Benavente Kevin, Banaschak Cory, Szotek Paul
University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA.
Ascension St. Vincent General Surgery Residency, Indianapolis, IN, USA.
Surg Endosc. 2023 Mar;37(3):2182-2188. doi: 10.1007/s00464-023-09869-z. Epub 2023 Jan 27.
The ability to effectively communicate with patients continues to be a challenge for physician offices. Mobile healthcare applications have enhanced the accessibility of healthcare providers to their patients. However, the efficacy of unrestricted, personalized, bidirectional, freeform texting has not been previously evaluated.
We investigated patient preference and self-reported outcomes using a smartphone HIPAA compliant mobile healthcare texting app, compared to conventional telecommunication, in self-reported quality of care, and impact on preventing unnecessary emergency department visits. A retrospective cohort survey study of a single-surgeon hernia specialist's practice was utilized. Patients with access to a smartphone who received care between July 2017 and March 2020 were instructed to utilize the healthcare texting app as a replacement to calling/receiving calls from the physician's office. Messages to and from patients were delivered directly to their surgeon and the surgical team via non-automated, personalized, freeform text messages, and templates, available to patients at all hours of the day. A depersonalized online survey was then distributed to assess patient perceived quality of care using the app, compared to their past experiences calling physician offices, and whether they preferred using text or conventional telecommunication. Additional statistics were reported using the application's built-in software, including response times, adoption rates, and message volumes.
90 patients successfully completed the entirety of the survey, median age range 50-60 years old. 97% of respondents reported the texting app provided at least non-inferior quality of care compared to conventional telecommunication, with a majority (75%) experiencing a relatively improved quality of care. 9% reported an unnecessary ED visit being avoided after consulting their physician through the application.
Unrestricted, freeform, non-automated communication via texting may be preferred by patients over conventional telecommunication. However, further research is warranted to assess the external validity and clinical impact of such results.
对医生办公室而言,与患者进行有效沟通仍是一项挑战。移动医疗应用提高了医疗服务提供者与患者联系的便利性。然而,此前尚未评估无限制、个性化、双向、自由形式短信的效果。
我们使用一款符合健康保险流通与责任法案(HIPAA)的智能手机移动医疗短信应用程序,调查患者的偏好和自我报告的结果,并与传统电信方式进行比较,涉及自我报告的医疗质量以及对避免不必要的急诊就诊的影响。我们利用了一项对单名疝气专科医生诊所的回顾性队列调查研究。指示2017年7月至2020年3月期间接受治疗且能使用智能手机的患者使用该医疗短信应用程序,以取代拨打/接听医生办公室的电话。患者与医生之间的信息通过非自动、个性化、自由形式的短信和模板直接发送给其外科医生和手术团队,患者可在一天中的任何时间使用。随后进行了一项非个性化的在线调查,以评估患者对使用该应用程序的医疗质量感知,与他们过去拨打医生办公室电话的经历相比,以及他们更喜欢使用短信还是传统电信方式。还使用该应用程序的内置软件报告了其他统计数据,包括响应时间、采用率和短信数量。
90名患者成功完成了整个调查,年龄中位数在50至60岁之间。97%的受访者表示,与传统电信方式相比,短信应用程序提供的医疗质量至少不逊色,大多数(75%)患者体验到医疗质量相对有所提高。9%的受访者表示,通过该应用程序咨询医生后避免了不必要的急诊就诊。
与传统电信方式相比,患者可能更喜欢通过短信进行无限制、自由形式、非自动的沟通。然而,有必要进一步研究以评估这些结果的外部有效性和临床影响。