There’s nothing more frustrating than watching the (very expensive) minutes tick by in empty ORs when cases have to be called off at the eleventh hour. Officials at Cincinnati (Ohio) Children’s Hospital Medical Center know the feeling. In 2011, they were losing about 5.5 hours of revenue-producing OR time a day due to last-minute cancellations. The 3 main culprits: patients got sick; patients simply wouldn’t show or would go to the wrong campus; or patients weren’t going NPO before surgery.

Patients and their families typically received phone calls from a nurse 2 days before scheduled procedures, during which the nurse would review pre-op care instructions, remind patients of their arrival time and provide directions to the hospital. It was obvious that the information wasn’t getting through to some patients, so Cincinnati Children’s decided to invest in an automated text message system that integrated with the hospital’s electronic medical records.

Families can opt to receive the texts when they visit surgeons in the clinic. Patients receive the texts the evening before surgery. The messages include NPO reminders, the arrival time on the day of surgery, the estimated time of surgery and directions to the campus location where the surgery will be performed.

Officials at Cincinnati Children’s estimate that the text reminders have reduced lost OR time by 37%, which has let the hospital recapture an estimated $20,000 a week — about $1 million a year — in lost revenue.

“The advantage of using automated texts is primarily that they are persistent reminders,” says Jayant “Nick” Pratap, MA, MB BChir, MRCPCH, FRCA, an associate professor of anesthesia and pediatrics at Cincinnati Children’s. “The information remains available on patients’ cell phones, unlike instructions from a phone call, which persist only if patients write them down.”

Patients who schedule procedures at Boston Out-Patient Surgical Suites in Waltham, Mass., are asked to pre-register through an online portal, which lets them answer a series of pre-admission questions at their own pace and on their own time. Patients are informed that they won’t be booked for surgery until they’ve registered online and completed the questionnaire.

“You need to make sure they answer the questions as soon as possible, but they can do it at their own convenience,” says Greg Deconciliis, PA-C, CASC, administrator at Boston Out-Patient Surgical Suites.

Pre-admission software captures and organizes information it would take a member of your staff many hours and countless phone calls to collect. It also flags potential issues — patients with high BMIs, who’ve had previous complications with anesthesia or are on blood-thinning medications — that require attention before patients can undergo surgery.

Be sure to invest in a customizable platform so you can tailor the questions to your specific patient population, says Mr. DeConciliis. As an orthopedic specialty center, Boston Out-Patient Surgical Suites wanted to add a deep vein thrombosis risk assessment to its pre-admission questionnaire. They were able edit the online form to include questions — Have you recently been on a long flight? Have you had periods of extended inactivity? — that would help them identify patients at risk of suffering a post-op clot.

“By customizing the questions, you can get any information you want, and then get immediate notifications about potential issues,” says Mr. DeConciliis. “You then know to call patients right away to discuss their responses.”

An added bonus: Pre-registration software lets you acknowledge receipt of forms from patients and provide important information, including directions to the facility, that patients can print out in preparation for surgery.

Don’t fall into the trap of assuming that your patients will refuse to register online or that they’re too old to understand how to access digital forms.

“Well, they will register online because you’re going to tell them they have to,” says Mr. De-Conciliis. “And plenty of older people use computers, tablets and smartphones, or they can have their family members help them. It’s amazing how much technology is out there. I don’t understand why everybody doesn’t let it do some of the work for them.” OSM