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Health System Addressing Social Determinants of Health with Text Messaging

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Summary

In their most recent community needs assessment, a large health system in Michigan identified an opportunity to use text messaging to better engage patients. The organization, which serves over one million people, has a mix of rural and urban populations with a variety of challenges. To help use text to better connect with their diverse patient population, they selected SR Health by Solutionreach.

 

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The providers at this full-service health system see patients for everything from coughs and minor injuries to open-heart surgery. In their emergency department alone, they see over 100,000 patients a year, many of whom don’t have a primary care provider (PCP). While they are largely fee-for-service, the organization has been actively looking for ways to improve the health of the community and reduce readmissions.

“The top two reasons we see readmissions are lack of a PCP and not taking medications as prescribed,” explained the chief information officer. “Our community health needs assessment showed that most of our patients have smartphones and we saw that as an opportunity to connect with them through text.”

Prior to the COVID-19 pandemic, the organization’s team had started looking at new options for patient communication. They had a few conversations with SR Health but hadn’t made a decision. According to the CIO, “One of the things that most appealed to us was the two-way texting with patients with SR Health.” Then, the pandemic hit and the project was put on hold.

One of their early projects to address patients’ needs during COVID was to set up a virtual urgent care. “It was basically a nurse health line that patients could call and we could rapidly transition them to a provider, order a COVID test, or order medications,” the CIO says. “We realized that we needed more options to connect with patients than the phone and two-way text was a good option. It was a way that we could use to engage patients who prefer text.”

The organization reached back out to SR Health and they quickly set up the system for two-way text with patients. Patients and non-patients can text the virtual urgent care health line with questions as well as calling. The response was so positive that the organization quickly added a follow-up text to patients after discharge. “We just text them to say we’re here for you if you need us,” says the CIO.

The response has been very positive, and the CIO believes that they really are addressing a critical need in the community. “There are many social determinants that impact patients’ ability to get the care they need and avoid poor outcomes or readmissions,” he says. “Those include things like lack of social support and isolation. We can now reach out with a simple text to engage those patients and let them know we are here to help.”

The CIO adds that it seems to be working based on some of the responses they have received, like this one from a patient’s daughter, “Thank you guys…my dad needs the help…my mom died 3 years ago…and he hasn’t seen a Dr. since…because she used to handle his appointments.”

“Text is less intrusive and can help us break down barriers to keep the care process going with patients who might not respond to a phone call or an email,” adds the CIO. Based on the success of the text messaging program so far, the organization is expanding it to different use cases. “We’re looking at using it for patient groups like heart patients to follow up and stay connected. It can often be hard to remember all the discharge instructions and a simple follow-up lets them know how they can reach out with questions instead of waiting for them to reach out on their own when things might be worse.” Essentially, it’s allowing the organization to be more proactive with patient follow-up instead of reactive to avoid potential complications or readmission.

“We think text is having a big impact on engaging patients early,” the CIO says. “We’re looking forward to continuing to expand how we are using it to reach patients and improve the health of our community.”


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