Inclusive improvement – Why SMS matter in mHealth

If there is one thing that has become very obvious in the past weeks, it is how immensely important digitization is for the health care system. However, even before Corona, the focus was slowly but surely shifting towards digital possibilities to support personal well-being. Pedometers and diet apps, virtual personal trainers and mindfulness exercises, and last but not least the app of your own health insurance company – our smartphones know a lot about what we do (or do not do) to stay healthy. This development is only logical, as the smartphone is our omnipresent companion today.

Ever since the release of the Corona-Warn-App, the benefits mobile devices and applications can offer in health care have reemerged to the public eye. mHealth offers the means to handle certain health topics via mobile devices and is certainly one of the trends that will accompany us for a long time to come. The possibilities for applications are endless, the potential is enormous. In this technologically advanced field, SMS play an important role. They are considered to be trustworthy and reach the end devices even when there is no internet. We would like to show you a few examples where SMS are used to positively influence the lifestyle and health of the recipients.

A word on data protection: Wherever extensive data is collected, data protection concerns are raised. Even though providers bear a great deal of responsibility, it is also up to the users to pay attention to who is using their data for what purpose. However, especially because of the fact that the field of eHealth in particular should remain accessible to older people, it is very important that health service providers and application developers also do their part to make the process transparent.

mHealth stands for mobile
health. The term describes (supporting) health measures that can be accessed on mobile devices.
It is a specialization in the field of eHealth

Prevention and Inclusion

Especially in countries where access to the internet is not a given, studies have shown that sending text messages can be useful in the prevention of diseases. Here, organisations often send out hygiene rules or detailed information on certain diseases to educate the recipients.

In some regions, SMS may even provide the only reliable access to health information. In this situation, messages are not just an additional service. They provide valuable information that dramatically improves the quality of life of their recipients. The implication here is that SMS can not only help to prevent disease, but also ensure that groups that are low on resources are included in health programs.

Even in more affluent areas, SMS reach their recipients reliably. Here, they are mainly used as an attention-grabbing tool to promote a better lifestyle. Not very surprisingly, it has been shown that people find it easier to maintain healthy habits if they are reminded regularly. In the end, this improved lifestyle also leads to an improvement in health.

In a joint effort with the government in Tanzania, the GSMA runs the initiative “Healthy pregnancy, healthy baby”. The expectant mothers receive important information through messages tailored to the course of their pregnancy. This is supposed help them stay healthy themselves and ensure that their children grow up healthy as well. The evaluation found that those who took part in the programme made positive changes to their behaviour in line with the recommendations.

Treatment

Especially in the treatment of chronically ill patients, SMS have proven to be useful. In a study by the eHealth Initiative (USA), for example, it was shown that the rate of those who take their medication regularly doubles when they receive SMS reminders. Many other studies confirm an improvement of this rate through the use of SMS reminders.

The advantage SMS have over OTT apps is obvious. SMS are more likely to be perceived as serious and can be sent to any mobile phone, no matter how old it is or what operating system it is running. Furthermore, the entry barrier for such health programs is lower if no separate app needs to be installed.  Of course the benefits of SMS reminders do not stop there. When the medication supply is running low, a message can remind patients that they will need to replace it soon. All you need to know is the size of the pack and how much medicine is taken, everything else is calculated and automated.

Even beyond these application examples, SMS can provide added value for patients. Personalized messages and inquiries make patients feel less alone on their journey. Various thought-provoking impulses or instructions for exercises can also help them feel better. Here, the effort is low and the benefit on the recipient’s side is very high.

Aftercare

The patient is healthy again, so the treatment is complete. Therefore, doctor and patient no longer need to communicate with each other. You know what is coming: this is not true, of course. Aftercare and regular checkups are an elementary part of the work of health care providers, especially following more serious illnesses.

In aftercare, you can occasionally ask former patients how they are doing through two-way communication. This not only strengthens the bond between doctor and patient, but can also help to detect relapses early on. It is particularly helpful for people with heart diseases to receive reminders of regular blood pressure measurements. Only if the measurements are taken and communicated regularly, deviations can be detected early and discussed with the authorised doctor.

Moreover, two-way communication can be very valuable in the aftercare of mental illness. In addition, patients can receive SMS resources for self-help, if they wish to do so.

Reminder for blood pressure values via SMS

Beyond mHealth: Organization and appointment reminders

The possible applications for mHealth are various and complex. But SMS can also offer healthcare providers great added value beyond mHealth. All health care workers know that occasionally, patients do not show up for their appointments. These appointment cancellations due to no-shows, cost time and therefore money. In the past it has been proven countless times that an appointment reminder via SMS in advance significantly reduces the no-show rate. In a 2019 study, the authors estimate that the Cantonal Hospital Aarau avoids a loss of approximately $9200 per month due to the increased number of appointments kept.

Moreover, SMS are very suited for internal purposes, because successful communication does not depend on which app the recipients have installed. The Malteser Hilfsdienst in Koblenz, for example, uses SMS to coordinate their volunteers.

This shows that SMS offer a simple and effective way to optimize internal processes.

Why should you use SMS to communicate with patients?

Of course mHealth is not limited to interventions or reminders via SMS. The possibilities it facilitates have grown complexly, especially through the Internet of Things. This also means that the opportunities, but also the technical demands, are manifold. But keep in mind: Wherever progress is made in digitalization, some people are left behind. Older generations in particular often find it difficult to adapt to technological developments and are thus excluded from innovations that could be beneficial for them. Especially to include these people, health care providers should always keep SMS as a means of communication in mind. Finally, we should also ask ourselves the moral question of whether it is legitimate to exclude people from services because they cannot or do not want to use certain apps.

What do you think? Have you ever had contact with a doctor’s office via SMS? Would you participate in an mHealth aftercare program? We are curious to hear your opinion!

Best regards
Your sms77 team
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