CHICAGO – Reducing a radiology department’s missed appointment rate not only improves productivity, but also translates to financial gain, according to study results presented December 2 at the RSNA meeting.
It can be fairly simple to do this using common social media platforms, presenter Patricia M. Carrascosa, MD, PhD, of Diagnóstico Maipú por Imágenes in Buenos Aires, Argentina, told session attendees.
“Reducing no-show rates is essential for optimizing resource use and financial performance in radiology departments,” she said. “A structured and automated patient confirmation process — leveraging widely used platforms such as WhatsApp — proved highly effective and sustainable over a six-year period.”
Rates of patient no-shows can be as high as 25%, according to Carrascosa, and “these absences lead to underutilization of imaging equipment, disrupt workflow, and cause substantial financial losses,” she said. She noted that although some centers try to decrease no-shows by overbooking, “such strategies are often ineffective, especially when cancellations occur too close to appointment times.”
To reduce their incidence, Carrascosa and colleagues piloted a “structured, multichannel patient confirmation system” for imaging exams. From the pilot data, the team quantified the program’s long-term impact on productivity and revenue.
The group evaluated missed appointment rates from 2018 to 2025 across all imaging modalities. In 2018, no appointment confirmation system was being used, but in 2019, the department implemented a WhatsApp-based confirmation protocol that sent patients automated reminders at 72, 48, and 24 hours before the scheduled exam and asked them to confirm or cancel. If the patient canceled, the time slot was released for rebooking. For the economic analysis of the data, the investigators set an estimated average loss of $30,000 per 1% of no-shows.
In 2018, the annual missed appointment rate was 15%. After the department began using the confirmation protocol, the annual rates decreased.
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Annual no-show rate in the radiology department, 2018 to 2025 (confirmation system implemented in 2019) |
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2018 |
2019 |
2020 |
2021 |
2022 |
2023 |
2024 |
2025 |
| No-show rate |
15% |
9.5% |
12.4% |
10% |
8.2% |
7.4% |
6.8% |
6.6% |
*The team noted that the increase in the no-show rate in 2020 was due to the COVID-19 pandemic.
It also reported that, between 2018 and 2025, the patient exam absence rate decreased by 55%, corresponding to an 8.4 percentage point improvement, and that the reduction in no-shows between 2018 and 2024 resulted in approximately 79,535 additional patients being scanned in 2024 alone.
Finally, the group found that, as each percentage point of no-show reduction represented an estimated value of $30,000, the improvement in the no-show rate translated to a gain of approximately $251,400 in productivity and billing.
Carrascosa listed a number of benefits to reducing a department’s missed appointment rate, including better use of MRI and CT scanners; shorter waiting times for patients; decreased financial losses; and less wasted energy and resources.
“Maintaining low no-show rates offers significant operational and economic benefits and should be a priority in imaging service management,” she concluded.
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