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Text Messaging — A Valuable Tool for Patient Engagement

In a September 19 news release, the U.S. Department of Health & Human Services announced a Text4Health task force and recommendations on health text messaging and mobile health technologies. The accelerated growth of smart phones and mobile applications puts a great deal of communication power in the hands of consumers; however, in addition to more sophisticated mechanisms of mobile communication, text messages have an important role to play in education as well as simple notifications.

With text messaging growing as a device agnostic form of mobile communication, the ability to leverage this medium in order to influence behavior and promote better health holds great promise. A 2010 PewInternet study titled “Teens and Mobile Phones” reports that “Half of teens send 50 or more text messages a day, or 1,500 texts a month, and one in three send more than 100 texts a day, or more than 3,000 texts a month.“ My personal experience with three teenage/young adult children is that text messaging is the most prevalent form of communication. I have difficulty getting my children to answer the phone, but they will generally respond to a text message within minutes.

The report recommends that:

  1. HHS develop and host evidence-based health text message libraries that leverage HHS’ rich and scientifically-based information,
  2. HHS develop further evidence on the effectiveness of health text messaging programs, and
  3. HHS explore and develop partnerships to create, implement, and disseminate health text messaging and mHealth programs.

There are many examples of the use of text messaging in healthcare, including the following:

  • The Centers for Disease Control and Prevention offers a Mobile CDC site that provides information on public health emergencies and flu updates as well as a text messaging notification service to which users can subscribe.
  • The National Cancer Institute has launched a smoking cessation website smokefree.gov and through this also offers smokefreeTxT, which is described on the website as a “free mobile service designed for teens and adults across the United States, created to provide 24/7 encouragement, advice, and tips to help smokers stop smoking for good.”
  • Chronic disease management programs for Diabetes, such as this study conducted in 2010 at George Washington University Hospital, through which personalized messages and alerts are generated via text message when a patient enters their blood sugar level into their cell phone.

The simple time management capabilities of text messaging in healthcare are considerable. For example, in Singapore, the majority of waiting rooms in public health facilities offer a text messaging service to patients who are able to sign in upon arrival and are then free to attend to other activities and receive a text message to return approximately 15 minutes before they are to be seen.

These are exciting developments that are complimentary to the adoption of Electronic Health Records. In my opinion, the difference with targeted mHealth applications and services is the ubiquitous nature of mobile phones and the ability to reach large numbers of individuals using a common medium — right now. EHRs are much more complex tools and will take longer to reach a matching level of maturity.

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