Preappointment surveys and reminder calls to improve show rate.

OBJECTIVES: To assess the impact of preappointment surveys and reminder phone calls on show rate and time spent in new patient appointments at a multidisciplinary pediatric chronic pain clinic. STUDY DESIGN: We examined show rates and appointment length during the 1-year period before and 1-year period after a preappointment survey and phone reminders were implemented. Fisher exact test was used for categorical variables and Student's t test with equal variances was used for continuous variables. METHODS: The setting was a multidisciplinary pediatric chronic pain management clinic in Florida. Participants were 362 patients scheduled for an initial pain clinic evaluation 1 year prior to and after the implementation of a preappointment survey on August 19, 2019. Our main outcome measures were show rate and appointment length. RESULTS: Patients who completed a preappointment survey were significantly more likely to attend their clinic appointment than noncompleters (97.2% vs 36.2%) and spent significantly less time in their appointment. CONCLUSIONS: With new patients, preappointment surveys can improve clinic show rate and decrease time spent in initial appointments. Clinics may consider policies targeting completion of preappointment surveys to assist with show rate, but they must consider their patients' barriers to completing surveys so access to care is not limited.

Feasibility of Conducting Long-term Health and Behaviors Follow-up in Adolescents: Longitudinal Observational Study.

BACKGROUND: Machine learning uses algorithms that improve automatically through experience. This statistical learning approach is a natural extension of traditional statistical methods and can offer potential advantages for certain problems. The feasibility of using machine learning techniques in health care is predicated on access to a sufficient volume of data in a problem space. OBJECTIVE: This study aimed to assess the feasibility of data collection from an adolescent population before and after a posterior spine fusion operation. METHODS: Both physical and psychosocial data were collected. Adolescents scheduled for a posterior spine fusion operation were approached when they were scheduled for the surgery. The study collected repeated measures of patient data, including at least 2 weeks prior to the operation and 6 months after the patients were discharged from the hospital. Patients were provided with a Fitbit Charge 4 (consumer-grade health tracker) and instructed to wear it as often as possible. A third-party web-based portal was used to collect and store the Fitbit data, and patients were trained on how to download and sync their personal device data on step counts, sleep time, and heart rate onto the web-based portal. Demographic and physiologic data recorded in the electronic medical record were retrieved from the hospital data warehouse. We evaluated changes in the patients' psychological profile over time using several validated questionnaires (ie, Pain Catastrophizing Scale, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Pediatric Quality of Life Inventory). Questionnaires were administered to patients using Qualtrics software. Patients received the questionnaire prior to and during the hospitalization and again at 3 and 6 months postsurgery. We administered paper-based questionnaires for the self-report of daily pain scores and the use of analgesic medications. RESULTS: There were several challenges to data collection from the study population. Only 38% (32/84) of the patients we approached met eligibility criteria, and 50% (16/32) of the enrolled patients dropped out during the follow-up period-on average 17.6 weeks into the study. Of those who completed the study, 69% (9/13) reliably wore the Fitbit and downloaded data into the web-based portal. These patients also had a high response rate to the psychosocial surveys. However, none of the patients who finished the study completed the paper-based pain diary. There were no difficulties accessing the demographic and clinical data stored in the hospital data warehouse. CONCLUSIONS: This study identifies several challenges to long-term medical follow-up in adolescents, including willingness to participate in these types of studies and compliance with the various data collection approaches. Several of these challenges-insufficient incentives and personal contact between researchers and patients-should be addressed in future studies.