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FOLLOW-UP: See how community clinics are using low-cost text messaging systems

After “Power of a Text” story in eNEWS, clinics share how mobile messaging is reaching vulnerable patients
Screen Shot 2015-04-16 at 4.45.45 PM.pngPhoto Courtesy: CareMessage

With just two employees, Deborah Edington found it tough enough just to remind patients of upcoming appointments at the Community Health Clinic in Brenham. The thought of helping each patient with personal disease education and monitoring was almost impossible.

Then, Edington discovered the power of a text.

“We really realized the capabilities,” said Edington, the clinic’s nurse practitioner. “We have fully implemented the text message based program in our clinic.  Patients really like it.”

Edington first learned about text messaging systems at the Lone Star Association of Charitable Clinics annual conference in 2014.

Since then, Edington’s clinic uses texts to help patients learn more about living with diabetes and high blood pressure. She sends out individualized medication reminders and even exercise prompts. The text messaging system has helped drop appointment “no shows” by around 15% and there’s far less panic when patients get a reminder text about reordering monthly medications.

“I had a chaotic diabetic patient who was quite inconsistent with his insulin regimine,” Edington said. “I set up a plan to text him a reminder for medication administration for two weeks. At the end of the two-week texting marathon, the patient verbalized that he had stopped to administer his medication with each text.”

So how much does all this cost? The clinic uses the text messaging system for FREE. It’s provided by a non-profit group called CareMessage.

“We developed the CareMessage mobile technology with these clinics as our mission,” said Vineet Singal, co-founder and CEO of CareMessage.  “Very few technologies just focused on underserved populations. We wanted to take on the unique challenge and serve the organizations that serve these patients.“

CareMessage offers a low-cost (in some cases free) texting technology program designed specifically for free and charitable clinics. The group’s story began in the very place it now hopes to help.

 “Volunteering in a clinic was the most rewarding and life-changing four months of my life,” Singal said. 

Singal had just finished his freshman year of college and came back in the summer of 2009 to visit his parents who worked at UTMB in Galveston.  During the break, he happened to meet leaders at St. Vincent’s Episcopal House Free Clinic. Then, he spent a few days volunteering.

Four months later, Singal was still there.

“I was so inspired by the clinic and its work, I didn’t go back to school,” Singal recently told eNEWS from the CareMessage offices in San Francisco. “It was a defining moment for me and a defining moment for CareMessage.”

Singal says he first noticed the underlying socio-economic realities that plagued the clinic’s patients. Soon after, he noticed another pattern.

“There seemed to be gaps in reaching the patients after they left the clinic,” Singal said. “They were coming back to the clinic weeks or months later worse, not better. And that seemed to be happening visit after visit.”

Singal thought there needed to be some way to give patients some ongoing support outside of the clinic. There needed to be a way to help the patients manage their own health problems and chronic diseases before they came back. 

So, he went back to Stanford University and got to work. Three years later, CareMessage was born.

Along with appointment reminders, CareMessage offers a multi-week disease management outreach program that helps patients with the proper management of diabetes, high blood pressure, pregnancy, depression, and more. The texting program is interactive and allows patients to answer simple questions to guide their own disease management.

Screen Shot 2015-04-16 at 4.44.48 PM.png
Courtesy: CareMessage

“We want it to feel personal and useful – like there’s a person on the other end of the line talking with them,” said Singal. “We’re trying to help them with ‘social isolation.’ With diseases like depression, it’s hard to talk with anyone.  This technology allows for a positive connection.”

It’s that “positive connection” that Edington says is making an immediate difference for patients.

“We really like the education modules customized for our clinic,” she said. “Patient feedback is positive and they’re demonstrating a improved understanding of diseases like diabetes.”