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Text messaging has the power to improve the quality of hospital care

By: Nigel Shanahan, Managing Director of Rapide
Published: Wednesday, August 7, 2013 - 11:03 GMT Jump to Comments

Managing Director of Rapide, Nigel Shanahan, discusses the possible benefits of an SMS-savvy National Health Service.

This month Imperial College London launched a clinical research program into how diabetes sufferers can improve their quality of life through SMS. The three year study will be the first of its kind in the UK, looking at the concept of motivational text messages and seeing if they are an effective way of preventing the development of the disease.

Using our proactive communication solution, Inform & Interact, ICL will be sending out three text messages every week (Monday, Wednesday and Friday) to half of the people on the study. These will be motivational messages encouraging people to take positive action to improve their condition and examples include “Try to reduce your salt intake” and “Take a walk rather than use the bus today.” The other half of the people on the study will receive no motivational messages.

If this approach is proven to be effective through the study, SMS could be widely used across the health service to reduce type 2 Diabetes and this would in turn have a hugely positive impact on the NHS and the general public.

While using SMS in healthcare is far from new, it is something that has massive room for development. Today, SMS messages are being sent out to people all over the country, reminding them about their appointments. This is all in an effort to reduce DNA (Did Not Attend) rates that cost trusts hundreds of thousands of pounds each year in wasted time and staff resource.

However, there are many other ways that I think text messages could be used to help improve the health of individuals and reduce costs to the NHS, thus releasing extra funds which could be used to focus on more acute or problematic areas which would benefit from additional investment. 

Firstly, it’s important to look at SMS as a two way interaction; not only are they a great way to send out proactive messages reminding people to do something, but they’re also a great way of finding out exactly what people are thinking by asking them for feedback.

The same financial pressures seen in other public sector bodies apply to the NHS. SMS can support a “doing more with less policy”, reducing the size of call centres with a simple method of texting, asking for feedback and automating the analysis. Appointments, for example, can be amended by engaging patients via text message. Using text messages means that individuals can reply as and when suits them, rather than having to take calls during work or worse still, missing them all together. This places the choices with the patient and not the NHS, involving the patient more in the decision-making process.

Similarly, there is a huge amount of pressure on the government for the NHS to listen to the views of patients and sending an SMS is the quickest way for a relative to share their views on how their loved one was treated. Currently there are many ways of capturing the Friends & Family question (NPS question for those outside NHS), “On a scale of extremely unlikely, to extremely likely how likely are you to recommend our department to your friends and family?” The answer enables a department to find out how they’re doing in a fast and clear way. A great benchmark. However, with a follow up SMS the healthcare industry can truly find out where it’s going right or wrong, simply by asking ‘WHY?’ This second question not only indicates that you care what they think, but it also gives the recipient a chance  to reply in their own words, with no leading questions (as with many surveys) that may sway their answer and make it less impartial. The verbatim feedback therefore gives the insight a qualitative feel to their quantitative score.

I’ll use a recent personal experience to elaborate further; we took my son to hospital recently and had I been sent the initial feedback request I would have responded with a middle of the road “likely”. The follow up question of “Why?”, however, would have given me the chance to add a little more context to my score. I would have explained that Jenny, the staff nurse, looked after us so well that she turned what was otherwise a stressful experience into a pleasant one. In the same message, however, I would have added that the waiting room seemed chaotic and in need of a good clean. In this situation the positive standard of care outweighed the negative experience in the waiting room but the latter was still enough to take my score down from an “extremely likely”.

This response would have been useful to the hospital involved in several ways. Not only would they have been able to recognise Jenny for her great standard of care but the real-time nature of the text message – sent and received straight after treatment - would have presented them with actionable insight that they could act upon straight away. By addressing the issue of the unkempt waiting room they would have been able to prevent other patients from the same negative experience.

But why text messaging and not calling or emailing? The Department of Work and Pensions is already a big fan of text messaging, using them to remind people about their Jobcentre Plus appointments and keeping them up to date with developments in relation to their benefit claims.  They use this method as they know that if you ring someone on a given landline you are not guaranteed to reach the person you are trying to get hold of.  Email presents a different challenge, some people receive thousands of emails each day – so it’s possible your one, very important health related email could get lost in a sea of emails, or worse be sent straight to a junk folder. But most importantly, it’s a fact that an overwhelming 96 per cent of all text messages are read within four minutes, the average email, 48 hours! 

Other innovative ways that text messaging could be used to improve the NHS include:

- Giving people essential advice on health matters relevant for them - For example, 15 years ago when a newspaper  article informed parents about the potential risks associated with the MMR vaccine, localised drops in vaccinations occurred, leading to an influx of cases earlier this year, risking the children’s health and the health of others around them. Potentially, SMS could have greatly helped the situation. If a parent were to receive a personal and targeted text message direct from their doctor, or the NHS, explaining what the MMR vaccine is, and the possible side effects, this will help people understand the facts rather than being led astray by rumours. At the very least, an invite to discuss the subject with your doctor if you feel the need demonstrates a level of empathy expected from a national health service.

- Deliver reminders for all to live a healthy lifestyle - As with the current diabetes study with ICL, reminders could be sent out to people with sensitive health issues, reminding them to take their medication or vitamins.  For example, during pregnancy, women could receive messages reminding them to take their folic acid or post pregnancy they could ask, “Have you seen your health visitor lately?”  While many people will take these things into consideration, many won’t or will forget and so for them these messages could be life changing. 

- Paying for prescription drugs – SMS technology could also be used to help people pay for their prescriptions using their mobile phones. In some third world countries this is already in full force because it’s difficult to carry money while everyone owns a mobile phone. 

The big question is, can SMS save money? And can it help improve people’s health?  Well, Rapide typically see our clients get their investment back after just three months, showing that by month four, trusts can be saving money as a direct result. Can it improve people’s health? We believe it can but only time, and many hours of research, will tell. 

Nigel Shanahan is the founder of customer engagement specialists, Rapide.  They provide state-of-the-art proactive communication and fast feedback technology to many prestigious Public Sector organisations, as well as half the FTSE.  An industry innovator, Nigel is a regular speaker at conferences and an executive member of the Mobile Marketing Association.  He also has an MBA from Warwick Business School. To find out more about Rapide visit www.rapide.co.uk

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The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of The Information Daily, its parent company or any associated businesses.

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