Pretest Messaging to Reduce Cancellations in Nuclear Medicine: Evaluation in Cardiac Stress Testing and Fluorine-18-2-Fluoro-2-Deoxy-D Glucose PET Scheduling.

Abstract

Efficient scheduling is increasingly critical as demand for nuclear medicine services grows. This study evaluated the impact of preprocedure messaging on reducing appointment cancellations, rescheduling, and delays for cardiac stress testing and fluorine-18-2-fluoro-2-deoxy-D glucose (FDG) PET at a US tertiary hospital. This pre-post study evaluated messaging for cardiac stress test (launched June 1, 2025) and FDG PET (July 18, 2025) appointments. Outcomes were assessed using intent-to-treat (ITT; messages sent versus not sent) and per-protocol (messages opened versus not opened) analyses. Primary outcomes were appointment cancellation or rescheduling; for FDG PET, appointment delay, defined as the time difference between the scheduled and actual start times, was also evaluated. Logistic regression was used for binary outcomes and generalized linear models for delay (P < .05). Among 1,478 cardiac stress test appointments, the ITT analysis showed a nonsignificant reduction in cancellations or rescheduling, and the per-protocol analysis showed significantly lower cancellation or rescheduling (5.91% versus 3.21%, P = .021). Among 2,638 FDG PET appointments, auto-messaging significantly reduced cancellations or rescheduling in the ITT analysis (2.46% versus 1.13%; P = .020), with consistent per-protocol findings in the per-protocol analysis. Among completed PET appointments, median delay times were significantly reduced with the intervention based on both scheduling timestamps (5.67 versus 0.43 min; P = .019) and imaging system metadata (59.6 versus 52.5 min; P < .001). Preprocedure messaging improved scheduling efficiency by reducing cancellations, rescheduling, and appointment delays for cardiac stress tests and FDG PET, highlighting the potential of preprocedure communication to enhance patient adherence and operational workflow.