1) It is known: no-shows cost a lot of money. Additionally, when patients are late, schedules are negatively effected and often create a domino effect of inefficency, sometimes at the cost of patients who are early or are on time.

My proposal is to provide texting services appotintment confirmation (both a few days prior to appointment and a few hours before appointment - press 1 if you will be at your appt, press 2 if you need to reschedule) and for real-time information (e.g., location of appt (bldg, floor, etc.), information regarding lateness to appt, and last-minute cancellation  - when the spot can be used by another patient or help with visit flow). The UCSF Shuttle Service uses a simple texting program that could be emulated for information topics.

Patients use cell phones, yet they rarely pick up calls from unkown numbers. Texting is more efficient than calls and knowing if patients are planning on no-showing or running a bit late and helps make the schedule more efficient and squeeze in patients who are waiting for same-day appointments, consultations, or who are on-time/early. Clinicial staff also will appreciate knowing which patients are coming in real time.

2) Both UCSF Health System or San Francisco General Hospital