As the trend toward consumer-driven health care becomes the norm, many aspects of the provider-patient relationship are likely to be affected. To gain deeper insight into how today’s healthcare consumers are searching for and scheduling care, we collected and analyzed relevant scheduling data from online appointments made online through DocASAP in the last year. In a new Ebook entitled Top Digital Consumer Trends Shaping Patient Access, DocASAP shares insights on how consumers search for and access care. Today we focus on a challenge that many providers face: the “no-show patient.”

The No-Show Problem

Patients who don’t appear for a scheduled appointment, or cancel their appointment at the last minute, pose significant healthcare and cost consequences for medical providers at every level from primary care providers, to diagnostic imaging services and outpatient surgery facilities. In some settings, up to 18% of booked appointments can result in no-shows.

Patients Who are a No-Show Hurt Themselves First

Patients who don’t keep their appointments risk negative effects on the quality of their own health. They miss important screenings, delay necessary diagnostic or pre-surgical testing, and postpone treatment or therapy they need.

Patient Flow Consequences

In any practice that aims to improve efficiency – which is pretty much every practice – the no-show problem is disruptive, and places unnecessary strain on patient flow and staff resources. It’s frustrating and time consuming for staffers to try and re-book late cancellations; when a re-shuffle causes a waiting room delay, patient satisfaction can plummet.

No-Shows Hurt the Bottom Line

The financial consequences of no-show patients are significant. estimates that in physician practices, the cost of missed appointments can be up to 14% of projected daily revenue.

To summarize, no-show patients present health challenges, as well as administrative problems and financial challenges for providers.

Which Remedies Work, and Which Do Not

Providers and their practice managers utilize a variety of tools to reduce the no-show rate, although not all these are equally effective. A report titled Maximizing Patient Access and Scheduling by MGMA discusses these remedies in depth:

  • Staff reminder calls can be costly and time consuming. Although a person-to-person conversation can be compelling, it’s not always possible to reach the patient, resulting in either less-effective voice mail, or repeated attempts to speak in person.
  • Automated “robocall” reminders yield minimal improvement, perhaps because they’re easier for patients to screen or ignore.
  • Fines or penalties for no-show or late cancellations are not necessarily effective. Many people who miss an appointment tell they simply forgot to come in or cancel.
  • Others say they weren’t aware of a no-show or late cancellation penalty, which highlights a dilemma: an unpublicized penalty is not a deterrent, but overemphasizing penalties can be off-putting, even insulting, for patients who reliably keep their appointments.
  • Overbooking and walk-in patients can mitigate the effects of no-shows, but this approach can lead to disruption in patient flow, with the downside of waiting room delays and patient dissatisfaction.

One remedy that shows positive results: carefully crafted phone, email or text message follow-up campaigns. In surveys, four of five patients who didn’t keep their appointments report that a timely reminder would have helped.

Other useful approaches include:

  • Shorter Lead Time. DocASAP’s own survey shows that shorter lead time on appointments can help reduce no-shows. This matches up with the preference of Millennial-aged patients for quick turnaround, including same-day appointments when offered.
  • Online Self-scheduling. According to Hanover Research’s “2019 Health Care Consumer Annual Benchmark Study”, 43% of healthcare consumers now look to schedule care appointments through their health plan’s member portal or mobile app. This finding is reinforced by our survey of appointments booked through DocASAP, which reduced no-show rates to just 6%.
  • Pre-appointment assessments. Contact before the appointment can help focus the provider on the patient’s needs, and help to direct the patient’s attention to their upcoming interaction with the provider.

Follow the Latest Consumer Trends

To learn more about no-shows and other important trends in digital patient access, download the DocASAP eBook Top Digital Consumer Trends Shaping Patient Access.


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Some of the nation’s largest, richest and most powerful companies are making moves into healthcare, and foreshocks of the disruption to come are already rumbling. Amazon, Apple, Google, and Walmart are among tech and retail leaders making headlines with new and expanding ventures.

Why are these companies entering the healthcare industry? First, it’s an economic segment . Second, healthcare is a target for the kind of disruption and innovation that have made Apple, Amazon and Google the giants they are today. Healthcare is “overly complex, has not evolved all that much over time, and remains a frequent pain point for customers,” says Morgan Stanley analyst Simeon Gutman in a recent story at  “All of these factors make healthcare ripe for disruption.” Further, according to a research report from the business intelligence firm CB Insights, “Lack of standardization and focus on consumer experience has resulted in a . . . fragmented, opaque” healthcare market.

For companies with the technical capacity, and the funding, it’s a strategically promising play.

Innovators, Disruptors and Corporate Titans on the Move

Google, Verily and partners

As reported October 1 by Kaiser Health News, Google parent company Alphabet has hired former FDA Commissioner Robert Califf to be head of strategy and policy for Google Health and Verily Life Sciences. Verily is engaged in such soon-to-market projects as:

  • A partnership with iRhythm to build sensors that alert patients and caregivers to episodes of atrial fibrillation
  • Miniaturized continuous glucose monitors, with Dexcom
  • A venture with Alcon/Novartis to build wireless microelectronics into ocular devices, to improve vision post-cataract surgery

Amazon has a bushel of advantages among the companies taking steps into healthcare. Its sheer size is a factor: 300 million active retail customers (and 100 million Amazon Prime members), plus an established customer base in wholesale medical supplies and products; a well-developed and expanding distribution network; and Amazon Web Services, its cloud computing, analytics, and IT development powerhouse.  All that, and one of the most powerful brands on the planet, of course. Amazon is on the move with these recent and soon-to-come ventures:

  • Just a year ago, with financial partners Berkshire Hathaway and JP Morgan, Amazon launched its Haven healthcare venture, “aimed at cutting healthcare costs for their U.S. employees”
  • Amazon spent $1 billion to acquire the mail-order pharmacy PillPack, adding healthcare market share and another important customer segment that it expects to expand dramatically in 2020 and beyond
  • AWS announced a new natural language processing service called Comprehend Medical intended to pull keywords and important messages from electronic health records
  • Amazon has developed six new HIPAA-compliant skills for its voice assistant, Alexa, launching this past September
  • Haven partner JP Morgan recently acquired InstaMed, a healthcare technology company that aims to eliminate paper billing while improving the consumer-patient experience and lower collection costs

Apple’s Health App, first introduced in 2014, has evolved into a useful and much-used suite for collecting – and aggregating – health, nutrition, and exercise data. Apple Health connects not only with Apple Watch, but now also with FitBit and Garmin trackers, and is compatible with a trackers and exercise logs, including Nike+, Strava, Pocket Yoga, MyFitnessPal, Gymaholic and more.


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