Home Discharges Post-discharge automatic texts prevented bouncebacks

Post-discharge automatic texts prevented bouncebacks

A new study found that the texts reduced readmissions by 55%.

January 2023

A NEW STUDY found that sending automated texts to patients in the 30 days after discharge reduced patients’ use of acute care resources, including readmissions and visits to the ED.

A study in JAMA Network Open looked at an automated text program used by two academic primary care practices associated with the University of Pennsylvania in Philadelphia. The PCP groups sent text messages to patients who had been hospitalized for an acute care problem on a tapering schedule for 30 days after discharge.

Between January and August of 2021, the intervention arm of the program sent automated texts to about 1,100 patients.

The practices had already been placing automated phone calls to post-discharge patients as part of a transitional care management program. Patients in the study still received those phone calls, but people who didn’t answer or respond to those calls were enrolled in the automated text program.

How it works
The first text told patients how they could reach the practice or opt out of the texting program. The text also asked patients if they had a follow-up appointment scheduled within the following two weeks. For patients who said they didn’t have a follow-up visit scheduled, the practice would reach out and help arrange a follow-up visit.

Follow-up text messages asked patients if they needed any help from the practice. Patients who answered “yes” then received texts asking them to categorize the kind of help they needed (“I don’t feel well” or “I need help with my medication”). The practices called those patients within one business day.

Patients who didn’t respond to three consecutive text messages received a final check-in message asking if they needed help or wanted to continue to receive messages. If they didn’t respond, patients continued to receive text messages for the duration of the 30-day post-discharge period.

Of 1,114 patients in the intervention group, 301 responded to a text message and required some kind response from staff. On average, the practices had to handle just over one text response a day.

The study found that the 30-day use of acute care resources after implementation of the intervention was 41% lower for the intervention group. The odds of readmission within 30 days were 55% lower and the odds of an ED visit within 30 days were 33% lower in the intervention group. (Researchers noted that the reduction in ED visits was not statistically significant.)

Researchers noted that texting can help reduce the time staff spent reaching out to patients. They also pointed out that the two-way nature of texting (compared to a voice message) may have given patients an easier way to initiate an interaction than a phone call.

The study noted that previous studies have shown text messaging has been associated with higher rates of patient engagement than automated phone calls.

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