{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T02:52:35Z","timestamp":1781751155929,"version":"3.54.5"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":48,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA271031"],"award-info":[{"award-number":["R01CA271031"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA271031"],"award-info":[{"award-number":["R01CA271031"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High demand for endoscopic procedures contributes to prolonged wait times and limited access to care, particularly in safety-net health systems. Missed appointments, including no-shows and late reschedules, further strain resources and delay diagnosis and treatment. Epic Systems provides a proprietary Risk of Patient No-Show Model, previously validated in primary care settings, but its performance in predicting attendance for endoscopy appointments has not been evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted among adults scheduled for outpatient endoscopy at a single safety-net hospital between January 1, 2023, and August 1, 2024. Patients aged\u2009\u2265\u200918 years with at least one prior encounter in the electronic medical record (EMR) were included; inpatient procedures and early cancellations (&gt;\u20092 days before the appointment) were excluded. The primary outcome was appointment completion versus no-show. Epic\u2019s predicted no-show risk, demographic characteristics, procedure type, and patient portal activation status were extracted. The relationship between predicted and observed no-show rates was assessed using the coefficient of determination (R\u00b2) and linear regression. Secondary analyses stratified results by patient portal activation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 4,658 unique patients, the median age was 59 years, 52.2% were male, and the cohort was racially and linguistically diverse. Overall, 1,493 patients (32.1%) did not attend their scheduled endoscopy. Epic\u2019s predicted no-show risk demonstrated a strong linear correlation with actual no-show rates (R\u00b2 = 0.87). Observed missed appointment rates followed the equation:\n                      <jats:italic>Missed Appointment Rate\u2009=\u20091.30 \u00d7 (Epic Risk)\u2009+\u20090.16<\/jats:italic>\n                      , indicating a baseline no-show rate of 16%. Each percentage-point increase in Epic\u2019s predicted risk corresponded to a 1.3-point increase in observed no-show rate. Patients without an activated patient portal (MyChart) had approximately 5-percentage-point higher no-show rates across the risk spectrum.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Epic\u2019s Risk of Patient No-Show model shows strong correlation with real-world endoscopy attendance and may support predictive overbooking and targeted outreach to improve endoscopy unit efficiency. Given its integration within the EMR, this tool offers a practical framework for operational interventions, though further validation across diverse health systems is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-026-04874-7","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:25:03Z","timestamp":1777613103000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimated no-show rate from the electronic record strongly correlates with endoscopy no-show"],"prefix":"10.1186","volume":"26","author":[{"given":"Lilah","family":"Blalock","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Corona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalia","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin L.","family":"Sewell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma","family":"Somsouk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"4874_CR1","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1186\/1756-0500-6-233","volume":"6","author":"LW Day","year":"2013","unstructured":"Day LW, Bhuket T, Inadomi JM, Yee HF. Diversity of endoscopy center operations and practice variation across California\u2019s safety-net hospital system: a statewide survey. BMC Res Notes. 2013;6:233.","journal-title":"BMC Res Notes"},{"key":"4874_CR2","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s12913-015-1243-z","volume":"16","author":"P Kheirkhah","year":"2016","unstructured":"Kheirkhah P, Feng Q, Travis LM, Tavakoli-Tabasi S, Sharafkhaneh A. Prevalence, predictors and economic consequences of no-shows. BMC Health Serv Res. 2016;16:13.","journal-title":"BMC Health Serv Res"},{"issue":"7","key":"4874_CR3","doi-asserted-by":"publisher","first-page":"e2521637","DOI":"10.1001\/jamanetworkopen.2025.21637","volume":"8","author":"AM Agovi","year":"2025","unstructured":"Agovi AM, Serdarevic M, Gehr AW, et al. External Validation of an EHR-Based Model for Risk of Patient No-Show in Primary Care. JAMA Netw Open. 2025;8(7):e2521637.","journal-title":"JAMA Netw Open"},{"key":"4874_CR4","unstructured":"Epic UserWeb galaxy. Cognitive Computing Model Brief: Risk of Patient No-Show (Version 2). https:\/\/galaxyepiccom\/?#Browse\/page=1!68!50!100020266&from=Galaxy-Redirect. 2022."},{"key":"4874_CR5","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s12876-015-0358-3","volume":"15","author":"JT Chang","year":"2015","unstructured":"Chang JT, Sewell JL, Day LW. Prevalence and predictors of patient no-shows to outpatient endoscopic procedures scheduled with anesthesia. BMC Gastroenterol. 2015;15:123.","journal-title":"BMC Gastroenterol"},{"issue":"12","key":"4874_CR6","first-page":"902","volume":"21","author":"MW Reid","year":"2015","unstructured":"Reid MW, Cohen S, Wang H, et al. Preventing patient absenteeism: validation of a predictive overbooking model. Am J Manag Care. 2015;21(12):902\u201310.","journal-title":"Am J Manag Care"},{"issue":"9","key":"4874_CR7","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1038\/ajg.2016.269","volume":"111","author":"MW Reid","year":"2016","unstructured":"Reid MW, May FP, Martinez B, et al. Preventing Endoscopy Clinic No-Shows: Prospective Validation of a Predictive Overbooking Model. Am J Gastroenterol. 2016;111(9):1267\u201373.","journal-title":"Am J Gastroenterol"},{"issue":"6","key":"4874_CR8","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1007\/s11606-014-3165-6","volume":"30","author":"DM Blumenthal","year":"2015","unstructured":"Blumenthal DM, Singal G, Mangla SS, Macklin EA, Chung DC. Predicting Non-Adherence with Outpatient Colonoscopy Using a Novel Electronic Tool that Measures Prior Non-Adherence. J Gen Intern Med. 2015;30(6):724\u201331.","journal-title":"J Gen Intern Med"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-026-04874-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-026-04874-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-026-04874-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T02:22:38Z","timestamp":1781749358000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12876-026-04874-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4874"],"URL":"https:\/\/doi.org\/10.1186\/s12876-026-04874-7","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]},"assertion":[{"value":"28 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study adhered to the Declaration of Helsinki. The study was approved by UCSF IRB #13-11900. The need for consent to participate was waived by the University of California at San Francisco Institutional Review Board (UCSF IRB).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"371"}}