Text Messaging: An Often Overlooked Patient Engagement Tool

Population Health,Mobile,Patient Compliance,Text Messaging,Patient Journey

One size does not fit all...

Health care leaders across the country are focused on optimizing health system performance. The Institute for Healthcare Improvement (IHI) developed a widely recognized framework for performance improvement, known as the Triple Aim. This framework posits that “new designs must be developed to simultaneously pursue three dimensions”: improving the patient experience (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care. A key ingredient to achieving these goals is strong and consistent patient engagement.

Before going any further, it is useful to define patient engagement (the term has recently reached buzz word status and lost its meaning – think “big data”). One definition that captures its true meaning was described in a 2014 HealthAffairs article. The authors define patient engagement as a “broad concept that combines patient activation – a patient's knowledge, skills, ability, and willingness to manage his or her own health and care – with interventions designed to increase activation and promote positive patient behavior, such as obtaining preventive care or exercising regularly”.

There are many ways to truly engage patients and one size does not fit all. However, of all the methods available to health care professionals, mobile communication – specifically text messaging – holds great promise.

An often overlooked characteristic of mobile communication is the highly personal relationship we have with our mobile devices. It has become second nature to constantly check our phones - once every six minutes, according to a study commissioned by phone manufacturer Nokia. When we are not checking our phones, we still have them nearby. One study indicates that we have our mobile devices with us 22 hours out of every day. It is clear that if the health care industry wants to reach patients and increase engagement, the fastest way is through texting.

In addition to being direct, text messaging is also interactive. Upon receiving content or questions from their provider, patients can easily respond with information such as current health status or feedback on their overall experience. The quick cycle of information – content, feedback, and response to feedback – makes text messaging an engaging and efficient platform for health care management.

Additionally, text messaging is a cost-effective and efficient communication channel. Technology platforms are available that support both sending messages automatically – at precisely the time when patients need to do something or know something about their care – and on demand. These platforms provide a great alternative to having highly trained health care resources making phone calls and leaving voice mails. Patient engagement takes time – it’s about building relationships, after all – so it makes sense that an affordable method of communication is used to ensure its sustainability.

But because of concerns about HIPAA compliance, text messaging hasn’t been getting the attention it deserves. Though patients respond positively to it, the question of privacy and security hangs in the air and acts as a major barrier to adoption. A text messaging program that includes thoughtful message design and the appropriate elements of consent, authentication and securing protected health information (PHI) significantly reduces the compliance risk and makes text messaging an attractive patient engagement platform. It’s time for health care providers to take a fresh look at this communication channel and imagine the possibilities for enhancing patient engagement.