When it comes to health, we love small and simple interventions that have significant impacts. A new study shows that check-in text messages sent after emergency care from a primary care team can significantly decrease hospital readmission rates.
Of course, a text can't diagnose or treat medical conditions, but it does seem that this little nudge does help discharged patients take a moment to consider how their health is recovering and how they're adjusting to any new treatments.
The follow-up texts, sent over 30 days, appear to play an important role in keeping patients connected to a source of support.
"In a fragmented healthcare landscape, relatively simple applications of technology can help patients feel more connected to their primary care practice," says Eric Bressman, an internist at the University of Pennsylvania's Perelman School of Medicine.
"This is especially important as patients recover from acute illness, as it reminds them that they have a medical home to which they can turn for support."
The researchers compared more than 400 who did get text messages to more than 1,000 who didn't. Among the texted group, there was a 55 percent decline in the likelihood that they would need to stay at the hospital again within the next month and a 41 percent reduction in the chance that they would need emergency care of any kind over that 30-day period.
The text message system started with three check-in texts a week in the first week, going down to a single check-in text in the fourth week. The regular text question was "Is there anything we can help you with today?" with various responses given, such as "I don't feel well" and "I need help with my medicines".
Patients were also advised to call the hospital or the emergency services if needed, adding to the support options available. After 30 days, a final text message was sent indicating the follow-up program had finished.
According to the researchers, the texts can help patients feel more connected and encourage them to seek extra help as soon as needed – rather than waiting until emergency care or rehospitalization might be needed again.
Phone calls from nurses are often used to follow up with people who have recently left the hospital, but text messages promise to be quicker, simpler, easier to scale up, and more effective. And while these phone calls do help, they also come with some issues that a text messaging system could solve.
"In our experience, the calls can be time intensive, often go unanswered, and generally connect with patients only once, early in the course of their recovery," write the researchers in their published paper.
The researchers are hoping that the trial's success – more than 80 percent of patients responded to at least one introductory text message – will lead to it being adopted and rolled out more widely.
"We hope this all will build toward the roll-out of more applications of digital medicine that bridge gaps in care and offer patients easier pathways to connect with their primary care team," says Bressman.
The research has been published in JAMA Network Open.