Text messaging is a proven communication channel that is recognized in study after study for being an effective way to engage patients, change behavior, and improve outcomes.
Despite these results, there is a tendency to dismiss text messaging as a strategic communication and engagement tool within healthcare. Providers often express concerns that texting is not HIPAA compliant, their patient population does not text, and the utility of texting doesn’t extend beyond appointment reminders.
As I will share in this post, while the above concerns are questions that should be explored and understood, they do not represent barriers. Rather, it’s incumbent on healthcare leaders to imagine the potential ways to apply this simple communication channel as a strategic solution to improve patient engagement, overall communication, and patient health. Here is a brief examination of how texting can benefit patients and providers alike.
What is “Text-First” Communication and Why Should Providers Use It?
When it comes to exploring the full potential of texting as a healthcare tool, it’s critical to understand the concept of "text-first" communication. Simply put, when using this communication channel, a text-first approach means that all patient communications begin with a text message. Where the patient goes next is dependent upon the characteristics of the information exchanged or the call to action.
Before going any further, we should briefly touch on the question of HIPAA compliance. Like all processes that deal with protected health information (PHI) and patient communication, HIPAA rules must be understood and adhered to firmly. Text messaging, by itself, is not a secure channel. As a result, PHI should not be shared via text message. The requirement for HIPAA compliance does not disqualify texting as a viable healthcare communication channel. Any texting initiative requires a thoughtful program design and thorough compliance review before launch.
Simple interactions that do not require PHI can be accomplished entirely through text messaging. In these interactions, the patient's context is a powerful asset. Assuming that the information being shared is timely and relevant, the patient knows, for example, that they are scheduled to have a diagnostic procedure on Thursday and the instructions being shared relate to that procedure. With this in mind, communication that omits the specific details about a patient's encounter and avoids inclusion of PHI does not lose its effectiveness.
In situations where the message can be conveyed more clearly through multimedia (e.g., pictures or video) or there is a need to exchange detailed PHI, the text message becomes a gateway to the mobile web through hyperlinks. The links can take the patient to portals, educational content, or custom developed web applications that support the safe and secure exchange of PHI.
A text-first approach can be the primary enabler of a provider's mHealth strategy, because it’s an extremely effective and efficient way to engage with patients. Texting is the equivalent of a "digital tap on the shoulder,” and it’s ideal for quickly grabbing a patient's attention. In fact, that is one of texting's key advantages. When sending emails or leaving a voicemail, the sender has no idea when the intended recipient received the message. The vast majority of text messages, on the other hand, are read within three minutes. Our data also shows that most patients respond to messages within fifteen minutes. Text messaging is clearly well suited for time-sensitive interactions.
Using a text-first platform, providers can regularly and consistently check in or communicate with a patient. This allows for lightning-fast communication and also permits providers the chance to gather specific feedback from patients on a periodic basis. By taking advantage of rules driven, scheduled messages, and on-demand messaging, it’s easy for providers to integrate text interactions into their daily workflow.
Texting gives case managers and even health coaches, for example, the opportunity to periodically reach out to their patient populations and, based upon responses, follow up with only those particular cases that demand an immediate response.
Text Messaging Reaches All Demographics
So, why should texting be treated as a primary means of mobile communications for healthcare providers? Simple: texting is a reliable resource for reaching every segment of the American population, ranging from the elderly to Millennials. For instance, mobile device ownership for American adults currently sits at 91 percent, and two-thirds of American adults own a smartphone.
Texting is the top means of communication for Americans under the age of 50: two-thirds of 18-to-29-year-olds and half of 30-to-49-year-olds surveyed texted "a lot" the day before their interview. Also, while many believe that seniors do not text, the data indicates otherwise. Our data shows that 55 percent of seniors have SMS capable mobile numbers and, when asked a question via text, their response rates are equal to or better than the younger demographics. It is important to note that these figures hold up regardless of socioeconomic status.
Texting, in short, is a universal tool: it’s something that all Americans, ranging from the young to the old, use consistently and regularly. Moreover, for the vast majority of Americans, texting is the preferred means of communication, especially when compared to more traditional methods, such as voice calls. It’s important to imagine what it would mean for providers to instantly reach the vast majority of their patients across all demographics.
Patient Health and Engagement
Texting can also be useful for driving patient engagement. When patients are positively engaged and informed, their health results improve. For instance, according to a Gallup poll, when surgery patients know what to expect before surgery, 72 percent were satisfied with the results. However, when patients did not know what to expect, satisfaction falls to only 39 percent. Texting can be used to educate patients quickly and efficiently, helping to save providers time during appointments or pre-surgery meetings. With texts, providers can supplement and reinforce instructions, pass along links to more detailed information, and provide contact information for phone calls.
Furthermore, texting can be used to check in with patients post discharge, helping to ensure that they follow their discharge instructions. In fact, one study noted that frequent provider text messages double the odds of medication adherence for patients. Post-discharge phone calls have also been shown to help lower readmission rates, and since texting is the preferred form of communication for most Americans, it follows that post-discharge texts could also be used to help lower readmission rates.
Confining text messaging's benefits to appointment reminders is not unlike saying that the mobile phone is only useful to make phone calls—it misses the real power of this communication channel to change behavior and improve outcomes.
Text Messaging – Accessible to All
As noted above, texting is a highly accessible tool—all American demographics text. By contrast, not all of Americans own a smartphone or tablet, which makes it difficult for many Americans to access a mobile app. When it comes down to it, text messaging is a mobile app that comes pre-loaded on virtually all cell phones from old school flip phones to the most sophisticated smartphones.
As a communication tool, texting is a scalable, cost-effective, and a simple-to-use resource that healthcare providers should not overlook. Healthcare providers need to see the simplicity of texting as a positive and recognize the extensive and diverse engagement opportunities a text-first approach can support.
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