Odds of readmission and ED visits drop 41% with automated text messages

Automated text messaging may be a viable way to improve patient outcomes after they’ve been discharged from the hospital, and it’s a solution that won’t burden already-busy doctors and their staff, according to a report. recently published study in JAMA Open Network™.

A 30-day automated texting program at a Philadelphia primary care practice that allowed patients to interact with their doctor’s office, and with the doctor if necessary, reduced the chances that a patient would need to return to the department emergency room or being readmitted to the hospital in 41%, according to the study, published in autumn.

“This result was largely due to a 55% decrease in the odds of readmission at 30 days,” wrote Eric Bressman, MD, an internist and member of the National Clinical Fellows Program at the University of California Perelman School of Medicine. Pennsylvania, and his coauthors.

“The mechanism through which this composite program avoids the use of intensive care is likely to be complex, but we theorize that more frequent checks and a less frictional means of patient-initiated outreach led to earlier identification of needs and a greater chance that problems will be resolved. scaled and managed by primary care practice than in any other setting,” Dr. Bressman and his colleagues wrote.

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The JAMA Open Network The research, which was conducted between August 2020 and August 2021, compared the results of two primary care academic practices in Philadelphia. The groups, separated by just one floor in the same building, are cared for by Penn Medicine physicians and primary care staff and have similar patient populations.

A group of adult patients established in a practice received the usual transitional care management phone call within two days of discharge from acute care hospitalization. All 953 patients in this group scheduled their post-discharge office visit during the call. If these patients didn’t respond to the first call, a nurse would make one more try. Any further extension was left to the discretion of the nurse.

A group in the second practice received the same phone call, but were also told about the text message program. These 604 patients received an introductory text on the day they enrolled advising them how to contact the doctor’s office at any time. Via text message, patients were asked if they had a follow-up appointment with their primary care physician or a specialist within the next two weeks. If they answered no, their response was sent back to the practice via the EHR indicating that the patient needed help making an appointment.

The day after patients signed up for text messages, they began receiving automated verification text messages from their primary care practices. This happened on a tapering schedule over the 30 days after discharge.

The texts asked if the patient needed help. If the answer was “yes”, the patient received a follow-up message asking them to categorize their need for it. They might respond, for example, “I don’t feel well” or “I need help with my medication.” The system then alerted the practice so someone could follow up with a phone call to the patient. The practice responded to these text messages during business hours and responded within one business day.

Nearly 83% of patients responded to at least one of the introductory text messages, a “much higher” response rate than traditional transition phone calls, the study authors wrote. Only 8.6% of patients enrolled in the program opted out.