By Barbara Ficarra, RN, BSN, MPA
Educating patients through texting
Mobile technology may help to transform the lives of patients and provide a stronger partnership with health care providers.
I received a text message from my mobile service provider regarding a quick survey as a follow-up to a phone conversation I had with one of their representatives.
The first text thanked me for calling the customer care center and said, “We’ll text you shortly for some feedback about your call experience.” Three short text questions followed and I needed to reply back with a number, 1 (very dissatisfied) to 10 (very satisfied). I was happy to reply since the text message was short and barely took any time.
If this quick survey was sent in the mail, or it was through a phone call, or online, I would not have completed it. Since it required a simple text message, I didn’t ignore it. The wireless service company received my immediate feedback.
Texting to connect with patients
Text message is easy and in real-time, and the way this wireless service connected to its customers; health care providers can connect to patients to help them manage their health care.
Health care technology has made it possible to go where the patients are. They are online, in social networking sites and they are using mobile devices which make it easy to connect with them.
Patients are savvy health care consumers. According to Pew Internet and American Life Project, 80% of adults gather health information online and 88% of American adults have a cell phone, and among the cell phone owners 53% own a smartphone.
Patients have the health information they were searching for, now what do they do with that information? How does the information help them transform their health? Gathering health information isn’t enough. Now, patients need to take action, but they can’t do it alone.
Once they decide they are ready to take action and they are motivated and are capable of understanding and managing their condition, technology can help move them forward. Patients can utilize mobile technology to help leverage their capabilities; and develop a closer partnership with their health care providers.
Patients can help transform health care and may help drive innovation and behavior change by engaging in the power of mobile devices. Research conducted At the Center for Connected Health, showed that “sending people a text message each AM with the weather report and a reminder to put on their sunscreen increased sunscreen use dramatically,” said Joseph C. Kvedar, MD, Founder and Director at the Center for Connected Health.
The Center for Connected Health is an innovative company that is actively involved in sponsored research, and it evaluates new technologies and programs with randomized controlled clinical trials.
Issues such as medication adherence, chronic disease management, and prenatal care may be a “tap” away. By receiving text messages through a smartphone, patients can become proactive in their health care. There are tools to help empower patients, and the Center for Connected Health offers a variety of ways to help health care providers interact through mobile technology.
For example, they offer clinicians a text-messaging based platform to interact with their patients. They can customize the type of messages they would like their patients to receive. It can be anything from health tips, educational support or interactive surveys.
Take a look at this pilot study [PDF of pilot study] “A low-cost text message reminder system” from the Center for Connected Health. Two programs were conducted, “OB” – pregnant women and teens and “STAR” – patients in treatment for opiate addiction.
Weekly and monthly motivational messages and reminders were sent. A sample reminder for “OB”-“Your OB Team wants to remind u that u can call us anytime @ (781)000?0000. Stay on the line and don’t forget to tell us you’re pregnant.” A sample motivational message for “STAR-“Hi, it’s Marylee. We hope you’re doing well. Reminder: 3 urines/week. Attend your weekly recovery group. Followup with me. C U Soon.”
Medication adherence: Minding our Meds
According to a press release statement from The New England Healthcare Institute (NEHI) patients who do not take their medications as prescribed by their doctors cost the U.S. health care system an estimated $290 billion in avoidable medical spending every year. Will a simple text message with friendly reminder for patients to take their medication help them adhere to their medication regime?
In an attempt to improve medication adherence among seniors, the Center for Technology and Aging to the Front Porch Center for Technology Innovation and Wellbeing launched “Minding Our Meds: Demonstrating Senior Medication Adherence With Cell Phone Texting Reminders,” a project that uses text messages to remind older adults to take their medications.
“The project addresses medication adherence among active, independent older adults using a cell phone texting service, and focuses on 150 adults, over the age of 50, living across Front Porch communities and neighboring senior centers.
“This project is about keeping seniors healthy, independent and connected. To the extent that a simple and widely available communication tool can help accomplish this makes it that much more powerful,” said Davis Park, director of the Front Porch Center.”
