Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Text Messaging  Benefits for Patient & Health Provider
Did Not Attends (DNA’s) <ul><li>Wasted or underutilised resources </li></ul><ul><li>Patients don’t receive care that may i...
Efficiency & cost <ul><li>More cell phones than people in NZ </li></ul><ul><li>Text costs approx half a stamp or call to m...
Text messaging pilots <ul><li>Two District Health Boards – Counties Manukau & Bay of Plenty </li></ul><ul><li>Goal was to ...
Counties Manukau DHB <ul><li>DNA rate constant at 12% for some time </li></ul><ul><li>Research showed “forgot appointment”...
Counties Manukau DHB <ul><li>Two texts sent  </li></ul><ul><li>1st text – day before Outbound Callers attempt contact </li...
Counties Manukau DHB <ul><li>Extracts from Patient Management System uploaded to Dialhog website  </li></ul><ul><li>1st te...
Counties Manukau DHB <ul><li>Text messages generally from family & friends so an opportunity & potential hazard  </li></ul...
Counties Manukau DHB <ul><li>Manukau SuperClinic rollout started March 07 and was completed mid June 07 </li></ul><ul><li>...
Counties Manukau DHB Results
Counties Manukau DHB Analysis of Results <ul><li>17% reduction in overall DNA rate all from 50% of patients who received t...
Bay of Plenty DHB  <ul><li>Utilise most of the Counties Manukau DHB strategy </li></ul><ul><li>Change to reflect differenc...
Bay of Plenty DHB <ul><li>Pilot started in November 08 ran till end Mar 09 </li></ul><ul><li>Clinics added during period, ...
Bay of Plenty DHB <ul><li>Only clinics in texting program at end Mar available to work with for analysis </li></ul><ul><li...
Bay of Plenty DHB Results Clinics using texts at Mar 09 Clinics NOT using texts at Mar 09 Jan 08 - Mar 08 11.19% 5.72% Jan...
Bay of Plenty DHB  analysis of results <ul><li>44% of patient records with cell phones. 38% received text </li></ul><ul><l...
Return on investment <ul><li>Appts texted clinics Mar 09 5254 </li></ul><ul><li>DNA’s 510 </li></ul><ul><li>Expected DNA’s...
Patient Acceptance “Recently you recvd a txt reminder about appt at {LOCATION} Hospital. Plse text bk YES if you liked rem...
Patient Acceptance BOP Comments <ul><li>“ Yes thanks” or “Yes thank you” (5 times) </li></ul><ul><li>“ Yes it’s a great id...
Patient Acceptance  Survey Analysis <ul><li>50% response = high level of engagement </li></ul><ul><li>Surveys confirm each...
Information Security <ul><li>All communication & transmission encrypted using https </li></ul><ul><li>All data stored in e...
Different text content choices  <ul><li>No names other identifiers or replies  </li></ul><ul><li>*SCREENING APPT REMINDER*...
Letter / text security comparison <ul><li>Letters & texts can go to a wrong or an old address </li></ul><ul><li>Letters & ...
Scalability <ul><li>Some scalability issues with database searches encountered as service expanded at Counties Manukau </l...
Current customers include <ul><li>Counties Manukau DHB </li></ul><ul><li>Bay of Plenty DHB </li></ul><ul><li>Southland DHB...
Other health users <ul><li>Text reminders work as effectively for small as well as large providers  </li></ul><ul><li>Phys...
Upcoming SlideShare
Loading in …5
×

Text Messaging - Benefits for Patient and Health Provider

1,215 views

Published on

Chris Lewis
Dialhog Ltd
www.dialhog.com
(P46, 1/10/09, Sigma Room, 11.28)

