This project proposes administer and evaluate via a randomized controlled trail a text message-based appointment reminder system to promote attendance at clinic appointments after ED discharge.

Failure to attend scheduled clinic appointments causes inefficiency within the healthcare system, and frequently results in ED visits for non-emergent conditions such as medication refills, ambulatory care sensitive conditions which are potentially preventable with appropriate outpatient management (e.g. foot infections). Many patients seen in the ED report they were unaware of past or future outpatient appointments for which they had been scheduled. These patients are clearly in need of primary care, yet fail to attend 30% of all scheduled outpatient appointments. Patients most often report that they failed to attend scheduled appointments as a result of forgetfulness or confusion regarding dates, times, or locations. National data confirmed by our previous work in the LAC+USC ED demonstrates that > 80% of this population reports using a text-capable mobile device. The investigators believe a system of text message appointment reminders has tremendous potential to facilitate clinic attendance among these patients in desperate need of primary care.

Inclusion Criteria:

• Age >18
• Able to provide consent and read in English or Spanish
• Have a text message capable mobile phone
• Know how to receive text messages
• Have upcoming scheduled clinic appointments

Exclusion Criteria:

• Unable to provide written informed consent
• Incarcerated
• Critically ill
• Altered Mental Status