No observed reduction of non-attendance rate in telehealth models of care

Objective This study investigated the provision of public specialist out-patient services in Queensland delivered in traditional hospital settings (in person) or through a two-way synchronous videoconferencing session (telehealth). Rates of attendance between these delivery methods were compared to detect any difference in rates of non-attendance among patients. Methods An extract of all specialist out-patient appointments reported in Queensland Health’s corporate patient administration systems between 1 July 2017 and 30 June 2018 was obtained (n = 2 921 702). Variables including how the service was delivered and whether the patient attended were captured for each event. Results No reduction in non-attendance was observed in the telehealth patient group (9.1%) compared with in-person service delivery (9.1% vs 7.9% respectively; = 113.56, P < 0.001, relative risk = 1.15). Discussion The study found no evidence that telehealth is effective at reducing rates of non-attendance in a specialist out-patient setting. This supports existing findings that most non-attendance is the result of forgetfulness or confusion with appointment details, to which telehealth appointments are also vulnerable. What is known about the topic? Non-attendance of out-patient appointments remains a persistent and costly problem for public and private providers of health services. Forgetting or being confused about appointment details are the most commonly reported reasons for patient non-attendance. What does this paper add? Telehealth models of care are increasingly being offered by health service providers, reducing travel requirements to all patients, particularly those in regional and remote settings. However, telehealth models of care do not address the most common reasons for patient non-attendance and telehealth patients are not less likely to miss their appointments. What are the implications for practitioners? Suggestions that telehealth models of care can reduce rates of non-attendance should be treated with caution by health service administrators and clinicians. More timely appointment reminders and easier processes to cancel or reschedule appointments remain the most effective techniques for reducing non-attendance.