  • Be the first to comment

Text Messaging - Benefits for Patient and Health Provider

  1. 1. Text Messaging Benefits for Patient & Health Provider
  2. 2. Did Not Attends (DNA’s) <ul><li>Wasted or underutilised resources </li></ul><ul><li>Patients don’t receive care that may improve quality of life </li></ul><ul><li>May present later with worse problems requiring more resources than previously </li></ul>
  3. 3. Efficiency & cost <ul><li>More cell phones than people in NZ </li></ul><ul><li>Text costs approx half a stamp or call to mobile </li></ul><ul><li>Low human resource cost as many done at once </li></ul>
  4. 4. Text messaging pilots <ul><li>Two District Health Boards – Counties Manukau & Bay of Plenty </li></ul><ul><li>Goal was to reduce DNAs </li></ul><ul><li>Analysis of DNA rates before & after texting </li></ul><ul><li>Analysis included ethnicity in Counties Manukau </li></ul>
  5. 5. Counties Manukau DHB <ul><li>DNA rate constant at 12% for some time </li></ul><ul><li>Research showed “forgot appointment” major reason given for DNA </li></ul><ul><li>Time gap between other reminder methods – letters & phone calls – and appointment </li></ul>
  6. 6. Counties Manukau DHB <ul><li>Two texts sent </li></ul><ul><li>1st text – day before Outbound Callers attempt contact </li></ul><ul><li>2nd text – as close as possible to appointment </li></ul>
  7. 7. Counties Manukau DHB <ul><li>Extracts from Patient Management System uploaded to Dialhog website </li></ul><ul><li>1st text – goal to reduce need for reminder phone call & therefore reduce expenses </li></ul><ul><li>2nd text – different timings for morning & afternoon appointments to increase immediacy </li></ul>
  8. 8. Counties Manukau DHB <ul><li>Text messages generally from family & friends so an opportunity & potential hazard </li></ul><ul><li>Text should be personalised with information relevant to the particular patient </li></ul><ul><li>Text replies routed as emails to relevant booking area for follow up </li></ul><ul><li>Content easily changed e.g. H1N1 </li></ul>
  9. 9. Counties Manukau DHB <ul><li>Manukau SuperClinic rollout started March 07 and was completed mid June 07 </li></ul><ul><li>DNA rate in initial area dropped from 13% to 11% (15% reduction) </li></ul><ul><li>40% of patient records had cellphone numbers recorded in any of three phone fields </li></ul>
  10. 10. Counties Manukau DHB Results
  11. 11. Counties Manukau DHB Analysis of Results <ul><li>17% reduction in overall DNA rate all from 50% of patients who received texts </li></ul><ul><li>Maori DNA rate reduction 10% above average </li></ul><ul><li>Patient reminded by text 33% less likely to DNA </li></ul><ul><li>6500 patients attended who wouldn’t have </li></ul>
  12. 12. Bay of Plenty DHB <ul><li>Utilise most of the Counties Manukau DHB strategy </li></ul><ul><li>Change to reflect difference in their Call Centre system </li></ul><ul><li>1 st text only to unconfirmed patients </li></ul><ul><li>No significant changes to text content </li></ul>
  13. 13. Bay of Plenty DHB <ul><li>Pilot started in November 08 ran till end Mar 09 </li></ul><ul><li>Clinics added during period, particularly March </li></ul><ul><li>Successful results have meant subsequent expansion of program </li></ul>
  14. 14. Bay of Plenty DHB <ul><li>Only clinics in texting program at end Mar available to work with for analysis </li></ul><ul><li>Two comparisons decided on </li></ul><ul><li>Jan – Mar 08 compared with Jan – Mar 09 </li></ul><ul><li>Mar 08 compared with Mar 09 </li></ul>
  15. 15. Bay of Plenty DHB Results Clinics using texts at Mar 09 Clinics NOT using texts at Mar 09 Jan 08 - Mar 08 11.19% 5.72% Jan 09 - Mar 09 9.57% 6.27% Change -14.48% + 9.62% Mar 08 12.03% 5.76% Mar 09 8.85% 6.47% Change -26.4% + 12.3%
