Researchers from the University of Pennsylvania (U-Penn) published a fascinating new study, in The Journal of General Internal Medicine, suggesting that “texting” may improve patient care . This study comprised more than 10,000 patients at two different hospitals. Through other published articles, we know that more than one study has suggested that mobile secure text messaging may improve communication; however, this new study is among the first to assess its impact on patient outcomes. Patients, whose hospital care providers used mobile secure text-messaging as a means of communication, had a shorter length-of-stay compared to patients whose providers used the standard paging system to communicate. If you have read our blogs before, you know we are consumed by all the new communication advancements resulting in faster response times that could impact both the quality of care and the cost of that that care.
Both of the hospitals in this study began with the same paging system before implementing the secure text-messaging communication. Secure text-messages are sent through an application that encrypts the text before it sends, and decrypts it before it’s viewed. After introducing this new secure text on select floors of the hospital at the University of Pennsylvania, the average patient length-of-stay declined in the first month from 6.0 to 5.4 days. However, similar floors using the paging system at the control site, Penn Presbyterian Medical Center did not see any changes. After controlling for patient characteristics and time trends over the course of one year, researchers found that patients whose providers used mobile secure text-messaging left the hospital about 0.77 days sooner – this is equivalent to about a 14 percent reduction in their overall hospital stay. This finding suggests that a shorter length-of-stay associated with mobile secure text-messaging did not lead to higher rates of readmission.
Doctors today are using short message service (SMS) even if not secure, and likely not HIPAA compliant. Some hospitals today use one-way paging systems that are sometimes unsecure, have limited mobile access, and require either a phone call or face-to-face communication to close the loop. Most email and SMS text-messaging platforms are not secure and are not prohibited by hospitals.
The reports note that during the twelve-month intervention period, 446,342 secure text-messages were sent – 377,347 of which were to individuals, and 68,995 of which were to more than one recipient. The highest volume of secured text-messages sent were from nurses (39.7 percent) and residents (37.5 percent), followed by social workers and clinical research coordinators (eight percent), attending physicians (7.8 percent), pharmacists (5.9 percent), and unit secretaries (1.1 percent).
We have been driven, if not obsessed, for a quarter of a century by the lack of effective communications in healthcare at every level. We are in full support of anything that is secure, and promotes the flow of communication. We want to see a system that not only allows for better communication but also, reduces the cost of care. I recall many incidents where doctors caring for the same patient were in the same hospital but did not know it, and a patient’s life was at risk. We see an integrated medical record as the foundation first; then the patient’s ability to see their combined record; followed by the push for a better, faster, and more global means of communication. I applaud the results of this study, and I hope we have an industry-wide adoption.
– Noel J. Guillama, President