Missed health care appointments present a serious challenge to patient care. Especially in government funded health systems like that of Chile, missed appointments can lead to delayed care, wasted resources, and escalating costs.

This private-public-research collaboration seeks to provide a rigorous, practical evaluation of a new patient reminder system, evaluate how health beliefs impact patient attendance, and capture the potential for scaling up this or other health technology systems. Using a mixed-methods approach this study will provide contextualized, triangulated analysis of pediatric patient attendance in Chile.

The Health Call study is divided into two phases. The first phase is a randomized controlled trial and side-by- side cost-benefit analysis. Enrolled guardians of pediatric patients will complete a questionnaire at the point of referral and then be randomized to intervention, the automated reminder system, or no reminder. The investigators will then monitor attendance status at their subsequent appointment and evaluate whether the appointment reminders affected attendance as well as the cost-benefit ratio of using the reminder system.

The second phase will involve interviewing guardians and healthcare professionals. These interviews have two foci. First, combined with patient, guardian, and/or household data from the randomized trial, these results will be used to develop a more comprehensive understanding of why pediatric patients attend appointments. The second focus is on improving the reminder system and developing new health technology interventions that can increase patient attendance.

Inclusion Criteria:

• Guardian with a phone number (land-line or mobile) who is able to receive and answer voice calls
• Guardian who is willing to take part in the study and complete the consent form
• Guardian who is sufficiently proficient in Spanish so as to complete the questionnaire
• Guardian's patient who has a referral appointment at Hospital Luis Calvo Mackenna who is 18 years of age or younger

Exclusion Criteria:

• Guardian or child who do not meet the inclusion criteria
• Anyone that lives in the same household as an enrolled study participant.