The Effect of the 2021 Irish Cyber-Attack on Otolaryngology Outpatient Non-attendance at a Model 4 Hospital in the Post-COVID Era

Aim This study investigates the rate of non-attendance at ENT outpatient appointments in the post-COVID era and the effect of the 2021 Irish cyber-attack on non-attendance. Methods A retrospective review of the rates of non-attendance in a post-COVID pre-cyber-attack era wherein patients received an automated text message reminder about their appointment was compared to a post-cyber-attack era wherein the text message reminder system was disabled. In addition, these were compared with rates of non-attendance prior to when the reminder system was introduced. Three periods were compared, two weeks prior to the introduction of the text reminder system, two weeks pre-cyber-attack, and two weeks post-cyber-attack. Results Period 1 measured rates of non-attendance prior to the introduction of the text reminder system. Period 2 measured rates of non-attendance at outpatient appointments and consisted of nine clinic days, with two clinics per day. Period 3 similarly measured rates of non-attendance at outpatient appointments and consisted of 10 clinic days, with two clinics per day. The text reminder service was disabled during this collection period because of the cyber-attack. The average non-attendance rate was 16.99% for period 1, 13.00% for period 2, and 16.13% for period 3. A Fisher Exact Test was carried out on data with a p-value set at <0.05. Results reached statistical significance. Conclusion Our data shows non-attendance at ENT outpatient appointments increased without the text reminder system. Over two weeks after the attack, non-attendance increased by approximately 3%, which was statistically significant.