Manx Care sent out more than 430,000 text messages last year - but can't replace them all with emails.
So says Health Minister Claire Christian, after a question for written reply from Rushen MHK Juan Watterson.
He wanted to know how many SMS messages were sent to patients about appointments, and whether they could opt to get emails instead.
However, in her response the minister said there was no central system for appointments and email couldn't yet be used in areas such as Noble's Hospital outpatient appointments.
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