A Louisville tech startup is using text messages to make sure patients show up for medical appointments, reducing health risks while saving them — and the care providers — valuable time.

During a recent trial at the University of Louisville, MedaPrep helped doctors decrease the number of patients who canceled colonoscopy appointments by 30 percent, the company co-founder Aaron Tomes told Insider Louisville.

When patients don’t show up for appointments, medical staff often have to scramble to fill the time slot, Tomes said, and if they can’t, they lose additional time.

Aaron Tomes

In addition, patients who don’t show up to colonoscopy appointments often don’t make another appointment, he said, because preparing for the treatment — not the procedure itself — is the toughest part, as it involves ingesting a prep drink and fasting.

Further, if patients don’t prepare properly for the procedure, the visual information doctors gather may be flawed, which could make doctors miss polyps that can develop into cancer and spread before the next screening.

Making sure that patients properly prepare and show up not only saves them and their health care providers time and money, Tomes said. The procedure may detect signs of a potentially lethal illness early enough to avoid complications, invasive treatments and even death.

MedaPrep sends patients about a dozen text messages, which can be customized by the provider, starting about 10 days before the procedure. The messages provide information and ask simple questions, such as whether the patients have obtained the prep, still plan to come to the appointment and whether they have a ride home. The patient response may lead to additional tests or a follow-up phone call.

Tomes said he came up with the idea for the text prompts after his wife, Angie, a nurse who worked in endoscopy for more than a decade, wrote a paper on the topic for her master’s degree. Some doctor’s offices were handing patients faded paper instructions, which can be lost, he said. Patients also often are confused about the proper steps to take to prepare for the procedure.

MedaPrep uses text messages to provide patients information about medical procedures and to ask whether they need help. | Courtesy of MedaPrep

Tomes learned of the existence of an app, but he said the provider charged $10 per patient, and most people don’t want to download another app to their phone, and some people don’t have a smartphone. Texts are easier, he said, in part because such messages have a read rate of more than 90 percent. Tomes developed the business with two business partners.

The co-founder said the no-show rates at the university’s hospital during a trial this year fell from 7 percent to 5 percent, and at an outpatient center fell from 10 percent to 7 percent.

Two or three percentage points may not sound like much, but medical providers like the University of Louisville may perform 3,000 such procedures a year, which means a no-show rate of 7 percent, rather than 5 percent, means one additional no-show per day.

“That starts … adding up,” Tomes said.

Lisa Jackson, director of surgical services at UofL, told Tomes via email that she was “pleased to see that our overall no show rate is declining in both areas, so that is what I’m using to justify that we continue using this product.”

UofL officials could not be reached, but Tomes said physicians at the institution plan to write a paper about the benefits of using text reminders.

MedaPrep charges $1.99 per patient and a $90 monthly fee. The company employs three, and is close to breaking even, Tomes said. A large part of the expenditures go toward insurance and federally required medical data protection.

Employees are working with health providers to determine whether text message reminders can help reduce no-shows for other procedures, he said. They also are exploring whether such reminders can increase the share of post-procedure patients who adhere to their physician-prescribed medication and exercise regimens to reduce the risk for complications and increase the speed of recovery.

Boris Ladwig is a reporter with more than 20 years of experience and has won awards from multiple journalism organizations in Indiana and Kentucky for feature series, news, First Amendment/community affairs, nondeadline news, criminal justice, business and investigative reporting. As part of The (Columbus, Indiana) Republic’s staff, he also won the Kent Cooper award, the top honor given by the Associated Press Managing Editors for the best overall news writing in the state. A graduate of Indiana State University, he is a soccer aficionado (Borussia Dortmund and 1. FC Köln), singer and travel enthusiast who has visited countries on five continents. He speaks fluent German, rudimentary French and bits of Spanish, Italian, Khmer and Mandarin.


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