The goals of “Minding Our Meds” are to demonstrate that mobile alerts and monitoring lead to improved medication adherence in chronic disease management and to create a replicable and sustainable model for using mHealth technology solution for medication adherence.
Text messages for pregnant women and new moms
Text4baby messages (founding sponsor Johnson & Johnson) are free text messages for pregnant women and new moms even if the individuals don’t have a text message plan and if they have a limited texting plan, these text4forbaby messages don’t take away from that limit.
The short simple text-length messages provided helpful and accurate snippets of health information.
Sample text messages
- “Even if U feel great, a pregnant woman needs checkups with a Dr./midwife. To find care, call your health plan. For help with costs, call 800-311-2229.”
- “Your baby will be here soon, & it’s time to get a car seat. The hospital won’t let you leave by car or taxi without one.”
- “See the world from your baby’s point of view! Crawl around on the floor to see where dangers are for baby. Curious babies will go everywhere!”
- “Holding, talking, reading & singing to your baby help her learn. Soon your baby will coo, babble, hum & laugh back!”
Texts-educational and motivational reminders
“Texts represent bite-sized bits of educational or reminder information. They are helpful without being intrusive. They act as efficient memory triggers,” said Kvedar. “Patients are generally ready to embrace connected health as a part of their health, wellness and care platform. Within that broader enthusiasm there is a significant population who prefers communication of health messages via the platform of text,” he adds.
Leveraging mobile technology is paramount and widespread adoption may be possible. Simple motivational messages and reminders may help foster a stronger relationship with health care providers and it may allow patients and consumers to take action. Patient engagement is essential for quality health care.
Mobile technology may be the link to connect the dots in health care. It may help to transform the lives of patients and provide a stronger partnership with health care providers. To help move mHealth forward, having all the health care silos (from payers to providers, physicians, pharmaceutical industry, research centers, academic institutions, patients etc.) join the movement for better quality health care.
What do you think about text messaging for health? Do you think it’s a link for better health? Are you a provider that uses text messaging for your patients?
As always, thank you for your valuable time.
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What I have found over the course of a years worth of research is that there is a very fine line between providing great health information via mobile apps and being intrusive. It is estimated that 75% of all apps are deleted within 2 weeks because people either don’t use them or don’t want them anymore. This, however, should not discourage healthcare marketers from developing mobile apps they just need to ensure that they conduct extensive usability testing along the way and that the app remains relevant. This means continued investment in mobile marketing technology.
Why has it taken so long for people to realize that the better you educate the patient the better the results…People want to know what is wrong with them ONLY when they are sick. That is WHY mobile apps are perfect…you can provide incredible patient education right at the point of care and in the palm of your hands…patients love seeing the 3D animations and will watch them again and again. This should be the beginning experience for every patient. The additional apps and assessments keeps the patient informed, engaged and hopefully responsible for their health.
Very good examples indeed! This is very good to help people cope with all kind of demands/challenges to their behavior to adapt to their health condition.
There is however a specific risk here. And that is very much related with Rich’s remark: the fine line between actual support and intrusion. That’s why I am convinced that rendering support is a two-sided action: acceptance is an active word here. In my experience, patients will be more keen to accept support if it is grounded on a mutual concordance on how to support, with what means and in what frequency. Too often, I detect an authoritative stand towards helping, like in the meaning of: “I determine that you should be educated”..
All support must be based on agreement in concordance. This will need trust – and thus a specific discussion on what and how between protagonists. I’m also convinced that real trust will only come about after a learning phase about how it is done. This means that there should be possibilities to adjust service/support to personal wishes/conditions.
Specifically in studies of adherence we detect the many ways that patients are able to avoid “support”. If so, caring is far away.
As patient support and services is growing, we will find out more form evaluation! But this is not to mean that we should linger, on the contrary. For better health, we cannot go fast enough. But reflection up front would be nice.
Thanks, Rob @rohal