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Texts Provide Health Care Options

By Mark Watts

In my last column “Betty or Bots,” I spoke about a patient engagement company in Canada that used a simple SMS or text message to communicate with patients. I understood in January 2020 that this product helped with HIV patients to adhere to treatment plans in Kenya. I was intrigued by simple user-friendly information technology making a difference in patients’ lives. I have seen IT solutions send scheduling reminders or follow-up calls. I did not know what I did not know.

This conversation with the student happened February 25, 2020, I said to her, “We do not have a policy requiring that you wear a mask, but if it makes you feel more comfortable please do.”

On February 27, 2020 I read an article about a mobile text messaging service, successfully used in Kenya to support HIV positive patients, and how it may soon be available to British Columbians where it could be adopted for those self-isolating at home to prevent transmission of the coronavirus.

Richard Lester, an infectious diseases physician with Vancouver Coastal Health, was leading a pilot project involving Vancouver General Hospital for patients to test if the mobile health platform WelTel can reduce readmission rates by monitoring patients newly discharged from a hospital. With COVID-19 quickly becoming a global health concern, Lester is working with his partners in Kenya to make the program accessible to self-quarantined people in Canada and other countries.

“This actually is an ideal opportunity to be able to check in on them by text. We can actually do phone and video as well,” he said.

The concept that this product could play a role in a non-pharmaceutical intervention to limit the spread of COVID-19 was mindboggling to me. It was tested for one purpose (HIV adherence) and was successful in Kenya, was being applied to help reduce readmissions into hospitals in British Columbia and then morphed into a disaster response platform for bi-directional patient engagement, education and monitoring.

British Columbia has one of the highest hospital readmission rates in Canada – about 10 percent within 30 days of discharge. Lester said this costly issue is “an indicator of gaps in the health system,” and the WelTel platform can help to streamline the triage process and make health care less expensive.

“The care management team from the hospital … dedicated a team of nurses and other experts to help to manage … the ‘my discharge plan,’ which has normally been in paper form, but patients can lose and forget it. Now, it’s all going to be available digitally on their phone as well as the managers to help them navigate that.”

Lester said the virtual care system can cut unnecessary emergency visits by allowing patients to send timely texts to the care management team, which may decide to provide medical solutions in an outpatient setting instead.

There are gaps in health care, there are information gaps, policy gaps, service gaps and availability gaps.

Imaging providers can use tools like this to facilitate meaningful communication with patients without the need for EMRS or portals. The most meaningful communication for an imaging director may turn out to be the direct policies and updates we give our staff to keep them and their families safe during uncertain times in health care.

When this article is published, the COVID-19 situation might be resolved. However, my recommendation to the student to wear a mask if it made her feel more comfortable to protect herself and family will stay a constant.

Mark Watts has over 20 years as an imaging professional with vast expertise in imaging informatics and IT issues. He has served in many roles in both hospitals and industry as a health care vice president, imaging director, and IT consultant. His knowledge and experience in the convergence of IT and imaging has made him a sought after author, speaker and consultant. He has authored a textbook on informatics and was a pioneer in the adoption and development of PACS and VNA technologies.

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