Written by: Center for Care Innovations

Altura Centers for Health had a nagging problem. The Tulare, California, health center serves as the primary medical stop for about 30,000 residents in the Central Valley, but patient scheduling was an ongoing frustration.

Patient no-shows and call volume were at an all-time high. Clinics were bombarded by phone calls from patients seeking to cancel or reschedule appointments. Those callers, in turn, were often left on hold while clinic staff scrambled to triage them– something that took a toll on patient satisfaction surveys. “Our organization system needed a reliable messaging system.” said Chief Information Officer Manuel Pedroza, “and our existing robo-dialer wasn’t doing the job.”

Two hundred miles away, in Santa Cruz, California, Santa Cruz Community Health Centers was facing a similar issue. Their patients sometimes sat on hold for five or ten minutes at a time while staffers scrambled to field all the calls. Not only was it difficult generating reliable healthcare reminders from the center’s electronic health record (EHR), only 5 percent of the patients were using the health centers’ portal. In addition, the clinic staff learned that only a small percentage of patients in the coastal university town and nearby communities were getting their influenza vaccine. Surely, they thought, that percentage could be improved.

Independently of each other, both clinics decided to test out text messaging. This is the story of their innovative experiments.

A rural community clinic tackles long wait times

Altura Centers for Health is rich in care delivery innovation. It provides transportation to and from medical and dental appointments to all patients in its far-flung rural county. Its providers do home visits for preventive health. Its pediatricians provide family-centered care for kids from birth through adolescence. It also offers top-notch ob-gyn and specialty care, including geriatrics.

Close to the Sierra Nevada mountains on the east and a striking coastline on the west, Altura has seven branches in the city of Tulare – a Central Valley town in a farming county that is the number one milk producer in the nation. Altura executives were not certain that adding that text messaging would solve the problem with high-volume phone calls, but they felt it was important to find out.