ArticleBMC gastroenterology2026
Estimated no-show rate from the electronic record strongly correlates with endoscopy no-show.
Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHigh 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.
methodsA 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 ≥ 18 years with at least one prior encounter in the electronic medical record (EMR) were included; inpatient procedures and early cancellations (> 2 days before the appointment) were excluded. The primary outcome was appointment completion versus no-show. Epic's 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 (R²) and linear regression. Secondary analyses stratified results by patient portal activation.
resultsAmong 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's predicted no-show risk demonstrated a strong linear correlation with actual no-show rates (R² = 0.87). Observed missed appointment rates followed the equation: Missed Appointment Rate = 1.30 × (Epic Risk) + 0.16, indicating a baseline no-show rate of 16%. Each percentage-point increase in Epic's 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.
conclusionsEpic's 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.
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