Should you pay attention to texting (also known as SMS – or Short Message Service) as a communications tool for telehealth?


Even more than email.

In fact, statistics show that people are more likely to open a text message than an email.

Texting has been used effectively on an individual level to alert people of flight status/changes, events in their bank account, and tracking packages.

And of course, it has grown on a massive scale through integration with broadcasting platforms like Twitter.

More recently, people have figured out some very interesting ways to use it in healthcare, such as appointment reminders, medication refill reminders, and epidemic alerts.

Today I’ll share a few ways that texting can help you overcome some of the challenges in telehealth and mHealth.

First the basics – let’s assume we’re talking about texting on mobile devices such that a person can see a text essentially at the time it is sent.

So the examples I include here will exclude broadcasts on Twitter (For ideas on how to use Twitter with telehealth, you can refer to this article).

Three of the basic challenges in telehealth are:

  • Getting the solution adopted
  • Getting it used
  • Getting the handoffs right when multiple people are involved

What if you could use texting to address these challenges?

Truthfully, all you need is a little imagination and the desire to carry it forward.

Today, we’ll get your ideas flowing by covering just a few of the things you could do with SMS.

Telehealth Texting Strategy #1: Increasing Utilization

There are two big reasons why telehealth utilization can be low.

One, people forget about the service.

This can be true of a simple mHealth app fighting to be remembered amongst the 30 other apps on someone’s smartphone or tablet.

It’s also true of a complex and critical telestroke service, which if not used often enough at a rural hospital, tends to have the technology end up in a closet.

Out of sight = out of mind.

The other big reason is that even if people remember the telehealth service is available, the telehealth solution’s benefit has not been made so crystal clear that they don’t recall the value at the moment they have to choose between the telehealth service and their traditional options.

For example, you may have an online physician service designed as an alternative to ER visits or regular checkups.

At the moment when they need healthcare, people can be inclined to go with the status quo (urgent care clinic, ER, appointment at the clinic) if they can’t sufficiently recall the benefits of the telehealth program (time savings, equivalent clinical care, possible cost savings, etc.).

Now imagine if you had an SMS solution in place to complement your overall telehealth solution.

You could drive utilization by …

  • Sending intermittent texts to remind people that the system is there
  • Sending intermittent texts to remind people of the benefits
  • Sending texts of success stories associated with the telehealth solution.

These texts can/be short little reminders or may link to more detailed web pages.

And utilization is a numbers game.

Every incremental use matters.

If your solution itself is good, then each use has the potential to become “sticky” for the user (i.e. they will enjoy receiving the benefits and come back for more), and an increased likelihood that the satisfied user will recommend it to other potential users.

Telehealth Texting Strategy #2: Coaching / Compliance / Training

NPR (National Public Radio) recently broadcast an article about how texting is helping with smoking cessation.

Whether or not you’re a smoker, you know how hard it is for someone to quit.

While only 4-5% of smokers successfully quit the first time they try, a study compilation by Dr. Robin Whittaker of the University of Auckland in New Zealand showed that text messaging increased the success rate to between 6-10%.

Basically, patients in the study would receive text messages 2 to 3 times per day reminding them of the benefits of quitting, encouraging them to stay on track, guiding them through periods where they felt cravings, and even supporting them into getting back on track if they had a lapse.

Now, if texting can nearly double the success rate for something as difficult as quitting smoking, imagine what it could do for less challenging addictions (i.e. to the status quo of how you deliver or get your healthcare).

SMS can be used to …

  • Remind a patient to “check in” with their mHealth app
  • Remind a home telehealth patient to upload their data (BP, heart rate, etc.) so that a clinician can look at it
  • Coach a telemental health patient through removing a fear or addiction. (possibly as a supplement to video consults and/or in-person consults)
  • Teach people how to use a telehealth technology
  • Send tips to physicians on best practices for providing telehealth services
  • Send clinical training snippets to nurses in a rural hospital

Telehealth Texting Strategy #3: Coordinating Care

Care coordination is one of the hallmarks of telehealth.

Examples of care coordination include any of the following:

  • Informing a consulting physician of a consultation request
  • Informing a requesting clinician of a physician’s availability
  • Informing a clinician that patient data is available for analysis
  • Informing a care team that a patient is being transferred for higher level care

Sometimes this kind of coordination doesn’t even get done.

Other times it gets done poorly because people don’t have good systems in place to coordinate with each other.

SMS is just one of the tools people could employ to streamline communications.

As an example, imagine a telestroke network where a primary stroke center provides telestroke services to a rural hospital.

In some telestroke consults, the consulting neurologist may determine that the patient must be transferred to the primary stroke center for higher level care (perhaps for an intracerebral hemorrhage).

Now let’s imagine how SMS could be used at the moment the ER physician at the rural hospital agreed to transfer the patient to the primary stroke center.

SMS could be used to alert and mobilize an entire care team at the primary care center to receive the patient.

When the patient arrives, the team could be ready to take the patient to an already prepped Operating Room.

This is great for the patient, great for the rural hospital who is assured of speedier care (and hopefully high quality as well) for their patient, and great for the receiving hospital who streamlines use of its facilities and resources for critical (and higher revenue) patients.

Telehealth Texting Strategy #4: Marketing

We’ve put out plenty of articles about how you can market telehealth better so we won’t restate those points here.

The key here is that if you can embed your telehealth marketing in platforms like email, print, and social media, then you can surely consider SMS, given the following fact from Clark Herman of Get Busy Idea:

Many businesses are not taking advantage of SMS. In a recent survey, 61 percent of respondents receive three or fewer marketing messages per month on their phones, and 31 percent haven't received any.

When you couple that statistic with the fact that SMS messages are more likely to get opened than emails, you see the immense opportunity to market via text message.

After all, the first goal of your marketing material is to be opened or looked at. SMS serves that goal well.

Final thoughts

SMS is a simple, easy-to-use and very widely used communications platform.

It is underused in telehealth.

This gap creates great opportunity for you to use SMS to differentiate your telehealth offering and accelerate the growth of your telehealth solution by:

  • Encouraging higher utilization
  • Increasing coaching, training, and compliance
  • Improving care coordination
  • Enhancing marketing



What unique ways have you seen to advance telehealth and mHealth through texting? Please share your comments below.

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