The New New Things in mHealth Text Messaging

Text messaging is unequivocally the No. 1 communication tool for the younger generation. According to Nielsen consumer research group, teenagers send an average of 114 text messages per day. Meanwhile, 39 percent make or receive voice calls daily, and only 6 percent of teens use e-mail daily, according to Pew Research. For this reason, it makes sense that more organizations are realizing the powerful potential of text messaging to reach teens and young adults as a positive influence in the healthcare sector. 

These conversations are often opened in text lines for health advice and education Q&A, a use that is not new, but is hardly saturated in the industry. Healthcare, along with research, is being positively influenced by text messaging by engaging patients in effective, practical ways—even beyond Q&A text lines. We discuss specific use cases and best practices about adding text messaging to hotlines and helplines in our chapter in mHealth Innovation: Best Practices from the Mobile Frontier (HIMSS Books, 2014). 

Clinical Research: Developing

Within the realm of research, text messaging has a variety of applications for patient engagement. From the start to finish of a clinical trial, two-way texting is a cost-effective way to connect patients to studies in recruitment, retention, and in monitoring progress throughout the life of a study. 

Researchers are increasingly realizing the value of text messaging to efficiently communicate with teens and young adults, improving recruitment and retention success in clinical trials for this demographic. As teens constantly attached to their phones, clinical trials have an opportunity to be more engaging to the younger demographic by effectively using this channel on mobile devices. Use cases include personalized messages about compliance, dosing, collecting electronic patient recorded outcomes (ePRO) data or in the delivery of incentives for study participation.

Reminders and Alerts: Emerging

With busy schedules of homework, after school activities and maintaining social lives, teenagers are rarely focused on health-related decisions, including appointments and educational details to help them make informed decisions about their health. Appointment reminders, health tips and information enable healthcare providers to deliver timed messages with a high probability of those messages getting read and replied to upon receipt. Mosio is currently working with a client on a pilot study to get students to in-school clinic appointments through text messages. Students were showing a high rate of missed and not returned phone calls, wasting valuable resources on ignored telephone call reminders. If teens aren’t calling each other as much as they are texting or using social media, they’re not going to call to confirm a clinic appointment, either.

Personalized health education and motivation messages can assist in leading a healthier lifestyle or living with a chronic or acute condition. Whether an alert or reminder to check blood sugar, keep up with a workout regimen, or get screened for STDs, text messaging provides an easy and automated way for healthcare providers to increase engagement for the desired outcomes of their young patients.

Gamification: The Not So Distant Future

Gamification is becoming a key player in promoting positive behavioral change and improving healthcare amongst teens and young adults. From improving the reading abilities of dyslexic children to teaching a younger generation about adding 10 years to their lives, games are proving their power in helping people achieve a better quality of life and in living healthier lifestyles. 

As a young patient moves along a path in his or her healthcare journey, SMS can be used as a text-based rewards system to win points or unlock achievement badges or levels for desired behavior. Instead of listening to long-winded explanations, reading brochures, or wondering about the outcomes of a healthcare issue, patients can play games via text message or receive the delivery of incentives, real or virtual. While many gamification elements currently exist inside of apps, text messaging is a powerful engagement tool with greater access to more young people throughout the world.

The Beyond

Mobile communications are already showing significant contributions towards the achievement of the Triple Aim: improving the experience of care for individuals through increased and regular engagement, improving health populations through personalized communications to defined patient populations while reducing the cost, time and effort to reach patients and health consumers. 

Noel Chandler is the CEO and Co-Founder of Mosio, a mobile messaging company specializing in two-way text messaging communications used in clinical research, health and event services. Winner of the Mobile category at South by Southwest in 2008, Mosio’s client list includes McKesson, American Hospital Association, Quintiles, Blue Cross, Kaiser Permanente, CareWire,, Albert Einstein College of Medicine, BrdsNBz National and Young Moms Connect.

Marilyn Teplitz, MBA, FHIMSS, is the founder and principal of MGT Associates, LLC, a global management consulting firm providing B2B strategic and product business consulting to healthcare, life science, medical device and software companies. Worldwide clients range from startups to Fortune 100 companies including Avnet Technology Solutions, Banner Health Network, Encore Health Services, iSirona, McKesson, Mosio and Wipro. Ms. Teplitz held senior management positions with Siemens Medical, McKesson, Ernst & Young, Motorola and Dignity Health where she has introduced new products, improved operations and provided strategic consulting for businesses in the U.S. and globally. She holds an MBA from Wharton Graduate and is a HIMSS Fellow. Ms. Teplitz is past-president and current Advocacy Director for the Arizona chapter of HIMSS.

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