Messaging in a clinic: the appointment is the easy part

Appointments, reminders and repeat prescriptions work beautifully over messaging. Symptoms arrive whether you invite them or not, and the whole design problem is what happens in the sixty seconds after somebody describes one.

What works

• Appointment reminders. The clearest win, and the no-show reduction usually pays for everything else - see how many and when.
• Repeat prescription requests. Structured, repetitive, and currently done by phone at the busiest hour of the day.
• Results are ready, come in. Not the results - that they are ready.
• Preparation instructions. Fasting, what to bring, where to park. Read far more reliably than a leaflet.

The symptom message

"My chest has been hurting since yesterday, should I come in?" will arrive. The receptionist reading it is not clinically qualified and is being asked a clinical question by somebody who trusts them.

Decide the response before it happens, and make it one saved reply:

We can't give medical advice over messages, and I don't
want to guess with something like this.

If it's urgent, please call us on 0xxx or go to
[nearest emergency department].

Otherwise I can get you an appointment - would today
at 3pm work?

It does three things: refuses clearly, gives an urgent route, and offers the thing the channel is actually for.

What to keep, and what not to

1. Keep the administrative record. Who asked for what appointment, when.
2. Do not copy clinical detail into tags, notes or custom fields. One copy in the conversation is unavoidable; spreading it is a decision.
3. Set a retention period and enforce it, shorter than you would for retail. See retention.
4. Never let an automation reply into an open clinical conversation. A promotional template after a symptom message is indefensible.

Identity, on a shared phone

One handset serves a household. A message from a number you hold for a patient may be their spouse, their child or their neighbour, and confirming an appointment reveals that the person has one. Ask who you are speaking to before saying anything about anybody.