up strategy run the risk of missing valuable insights of how, when or indeed if patients are responding to notification attempts. This makes it enormously difficult for quality improvement activities to be implemented to address any gaps.

Mistake #7: Poor documentation of contact attempts in patient records

Good records and comprehensive documentation go a long way in protecting the practice and its staff against litigation. For this reason, it is paramount that any recall attempt be clearly documented in the patient file indicating date, reason for contact, communication method and number of attempts to date.

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