Using SMS/text messaging to communicate with patients may be the next big thing in mHealth. But you can't just create a pithy message and push "send."
According to digital marketing firm mobileStorm's new report, "Making Healthcare Mobile," there are some critical planning steps you need to take first. Company officials recommend a pilot or proof-of-concept project, and to get that right, you need to:
- Map out message flow. You need to know exactly where (and when) the messages will flow through the system, including where they travel in your own network, and where they go once they transfer over to outside carriers, the report says. This can help determine any points of risk for the message to get stalled, be on an unsecure channel, or not reach its ultimate target.
- Start with outbound messaging. Enabling your system to send messages out is generally easier than setting it up to process incoming messages. "If possible, consider a phased approach to test outbound functions quickly, and then move to inbound applications," the authors recommend.
- Plan for unexpected replies. Once you're ready to accept incoming messages, you need to build as broad a pathway as possible, the authors say. You can expect plenty of replies that don't fit your proscribed menu of options. You also need a clear method for acknowledging that you've received the users' reply as well. "Establish and review an SMS inbox continuously to tune your system's logic to handle a wide variety of messages inbound to your application," the authors say.
- Watch for personal health information. SMS-level messaging just isn't equipped to secure data at the level needed for HIPAA compliance, the authors say. They acknowledge that some providers are doing it anyway, but caution against including any clinical information. They admit it's the "glaring limitation with SMS...that it can't be used to send PHI."
- Create a multi-level test group. Don't just send texts to your PC techs to test if they arrive safely. You need a test group of individuals with different types of mobile devices, different experience levels with the technology. This will alert you to any potential problems with the messages going astray on different platforms, or being difficult for less sophisticated users to access.
- Send text messages in the right context. Because they usually spark an immediate response, it's important to plan when you'll send texts, and how quickly you'll expect a response. The authors use the analogy of sending an email at 3 a.m. Ostensibly, the bandwidth traffic will be light, ensuring the message arrives, but an email won't disturb the patient, even at that hour. A text message, on the other hand, may create an incoming beep or alarm in the wee hours of the morning, and result in unhappy users.
- Determine if you can be concise enough for texting. SMS messages must be short, under 160 characters generally, and "it's important to understand if each type of message you'd like to send can be contained in this envelope," the authors warn.