Missed appointments at outpatient clinics are a significant problem inherent in local and regional healthcare systems in the United States, as well as globally. The outcome is costly to organizations and burdensome on organizational productivity, the healthcare system, and poor patient outcomes. The use of text message appointment reminders potentially offers a cost-effective and time-efficient strategy to decrease missed appointments, thus, improving the efficiency of outpatient healthcare delivery. The objectives of the project were: (1) to implement a text message reminder system to reduce missed appointments; (2) to maintain the standard practice of patient reminders using telephone calls; (3) and to reduce lost revenue from missed appointments. The goal of the project was to reduce the number of missed appointments at the outpatient community clinic.