With all the negative coverage surrounding text messaging, it looks like they might be useful after all. Here are three innovative ways text messaging can be used to improve medical care.
In the case of a cardiopulmonary emergency, time is life. Each minute that passes in a cardiac arrest patient decreases their chance of surviving by about 10%. Dialing 911 in the United States, or 112 in Sweden brings emergency response to your door in minutes. But a program called SMSLifesaver doesn’t think that’s fast enough.
“The traditional emergency services, especially the ambulance—they have problems in the Stockholm area,” said Dr. Mårten Rosenqvist, a professor of cardiology and spokesperson for the group. “First there are not so many, second there is heavy traffic in Stockholm, and third, they are usually occupied by doing other things: transporting patients to the emergency room, or transporting patients between hospitals.”
Thanks in part to SMSLifesaver, Stockholm County has seen survival rates after cardiac arrest rise from 3% to nearly 11%, over the last decade. There are about 9,600 Stockholm residents are registered SMSLifesaver. An estimated 200,000 Swedes have completed the necessary CPR training, and could potentially join the program.
Women’s Health Telemedicine in Rural Kenya
The slums of Kenya are filled with poverty, crime, and inadequate health education, which unfortunately leaves many mothers at home to give birth to their children with no medical care at all. These conditions dramatically increase the mortality rate of the child and mother. Thanks to Aggrey Otieno, a human rights activist, there is hope. He wants to make Kenya a safer place for pregnant Moms. In addition to community education workshops, Otieno has also set up a network of 24-hour telemedicine centers, which provide assistance for pregnant women from afar via text messages and even send vans to take them to the hospital if necessary. Accodring to Otieno, 8% of Kenyans, even in poverty, have cell phones and can participate in this program. For the others, Otieno offers front line health workers that travel to your house and send texts to the telemedicine center themselves. Doctors then review the texts and respond appropriately.
“So many women are dying during delivery, dying during pregnancy,” says Muguma. “In the slums it is due to poverty, lack of awareness, transport. “We get a text message on our computer. This tells us the mother is sick or in labor and then I make arrangements for an ambulance or for someone to pick her up and take her to hospital… When you save a life a lot of satisfaction comes out of that.”
Text Messages Improve Drug Adherence
A major glitch in the medical delivery system is the lack of intervention and oversight apart from the 12 minutes your patient is in the office. This is one of the most egregious holes in our chronic disease management, and instead of blaming the patient for not listening, we should create an environment where they are non-paternalistically incentivized and empowered to take their medications. Researchers at OptimumRX tested this philosophy in a study by sending text message reminders and measuring adherence rates in 580 subjects taking medications for their diabetes or blood pressure.
Participants who were taking chronic oral anti-diabetes medications realized adherence rates of 91% versus 82% in the control group who did not have text message reminders. In addition, patients who received text message reminders for beta-blocker therapy realized 88% medication adherence versus 71% in the control group.
These three stories are a testament to how a very basic technology can have a dramatic impact on medical care if it is leveraged properly.