Get the Message? Texting Improves Patient Care

As a whole, medicine is slow to adopt new technologies. If that new technology involves an erosion of a doctor’s already-spare private life, you pretty much find yourself with a non-starter.

That’s the confluence of concerns that has prevented texting from taking a wider role in the physician–patient relationship. Despite its prevalence, its convenience, its ease, and its low cost, health care providers have not exactly embraced it as a viable option, regardless of its potential to improve care.

As a whole, medicine is slow to adopt new technologies. If that new technology involves an erosion of a doctor’s already-spare private life, you pretty much find yourself with a non-starter.

That’s the confluence of concerns that has prevented texting from taking a wider role in the physician–patient relationship. Despite its prevalence, its convenience, its ease, and its low cost, health care providers have not exactly embraced it as a viable option, regardless of its potential to improve care.

Nevertheless, there is evidence that patients consider texting a highly desirable means of communicating with their doctors. According to a recent study from the PriceWaterhouseCoopers Health Research Institute, 27 percent of consumers said they would benefit from medication reminders sent via text message. Moreover, 40 percent of respondents said they would be willing to pay a monthly fee for a mobile phone application that would send texts or email reminders to take medications or refill prescriptions. In the same study, almost 80 percent of Medicaid respondents who own mobile phones said they text regularly.

Now, one group of doctors at University of Texas (UT) Southwestern Medical Center has demonstrated tangible clinical benefits from texting. A study published in July by the journal Plastic and Reconstructive Surgery found that texting reduced post-operative office visits, phone calls to the clinic, and, perhaps most significantly, the number of days until removal of the bodily fluid drain in patients who underwent breast reconstruction for an oncologic diagnosis.

“Our doctor gave the patients his cell phone number and told them to send a text between a given time window with deidentified data about the drain,” said Rosni Rao, MD, a study co-author and vice chief of staff at UT Southwestern’s Zale Hospital. “Once the data was where it was supposed to be, he told them to come in the next day. We were surprised to find fewer days until the drain removal. This is good because it’s not pleasant at all for the patient, and the faster you can remove it, the lower the risk of infection.”

Giving out personal contact information might feel like Pandora’s Box to doctors. In the case of this study, however, interruptions were minimal.

“Our colleagues said, ‘What’s wrong with you? Why are you giving patients your cell phone number?’” Rao said. “But we didn’t find it problematic. When patients do call, they’re very apologetic and very respectful. They just want to know they have the access.”

Legal as well as personal privacy concerns — particularly around the Health Insurance Portability and Accountability Act (HIPAA) — are undoubtedly an issue. Though UT Southwestern’s approach happened by phone, there are other short-message methodologies that bring peace of mind as well as convenience. Doctor–patient communication apps currently available for mobile devices include MedXCom and mRx.

Rao acknowledged that, in many cases, the short-message approach might not work for practices with high patient loads. “Lower numbers of patients made it possible for us to work with de-identified data without confusion,” he said. “That method won’t be for everyone.”

Overall, though, Rao called the move inevitable.

“We’ve just got to get over it and start texting,” she said. “It’s the way everything is going.”