  16. 16. Bay of Plenty DHB analysis of results <ul><li>44% of patient records with cell phones. 38% received text </li></ul><ul><li>Patient texted 38% to 69% less likely to DNA </li></ul><ul><li>In Mar 09 there were 510 DNAs from 5764 appointments in texted clinics </li></ul><ul><li>Would have been 693 DNAs based on Mar 08 </li></ul>
  17. 17. Return on investment <ul><li>Appts texted clinics Mar 09 5254 </li></ul><ul><li>DNA’s 510 </li></ul><ul><li>Expected DNA’s (Mar 08%) 708 </li></ul><ul><li>Extra attendees 198 </li></ul><ul><li>Value @ $100 per appointment $20,000 </li></ul><ul><li>Texting cost in March $1200 </li></ul><ul><li>$1 spent on texting = $16 savings </li></ul>
  18. 18. Patient Acceptance “Recently you recvd a txt reminder about appt at {LOCATION} Hospital. Plse text bk YES if you liked reminder txt, NO if you didn't. Any other comments. Thanx “ Texts sent Response rate Approve Disapprove Counties Manukau DHB 361 46% 99% 1% Bay of Plenty DHB 160 55% 99% 1%
  19. 19. Patient Acceptance BOP Comments <ul><li>“ Yes thanks” or “Yes thank you” (5 times) </li></ul><ul><li>“ Yes it’s a great idea” (4 times) </li></ul><ul><li>“ Yes it was good” (2 times) </li></ul><ul><li>“ Yes! What a great service. The reminder text was much appreciated. Thank you!!” </li></ul><ul><li>“ Yes very good. Makes life easy” </li></ul><ul><li>“ Yes I thought it was very helpful we all lead busy lives and a little reminder never hurts” </li></ul><ul><li>“ Yes excellent service thanks” </li></ul>
  20. 20. Patient Acceptance Survey Analysis <ul><li>50% response = high level of engagement </li></ul><ul><li>Surveys confirm each other & very high level of patient acceptance </li></ul><ul><li>Patients see texting as valuable self-management tool </li></ul><ul><li>Patients see texting as the friendly personal face of the Health Provider </li></ul>
  21. 21. Information Security <ul><li>All communication & transmission encrypted using https </li></ul><ul><li>All data stored in encrypted databases in physically highly secure premises </li></ul><ul><li>Different views on text content, privacy requirements and retention periods </li></ul>
  22. 22. Different text content choices <ul><li>No names other identifiers or replies </li></ul><ul><li>*SCREENING APPT REMINDER* - {Appt Date} @ {Appt Time} at {Location}. To change, ph 0800 000 000. PLEASE DO NOT REPLY TO THIS TXT. </li></ul><ul><li>Names NHI Numbers & replies </li></ul><ul><li>{Title} {LastName} {NHI-NO} reminding you of appt at {LOCATION} {APPT-TIME} {APPT-DAY} {APPT-DATE}. Plse reply or ph 222 1234 if you cannot attend </li></ul>
  23. 23. Letter / text security comparison <ul><li>Letters & texts can go to a wrong or an old address </li></ul><ul><li>Letters & texts can be read by others if left unattended </li></ul><ul><li>Texts may be marginally more secure as they do not generally get delivered to a shared space </li></ul>
  24. 24. Scalability <ul><li>Some scalability issues with database searches encountered as service expanded at Counties Manukau </li></ul><ul><li>User setting allows time period to be specified </li></ul><ul><li>Other issues addressed by providing separate database and functional areas for some service areas </li></ul>
  25. 25. Current customers include <ul><li>Counties Manukau DHB </li></ul><ul><li>Bay of Plenty DHB </li></ul><ul><li>Southland DHB </li></ul><ul><li>Capital & Coast DHB </li></ul><ul><li>Waitemata DHB </li></ul><ul><li>BreastScreen Auckland </li></ul><ul><li>BreastScreen South </li></ul><ul><li>BreastScreen Counties Manukau </li></ul><ul><li>BreastScreen Waitemata/ Northland </li></ul>
  26. 26. Other health users <ul><li>Text reminders work as effectively for small as well as large providers </li></ul><ul><li>Physiotherapists </li></ul><ul><li>PHOs </li></ul><ul><li>Addiction helpline </li></ul>

×